Workers compensation, or workers comp, refers to insurance that most employers are required to carry for all of their W-2 employees. Its purpose is to cover lost wages and medical expenses for employees who become injured or ill in the workplace as a result of their job duties. Coverage requirements vary by state. Here we will focus on the rights of workers compensation claimants in Florida.
Overview of Workers Compensation in Florida
The Division of Workers’ Compensation in the Florida Department of Financial Services is responsible for the state’s workers compensation program. A company pays into workers compensation insurance and, in exchange, employees sacrifice their right to file a lawsuit for negligence against their employer. An employee can only sue if the company does not have proper workers’ compensation coverage as required by the law. There are exceptions, such as an intentional injury or other, highly specific circumstances.
What Injuries or Illnesses Does Workers Comp Cover?
If an injury or illness occurs at work or is a direct result of working conditions, the injured or sick employee can file a workers compensation claim. They can also seek coverage for complications of work-related injuries, such as secondary illnesses or infections. However, an insurance company can always deny a claim — and they often do.
Some illnesses or injuries are simply not covered, such as those that occured:
- As the result of the employee starting a fight
- While the employee was under the influence of drugs or alcohol
- While the employee was committing a crime
- Due to the employee’s negligence or willful ignorance of company policy
Coverage also excludes self-inflicted injuries.
What Are My Rights as an Employee?
Every employee has the right to a reasonably safe and healthy work environment. As a requirement of their insurer, employers must meet certain workplace safety standards. However, even with proper precautions in place, workers can get hurt or sick as a result of their jobs. If you sustain an injury or illness at your workplace, it is important to understand your rights under workers compensation in Florida.
- You have the right to file a workers compensation claim without fear of harassment or retaliation.
- You are entitled to wage benefits in the form of temporary or long term disability to replace your lost income.
- You have the right to seek medical treatment — however, the insurance company will select the provider. In Florida you do NOT have the right to get a second opinion from a doctor of your choosing.
- If a doctor deems you fit to return to work, you have the right to do so.
- If you are permanently unable to return to work because of your injury or illness, you have the right to disability compensation.
- You have the option to take a cash settlement of your medical benefits, wage benefits or both, waiving future rights and benefits.
- You can (and should) refuse any attempt to negotiate on the part of your employer, such as a promotion if you cease to pursue your claim.
- In the event that an injury leads to death, spouses and dependent children are entitled to survivor benefits or a wrongful death settlement.
- You have the right to appeal a decision on the part of your employer, the insurance company, or the workers’ compensation court, if their decision is unreasonable.
- You have the right to legal representation throughout the process.
A critical part of protecting these rights is to report the incident immediately and seek medical treatment. Keep detailed records and, if necessary, retain the services of a Florida workers compensation attorney.
When a Lawsuit May Be Justified Due to a Worker Injury
If your employer does not have workers compensation insurance, fails to keep it current, or otherwise shirks their responsibilities, you can file a lawsuit for their negligence. Sometimes, a situation arises where someone other than the employer caused the injury, such as an outside contractor. In that case, the injured person might be able to seek legal damages from a third party, such as the individual who was involved or their employer. A third party claim such as this would be filed as a civil lawsuit in state or federal courts — not a workers compensation claim.
Another example of third party causing an employee’s injury is a car accident while the employee was “on the clock.” If an employee drives as part of their work and gets into a car accident while working that is another driver’s fault, that employee is entitled to pursue both a worker’s compensation claim and a personal injury claim against the at-fault. With both worker’s compensation and personal injury attorneys on our Team, we are capable of coordinating and handling both claims from beginning to end.
How to File a Workers Compensation Claim in Florida
The office of Florida’s Chief Financial Officer provides forms and information for employees pursuing workers compensation claims in the state. You can start there for information, but you must also file a report with your company’s human resources department immediately. If you are unable to file right away — for example, because you are hospitalized — you should handle it as soon as you can. A relative with power of attorney may be able to step in. It is important to keep detailed medical records, including at home, to track symptoms, costs, and any disruption to everyday life. If you have questions about calculating your potential workers’ comp benefits, you can read our article here.
When to Hire a Workers Compensation Attorney
For a clear-cut workers compensation claim, you may choose to proceed without an attorney but, remember, insurance companies always look for the cheapest resolution. It is a good idea to get in touch with an experienced workers compensation attorney early, since situations can change and become more complicated over time. If your employer or their insurance company disputes or refuses your claim, you will need legal representation to protect your rights. Hire an attorney when your:
- Illness has a cause that is challenging to prove, such as in cases of COVID-19
- Injury was a clear result of misconduct or negligence
- Employer’s insurance company denies your claim
- Payments do not arrive in a timely manner or cover all of your lost wages or medical bills
- Treatment is not approved
- Treatment is delayed
- Plan to apply for Social Security benefits
- Employer retaliates against you or fires you
- Employer goes out of business
At Matthews Injury Law, our attorneys in Tampa, Sarasota, and Lakeland will work to get you the compensation you seek for your workers compensation claim. If you or someone that you love has been injured or contracted an illness on the job, please contact us to schedule a free consultation about your workers’ comp case.
*The information on this page was written or reviewed by attorney Marc Matthews, Managing Partner at Matthews Injury Law, to ensure its accuracy.