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What To Know About Filing a Workers’ Compensation Claim

If you get hurt on the job, you’re probably aware that you can file a workers’ compensation claim to pay for your medical care.

However, there are certain steps you must take to get that claim started, as well as specific rights you may be giving up when you agree to a settlement.

Here’s how the workers’ compensation process works in Florida and what you should know before you file and settle your claim.

What Is Workers’ Compensation?

Workers’ compensation pays benefits to employees who are injured on the job. Because Florida has a no-fault workers’ compensation system, there is no need to prove your employer was at fault. You should be eligible for benefits if your injury was related to work activity.

Workers’ compensation benefits may include: 

  • Reasonable & necessary medical care
  • Vocational rehabilitation 
  • Temporary disability 
  • Impairment

In general, your medical bills and lost wages should be covered. As a stipulation, you have to agree not to sue your employer. There are requirements you have to meet to be able to file a workers’ compensation claim, including reporting the incident to your employer within a certain amount of time.

How Can I Start a Workers’ Compensation Claim?

To begin a workers’ compensation claim in Florida, you must notify your employer within 30 days of the injury. Otherwise, you might lose some or all of your benefits. 

You should report as much information as possible, including when the accident occurred, how the injury happened, and which symptoms you’re having. After you’ve provided all of these details, your employer has to report your claim to its insurance company within a week. Then, the provider will start an investigation. 

The insurance company may review your medical records as well as analyze your work experience, education, and wages. The representative could order a medical examination and a functional capacity evaluation to assess your physical condition and your ability to perform work duties. 

At this stage, another workers’ compensation stipulation comes into play. You probably won’t be able to see your primary physician. Your employer may get to choose your doctor unless emergency treatment is needed. The opinion of the physician who treats you will carry significant weight in your case.

What Do I Need to Know About Workers’ Compensation?

Besides losing the right to sue your employer and possibly getting treated by an unfamiliar doctor, there are other things you should know before you get involved in a workers’ compensation case.

Future Medical Care

If you file a claim and then agree to settle, you can’t change your mind later and ask for more money. You’ve now entered into a binding contract. The insurance company will likely insist on a full and final settlement, which means they won’t have to pay if you need medical care in the future. It’s best to wait until the doctor says you have reached maximum medical improvement (MMI) before you settle.

Personal Injury Claims

Depending on the circumstances of the accident, you may be better off filing a personal injury claim instead of building a workers’ compensation case. With personal injury, you would have to prove fault, but you may be able to get more damages. Plus, you could be treated by a familiar physician who has examined you more than once.

To be able to file a personal injury claim following a work-related accident, someone else would have to be determined to be at fault. You would then file a claim against their insurance provider. 

For example, if you were working a booth at a trade show and you tripped over an extension cord that wasn’t properly secured, you may be able to file a claim against the venue’s insurance company. If you were driving a company car to meet a client and you were rear-ended on the highway, you could file a claim against the other driver’s insurance provider if they were proved to be at fault.

Pain & Suffering

There’s one more stipulation that goes along with workers’ compensation cases. Because you don’t have to prove your employer was at fault, you don’t get to ask for damages such as pain and suffering, which could significantly reduce your settlement. In the end, you need to examine all of your options and decide if a workers’ compensation claim will give you the best outcome.

What to Know About Filing & Settling Workers’ Compensation

Now you know more about the pros and cons of filing a workers’ compensation claim in Florida.

In these cases, you don’t have to prove fault and your medical expenses should be covered. However, you are likely giving up the right to sue your employer, see your doctor, and receive compensation in the future if your condition worsens. 

You may be able to seek more damages with a personal injury claim—including pain and suffering—if you can prove someone else was at fault.

An experienced attorney can help you figure out whether a workers’ compensation claim or a personal injury case is the optimal route.  Contact Bulluck Law Group today!

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