The provision of workers compensation benefits is not always black and white. It is not always easy to tell if and when you need to seek the advice of a qualified Florida workers’ compensation attorney.
Employers often ask injured workers to just treat for the condition on their private health insurance to help the company out with their workers compensation premiums. Carriers often drag their feet on the authorization of specific benefits like x-rays, physical therapy and medications. Carriers will pay lost wage benefits, but will pay them a week or two late causing bills to pile up on top of already reduced pay.
Just because an insurance company has not denied your claim entirely does not mean that you do not need to speak with an attorney, though if your claim has been denied contact an attorney immediately. I always tell my clients there are three times you need to immediately call a workers’ compensation attorney to advise you on your claim.
Call an attorney if the insurance company says anything other than “yes”.
What is most important to point out is that I did not say “if the carrier says no”. Most people understand that if the carrier says no to any benefit (mileage to doctor’s appointments, lost wages, authorization of medical referrals, payment of medications) that they should seek counsel and speak to an attorney immediately.
However, carriers do not always say no outright. They will often delay authorization of benefits and or fail to return phone calls and give the status on provision of your new doctor or the MRI that you need. Doctors will request eighteen physical therapy visits and the carrier will authorize six with a determination on the remaining twelve to be made after the completion of the first six visits. This is unacceptable and not what your doctor ordered.
Insurance adjusters are not doctors. They do not get to make medical decisions that should be kept between you and your physician. If the carrier does not provide the benefits recommended by your doctors immediately, you should call and speak with an attorney.
You should call an attorney if you disagree with what your doctor is telling you.
Doctors are running a business, and in the workers compensation system the insurance company is the hand that feeds them. They will hesitate to bite that hand by recommending too much or too expensive treatment. While the vast major of doctors will act in your best medical interest, you should take all statements and recommendations with a grain of salt. You know your body and you know if something is still wrong. Just because a doctor has told you that there is nothing more that can be done and no further treatment is necessary that does not mean that nothing can be done and that no more treatment is possible. You have a right to change physicians one time over the life of your claim. You can also have your attorney conference with the doctor to substantiate his opinions. Either way, if you do not like what you hear from your doctor, contact an attorney immediately and see what your options include.
You should call an attorney immediately if the insurance company starts talking to you about settlement.
Experienced attorney are familiar with settlement values for different injuries and treatment courses and can advise whether the amount you are being offered is fair or too low. There are issues which must be considered like taking Medicare’s interest into account if you are applying for Social Security Disability or closing in on retirement age. There are also issues like outstanding liens, child support arrearages, and continuations of benefits that can come up and need to be addressed by someone familiar with the system. If you are considering settlement you should not hesitate to call and speak with an attorney.
Just because your Florida Workers’ Compensation claim has not been denied does not mean that you do not need to speak with a qualified attorney. There are gray areas throughout claims that required good counsel and knowing your rights and options. I have been practicing workers compensation law in Florida since 2004 and have represented both insurance companies and injured workers. I now exclusively represent injured workers and protect them from a system that is tilted in the insurance companies favor.
Call, email or simply join our mailing list if you would like to know more about Florida Workers’ Compensation Law or set an appointment to ask questions. Our initial appointments are always free and the sooner you call the sooner we can start avoiding those pitfalls together.