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Workers' Compensation: Learn the Basics

Workers’ Compensation was a basic theory that originated in the early 1900’s. A statutory law that varies widely from state to state, the Florida workers’ compensation law was enacted in 1935. The original intent was to provide a safety structure to workers that would provide medical treatment for injuries and compensation for lost wages. The employee waived any right to compensation for pain and suffering in exchange for a no-fault system – negligence of the employer was not a pre-requisite to recovery.   The workers’ compensation system has changed via statutory amendment multiple times over the years, but the basic format has remained the same.

Notification Requirements

When an employee suffers an accident resulting in injury – the employee has 30 days to notify the employer. Many employers have the policy that accidents must be reported within 24 hours. This may be a condition of ongoing employment, but does not negate state law. While the employer may suspend or terminate the employee for violating this employment rule, it does not preclude the filing of a workers’ compensation claim.

Medical Provider

Unfortunately, current state law places the power of selecting a medical provider in the control of the employer/carrier. However, many time appointments are scheduled with physicians that live in towns other than the location where the injured worker lives. In most situations, this is not permitted. The employer/carrier cannot “doctor shop” by forcing the injured worker to travel unnecessarily. In the event the injured worker is dissatisfied with the physician, the injured worker gets one opportunity to change physicians during the course of the workers’ compensation claim. The employer/carrier gets the initial right to select that physician, but there are deadlines and the right to choose can switch to the injured worker.

Physical Work Limitations

Often, following an accident an injured worker will have physical restrictions limiting the ability to work. During this time, the injured worker is entitled to up to 104 weeks of lost wages – temporary total indemnity or temporary partial indemnity. The classification is based on whether the restrictions assigned by the doctor are “no work” vs. “light duty”. The amount of the lost wage owed by the employer/carrier is based on the average weekly wage of the injured worker. This amount is the average gross amount earned in the thirteen weeks prior the accident. Once the base wage is determined, the injured worker is entitled to sixty six and two-thirds percent of the average weekly wage, if on no work restrictions.

Alternatively, if the doctor assigns light duty, and the employer cannot accommodate the restrictions, the injured worker is entitled to sixty four percent of the average weekly wage. Sometimes, the employer provides some work, but the injured worker earns less than eighty percent of the average weekly wage. In this situation, the claimant is entitled to recover some wages per a complex formula.

Maximum Medical Improvement

Ultimately, the injured worker will be placed at maximum medical improvement. At this stage, the primary question is whether the injured worker can return to their original position. If not, then there is an assessment of whether they are permanently and totally disabled. If so, the injured worker would be entitled to wages until age seventy-five.   This often requires an assessment by a vocational expert to determine if there are jobs the injured worker can perform within a fifty mile radius of their home.

Ongoing Medical Treatment

Finally, ongoing benefits are dependent on the doctors opinion that the work accident is the continued major contributing cause, or greater than fifty percent the need for treatment.   This is frequently the primary issue in each workers’ compensation claim.

If you have any questions about your on the job injury or any other accident suffered at work, call Michles & Booth immediately to set up your free initial consultation and make sure your rights to workers’ comp benefits are protected.

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