101 Frequently Asked Florida Workers' Compensation Questions

Questions 1-25 below

The answers below are designed for general information only. The information presented at this site should not be construed to be formal legal advice nor the formation of a lawyer/client relationship. If you have questions regarding your specific case, please use our Find A Lawyer tool to contact an attorney to discuss your case.

1. How long after an accident do I have to report an injury?

Report your injury immediately. By law, you have thirty (30) days to report your injury, or your claim may be denied for failure to notify your employer. However, there are exceptions to the notification requirement that can be found in §440.185. Fla. Stat.

2. When does my Employer have to report an accident to its insurance company?

Your employer should report your injury immediately, but no later than seven (7) days following the industrial accident. The insurance company must send you an informational brochure, explaining your rights and responsibilities, under workers’ compensation law, within three (3) days. If the insurance company fails to provide the brochure, it may be estopped from raising certain defenses in subsequent litigation.

3. My Employer will not report my injury to its insurance company, what can I do?

You have the right to report the injury, and your employer is subject to a fine for failure to report the accident/injury. If you need assistance reporting your injury, contact a workers’ compensation attorney or the Employee Assistance Office of the State of Florida.

4. Do I have to pay for medical bills related to my injuries?

No, all authorized medical bills should be submitted to your employer, if self-insured, or your employer’s insurance company. If you are required to pay any medical bills out of pocket, you should submit your expenses to the above entities for reimbursement. If the employer or carrier has authorized medical treatment, do not submit to any unauthorized providers or treatment. Otherwise, you are not entitled to seek payment or reimbursement from the employer or carrier.

5. How much will I receive if I lose time from work?

In most cases, you will receive 66 2/3 percent of your average weekly wage, which is calculated based upon your 13-week wage history immediately preceding your date of accident.

6. When will I receive my first workers’ compensation check?

You should receive your first check within 8 to 21 days following your date of accident. You will not be paid for the first seven days following your date of accident unless your disability results in more than 21 days of lost time from work.

7. Are workers’ compensation benefits taxable?

No.

8. How long can I receive temporary disability?

Currently, you can receive temporary total disability benefits, temporary partial disability benefits, or a combination of both for a maximum of 104 weeks. Thereafter, you may be entitled to permanent total disability benefits, which if eligible, you can receive until you are 75 years of age.

9. What if I don’t have a car or transportation to get to my medical appointments?

Your employer or its insurance carrier is responsible for arranging and paying for transportation for medical appointments.

10. What is “light duty” or “modified duty” work?

While there is no black letter definition of “light duty” work, the term generally refers to work available with an employer that complies with physical restrictions placed on an injured worker by their authorized treating physicians, e.g., no lifting more than 15 pounds. “Modified duty” work refers to a position or job created by an employer to specifically comply with any physical limitations an authorized treating physician has placed on an injured worker.

11. What happens if my doctor assigns work restrictions, but my employer does not have light duty work available to offer me?

You are entitled to temporary partial indemnity benefits until your employer can accommodate your work restrictions, or your doctor releases you to return to work, full duty.

12. Can my employer fire me while I am out on workers’ comp?

No, your employer cannot fire you for filing a workers’ compensation claim. If it does, you may have a claim for coercion under §440.205 or a private cause of action for wrongful termination.

13. Does my employer have to keep my job for me if I am out on workers’ comp?

Unfortunately, there is no provision requiring your employer to hold your job until you return. Typically, employers have policies within your employment contract that state the amount of time you may miss prior to being properly terminated for an extended leave of absence.

14. If I am unable to return to the type of work I did before I was injured, what can I do?

The law provides reemployment services to help you return to gainful employment, for example, vocational counseling, transferable skills analysis, job-seeking skills, job placement, on-the-job training, and formal retraining.

15. What is the statute of limitations for workers’ compensation benefits?

Depending on the type of injury you have sustained, the statute of limitations for filing your claim is two years from the date of accident, or alternatively, two years from the date you knew or should have known that your injury or illness was related to your employment. Additionally, once a claim has been accepted and medical treatment has been authorized, you must treat once every 365 calendar days with an authorized treating physician. If a claim has previously been accepted and disability benefits were subsequently terminated, you must file a claim for reinstatement of the disability benefits within one year of the date of termination. Regardless, the statute of limitations, and its exceptions, is a very technical area of the law, and it his highly recommended that you seek the assistant of a workers’ compensation attorney.

16. Can my workers’ compensation case be settled for a lump sum of money?

Yes, there are two parts to every workers’ compensation claim: 1) the indemnity, or lost wages; and 2) future medical treatment. Each part can be settled separately, or you can globally settle both parts simultaneously. The latter is customary. However, settlement is completely voluntary for both parties.

17. What benefits are available if I cannot go back to the type of work that I used to do?

If you have reached the point of Maximum Medical Improvement (MMI) and have permanent restrictions that prevent your return to your past work, the current version of the workers’ compensation Act has very little for you in the way of benefits. However, if you cannot return to your past work, you can apply for vocational rehabilitation with the State of Florida. If you are accepted into a retraining program, Rehab TTD benefits will be available for the weeks that you are attending retraining courses. If you have not yet reached the point of MMI and cannot return to your past work due to work restrictions, you will be entitled to Temporary Partial Disability benefits, provided that the employer has no light duty work available for you and you have not been able to find light duty work outside of your employer.

18. The workers’ compensation insurance company is not paying me any checks. What can I do?

You should seek the assistance of a workers’ compensation attorney, or you may explore the self-help options provided by the State of Florida.

19. Can I go to my own personal doctor to have him treat my work related injuries?

You can, but neither you nor your personal doctor may seek payment or reimbursement for the treatment unless your claim has been controverted by the employer or carrier, and you later prevail in subsequent litigation. Additionally, your group health insurance company may deny your claim as they have exclusions in their policy for medical care for work-related injuries.

20. Do I have to pay any co-payments for doctors’ appointments, prescriptions or hospital visits?

No, you do not have to pay any co-payments, at least initially. Following the date your authorized treating physician places you at maximum medical improvement, you are required to pay a $10.00 co-pay per visit for additional medical treatment for your work-related injury.

21. The insurance company is totally denying my case. What can be done?

You should immediately seek the assistance of a workers’ compensation attorney.

22. What if I can never work again as a result of my work related injury? What benefits are available?

If you can never work again as a result of your work-related injury, you are entitled to permanent total disability benefits. For accidents occurring on or before September 30, 2003, an injured worker can collect benefits for life. However, for accidents that occurred on or after October 1, 2003, an injured worker can only collect disability benefits until age 75, unless the injured worker is not eligible for Social Security disability or retirement benefits due to the compensable injury preventing he/she from working sufficient quarters to be eligible for federal benefits. In addition to permanent total disability benefits, supplemental benefits are also available to permanently and totally disabled injured workers. The subject of permanent total disability benefits and supplemental disability benefits can be complicated. Therefore, it is highly recommended that you seek the assistance of a workers’ compensation attorney.

23. Can I make a claim for workers’ compensation benefits and unemployment compensation benefits at the same time?

No, an injured worker is not entitled to any temporary total or permanent total disability benefits for any week they have received unemployment compensation benefits. If an employee is entitled to temporary partial benefits and reemployment assistance or unemployment compensation benefits, the reemployment assistance or unemployment compensation benefits shall be primary and the temporary partial benefits shall be supplemental only, the sum of the two benefits cannot exceed the amount of temporary partial benefits which would otherwise be payable.

24. How often are workers’ compensation checks payable?

Typically, workers’ compensation checks are paid bi-weekly.

25. Are there benefits available for retraining and education in the workers’ compensation system?

The State of Florida has reemployment services designed to help an injured worker return to work when their work-related injury or illness prevents them from returning to their usual line of work. These benefits are only available after the employee has reached overall MMI. More information can be found here.

If an employee gets into a retraining program, Rehab TTD benefits are due to the employee from the workers’ compensation carrier. These benefits are paid biweekly at 2/3 of the AWW while the employee remains in a retraining program subject to the 104 week limitation of temporary disability benefits.