Worker's Compensation
Introduction
Definitions
Benefits under the 1994 Florida
Workers' Compensation Act
Frequently Asked
Questions
Overview of Denied Claim
Procedure
Conclusion
I. INTRODUCTIONBeing injured at
work is annoying. We have found that injured workers have become confused about
the workers' compensation system because they are uncertain as to their rights
under the system in Florida.
It is important that injured workers be made
aware of what he/she can expect after being injured at work. It is our goal as
your lawyers to ease some of the frustration and stress an injured worker
suffers.
It is important to know that the Workers' Compensation Law has been
modified and amended by the Florida Legislature many times. We encourage
pre-1994 injured workers to contact our office if they have any questions
regarding their rights and responsibilities under the specific Law that governs
their injury date.
II. DEFINITIONS
Authorized Treating Physician
No health care
provider can render service to an injured employee (except for in emergency care
situations) without prior authorization from the employer or workers'
compensation insurance carrier. Further, a health care provider may not refer
the employee to another health care provider, diagnostic facility, therapy
center, or other facility without prior authorization from the carrier, except
when emergency care is rendered.
Average Weekly Wage (AWW)
The wages of the injured
employee at the time of the injury used to calculate payments for lost wages. It
is the average weekly wage earned by the injured worker during the 13 week
period before the injury.
Concurrent Employment
Any job the
injured worker was employed at the time of the accident, other than the job
where the actual injury occurred. The wages earned from concurrent employment is
factored in for calculations of the Average Weekly Wage.
Compensation Rate (Comp Rate)
66 2/3% of the AWW up
to a maximum benefit which is determined by the Division of Workers
Compensation.
Employee
Any person engaged in employment under
an appointment or contract of hire, express or implied, oral or written. This
includes minors and aliens, whether lawfully or unlawfully employed. However, it
does not include independent contractors.
Impairment Rating
A percentage which represents the
extent a work related injury has permanently impaired the injured worker to
his/her body as a whole.
Impairment Benefits
Benefits which begin the day
after the injured worker reaches Maximum Medical Improvement (MMI) or is no
longer entitled to temporary benefits. These benefits are to be paid weekly at a
rate of 50% of the AWW. The duration of these benefits depends on the injured
employer's impairment rating. For each percentage point of impairment, the
injured employee reaches three weeks of impairment benefits.
Independent Medical Examination (IME)
An objective
evaluation of the injured employee's medical condition, including, but not
limited to, impairment or work status, performed by a physician at the request
of a party, a judge of compensation claims, or the Division to assist in the
resolution of a dispute arising under the Florida Workers' Compensation
Statute.
Maximum Medical Improvement (MMI)
The date after
which further recovery from, or lasting improvement to, an injury or disease can
no longer reasonably anticipated, based on a reasonable degree of medical
certainty. It is the time when the treating physician(s) believes the injured
worker has recovered as much as he/she is going to. When you reach MMI, we will
then write to your treating doctor and request your impairment rating as well as
an estimate of your future medical care expenses. Once we have a response, we
will then be able to prepare a settlement proposal to submit to your workers'
compensation carrier for a total lump sum settlement of your claim.
Notice of Injury
Document that must be completed
after a work related injury. The injured employee is required to advise the
employer of the injury within 30 days after the date of the injury. Within 7
days after actual knowledge of injury, the employer shall report such injury to
its carrier on a Notice of Injury form and provide a copy of the completed
Notice of Injury to the employee.
Petition for Benefits
A form that is served by
certified mail upon the employer, the employer's carrier and the Division in
Tallahassee when any employee has not received a benefit to which he believes
his is entitled under the Florida Workers' Compensation statute.
Permanent Total Disability (PTD)
When an employee is
unable to return to gainful employment as a direct result of the work related
injury.
Temporary Partial Disability (TPD)
A disability that
temporarily prevents an injured working from performing his/her normal job
duties.
Temporary Total Disability (TTD)
A disability that
completely prevents an injured from returning to work for a temporary time
period.
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