Regarding workers’ compensation, reporting your injury to your employer is crucial for initiating the claims process. However, there are unfortunate cases where employers fail to report injuries to their insurance providers. This can leave injured workers without the benefits they are entitled to.
Unfortunately, this scenario is common in workers’ compensation claims. Many employers tend to “forget” or even refuse to report workplace injuries to their insurance providers. That’s because work-related injuries can drive up the cost of premiums. And if you’re running a business, the last thing you want is to pay more for workers compensation insurance.
This is why many injured workers are often left to the curb. Some employers will just tell them to use their personal health insurance. While others would even go as far as threatening employees who file workers comp claims. With no benefits, they often have to shoulder medical expenses from their own pockets. Plus, recovering from their injuries will cause them to miss work for days – most of the time without pay.
If you’re in this situation, know everything is not lost yet. Here’s a quick guide on what to do when your employer does not or refuses to report your injury.
WHEN TO REPORT AN INJURY
You should report the injury to your employer when you get injured at work. Otherwise, they won’t be able to start processing your workers’ compensation claim.
Most states have a prescription period when reporting work-related injuries. In Florida, like most states, you only have 30 days to report a work-related injury to your employer. This starts on the day you got injured or, in the case of cumulative injuries, when you’ve had knowledge of it.
However, it is generally advised not to wait until the 30-day deadline to report an injury. Reporting the injury to your employer on the day it happens or immediately after seeking medical attention is recommended. By informing your employer promptly, you can initiate the claims process sooner and potentially receive your benefits earlier.
Some employers, especially large corporations, have protocols for reporting workplace injuries. Usually, it requires you to fill out a form, attach the supporting evidence, and submit it to human resources. Your insurance provider should have a workers’ compensation claim form if they don’t.
So, to report an injury, you should:
1. FILL OUT THE INJURY CLAIM FORM
The work injury claim form typically requires information about you, the kind of work you do, and the circumstances of your injury. Make sure you fill out the form correctly and thoroughly. Don’t forget to include details like the exact time and date of the accident, where it happened, who witnessed it, what body parts were affected, etc.
Ideally, your employer should help you complete the form. If they seem uncooperative or withhold the form from you, it might be a sign that they don’t intend to inform the insurance provider of your injury.
If your injury requires immediate medical attention, get the necessary treatment before reporting the incident. However, report the injury as soon as possible afterward.
2. ATTACH MEDICAL EVIDENCE AND OTHER SUPPORTING DOCUMENTS
Your workers’ comp claim should be substantiated with medical evidence to prove you are injured. So, make sure to include your medical records when you submit your work injury report. Depending on the circumstances of your injury, you may also need to attach other supporting documents like affidavits from witnesses, police reports, or your employment history.
After submitting your work injury claim, your insurance provider will contact you to verify your claim. Afterward, they will schedule you for an initial examination with a doctor of their choosing. They can approve or deny your claim depending on the medical examination results and the other evidence you submitted.
WHAT HAPPENS IF AN EMPLOYER FAILS TO REPORT AN INJURY IN A TIMELY MANNER?
As mentioned, if your employer fails to report your injury to your insurance provider, your workers’ compensation claim can be denied. This means you won’t get any medical benefits and must pay for medical expenses from either your personal insurance or out of your pocket. You won’t be eligible for lost wages reimbursement if you must take time off work.
After informing your employer, they, in turn, need to inform the insurance company about it within seven days. Section 440.185 of Florida Statutes states that failure to report an injury in a timely manner shall render the workers’ compensation claim invalid.
Since each state has different workers comp laws, the timeframe can also vary. To ensure you won’t lose your benefits, report workplace injuries immediately after the incident or as soon as you know about it.
WHAT CAN YOU DO?
If the prescription period hasn’t expired yet, you can remind your employer to submit the report as soon as possible. But if that fails, you can go directly to the insurance provider.
Under Florida’s workers’ comp laws, employers must post workers’ comp insurance carrier information in the workplace. Contact the insurance provider and inform them directly of your injury. You can contact the Employee Assistance Office if no such information is posted. They can help you obtain that information.
After you inform your insurance carrier of your injury, they should send you an informational brochure within three days. The brochure will explain your rights and responsibilities as an injured worker. It also contains additional information about the state’s workers’ compensation laws.
The insurance provider will also start evaluating your claim. If they see that the claim is legit and you’re eligible for workers comp, you should receive your benefits within a few weeks.
In some states, however, you can’t go directly to your insurance provider. In such cases, your best recourse is to contact your state’s Department of Labor or any government office handling workers’ compensation complaints.
WHAT TO WATCH OUT FOR
Sometimes, employers won’t directly tell you they won’t report your injury. Instead, they employ tactics that can cause you to receive less or totally lose your workers’ compensation benefits. Unfortunately, most injured workers will only realize the ploy after it’s done. To avoid falling prey to these tactics, here are some things you need to watch out for:
1. PROMISES OF BIGGER PAY AND LIGHTER WORKLOADS IF YOU RETURN TO WORK.
Employers know that the longer you miss work, the higher the workers’ compensation cost will be. This, in turn, will raise their workers’ compensation premiums. That’s why it’s not uncommon for some employers to entice injured workers with bigger pay and a lighter workload if they return to work, even if they haven’t yet fully recovered.
If this happens to you, know you are not required to work unless your doctor gives you the green light. If you return to work before you are physically ready, it may worsen your condition. And this time, you won’t be able to claim any benefits since you’ve already returned to work.
2. PROMISES OF REIMBURSEMENT IF YOU USE YOUR PERSONAL INSURANCE TO PAY FOR MEDICAL COSTS.
If you pay for emergency treatment and other medical expenses using your personal injury insurance, it can be used as evidence that your injury is not work-related. As such, it may invalidate your workers’ compensation claim.
3. THREATS OF PUNISHMENT OR TERMINATION
This may seem a bit extreme, but they do happen. If your employer threatens to punish or fire you for filing a workers’ compensation claim, don’t hesitate to report it to your state’s workers comp board.
PENALTIES FOR EMPLOYERS WHO DON’T REPORT WORKPLACE INJURIES
If your employer fails or refuses to report an injury to the insurance carrier, will they pay a fine? In Florida, yes.
Florida’s worker comp law states that:
Any employer or carrier who fails or refuses to send any form, report, or notice required by this section shall be subject to an administrative fine by the department not exceeding $500 for each failure or refusal.
So there it is. Your employer may pay up to $500 if they fail to inform the insurance carrier of your injury within 7 days.
DO ALL INJURIES NEED TO BE REPORTED TO WORKERS COMPENSATION?
Not all injuries show up on the day of the accident. Some may take a few days before you feel any symptoms. While other work-related injuries like carpal tunnel syndrome tend to develop over time. This is why all injuries should be reported to your workers’ comp insurance provider, no matter how minor. It may not look that much right now, but if it gets worse later on and you don’t report it, you could be in trouble.
Remember that prescription period? It starts on the day you get injured. So, if you don’t report your injuries immediately, there’s a chance you won’t be able to claim any benefits.
CAN I SUE MY EMPLOYER FOR NOT REPORTING MY INJURY?
In Florida, employees generally cannot sue their employers for not reporting their injury. Workers’ compensation laws are designed to provide compensation to injured workers without the need for litigation. If an employer fails to report an injury, the employee’s recourse is typically to contact the insurance provider directly or seek assistance from the Employee Assistance Office.
However, there may be exceptions to this general rule. For example, if an employer does not carry workers’ compensation insurance as required by law, the employee may be able to pursue legal action against them. It is crucial to consult with an attorney specializing in workers’ compensation law to understand the specific circumstances of your case and explore your legal options.
CAN I SUE MY EMPLOYER FOR DENYING WORKERS’ COMP?
In Florida, you generally cannot sue your employer for denying workers’ compensation benefits. Workers’ compensation laws provide a no-fault system to compensate employees for job-related injuries. While employers and their insurance companies must provide benefits to qualifying workers, filing a lawsuit for personal injury from a job-related injury is typically prohibited after two years.
If your employer denies your workers’ compensation claim, the appropriate course of action is to pursue the claim through the administrative court system. Consult with an attorney specializing in workers’ compensation law to understand your rights and navigate the legal process.
WHAT HAPPENS IF AN EMPLOYEE DID NOT REPORT INJURY IN A TIMELY MANNER?
In Florida, failing to report an injury in a timely manner can have consequences for employees. According to Section 440.185 of the Florida Statutes, failure to report an injury in a timely manner can affect a workers’ compensation claim. It states that such failure shall render the claim subject to potential issues or challenges.
It is important for employees to promptly report their job injuries to their employer to avoid potential complications. Failing to report an injury in a timely manner may result in reduced or denied benefits.
SHOULD YOU HIRE A LAWYER?
Hiring an experienced workers’ comp lawyer like Victor Malca would be very beneficial. With almost three decades of experience behind him, he knows the ins and outs of the state’s workers comp system like the back of his hand. He has already helped thousands of injured workers in Florida get the benefits they deserve. He can help you too. Call us now for a free consultation.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.