When Does Workers Comp Start Paying?

According to Florida law, your insurance carrier should start paying workers comp benefits within 21 days after you report your injury to your employer. You can expect to receive your first workers’ comp check within three weeks of reporting your injury.

The above timeline, however, is only applicable if your claim is approved immediately. More often than not, your insurance carrier will find any reason to deny your claim.

When this happens, you’ll have to go through the appeals process and even bring your case before a judge. This can significantly delay your workers’ comp payment.

On average, appealing a workers comp can take 3 to 6 months. Some cases can even take years. This means that instead of 21 days, you may have to wait years before receiving your first workers’ comp check.

So when does workers comp start paying? To answer this, you must understand how workers comp works in Florida.

HOW DOES WORKERS COMP WORK?

In Florida, workers’ compensation works by providing benefits to employees who suffer work-related injuries or illnesses. When an employee is injured, they must report the injury to their employer within 30 days. Once reported, the employee can seek medical treatment for their work-related condition.

Workers’ compensation insurance typically pays for medical bills, lost wages, prescription medications, and necessary rehabilitation. The benefit check, paid bi-weekly, is usually 66 2/3 percent of the employee’s average weekly wage.

Employers in Florida are legally required to secure workers’ compensation insurance to compensate employees for lost wages and medical expenses resulting from work-related injuries or illnesses.

WORKERS COMP TIMELINE IN FLORIDA

The first step to getting your workers comp benefits is to report your injury to your employer. In Florida, you must report your injury within 30 days after it happened or after you’ve known of it. Otherwise, your claim can be denied.

After reporting your injury, your employer has 7 days to inform your insurance carrier about it. Your insurance carrier will then verify your claim. They’ll start paying you your workers’ comp benefits if they have no objections.

For disabilities that are immediate and continuous for at least 8 days, the first benefit check should arrive no later than 14 days after you’ve reported your injury. But if the first seven days of your injury are delayed or nonconsecutive, you should receive your check on the 6th day after the first 8 calendar days of disability.

But, if your claim is denied, you can appeal it. You and your insurance carrier will then be brought together for mediation. If that doesn’t work, your case will be brought before a workers compensation judge. As I’ve said, workers comp cases that make it to court can take months or years to get approved or denied.

Sometimes, your insurance carrier may need to investigate your claim further. If the investigation extends beyond the time limit set by the law, they may still pay your benefits even before judgment is rendered.

However, they should issue an approval or denial within 120 days after issuing your first check. If they fail to do so, they can’t deny your claim anymore unless they can produce material evidence that would have been impossible to get within 120 days.

HOW OFTEN DOES WORKERS COMP PAY?

Workers comp benefit checks in Florida are paid bi-weekly. However, the amount will be based on your average weekly wage before the injury.

How much does workers’ comp pay for lost wages? For instance, let’s say you’re earning $1,000 a week before you get injured. Your benefit check is usually 66 2/3% of your average weekly wage. This means that your weekly benefits are $666.67. Since your checks are paid bi-weekly, you can expect to receive $1,333.34 every two weeks.

WHAT’S INCLUDED IN YOUR WORKERS COMP CHECK?

There are two types of workers comp benefits: medical benefits and lost wages compensation. But your workers’ comp check will likely contain only your lost wages compensation. That’s because your medical benefits are usually paid directly to your healthcare provider.

WHAT IF MY WORKERS COMP CHECK IS LATE?

There are a lot of reasons why a workers comp check gets delayed. It could be that there was a clerical error on the part of your insurance provider. Or maybe you moved and didn’t inform them of your new mailing address. It’s also possible that your check got lost in the mail.

If your workers’ comp check is delayed, you first need to check with your workers’ comp claims adjuster. They can help you track where your check is and resolve whatever is preventing you from getting hold of it.

However, you should talk to your lawyer if the delay is intentional. Florida law imposes penalties and fees for insurance carriers who fail to issue benefit checks within the legally mandated timeframe.

(Related: HOW TO TRACK YOUR WORKERS COMP CHECK: A QUICK GUIDE)

WHEN DOES WORKERS’ COMP START PAYING LOST WAGES

Under Florida law, workers’ compensation benefits begin once an injured employee notifies their employer of the injury. However, there is a waiting period of seven days before you start receiving wage benefits. This means that your wage benefit claim will begin on the eighth day after reporting the injury. 

The injured employees want to claim workers' compensation.

WHY WOULD YOU HAVE TO PAY BACK WORKERS’ COMP

In Florida, there are circumstances where you may have to pay back workers’ compensation benefits. Here are a few scenarios:

  1. Settlements: If you receive a settlement from a personal injury lawsuit related to your work-related injury, your employer’s workers’ compensation insurance carrier may be entitled to reimbursement for the benefits they paid out.
  2. Double Recovery: If you receive workers’ compensation benefits for the same injury or illness and later receive benefits from another source, such as Social Security Disability Insurance (SSDI), you may be required to reimburse the workers’ compensation carrier for the overlapping benefits.
  3. Fraudulent Claims: If it is discovered that you made a fraudulent claim or provided false information to obtain workers’ compensation benefits, you may be obligated to repay the benefits received.

It’s important to note that the specific circumstances and laws regarding the repayment of workers’ compensation benefits can be complex and may vary on a case-by-case basis. Therefore, it’s advisable to consult with an attorney.

WHO PAYS FOR WORKERS’ COMPENSATION?

In Florida, employers are responsible for providing workers’ compensation insurance for their employees. The employer must purchase workers’ compensation insurance coverage, which provides benefits for job-related injuries or illnesses. This insurance coverage is typically obtained through an insurance carrier or a self-insured program.

Workers’ compensation insurance ensures that employees receive necessary medical treatment, compensation for lost wages, and other benefits in the event of a work-related injury or illness. Employers bear the financial responsibility for paying premiums for this insurance coverage.

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.