If you get hurt on the job in Florida, you’re likely wondering what comes next. How will you pay your medical bills? What happens to your paycheck if you can’t work? Florida’s workers’ compensation system is designed to answer these questions by providing benefits to injured employees.
The system is “no-fault,” which means you don’t need to prove your employer was negligent to receive benefits. You only need to show that your injury occurred while you were performing your job duties. This guide will walk you through the types of benefits available and how they are calculated.
What Does Workers’ Comp Cover?
Depending on the details of your injury, you may be eligible for several types of assistance. These benefits are meant to help you recover and manage the financial impact of your workplace injury.
The primary benefits include:
- Coverage for all necessary medical care.
- Payments to replace a portion of your lost wages.
- Vocational rehabilitation if you cannot return to your old job.
- Death benefits for surviving family members.
The total amount you receive depends on the severity of your injury, your pre-injury wages, and the specific benefits you qualify for.
Medical Benefits Explained
Under Florida law, your employer’s workers’ compensation insurance must cover 100% of all medical treatment deemed necessary for your work-related injury. These benefits are paid directly to the healthcare provider, not given to you as cash.
This coverage includes:
- Emergency room visits
- Hospital stays
- Doctor’s appointments
- Prescription medications
- Physical therapy
- Medical supplies and equipment, like crutches or prosthetics
It is crucial to seek medical care from a doctor authorized by the workers’ compensation insurance carrier. Going to your own doctor without approval could jeopardize your claim and leave you responsible for the bills. Equally important is reporting your injury and seeking treatment promptly. Any delay can give the insurance company a reason to question the validity of your claim.
Compensation for Lost Wages
If your injury forces you to miss work or reduces your earning capacity, you can receive payments to replace some of your lost income. Florida law states that you will not be paid for the first seven days you are out of work unless your disability lasts for more than 21 days. After 21 days, you will be retroactively paid for that initial seven-day waiting period.
The amount you receive is based on two main factors:
- Your Average Weekly Wage (AWW): This is calculated from your earnings in the 13 weeks leading up to your injury.
- Your Disability Classification: A doctor will assess how your injury impacts your ability to work.
Types of Disability Benefits
Temporary Total Disability (TTD)
If your doctor determines you are completely unable to work for a limited time, you qualify for TTD benefits. These payments are typically calculated as two-thirds (66.67%) of your AWW. However, this amount cannot exceed the statewide maximum compensation rate, which is updated annually. For certain severe injuries, like paralysis or blindness, you may receive up to 80% of your AWW for the first six months.
Temporary Partial Disability (TPD)
If you can return to work but in a limited capacity (e.g., fewer hours or lighter duties) that results in you earning less than 80% of your pre-injury wages, you can receive TPD benefits. These payments help bridge the gap between your current earnings and what you were making before the injury. TPD benefits are paid until you can return to your regular duties or you reach your maximum medical improvement.
Permanent Impairment Benefits (PIB)
Once your doctor determines that your condition has stabilized and is unlikely to improve further (a status known as Maximum Medical Improvement or MMI), you will be assigned a permanent impairment rating. This rating is a percentage that reflects the degree of your permanent injury. You will then receive Permanent Impairment Benefits based on this rating and a state formula.
Permanent Total Disability (PTD)
In the most severe cases, an injury may leave you permanently unable to perform any type of work. If you are classified as having a Permanent Total Disability, you can receive benefits equivalent to your TTD rate. These payments can continue until you reach age 75, providing long-term financial support for you and your family.
Other Available Benefits
Vocational Rehabilitation
What if your injury prevents you from ever returning to your previous job? The law requires your employer’s insurance to help you re-enter the workforce. This can include services like job retraining, vocational counseling, and assistance with finding a new position that accommodates your physical limitations.
Death Benefits
If a work-related accident results in an employee’s death, their dependents are entitled to death benefits. This includes compensation for lost financial support, up to a maximum of $150,000. Additionally, the insurance carrier must cover funeral and burial expenses up to $7,500. A surviving spouse may also be eligible for educational benefits to help them build new skills.
Why You May Need an Experienced Attorney
Navigating the workers’ compensation system can feel overwhelming, especially when you are focused on recovering from an injury. Unfortunately, insurance companies sometimes look for reasons to deny or undervalue valid claims. They have legal experts on their side, and so should you.
An experienced workers’ compensation attorney can protect your rights, ensure all paperwork is filed correctly, and fight to get you the full benefits you deserve. From negotiating with insurers to representing you in court, a lawyer can make a significant difference in the outcome of your case.
Who is eligible for workers’ compensation in Florida?
Most employees in Florida are covered from their first day on the job. The law requires employers in non-construction industries with four or more employees (full-time or part-time) to carry workers’ compensation insurance. In the construction industry, the requirement applies to employers with one or more employees.
How do I file a workers’ compensation claim?
You must report your injury to your employer within 30 days of the accident. It’s best to do this in writing. Your employer will then report your injury to their insurance carrier, which officially begins the claims process.
What should I do if my claim is denied?
If your claim is denied, you will receive a formal notice explaining the reason. You have the right to appeal this decision. The first step is to file a Petition for Benefits with the Florida Office of Judges of Compensation Claims. An attorney can be invaluable during this process, helping you gather evidence and build a strong case for your appeal.
Can I choose my own doctor?
Generally, you must see a doctor who has been authorized by the workers’ compensation insurance carrier. The carrier has the right to direct your medical care. If you are unhappy with the assigned doctor, you have the right to request a one-time change to another authorized physician.
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
Meet writer Rei Bayucca, a graduate of Saint Louis University with a passion for writing about legal topics. Explore insightful articles tailored to solve your most pressing issues. Rei’s expertly crafted content is thoroughly researched and fact checked.