Workers' Compensation
Introduction
Definitions
Benefits
under the 1994 Florida Workers' Compensation Act
Frequently
Asked Questions
Overview
of Denied Claim Procedure
Conclusion
I. INTRODUCTION
Being 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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