Workers’ compensation cases are often adversarial, because they pit the interests of an injured worker against a company that wants to contain its financial losses. Dealing with the employer during this time is often extremely stressful. However, you can always control your own attitude. Make it a point early on to act professionally, even if your boss or other people in management do not act the same way towards you.
Attend Medical Appointments as Requested
You must produce strong medical proof that the injuries you sustained at work continue to affect your everyday life. That is why it is so important to go to all medical appointments and to follow your doctor’s advice. Since this information goes back to your employer, you want it to reflect you in the best possible light. If you do not like your doctor do not ask for or accept a new one without consulting an attorney. You only have the right to a new doctor one time in any case. The carrier can always choose that new doctor, unless they do not respond to your request in a timely manner. If the response is late you can chose your doctor. It is best to have a lawyer help you with the process of requesting your one time change of doctors.
Show up on Time for All Hearings and Depositions
When you receive a notice of an upcoming hearing or deposition, try to clear your schedule immediately so that you can attend it. If that’s not possible, let your attorney know so he or she can reschedule. It won’t look good to your employer if a company representative makes it to each legal meeting and you do not.
What to Do If You Feel You’re Being Treated Unfairly
Unfortunately, your employer may choose to act in unfair or illegal ways towards you after you file a workers’ compensation claim. Your employer may demote you, wrongfully terminate you, or encourage others to treat you in an openly hostile manner. Documentation is extremely important if any of these things happen. You should write down the date, time, and the employer’s actions for anything you feel is unjust. Your next step is to contact a workers’ compensation attorney for guidance and possible representation.
DDB Law attorneys understand your vocational rehabilitation rights, and are your best advocates in Lakeland. According to Florida Workers’ Compensation statutes, Title 31, Labor, Chapter 440, if an employee who’s suffered an on-the-job injury that falls under Workers’ Compensation is still off the job 60 days after the date of injury and is receiving compensation for “temporary total, or temporary partial disability or wage loss,” the insurance provider has the duty to figure out if this employee “is likely to return to work.”
Florida Law for Serious Injuries at Work
The insurance carrier must make sure the injured Florida employee gets a reemployment assessment if the employee is at risk of remaining unemployed, and the employee has been very seriously injured. After the insurance company sends the employee to a state-certified provider for assessment, this testing is completed (within 30 days) with recommendations for reemployment services and the employee accepts the recommendation (within 15 days), the employee must begin receiving said services within the following 15 days.
If this reemployment provider ultimately decides that training and education are needed in order for this employee is to be “suitably gainfully employed,” and the employee hasn’t gone back to work in 180 days–or re-employment services reach $2500 in cost–(whichever comes first), the insurance provider must direct the employee to the state’s Department of Rehabilitation Services.
The Department may conduct its own training and education screening, and/or vocational evaluation, approve training and education, or agree to provide some other type of vocational services for this injured employee.
Workers’ Compensation Administration Trust Fund
This state Department of Rehabilitation may aid the employee is securing a high school equivalency diploma, or tap into the Workers’ Compensation Administration Trust Fund to pay for this employee’s further training/education at a Florida public college or career center.
If the most appropriate and efficient training/education for this particular injured employee can only be received from a public college or career center more than 50 miles from the employee’s residence, can only be obtained from a provider other than a public college or career center–or the nearby public college and career center can’t offer the appropriate courses in the near future–the Department must make every effort to accommodate the employee’s needs.
And, if the employee comes to attain “maximum medical improvement” and is still unable to earn at least 80% of their (previous) compensation rate, their employer–or the employer’s insurance company–must provide additional training and education temporary total compensation benefits during the time the employee takes advantage of this extra training/education, not to exceed 52 weeks. These 52 weeks may not be added to any education/training described in the previous paragraph.
These vocational rehabilitation rights–as summarized from Florida’s Workers’ Compensation statutes–are not as straightforward as they appear. Contact our workers’ compensation attorneys for expert guidance.
Your ability to receive medical benefits under Florida workers’ compensation is dependent on strict guidelines–guidelines that can, nevertheless, be challenged in court. According to the Florida Division of Workers’ Compensation, your employer may have to provide you with medical treatment, but it is your responsibility to quickly report any on-the-job illness, or injury. And, the doctor who aids you at the scene of the workplace mishap may not be the doctor who continues your treatment under your employer’s insurance plan. Likewise, be sure to advise hospital emergency-room personnel–if they are your “first responders”– to forward your records to your employer, and/or your insurance carrier.
Florida Workers’ Compensation laws declare, also, that you can only receive initial, ongoing and “specialist” medical care for a (supposed) on-the-job injury if insurance-company physicians declare this “medically necessary.” However, the term “medically necessary” is subject to interpretation, and you can, therefore, present a legal challenge whenever the carrier denies medical help you feel is crucial.
The types of medical care usually offered by workers’ compensation for physical-health problems–doctor’s visits, hospitalization, therapy, exams/tests and prescription medications–also apply to “mental and nervous injuries,” as described by Florida Statute 440.093. In order for “mental/nervous” treatments to be covered, though, your mental “stressors” must be directly attributable–by at least 50%–to the “compensable physical injury” that occurred while you were working. This 50% is used in comparison with any other possible causes of your mental-health issues. And, the term “directly attributable” is another that can be viewed differently by you, and by your insurance company.
Your “mental and nervous injuries,” therefore, must be proven by clear and convincing medical evidence, and this evidence can only be provided by a licensed psychiatrist–not a psychologist–who can give your condition a unequivocal diagnosis by employing the criteria now extant in the DSM-IV, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.
Asserts Florida laws: A mental injury that results from stress, fright or excitement are not an “accidental injury,” even if it was, you believe, engendered from an on-the-job incident. Workers’ Compensation, in other words, must see a trauma to your physical body in order to permit your employer’s insurance to help you to heal. –Can this “nervous injury” interpretation be legally challenged? Yes!
But can the insurance company claim, in a situation such as this, that your “mental challenges” existed prior to your current employment? Yes!
Some physically injured employees have, conversely, been accused of mental malingering, when in fact; the trauma they experienced was real–just not easily diagnosable.
This overview of actual, nameable and feasible workplace injuries–which may be denied by Florida Workers’ Compensation–should convince any employee with questions to seek legal help.