If you’ve been injured at work, workers’ compensation is there to take care of you, right?
Technically, yes.
Yet, we have talked to hundreds of people from Lakeland and across Polk County who’ve learned the hard way that while technically true, reality was something else entirely when it came to navigating a workers’ comp claim.
How Workers’ Compensation Works
Workers’ compensation is a type of insurance administered by the workers’ compensation boards of individual states that is designed to protect both the employer and the employee, and to provide benefits to injured workers while eliminating the need for litigation.
Under workers’ compensation law, benefits are generally available to a worker who is hurt on the job, but benefits are by no means automatic.
While hiring an attorney may seem a bit aggressive, workers’ compensation law is relatively complex and legal expertise may be required to ensure that you will be found eligible for benefits.
Here are four things a workers compensation attorney can help you with:
1. Explain What Injuries Qualify for Workers’ Compensation
Generally, if your employer employs at least three to five workers and you are no
t part of a class of employees that may be excluded from workers’ compensation coverage in Florida, you will have access to workers’ compensation benefits. Although no proof of fault on the part of your employer is required, you will need to establish that the injury occurred on the job and is connected somehow with the work performed to be eligible for benefits.
If a worker is injured outside the course and scope of his employment, he is not usually covered under workers’ compensation. But as a workers’ compensation attorney will tell you, this does not mean that an employee is only covered for injuries occurring at his principal place of work. Employees who are required by their employers to perform work-related activities in other locations, such as construction workers and road maintenance crews, are usually covered by workers’ compensation, as long as the injury occurred while they were engaged in duties related to their employment.
2. Assemble and File a Proper Claim
Workers’ compensation will pay for medical care, rehabilitation, and some wage replacement if you have to miss work because of your injury, but to obtain these benefits, you’ll have to file your claim and follow your state’s procedures carefully.
You will need to get immediate medical care if your injury requires it, and then inform your employer about your injury as soon as possible, in writing. In Florida, it is best to submit no later than 30 days after the day the accident occurred. Overall, the sooner you’re able to submit, the better off your case will be.
Your employer will have claim forms for you to fill out and submit. Generally, you will need to provide the following documentation:
• Date, time, and location of injury.
• Parties involved in the accident.• How the accident occurred.
• Type of injury and area of body affected.
• Medical treatment received.
After you have filled those out (with or without the help of an attorney, who can ensure that they are completed properly),. There is a time limit for this too.
3. Guide You Through the Appeals Process if Necessary
If the insurance company for your employer denies your claim, your first step should be to contact them and find out why it was denied. If the denial was due to incorrectly filed paperwork or a missing document, you may be allowed to fix these types of mistakes and your claim might be reconsidered.
But if the workers’ compensation carrier believes that you have not met the eligibility requirements to receive benefits, you may have to provide additional facts and documentation or file a formal appeal, something you might consider hiring a workers’ compensation attorney to help with, since if you fail to follow the rules, you may be denied benefits that you would have otherwise been entitled to.
4. Advise You of Any Other Benefits You Might be Eligible For
If you do not qualify for workers’ compensation benefits, you might be able to apply for Social Security Disability or file a personal injury claim to obtain compensation for your injury, something an attorney can help you do.
Dealing with a complex workers’ compensation claim can be difficult and stressful for non-lawyers, particularly those feeling the effects of a serious work injury. For this reason, successfully navigating the workers’ compensation claims process often requires the assistance of an experienced legal profession