Workers often assume that they have workers’ comp coverage, and this is usually – but not always – the case.
Most Florida employees are covered by workers’ compensation insurance, with a few exceptions. Under Florida state law, if an employer in any industry (other than construction) has four or more employees, either full or part-time, they are required to carry workmen compensation insurance. Employers in the construction industry who have one or more employees must have insurance to cover each employee in need of workers compensation.
Construction industry employers in Florida must ensure that any subcontractor has workers’ compensation coverage for all their employees, and farmers with six or more regular employees and 12 or more seasonable employers who are employed over 30 days must provide workers’ compensation coverage for all employees. An out-of-state employer with employees working in Florida must have a Florida workers’ compensation insurance policy in force, or add an endorsement listing Florida to an out-of-state policy.
I’m Covered – Now What Should I Do?
The first thing you need to do is to report the injury to your employer, and ask them what doctor you can see. Florida workers’ compensation requires that injured workers see a doctor that is authorized by their employer or the insurance company. If it is an emergency and your employer is not immediately available, you should go to the nearest emergency room for treatment and advise your employer of the injury as soon as possible.
Your employer is required by Florida law to report the injury to the insurance company within seven days of when it was reported to them. After the injury is reported, many companies will have an insurance claims adjuster contact the injured employee within 24 hours to advise them of their rights and responsibilities.
Within three to five business days, you should receive an informational packet from the insurance company, which should contain:
- An informational brochure explaining the employee’s rights and obligations.
- A Notification Letter explaining the services provided.
- A copy of the accident report or “First Report of Injury or Illness” that you should review for accuracy.
- A fraud statement that you should read, sign, and return as soon as possible.
- A release of medical records to sign and return.
- Medical mileage reimbursement forms to fill out after seeking medical treatment.
Injured employees in Florida may be entitled to some or all of the following benefits under the state’s workers’ compensation system: indemnity benefits if they are unable to work for more than seven days; temporary total disability benefits if the doctor says they cannot work at all; temporary partial disability benefits if you can return to work but cannot earn the same wages that you did at the time you were injured; and impairment benefits once you reach Maximum Medical Improvement.
Your employer will be responsible for providing medical treatment to you, but do not go to your own private doctor for treatment. If you are unable to return to work because of permanent work restrictions, you may also be eligible for Reemployment Services assistance.
More Florida Workers’ Comp Facts
Here are some more basic facts about workers’ compensation in Florida:
- Florida employers are responsible for paying the entire premium for workers’ compensation coverage, and are not allowed to shift any of the cost to their employees.
- The law covers accidental injuries and occupational diseases arising in the course and scope of employment, including deaths within specific periods of time.
- Florida workers’ compensation does not cover mental or nervous injury due to stress, fright, or excitement, nor does it pay benefits for pain and suffering.
- If a minor child is injured while employed in violation of child labor laws in Florida, the employer might have to pay double compensation.
- If an employee fails to use safety equipment or observe safety rules, compensation may still be paid, but partial wage replacement could be decreased by 25 percent if the employee knew of the safety rules prior to the accident and failed to observe them, or refused to use safety equipment after the employer told him to do so.
Workers’ compensation insurance will compensate employees for occupation-related injuries regardless of fault, and makes employers immune from being sued by injured employees in civil court, unless the accident was caused by the employer’s or a co-worker’s intentional harmful conduct.