Work Related Injuries
If you are injured as a result of a work-related accident, your employer's workers' compensation coverage provides medical and partial wage replacement benefits to which you may be entitled.
As soon as your carrier knows about your work-related injury, the carrier will:
• Determine the compensability of your injury
• Provide an authorized doctor
• Pay for all authorized medically necessary care and treatment related to your injury
Authorized treatment and care may include:
• Doctor's visits
• Physical therapy
• Medical tests
• Prescription drugs
• Travel expenses to and from your authorized doctor.
Once you reach maximum medical improvement (MMI), you are required to pay a $10 co-payment per visit for medical treatment. MMI occurs when the physician treating you determines that your injury has healed to the extent that further improvement is not likely.
Wage Replacement Benefits
Your workers' compensation benefits for lost wages will start on the eighth day that you are unable to work. You will not receive wage replacement benefits for the first 7 days of work missed, unless you are out of work for more than 21 days due to your work-related injury. In most cases, the wage replacement benefits will equal two-thirds of your pre-injury regular weekly wage, but the benefit will not be higher than Florida's average weekly wage. If you qualify for wage replacement benefits, you can generally expect to receive your first benefit check within 21 days after the carrier becomes aware of the injury, and bi-weekly, thereafter.
You will be eligible for different types of wage replacement benefits, depending on the progress of the claim and the severity of the injury.
• Temporary Total Benefits : These benefits are provided as a result of an injury that temporarily prevents you from returning to work, and you have not reached MMI.
• Temporary Partial Benefits : These benefits are provided when the doctor releases you to return to work and you have not reached MMI and earn less than 80% of your pre-injury wage. The benefit is equal to 80% of the difference between 80% of your pre-injury wage and your post-injury wage.
• The maximum length of time you can receive temporary benefits is 104 weeks or until the date of MMI is determined, whichever is earlier.
• Permanent Impairment Benefits: These benefits are provided when the injury causes any physical, psychological or functional loss and the impairment exists after the date of MMI. A doctor will assign a permanent impairment rating, expressed as a percentage, to the injury.
• If you return to work at or above your pre-injury wage, the permanent impairment benefit is reduced by 50%.
• Permanent Total Benefits : These benefits are provided when the injury causes you to be permanently and totally disabled according to the conditions stated in the law.
• Death Benefits: The maximum benefit is $150,000 for any death resulting from a work place accident.
• The rate, amount, and the duration of compensation for all wage replacement benefits are detailed in the workers' compensation law. If you have any questions about your benefits call your claims adjuster or the Employee Assistance Office at 1-800-342-1741.
Anti-Fraud Reward Program
Workers' compensation fraud occurs when any person knowingly and with intent to injure, defraud, or deceive any employer or employee, insurance carrier, or self-insured program files false or misleading information. Workers' compensation fraud is a third degree felony that can result in fines, civil liability, and jail time