Florida Workers’ Compensation: Filing, Benefits, & Appeals
Learn how to start your claim, how much you will receive, and how to appeal a denial.
If you were injured on the job in Florida, or sustained an occupational disease or illness as a result of your employment in Florida, you likely have a Florida workers’ compensation claim. This article explains who is covered by workers’ comp, how to file a claim, how much benefits are in Florida, and what to do about a denied claim.
Who Is Covered?
With some exceptions, Florida employers with four or more employees must carry workers’ compensation coverage. Employers in the construction business must have workers’ comp coverage if they have even one employee. To verify whether your employer has workers’ compensation coverage, you can use the Division of Workers’ Compensation’s online proof of coverage search page. You can also contact the Florida Employee Assistance and Ombudsman Office at (800) 342-1741.
Workers’ compensation covers all injuries or illnesses "arising out of and in the course of employment."
This means that the injury or illness usually must occur while you were at work or performing work-related duties. Injuries occurring during a commute to work, in the parking lot at work, and during non-work related activities usually will not amount to a workers’ compensation claim. (For more information, see What Injuries Aren’t Covered by Workers’ Comp?)
Typical industrial injuries include back strains or sprains, knee injuries, elbow injuries, shoulder injuries, and the like. Occupational illnesses can result from extended exposures to toxic substances or repetitive movements at work (such as carpal tunnel syndrome from typing).
How Do I Start a Workers’ Compensation Claim?
You should report your workplace injury or work-related illness to your employer as soon as possible. If you are involved in a work-related accident, the state of Florida requires you to report the incident to your employer within 30 days of the date of the accident. Alternatively, if your doctor informs you that you are suffering from a work-related injury or illness, you must report the injury or illness to your employer within 30 days of the date your doctor told you this information. Failure to report within the timeframe required can result in denial of your workers’ compensation claim.
You may also report your workers’ compensation claim directly to your employer’s workers’ compensation insurance carrier.
Your employer or its insurance carrier will likely provide you with the forms necessary for filing your workers’ compensation claim. These forms include the Florida forms DFS-F2-DWC-1 and potentially the DFS-F2-DWC-1a and DFW-F2-DWC-3 if you believe you are unable to work at this time due to your injuries or illness related to your employment.
If your employer does not provide you with the forms, you can also obtain the required forms from the Employee Assistance Office of the Florida Department of Workers’ Compensation.
How Much Are Florida Workers’ Compensation Benefits?
If your workers’ compensation claim is allowed, you will be eligible for workers’ compensation benefits. These benefits include medical treatment, compensation for lost wages, and compensation for permanent partial or total disability.
Medical coverage. Your employer is required to pay for medical treatment necessary to treat your workplace injury or occupational disease. This includes doctors’ visits, physical therapy, hospital visits, prescription medication, and diagnostic tests. You can also receive reimbursement for mileage in traveling to and from doctors’ appointments.
Temporary Disability Benefits. If you are unable to return to work at your previous job, working the same hours as before your workers’ compensation claim, you are entitled to temporary disability benefits. Should you be unable to work in any capacity, you will receive 66 2/3% of your regular wages at the time of injury in temporary total disability benefits. Alternatively, if your doctor says you can return to work with restrictions, you may receive temporary partial disability benefits. You will be eligible for these benefits if your new earnings are less than 80% of your wages at the time of your workplace injury. Florida sets a maximum weekly benefit of $863 (for 2016), so you cannot receive more than this amount.
Permanent Disability Benefits. Once your doctor finds that your condition is fixed and stable, and you have reached maximum medical improvement, you will be eligible for other workers’ compensation benefits. If you’re still able to work in some capacity, you can receive permanent partial disability benefits to compensate for a permanent loss of bodily function or a permanent loss in earning capacity. If you are unable to hold any gainful employment, you can receive permanent total disability benefits (sometimes called a lifetime pension). (To learn more, see How Are Permanent Partial Disability Benefits Calculated?)
How Do I Appeal a Florida Workers' Compensation Denial?
When you want to dispute a decision on your claim for workers' comp benefits, you must file a Petition for Benefits with the Offices of Judges of Compensation Claims within two years of the date of your injury.
The Judge of Compensation Claims will schedule a mediation conference within 40 days and notify all parties of the date of the conference. The conference must be held within 130 days of the filing of the petition. During this waiting period, you may be asked to submit additional evidence or undergo a medical exam.
At the mediation conference, a neutral third party (called the “mediator”) will try to help you and your employer and its insurance company reach a settlement agreement. If you cannot reach a settlement, a final hearing will be held within 90 days of the mediation conference.
At the final hearing, you and your employer (or its insurance company) will have an opportunity to present evidence and witness testimony. Expert testimony by your doctor, attesting to the extent of your injuries, can be especially helpful. The judge will issue a final decision within 30 days of the hearing. If you wish to appeal the judge’s decision, you must file an appeal with the First District Court of Appeals.
Do I Need a Workers’ Compensation Lawyer?
Hiring a Florida worker compensation lawyers is optional. You probably don't need to hire an attorney if your claim is accepted, and the insurance company is paying your benefits. However, you may need a lawyer if your claim is denied, if your permanent disability award seems low, or if you want to file an appeal. In most cases, it’s highly beneficial to hire a workers’ compensation lawyer for a final hearing or for an appeal to the District Court of Appeals. (For more information, see Do I Need a Lawyer to Get Workers’ Compensation Benefits?)