Florida Worker Injury: Workers Comp Claims and Appeals

If you are injured on the job in Florida, or sustain an occupational disease or illness as a result of your employment in Florida, you likely have a Florida workers’ compensation claim.

With some exceptions, if your employer in Florida has four or more employees, your employer is required by law to carry workers’ compensation coverage for you. And if you work in construction, your employer must have workers’ compensation coverage regardless of the number of employees. To verify whether your employer has workers’ compensation coverage, you can contact the Florida Employee Assistance and Ombudsman Office at (800) 342-1741.

Work-Related Injuries and Illnesses

Employees that sustain an injury "arising out of and in the course of employment," or a disease or infection as a result of a work-related injury, have a workers’ compensation claim in Florida.

The injury or illness must occur within the scope of your employment. This means that injuries occurring during commuting, in the parking lot, and during non-work related activities usually will not amount to a workers’ compensation claim.

Typical industrial injuries include back strains/sprains, knee injuries, elbow injuries, shoulder injuries, and the like. Occupational illnesses can include anything from toxic exposures over a long period of time to conditions such as carpal tunnel syndrome.

How Do I Report a Possible 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 your employer’s workers’ compensation 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 obtain the required forms from the Employee Assistance Office of the Florida Department of Workers’ Compensation.

Florida Workers’ Compensation Benefits

If your workers’ compensation claim is allowed, you will be eligible for workers’ compensation benefits. These benefits include medical benefits, compensation for lost wages, and compensation for permanent partial or total disability.

Your employer is required to pay for medical treatment necessary to treat your condition(s) related to your workplace injury or occupational disease. This includes doctor’s visits, physical therapy, hospital visits, prescription medication, and diagnostic tests.

Your employer must authorize the doctor treating you for your workplace injuries or occupational disease.

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, at a minimum, 66 2/3% of your regular wages at the time of injury. The amount of these benefits depends on how long you are disabled and the severity of your injuries.

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.

Once your doctor finds that your condition is fixed and stable, and you are at maximum medical improvement (meaning that your doctor doesn't think that further treatment will improve your condition), you will be eligible for other workers’ compensation benefits. These include permanent partial disability benefits to compensate for any permanent bodily impairment as a result of your workplace injury or occupational disease, or permanent total disability (lifetime pension) benefits.

Appealing a Florida Workers' Compensation Denial

When you want to dispute a decision on your claim for workers' comp benefits, you must file a petition with the Florida Division of Administration Hearings. The Judge of Compensation Claims, an administrative judge, then schedules a mediation conference within 40 days of the filing and notifies 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.

A pretrial hearing is scheduled prior to the Final Hearing, and during this pretrial hearing, mediation is encouraged. If you and your employer, or its insurance company, cannot reach a settlement during this period, the final hearing must be held within 90 days of the mediation conference. You are allowed to present evidence and expert testimony, as is your employer or its insurance company. The judge will then issue a final decision within 30 days of the hearing. If you wish to appeal the judge’s decision, you then must file an appeal with the First District Court of Appeals. (Learn more about the Workers Comp Appeals Process in Florida)

Hiring a Workers Compensation Lawyer

Hiring a Florida worker compensation lawyers is optional. You probably don't need to hire an attorney to fill out the forms and to ensure you are complying with all rules regarding obtaining medical exams and treatments. But if you are denied benefits, you are offered a permanent disability award that seems low, or you want to file an appeal, you should hire a workers' comp attorney to assist you.

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