Workers Compensation in Florida

Workers Compensation Insurance In Florida

Most companies in Florida must provide the workers’ compensation insurance to their employees. Florida workers’ compensation laws guarantee to protect the employees and provide support in covering medical expenses and lost wages if they are injured at work.

About Workers’ Compensation Insurance In Florida

Florida Workers’ Compensation Law ensures that all the employees will be protected from lost wages, costs on medical bills, and other unexpected expenses associated with the injury at work.  Such insurance can also cover funeral costs and benefits to an employee’s family in the case of a worker’s death. 

 

Who Is Required To Carry Workers Comp Insurance?

In Florida, most employers must carry workers’ compensation insurance for their employees:

  • All businesses that have more than four employees. It does not matter whether a worker is a full time or part-time.
  • Construction businesses in Florida must carry such insurance for every employee.
  • A farmer must provide workers’ compensation insurance coverage if he has five regular workers and/or twelve seasonable workers that work for 30 days, but not more than a total of 45 days during a year.
  • Self-employed workers should also carry workers’ comp insurance.

 

There are some exceptions for corporate officers:

  • Sole proprietors and partners are not supposed to have the insurance.
  • Construction businesses can exempt up to three corporate officers only if they can show ownership at least 10% of the company.

 

 

 

What Is The Average Cost For Workers’ Compensation Insurance In Florida?

In Florida, the insurance rates are written by the state. The National Council on Compensation Insurance (NCCI) establishes the rates for Florida Workers’ Compensation insurance. There are factors that are important for calculations:

  • The state where the business is
  • Industry and work classification
  • Type of work the employees do
  • The gross payroll
  • Experience Modification Rate

 

Different types of jobs have a different level of risk. Based on the risk of injury every type of job has a special class code. Every worker’s comp insurance rate uses “payroll per $100”.

There is the formula to calculate the premium:

Workers’ Comp Premium = Payroll (per $100) * Classification Code Rate * Experience Modification Rate

 

What Are The Compensation Benefits?

There are three categories of benefits for workers who are injured at work:

  • Medical Benefits
  • Lost Wages and Other Monetary Compensation
  • Death Benefits

 

The Medical Benefits include:

  • Doctor’s visit
  • Hospitalization
  • Necessary transportation
  • Physical therapy
  • Medical tests
  • Prescription drugs
  • Prostheses
  • Attendant care

 

According to the workers’ compensation law, there are such disability types:

  • Temporary Total Disability (TTD) – cannot work
  • Temporary Partial Disability (TPD) – can return to work, but you cannot earn the same wages
  • Impairment Income Benefits (IIB) – at Maximum Medical Improvement
  • Permanent Total Disability (PTD) – can never work again

 

 

What are Death benefits under Florida workers’ compensation law?

In case of a serious accident leading to an employee’s death, his or her family will get the benefits. Under Florida workers’ compensation law, if the worker dies within one year from the accident or within five years of continuous disability, his family has the right to get:

  • up to $7,500 to cover funeral expenses
  • up to $150,000 in compensation benefits to dependents
  • education benefits to the surviving spouse.

 

What Is The Division of Worker’s Compensation?

In Florida, the Division of Worker’s Compensation is the main controller for ensuring that employees receive appropriate support according to the insurance. The Division does special inspections to know whether all the employers provide workers’ compensation insurance coverage for employees. The Division informs the participants about their rights and obligations.

 

Contact Information of The Division of Worker’s Compensation:

Address: 200 East Gaines Street, Tallahassee, FL 32399-4220.

 Email: Workers.CompService@myfloridacfo.com

Workers’ Compensation Claims: 1-800-342-1741

Workers’ Compensation Exemption/Compliance: 1-800-742-2214

For more information https://www.myfloridacfo.com/Division/WC/contactUs.htm

 

What are the penalties for not having workers’ comp in Florida?

If the business doesn’t have the required workers’ comp insurance, the Division can issue a Stop-Work Order (SWO). It means that the employer must stop all operations immediately until it complies with the law and pays a penalty. Such fee is usually equal to 1.5 times the amount which employer would have paid in premium for the previous three-year period. If a Stop-Work Order is violating, it may result in a penalty of $1,000 per day for each day from the time the order was issued. But if the employer refuses to obey the order it will mean the criminal charges.

Additionally, the employer can get such a Stop-Work Order if:

  • The employer understates payroll
  • The employer misrepresents or hides employee duties
  • The employer avoids paying workers’ compensation premiums.

 

What the employee must do after a workplace injury in Florida?

  1. Tell your employer you have been injured, as soon as possible. (according to the law it should be within 30 days)
  2. Ask your employer what doctor you should visit. Do not go to your private doctor for treatment! The doctor must be authorized by the insurance company.
  3. You should report the injury to the insurance company.
  4. An insurance claim adjuster calls you within 24 hours to explain your rights and obligations. (Sometimes they send a message with a phone number, so call it as soon as possible to get the information)
  5. Within 3-5 business days, after you and your employer report the accident, you should receive the information packet from the company. The packet can also include some documents which you should read, sign and return. So be very attentive.

 

What the employer must do after a workplace injury in Florida?

  1. Report about the injury to the insurance company within 7 days.
  2. Provide a copy of the injury report to the injured worker (Form DFS-F2-DWC-1).
  3. Report required wage information to the insurance company within 14 days of learning of an injury that will require the employee to miss work for more than 7 days or that results in a permanent impairment.
  4. If requesting the employee’s authorization for release of social security benefit information, give the Form DFS-F2-DWC-14 to the employee, submit the Request for Social Security Disability Benefit Information to the Social Security Administration office nearest to the employee’s address, and send a copy of the completed form to the Division within 14 days of the request (Form DFS-F2-DWC-14).

To get more information read the workers’ compensation System Guide

 

Workers’ Comp Settlements In Florida

When the insurance company doesn’t want to pay the benefits that the employee wants to get, the worker can file a Petition for Benefits with the Office of the Judges of Compensation Claims.  The Employee Assistance and Ombudsman Office (EAO) also can assist the employee in order to help with the workers’ compensation claim. The employees can file a workers’ compensation claim with the help of an attorney.

After the claim is settled the employee and his attorney calculate the total amount of expected expenses. Of course, it doesn’t mean that the insurance company will pay for all of that, but the employee’s attorney will insist on a number that satisfies both parties. In general, the settlement can be either a lump sum or a structured payment plan.  It happens that the employee can decide to go to trial. It’s always a risk for the employee to get even less than the insurance company was ready to pay.

During all these negotiations the employer should take an active role. It’s really important to be involved in that situation and always be ready to help the employee with some documents or information.  In such a way the employer will protect himself and try to avoid the trial.

 

What Are Limitations For Workers’ Compensation Claims In Florida?

A statute of limitation is a law that bans the claims after a certain period of time that passes after the injury.  Under Florida state law, the employer cannot claim benefits or receive any medical treatment:

  • If it passes more than two years from the date of the injury
  • If it passes one year from the date you last receive any medical treatment

 

In Florida there are some exceptions to the two-year statute of limitations:

  • If the injured worker is a minor
  • If the injured worker is mentally incompetent
  • If the worker was misled by the employer about coverage entitlement
  • If the insurance carrier did not properly inform the worker of his or her rights
  • There is no statute of limitations in Florida for care associated with medical prosthetic devices

 

Conclusion

All in all, employers and their employees should be well informed about their rights and obligations. Educating the employees about the workers’ comp insurance will help them to be prepared for unexpected situations in the future.

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