No-Fault: Florida Workers Compensation, And What No-Fault Actually Means
Unlike personal injury claims, the Florida Workers’ Compensation system is a no-fault law. The law attempts to provide medical and lost wage benefits in a quick and efficient manner. An injured worker does not need to prove that the employer’s actions (negligence) were responsible for the injury. Generally, an employer with four or more employees in Florida must purchase a Workers’ Compensation insurance policy (1 or more in the construction industry). The employer is required to provide medical and lost wage benefits through the insurance policy. An injured worker in Florida does not need to demonstrate that someone else caused the accident and/or injury. There is “No-fault” assessed in the Florida Workers Compensation system.
WHY IS THERE A NO-FAULT FLORIDA WORKERS’ COMPENSATION LAW?
The Florida Workers’ Compensation law leads to two distinct results: 1) Because it’s a no-fault system, an employee cannot sue the employer in tort. In other words, an employee cannot sue the employer for negligence, alleging the employer caused his/her injuries/accident. It protects the employer from lawsuits and in effect, protects the injured worker. 2) The Florida Workers Compensation law ensures that the employee does not have to prove that someone else caused the injurious accident. The system is set up to disperse medical and lost wage benefits quickly without any litigation. An employer does not have the right to dispute your accident arguing that the injured worker was at fault. In Fl
Does this always prove true?
Absolutely not. Many times, medical and lost wage benefits are delayed due to inaction on the part of the Florida Workers Compensation insurance company.
WHAT DO I NEED TO PROVE?
All you have to “prove” is that you were an employee, injured while in the course and scope of employment. In Florida Workers’ Compensation-there is a requirement of an employee-employer relationship and an accident that occurs while you are discharging duties of your employment. You do not need to prove that someone owed a duty, breached the duty and ultimately caused your accident/injuries. The basic tenet of a no-fault system is that liability is taken out of the analysis.
An injured worker in Florida must report the accident to his supervisor/employer within 30 days of the accident. The employer will accept the claim so long as the injured worker was injured while working, during business hours. If the injured worker doesn’t report the accident within 30 days, benefits are forever barred, subject to a few exceptions.
WHAT DOES THE LAW PROVIDE ME?
Generally, the Florida Workers Compensation employer must secure Workers’ compensation insurance that provides injured workers lost wages and medical benefits that result from a work-related accident. You will not have to pay for any authorized medical treatment and/or time off from work. An injured worker in Florida will not have to reimburse the carrier at the time of settlement for any medical expenses paid throughout the lifetime of the Florida Workers’ Compensation claim. There are no Letters of Protection in Florida Workers’ Compensation. If the carrier accepts your claim, they will pay for treatment, and lost wages for the time you miss from work (if the authorized doctor places you on restrictions and/or takes you out of work).
The insurance company may also provide rehabilitation benefits, vocational training, medical bill reimbursement, permanent disability benefits, etc.
CAN THE INSURANCE COMPANY STILL DENY MY CLAIM EVEN THOUGH THE SYSTEM IS NO-FAULT?
Sadly, yes, the carrier has the right to deny your Florida Workers’ Compensation claim. However, keep in mind, the insurance company CANNOT deny the claim because they believe the injured worker was at fault. The insurance company simply cannot place the blame on the injured worker, unless the injured worker attacked a co-worker/someone who worked at the same employer. An employer need not furnish benefits if the employee engaged in “horseplay” and provoked/attacked a co-worker.
If you were injured while working your normal duties during business hours, you’ll generally qualify for Florida Workers’ Compensation benefits. The Insurance carrier CAN deny your claim if you were driving home or driving to work subject to numerous exceptions. This is known as the “Going and Coming Rule”. If you’re going to or coming home from work, you are no longer eligible for Workers’ Compensation benefits in Florida.
CAN THE JUDGE AND/OR JURY AWARD ME A VERDICT/SETTLEMENT?
No. In Florida, Workers’ Compensation law is no-fault and administrative in nature. There is no jury in a Florida Workers’ Compensation case. There are no jury trials. You/your attorney file Petitions for Benefits. These “Petitions” are requests for benefits (lost wages, rehabilitative benefits, medical benefits, etc). The Judge of Compensation Claims has the power to administer these benefits and rule on the Petitions for Benefits. The Judge of Compensation Claims has no jurisdiction/power to award a verdict or lump-sum settlement. The Judge does have the authority and must approve a lump-sum settlement between the employer and employee, in order for the settlement to be binding. However, the Judge of Compensation claims cannot settle your case or award you a settlement.
If the insurance company denies your Petition for Benefits, you have the option of litigating the Petition at a Final Hearing in front of the Judge. The Judge has jurisdiction to award medical and lost wage benefits at the Final Hearing. The Judge of Compensation Claims will enter an order either granting/denying the benefits requested in the Petition for Benefits. Your claim may not end after the Final Hearing if it’s solely based on one or more narrow issues not directly impacting the overall case/claim.
HIRE AN EXPERIENCED FLORIDA WORKERS COMPENSATION ATTORNEY
The Florida Workers’ Compensation attorneys at LaBovick Law Group are aggressive and are warriors for justice. It’s crucial to have LaBovick Law Group on your side to ensure Workers’ Compensation benefits are paid without delay. Without an attorney, the insurance company may delay payment of essential lost wages and medically necessary treatment. If you were injured on the job, call LaBovick Law Group immediately!
