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Filing a Claim for Workers' Comp Benefits

How to File a Workers’ Compensation Claim

The majority of workers in Florida have recourse to workers’ compensation benefits if they are hurt on the job. Unfortunately, filing a workers’ compensation claim can be a complicated process.

The workers’ compensation system is governed by a number of complex rules. In addition, employers and their insurers have an interest in paying as little as possible on workers’ claims.

An experienced workers’ compensation attorney in Orlando can protect your rights and advise you how to proceed with your claim. The first step in being fairly compensated for a workplace injury is to file the claim properly:

1. Seek Medical Attention

If you are seriously injured on the job, you should not hesitate to get medical care. Call 911 or go to the closest emergency room to get immediate treatment for your work injury.

Workers’ compensation law in Florida gives employers and insurance companies the right to specify the physician workers have to see in the event of an injury. However, this rule does not apply in an emergency situation.

2. Report the Injury to Your Employer

The Florida Division of Workers’ Compensation requires workers to report an injury to their employer within 30 days. For occupational illnesses and conditions that develop over time, you must report the injury to your employer within 30 days of “the date the doctor says you are suffering from a work-related injury.”

Provide the following information when reporting the accident, injury, or illness to your employer:

  • The date your injury occurred
  • The nature of your injury
  • How the injury affects you, including the ability to do your job

If you do not report the injury or illness within 30 days, your workers’ compensation claim may be denied.

After you report the injury, your employer has 7 days to notify its insurance company. In the event that your employer fails to report the injury to the insurer, you can contact the company directly. (Your employer should have information for the insurance carrier posted in the workplace.)

3. Insurance Company Review

Once you report the accident and your employer notifies its insurance company, the insurer will review the case to determine your eligibility for workers’ compensation benefits. The insurance company will send you a brochure outlining your rights and responsibilities under workers’ comp.

The insurance company must review your claim promptly. If your claim is approved, the insurance company will advise you of the physician who is authorized to provide care and treatment for your injury. Your employer’s insurance company will receive and pay bills for authorized medical care.

If you qualify for wage replacement benefits, you will begin receiving payments 7 days after you are determined to be disabled. Depending on the nature and extent of your disability, you may qualify for additional benefits.

What If My Workers’ Compensation Claim Is Denied?

If your workers’ compensation claim is denied, you should consider contacting a workers’ compensation attorney in Orlando. A knowledgeable work injury lawyer can review your case and advise you of your options for pursuing the benefits you deserve.

The first step of appealing a workers’ compensation claim in Florida involves filing a Petition for Benefits with the Office of Judges of Compensation Claims. Your attorney can assist you with completing and filing the petition.

Information that needs to be provided in the Petition for Benefits includes:

  • Your job duties
  • How you sustained your injury on the job
  • The injury or condition you have sustained, as well as the nature of the disability you are experiencing
  • Your average weekly wages
  • The benefits you are due, including:
    • Temporary Total Disability benefits
    • Temporary Partial Disability benefits
    • Permanent Impairment benefits
    • Permanent Total benefits

The insurance company has 120 days (approximately 4 months) to begin paying benefits or issue a response that describes why it denied coverage of your injuries. If the insurer disputes your claim, the judge handling the case will hold mediation proceedings in an effort to resolve the matter.

In the event that the judge does not make a determination in your favor, you have the option to request an administrative hearing. If this hearing does not result in a favorable outcome, you can file an appeal.

What If My Workers’ Compensation Benefits Are Insufficient for My Injuries?

Sometimes workers’ compensation claims are approved, but the benefits do not adequately compensate the injured worker. You may also be entitled to additional benefits that were not awarded in your initial claim.

If you are facing either of these situations, you can pursue the benefits you deserve through the appeal process described above. An experienced workers’ compensation attorney in Orlando can help identify underpaid or unpaid benefits and file a petition to pursue the full compensation you deserve for your work injury.

Contact a Workers’ Compensation Attorney in Orlando, FL

The attorneys at Colling Gilbert Wright have extensive experience helping injured workers recover the benefits and compensation they deserve. In addition to workers’ comp, you may also be able to file a personal injury claim for damages caused by one or more negligent parties.

Please call (407) 712-7300 today to speak to a workers’ compensation attorney in Orlando, Florida. Your initial consultation is free.

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