Breaking Down Workers’ Compensation: The Roles of Victim and Attorney

 In Blog, Workers' Compensation

Accidents happen especially in the workplace which is why workers’ compensation insurance is required for employers to purchase this coverage. This coverage helps replace lost wages of employees who have had a job-related injury or illness.

The Basics of Workers’ Compensation

Workers’ compensation can help cover lost wages, medical expenses, therapy costs, legal fees, and in some cases covers a permanent disability that keeps the injured party from returning to work or even the funeral cost of job-related deaths. On top of those covered costs, the insurer will pay two-thirds of the average weekly wage. Businesses are required to purchase this coverage if they meet the guidelines:

  • Construction companies with at least one employee*
  • Non-construction business with at least four workers*
  • Agriculture companies with at least six employees or 12 temporary employees who work more than 30 but less than 45 days in a calendar year
  • Out-of-state employers with workers in FL
  • Contractors also need to make sure they have workers’ compensation for any self-employed or independent contractors by the start of the project

*Corporate Officers and LLC members account as employees

Starting Your Claim Off Right

Once injured, timing is everything with a workers’ compensation claim with the injured party needing to report it to their employer within 30 days of the initial date of the injury. After 30 days, there is a higher chance your claim will be denied. Failure to advise the employer shall bar a petition unless:

  • The employer had actual knowledge of the injury
  • The cause of the injury could not be identified without a medical opinion and the injured party informed the employer within 30 days of the diagnosis
  • The employer did not put its employees on notice of the requirements by posting notice pursuant to s. 440.005
  • Exceptional circumstances

When filing your report be sure to include where the accident occurred, if there were any witnesses, the date/time it occurred, and what caused the injury or illness. It is important to not downplay any work-related injury, some of the most common types of injuries that are seen with workers’ comp claims are broken bones, traumatic brain injuries, spinal cord injuries, muscular injuries, head injuries, hearing loss/damage, chemical exposures, and electrocution injuries. All of these are severe so report your injury immediately and follow the next steps of your employer.

When To Hire a Workers’ Comp Attorney

Injured person in an attorney's office getting advice
There are plenty of obstacles to dodge when filing a workers’ comp claim and when fighting it alone, it can be intimidating. While businesses are required to have this insurance and you have the right to these benefits, not all employers or even insurance companies have the compassion to make this easy for you. A few situations where an employer or insurance company can try to deny your claim can include:

  • Employer states the accident did not happen on the job
  • Permanent disabilities are likely to be disputed by insurance due to cost
  • Employer is stalling your claim
  • The insurance claims your injury is non-compensable
  • The insurance claims you suffer from a pre-existing condition
  • The insurance claims you lack the necessary supporting documentation

This is when a workers’ comp attorney comes in. With a full understanding of the full extent of how your injury can affect your daily life, income, and even mental health. With so many potential factors that can hurt your compensation claim, a qualified attorney is equipped with the knowledge and resources to assist victims in getting the claim they deserve.

They will passionately advocate for you, present evidence and details that prove your work-related injury, can protect your rights to your claim, aid in proving your right to any disability or partial disability benefits, offer assistance in any retaliation efforts made by insurance or employer and can help you appeal a benefits denial. In addition, a workers’ comp attorney can aid by submitting your petition for benefits and ensuring all necessary information is included and if your claim leads to a hearing or trial, they are ready to fight for you.

Workers’ comp attorneys are also great for opening the lines of communication and understanding and are ready to ensure you are aware of what is happening with your claim. Asking questions and voicing concerns is always an option. Here are some frequently asked questions of workers’ comp attorneys:

1. When will I receive my first check?
a. Within the first 21 days.
2. Do I have to pay income tax on this money?
a. No, unless you go back to light or limited duty approved by an authorized doctor. Those working hours will be taxed.
3. If I am unable to go back to work due to Doctor’s orders, will my job be held for me?
a. No, your employer is not legally required to hold your position.
4. What can I do if I have received my benefit check?
a. Call the insurance company and ask for your claim representative immediately.
5. Can I receive social security benefits or reemployment assistance at the same time as workers’ compensation?
a. You can receive social security benefits but a reduction to your check may be applied. You cannot receive reemployment assistance.
6. Can I be fired if I am unable to work because of my injury?
a. No, it is against the law after a workers’ compensation claim is filed.

If you or a loved one had a work-related injury and are having trouble navigating the process or find yourself reaching multiple roadblocks, contact us today at Gechtman Law. We are ready and armed with the passion and experience to help fight for your rights and the benefits you deserve from work-related injuries or illness.

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