What Exactly Is Workers Comp Law In Florida And What Are An Employee’s Rights?
Florida Workers’ Compensation Law is governed by Chapter 440 of the Florida Statutes. Under Chapter 440, when workers are injured on the job in the course and scope of their employment, they are entitled to two distinct categories of benefits. When the injured worker misses time and they are out of work for more than a week, they are eligible for indemnity benefits. Indemnity benefits are monetary benefits that are intended to replace the injured worker’s wages they missed during the recuperation or rehabilitation from their injury. Indemnity benefits are specifically broken down into four different types. Temporary total disability (TTD) benefits are payable when the injured worker is unable to work at all and is calculated by first determining the injured worker’s average weekly wage using the average pay for the 13 weeks immediately preceding the date of their accident (AWW). The injured worker is then paid 66 2/3% of that amount for the duration of their recovery or 104 weeks, whichever comes first.
When the injured worker is able to do some work, working at a reduced capacity or working fewer hours but making less money than they did before their injury, they are eligible for temporary partial disability benefits (TPD). TPD benefits use the same AWW calculation and they are equal to 80% of the difference between the 80% of their average weekly wage (AWW) and their actual earnings.
Once the injured worker reaches a point of maximum medical improvement, that is a plateau in their recovery where reasonable medical improvement is not anticipated, their physician is supposed to identify any permanent impairments. Those permanent impairments are assigned a percentage impairment of the individual’s body as a whole and the Employer and their insurance carrier are obligated to pay these impairment benefits at a weekly rate based on the percentage of impairment. The higher the percentage of impairment the greater the number of weeks of impairment benefits.
The fourth and final type of indemnity benefit is when the injured worker’s injuries are of such severity that they are unable to return to work in any capacity. They are eligible for permanent and total disability benefits. Permanent total disability benefits come with the requirement that the injured worker demonstrates that, not only can they not do the work they used to do, but they also cannot do any other jobs within a specific area in relation to the location of their previous employment. Permanent total disability benefits pay the same as temporary total disability, 66 2/3% of their average wage for a minimum of 5 years or until the injured worker reaches the age of 75, whichever is longer.
Perhaps more importantly than indemnity benefits, the injured worker is entitled to medical care for any injuries sustained in the course and scope of their employment. What is important to understand is that the injuries not only have to be sustained in the course and scope, but the accident that happened on the job has to be determined to be the major contributing cause of their need for treatment as demonstrated by medical evidence.
This medical treatment is provided at no cost to the injured worker, but it would be a gross misstatement to say that this happens routinely. The major contributing cause standard that exists currently in Florida makes medical treatment for many conditions very difficult to be covered under the workers’ compensation system, especially those that might also involve an age-related or a degenerative condition. This gives an incentive to the insurance company to find a way to deny those claims. They often assert that an injury may have been temporarily aggravated on the job, but the underlying major contributing cause is some other degenerative or age-related condition.
Those two benefits, medical and indemnity benefits, are the only things guaranteed to an injured worker under the current statutory scheme. However, the vast majority and well into the 90% of the time, an injured worker has the option to resolve their case via a washout settlement.
Unlike a personal injury where a benefit or an amount of damages is calculated based on predictions of future costs, workers compensation cases have no obligation by the carrier or the injured worker to ever settle the case. Often times, both parties enter voluntarily into an agreement to resolve the future obligation of the insurance company and the future right to receive benefits by the injured worker. Therefore, they enter into a settlement agreement that accounts for an estimate of the future medical and indemnity benefits.
It is important to note that workers compensation cases do not contain any consideration for the non-economic damages as in personal injury. There is no pain and suffering, no loss of consortium with the spouse, or loss of enjoyment of life, or loss of future earning capacity. Those are not available to the injured worker because the basic premise of workers’ compensation is that an injured worker is entitled to benefits in the absence of a determination of fault and simply because they were working in the course and scope of their employment.
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