Indemnity benefits:
- Temporary total disability. TTD is payment of lost wages at the rate of 66% of the worker’s average weekly wage. It can be paid for a total of two years only, but most times, an injured worker does not receive benefits that long because he/she is returned to work before two years has expired. Over the years, this benefit has been severely eroded. TTD is only paid to an injured worker if he/she has been taken out of work completely. Unfortunately, doctors more and more are returning the injured back to work with some type of restriction, soon after the accident. We commonly see people with broken arms or broken legs or feet, returned to work one or two weeks after their injury. The person with a broken arm is returned to work with no use of the right arm. The person with the broken leg is returned to work sitting down only. Of course most employers are not able or willing to accommodate workers with a cast on, so if the employer does not have work within these restrictions, the insurance carrier is obligated to pay, but at a reduced rate.
- Temporary partial disability. TPD is payment of lost wages also, but at a lower rate. Also, if a worker is returned to work but not earning 80% of the average weekly wage, the insurance will pay a percentage of the lost wage. For example, if your AWW is $300 but you are earning less than $240 per week, you will be entitled to a check from the employer for the hours worked, and a check from the insurance company for a percentage of the difference.
- Impairment benefits. IBs are paid if and when you receive an impairment rating for your injury. In general, the higher the rating, the more checks you will receive. This benefit is also based on your AWW, so the lower paid or part-timers will receive less money for their herniated disc than a high earning individual.
- Medical benefits. An injured worker is entitled to medical treatment that is medically reasonable and appropriate, and causally related to the industrial injury. This is one of the most common benefits that is fought about in the workers’ compensation arena. When a medical procedure is costly, it is more likely to be denied by the insurance company.
Common Benefits:
Surgery is denied regularly, or at the very least, the insurance company will request a second opinion in attempts to deny the procedure. Unfortunately, even lower cost items are being denied, or simply not authorized in a timely manner, and are then subject to litigation. In the past year, some of the medical benefits that we have had to fight for:
- Medication;
- transportation;
- mileage;
- MRI of the knee;
- stellate ganglion blocks;
- lumbar fusion ( multiple fights);
- facet injections; and many more.
Common Questions:
- Why should I hire a lawyer? Not every injured worker needs a lawyer. If you have minor injuries, or you are receiving all of your entitled benefits, then you might not need one. Unfortunately, though, in many cases people are being deprived benefits and they do not even know it, because they do not know their rights under the law. For example, a worker receives an impairment rating of 5%. Sometimes they do not even know it, but the insurance company does. That rating should be followed by ten weeks of Impairment benefits, but the worker doesn’t know he received the rating, or doesn’t know it entitles him to benefits. The insurance adjuster knows, but does not always pay these checks. There are many other benefits that are either overlooked or denied by the adjuster. Let us help so that you are not taken advantage of.
- Is it illegal to fire me if I am hurt? It is illegal to fire an employee because of a workers’ compensation injury. However, Florida is an at will state, meaning an employer can fire you for almost any reason that is non-discriminatory. Unfortunately, when a person is injured, they are usually not as valuable to the employer, and a favored employee is no longer treated the same. The employer may become “nitpicky” and at times, harass the injured worker. This may ultimately lead to termination.
- How long do I have to report my injury? Sometimes an employer may write you up or punish you for not reporting the accident immediately, but the statute usually allows thirty days from the date of accident. To be safe, you should report your accident immediately to your employer to a supervisor or manager.
- Do I have to use a “company doctor”? Unfortunately, you do have to use a doctor on the insurance company’s list. There are few exceptions to this rule. You do have the right to an independent doctor to evaluate you, but if they are not on the insurance company’s list, they probably will not be able to treat you. Because the insurance companies are trying to save money, the often select doctors who will favor them, not you. If you are given the choice of doctors, we will select one for you who will treat you fairly.
- Can I receive long term disability benefits at the same time I receive lost wages from workers’ compensation? This is a complicated question and will often require us to review your disability policy. If you have disability insurance, you should bring it to us right away so that we can review the benefits that are provided by your carrier.
- Am I entitled to pain and suffering damages? Unfortunately no. Over the years we have represented thousands of injured workers, some of whom have suffered catastrophic injuries. No matter what type of injury you have, though, pain and suffering damages are not provided by the workers’ compensation law. The exception to this rule is when a third party, that is someone or some entity separate from your workplace or co-workers, causes your injury. If you have questions regarding this subject, you should speak to us about it.
- The insurance company offered me a reasonable settlement, why shouldn’t I just accept it? You should never settle and release your case until you first speak to a Bartow Workers Compensation lawyer. We have experience in workers’ compensation cases and are in a better position than you to determine the value of the case. Insurance adjusters are also very familiar with the law and case values, and may take advantage of you if you are not represented. It would be like buying a car with no research and no advertisements and no basis to determine the value of the car. Some car salesmen will treat you right and tell you the real price of the car, but others may try to use their knowledge and your lack of knowledge to their advantage. Have you even read your medical records? The insurance adjuster has read them.
When your loved one has been the victim of a work related accident or incident, you should seek the legal advice and representation of an experienced Bartow workers compensation attorney or lawyer as soon as possible. The longer you wait to obtain legal representation, it may directly affect your ability to achieve a successful outcome. Contact the law offices of Lopez & Humphries, P.A., today by calling us.