You suffered an injury at work. However, your employer and its insurance company refuse to pay the workers’ comp benefits that you believe you deserve. What can you do next?
Under Florida law, you can file a workers’ compensation claim that is called a Petition for Workers’ Compensation Benefits.
The law firm of Frank M. Eidson, P.A., is available to help you to file this form and aggressively seek the benefits you are due. We offer decades of experience in this area of the law to clients in Orlando, Winter Park and throughout Florida. Simply call or reach us online today to get started.
We present the following to help you understand what is involved in the Florida workers’ compensation claims process.
How The Workers’ Compensation Claim Process Works
1. Make sure you reported your injury to your employer.
If you fail to report your injury to your employer within 30 days after you know you have suffered a job-related injury, your workers’ compensation claim can be barred. Hopefully, you have already taken this mandatory step. If not, make sure you report the injury right away.
The report can be oral or in writing. Check to see if your employer has a special procedure for reporting workplace injuries.
2. Try to resolve the dispute before you file the Petition.
After you reported your injury to your employer, you should have received a copy of the First Report of Injury or Illness that your employer filed with its insurance company (or “carrier”) as well as a brochure explaining your rights.
If you qualify for benefits, you should have started to receive bi-weekly checks (every two weeks) in the mail 21 days after you reported your injury.
If you have not received any checks or correspondence from the insurer, or if a dispute has arisen concerning your workers’ compensation benefits, you should try to resolve it first by discussing it with your employer and/or its carrier. Florida law actually requires you to make this “good faith effort” to resolve the dispute.
You may want to call the Florida Employee Assistance and Ombudsman Office (EAO) for guidance on how to resolve the dispute without the need to file a Petition. The hotline is (800) 342-1741, and the e-mail address is email@example.com. You can find a local EAO office here.
Also, if you are dissatisfied with the medical benefits being provided to you – for example, the carrier refuses to cover treatment by a specialist – you may need to go through a “managed care grievance procedure” before you file a Petition.
Generally, the grievance process starts by filing a written grievance form that is provided by the workers’ compensation carrier. This grievance form provided by Summit Holdings is an example of such a form. Make a copy of the grievance form you submit and any other documents you receive during the grievance process.
3. Contact an attorney for help before you file a Petition.
If your efforts to resolve the dispute have been fruitless, your next step is to go forward with filing a Petition. You can see what the Petition looks like here.
You are not required to hire an attorney to help you to file the Petition or to represent you in the claims process. However, you will benefit greatly by doing so.
Keep in mind: A law firm such as Frank M. Eidson, P.A., has a thorough understanding of how to file a Petition and has done so for thousands of clients throughout Florida. We will not charge you for simply coming into the office to receive a consultation about your case. Also, we won’t charge for our legal services unless we obtain the benefits you are seeking.
4. Carefully fill out the Petition.
The Petition requires you to provide a good deal of information, including:
- Contact information for you, your employer and its workers’ compensation carrier
- Summary of your job responsibilities and what you were specifically doing on the date your injury arose
- Detailed description of the accident and a listing of body parts injured
- Listing of all medical, lost-wage and other benefits you claim are “due, ripe and owing” to you, including the rates and dates of denied coverage
- Claim for interest/penalties on unpaid benefits and a claim for attorney fees and costs.
If you fail to provide required information, your claim could be dismissed. Even though you can file another Petition, you may risk missing an important deadline. You have only two years from the date of your injury in which to file the Petition.
This is a major reason why you would benefit from working with a lawyer who knows how to properly file a Petition.
5. File and serve the Petition.
You must make sure the Petition is filed with the Office of the Judges of Compensation Claims (OJCC) Clerk’s Office. If you are represented by a lawyer, he or she will file the Petition using the OJCC’s electronic filing system. If you are not represented by lawyer, you can file the Petition at 1180 Apalachee Parkway, Suite A, Tallahassee, FL 32301-4574, or by fax at (850) 487-0724.
You must also serve a copy of the Petition by certified mail on your employer and the employer’s workers’ compensation carrier (and, if known, the attorney(s) for the employer/carrier).
6. Be prepared to go through mediation and, if needed, a hearing.
Within 130 days after you file the Petition, mediation will likely be held in your case. (In some cases, mediation is not ordered, and a case goes straight to a final hearing.)
Mediation is an informal process. It is aimed at reaching an agreement about benefits between you and your employer (and its workers’ compensation insurer).
If no agreement (or settlement) can be reached through mediation, your case will go to a pre-trial hearing. Then, you will go to a final hearing before a Judge of Compensation Claims (JCC).
At the hearing, you should expect to put on evidence about how your injury occurred, the nature and extent of your injury and how it has kept you from working (or working at the same job you had before). Both you and your employer/carrier may present medical experts as witnesses.
7. If you don’t agree with the decision, you can file an appeal.
Within 30 days after the final hearing, the JCC will issue a decision. If you disagree with this decision, you (and your lawyer) can file an appeal with the First District Court of Appeal within 30 days of the decision.
The appellate court will affirm the JCC’s decision, reverse it or send it back to the JCC for more proceedings.
Contact an Orlando Workers’ Compensation Lawyer Today
As you can see, there is much involved with filing a claim for workers’ compensation benefits in Florida. An attorney’s skill, experience and guidance can be an invaluable asset as you seek the benefits you rightfully deserve.
Don’t wait to get legal help. If you are an injured worker in Orlando, Winter Park or elsewhere in Florida, contact attorney Frank M. Eidson as early in the process as possible. He will be involved in your case from start to finish, helping you to identify and overcome any obstacles you may face in your claim.
Schedule your free consultation by calling or connecting with us online today.