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How Do I Know if I’m Eligible for Workers’ Compensation?

How Do I Know if Im Eligible for Workers Compensation
How Do I Know if Im Eligible for Workers Compensation

Workers’ compensation benefits, which include payments for medical expenses and some lost earnings, may be available to you if you were harmed or fell ill as a result of your employment. Regardless of who was responsible for the harm, you are entitled to work injuries compensation as long as you are qualified. You give up your ability to sue your employer for work injury damages in return for this protection, with the exception of a few limited circumstances when you may litigate outside of the workers’ compensation system.

In this guide, we’ll take a look at how you can discover if you are eligible for damages after a workers’ compensation accident in Orlando, FL. You might be surprised by how many unique workplace accident scenarios will make you eligible for compensation in the state of Florida. That being said, there are some exceptions in which you would not be eligible.

How to Find Out if I Am Eligible for a Work Accident Compensation Claim

Workers’ compensation insurance can be very helpful for your recuperation and perhaps missed pay if you have been hurt at work in Florida. Consulting with an Orlando worker’s compensation attorney is unquestionably in your best interest since these benefits granted by workers’ compensation may cover more than you’d anticipate.

You almost certainly will be protected by Florida’s workers’ compensation insurance if you are an employee. These benefits were created with the express purpose of defending wounded workers from lost pay and financial hardship brought on by medical expenses associated with a work-related accident. However, there is a little catch: in order to get workers’ compensation, you often have to waive your right to sue your employer in any way. Employer and employee are both covered by workers’ compensation insurance under this provision. One of the key reasons to speak with your workers’ compensation lawyer is because of this important and significant topic. You and your attorney may determine that you need to file a lawsuit in order to obtain the money you need to recuperate and prosper financially if your workers’ compensation injuries are severe enough and may be the result of carelessness, faulty or poorly maintained equipment, etc.

Like vehicle insurance, etc., workers’ compensation is only another form of insurance. If you were hurt in an auto accident, it will usually cover what you would anticipate your auto insurance policy to cover. This could comprise, but is not restricted to:

  • Most medical expenses and services
  • Lost wages you might experience while you’re recovering
  • Prescription drugs that you could need
  • Job replacement benefits
  • Specialized medical gear to speed your recuperation
  • General income replacement while you are absent from work

How bad your injury is will have a significant impact on the kind and amount of benefits you receive. Therefore, you must decide with the help of your attorney if your injury left you with a temporary impairment, a partial impairment, or a permanent impairment that you could have to live with for the rest of your life. Simply said, from a legal standpoint, you most likely will receive workers’ compensation for your injuries; nevertheless, waiving your right to sue may result in irreparable loss to your future health, income, and the well-being of your family.

Requirements to File a Work Injury Compensation Claim

There are typically four prerequisites to qualify for workers’ compensation benefits:

  • You have to be employed.
  • Workers’ compensation insurance is required for your employer.
  • You must be suffering from a sickness or accident at work..
  • The deadlines in your state for disclosing the injury and submitting a workers’ compensation claim must be met.

Particularly types of employees, including domestic workers, seasonal workers, agricultural workers, and those hired by an employer through a staffing firm, are subject to unique regulations.

Let’s look more closely at the fundamental qualifying conditions and some of the unique regulations. Even though it is not required by law, many firms purchase workers’ compensation insurance. State regulations often provide these excluded firms the option to opt-in to the workers’ compensation system. In that situation, their workers may be eligible for benefits for workers’ compensation accidents, but they won’t be able to sue the company. Workers’ compensation insurance is often purchased by employers on the open market or, in certain jurisdictions, through a public fund. However, many major employers accept the financial risk for their employees’ workers’ compensation payouts, particularly state and municipal governments (known as self-insurance).

There is a separate workers’ compensation system for the federal government. If you work for the federal government, your benefits must come from their system rather than your state’s. Learn more about the workers’ compensation system under the federal government. Additionally, there are different guidelines under federal law for compensating wounded railroad personnel and marine workers.

In the end, you have to be an employee to be eligible for workers’ compensation. When it comes to qualifying for workers’ compensation, not all employees are workers. Independent contractors, such as freelancers, contractors, or anyone employed in the side-gig economy, often do not qualify for any workers’ compensation insurance in the state of Florida, as they are technically not employees. However, a lot of workers, notably drivers for Uber and Lyft, have been vocal about the fact that their status as independent contractors is egregiously incorrect and that their employers should have classified them as employees instead.

In order to get out of having to pay payroll taxes or workers’ compensation premiums, employers frequently identify employees as independent contractors. You can still be eligible for workers’ compensation as an employee even though you signed the 1099 tax form as an independent contractor. But a courtroom hearing for your issue is likely. Although state laws differ, courts often consider your level of control over your job and other aspects of your working relationship with the business or person who hired you.

There are some exceptions to the general rule that volunteers are not entitled to workers’ compensation payments. For instance, some states provide organizations the choice to insure their volunteers or expressly protect volunteer firefighters.

In addition, you should be mindful of when you file your work injury claim, as there are deadlines. If you wait more than thirty days to report the accident or injury, your claim may be rejected. As soon as your employer learns of the injury, but no later than seven days later, they must report it. After getting a notification from your employer, the insurance provider has three days to give you an informative pamphlet. The leaflet will outline your obligations and rights and offer further details on the workers’ compensation act.

Remember, if your employer won’t let you report the injury, you have the right to do so. We recommend that you speak with a workers’ compensation attorney for additional work injury advice.

Are There Any Exemptions for Companies Who Do Not Wish to Carry Workers’ Compensation Insurance?

If you are worried that your employer is exempt from carrying workers’ compensation insurance, there are some scenarios you should be aware of.

In the State of Florida, almost all businesses are required to have workers’ compensation insurance for their employees. A small percentage of workers are excused from having workers’ compensation plans, nevertheless.

Here are some instances of these:

  • Workers of businesses with less than four employees, except those in agriculture and construction. Please be aware that if a company employs even one person who performs construction or construction-related labor, they must obtain workers’ compensation insurance.
  • Workers in agricultural businesses with six or fewer full-time staff members or twelve or fewer seasonal workers.
  • Corporate officers are often free from carrying workers’ compensation insurance in non-construction enterprises. Additionally, construction businesses may exclude up to three corporate officials from carrying workers’ compensation insurance.

There are more, and your Florida workers’ compensation attorney will be able to tell you with certainty if any of these exclusions apply to you thanks to his in-depth knowledge of the issue. Receiving any benefits under Florida’s workers’ compensation rules shouldn’t be left to chance. Your Florida workers’ compensation attorney will see to it that you get what you legally and properly deserve.

What Do I Do if I Can’t Receive Work Accident Compensation Payouts or My Work Injury Claim Declined?

The whole cost of any required, reasonable medical care must be covered by your workers’ compensation insurance. Additionally, be aware that you are not required to make any co-payments for this service. Law forbids the medical professionals you utilize from charging you for any balances or overages you might accrue. Despite the fact that this practice, known as balance billing, is prohibited, the majority of employees are unaware of it.

By balance billing, a medical professional may try to charge you the difference between what the workers’ compensation insurance company has paid them and what they would typically charge a patient without insurance. This practice disregards the requirement that your employer’s workers’ compensation insurance covers 100% of your work-related medical expenses as set out in Florida’s workers’ compensation legislation.

To seek benefits that you feel are ripe due and owing if your Florida workers’ compensation claim has been denied, you must submit a petition for benefits to the Department of Administration Hearing Office of the Judge of Compensation Claims Division of Workers’ Compensation. An appointment for mediation, where you can meet with the insurance company and a mediator to help the parties try to reach an amicable resolution, will be made.

It should be remembered that even if the mediator is a lawyer, he or she is not your lawyer and instead represents both sides. The mediator’s main job is to help the parties communicate with one another. If the dispute cannot be settled through mediation, a judge may schedule a pretrial and a subsequent Merit Hearing during which the evidence will be examined and a Compensation Claims Judge will decide whether or not the benefits should have been granted or the refusal was proper. After the Workers’ Compensation Judge’s decision, a later appeal can be required in some cases.

A workers’ compensation attorney may help you prepare and submit a petition for benefits if your claim has been rejected, as well as represent you in any obligatory mediations and hearings before a judge of work injury damages claims. The lawyer can also respond to any inquiries you may have about workers’ compensation, including those about the denial, its legal foundations, and the evidence requirements and burden of proof you must satisfy before a judge.

Unsure If You Are Eligible for a Workers’ Compensation Injury Settlement? Sternberg | Forsythe, P.A. Can Help

You need experienced legal counsel if your employer or their insurance provider did not take your work-related injuries seriously or if your original application for Social Security Disability payments was denied. You must take immediate action for the benefit of your family, finances, health, and future. Additionally, you could be unclear about your workers’ compensation eligibility. In this case, a workers’ compensation attorney might be quite helpful. Sternberg | Forsythe, P.A.’s skilled attorneys have devoted their whole legal careers to defending the rights of injured workers. Our decades of combined experience with issues related to workers’ compensation can be of use to you.

Sternberg | Forsythe, P.A. assists people in Orlando, Florida who are employed by businesses or work as contract workers. Our full-service law firm only handles work injury damages cases due to our expertise in this field. As a result, we are aware of the various injury types, your right to choose your doctor, when to report an injury, the significance of hiring a skilled work injury attorney, the potential compensation you may be entitled to, and the justifications for reopening a case that has already been dismissed. To learn more about how we can help you with your workers’ compensation case, contact our professionals at 561-513-4376 right now. Contact Sternberg | Forsythe, P.A. as soon as you can to arrange a free first consultation.

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