Almost all forms of employment come with some risk of injury, with some industries being more dangerous than others. In an effort to protect workers everywhere, the US government has made it mandatory for almost all employers to have workers' compensation benefits for their employees.
However, the nuances of workers' comp are more complex than it seems. Several factors can affect how much financial compensation you get if you get injured at your place of work, and there are cases wherein your claim may even get thrown out. Instead of navigating the legal process on your own, it's imperative that you hire an experienced workers comp lawyer to guide you throughout the process.
Workers' Compensation refers to a set of benefits mandated by the government to protect employees in the event that they suffer a workplace injury. This is a kind of insurance policy that pays out monetary compensation to employees to cover medical bills and other injury-related expenses.
This type of insurance also protects employers from lawsuits. Once a worker decides to accept and make use of their workers' compensation benefits, they are no longer allowed to file a claim against their employer. However, there are exemptions to this rule, and usually, your workers' compensation attorney will let you know if your case falls under these special circumstances.
Before we get down to estimating how much your workers' comp claim is worth, let's first establish the validity of your claim. In a sense, workers' comp is a type of "no fault" insurance, meaning it assumes that getting a work-related injury is a natural by-product of employment and that employees should be compensated for it regardless of who is at fault. However, not all workplace injuries are eligible for workers comp settlements. For your claim to be considered valid, it has to satisfy the following conditions:
Your Employer Must Have Workers' Comp
While almost all employers are required to provide this benefit to their employees, the state of Florida does allow for exemptions. A company can be exempt from workers compensation if they are a non-construction industry with less than 4 employees. Certain businesses in the construction industry can also be exempt from this if their employees are contractors or work "as needed" or on a project-to-project basis.
You Must Be An Employee of the Company
For your claim to be valid, you must present proof that you are indeed an employee of the company. To protect yourself from future problems, make sure you are designated as an employee in all company books and documents. Just because you are working for a company doesn't mean your employer sees you as an employee. A lot of shady employers purposely write people down as "contractors" in order to avoid workers comp. Nowadays, some insurance companies offer insurance policies that include contractors, so make sure you're aware of what kind of policy your company carries.
It is a Workplace Accident
Injured workers must prove that their injuries sustained while they were at their place of employment, or performing a job-related task. If for example, you were injured while operating machinery as part of your work duties, you are eligible for this type of compensation. However, if you decided to use the company vehicle to run a personal errand if you get into a car accident while on that personal errand, your employer may contest your claim because it is not work-related.
Criteria For Disqualification
As stated earlier, not all injuries are considered work-related, and there are situations wherein your workers compensation claim may get thrown out entirely. Here are some instances where an employee can be disqualified from receiving their comp benefits:
Aside from these criteria, another common reason why a lot of claims get thrown out is that they are filed outside the statute of limitations. According to workers' compensation laws, employees file a claim within 2 years from the date of injury. If you think 2 years is a long time, you'd be surprised to discover that a lot of employees attempt to file a claim beyond the statute of limitation. Usually, these employees were ill-informed by their employers that they were not eligible for comp benefits, or were manipulated into receiving a sum of money to get treated and move on from the incident.
Here are some factors that influence how much financial compensation you can get out of your comp benefits:
The Extent of Injuries
The amount of money awarded to you will depend on the type of injury and its severity. Typically, the more body parts involved, the higher the amount of money awarded to you. You also get more money if the injury is in vital parts of your body, such as a traumatic brain injury or rib fractures. The longer your hospital stay, the more benefits you will receive.
Comparative Negligence
Although workers comp is a "no fault" insurance, insurance companies do take into account your contribution to the accident. For example, if you are completely innocent and your employer's negligence was the cause of your injuries, you can get the maximum compensation you deserve. However, if you are also partly responsible for the accident, this may lessen the amount you can receive.
Employer's Insurance Policy
How much monetary compensation you receive will depend on your employer's policy limits. As of January 2021, the minimum compensation rate is $20 per week, and the maximum is $1,011 per week. This will all depend on the type of worker's comp insurance your employer has and the number of premiums paid by your employer.
The goal of workers compensation benefits is to ensure that employers can fully recover from work-related injuries without worrying about medical costs and that they receive the best medical care possible so they can return to work quickly and healthily. Here are some of the benefits that can be awarded to injured employees:
Medical Benefits
This encompasses all procedures done to treat your medical condition. Some items on this list include:
Any medical expenses must be documented and reported to the compensation insurance carrier, so they can approve it and reimburse all expenses made by the injured party. Any miscellaneous out-of-pocket expenses incurred while carrying out medical treatment, such as travel expenses, will also be reimbursed by the compensation insurance company.
Lost Wage Benefits
Your employer understands that because of your injuries, you need to be hospitalized and therefore, can't earn your daily wages. As compensation, you can receive wage loss benefits starting on the 8th day of hospitalization and onwards. The benefit is equal to two-thirds of what your daily wages were at the time of the accident for non-serious injuries, and up to 80 percent of daily wages for serious injuries like a traumatic brain injury.
This type of benefit is paid out every two weeks and stops once you return to work, or once you reach the 104-week limit.
Temporary Disability Benefits
Some workplace accidents result in temporary injuries that will render you temporarily disabled. Knee injuries, for example, can result in the injured employee wearing a cast for a few weeks, requiring them to use a crutch and limiting their mobility at work. Usually, workers who are temporarily disabled but are still able to work will be asked to cut their hours or will be asked to move to a less taxing position with a lower pay rate.
For example, a worker may be asked to work 4 hours a day instead of the usual 8, meaning their earning capacity is halved. To compute for temporary partial disability benefits, take 80% of what you were earning at the time of injury, and the amount you're earning right now, and find the difference. Your weekly benefit is 80% of that difference.
Keep in mind that all benefits are capped at $1,011 per week as per Florida law, so even if your computation gives you an amount higher than that, $1,011 is the maximum amount you will receive. Also, temporary partial disability payments will cease once the doctors say you have reached maximum medical improvement, or once you have reached the 104-week limit.
Permanent Impairment Benefits
There are situations wherein the doctors will declare that you have reached maximum medical improvement, but are still unable to return to work. This simply means they have done everything medically possible to treat you, and your condition can't be improved further. Accidents resulting in traumatic brain injury can lead to permanent disability or paralysis, making it impossible for the person to return to work or seek future employment.
In cases of permanent injury, the employer can receive monetary benefits equivalent to 75 percent of their daily wages at the time of injury, although it is still subject to the $1,011 per week limit. However, unlike partial or temporary disability, permanent impairment benefits are likely to be paid out indefinitely.
Hiring a personal injury attorney after you sustain work-related injuries is the best course of action if you want to receive the maximum compensation afforded to you by the legal system. As stated previously, many workers comp claims fail because employees file them too late, or they are led to believe their situation doesn't fall under its scope.
Employers have been known to use shady means to avoid paying workers compensation, and sadly, most companies don't educate their employees regarding their rights on the matter. If you want to receive monetary benefits from your injury, hire a workers compensation lawyer to ensure that you get enough money to pay for your medical treatment, and to ensure that you are financially stable while you are unable to work because of your injuries.
At VG Law, we recognize that workers are often taken advantage of in workers' compensation proceedings. This is why we actively fight for our client's rights and ensure that they get the worker's comp benefits that they rightfully deserve.
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