Articles Posted in Workers’ Compensation

When you are injured at work and your employer tells you that they do not have workers’ compensation Insurance because they are self-insured, it might be concerning. You may be wondering what having a self-insured business means if you have been injured o become ill at work for your workers’ compensation claim.

In Florida, it is required to have workers’ compensation insurance if the company has four or more employees. The insurance company will pay workers compensation benefits when the company has an injured employee. However, a company can also insure themselves if that’s what they wish. This means that if an employee gets injured the business will have to cover all the expenses instead of an insurance company.

A business usually chooses to self-insure their liability of workers’ compensation because they save money on paying third party companies and because they have more control over the workers’ compensation claims in which they would grant or deny them. An employer must go through an application procedure and achieve certain financial conditions to lawfully run a self-insured workers compensation program.

After an injury at work, many employees essentially consider quitting their jobs. If you have an open workers’ compensation claim you are most likely receiving benefits, whether is medical benefits, wage benefits, or disability benefits.

If the injured victim decides to terminate his or her employment the medical benefits will be continued under workers’ compensation. It is his or her right to receive medical benefits even if you are unemployed, work in another job or decide to relocate to another state.

Something that would change in your workers’ compensation case if you quit your job is the injured victim’s eligibility on wage benefits or disability benefits. The insurance companies would try to not pay anything to the injured victim because he or she voluntarily limited his or her income and they shouldn’t have to pay because of the injured victims’ choices.

Any worker is at risk of getting hurt at work, some are more at risk than others. Some of the major events in which an injury can occur are violence and other injuries by persons or animals, transportation incidents, fires, and explosions, falls, slips, trips, exposure to harmful substances or environments, or contact with objects and equipment.

According to the U.S. Bureau of Labor Statistics Census of Fatal Occupational Injuries (2019), the following are considered the top five most dangerous jobs in Florida:

  1. Construction and extraction occupations 

Injuries at work happen very often and many people are not informed what to do if this happens, which is very understandable. It is important to know what to do and what NOT to do in case you suffer any injuries at work. Opening a workers’ compensation may be difficult and tedious that’s why it is important to know what can greatly decrease your chances of a successful claim. If you would like to know more about what a workers’ compensation claim is, visit our website here.

There are different ways in which you can easily make a mistake and cause your workers’ compensation claim to be denied or receive fewer benefits:

  1. Failure to meet the reporting deadline: Florida law states that an injured employee must report his or her injuries within 30 days of the accident, it is best to report your injuries immediately. Some exceptions do exist, but by not reporting your injury on time you will run the risk of your claim being denied.

A deposition is a meeting between the injured victim, his or her attorney, the insurance adjuster, and the insurance attorney based on a question-and-answer session. The deposition is made under oath and admissible in a legal proceeding, therefore a court reporter is also present during the deposition. This is the best way to gather information in a claim is through a deposition according to the Florida Workers’ Compensation Act.

The insurance company of your employer may ask the injured victim to do a deposition with the purpose of gathering more information for their case. It is important to always keep in mind that the deposition of the injured victim does not help in any shape or form the injured victim’s claim. With that being said, the most important thing an injured victim should never do is provide more information than what he or she is being asked.

The injured victim will need to prepare for the deposition by:

If you suffered an injury or illness while at work, you can’t sue your employer instead you are entitled to workers’ compensation in which your employer has to provide benefits for you. The benefits are medical benefits and wage benefits. According to the Florida statute section 440.185(1) “An employee who suffers an injury arising out of and in the course of employment shall advise his or her employer of the injury within 30 days after the date of or initial manifestation of the injury”

You are entitled to medical benefits. This means that you are allowed to seek medical treatment at the expense of your employer. It is necessary to do this immediately because you might have something more important than what you think. Your employer will pay for everything you need, recommended by your authorized medical provider. However, you must keep in mind that you don’t decide what you need or where you want to be treated.

A restriction you should be aware of is that in Florida, the doctor who is treating you must be approved by your workers’ compensation insurance carrier. In addition, unlike many other states, Florida’s workers’ compensation regulations do not compel your employer to maintain your position open for you to return to when you are healthy enough.

Florida statute section 440.015 states that “It is the intent of the Legislature that the Workers’ Compensation Law be interpreted so as to assure the quick and efficient delivery of disability and medical benefits to an injured worker and to facilitate the worker’s return to gainful reemployment at a reasonable cost to the employer”.This section of the law goes on to states specifically “an efficient and self-executing system must be created which is not an economic or administrative burden.”

So a few questions automatically arise; what does this mean and why do injured workers and insurance companies hire attorneys?

The answer to these questions cannot be answered in just one blog, however I will attempt to address these queries in this and the next few blogs to follow. Self executing means, as indicated in the statute, that the Florida Workers Compensation Law was enacted to “ensure the prompt delivery of benefits to the injured worker” .

The Supreme Court of Florida has issued its decision in a case (Marvin Castellanos v. Next Door Company) that will make a huge impact on the rights of injured workers in this State.

Specifically with regard to the workers compensation claimant’s due process rights under the constitution. The Court, in a five to two decision, opined that the law that was amended in 2009 is a violation of both the Florida and U.S Constitution because it blocks any challenges to the reasonableness of attorney’s fees awarded to the worker’s lawyer.

The Court also focused on the goal and intent of the workers compensation system in this State. That is to quickly provide benefits to get those that have been injured back on the job at a reasonable cost to employers. This, however, is not always the outcome. The Court recognized that in many situations the injured workers undergoes significant delays and resistance by the employer in obtaining the benefits.

Workers compensation lawyers and legal practitioners are sitting on the edge of their seats awaiting the ruling of the Supreme Court in the high profile case of Castellanos v. Next Door Company.

To the average Miami resident this case may seem unimportant. But it has significant impact on the rights of injured workers throughout the State of Florida.

This case involves a gentleman by the name of Marvin Castellanos who was injured during the course of his employment in 2009. As the claim progressed the employer/carrier denied Mr. Castellanos’ claim for additional medical treatment which included three physical therapy visits for two weeks.

He then hired an attorney who litigated and prevailed on this issue, assisting his client in obtaining these medical benefits in at a cost of $822.70.Florida’s statutory attorney fee schedule afforded Castellanos’ attorney a fee of $164.54 for 107 hours of work. The equivalent of approximately $1.53 per hour. This is well below Florida’s minimum hourly wage which is $7.93 per hour.

The attorney representing Castellanos has argued to the Supreme Court that the current statutory attorney fee schedule is unconstitutional . This argument is based on the inability of an injured workers to gain access to courts due to prohibitively low attorney fees and difficulty obtaining representation.

The counter arguments seems to suggest that this statute solely impacts the attorneys and not the benefits received by the worker. As pointed out by several of the Justices, however, the reality is that restriction on fees for the claimant , directly impacts the worker. The workers compensation laws are complex and not similar to small claims, as the defense attorney attempted to argue.

In addition, the employer and its insurance carrier have no statutory restriction what so ever on the amount of fees they may pay their counsel for representation in defense of the same claims.

So what does this mean?

Like so many things in life,we will have to wait to see Continue reading

Saturday evening a local Miami area police officer was seriously injured in an auto accident while riding his motorcycle. The Doral police officer, who was on duty, was traveling on his motorcycle when the driver of a car made an illegal U-turn, hitting the officer and his bike.

The officer is 51 year old Rafael Cubelo. Reports state that the force of the impact sent this individual into the air several feet. He was then transported to the Ryder Trauma Center. We are wishing him a speedy and successful recovery.

Automobile drivers are often the cause of motorcycle accidents and resulting injuries. In this instance the driver of the car involved was cited for disobeying the traffic laws. Often the simplest offense can result in serious injury, especially when a motorcycle in involved.

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