Workers' Compensation claim form

Workers’ compensation is a type of insurance, just like auto insurance, etc. It commonly will cover what you would expect your car insurance policy to cover if you sustained an injury in an automobile accident.

This may include, but not be limited to:

  • Medical bills and most all medical care.
  • Lost wages that you may incur while you recuperate.
  • Prescription medications that you may require.
  • Special medical equipment to aid in your recovery.
  • General income replacement while you cannot work at your job.
  • Certain other job replacement benefits.

The type and extent of your benefits will depend on how serious your injury is. If, for example, it created no disability, partial disability, or a permanent disability that may go on for months, years, or the rest of your life.

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Even the type of job you have may affect your coverage. For example, if you are an office worker and slipped at work and broke an ankle, you will have medical bills but be able to return to work in a relatively short time. In this case, workers’ compensation may cover medical bills, but not require income replacement, as you could return to work quite soon.

However, if you work construction, and injure your foot or ankle, you could have a partial disability as you can’t perform your normal job function for the next few months or more. In this case, workers’ compensation would have to provide you with lost wages and income replacement benefits until you can resume your normal job activities.

Even worse, if you’ve had a spinal or neck injury, and are paralyzed, this would be considered a total disability, and your workers’ compensation insurance may have to replace your income for the remainder of your life!

On the surface, a workers’ comp claim may seem simple, and straightforward, but that is not so. This is why you must consult with a Tampa workers’ compensation attorney who will sift through the details of your case and will focus on how your injury will impact your skills, and life going forward.

What Can I Do If Workers’ Comp Refuses to Pay for Care I Need?

So now you’ve been injured on the job and your injury requires medical care. Your workers’ compensation insurer should be responsible for paying the entirety of any necessary, reasonable medical treatment. You should also understand that you are not responsible for co-payments for any of this care. The medical providers you use are prohibited by law from billing you on any balances, or overages, you may incur. This is referred to as “balance billing” and is illegal, yet you may be ignorant of this fact.

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“Balance billing” is a practice where your medical provider may attempt to bill you for the difference between what the workers’ comp insurance company has paid them, and the amount they would usually bill a patient who does not have any insurance in place.

This practice ignores the fact that there are workers’ compensation laws that mandate your employer’s workers’ comp insurer pay for 100% of your work-related medical bills.

Unfortunately, we know that insurance companies will always try to pay as little as they can and that they may not follow the letter of the law, especially if you are ignorant of these pertinent facts! Your Tampa workers’ comp lawyer will make sure that you receive all the funds you need to recover and have the right to get.

Is There Anything I Should Do Involving the Medical Providers?

If you have been injured at work and pay for your health insurance, make sure you provide all of your health insurance information to the medical providers as soon as you can. You can also ask them to bill your health insurance in the uncommon event that the workers’ compensation insurer declines to authorize all necessary treatment. Your health comes first, and your doctor or medical professional will know what you need immediately.

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Most personal health insurers are not required to pay for any kinds of work-related injuries if workers’ compensation has issued a denial, but your health insurer is certainly required to pay for your treatment. Please remember this and do it at the first opportunity you get. This can be a “sticky” legal area and your workers’ comp lawyer will be vitally helpful in assuring that you get the treatment you need and that it is paid for on time.

Is It Possible to Be Exempt from Filing for Workers’ Comp in Florida?

In practice, almost all employees in the State of Florida must be covered by employers’ workers’ compensation insurance. However, certain employees are exempt from having workers’ compensation policies, some examples are as follows:

  • Employees of companies with four or fewer employees, except for agricultural and construction companies. Please note, that employees of companies that do construction or construction-related work are required to have workers’ compensation insurance if they employ even one person.
  • Employees of agricultural companies that employ six or fewer full-time employees or 12 or fewer seasonal employees.
  • Usually, corporate officers in non-construction companies are exempt from having workers’ compensation insurance. Also, up to three corporate officers of construction companies could be exempt from having workers’ compensation insurance.

I Have Been Injured at Work, What Should I Do First?

First, get the immediate medical help you need as nothing is more important than that! Then understand that even by having workers’ comp, will it necessarily mean you will receive all the funds needed for treatment, recovery, and possibly a great deal more.

Carlson, Meissner, Hart, and Hayslett are a Tampa-based Florida workers’ comp law firm that has decades of experience providing a voice for those who need it most. Get a consultation and make sure you, and your family, get what you need and rightfully deserve.

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