Workers' compensation is, fortunately, one of those things that employees in Florida don't have to put much thought into. Unlike life insurance or medical insurance, this isn't something that workers necessarily have to "opt in" to. By state law, this is something that most businesses in Florida have to cover themselves and have to offer to employees when appropriate.
Because of this, workers may not know a lot about workers comp or what it is supposed to do for them. To help lift some of the fog on this, here are four facts about workers comp to help keep you more informed about what you can expect.
It's Not 100% Mandatory
The majority of businesses in Florida must, by law, have some kind of workers compensation insurance in place for employees. However, while the vast majority of companies will offer this, not every business will be required to do so. Size is definitely the most significant consideration.
If you work for a large, medium, or even slightly bigger small business, then odds are you workers comp is implemented. You have nothing to worry about in terms of coverage. Even if you are only a part-time employee, you will still be valid for workers comp. However, if a business is very small, with less than five employees, there is no legal requirement. So small, one-person start-ups in a home, for example, don't have to worry about insuring themselves for workers comp.
There's No Second Opinion
For a medical check-up, if you receive a diagnosis that you may disagree with, you're always free to see another doctor to get a second opinion. However, this is not the case for an exam conducted to see whether you qualify for workers comp or not.
In 2003, state law was changed so that workers can only see one doctor about workers' comp-related medical check-ups. That doctor is the one selected by the insurance carrier, so be aware that if the doctor working with the insurance company doesn't believe you qualify, that's the final "free" word. You cant get a second opinion, but you'll have to pay for it, and this may cost anywhere between $1000-$2500.
It's For Bills & Salary
Workers' compensation is created primarily to help employees deal with the bills required for medical treatment and compensate for any salary that is lost while the employee is unable to work. In other words, it is there to help offset the unexpected expenses that arise from an accident, and not deprive an employee of a salary that would be paid out if the accident hadn't occurred.
However, "pain and suffering" are not part of this equation. Whereas in civil lawsuits, if the quality of a person's life is negatively impacted due to trauma, or the inability to participate in activities or events, this has no bearing on a workers compensation payment. Some factors, like a permanent disability, for example, will be considered, but not the quality of life issues.
Denials Aren't Final
Insurance companies would like people to think that if a claim is denied, that's the end of the story. However, nothing could be further from the truth. There are some instances where a claim may be rejected, but that's because insurers suspect they can save some money on less than straightforward claims.
Fortunately, workers comp lawyers do exist to help challenge these rulings. If you find that your claim is denied, or you're having some difficulty getting the treatment you need or even find your disability rating is being disputed, get professional help. Talk to a workers' compensation employee about your situation and get an advocate to guide you through the process and have your claim resolved.