March 03, 2009
What to do if you are in in injured on the job.
WHAT TO DO IF YOU ARE INJURED ON THE JOB
INJURED WORKER DUTIES:
1. If you have an accident or are injured on the job, you must:
• Tell your employer you have been injured, as soon as possible. The law requires that you report the accident or your knowledge of a job-related injury within 30 days of your knowledge of the accident or injury.
• When you do so, you must ask your employer what doctor you can see. You must see a doctor authorized by your employer or the insurance company.
• Your employer may tell you to call the insurance company handling your claim; the name and phone number should be on the “Broken Arm” poster that should be posted at your workplace.
• If it is an emergency and your employer is not available to tell you where to go for treatment, go to the nearest emergency room and let your employer know as soon as possible what has happened.
Your employer is required by law to report your injury to the insurance company within 7 days of when you report your accident or injury. If they do not do this, and they do not give you a phone number for the insurance company to call, call MARSHALL D. DAVIS, P.A, for assistance at 1-877-354-2738.
• After you or your employer report the injury to the insurance company, many companies will have an insurance claim adjuster call you within 24 hours to explain your rights and obligations.
• If you receive a message and a number to call, you should call as soon as possible to find out what you need to do to get medical treatment.
• Within 3-5 business days after you or your employer report the accident, you should receive an informational brochure explaining your rights and obligations, and a Notification Letter explaining the services provided by the Employee Assistance Office of the Division of Workers’ Compensation. These forms may be part of a packet which may include some or all of the following:
• A copy of your accident report or “First Report of Injury or Illness,” which you should read to make sure it is correct;
• A fraud statement, which you must read, sign and return as soon as possible, or benefits may be temporarily withheld until you do so;
• A release of medical records for you to sign and return; and
• Medical mileage reimbursement forms that you should fill out, after seeking medical treatment, and send to your claims adjuster for reimbursement.
If you do not receive a call or the information packet from the insurance company, you can call MARSHALLD.D DAVIS, P.A., at 1-877-354-2738 for assistance.
2. When you see the doctor:
• Give the doctor a full description of the accident or how you were injured.
• Answer all questions the doctor might have about any past or current medical conditions or injuries.
• Discuss with the doctor if the injury is related to work or not.
• If related to work, find out if you can work or not.
• If you are released to work, but can’t return to your same job, you should get instructions from the doctor on what work you can and cannot do.
• Keep and attend all appointments with your doctor, or benefits may be suspended.
3. After seeing the doctor:
• Speak with your employer as soon as you leave the doctor. Tell your employer how much your job means to you and explain to them what work the doctor said you can and cannot do.
• If you are admitted to a hospital, call or have someone call your employer for you to explain what happened and where you are.
• Give your employer the doctor’s note as soon as possible.
• Ask your employer if they have work for you to return to that does not require you to do things the doctor said you cannot do yet.
• If yes, ask when you should report for work.
• If not, make sure your employer has a way to contact you if appropriate work becomes available.
• Contact the insurance company and let them know what the doctor said about your injuries and work status.
• You should continue to stay in contact with your employer and the insurance company throughout your treatment and recovery.
4. Benefits you may receive:
• Money you may be entitled to:
• Indemnity Benefits: If you are unable to work for more than 7 days, you should receive money to partly replace what you were not able to earn after your accident.
• Temporary total disability: If your doctor says you cannot work at all:
• You should receive money equaling about 66 2/3% of your regular wages at the time you were hurt. Your benefit is paid to you beginning with the 8th day you lose time from work.
• The first 7 days lost from work is only paid if you lose more than 21 days from work.
• If your injury is critical, you may receive 80% of your regular wages for up to 6 months after the accident.
• You can receive up to a total of 104 weeks of temporary total disability and/or temporary partial disability benefits.
• Temporary partial disability: If you can return to work, but you cannot earn the same wages you earned at the time you were hurt:
• You will receive money equaling 80% of the difference between the 80% of what you earned before your injury and what you are able to earn after your injury.
Example:
Your average weekly wage: $320 (Earnings before injury) x 80 = $256.00
Your weekly earning after injury: -$150.00
$106.00
$106 x .80 = $84.80
Weekly temporary partial disability benefit: $84.80
• You can receive up to a total of 104 weeks of temporary total disability and/or temporary partial disability.
• Impairment benefits: Once your doctor says you are at Maximum Medical Improvement, you are as good as he or she expects you to get. At this point, your doctor should evaluate you for:
• Possible permanent work restrictions, and,
• A permanent impairment rating. If you receive a permanent impairment rating, you will receive money based on that rating.
• Medical treatment:
Your employer is responsible for providing medical treatment.
• Do not delay in getting a doctor’s appointment from your employer or insurance company.
• Do not go on your own to your private doctor for treatment. The insurance company must authorize the doctor who is to treat you.
• If you do not get a doctor’s name from the insurance company, you should contact your adjuster and ask for a doctor.
• Vocational rehabilitation assistance you may receive:
If you are unable to return to your job because of permanent work restrictions resulting from your on-the-job injury, you may obtain assistance from the Workers’ Compensation Vocational Rehabilitation Section of the Florida Department of Education at the following web site or phone numbers:
• http://www.rehabworks.org/
• Telephone: (850)245-3470
5. If you have a dispute with your insurance company:
• First, try to talk about the problem with your adjuster or their supervisor.
• If you still need assistance, contact MARSHALL D.DAVIS, P.A., at 1-877-354-2738.
• If the insurance company still will not agree to pay the benefits that you believe you are entitled to, you can file a Petition for Benefits with the Office of the Judges of Compensation Claims.
• You may wish to hire us to represent you in this action. If so, contact MARSHALL D. DAVIS, P.A., at 1-877-354-2738.
6. Employee Workers’ Compensation Criminal Violations:
The following are criminal violations of §440.105, F.S., that constitute a felony of the first, second or third degree depending on the monetary value of the fraud as provided in §775.082, §775.083, or §775.084, F.S.:
• Filing a false claim of on-the-job injuries or exaggerating injuries.
• An injured employee or any party making a claim of an on-the-job injury will be required to provide his or her personal signature attesting that he or she has reviewed, understands, and acknowledges the following statement:
“Any person who, knowingly and with intent to injure, defraud, or deceive any employer or employee, insurance company, or self-insured program, files a statement of claim containing any false or misleading information commits insurance fraud, punishable as provided in §817.234.”
• If the injured employee or party refuses to sign the document, benefits or payments shall be suspended until such signature is obtained.
HOW TO GET MORE INFORMATION AND HELP WITH YOUR CLAIM:
1. Division of Workers’ Compensation Employee Assistance and Ombudsman Office:
• The Employee Assistance and Ombudsman Office (EAO) will assist you at no cost with questions or concerns you may have about your Workers’ Compensation claim.
• EAO works on your behalf to resolve issues with your Workers’ Compensation claim.
• EAO offices are located around the state to assist you.
• Website: http://www.myfloridacfo.com/wc/organization/eao.html
• Phone (toll free): 1-800-342-1741
2. The Division of Workers’ Compensation Website: http://www.myfloridacfo.com/WC
• For additional information click on “Information and FAQs” on the left side of the Division’s homepage.