If you have been injured in a work related accident, you probably have several questions. The most important of which is, “What does workers comp cover?”
No matter how diligent you might be about preventing workplace accidents, they sometimes happen anyway. You rarely get a warning that your lifestyle and physical condition are about to drastically change. When you do get hurt, you may be left with dozens of questions about the workers’ comp process.
Aside from missing out on your regular paychecks, you might be facing hundreds of thousands of dollars in medical bills and possibly the loss of your livelihood. It is important to understand what workers’ compensation benefits you have so you can prepare for the future.
What Does Workers’ Comp Cover?
At its core, workers’ compensation is designed to answer a simple question: “What will workers’ compensation cover when you are hurt on the job?”
Workplace injuries can have far reaching and long-lasting consequences, and workers’ compensation benefits were developed to soften your financial burden after an accidental injury or illness caused by your work.
If you have been injured in a work related accident, here are some of the benefits you can receive from the workers’ compensation insurance company. In general, workers’ comp can help with:
- Medical treatment related to your work injury or illness
- A portion of your lost wages when you cannot work
- Vocational training or rehabilitation when you cannot return to your old job
- Funeral costs and death benefits for surviving dependents in fatal cases
What Medical Treatment Is Covered by Workers’ Compensation?
Being injured or contracting an illness because of your job will naturally result in you needing medical attention. Many injured workers want to know exactly what medical treatment is covered by workers’ compensation, because they are worried about how they will pay for doctors, tests, and surgery.
Your employer’s workers’ compensation coverage will pay for your:
- Doctor’s visits
- Medical equipment
- Surgery
- Prescriptions
However, they will only pay for treatment from authorized providers or for treatment that was provided on an emergency basis. Depending on the circumstances of your case, the insurance company may provide you with authorized medical treatment indefinitely.
For instance, if you have a work related injury that leaves you permanently disabled and there have been no new accidents that have worsened your work related condition, the workers’ comp insurance company will cover your long term medical care as well.
Does Workers’ Comp Pay For My Lost Wages?
Depending on the severity of your injury and the nature of your job, your doctor may require that you do not work for a certain period of time.
In the event that your injury leaves you unable to work, and therefore unable to receive a paycheck, workers’ comp benefits will pay for a portion of your lost wages.
In most cases, benefits amount to 66 2/3% of your Average Weekly Wage (AWW), but this can vary if you are working in another capacity while you are recovering from your injury.
Will Workers’ Comp Cover Vocational Training or a New Job?
In the best case scenario, you recover quickly and suffer no lasting effects. Unfortunately, this is not always the case.
For some people, a workplace illness or injury may leave them permanently disabled in such a way that they cannot return to their prior job duties. In these cases, workers’ comp may cover vocational training and rehabilitation to relearn job skills within your new limitations or train you for an entirely new career.
For example, if your old job involved heavy physical labor that you can no longer perform, vocational training could help you transition into a lighter duty role or a different field that fits your restrictions.
If you have no backup plan, this can be an incredibly helpful way to get you and your family back on your feet.
Does Workers’ Comp Pay Funeral Costs and Death Benefits?
In the most severe circumstances, a workplace accident does not result in an injury, but in death.
In such cases, workers’ comp would cover the funeral costs of the deceased employee and also pay regular benefits to any surviving dependents.
Injured at Work In Florida?
What Workers’ Comp Does Not Cover
Workers’ compensation insurance is an extremely helpful type of coverage for both employers and employees, but it is far from being a blank check solution to any and every form of injury or loss.
In short, workers’ compensation is designed to cover work related medical care and a portion of your income, not every hardship or personal loss you experience after an accident.
Here are a few things that workers’ comp will not cover.
Pain and Suffering
There is no mechanism under the Florida Workers’ Compensation law for an injured employee to receive compensation for pain and suffering or loss of enjoyment of life resulting from a workplace accident. No amount of lawyering and no amount of sympathy from a judge can provide an injured worker with compensation for these things.
This is one of the most common myths injured workers hear, and it often comes as a surprise.
Non Work Injuries
An injury or illness sustained on an employee’s personal time, even if it affects the employee’s ability to do his or her job, will not be covered by workers’ compensation.
Intentional Acts and Safety Rule Violations
Even if a worker is injured due to their own negligence, such as rushing from one place to another, the Florida Workers’ Compensation Law still requires provision of benefits to that worker.
However, an employee who intentionally injures themselves is not entitled to any workers’ comp benefits. Further, if an employee is injured because of the employee’s knowing refusal to use a safety appliance or observe a safety rule required by law or provided by the employer, the law requires that they receive a 25% reduction in the lost wage reimbursement.
How To Use Your Workers’ Comp Benefits Wisely
Once you understand what workers’ comp covers, and what it does not, the next step is using those benefits wisely so you can focus on your recovery.
Here are some simple, practical tips:
- Keep all of your medical records, work notes, and claim paperwork together in one place.
- Go to all appointments with your authorized workers’ comp doctors and follow their instructions as closely as you can.
- Tell your doctor exactly what your job requires so they can give realistic work restrictions.
- Follow those work restrictions, even if you feel pressure to “push through” or go back to full duty too quickly.
- Ask questions if you are unsure why a treatment was denied, why a check is lower than expected, or whether a benefit should apply to you.
- Reach out for help if there is a dispute about your benefits, or if something does not match what you have been told.
For more background, you can review the state’s information on benefits available to injured workers.
You can also look at the Florida Workers’ Compensation System Guide for a broader overview of how the system works.
When To Talk To a Florida Workers’ Comp Attorney
Workplace injuries and illnesses can cause confusing and overwhelming lifestyle changes. But knowing what workers’ comp covers, and what it does not, will help you prepare for the future so you can stop worrying about your day to day expenses and start focusing on your recovery.
At The Law Office of Brian D. Tadros, P.A., we practice workers’ compensation law and only workers’ compensation law. Our main focus is to act as an advocate and counselor for each of our clients, so that they can make informed decisions and receive the benefits they are entitled to.
You should consider talking to a lawyer if:
- You do not understand which benefits you should be receiving
- The insurance company denies or reduces benefits you thought would be covered
- Your checks seem too low compared to your wages
- You are being pressured to go back to work before you are ready
- Your injury has left you permanently limited or unable to return to your old job
If you are still unsure what workers’ comp should cover in your situation, talking with an experienced Florida workers’ comp attorney can give you clear answers before you make big decisions.
Do not trust your workers’ compensation claim to the goodwill of your employer or their insurance company. They will be looking out for their own interests. If you are suffering from a work related injury, it is in your best interest to have an experienced workers’ comp attorney like Brian Tadros on your side. Call today for a free consultation.
