What Does Florida Workers’ Compensation Insurance Cover?
Due to the rate at which people are injured while on the job and the conflicts that come with employees having to sue employers for their injuries, Florida requires employers to purchase workers’ compensation insurance, better known as workers’ comp. Florida Workers’ Compensation laws require employees to avail themselves of workers’ comp if they were injured on the job. By doing so, employees are generally prevented from suing their employers. So if you were injured on the job, what does workers’ compensation cover? And is your employer ever liable for your injuries in a court of law outside of the workers’ compensation requirements?
Obtaining Compensation for Your Workplace Injury
Because workers’ compensation is a type of insurance, it generally covers what you would expect your car insurance policy to cover if you were injured in an automobile accident. This includes, but may not be limited to:
- Medical bills
- Lost wages
- Prescription medications
- Medical equipment
- Income replacement
- Certain job replacement benefits
For example, an accountant who slipped at work and broke an ankle may have medical bills but return to work the next day. In this case, workers’ compensation may cover medical bills, but not income replacement benefits.
If you work construction, however, and you injure your ankle, you may now have a partial disability because you can’t perform your normal job function for the next six weeks. In this case, workers’ compensation would have to provide you with lost wage and income replacement benefits until you can resume your normal job activities.
If your disability is not permanent, but it will permanently disqualify you from your field, workers’ compensation may have to pay to assist you in finding a different job or career.
Finally, if you broke your neck at work and are now paralyzed, this is likely considered a total disability, and your workers’ compensation insurance may have to replace your income for the remainder of your life.
Prohibitions on Receiving Workers’ Compensation Benefits. To qualify for workers’ compensation benefits, you must have sustained at least 50 percent of the injury on the job. For example, if you fell in your home and injured your arm and then you tripped at work and exacerbated the injury slightly, you are likely not eligible to receive workers’ compensation benefits.
You also may not receive workers’ compensation benefits under the following circumstances:
- The injury was intentionally self-inflicted
- The injury was caused because you were on drugs or intoxicated
- The injury was intentionally inflicted to obtain workers’ compensation benefits
- The employee refused to observe safety rules or use readily available safety equipment
Furthermore, if you fall into these excluded categories, you can’t successfully sue your employer for negligence. If the injury was purposefully self-inflicted or occurred because the employee was intoxicated, there is generally no case against another party because of the workers’ own negligence. You probably could not successfully sue your employer if you refused to obey safety rules under the doctrine of assumption of risk.
What are the penalties for not having workers’ compensation in Florida?It is not uncommon for business owners to be looking for ways to cut costs and improve the bottom line. But one area where this is definitely not okay is with workers’ compensation insurance. Cutting workers comp insurance is especially tempting if you think your employees’ jobs are not dangerous or if you haven’t had a serious work-related injury at your company in a while. However, business owners who don’t have workers’ comp insurance for their employees in Florida could face serious, and costly, consequences.
The Florida Department of Financial Services is in charge of regulating and inspecting Florida businesses when it comes to many financial matters, including whether or not they have proper workers compensation coverage.
If a Florida employer is operating without workers comp, they will first be issued a Stop-Work Order, which requires the business close down and stop all work until they comply with Florida law and pays any penalties that were issued.
The penalty is usually equal to 2 times the amount that the business would have paid in workers comp premiums during the two year period prior to being caught.
Additional civil actions or criminal charges could also be filed if the business:
- is operating without workers’ compensation insurance (if their business type requires WC),
- continues as usually after Stop Work order is issued,
- tries to conceal or forge worker comp violations,
- fails to report an injury,
- tries to ensure your claim is denied,
- threatens to fire or intimidate to prevent employee from filing a claim,
- deducts the workers comp cost from the injured employee’s paycheck,
- tries to pass an employee off as an independent contractor.
Exceptions to Workers’ Compensation LawsWorkers’ compensation insurance only covers injuries that occur during the scope of your employment. For example, if you and your boss take the same route to work and your boss rear-ends you, he can’t defend your litigation against him by saying he is your employer. You can sue him for your personal injuries in Florida court because you were not injured during the scope of your employment.
If you were injured on the job, however, you may directly sue an employer who did not carry workers’ compensation insurance. An employer may not use the workers’ compensation law to defend against a suit for personal injuries or wrongful death if it did not carry the necessary coverage. This means that an employer would face direct liability if:
- Your injury was caused by the negligence of another employee
- The employee assumed the risk of the injury
- The injury was caused, in part, by the comparative negligence of another employee
Furthermore, an employer who did carry insurance but refused to process your claim in a timely manner could face a lawsuit—for example, if your injury was serious and the employer was afraid that the insurance company would drop him or raise his rates. Sometimes this is also down to disorganization.
Talk to your Florida workers’ compensation lawyer about whether you qualify for an exception. Here is a breakdown of what fees to expect.
Pain and Suffering after a Work InjuryAs we have discussed, Florida workers’ compensation will cover medical bills and lost wages after you are injured on-the-job, but what about pain and suffering?
Florida workers’ comp does not compensate an injured worker for pain and suffering, as you might expect with a personal injury that is not work-related.
Despite this lack of coverage, this does not mean that it is impossible to be compensated for pain and suffering after a Florida work injury. That’s because your employer is not necessarily the only person or party responsible for your injury.
Florida Workers Comp is Not Limited to EmployersThird parties may be responsible for your Florida work injury if you were injured due to some other circumstance, for example, a defective piece of equipment at work. If this is found to be the case, the third-party can be named in a separate lawsuit.
All kinds of parties can be liable other than your employer in a workers comp claim. A maintenance company could be negligent in repairing a piece of equipment that malfunctions and injures someone. Cleaners could be negligent by failing to properly place the notice that an area is wet and a worker could suffer a slip and fall injury. The list goes on but the point of many parties possibly being negligent is the same.