At The Workers' Compensation Trial Group, P.A., we understand the frustration you are facing if you are encountering a difficult issue regarding workers' compensation. It can be a very stressful circumstance to deal with when you are injured or ill, and you will need to have all of your questions answered. Below, we provide answers to frequently asked questions that can serve as a starting point for your understanding of workers' compensation in Florida.
What If My Claim for Benefits Has Been Denied?
You will want to obtain the legal assistance of a knowledgeable workers' compensation attorney who can help you file an appeal. When you are facing a dispute with your employer regarding workers' compensation or a denied claim, we can help you through the appeal process. Whether your employer has claimed that your injuries occurred outside the workplace or are pre-existing conditions, we can determine the best possible solution for your case.
As an Employer, When Should I Report the Employee's Injury to the Insurance Company?
As an employer who is handling a workers' compensation issue with an employee, you should report the injury as soon as possible. You have seven days after becoming aware of his or her injury to file a report. The insurance company is required to send the employee an informational brochure within three days after the employee or employer informs the claims administrator.
What Will Happen to the Employee's Job After He or She Files a Claim for Compensation?
Employers are not allowed to fire employees who have filed or have attempted to file a workers' compensation claim. The law offers reemployment services to injured employees to help them return to work. Some of the services include on-the-job training, formal retraining, and transferable skills analysis.
What Is the Time Limit for the Filing of a Petition for Benefits?
Employees have two years to file a petition for workers' compensation. Injured workers only have two years from the date of the accident or date of discovery of the illness. For assistance meeting this time limit, speak with our firm at once. It is advisable to seek medical attention and file a workers' compensation claim as soon as possible.
What Are the Reasons That a Workers' Compensation Claim Can Be Denied?
Injured parties' workers' compensation claims can be denied for a number of reasons. If the insurance company denies that the injury occurred on the job, the employee did not likely have enough medical evidence to prove the work-related cause of the injury. A claim can also be denied if the insurance company accuses the employee of fraud or misrepresentation. If the injury was from a preexisting condition, the claim can also be denied.
Does Florida Law Treat Construction Employers Differently Than Other Employers?
YES. This is one of the most common areas of confusion for an employer, and the majority of Stop-Work Orders and penalty assessments occur in the construction industry. This is because Florida does not recognize the standard three employee exemption from coverage for employers in the construction industry. Exemptions are available ONLY to owners of the business, only under certain circumstances, and only if an exemption has been applied for with the state. Furthermore, the state does not recognize the existence of independent contractors in the construction industry for purposes of determining if workers' compensation coverage is required (this has nothing to do with taxes or anything else - it is a legal distinction made only for coverage purposes). To put it simply - if you own a business in the construction industry and have ANYONE working for you who is not also an owner of the business with an exemption, you are required to carry workers' compensation coverage for them (unless you verify that they have their own).
I Don't Understand How My Penalty Was Calculated. Could the State Have Made a Mistake?
It is very possible. As part of the penalty assessment, the state will usually require you to produce payroll records and/or bank statements. Payroll is a component of the penalty calculation. Unfortunately, if the information is incomplete or the payroll cannot be determined with accuracy based on the information you have provided, the state "imputes" payroll to your employees. In basic terms, payroll is estimated based on statewide averages and hourly estimates consistent with your particular area of business. Frequently this results in penalty assessments which are much, much larger than what is actually warranted. We can help you obtain the correct documentation and make an independent assessment of what the correct penalty should be.
I Can't Afford to Pay This Penalty. Does the State Compromise or Settle? Can an Arrangement Be Reached?
Yes and no. Generally the state does not negotiate penalties as a matter of policy, if the penalty amount is otherwise correct. However, if the penalty amount has been incorrectly calculated, the state may be willing to adjust the penalty to the correct amount if given the necessary information. Most importantly, the state permits any penalty to be paid out in monthly installments, prorated out over a fixed period for up to five years (depending on amount). These monthly payments can be set up online through a direct account withdrawal, if desired. If a payment plan is agreed upon, the state requires a single up front "good faith" payment of 10% of the total amount. The payments are interest free, but the state does have the right to accelerate the balance and demand immediate payment of any remaining amount if a payment is missed under the plan.
I Want to Just Close My Business, But I'm Worried It May Affect Me Personally. Is That Possible?
Maybe, but this is a complicated question which is very dependent on your particular situation. If your business is a corporation or some other type of corporate entity which protects its owners from liability, the business should be solely responsible for payment of the debt. If you file for bankruptcy, the debt will get discharged along with any other debts which the business may have, shielding you from personal liability. However, the state is wary about business owners simply trying to "game" the system by closing an affected business and then starting a new one doing the same thing as the old business. Under this scenario, the Stop-Work Order and penalty may follow you personally and attach to your new business. Also, if you have failed to observe the necessary formalities for owning a corporation or other type of business entity (e.g. state filings, taxes, separate bank accounts) the state may attempt to "pierce the veil" and argue that you should be personally liable for the debts of the business since the entity itself was a sham or a fraud. The Workers' Compensation Trial Group, P.A. can assist you in evaluating your options.
Do You Provide a Free Consultation? How Much Would It Cost to Have You Represent Me or My Business?
Yes, we will be happy to discuss your particular situation free of charge to determine if we can assist you. Our fee structures for these sorts of matters are usually handled as a one-time flat fee which covers all of our time and costs in handling your particular issue. After you make the initial payment, no further charges are assessed. The amount of the flat fee will vary based on the particulars of your situation and amount of work we believe will be required to represent your interests in a zealous, but cost-conscious manner. Alternative fee arrangements, such as an hourly rate structure or a replenishing retainer, may be negotiated depending on your circumstances and needs.