If you are injured at work in the course of your employment, your employer is generally responsible for providing medical treatment including:
- An authorized primary doctor and specialist(s) when medically necessary
- All authorized medically necessary care and treatment related to your injury such as:
- Doctor’s visits
- physical therapy
- medical tests
- prescription drugs
- Mileage reimbursement for travel to and from your authorized doctor and the pharmacy
Ordinarily, you may not seek a doctor of your choice- you must see a physician selected and authorized by the insurance company (Workers’ Compensation carrier).
In addition, you may be entitled to wage replacement (loss) benefits which come in different forms:
Wage Replacement Benefits (Indemnity Benefits)
There are two types of indemnity benefits that you may be entitled to during your recovery, to make up for some of your lost wages:
- Temporary total disability (TTD):
- If your doctor says you cannot work as a result of your work-related injury or illness, you will receive 66 2/3% of your regular wages (average weekly wage- AWW) subject to a statewide maximum reimbursement amount payable every two weeks.
- You will not receive temporary disability benefits for the first 7 days of disability unless you are disabled more than 21 days due to the work-related injury as determined by the authorized doctor.
- Certain severe injuries may entitle you to 80% of your regular wages for up to 6 months after the accident.
- Temporary partial disability (TPD):
- When the doctor states you can return to work with restrictions, you may be eligible to receive Temporary Partial Disability Benefits if you are unable to earn 80% of the wages you were earning at the time of your accident. TPD benefits are slightly lower than TTD benefits
Permanent Total Disability Benefits (PT)
If after reaching Maximum Medical Improvement your injuries are so severe, as defined by law, that you are left permanently unable to work, you may receive permanent total disability benefits.
If the insurance company representing the employer does not pay benefits that may be due, your attorney will file a claim (Petition) on your behalf. Workers’ Compensation claims are heard in special Courts and cases are decided by a Judge of Compensation Claims. Ordinarily, except in the case of a Lump Sum Settlement (see below), you, the claimant, will not pay any attorney’s fees– if you win the case, the insurance company pays your attorney in accordance with a statutory formula that is part of the Workers’ Compensation law.
Lump Sum Settlement
Often, the insurance company is willing to pay a lump sum settlement to end your workers’ compensation claim. They will do this to end any further responsibility for your injury; you will no longer be entitled to medical or wage loss benefits. Since in Workers’ Compensation claims there is no compensation for pain and suffering or loss of ability to enjoy life (engage in sports, recreation etc.) the settlement amount is usually less than what could be recovered in a personal injury case. An experienced Workers’ Compensation attorney will be able to render an opinion as to the potential amount that a case may be settled for.
Worker’s Compensation law is complex and changes often. At Hoffman, Larin and Agnetti, PA we offer a free consultation so that you can learn your rights. Ordinarily you will not be responsible for any fees if we accept your case. We have offices in Dade, Broward and Monroe Counties for your convenience.