If you sustained an injury on the job, workers’ compensation benefits could help get you back on your feet. If your claim is successful, you could recover wage replacement benefits and have your medical bills paid for following an injury at work.
Workers’ compensation benefits could help you ensure that you and your family have the resources you need while recovering from a work-related injury. Unfortunately, these claims are not always accepted. A workplace injury lawyer from our Daytona Beach office could help you pursue a workers’ compensation claim.
Understanding Workers’ Compensation Benefits
While much of the focus on workers’ compensation benefits following a workplace accident concerns disability payments, there are several forms of compensation that could prove valuable to you following an injury. A workplace injury lawyer from our Daytona Beach office could help you understand the benefits that could be available to you.
Medical Benefits
The workers’ compensation system will cover the cost of your medical care required by your work-related injury. This treatment is open-ended, meaning you will not pay anything for your medical expenses as long as you are prescribed treatment by an authorized physician.
In addition to medical care, these benefits also cover the cost of traveling to and from the doctor as well as the cost of your prescription drugs.
Temporary Impairment Benefits
Under state law, you could be entitled to recover temporary wage replacement benefits while you recover from your injuries. Known as temporary impairment benefits, this compensation comes in the form of weekly payments. The amount paid to you will depend on your wage at the time of your injury, and these payments can continue for up to two years.
These benefits could cut off earlier than that if your doctor says you are ready to work. You can begin recovering benefits as early as seven days following your injury. In cases of serious injuries that will clearly leave you out of work for at least 21 days, you could begin receiving benefits immediately.
Permanent Impairment Benefits
Impairment benefits are also available for permanent disabilities. These benefits could be partial or total. Total disability benefits are available in cases in which, despite obtaining as much medical improvement as possible, you are unable to ever return to work again.
A partial permanent impairment is an injury that will last forever but allows you to return to work eventually in a limited capacity. Like other impairment benefits, the compensation for permanent conditions is tied to your wages.
Vocational Rehab
Some injuries are severe enough that you cannot return to your old job, but you might be able to work in a different field. When your injuries require a career change, you could be entitled to benefits that cover the cost of your vocational rehabilitation. This benefit could include the cost of counseling, replacement services, or additional training.
Death Benefits
Typically, benefits under the workers’ compensation system are targeted at the injured worker. However, their surviving family could be entitled to benefits if a workplace injury proved fatal.
Death benefits vary by amount, depending on the number of dependents the worker had at the time of their death. However, these benefits remain only a portion of the worker’s salary at the time of their passing. The workers’ compensation system also pays for burial and funeral expenses.
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Appealing a Denied Workers’ Compensation Claim
Unfortunately, many workers’ compensation claims are ultimately denied. However, this denial does not mean you are out of options when it comes to pursuing benefits. There is a process to provide additional information to the insurance company or alternatively pursue an appellate process that could overturn your denied claim.
There are five primary steps in the appeals process:
Contact the Employee Assistance Office
Your first step toward filing an appeal requires you to contact the Employee Assistance Office (EAO) with the Florida Division of Workers’ Compensation. Once you contact this governmental entity, it will reach out to the insurance company in an effort to resolve any dispute.
In cases where the denial is based on missing documentation, this step could resolve the complaint. Most of the time, the insurance provider will reject the EAO’s intervention.
File Your Petition for Benefits
Initiating the appeals process formally requires the filing of a Petition for Benefits. This petition must be filed with the Offices of Judges of Compensation Claims (OJCC). From there, that office has 40 days to schedule a mediation.
Mediation
A mediation is a form of alternative dispute resolution (ADR). At a mediation, you will sit down with representatives of the insurance company, along with a neutral mediator. This individual will work to bring both sides together in an effort to reach a resolution for your claim.
Hearing
If mediation fails, the next step is a hearing before the OJCC. This hearing must occur within 90 days of the mediation and no later than 210 days following the filing of your Petition for Benefits. These trials are similar to other civil lawsuits and include witness testimony and documentary evidence.
Final Appeal
If you are unhappy with the outcome at the hearing, you have a final opportunity to secure benefits with a final appeal. This happens not within the workers’ compensation system but in the Court of Appeals. You have 30 days to file your appeal in order for it to be heard in federal court.
Let Us Help You Recover Benefits Following a Workplace Accident
If your workers’ compensation claim was denied following a workplace injury, the team at Bogin, Munns & Munns can help. Call us for your free initial consultation. We look forward to assisting you with obtaining the workers’ compensation benefits you deserve.
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