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Wage Loss Benefits in Florida: Workers’ Compensation for Injured Employees
When a worker in Florida is injured on the job, understanding the workers’ compensation system becomes crucial. One of the key components of this system is wage loss benefits, which are designed to provide financial relief to employees who cannot earn their usual wages due to a work-related injury or illness. Being familiar with the types of benefits available, the calculation methods, and the claim process can help employees better navigate their rights and responsibilities. When challenges arise, legal assistance can help ensure workers receive the compensation they deserve.
What is Workers’ Compensation?
Florida’s workers’ compensation system provides benefits to employees who suffer work-related injuries or illnesses. This program covers medical expenses, rehabilitation costs, and wage loss benefits, which are intended to replace a portion of the income an injured worker loses while unable to work.
Types of Wage Loss Benefits
In Florida, wage loss benefits under workers’ compensation are categorized into four types.
Temporary Total Disability (TTD) Benefits
Workers who cannot work at all due to their injury are eligible for TTD benefits. TTD benefits are calculated as 66 2/3% of the employee’s average weekly wage (AWW), subject to a statewide maximum. Injured workers can receive up to 104 weeks of TTD benefits or until they reach maximum medical improvement (MMI), whichever comes first. MMI is the point at which a doctor determines that the injured worker’s condition is not expected to improve further with medical treatment.
Temporary Partial Disability (TPD) Benefits
TPD benefits are available for workers who work in a reduced capacity but earn less than 80% of their pre-injury wages. TPD benefits are calculated as 80% of the difference between 80% of the employee’s AWW and their post-injury earnings. Like TTD benefits, TPD benefits can also be received for up to 104 weeks or until the worker reaches MMI.
Permanent Total Disability (PTD) Benefits
PTD benefits are granted to workers who are permanently disabled and cannot engage in any form of employment. PTD benefits are calculated as 66 2/3% of the worker’s AWW and continue for the duration of the worker’s disability, potentially for life. PTD benefits are payable for life and subject to regular review and potential adjustments based on changes in the worker’s condition or other circumstances.
Impairment Income Benefits (IIB)
Workers who reach MMI and have a permanent impairment rating are eligible for IIB. IIB benefits are based on a predetermined schedule that considers the severity of the impairment. The benefits are typically calculated as 75% of the worker’s AWW and adjusted based on the impairment rating assigned by a physician. The impairment rating determines the duration of IIB payments, with a specific number of weeks assigned for each percentage point of impairment.
Calculating Average Weekly Wage (AWW) )
The Average Weekly Wage (AWW) is critical in determining wage loss benefits. It is generally calculated based on the worker’s gross earnings during the 13 weeks before the injury, including wages, overtime, bonuses, and other income. The AWW calculates all types of wage loss benefits under workers’ compensation in Florida.
Filing a Claim for Wage Loss Benefits
Injured workers should take the following steps to file a claim for wage loss benefits.
- Report the Injury: Notify the employer of the injury as soon as possible, ideally within 30 days of the incident. Delayed reporting can jeopardize the claim.
- Seek Medical Attention: Obtain medical treatment from an authorized provider. The doctor will evaluate the injury and determine the level of disability, which affects benefit eligibility.
- Complete Required Forms: Fill out the forms that the employer or insurance carrier provides to initiate the claim process.
- Keep Records: Maintain thorough records of medical visits, treatments, and any communications related to the claim.
Common Challenges and Solutions
While workers’ compensation aims to protect injured workers, several challenges can arise during the process.
Delayed Payments
Workers may experience delays in receiving wage loss benefits due to processing errors or disputes. To mitigate this, maintain open communication with the insurance carrier and promptly provide any requested information. If delays persist, consider seeking legal assistance to resolve the issue.
Denied Claims
Claims may be denied for various reasons, including disputes over the cause of the injury or failure to follow reporting procedures. Workers can appeal the decision through the Florida Office of Judges of Compensation Claims (OJCC) if a claim is denied. An attorney specializing in workers’ compensation can be beneficial in navigating the appeals process.
Disputed Disability Ratings
Disagreements may arise over the impairment rating assigned by the physician, affecting the benefits received. In such cases, a second opinion from an independent medical examiner (IME) can provide clarity. Workers can request an IME if they disagree with the initial evaluation.
Seeking Legal Assistance
Understanding the workers’ compensation system can be challenging, particularly when it comes to wage loss benefits. Employees have the right to seek assistance from an attorney. An experienced lawyer can offer valuable guidance, advocate for your rights, and work to secure the fair compensation you deserve.
Struggling with a Work Injury? Get the Compensation You Deserve!
Have you been injured on the job? Confused about your rights and benefits under Florida’s workers’ compensation system? Let Legler, Murphy & Battaglia, LLP guide you through the process and help you fight for the compensation you deserve! The complexities of the workers’ compensation system can be overwhelming. Let us help- we handle all injuries all the time. Contact Legler, Murphy & Battaglia, LLP at 941-909-3763 for a free case evaluation.
