This is called comparative fault. Fortunately for you, your fault in causing the accident is not taken into consideration unless you purposefully hurt yourself, unlike in a personal injury case where your own fault is important and diminishes the value of your case. Florida is a no-fault system that was created in exchange for not being able to sue your employer (in most instances).
If your work comp doctor recommends any medical care, I need to attach the report or script containing the recommendation to the PFB. If you aren’t getting paid, I need the date you were last paid/last worked, your 13-week wage statement, and information regarding any income you’ve received during that period of lost time in order to prove your claim.
The first thing we need to do is send the insurance company a grievance letter requesting payment for and provision of specific benefits to occur within the Statutorily-proscribed timeframe. If the insurance company doesn’t provide or authorize those benefits timely, then we can file our claim with the Court, which is a called a Petition for Benefits (PFB).
Work comp provides lost-wage benefits (called “indemnity” or disability benefits) as well as medical care. It does not provide for pain & suffering nor loss of enjoyment of life like a personal injury case does.
Then your case just became way more difficult in that it is your employer would have to pay for your benefits out-of-pocket. However, since your employer was required to have coverage but didn’t, per FS 440.06, it would lose certain defenses to the case such as that the injury was caused by the negligence of a fellow servant, that the employee assumed the risk of his/her employment, or, most importantly, that the injury was due to the comparative negligence of the employee.
Your employer is required to have work comp insurance in the following instances: (1) Non-construction industry – four or more employees including business owners who are corporate officers or LLC members; (2) Construction industry – one or more employees including business owners who are corporate officers of LLC members; (3) Agricultural industry – six or more regular employees and/or twelve or more seasonal workers who work more than 30 days during the season but not more than a total of 45 days in a calendar year.
No. Your employer should have work comp insurance, and what we do is petition to the Court for the insurance company to provide and pay for those benefits enumerated in the Statute.
You, as the injured worker, are considered a Claimant. Then you have your Employer and its work comp insurance company, called the Carrier, and its representative, called an Adjuster; sometimes the Carrier has another company handling the case, called a Servicing Agent. On the medical end, there are authorized doctors, expert doctors (called Independent Medical Examiners – “IME’s”), and the judge’s expert (called Expert Medical Advisor – “EMA”).
Some other experts include Vocational experts, who offer opinions as to the classification of your work and whether you can work at all; economists, who offer opinions on the present and future value of monies; and others. On the employment end, you have your supervisor and co-workers.
Basically, it’s a set of laws (Florida Statute 440) afforded to those whose injuries occurred by accident and arose out of the course and scope of employment. But it’s not as simple as that.
