Injured on the Job in Florida, What Rights Do You Have? - Part 3

If you are unhappy with the doctor the insurance company selected for you, under the current law as of the date this article was written, you may request a one-time change of care. The insurance company must select and authorize another doctor (not associated with the current doctor) within 5 days of your request or you will be allowed to select your own doctor who will then become the new authorized treating physician. There are a number of complicated issues regarding this rule, which have resulted in a good deal of litigation. I would suggest consulting with an attorney who specializes in workers' compensation to better understand this area rather than trying to ask for a change of physician yourself. After all, the doctor who treats you will be the one whose opinions will likely determine all of the important issues in your case such as the course of treatment, referrals to other specialists, work status and restrictions where appropriate, impairment ratings, and the date of Maximum Medical Improvement (which has an enormous impact upon your rights to receive both money and free medical benefits). Attorneys who specialize in Workers' compensation know the reputations of most of the local physicians and can greatly assist an injured worker who needs to change doctors.

Money Benefits:

Money benefits are often referred to as Indemnity Benefits in Workers' Compensation. These benefits are based upon how much an injured worker made during the 13 weeks (or 91 days) before the accident. All of your wages, bonuses, and commissions paid/earned during that 13 weeks are added together and then the whole sum is divided by 13 pay to get the average weekly wage (called AWW). If you worked less than 3/4 of your normal hours during the 13 weeks immediately before your accident, the wages of a similar employee who worked during that same period will be used to calculate the AWW.

The average weekly wage figure will provide the basis for calculating all other money benefits due in your case and therefore a lot of attention has been focused upon this subject. Conflicts frequently arise between the injured worker and the insurance company over the correct number to use for the average weekly wage, especially when one of the following has occurred: the injured worker has not worked for the entire 13 week period before his or her accident; the injured worker had a second job during the 13 week period before his or her accident and those wages should be added into the calculation as well; the employer was paying the injured worker in cash or under-the-table and thus there are no records to substantiate the actual amount paid; benefits such as group health insurance or a place to live, which were being provided by the employer during the 13 weeks before the accident, have been discontinued and therefore the cost/value should be added into the AWW calculation. These issues have been the source of a great deal of litigation, which have resulted in additional rules and legislation to resolve them. A complete description of the manner and method of resolving each of those issues is too complex a subject to get into in this overview of Florida Workers' compensation Law.

There is no money or compensation payable for pain or suffering in Workers' Compensation. The five (5) types of money benefits available in Florida's Workers' compensation Law are; Temporary Total, Temporary Partial, Permanent Total, Impairment Benefits, and Death Benefits. The following is a brief description of each.

1) Temporary Total Disability, also known as TTD, is paid to the injured worker at the rate of two-thirds (66.67%) of the worker's AWW when the doctor completely restricts the worker from returning to work while treatment to improve the condition is ongoing. Usually, the doctor will give the injured worker a prescription or a form DWC-25 stating the injured worker is under treatment, has not reached Maximum Medical Improvement and is on a No Work Status. These benefits must be paid every 2 weeks while the injured worker remains on No Work Status.

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