Florida Workers'
Comp Process.

Seeing A Doctor

If your injury does not require emergency treatment at a hospital, you are usually told to go to a walk-in clinic or urgent care center. You are not entitled to choose your own physician, except in limited circumstances.

Often, you will be asked to take a drug test on the day of the accident. If you refuse and your employer has a “drug-free workplace” policy in place, you risk losing your benefits. If your drug test comes back positive, then you may also have a problem that will jeopardize your benefits, but that depends on the circumstances.

Covered Benefits

Once you have been seen by your authorized treating physician, you will follow the course of treatment until you reach MMI. During this period, you will pay nothing for your medical care. Everything is covered, even your prescriptions and your transportation. You are entitled to a medical mileage reimbursement, or actual transportation provided by the insurance carrier.

At some point, your physician will place you at Maximum Medical Improvement. After that, you will have a $10 co-pay for all treatment visits.

You are entitled to future medical care following MMI as long as your industrial workplace accident is and remains the Major Contributing Cause of the need for the treatment. However, you must receive a benefit or treatment at least once a year, or your claim may be closed and you may be barred by the Statute of Limitations from ever making a claim for benefits under this accident again.

Temporary Total Disability Benefits

If you are unable to work at all following your accident, you should be entitled to Temporary Total Disability (TTD) benefits.

If you are released to work with restrictions (“light duty”), then, if your employer can accommodate you, you must return to work. If your employer cannot accommodate you, then you are entitled to Temporary Partial Disability (TPD) benefits.

All of your indemnity, or disability, benefits are based upon your Average Weekly Wage (AWW) at the time of the accident. Your AWW is calculated by taking your pretax wages from all “covered” employment for the 13 weeks prior to the date of the accident, adding them up and dividing them by 13.

You are entitled to TTD or TPD when you are unable to work due to your accident-related injuries, up to the point you reach MMI.

At MMI, your temporary benefits end. If you have a permanent injury, your physician should address that and assign you a Permanent Impairment Rating (PIR). If you have a PIR, you will be entitled to Impairment Benefits based on the percentage of your PIR.

If you are unable to return to work at even a sedentary job, then you may be entitled to Permanent Total Disability (PTD) benefits.

Reaching MMI

Maximum Medical Improvement is an important point in a workers' compensation claim. It generally means your physician believes your condition is not expected to substantially improve with further treatment.

Reaching MMI may affect temporary disability benefits, future medical treatment and whether your physician assigns a Permanent Impairment Rating.