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Workers’ Compensation Claim Process

The workers’ compensation claim process can be swift and efficient or long and drawn out. If all goes well, you can start receiving medical treatment within days of the accident and wage replacement within a week. However, if the insurance company decides to drag out the process, dispute the evidence, or deny the claim, getting the benefits you feel entitled to can be an uphill climb. Assistance from a skilled and experienced workers’ compensation attorney can be key at many stages of the process to help your claim move forward to a swift and successful conclusion.

Below you’ll find a brief outline of the Florida workers’ compensation claim process. For help with your claim, call Chadwick & Chadwick in Tampa. We handle workers’ compensation claims statewide and have a long record of helping injured workers get the benefits they are owed. At Chadwick & Chadwick, you’ll receive personalized attention and a high level of individualized service from a team of skilled and dedicated Florida workers’ compensation attorneys. Call 813-264-1500 for a free consultation and immediate assistance.

Step One: You Notify Your Employer

The first critical step in the workers’ compensation claim process is to make sure your employer knows about the injury. You must advise your employer of your injury within 30 days after the date the injury occurred or when it first manifested itself. If you fail to notify the employer within this time frame, you won’t be able to pursue a claim for benefits. Only a few exceptions to the 30-day notice requirement exist:

  • Your employer already knows about the injury
  • You didn’t know the injury was work-related until you saw a doctor, and you notified your employer within 30 days of getting that medical opinion
  • Your employer never notified you about this requirement by posting a notice as required by law
  • Other exceptional circumstances exist that justify the failure to notify the employer

Step Two: Employer Notifies Carrier

Once the employer is made aware of the injury, they have seven days to report it to their insurance carrier and provide a copy to the employee. You can also notify the insurance carrier directly if you believe your employer has not followed through on this step. The carrier’s name and contact information should be provided to you on the “Broken Arm” poster which is required to be displayed at your workplace.

Step Three: Carrier Sends Brochure to Employee

After the carrier learns of the injury, they have three days to mail or e-mail you an informational brochure that explains your rights, benefits, the procedures for obtaining benefits and assistance, and other required information. Along with the brochure, you should also get a letter informing you of services available from the Division of Workers’ Compensation (DWC) to assist you with your claim. You might receive these documents in a packet with other important documents, such as a copy of your accident report, a form authorizing you to release your medical records to the insurance carrier, a medical mileage reimbursement form, and a statement warning you about workers’ comp fraud.

Step Four: Carrier Files With DWC

Once notified by the employer, the insurance carrier has 14 days to file the required information with the DWC.

Step Five: Get Care and Benefits

If all goes smoothly, you should be authorized to receive medical care from an authorized doctor, and you should begin treatment right away. Ask your employer or the insurance company for the name of a doctor you can go see. The doctor bills workers’ comp directly, so you don’t have to pay for treatment out of pocket. You should never get a bill for medical services you receive through workers’ comp. You should also start receiving wage replacement payments once you have been out of work for seven days.

Step Six: File a Petition for Benefits if Necessary

If your claim is denied, or if is taking too long to be approved while you receive endless pushbacks and demands for more information from the insurance company, it might be time to file a petition for benefits with the Office of the Judges of Compensation Claims (OJCC). The petition you file must be well-drafted. It should be detailed, accurate, complete, and supplemented with medical evidence and other necessary and helpful information. An incomplete or insufficient petition will only cause your claim to be rejected or further delayed.

For these reasons, it is recommended to have an experienced workers’ comp attorney prepare your petition. Your lawyer can also intervene on your behalf and attempt to resolve your claim with the insurance company without involving the courts. Unless you’ve already made a good-faith effort to resolve your claim, your petition won’t be well-received by the OJCC.

Step Seven: Hearing

Once you’ve filed your petition, the insurance company has 14 days to either pay the claim or file a response with the OJCC. If they file a response, OJCC assigns a judge to hear your case. At this hearing, the judge receives evidence, listens to testimony, and hears legal arguments from the parties through their attorneys. At the conclusion of the hearing, the judge will make a decision regarding your claim.

Step Eight: Appeal

If the OJCC decision does not go in your favor, you have the option of appealing to the First District Court of Appeal in Tallahassee. Your lawyer should sit down with you and have a frank discussion about whether it makes sense to pursue an appeal in your particular situation. At Chadwick & Chadwick, we only charge a fee if we are ultimately successful in your case.

Contact Chadwick & Chadwick for Help With Workers’ Compensation Claims in Florida

The workers’ compensation attorneys at Chadwick & Chadwick are here for you throughout the claims process. Not only do we work toward a successful resolution of your claim with skill and efficiency, but we do so while providing personal attention to you and a high level of personal service to make sure your needs are being met not just in the end but along the way as well. Call 813-264-1500 for a free consultation to find out how we can help you. Based in Tampa, we help injured workers throughout Florida statewide who are having trouble getting their workers’ compensation benefits paid as they should be. Call now to start getting the benefits you are entitled to.

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