Can a Employer Not Approve My Disability Because Said I Will Not Be Back After Surgery

Injured Worker Frequently Asked Questions

How long after an accident do I have to report it to my employer?
When should my employer report the injury to their insurance company?
My employer will not report my injury to the insurance company. What can I do?
What kind of medical treatment can I get?
Do I have to pay any of my medical bills?
Will I be paid if I lose time from work?
How much will I be paid?
Do I have to pay income tax on this money?
When will I get my first check?
If I'm only temporarily disabled, how long can I get these checks?
Can I receive social security benefits and workers' compensation benefits at the same time?
Can I receive reemployment assistance and workers' compensation benefits at the same time?
What can I do if I am not receiving my benefit check?
If I am unable to return to work until my doctor releases me, does my employer have to hold my job for me?
Can my employer fire me if I am unable to work because of an injury and am receiving workers' compensation benefits?
If I am unable to return to the type of work I did before I was injured, what can I do?
My employer and the insurance company have denied my claim for workers' compensation benefits. Do I need legal representation to get my benefits? What should I do?
What is the time limit for filing a Petition for Benefits?
Is there a period of time after which my claim is no longer open?
Can I get a settlement from my claim?
If I settle my claim for medical benefits with the insurance company and my condition gets worse later, who pays for my future medical care, surgeries, etc?
What can I do when it is difficult to get a prescription filled or I am having problems with the pharmacy where I get my workers' compensation medication?
I am one of the individuals covered by s. 119.071 (4) (d), Florida Statutes who is eligible to have my "personal information" exempt from a public record release. If I am injured on the job, and my First Report of Injury or Illness is reported to your office, will your agency automatically withhold my personal information from a public record request?

How long after an accident do I have to report it to my employer?

You should report it as soon as possible but no later than thirty (30) days or your claim may be denied.

Reference: Section 440.185, Florida Statutes

When should my employer report the injury to their insurance company?

Your employer should report the injury as soon as possible, but no later than seven (7) days after their knowledge. The insurance company must send you an informational brochure within three (3) days after receiving notice from your employer. The brochure will explain your rights and responsibilities, as well as provide additional information about the workers' compensation law. A copy of the brochure can be viewed on this website under "Publications".

Reference: Section 440.185, Florida Statutes

My employer will not report my injury to the insurance company. What can I do?

You have the right to report the injury to their insurance company. However, if you need assistance, contact the Employee Assistance Office (EAO) at (800) 342-1741 or e-mail wceao@myfloridacfo.com

Reference: Section 440.185, Florida Statutes

What kind of medical treatment can I get?

The medical provider, authorized by your employer or the insurance company, will provide the necessary medical care, treatment and prescriptions related to your injury.

Reference: Section 440.13(2), Florida Statutes

Do I have to pay any of my medical bills?

No, all authorized medical bills should be submitted by the medical provider to your employer's insurance company for payment.

Reference: Section 440.13(13), Florida Statutes

Will I be paid if I lose time from work?

Under Florida law, you are not paid for the first seven days of disability. However, if you lose time because your disability extends to over 21 days, you may be paid for the first seven days by the insurance company.

Reference: Section 440.12, Florida Statutes

How much will I be paid?

In most cases, your benefit check, which is paid bi-weekly, will be 66 2/3 percent of your average weekly wage. If you were injured before October 1, 2003, this amount is calculated by using wages earned during the 91-day period immediately preceding the date of your injury, not to exceed the state limit. If you worked less than 90% of the 91 day period, the wages of a similar employee in the same employment who has worked the whole of the 91-day period or your full-time weekly wage may be used. If you were injured on or after October 1, 2003 , your average weekly wage is calculated using wages earned 13 weeks prior to your injury, not counting the week in which you were injured.

In addition, if you worked less than 75% of the 13 week period, a similar employee in the same employment who has worked 75% of the 13-week period or your full time weekly wage shall be used.

Reference: Section 440.02(28) & 440.14, Florida Statutes

Do I have to pay income tax on this money?

No. However, if you go back to work on light or limited duty and are still under the care of the authorized doctor, you will pay taxes on any wages earned while working. For additional information on Income Tax, you may want to visit the Internal Revenue Service website at: www.irs.gov

When will I get my first check?

You should receive the first check within 21 days after reporting your injury to your employer.

Reference: Section 440.20, Florida Statutes

If I'm only temporarily disabled, how long can I get these checks?

You can receive Temporary Total, Temporary Partial Disability payments or a combination of the two benefits during the continuance of your disability for no more than a maximum of 104 weeks.

Reference: Section 440.15(2), Florida Statutes

Can I receive social security benefits and workers' compensation benefits at the same time?

Yes. However an offset, or reduction in your workers' compensation check may be applied because the law states that the two combined may not exceed 80 percent of your average weekly wage earned prior to your injury. For further information on Social Security, you may contact the Social Security Administration at (800) 772-1213 or visit their website at www.ssa.gov .

Reference: Section 440.15(9), Florida Statutes

Can I receive Reemployment Assistance and workers' compensation benefits at the same time?

No, not if you are receiving temporary total or permanent total disability benefits as you must be medically able and available for work to qualify for unemployment. For additional information on Reemployment Assistance, you may want to utilize the Reemployment Assistance website at: www.floridajobs.org.

Reference: Section 440.15(10), Florida Statutes

What can I do if I am not receiving my benefit check?

Call the insurance company and ask for the adjuster or claims representative. If you still have questions and don't understand why the checks have stopped, call the EAO at (800) 342-1741 or e-mail wceao@myfloridacfo.com.

Reference: Section 440.14, Florida Statutes

If I am unable to return to work until my doctor releases me, does my employer have to hold my job for me?

No, there is no provision in the law that requires your employer to hold the job open for you.

Can my employer fire me if I am unable to work because of an injury and am receiving workers' compensation benefits?

No, it is against the law to fire you because you have filed or attempted to file a workers' compensation claim.

Reference: Section 440.205, Florida Statutes

If I am unable to return to the type of work I did before I was injured, what can I do?

If eligible, the law provides, at no cost to you, reemployment services to help you return to work. Services may include vocational counseling, transferable skills analysis, job-seeking skills, job placement, on-the-job training, and formal retraining. To find out more about this program, you may contact the Department of Financial Services, Division of Workers' Compensation, Bureau of Employee Assistance and Ombudsman Office (EAO) at (800) 342-1741 or by e-mail to wcres@myfloridacfo.com.

Reference: Section 440.491, Florida Statutes

My employer and the insurance company have denied my claim for workers' compensation benefits. Do I need legal representation to get my benefits? What should I do?

It is your decision whether or not to hire an attorney. However, the EAO can assist you and attempt to resolve the dispute. If unable to resolve, the EAO can further assist you in completing and filing a Petition for Benefits. This service is provided at no cost to you. For assistance call: (800) 342-1741 or e-mail wceao@myfloridacfo.com. For the location of the nearest EAO, see District Offices.

Reference: Section 440.191 & 440.192, Florida Statutes

What is the time limit for filing a Petition for Benefits?

In general, there is a two (2) year period to file a Petition. However, it depends on the type of issue in dispute. You may call the EAO at (800) 342-1741 or e-mail wceao@myfloridacfo.com for specific information.

Reference: Section 440.19(1), Florida Statutes

Is there a period of time after which my claim is no longer open?

If you were injured on or after January 1, 1994 , the claim is closed one (1) year from the date of your last medical treatment or payment of compensation. This period of time is referred to as the Statute of Limitations. If you were injured before January 1, 1994 , the period is two (2) years.

Reference: Section 440.19(2), Florida Statutes

Can I get a settlement from my claim?

Settlements may be made under certain circumstances and are voluntary; not automatic or mandatory.

Reference: Section 440.20 (11)(a)(b)(c), Florida Statutes

If I settle my claim for medical benefits with the insurance company and my condition gets worse later, who pays for my future medical care, surgeries, etc?

You are responsible for your future medical needs after your claim for medical benefits is settled.

What can I do when it is difficult to get a prescription filled or I am having problems with the pharmacy where I get my workers' compensation medication?

In Florida, an injured worker has the right to select a pharmacy or pharmacist.
Florida law prohibits interference with your right to choose a pharmacy or pharmacist. However, a pharmacy is not required to participate in the workers' compensation program. If at any time, you become dissatisfied with your pharmacy or pharmacist's services, you can seek another pharmacy to fill your prescriptions.

Reference: Section 440.13 (3)(j), Florida Statutes

I am one of the individuals covered by s. 119.071 (4) (d), Florida Statutes who is eligible to have my "personal information" exempt from a public record release. If I am injured on the job, and my First Report of Injury or Illness is reported to your office, will your agency automatically withhold my personal information from a public record request?

No. -- The "personal information" in s. 119.071 (4)(d), F.S. is defined as your address, telephone number, photograph, and social security number. Although photographs are not collected by our office, your social security number will always be redacted from any public record request pursuant to s. 119.071 (5) 5., F.S.. However, s. 119.071 (4) (d) 2., F.S., requires you or your employer to formally write to the custodial agency that is in possession of your personal information in order to claim the exempt status. Our office accepts emails, faxes or written correspondence when claiming the personal information exempt status. You must provide your occupation (title or description), name of employer, and date of injury associated with any Florida workers' compensation claim you filed, if applicable. You must also provide your date of birth and the last 4 digits ONLY of your social security number in order for us to establish accurate confidential record information. To request exemption of personal information maintained by our Division, you should email, fax or write to the following:

Division of Workers' Compensation
ATTN: Records Privacy Section
200 E. Gaines Street
Tallahassee, FL 32399-4226
dwcrecordsprivacy@myfloridacfo.com
Fax: 850-488-3453

Records Privacy Forms are located under Records

If you have a question and it was not answered in the above section, please contact the Employee Assistance Office at (800) 342-1741, or by e-mail:

Can a Employer Not Approve My Disability Because Said I Will Not Be Back After Surgery

Source: https://www.myfloridacfo.com/Division/WC/employee/faq.htm