What Issues Are Not Covered Under Workers' Compensation?

Workers' compensation coverage in Florida covers most on-the-job injuries; however, it doesn't always cover all of them. Today, we will review what issues are not covered under worker's compensation and what this means following your accident.

What Is Workers' Compensation?

Workers' compensation, also referred to as workers' comp, is a state-mandated program that covers an employee who becomes injured on the job. The employer and not the employees pay for the premiums for this insurance coverage. Each state has its own workers' compensation laws. To learn more, visit the US Department of Labor online.

What Injuries Are Not Covered

• While workers' compensation covers the majority of workplace injuries, some are not covered.
• Accidents that happen as the result of an act of God
• Common one-time illness
• Pre-existing condition that existed before the employee was hired
• When the employee contracts an ordinary disease of life
• The employee was fooling around, and this behavior caused the injury
• Employees who suffer a heart attack
• Injuries sustained after starting a fight in the workplace
• Injuries that are the result of repetitive mental trauma
• Injuries suffered during an off-duty recreational activity
• Injuries sustained after an employee violated company policy
• Injuries sustained while committing a crime
• Injuries were sustained while the employee was under the influence
• Injuries suffered while the employee was not on the job
• Minor injuries that can be taken care of with basic first aid
• When an employee willfully injures himself

What Expenses Are Covered Under Workers' Compensation?

It is important to review what kind of expenses are covered under workers' compensation. The payments for this coverage are typically modest, but they do cover the following:

• Medical care as the result of the injury or illness
• Doctor visits
• Prescription drugs
• Hospitalization
• Expenses for rehabilitation and physical therapy
• Replacement income
• Permanent injury compensation
• Survivor benefits

Are There Any Exemptions for Workers' Compensation in Florida?

If there is a business with fewer than four employees, that business may be exempt from establishing workers' compensation insurance. However, if a business has more than four employees, whether they work full-time or part-time, the employer must carry workers' compensation insurance that covers all employees in the workplace.

Filing a Workers' Compensation Claim

When filing a workers' compensation claim in Florida, there are steps you need to take. You want to begin by writing down the details of what happened and collect any evidence you can to prove your claim is valid. You need to seek immediate medical treatment and report the incident to your employer.

Once all this is done, you want to be sure to follow up with your employer while making sure to document everything. If you speak with the insurance company, be mindful of what you say.
Better yet, before speaking to the insurance company, inform them that you will be first consulting with your workers' compensation attorney. Your attorney can then handle the situation from there.

Now is the time to file your petition and resolve any disputes there may be. This step must happen when the employer and the insurance company have not resolved anything. You will provide a detailed description of the accident and the injuries, list all medical, lost wage, and other benefits due, and file your claim for interest and payment on unpaid benefits.

Statute of Limitations on Workers' Compensation Claims in Florida

In Florida, you have just two years from the date of the injury to file your petition. Your workers' compensation attorney can help you navigate the process and ensure that everything is handled correctly and in due time.

If you have been injured on the job and your employer and the insurance company have failed to provide coverage, consult with an experienced workers' compensation attorney. They can be the middleman and help negotiate a fair settlement for your injuries.