Workers' Comp - Florida

Can you settle before MMI

barbrajean — Tue, 30 Sep 2008 17:44:43 GMT

I am still having problems after my initial surgery 8 months ago and with 4 months of physical therapy. My new doctor says I may need another surgery. My hardware is coming out (which was shown on an x-ray) Also I may have some nerve damage. I had a nerve test and am still waiting results.(my doctor wouldn't give me results over phone, wanted to talk to me in person. I have very little ROM in my injured hand. Also because of non use of my hand I may have a problem with my other hand as a direct result of the original injury.

I have a mediation soon. Before mediation I will know for sure what my doctor plans to do. I at least know that he will be fixing that hardware that is coming loose. (which is surgery)

So can you settle before MMI? If so what is considered? I have not improved 10% since I first started PT. I can not bend my wrist in any direction without severe pain. I am tired of dealing with everything having to wait for authorizations for either tests or continued PT.

Old injury from job not reported, now having problems.

inxsary — Tue, 27 Jul 2010 03:17:45 GMT

Hi everyone,

Last October I injured myself at my job. It was (at the time) very minor- a slightly pulled muscle, or so I thought. I shook it off and continued to work. I did not report the injury as I was able to continue. I left the job last February. In June I decided to seek medical help with some nagging symptoms that may be related to the original on-the-job injury. My personal health insurance has sent me a form which is to help them determine if the original injury for which I now seek medical help with is from a work-related accident or automobile accident.

I am worried that if I report it on this form as a work-related injury, one that I never reported, I will be denied my health care insurance coverage. What happens next if I do tell my insurance company that this orignally happened at work? There was only one other person present when I did hurt myself, who also no longer works with the company, and whomI doubt would remember it happening.

My instinct is to not say it was possibly work-related, since in fact, I don't know that it is for sure

Thanks for any advice.

-K

W/C Question / almost 2 years later.

Beba813 — Sat, 24 Apr 2010 02:02:48 GMT

I was hurt at work in May 2008. Had major back surgery Jan 2009. Was back to work by April 2009. I never seeked a lawyer, but looking back now I think I shouldve. I wasnt mistreated. I received 2 bills but they were quickly taken care of by workers comp.

In March 2010, I was doing the only job I could really do, seeing how the DR. told me that I couldnt lift anything over 15 lbs. ever again. So I had to sort these assortment boxes.... I told them that they were getting to be too heavy, and they emailed the distribution center and they fixed it. Then it started again, and I told them they were getting too heavy again, because I tried to pick one up, but it didnt feel light. I was told to suck it up. And do my job. So I had to ask people to help me pick them up and place them on something so I could sort it out. So because my back started to slowly start hurting again I told my boss that I would have to slow down and take a break. He started to lecture me about my shoes. The same shoes I wear at my other job where I am always on my feet walking around with no problems at all.

April 2010, I was told to pull out a pallet to the front. I told them I couldnt do it, and they still made me. Some of the boxes fell off and I had to stop to pick them up. I picked one up that was too heavy. I told my boss that I thought I rehurt myself, and he lectured me about my shoes again. So i asked if I could go home. He told me "no.. not untill you finish what you were working on and then another dept" I then started to feel sick to my stomach because my back was hurting so badly. He then reminded me after I was done I could go. Then when the team went on break he and there were people around he asked me if I could stay. I left as soon as the store opened and havent looked back. Granted its only been 2 days. But wakeing up in the morning and not being able to move its my cup of coffee.

I dont know if I should presue a lawyer, I dont want to waste anyones time. But them refuseing to let me leave because Im in pain doesnt seem right.

Workers Comp. Deposition

Injured Confused — Thu, 25 Mar 2010 02:50:30 GMT

It's been 3 years now and I'm still fighting with WC for medical benefits. I'm scheduled to have a deposition in the near future... What will I expect, need to be aware of (heads-up) during this procedings is greatly appreciated. By the way, I had cervical neck fusion about 6 months ago ( 2 levels) and currently have a bulging disk below the implant due to the accident. According to my neurosurgeon, I will need further surgery and I'm still in alot of pain... Can someone point me to some statistical research in regards to this... I have search the net and can't find anything. Thanks in Advance!!!!

Settlement how long?

Stephanie209 — Fri, 19 Mar 2010 11:41:45 GMT

I had mediation a month ago and we came to a settlement(washout) I have signed all settlement papers, was wondering how long it takes to get check?

Florida Condo Law RE: Work. Comp.

Anacreon — Fri, 05 Mar 2010 17:20:08 GMT

Many condo associations will not allow contrators with Workers

Compensation "Exemptions" in Florida to work on the property.

Why? Because then the associations cannot be named

insureds, and as importantly, Forida condo law shifts the

responsibility to the associations if the contractor is uninsured.

True?

I would appreciate responses from any Florida condo lawyer who knows

about this problem. I would add that Florida Chapter 489 says that

Workers Comp. coverage is necessary to secure a contractor's license

from the State (for certain trades.) It says nothing about "Exemptions"

issued by the State Workers' Comp. agency.

Thank you.

the subject

Taxes?

Englishrose — Tue, 02 Feb 2010 18:52:00 GMT

Is the monies I received during 2009 from WC benefits taxable?

Wages vs Adjusted Gross Income

T Oroz — Sun, 31 Jan 2010 01:17:31 GMT

Work Comp attorney says Florida goes by the Adjusted Gross Income figure on our 1040 form for him to calculate how much we earned - and thus insurance needs to pay. We believe it should be the Non-employee Compensation figure from our 1099-Misc form. Subcontracting work. Who's right?

Workers' Compensation 101

Attorney Riviere — Thu, 21 Jan 2010 21:34:13 GMT

Workers' compensation is a no-fault statute. It doesn't matter whose fault the accident was, or whether your employer was at fault, it just matters that the injury arose in the course of employment from the nature of the employment.

This means not all accidents which happen at work are caused by work. See my earlier post.

In exchange for not having to prove what caused the accident, the benefits injured workers' get are more limited than what you would expect in a normal tort setting. You can't sue for pain, suffering, scaring, emotional distress, loss of earning capacity, or loss of spousal comfort.

The benefits you can receive fall into 2 basic categories. Loss of earnings and medical care.

Medical care for the work injury is generally available as long as it is medically necessary and related to the work injury. There are some exceptions to this rule, but the medical care will continue even after you reach maximum medical improvement as long as a more than a year doesn't go by between authorized doctors visits. Medical care continues even if you leave or are fired from your job.

Temporary loss of income benefits are available for up to 2 years. These benefits are paid at the rate of 2/3 of your weekly wage when you are on a no work status and less when you have returned to work, but are earning less than your regular wage.

After 2 years, the worker must be permanently and totally disabled, in order to continue to receive lost wages. Permanent total disability is defined as an inability to perform sedentary work within a 50 mile radius of your home.

FCE test what to know

jennifer1976 — Tue, 04 Aug 2009 18:50:22 GMT

I have an FCE test scheduled and I wanted to know that if they ask me to do something and I know I can not do, do I tell them I can't or do I try. Alot of the things I can not do involve pain. For example picking up anything over 5lbs hurts and my doctor has written up to 10lbs.

Is there anything else I should know about this test or anything. Thanks

Election Date on OWCP's Election Form CA-1105?

Sarah2010 — Tue, 10 Nov 2009 19:52:30 GMT

Hello,

I hope someone can answer this question because I've been trying to find an answer for the last 10 months but unable to.

My question is in regards to the Labor Department's Election form (Form CA-1105).

I have approved disability claims with both OWCP and OPM and I was told that I can switch between the two agencies at any time. I was originally with OWCP and switched to OPM about 2 years ago. Now I would like to switch back to OWCP due to a death in the family and financial reasons.

I read on a website that I would be eligible for retroactive pay from OWCP for the difference in pay between OPM and OWCP for the 2 years that I have been with OPM. Is this accurate?

If so, does the retroactive date (when I switched to OPM 2 years ago) go on the "election date" line on Form CA-1105? Is this how I let OWCP know that I want to claim retroactive benefits (e.g. the difference in pay between OWCP and OPM) for the 2 years that I was with OPM?

If anyone can answer this, I would greatly appreciate it.

Thank you for your help.

Workers' compensation - Causation and Notice

Attorney Riviere — Thu, 24 Dec 2009 16:10:43 GMT

Workers compensation is a no-fault statute. Anyone having an injury while working, and which is caused by the working conditions, has a workers compensation case. The injury must be reported within 30 days.

NOTICE

If you fall off a ladder at work and injure yourself, report the injury to your supervisor immediately. If you hurt yourself but you think it's minor and not worth reporting, mention it to someone if you can. You have 30 days to formally report the injury. If it's past 30 days you can still report it, but it gives the carrier a notice defense. But typically the carrier's case must be prejudiced by the lack of timely notice to get this defense to stick. So report your injury, even if it's past the 30 days.

If it is a repetitive trauma case, like carpal tunnel from using a keyboard, the 30 days begins to run from the last day you were exposed to the trauma with the same employer.

For heart and lung cases, or occupational disease/exposure cases, the time for reporting the injury runs from the date you became disabled, i.e. the date you were no longer able to perform your job.

CAUSATION

The biggest misconception here is that any injury which occurred at work must be work related. Not true. If you bend over and pick up a penny while at work and strain your back it is non-compensable. There is no increased risk of injury due to your working conditions. Likewise injuries suffered while going to or from a fixed office location, or lunchtime accidents off the employers property are generally considered non work related.

There must be an injury which results from conditions specifically attributable to work.

If you have questions, it's always better to speak to a lawyer. Many will answer questions over the phone, or you can contact the employee assistance office, through the division of workers' compensation at the Florida Department of Financial Services.

Unemployment and W/C

ProblematicGuy — Wed, 05 Aug 2009 19:36:03 GMT

I have settled my case and reached MMI. I am seeking new employment since being released for work but am not having much luck. An I elgible to claim unemployment after recieving TPD benefits for roughly a year and a half? Thank you in advance for any help.

Need some clarification please

Englishrose — Tue, 06 Oct 2009 19:37:44 GMT

Just got home from my last visit from the neurosurgeon who did a kyphoplasty back in July. He had sent me for a FCE (functional capacity evul) and wanted to go over it with me. He tells me I 'didn't do very good' and I asked him what that meant. He said the paperwork they sent to him says I "refused all lifting activities. Pt. states 'I'm afraid to lift anything due to my unsucessful surgery and I don't want to hurt myself'. This is true and it was the very last test that proposed. Everything else asked of me I did and it took three hours to complete. On another page it has a box that asks if consistent effort was given and it is checked YES. So now I am confused. I do not know if he was upset at saying the surgery he preformed was 'unsucessful' or what!!!

The thing is it is documented in his hospital, surgical report that he was not as sucessful as he had hoped as the INJURY WAS TOO OLD. The previous neurosurgeon (his partner) had told me back in June that if the surgery was not done SOON , that the bones on the collapsed vertebrae would fuse together and I would be in pain for the rest of my life. The surgery took place FIVE WEEKS after the initial office visits with them.

I have retained a Workmen's comp attorney as of about five weeks ago and even though I gave them all the doctor notes and surgical notes that I had (I try to get copies of everything) so far nothing has been done. When I inquired at the office today if they had received anything from my attorney they said NO. So I called the lawyer's office up right there. She REFAXED everything necessary to get the ball rolling. Someone is BS'ing me here.

Anyway, the Dr. filled out his own FCE form as well and wrote I could return to work with restrictions but also that I have a THREE percent permanent impairment rating. So what does that mean? This whole thing has dragged on and on since I was injured in Jan. of this year!! I have done all that was asked of me and I am upset the doctor was making me feel like I just didn't try hard enough to get an A or whatever it was I was suppored to accomplish. Sorry for the length. I am just waiting to see if the attorney's think I have a case or not. What does the 3 percent rating mean? Thanks.

No IIB yet

barbrajean — Thu, 17 Sep 2009 18:18:01 GMT

It has been about 7 weeks since my tpd benefits have stopped due to reaching MMI and I have an impairment rating and I still have not gotten anything from W/C. Also have not gotten mileage I sent out 2 months ago.

I called my attorney and let him know. His legal assistant said the insurance company has 60 days to pay mileage (thought it was 45?)but then when I asked her about the IIB she got my attorney on the phone and I let him know this and he said the insurance company wants to settle. He told me when I go see my doctor to get a Future medical expense report filled out.

Ok that's great and all but I want my IIB and mileage. Why isn't he asking the insurance company for these benefits? Is it so I don't look desperate for money and they will figure I would settle for less if I am and by filing a PFB they will know they are right about me needing money?

I go to my doctor next week cause I am having some problems still, if my doctor was to take me off MMI would the insurance company still have to pay me those IIB or would TPD start again?

Earlier this year it was stipulated that they pay me TPD benefits till I reach MMI.

The insurance company is even denying my medicine. Thankfully I found a pharmacy for injured workers and they give you your medicine even if the insurance company denies you them.

Sounds to me they are the desperate ones who want to settle. Any advice would be great thanks.

FMLA AND AWW QUESTIONS

barbrajean — Tue, 15 Sep 2009 14:40:08 GMT

Actually this is for a friend of mine who just got injured a few weeks ago.

He was told that he needs surgery on his shoulder. His doctor said he could be out 3 months. His employer told him if he was out three months they would have to let him go. FMLA protects your job for up to 12 weeks right? I told him he needed to fill out these papers with his surgeon before he has surgery. So the doctor needs to write the fmla papers from day of surgery till up to the 12 weeks. Is that correct fmla protects you for 12 weeks? He has been there for 6 years and they employ more than 50 employees.

Also he is a delivery driver and he gets paid hourly plus depending on how much he delivers.(gets money for each case delivered.) He is not making 80% of his aww because he is on light duty. Does W/C have to pay him the difference?

Should he get a lawyer? They are good about getting him his doctors appointments and everything but he is worried about losing his job. Any information would be great.

W/C questions

barbrajean — Fri, 04 Sep 2009 22:49:23 GMT

I have reached MMI and have gotten an impairment rating. I know the insurance company has 14 days after acknowledgement of my MMI and impairment rating to send me an Impairment income benefits check. Well I know they have acknowledgement because they stopped my TTD benefits. I mean is this true? If it is true will they have to pay intrest and or penalties? If so what is the rate?

After reaching MMI, I know there is a 10 dollar co-pay for office visits. Is there a co-payment for medicine?

I sent a mileage request in on July 1st. Give about 4 days to get there. I haven't gotten anything back yet. Is there a time limit? And if so how long and if it has been over that will they owe penalties and or interest on that?

Should I put in for a PFB?

OJCC case number inactive

jennifer1976 — Wed, 26 Aug 2009 22:06:45 GMT

Just wanted to know why a OJCC case number would be inactive?

Results of FCE test

jennifer1976 — Wed, 19 Aug 2009 14:01:43 GMT

I had my FCE test and my doctors office called me and told me that the physical therapist agreed with what he said. I can not lift anything over 10lbs and I have an impairment rating of 14%

What happens now?

I'd like to move forward with my life and put this all behind me. In my case what is considered in a settlement if I were to settle?

Workers compensation Appeal

Carltiff — Wed, 29 Jul 2009 16:05:03 GMT

My world came crashing down upon me along with the 20 foot ladder I was on top of at work on Feb 10, 2005. I was injured at work(Anheuser Busch) when a ladder fell out from under me. The accident occurred in 2005 and I was taken to a private doctors office by a security guard in a company vehicle instead of to the hospital by ambulance. I had an injury to my back , a concussion and an open head wound that required 28 staples on the outside and 32 stitches on the inside to close up. Since I had double vision, a Taxi was sent to my house for a couple of weeks everyday to pick me up and take me to work then take me back home after work so Anheuser Busch would not have a lost time accident on their hands. I was treated under workman's comp doctor at first until he said he could do nothing else for me. So I went to my primary care doctor to receive treatment unaware that it destroyed my my workman's comp case. I was needing relief from pain and some help. I underwent pain management nerve block shots for over a year and half. Before finally breaking down and having surgery. It got to the point I could not walk. The statute of limitations may have run on my case but it was not like I was not getting treatment. I feel as though I am slipping through the cracks of the legal system with no one to help. I NEED SOMEONE TO HELP ME. I had back surgery the first week of March this year and have just started back to work last week and I am afraid I will not be able to continue to work . Well I lost my workmans comp case (OJCC case No.08-006379SLR on a technical issue about whether or not the insurance company sent out a workman's comp rights pamphlet. I could not afford the appeal at the time because I was out of work. Is there anything else I can do? Thank you for your time and any recommendations you could make for me. Carl Johnson

Psychiatric impairment rating plus other questions

jennifer1976 — Mon, 06 Jul 2009 16:45:08 GMT

I was injured and during this time, I became depressed and the psychiatrist I am seeing feels my Psychiatric "condition" is that of my industrial accident. I was put at mmi for my physical accident but not yet for the psychiatric part of it. My question is What kind of an impairment rating can a psychologist give? Plus earlier this year it was court ordered that the work comp insurance company pay me till I reach MMI. Now I am at mmi for the physical part but not psychiatric part, do they still have to continue to pay me or not?

The judge just stated till I reach MMI but didn't state for both or a specific one.

If you need any additional information please let me know thanks

work in TN. employer in FL

need help in TN — Sun, 14 Jun 2009 19:03:45 GMT

I work in Tn and my employeris in FL. I needed immediate care while on my job and I called my supervisor and he told me to go to E.R, which I did. Now I find out my employer did not have W.C. insurance at the time and the bills have not been paid, The creditors are coming after me and informing the credit bureau that I have not paying my bills and sending them to collections. What can I do?

Imparment rating and compensation

Tapap — Thu, 11 Jun 2009 21:44:55 GMT

Hello.

I was injured at work and it resulted in a knee replacement. Now I have reached MMI and I was givven a 10% Permanent Imparment Rating (body as a whole) and it also says; Body part/system: 4%.

There are still alot of tasks I cannot do such as knel, squat, or go up and down stairs with my leg.

My adjustor says I am to recive only a few hundred dollars for my compensation and that if I need any more work on my knee in the future it will come out of my pocket. I do not understand. Iv been dealing with this for over 1 1/2 years now and I have to change the way I live my life because of this and im being told that i will only recive a few hundred dollars for my leg and no future medical help.

I am either interested in medical treatment in the future, because the doctors informed me that the implant will only last 10-15 years, or compensation for the impairment and pain and suffering with my leg so I can cover future medical treatment

Can anyone give me some advice as to what I should do or consider?

Thank you

not a work related injury

darkmoor — Fri, 05 Jun 2009 02:14:13 GMT

I hurt my lower back at work getting into the driver's seat from the driver's side. My job is delivering packages and driving is part of my job. This hapened on may 8, 2009. I have hurt my lower back twice before (95, and 02) working for the same company. Each time i have notified my employer and filed a claim.

The original diagnosis was a lower back strain/sprain. After i had an mri done, the diagnosis was lower back sprain/strain /severe degenerative disk disease. The mri also showed a "disc bulge" among a bunch of words that i have no clue what they mean. He also said that the injury/illness for which treatment was sought was not work related. How can this be true? I was on the clock when it happened.

I was released back to work with no functional limitations, even though I still have some pain, although not near as bad as it was a day ago.Do i need to retain a lawyer? Should I file for a one time change in doctors to get a second opinion? Also, i experienced sharp pain in my lower back at work while I was on TAW. I informed my supervisor and he said that they would not have me do that type of work again.I also informed my doctor on my next visit about what happened and he said it was up to me to follow my restrictions. yes, i had given my employer the papers with my restrictions on them.

Any advice or information would be appreciated and helpful

Workers Comps benefits denied

BenSpendor — Sat, 16 May 2009 13:39:58 GMT

Ive sustained an industrial injury to my back and have been paid TTD indemnity to the state maximum since Jan 1 2009. In March, my entire division was laid off. My physician has released me for light duty, which was unavailable due to the layoff. Now, the carrier has denied all indemnity for TPD because of the layoff. Should I contact an attorney to petiton for benefits or is the carrier in fact no longer liable for lost wages?