Delray Beach Workers’ Compensation Lawyer
If you have been injured at work or suffered a work-related injury, then you may be aware that personal injury law between an employer and an employee differs from other types of personal injury law. The state requires some employers to carry a special type of insurance, known as workers’ compensation insurance, to cover work-related injuries. The requirements for qualifying for this type of coverage differ from the requirements to recover for other types of personal injuries, in ways that can both benefit and hinder employees. That is because the workers’ compensation system actually requires both employers and employees to abandon the common law claims and defenses to injuries that are have developed in the personal injury context and, instead, adhere to very specific laws governing recovery for work-related injuries. The theory is that it will benefit both employers and employees, by making it easier for employees to recover for work-related injuries while limiting the potential liability of employers for those injuries.
However, at Demand the Limits Law Firm in Delray Beach, Florida, our workers’ compensation lawyers understand that workers’ compensation laws do not always work to protect both parties. Instead, by limiting an employee’s access to other traditional personal injury remedies, workers’ compensation claims can really hamper an employee’s ability to get compensation for an injury. If you have any concerns about your personal injury claim, we urge you to seek a consultation with an experienced workers’ compensation attorney, early in the process, to ensure that you are protected. We offer free consultations, but, even if you do not choose a consultation with our firm, we urge you to consult with an attorney before you do anything that might impact your right to recover.
What is workers’ compensation?
Workers’ compensation is a state-mandated insurance program. Generally speaking, workers’ compensation provides coverage for workers who received work-related injuries or illnesses, without requiring the worker to establish that the employer was at fault, and without the employer being able to avoid liability because the worker was at fault. However, while it may seem like the law provides blanket coverage for all work-related injuries, there are several exemptions in the law. For example, not all employers are required to provide coverage. In addition, specific types of workers, generally those in inherently dangerous and physically demanding jobs, may not be covered by workers’ compensation. Furthermore, while a worker may not have to establish fault to recover and while an employer may be barred from using some defenses, a worker whose behavior is reckless or illegal, may be barred from making a claim.
Florida Statutes § 440 governs the applicability of workers’ compensation laws to specific employer-employee relationships, and governs whether or not a workplace related injury should be covered by workers’ compensation. In addition to referring to the statute, you also need to understand the reimbursement or fee schedules that apply to workers’ compensation claims. These fee schedules are found in the reimbursement manuals maintained by the Florida Chief Financial Officer’s Workers’ Compensation Division.
What types of injuries or illnesses are covered by workers’ compensation?
In theory, workers’ compensation covers a wide range of workplace-related injuries and illnesses, including injuries received from workplace accidents, repetitive stress injuries, injuries or illnesses received from exposure to workplace chemicals or other environmental factors, and mental health illnesses or nervous conditions. However, while a workers’ compensation may cover a wide range of claim types, the injured worker must be able to establish that the injuries were a result of workplace or work-related conditions. In addition, if an outside, intervening factor, such as a pre-existing injury, exacerbated the severity of an injury or illness, the employer may only be liable for part of the injury.
Do injuries or illnesses have to occur at work in order to be covered by workers’ compensation?
No. Workers’ compensation covers work-related injuries and illnesses, which may or may not occur at the workplace. In fact, you may receive an injury at the workplace that might not be covered by workers’ compensation coverage if the injury did not arise out of employment or occur during the course of employment. The real question is whether you were doing something that would benefit your employer. If so, then it is usually considered in the course of employment and can be covered by workers’ compensation coverage.
Can workers’ compensation cover me for an injury I received while on a break?
One common question is whether injuries that are received while on breaks are covered under workers’ compensation. If the injury was received while you were still on the premises, especially if you were in a place designated for breaks by your employer, such as a breakroom or cafeteria, then the injury will probably be covered as long as you were engaging in behavior that was appropriate for that room or space. However, if you receive the injury off the premises during break-time, even if it occurred during your normal working hours, it probably will not be covered. However, if you are doing something work-related during that time, such as picking up food for your boss or entertaining a client at lunch, then it could be considered work-related.
What about injuries received at a work-related function?
Another common question is whether injuries or illnesses received at work-related functions are covered by workers’ compensation insurance. This is another complicated issue. Many workplaces sponsor off-duty events, such as holiday parties, picnics, or even company sports-teams. Whether or not injuries received at these events is covered can depends on several factors, including whether or not the employer expects or requires employees to attend these functions.
Are commuter injuries covered by workers’ compensation?
Generally, injuries received in the commute to and from work are not covered under workers’ compensation, even though you cannot do your job without getting yourself to work. However, do not just assume that if you have an injury during a commute that you are not covered, because there are several important exceptions to that general rule. For example, if you are commuting in a work vehicle, running work related errands for an employer, traveling on a business trip, driving as part of your job or to get to a client’s home or place of business, or required to drive your car to work for use during the work day, then it may be covered.
Does workplace misconduct bar me from recovering under workers’ compensation?
Not necessarily. If you were injured while breaking a workplace safety rule, you may be barred from recovery. However, it really depends on the circumstances of the injury. For example, if you violated a workplace safety rule that was not actually observed by anyone in the workplace, you may have a better chance of recovery than if you violated a safety rule that was observed and enforced.
Generally, drug or alcohol usage can bar you from recovering under workers’ compensation laws. If you were intoxicated at the time of the accident and the intoxication was a contributing factor or the cause of the accident, then it might bar any type of recovery.
In addition, willful misconduct can lead to you being ineligible for a workers’ compensation claim. Willful misconduct includes employees who are engaging in horseplay, who are intentionally breaking workplace safety rules, who are committing crimes, or who are trying to hurt themselves or others. However, once again, these general exceptions will not always bar coverage. If an employer knew about the misconduct and permitted or encouraged it, then an employee may still be covered by workers’ compensation.
Does workers’ compensation cover illnesses?
Workers’ compensation can cover some illnesses. This is especially true for illnesses that have a documented relationship to certain workplace working conditions. However, it can be difficult to prove that an illness was caused by workplace exposure. Therefore, if you are attempting to get coverage for an illness, especially one caused by long-term exposure, then you need to be prepared to demonstrate that the illness is directly linked to the workplace environment. This can be relatively simple in some contexts, where reliable medical research and evidence demonstrate a link between certain occupations or work conditions and certain medical diseases. However, for other diseases that can have multiple causes and are not specifically linked only to occupational conditions, the claimant is going to have the burden of proof to demonstrate that workplace exposure either caused or contributed to the illness. Some conditions that might be covered include heart-conditions, digestive issues, and lung conditions.
Does workers’ compensation cover cumulative or repetitive-stress injuries?
Yes, workers’ compensation can cover cumulative or repetitive-stress injuries. However, once again, it can be difficult to demonstrate that the repetitive-stress injury is due to working conditions. Repetitive stress injuries can occur anytime a worker is required to perform the same physical tasks repeatedly, and are associated with a wide variety of jobs.
Does workers’ compensation cover mental health, nervous conditions, or stress-related conditions?
While workers’ compensation may provide coverage for health conditions that are related to on-the-job stressors, the exact nature of the stressors and the resultant injury or illness are important factors in determining whether an employee has a viable workers’ compensation claim. Because every situation is very fact-specific, the best way to determine whether your stress-related claim might be covered by workers’ compensation is to consult with an attorney.
Can I get workers’ compensation if I had a pre-existing condition?
The existence of a pre-existing condition does not prevent you from collecting workers’ compensation for an illness or injury. In fact, many successful workers’ compensation claims are based on the theory that working conditions exacerbated a pre-existing illness or condition.
Do all employees get workers’ compensation coverage?
No. Whether or not an employer is required to have workers’ compensation coverage for employees is covered by statute. Whether an employer is required to carry that coverage is based on several factors, such as the number of employees, the type of business, and the nature of the work. In addition, the statutes specifically exclude certain classes of workers. Your employer may have different types of insurance coverage to cover you if you fall outside of workers’ compensation coverage, or you may be forced to seek damages under more traditional personal injury law.
Can a private doctor treat a workers’ compensation claim?
This is a difficult question to answer. Florida statute provides that employers can have managed care arrangements specifically designed to treat workers’ compensation insurance claims, and that, in those instances, the employer may not be responsible for bills incurred seeking treatment from other healthcare providers. However, it is an opt-in system and not every employer has the same arrangement.
Is workers’ compensation the only remedy for a workplace or work-related injury?
Maybe. Generally, if workers’ compensation covers your injury or illness, you will not be able to bring a tort-based claim against your employer. However, there may be exceptions, most based on employer misconduct. If your illness or injury was due to your employer doing something wrong or if your employer failed to have required workers’ compensation insurance, then talking with a workers’ compensation attorney who also handles other types of personal injuries is the best way to determine what remedies are available to you.
Does workers’ compensation only cover medical bills?
While the main purpose of workers’ compensation may be to cover employee medical bills for work-related injuries or illnesses, it is not the sole purpose. Workers’ compensation is also meant to provide the worker with time to recover from the illness or injury, which means paying a portion of the person’s missed wages. Fee schedules can help you determine the appropriate amount of a workers’ compensation claim, but they are generally less than full-salary, and cover the time period that you must miss work because of the illness or injury.
Conclusion
Workplace or work-related illnesses and injuries are probably the most stressful type of personal injury. After all, in order to seek compensation, you often have to file a claim against your employer. Suddenly, the company upon which you depend for your livelihood is now an adverse party. In many situations, workers’ compensation claims are processed smoothly and efficiently without any negative impact for the employee. However, that does not occur in all cases. If you have any concerns about being treated fairly in your workers’ compensation claim, we urge you to contact a workers’ compensation attorney before filing your claim. At Demand the Limits in Delray Beach, we offer free consultations, where we go over the facts and circumstances of your illness or injury and let you know how we can help you. We also handle personal injury cases if you are not covered by workers’ compensation or if your employer failed to have required workers’ compensation insurance.