Florida workers’ compensation system is designed to provide medical treatment and disability benefits to employees who were injured at work. Unlike a negligence lawsuit, like a car accident case for example, it does not matter who was at fault for your work injury. Even if you were at fault, you will likely be eligible for benefits if you were injured during the course and scope of your employment. But you need to know what benefits apply to your claim and you should expect that the insurance carriers will be looking for reasons to deny some, if not all, of the benefits your seek.

If you were injured at work, Florida law requires you to report a work injury within 30 days of the accident or within 30 days of learning the condition is work-related. The Florida statute that you can review concerning reporting your injury is Florida Statute §440.185. If you fail to report the injury timely, the insurance company can deny your claim.

I recommend that after a work accident, the injured workers does the following:

• Tell your supervisor as soon as possible.
• Make sure a written accident report is created.
• Keep a copy for your records.

Often an employer may not prepare a written report. In those instances, I recommend that you send some form of written communication to your employer that documents the incident. An email, or even a text message, can suffice. The worker simply needs evidence that he/she notified the employer of the accident, and written notice is always preferred over verbal notice.

Next, if you need medical attention, you should ask your employer to authorize a medical provider who can treat your injury. Too often injured workers go see their personal primary care provider for an initial evaluation but that would be a mistake. In Florida, the injured worker does not get to choose the doctor that will treat their injuries. Florida law allows the insurance company to select your treating physician. If you go to your personal doctor without approval, your medical bills may not be covered.

Internal link: Do I Get to Choose My Own Doctor in a Florida Workers’ Comp Case?

https://miamiworkcomplawyer.com/post/who-selects-the-doctors-that-will-treat-you-for-your-workers-compensation-injury-.html

After you report your injury to your employer, the employer should notify their insurance carrier of your injury. This would typically result in setting up a claim and an insurance claims adjuster is assigned to your case. Unfortunately, too often, an employer elects not to report the claim. Sometimes the employer is hopeful that you will recover quickly and avoid reporting the claim all together. So, to protect your rights, you may need to file a Petition for Benefits with the Office of the Judges of Compensation Claims (OJCC) to place the insurance company on notice of the claim and to seek the applicable benefits. The process for filing a Petition for Benefits can be found in Florida Statutes §440.192.

I would not recommend that you attempt to file a Petition prior to retaining legal representation because the applicable statutes have specific requirements that must be met. Otherwise, the Petition can be dismissed by the Judge of Compensation Claims.

As of January 1, 2025, Florida increased both medical reimbursement rates and weekly wage benefits:

• Medical providers treating injured workers now receive up to 175% of Medicare rates (surgeons up to 210%).
• The maximum weekly benefit has increased to $1,295.

These changes improve access to medical care and provide stronger wage protection for injured workers.

Many claims are denied due to avoidable errors:

• Waiting too long to report an injury.
• Seeking treatment from an unauthorized doctor.
• Not following the doctor’s restrictions or skipping appointments.
• Giving incomplete or inconsistent statements to the insurance company.

Even if you follow every step, insurance companies sometimes deny claims. They may argue that your injury isn’t work-related, that you missed a deadline, or that your medical condition is pre-existent to your work accident and therefore, not compensable.

If this happens, don’t give up. You have the right to challenge the decision.

Internal link: What to Do if Your Workers’ Comp Claim Is Denied in Florida

https://miamiworkcomplawyer.com/post/worker-s-compensation-claim-rejected-.html

While it’s possible to navigate the Florida workers’ comp process alone, I certainly would not recommend that you attempt to do so. Remember that insurance companies have attorneys working for them who advise the claims adjuster how/when the benefits you are requesting can be denied. You need an attorney on your side who can:

• Ensure all deadlines are met and paperwork is filed correctly.
• Push back against insurance company tactics designed to minimize benefits.
• Advocate for your right to medical treatment.
• Help you pursue additional claims (such as against third parties) if applicable.

​​​​​​​Remember: The insurance company has lawyers working to limit what they pay. You deserve someone fighting for your best interests.

Filing a workers’ comp claim, and then likely filing a Petition for Benefits, involves more than just reporting an accident. It will require navigating a legal process where insurance companies often look for reasons to deny benefits. By understanding how to file workers’ comp in Florida, knowing your rights, and avoiding common mistakes, you put yourself in the strongest position to recover the benefits you deserve.
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If your claim has been delayed, reduced, or denied, contact Juan Lucas Alvarez today for a free consultation. Juan Lucas has represented injured workers for the past 25 years. He’ll review your case, explain your options, and fight to protect your rights.