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Which Bills Are Covered By Workers’ Compensation?

WC_Claim

Workers’ compensation insurance can be confusing to the average layperson, who tends to come away from information sessions or meetings knowing only that if they hurt themselves on the job, they will in theory be covered. The reality is that things can be much more complex, depending on their specific job, the facts of their injury, the type of policy their employer has, and the industry they work in, among other potential questions. While there is no substitute for doing one’s due diligence on workers’ compensation, it is possible to get at least a good idea of the types of bills covered by the average employer’s policy.

General Coverage

There is a roughly accepted list of bills that nearly all workers’ compensation policies will cover, absent irregularities in the nature of the injury. Examples include immediate medical bills, equipment and medicine required for treatment and rehabilitation, lost wages (up to a point), and income replacement or temporary disability payments. It is noticeable, in looking over the law, that it explicitly states that “pain, and other subjective complaints alone,” are not compensable under workers’ compensation.

The degree and length of these payments will generally vary depending on the injured person’s employment and type of injury. A broken leg suffered on the job might totally disable, say, an EMT, while someone in a white-collar, sit-down job, such as a secretary, might need mere days before being able to return to the office. As such, the EMT and the secretary would likely receive different payments, because the injury disabled them to different degrees.

What Is Not Covered?

It may seem silly to state, but workers’ compensation will not cover the bills for injuries that were not sustained or exacerbated on the job (for example, if someone has carpal tunnel syndrome and was later diagnosed to have exacerbated that condition at work, it would in theory still be covered). That said, even some on-the-job injuries are not going to be covered by an employer’s workers’ compensation, because certain conditions were or were not observed. For example, if the employee does not observe standard safety protocol and is injured, they will usually be held to have assumed the risk or acted so negligently that their injury is not compensable.

Injuries that are not reported properly may also not be covered, even if sustained on the job. Florida law requires that any workplace injury be reported to the employer either within 30 days of the accident or, with certain conditions not immediately visible like repetitive stress injuries, within 30 days of a doctor’s diagnosis of a workplace-related injury. If this is not done, your injury may not wind up being covered as the insurance company essentially has no proof that the injury occurred in the manner stated. Being on top of such reporting requirements can help ensure that your injury is covered.

Call Our Orlando Workers’ Compensation Attorneys

If you are genuinely injured on the job, it is important to understand what is covered, what is not, and what ‘coverage’ actually means. If you still have questions, contacting an experienced workers’ compensation lawyer is a good next step. The Orlando workers’ compensation attorneys at the Hornsby Law Group are well versed in these types of cases and are happy to try and help you with yours. Call us today to schedule an appointment.

Resources:

myfloridacfo.com/Division/wc/pdf/WC-System-Guide.pdf

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.09.html

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