Workers Compensation in the State of Florida - Research Paper Example

Running Head: WORKERS COMPENSATION IN FLORIDA Topic: Workers Compensation in the of Florida Lecturer: Presentation: Introduction Workers compensation scheme is a state regulated law requiring employers to insure their employees against work related injuries or death. It is compulsory in Florida although in some circumstances are exempted or one can lodge for exemption. Insurance services are offered by insurance companies commonly known as carriers or employer self-insurance. Employers with less than four employees are exempt from workmen compensation and so is the case for domestic servants. Workers are entitled to benefits only if the accident or death arises in the course of employment and for work which he/she is assigned to do. Intentional injuries are not compensated and it is a criminal offence to give false information about the cause of injury. The purpose of this research is to evaluate the laws and policies involved and the type of injuries, benefits and how to claim compensation in the state of Florida. Benefits and Entitlements Workers are entitled to make claims in regards to injuries arising out of work while in the course of employment. These injuries may result in temporary total disability, permanent disability or permanent partial disability as well as death. To calculate benefit entitlements worker are divided into classes according to the type of duties they perform or job description. Each category has an average wage which is used in determining premiums paid by employer and in compensation (Justice Newsflash, 2010). Workers are entitled to claim benefits as a result of occupational diseases acquired at work due to use of harmful chemicals or other substances that may affect health. The employer is supposed to hire a certified medical practitioner or recommend a list of practitioners where injured employees can be medically examined. If established that indeed the employee suffered injury, the following benefits are payable:-Medical benefits whereby full medical benefits are given but after maximum medical improvement, a $10 patient copayment is required for all medical services and non attendance to medical exams is fined 50% (Larson, 2003). Temporary total disablement are subject to social security and unemployment insurance and are calculated as % of workers wage subject to weekly maximum and payment is up to 104 weeks. Permanent total disability benefits are paid as long as disability continues and are subject to legal deductions while permanent partial disablement is % of weekly payments and has no minimum. Disfigurements such as facial or head are also payable. Other benefits are; occupational hearing losses and physical rehabilitation. Death benefits are payable to deceased’s spouse or children and includes burial expenses. Injury Management Employers have a duty to ensure workmen compensation costs are minimized by putting up procedures and educating employees on steps that can be followed in case of injuries. The supervisors should be able to monitor employees and provide necessary assistance and report injuries as soon as they occur (Florida Law, 2007). Taking injured employee to medical practitioner quickly can minimize more problems. The employer should also liase with insurance carriers to ensure smooth administration of benefits and avoid further losses. He/she should also ensure a smooth return to work by injured employees to avoid further damage. Injury Statistics According to the department of finance of Florida (2010), the total number of permanent total disability in the year 2009 in the manufacturing industry was one and total medical bill of $ 111,136. The total benefits paid were $ 123,290. The figure was higher in the service industry as 11 people suffered permanent total disability in the same year. A total medical bill of $ 729,414 and total benefits $ 793,988 were paid. The total number of workers who suffered temporary total injuries in manufacturing sector was 1704 with total benefits amounting to $ 22,432, 747 and only 1647 cases were compensated. In service industries there were 8730 cases where 8343 were compensated with total benefits of $ 96,331, 018. We can deduce that temporary total impairments are few than permanent total and service industry has a higher number of injuries than manufacturing sector in the state of Florida. Making a Claim Making claims is a process that involves filling out forms for compensation. Before making a claim, the accident should have arisen from work performed in course and scope of employment. Employees working outside the state at request of employer are payable. Employees covered by other safety benefits are not liable to pay and same case applies to negligent, intoxicated and those involved in drug abuse. Employers fills application form on behalf of employee and together with policy documents from carrier, they are submitted to department of insurance for processing. Non use of safety compliance gadgets is liable to reduction of 25%. Accident arising out of transport provided by employer is not payable. For compensation to occur, enough evidence is required to support the claim. Medical evidence especially for occupational diseases is inevitable. Chapter 69L-3 is concerned with claims through various forms. DFS-F2-DWC forms are filled for claim (Workers Compensation, 2010). Preventing and Resolving Disputes The Employee Assistance and Ombudsman office is vital in dispute arbitration. It offers assistance to employees, employer and carriers and arranges meetings to settle disputes before an employee can result to court petitions. An employer can also prevent and control claims by offering safe working environment, training employees on prevention and engaging services of a competent insurance carrier to avoid delays and disputes. Reporting claims on time is also essential and taking care of necessary steps to control further claims (Finance department, 2010). The courts also help in resolving disputes. The office of judge of compensation claims deals with petitions from aggrieved parties and decides whether they are justifiable and if not he dismisses them. Petitions should be well drawn by competent lawyers or Employee Assistance Ombudsman where an employee does not have a lawyer. Certificate should be issued that shows other means of solving disputes had failed. An attorney fee is not paid if case dismissed. Reporting Incidents or Injury This is a process involving notification of relevant authorities. The first step is for employee to notify employer of injury within 30 days. After receipt of claim, employer reports the injury to carrier within seven days or within 24hours in case of death, employer to notify the department. Details provided are; name, address social security number, occupation, nature and cause of injury, date of occurrence and any other information (Florida Law, 2007). The carrier then files information with the department within 14 days from day of notification and also sends a brochure to employee detailing rights and responsibilities. Medical reports, funeral expenses are sent later to department. The employer provides employee with written notice regarding availability of Ombudsman services and failure to send notification to the department is subject to administrative fine not exceeding $ 1000 for each failure (Department of finance, 2010). Rights and Responsibilities An injured worker has a right to benefits that are payable to him/her which are owed and certified by the department. He/she also has a right to sue employer for non payment of due benefits, denial of proper treatment, being forced to return to work before recovery, termination for absence due to injury or denial of permanent total disability by practitioner. However, he has a responsibility of ensuring safety by wearing safety gears and following rules (Larson, 2003). Acts Workmen compensation is governed by a state Act. Chapter 440 of Florida statutes under title XXX1 Labor takes care of workers compensation while chapter 67-3 deals with claims. There are other Acts that guide certain groups of workers such as Jones Act for seamen, Harbor workers compensation Act among others. Those covered under those Acts are not covered under Act 440 of Florida statutes (Department of finance, 2010). Codes of Practice Under chapter 440.442, judges should abide by code of conduct as adopted by Supreme Court. Any judge violating laws is subject to suspension or termination by the governor as it is abuse of office. All other parties concerned should also bide by laws, should give correct information of injury occurrence as lying would result to fraud which is punishable. The judge should not favor any party whether employer or employee (Department of finance, 2010). Fraud Fraud occurs when either of the parties concerned knowingly provides false information regarding an accident or death of an employee at workplace or outside workplace. The correct details should be provided by employee, employer, carrier and the department. Chapter 440. 1051 stipulates the rules for fraud. The department of insurance should provide toll-free tel.no through bureau of fraud to received fraud reports, any informer giving false evidence commits felony of 3rd degree which is punishable. Reported individuals should not retaliate unless information given is false and is also punishable for committing a crime (McConnaughhay & Moniz, 2002).The fraud reporter is not liable for such actions and should be protected. Regulations and Standards Employers should ensure health and safety standards are maintained at the workplace. An employer with less than four employees can secure non payment of injury benefits. The employer should put posters or notices to inform such workers of the situation. Employer should insure more than four worker and failure to do so he/she is liable to pay such benefits if a case is filed against him/her by an injured employee. Employer in this case has no right to defend himself (Florida law, 2007).Safety gears should be provided to employees as well as first-aid kits for emergency use. A written safety policy and rules should be published and made available to employees and thorough inspection of workplace also ensures safety. A drug-free program should be established to curb such addictive behaviors and avoid injuries. Insurance Policies The policy covers the liability of employer to compensate employees and covers other businesses not covered in previous policy year. It protects employers from lawsuits by injured employees. The premiums paid yearly are based on payroll. The manual premium is multiplied by experience modification rate so as to encourage employers to reduce claims. The safety credit, drug-free credit and FCCPAP are then deducted to come up with total estimated annual premium which is audited thereafter to get the actual premium and make adjustment required (Florida law, 2007). Incentives in form of dividends are offered by insurance carriers for employers who have fewer claims. The limit of workmen compensation is $ 100,000 per occurrence, $ 500, 000 aggregate and $ 100,000 per disease. The rates are calculated according to classification codes given by NCCI (Justice Newsflash, 2010). Conclusion Workmen compensation in Florida is managed by the state and all employers are liable to offer this service except those with less than four employees or one employee in construction company whereas it’s voluntary for domestic servants. The workman compensation Act chapter 440 and 67-3 governs the administration of this law. Fraud cases are prohibited and offenders are punished according to supreme law .Benefits are paid in regard to temporary total disability, permanent total disability, permanent partial disability, medical benefits and death benefits. References Department of Financial Services. 2009. “Worker’s Compensation Statutes, Rules and Forms”. Division of Workers’ Compensation. April 20, 2010.http://www.myfloridacfo.com/wc/forms Florida Law. 2007. “Workers Compensation “. Bear Insurance Agency. Apr 21, 2010. Justice Newsflash. 2010. “NCCI is the Insurance Industry Cartel”. Injury News. Apr 2, 2010. Larson, A. 2003. “Florida Worker’s Compensation Benefits”. Expert law.com .Apr 21, 2010. http://www.expertlaw.com/library/comp-by-state/florida.html McConnaughhay, J. and Moniz, D. 2002. “Workers’ Compensation Settlements: The Next Generation”. Vol. LXXVI, 7 pp 71. WorkersCompensation. 2010. “Florida Workers Compensation”. WorkersCompensation.com. Apr 20, 2010. < http://www.workerscompensation.com/florida.php> Read More