Workers Comp Attorneys in Orlando

If your situation is similar to the examples below, it's time for a free consultation with a workers comp lawyer in Orlando. Read on to learn if you need an attorney, how they can help, and how much they charge.

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Workers compensation cases in Orlando don’t differ much from any city in Florida in most ways, but the city’s heavy reliance on tourism-industry jobs does produce one unique element.

How do companies deal with “freelancers”?

Freelancers are workers hired for a specific job, at a specific job site, for a specific amount of time. For example, if a convention is coming to Orlando, companies will hire freelancers to help with setting up the convention, catering it and breaking things down when it’s over. That employment could last anywhere from 1-to-4 weeks, depending on the length of the convention.

Freelancers aren’t considered full-time employees, but if they are injured on the job site, they still receive workers compensation benefits.

“They could be considered independent contractors (employers are not required to cover independent contractors for workers comp), but thankfully, because of the unions, they are considered employees and are covered for the time they are working,” said Scott Uricchio, the workers compensation expert at Orlando’s largest law firm, Morgan & Morgan.

“That’s really important with the convention industry we have in Orlando.”

One other unique aspect in Orlando is that most of the large employers self-insure for workers compensation. That means the companies pay all medical and wage-loss claims themselves rather than going through an insurance carrier.

“Dealing with the self-insured companies is actually a benefit in a lot of cases,” Uricchio said. “You don’t have to go through a third party (i.e. an insurance carrier) to get an answer during a settlement negotiation. You’re dealing directly with the guy signing the checks and it helps get things done. I don’t have any problem with it at all.”

» More about: The Workers Comp Process in Florida

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Reasons to Hire an Orlando Workers Comp Attorney

In an ideal world, when a worker is injured on the job, he would receive necessary medical treatment immediately, be fairly compensated for lost wages and return to work when he’s healthy.

Unfortunately, we do not live in an ideal world.

Workers often run into obstacles in one (or more) of the three key areas in workers comp – medical treatment, wage compensation or returning to their old job – and need help negotiating a system that has a lot of twists and turns.

“If the insurance company is doing what they’re supposed to be doing – paying for an injured workers medical treatment, paying lost wages – I’m more than happy to tell a client ‘you don’t need me. There’s nothing here for me to do,’ “ said Uricchio, who has been trying workers compensation cases in Orlando for more than 20 years.

“But if an injured worker has questions about his doctor or whether he’s receiving proper compensation, or what is involved in a settlement, then definitely, I would tell them to contact an attorney.”

Some of the signs that your case might be better handed by a workers compensation attorney in Orlando include:

  • Your employer or insurance carrier drags its feet with your claim.
  • You suffer permanent disability, either partial or total, that will prevent you from ever fully returning to work.
  • The insurance carrier denies your claim.
  • Your employer retaliates against you because you filed a claim.
  • You are ready for a settlement.

If any of these signs apply to your case, it could be time to call an attorney and see what can be done to receive proper benefits.

“There are rules and deadlines and procedures involved in workers compensation and if you don’t know them and meet them, you will lose your case,” Uricchio said.

That’s another sign you to hire an attorney!

What Does a Workers Comp Lawyer in Orlando Do?

Much of what is done (or not done) in a workers compensation case is based on the written recommendations of the doctors who treat the injured worker.

A doctor may tell a worker his injury requires surgery, but never put it in writing. Months go by with the injured worker waiting for a procedure that never takes place and finally asks: What happened?

“You need to get everything in writing,” Uricchio said. “I spend half my time telling clients that every time they walk out of a doctor’s office, they need to have something in writing that indicates the doctor’s recommendations and any work restrictions.”

That’s just one of many things a workers compensation attorney does for a client.

An attorney will represent you in the mediation process where you haggle with insurance carriers over a settlement. If mediation doesn’t settle the matter, it goes to a trial in front of a judge and no one should appear in front of a judge without an attorney representing them.

Some of the things you should expect an attorney to do for you include:

  • Assume responsibility for filing your case and meeting deadlines
  • Prepare your side of the argument, giving you the best chance of a favorable outcome
  • Conduct a pre-trial Investigation (deposition), which involves taking the sworn testimony of witnesses, Including the medical professionals that treated you
  • Handle ongoing settlement discussions with the Insurance carrier
  • Cross-examine the insurance company’s witnesses
  • If necessary, appeal the outcome.

That job should not be left up to amateurs.

“It’s my job to know how to navigate the obstacle course that is workers compensation,” Uricchio said. “Injured workers just don’t have the experience to know how a case is evaluated, what it’s worth and how to settle it. That’s my job.”

How Much Does a Workers Comp Attorney in Orlando Charge?

Workers comp lawyers work on a contingency basis, meaning they only get paid if they win and get you paid.

How it works is that the attorney’s fees come from a percentage of the benefits you win through a challenge in the court. If you lose, the attorney doesn’t get paid.

Now, how much they get paid is capped by the state of Florida, which has rules governing how much the attorney can charge. The limits are based on a percentage of benefits the worker receives.

The maximum fees for workers comp attorneys in Orlando are:

  • 20% of the first $5,000 of benefits
  • 15% of the next $5,000 of benefits
  • 10% of all benefits over $10,000

You have the option to waive these statutory percentages and agree to a set contingent fee in the attorney’s fee agreement. The judges in every case review the attorney’s fees to make sure the lawyer is compensated fairly and in accordance with the law.

What this system means for an injured worker is that if an attorney takes your case, he/she is fairly confident they are going to win. Most injured workers only ever pay an attorney’s fee directly from their settlement, if and when their case settles.

Handling a Workers Comp Case on Your Own in Orlando, FL

The first step in a workers comp case is to notify your employer. That will kickstart the process of filing a workers compensation claim. If your claim is denied, you have the option to appeal the decision.

Filing a Workers Comp Claim in Orlando, FL

Filing workers compensation claims in Orlando is a crucial first step in the workers compensation system and there are three parties involved  – injured employee; employer; and insurance carrier. All three have responsibilities that are vital in making the process work.

The injured worker obviously is the starting point. When a worker gets hurt in the workplace, he/she should inform their supervisor immediately, and, if necessary, go to the appropriate doctor, clinic or emergency room for medical treatment.

However, the law says that workers have 30 days from the date of the accident to report an injury. That deadline is important because the worker may initially experience only mild discomfort with something like a cut or muscle pull and not seek immediate treatment. However, if the cut gets infected or the muscle pull is aggravated and the employee suddenly realizes he/she needs treatment.

That’s why it’s so important to report an injury right away. Make sure your supervisor puts it on record that something happened and it may require medical attention. It could be the dealbreaker in getting a claim approved.

Employer’s Responsibility for Filing Claim

The employer has seven days after being notified of a work-related injury or illness, to file a report to their insurance carrier with details about the injury.

The initial report should include the employer’s identification information such as name, address, type of business. It should have similar information about the employee, including name, social security number, mailing address, phone number and occupation.

The report should have details about the type of injury, what caused it, statements from witnesses, the month, day and hour of the accident, where it happened and any other relevant information.

There could be occasions when the employer chooses not to report an injury. Often, it’s because the employer is worried about insurance premiums going up. If that happens, the employee can report it directly to the insurance carrier.

If an employee has any concerns about the way the accident was handled, they can call the Employee Assistance Office for Orlando at 800-342-1741 or email wceao@myfloridacfo.com.

Insurance Carrier’s Responsibility with Claims Form

The insurance carrier is the third part of the process and is responsible for filing a form called “The First Report of Injury” with Florida’s Division of Workers Compensation (FDWC). The employer and employee also should receive copies of the First Report of Injury to verify the information reported.

The carrier has three days to provide the employee with information that explains the rights, benefits and procedures for obtaining benefits. The brochure should explain the obligations injured workers and their employers have under Florida law and the penalties they face if they are found in violation of those laws.

If the employee misses eight days of work because of the injury, he/she becomes eligible for lost wages. In that situation, the carrier must notify the FDWC within 14 days.

It is in the carrier’s best interests to update the injured employee’s file with new medical reports and wage statements if the employee is due indemnity pay during recovery.

Deadlines for Orlando Workers Comp Claims

The deadlines for filing workers compensation claims in Orlando are clear, but it should be noted that an injured employee has up to two years to file a claim for benefits.

Here are some deadlines for the various players involved in workers compensation:

Employee: Florida law allows employees up to 30 days from the day of the accident to file an injury report, but all parties involved consider it best to do so immediately after the accident happens.

Employer: The employer must file an injury report with the insurance carrier within seven days of being notified.

Insurance carrier: The insurance carrier has three days to send a brochure to the injured employee that outlines their rights, benefits and procedures for obtaining benefits. If the employees expects to receive lost wages compensation, the carrier must report that to the FDWC within 14 days.

Occupational Diseases: If you are filing for death benefits due to occupational diseases, the death must have occurred within 350 weeks of the deceased’s last exposure to the source.

Appealing a Workers Comp Denial in Orlando, FL

The insurance carrier has 120 days from the time the injury was reported to tell the worker that a claim has been denied. When your claim is denied, there is a system set up to resolve the dispute. Here’s a walkthrough of what you’re facing on appeal of a workers compensation claim in Florida.

Step 1: Contact the Employee Assistance Office in Orlando

The Employee Assistance and Ombudsman (EAO) office counts itself as the first step in the appeals process. Their job is to investigate the dispute and try to get both parties to come to a resolution before the process gets costly. The EAO is part of the Florida Division of Workers Compensation and has satellite offices around the state of Florida.

Email: wceao@myfloridacfo.com
Phone: (407) 835-4407
400 W. Robinson Street, Suite N-509
Orlando, Florida 32801

Step 2: The EAO Contacts the Insurance Carrier

The EAO says it will contact the insurance company and see if it can resolve the issue to obtain benefits. There are common, and easily corrected mistakes with paperwork that can result in a denial. Sometimes the mistake is simply a miscommunication about what benefits are available and are easily resolved.

Step 3: The Insurance Carrier Issues a Denial

If things go well (that’s rare), the worker receives benefits and the case is closed. If not, (more often the case), the carrier has 14 days to deny lost wage benefits. If the dispute is over medical benefits, the carrier has 3-10 days to deny the benefit, depending on the cost. If they insist on denying the claim, the injured employee must decide if he/she wants to continue the appeal. If so, we move on to …

Step 4: Injured Worker Files a Petition for Benefits

The next step for employees is to file a “Petition for Benefits” with the Offices of Judges of Compensation Claims (OJCC). This is the start of what could be a long paperwork process. Details are vitally important. The Petition for Benefits has the usual identifying information (name, address, etc.), plus a detailed description of the injury, the employee’s responsibilities, the work assigned at the time of injury and a summary of the expected benefits.

Step 5: Insurance Carrier Responds to the Petition for Benefits

The carrier has 14 days to respond to the Petition for Benefits. They can choose to pay the claim or continue to deny it. Most claims are denied, and the process moves on to the next step.

Step 6: Mediation & Settlement Negotiation

A mediator is brought in to try and bring about a settlement. The Office of Judges of Compensation Claims has 40 days to set up a mediation. The mediator could be appointed by the OJCC’s office or, if both sides agree, a private mediator can be hired to try and resolve the issues. The mediator puts the two sides in separate rooms and goes back-and-forth between the two to try and reach a settlement. If the two sides agree, the appeals process ends and that is what happens in most cases. If not, it’s on to a hearing.

Step 7: Workers Comp Hearing

When the situation gets this far, it has official reached a really serious level. The hearing must take place within 90 days after the failed mediation, but no more than 210 days after the original Petition for Benefits was filed. The first step is a pre-trial hearing where the two sides identify disputed issues. The Judge sets a hearing date within the next 90 days. Lawyers for both sides introduce evidence and call witnesses to support their claims. The Judge has 30 days to reach a decision.

Step 8: Option to Appeal

If one side is still unhappy with the OJCC’s decision, there is an option for a final appeal to the First District Court. Rules say the appeal must be filed within 30 days of the OJCC Judge’s ruling, but this process often takes a year or more before the final appeal is granted or denied. The Court of Appeal receives the court records from the OJCC and both sides submit a written argument on the disputed issues. The Appeals Court can confirm the OJCC’s ruling; overturn that decision or turn it back to the OJCC for more findings.

 

About The Author

Bill Fay

Bill Fay has touched a lot of bases in his 45-year career. He started as a sports writer, gaining national attention for work on college and professional sports. He had regular roles as an analyst on radio and television and later became a speech writer for a government agency. His most recent work is as an internet content marketing specialist. Bill can be reached at bfay@workerscompensationexperts.org.

Sources:

  1. N.A. (2019, September) Workers’ Compensation System Guide. Retrieved from https://www.myfloridacfo.com/Division/WC/pdf/WC-System-Guide.pdf
  2. Barreiro, S. (2019, October 8) How to appeal Your Workers Compensation Denial in Florida. Retrieved from https://www.lawyers.com/legal-info/workers-compensation/the-workers-compensation-process/how-to-appeal-your-workers-compensation-denial-in-florida.html
  3. N.A. (2019, June 13) How to Appeal a Denied Workers’ Compensation Claim in Florida. Retrieved from https://www.payerlawgroup.com/how-to-appeal-a-denied-workers-compensation-claim-in-florida/
  4. N.A. (ND) Workers Compensation Programs. Retrieved from https://www.siia.org/i4a/pages/Index.cfm?pageID=4547#:~:text=A.,Compensation%20benefits%20to%20its%20employees.
  5. N.A. (January, 2020) Orlando’s Top 10. Retrieved from https://www.orlandostop10.com/employers.aspx