What Is a Retroactive Workers’ Comp Policy in Florida?

Under Florida law, there are two main types of workers’ compensation benefits. “Medical benefits” cover the cost of treating eligible workers’ job-related injuries, while “disability benefits” provide partial wage replacement for those who are unable to work for an extended period of time.

Eligible workers can receive medical benefits immediately. If you have been injured on the job and you qualify for workers’ compensation, the costs of your medical care should be covered from the date of your injury. But, disability benefits are different. Disability benefits are not available right away—although workers who qualify can receive full disability benefits retroactively.

Understanding Disability Benefits Under Florida’s Workers’ Compensation System

In Florida’s workers’ compensation system, disability benefits help provide financial stability for employees who are forced to miss work after suffering job-related injuries. For most employees, these benefits are calculated as two-thirds of their average weekly wage. An employee’s average weekly wage is determined based on the 13 weeks worked prior to the week in which the employee gets injured.

Like medical benefits, disability benefits are generally tax-free—which is why employees do not receive 100 percent of their average weekly wage. However, unlike medical benefits, injured employees do not receive disability benefits right away. Instead, Florida has adopted a system that entitles injured workers to retroactive disability benefits when warranted.

When Can Employees in Florida Receive Disability Benefits Through Workers’ Compensation?

To be eligible for workers’ compensation disability benefits in Florida, an employee must miss more than seven days from work due to his or her injury. If you get injured on the job and miss more than seven days from work, your disability benefits will begin on the eighth day.

At this point, your disability benefits are not retroactive. In other words, you do not receive disability benefits for the first seven days you missed from work. If you are able to return to work on the ninth day, you will only receive one day of disability benefits.

So, when do disability benefits become retroactive? In Florida, the cutoff is 21 days. If you miss 21 days or less, you remain ineligible for retroactive benefits. But, if you miss more than 21 days, then in addition to receiving ongoing disability benefits until you get better (or until you exhaust your eligibility), you are also eligible to receive retroactive benefits for the first seven days you missed from work.

Seeking Retroactive Workers’ Compensation Disability Benefits in Florida

Even if you are eligible for retroactive workers’ compensation disability benefits, collecting these benefits probably won’t be easy. There are several reasons why including:

• Employers and their insurance companies will go to great lengths to avoid paying more than necessary. Even though you may feel as though you are unable to work (or unable to work safely), they may still claim that you are able to return to work within 21 days.
• Since Florida law allows employers to choose the doctors who treat their employees’ job-related injuries (when their employees file for workers’ compensation), workers’ compensation doctors often have the incentive to keep employers happy. In some cases, this may mean clearing an employee to return to work as quickly as possible—even if this is not entirely in the employee’s best interests.
• As an employee, collecting any workers’ compensation benefits can be challenging. There are several legal requirements to preserve your eligibility, and if you make any mistakes, these mistakes could jeopardize your claim for medical and disability benefits.

With these considerations in mind, if you have been injured on the job and think you may be entitled to workers’ compensation benefits, there are some important steps you should take promptly. There are also some steps you should take during your recovery. For example, you should:

• Report your injury promptly. If you are eligible for workers’ compensation benefits, you should report your injury to your employer as soon as possible. This will allow you to seek treatment from an approved doctor right away, and this will help avoid any questions about the cause of your injury.
• Talk to a workers’ compensation lawyer. We recommend that injured employees seek legal advice as early in the process as possible. An experienced workers’ compensation lawyer can help you understand what to do, what not to do and what to expect as you move forward.
• Follow your doctor’s advice (or seek a second opinion). To maximize your chances of receiving full workers’ compensation benefits, you need to follow your doctor’s advice. However, if you have concerns about your doctor’s advice, you can—and should—seek a second opinion. In Florida, injured employees have a one-time right to seek a second opinion from a different approved doctor at no cost.
• Keep track of the days you miss from work. If you work eight hours a day Monday through Friday, this should be fairly straightforward. But, if you work part-time, if you work on weekends or if you have an irregular work schedule, you should not trust your employer’s insurance company to determine your eligibility for disability benefits (including retroactive disability benefits).
• Work with your lawyer to calculate your disability benefits. In addition to keeping track of the days you miss from work, you should also work with your lawyer to calculate your disability benefits. Again, you do not want to rely on the insurance company to do this for you.

While filing a successful workers’ compensation claim can be difficult, it is extremely important to protect your legal rights after getting injured on the job. With the right approach and an experienced lawyer on your side, you can collect the full benefits you deserve.

Are You Entitled to Retroactive Workers’ Compensation Disability Benefits?

What benefits are you entitled to receive for your workplace injury? Contact us to find out. To schedule a free and confidential consultation with an experienced workers’ compensation lawyer at The Gallagher Law Group, call 954-530-7314 or tell us how we can reach you online now.