The value of a Florida Workers’ Compensation claim encompasses several critical components, each of which contributes to the overall probable ultimate cost of the claim. Understanding these components is essential for injured workers to ensure they receive fair compensation. This article will break down the primary factors influencing a Florida Work Injury Worth. This includes future medical treatment, future Temporary Partial Disability (TPD) and Temporary Total Disability (TTD) benefits, and impairment benefits. It is paramount that someone is represented by an experienced and zealous advocate in a work injury case.
Future medical treatment under Florida workers’ compensation can include any necessary medical services or supplies required to treat a job-related injury or illness. These treatments must align with the patient’s diagnosis and recovery status. Common examples of future medical treatments include:
It is important to note that medical benefits under workers’ compensation do not have a monetary cap, meaning injured employees should not have to pay out of pocket for necessary treatments. However, if an employee settles their work injury claim for a lump sum, they may forfeit their lifetime medical benefits and become responsible for their medical costs after the settlement. An experienced attorney can play a crucial role in consulting with the injured employee’s treating doctor to determine the necessary treatments and procedures to aid in recovery.
In Florida, temporary disability benefits are calculated using the employee’s Average Weekly Wage (AWW). These benefits help replace a portion of the wages lost due to the injury.
TTD benefits are 66 2/3% of the employee’s AWW, up to a maximum amount set by state law. For example, if an employee’s AWW was $1,200 before an injury, their TTD benefit would be $800 (66 2/3% of $1,200). However, if their AWW was $2,400, they would receive the maximum rate, which was $1,260 in 2024.
TPD benefits are calculated as 80% of the employee’s AWW, minus any gross wages earned while working light duty, and then multiplied by 80% again. The result is then limited by the maximum weekly compensation amount allowed by law. For instance, if an employee’s AWW was $1,000 before an injury, and their doctor authorizes them to return to work with restrictions that limit their earnings to $500 per week, their TPD benefit would be $240:
$1,000 x 80% = $800
$800 – $500 = $300
$300 x 80% = $240
Impairment benefits in Florida are based on an impairment percentage rating (IPR) assigned by a doctor. The IPR, ranging from 1 to 100%, describes the degree of impairment and determines the duration of permanent impairment benefits. The benefits are 75% of the employee’s average weekly TTD benefits. The number of weeks of benefits depends on the IPR:
Employees with an IPR of 20% or higher are considered permanently and totally disabled and may be eligible for benefits until they turn 65. However, if an employee returns to work and earns the same or more than their pre-injury wages, their benefits are reduced by 50%.
In Florida, the value of a workers’ compensation case is generally determined by the insurance company’s exposure to potential benefits, which includes unpaid lost wage benefits and the estimated cost of future medical treatment. For instance, if there are $1,000 in unpaid lost wage benefits and an estimated $49,000 in future medical treatment costs, the total exposure would be $50,000.
However, insurance companies often settle for only 60-80% of this projected exposure, usually offering between $30,000 and $40,000. This is because they understand that the system tends to favor employers, allowing them to hedge against the full potential cost. The main point of contention between the insurance company and the injured worker usually lies in their vastly different assessments of future exposure.
Given these complexities, it is crucial to have an experienced workers’ compensation advocate, like the attorneys at Battle Law, PLLC, who have a track record of taking cases all the way to workers’ compensation judges to secure the compensation injured workers deserve.
