Who is Eligible for Workers’ Compensation?

Who is Eligible for Workers’ Compensation?

On Behalf of Rosenthal, Levy, Simon & Sosa | March 12, 2025 | Workers' Compensation

Workers’ compensation covers lost wages and reasonable medical expenses for employees who are injured or fall ill in the course of their employment. Workers’ compensation insurance offers both temporary and permanent disability benefits, with temporary total disability (TTD) benefits being the most common benefit plan for Florida workers. For dependents of a deceased worker, it provides funeral and burial costs, as well as weekly wage replacement. Florida businesses that employ four or more employees, part-time or full-time, are required to carry workers’ compensation, with limited exceptions.

With over 35 years of experience helping individuals recover just compensation, the legal team at Rosenthal, Levy, Simon & Sosa is ready to represent your interests. If you were recently injured on the job, our West Palm Beach workers’ compensation lawyers are here to recover maximum compensation on your behalf.

How Do Benefits Work Under Workers’ Compensation?

Worker’s compensation is a type of employer-provided insurance that offers wage replacement, coverage for medical expenses, and death benefits. To qualify, you must have suffered a work-related injury or occupational illness. However, benefits will not begin until you have missed at least 21 days of work. At that time, you will be retroactively compensated for the first consecutive days of missed work. The Florida legislature has set a maximum weekly compensation rate that is adjusted based on inflation each year, regardless of a person’s income. In 2025, weekly compensation is capped at $1,295.

West Palm Beach Workers’ Compensation Disability Benefits

Florida workers’ compensation insurance offers four types of disability benefits:

• Temporary Partial Disability (TPD): Under TPD, you may be allowed to work, but a physician may require you to perform lighter duties. However, performing lighter duties typically means that you will be compensated far less. Wage replacement benefits equal the difference between 80% of your average weekly wages (AWW) pre-injury and your current wages. 
• Temporary Total Disability (TTD): If your injury or occupational-related illness prevents you from working for a certain period of time, you may be eligible for TTD. Benefits will last for 104 weeks, with compensation being 66 2/3% of your AWW.
• Permanent Partial Disability (PPD): A disability that is permanent that prevents you from working as effectively or efficiently is known as a permanent partial disability (PPD). This could entail a traumatic amputation, losing the use of a body part, or being exposed to a toxic substance. PPD wage replacement is based on an impairment rating, which is determined by a physician once you recover to the fullest extent possible, known as reaching maximum medical improvement. Florida’s Workers’ Compensation Division provides a calculator to help residents estimate PPD benefits. 
• Permanent Total Disability (PTD): If an on-the-job injury or occupational illness prevents you from working for the remainder of your life, you may be eligible for PTD. Wage replacement equals 66 2/3% of your AWW, with benefits lasting until you reach 75 years of age.

Do I Need An Attorney to File a Workers’ Comp Claim in West Palm Beach?

While it is certainly feasible to file a workers’ compensation claim on your own, in hiring counsel, you have someone who will advocate for you. It is possible that the insurance company may deny your claim based on a lack of proof that your injury happened on the job. When you work with our West Palm Beach workers’ compensation lawyers, you know that you are taking all possible steps to recover fair compensation for your injuries. Our attorneys will investigate your claim and gather the necessary information to make sure that you are awarded the benefits you deserve. Every penny counts, so we believe that no claim is too small for us to take on.

Speak with Our West Palm Beach Workers’ Compensation Attorneys

Getting hurt or falling ill due to your job can prevent you from supporting your family. At Rosenthal, Levy, Simon & Sosa, our West Palm Beach workers’ compensation lawyers are dedicated to helping hard-working individuals such as yourself regain autonomy. If you have recently been injured at work or have been impacted by an occupational-related disease or illness, we want to hear from you. To schedule your free consultation, contact us online or by phone today. 

On Behalf of Rosenthal, Levy, Simon & Sosa | March 18, 2025 | Workers' Compensation

If you have sustained an injury at work, you may be unsure of which provider you should go to for treatment. For your medical bills to be covered, your insurance carrier will require that you be seen by a physician who has approved them. To ensure that you see an approved provider following your injury, ask your employer for a list of in-network physicians. If you are seen by a provider not listed, you risk having your medical claims denied.

If you have experienced one or more denied medical claims from a work-related injury, our Port St. Lucie workers’ compensation attorneys are available to protect your interests.

Reporting Your Accident

If you have been injured in an accident at work, you should seek medical treatment immediately if you sustained any life-threatening injuries. If you suffered only minor injuries, then you should notify your employer of the incident. It is crucial that you report your accident within 30 days to preserve your right to benefits. Failing to report within a timely manner may result in a claim denial.

Choosing Your Treating Physician

In choosing a treating physician, you will want to pick someone who specializes in treating patients with your condition as well as someone who has experience with workers’ compensation claims. This will give you the greatest opportunity for a speedy recovery.

After reviewing the list of insurance-approved providers, be sure to schedule an appointment as soon as possible. The sooner your appointment, the better your chance of recovering maximum benefits. When you call to schedule your examination, be sure to let the medical office staff know that you need to be seen following a work-related injury. While requesting an appointment for a potential workers’ comp claim will not necessarily mean that you will be seen quicker, it will make your treating physician aware of what questions to ask for insurance purposes. 

What Types of Medical Expenses are Covered?

Florida workers’ compensation will cover the cost of all reasonable and necessary medical expenses related to treating your condition. Under Fl. Stat. §440.13(2), the treating physician will submit authorized claims to your insurance carrier for payment. 

Florida workers’ compensation will cover the following medical services:

• Physician follow-up appointments
• Specialist appointments
• Prescriptions
• Hospitalizations
• Surgeries
• Medical imaging and diagnostic testing
• Physical Therapy
• Prosthesis
• Travel expenses to and from medical appointments and pharmacy

Advocacy As an Injured Employee

As an employee, you sacrifice a great deal for your job, yet it can be cumbersome to recover the benefits you deserve from your employer’s workers’ compensation insurer. Insurance companies often deny legitimate claims to pay their bottom line, which comes at the cost of an employee’s health and well-being. 

At Rosenthal, Levy, Simon & Sosa, we believe that injured employees should be compensated adequately to cover any accident-related medical bills and lost wages. Our legal team has over three decades of experience investigating claims and collecting pertinent evidence to demonstrate the extent of workers’ injuries. If you want to ensure that your rights are being protected, do not hesitate to contact our office.

Injured on the Job? Contact Our Port St. Lucie Workers’ Compensation Attorneys Today

If you have been hurt in the scope of your employment, our Port St. Lucie workers’ compensation attorneys are eager to assist you. With over 35 years of experience helping individuals recover from their injuries and work-induced illnesses, the legal team at Rosenthal, Levy, Simon & Sosa, does not give up fighting for our client’s rights. A work injury comes at a cost, but we believe that your hard-earned money should not be one of them. To learn more or to schedule your free consultation, contact us online or give us a call today.