How-Are Workers Comp Rates Determined In Florida?
The compensation rate is a term used in Florida Workers’ compensation to refer to the dollar amount of periodic benefits paid during periods in which the injured worker is on a “no work” status. These benefits can be either Temporary Total Disability (TTD), or Permanent Total Disability (PTD) benefits. They are calculated at 66 % of the Average Weekly Wage (AWW). Average weekly wage is calculated using a number of different methods. The most common method is to take an arithmetic average of the gross earnings during the 13 weeks prior to the accident. But in certain circumstances it is more equitable to look at the wage records of a similar employer or to look to an original contract of hire.
When considering employees that work on a seasonal basis or in industries that have significant changes to the employee’s income based on time of year, an average of 52 weekly prior to the accident might be more appropriate. Additional methods exist for calculation of AWW and may be more appropriate under certain circumstances. An attorney with experience in Workers’ Compensation law can determine if all calculations have been made properly, as well as that the most appropriate method of calculations were applied. If it is determined that there has been an underpayment of benefits, in addition to payment of the past owed amount, interest and in some matters even addition monetary penalties may be owed to the injured worker.
What Happens If Workers Comp Claim Is Denied In Florida?
If your Workers’ Compensation claim has been denied in Florida, in order to pursue benefits that you believe are ripe due and owing, your remedy is to file a petition for benefits with the Department of Administration Hearing Office of the Judge of Compensation Claims Division of Workers’ Compensation. Mediation will be scheduled in which you can meet with the insurance carrier, and with a mediator to assist the parties in attempts to amicably resolve the issues. It should be noted that although the mediator is an attorney, the mediator is not your attorney but instead is on either side. The mediator primarily acts as a facilitator of communications between the parties. If the matter cannot be resolved at mediation, a Judge may hold a pretrial and a subsequent Merit Hearing in which evidence will be considered and a Judge of Compensation Claims will rule on whether the denial was appropriate or whether benefits should be provided. In certain matters a further appeal may be necessary subsequent to the Workers’ Compensation Judge’s ruling.
If your Workers’ compensation claim has been denied, a Workers’ Compensation attorney can prepare and file a petition for benefits on your behalf, represent you at the mandatory mediation, and at any Hearings before a Judge of Compensation Claims. As well as the attorney can answer any Workers’ Compensation questions that you may have regarding the denial, its’ legal bases, and the evidence and standard of proof that you will need to meet in order to overcome and defeat the denial before a Judge.