Florida Workers' Compensation - Basic Concepts

Posted over 5 years ago. Applies to Florida, 32 helpful votes

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Medical and Indemnity Benefits

There are only two types of benefits available: medical and indemnity. Medical benefits include emergency room visits, authorized primary care doctors for evaluation and treatment, specialist physicians on referral from other authorized doctors, physical therapy, prescription medication, and so on. Indemnity benefits are substitutes for wages that are lost as a result of the workplace injury or condition. There are two kinds of indemnity benefits: temporary and permanent. The switch from one to the other comes when the injured worker reaches Maximum Medical Improvement.

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Maximum Medical Improvement (MMI)

Maximum Medical Improvement is the the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated, based upon reasonable medical probability. This date is fixed either when the injured worker's doctors decide that this point has been reached or by operation of law once the injured worker has received 104 weeks of temporary indemnity benefits. As soon as the injured worker reaches MMI, the doctors are required to assign a number called a permanent impairment rating (PIR). The PIR ranges from 0% up to 100%. It is intended to estimate the residual damage to the body left by the work-related accident. Thus, a 0% would mean that the doctor concluded that there was no permanent impairment as a result of the accident. The percentage assigned must be based on a scheduled injury listed in a uniform guidebook.

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Temporary Indemnity Benefits

There are two kinds of temporary indemnity benefits: total (TTD) and partial (TPD). An injured worker should be paid TTD benefits if: (a) s/he suffered an on-the-job accident, in the course and scope of employment, and (b) an authorized doctor has placed the injured worker on No Work status as a result of the accident. TPD benefits should be paid when the doctor has released the injured worker to return to work (although not necessarily the job s/he was doing at the time of the injury) with restrictions (such as 'no lifting greater than __ pounds') that arise from the accident. Both TTD and TPD will come to an end at MMI. At that point, permanent indemnity benefits, if any, will start.

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Permanent Indemnity Benefits

There are two kinds of permanent indemnity benefits: total (PTD) and partial. If the injured worker has suffered a catastrophic injury, or it is determined that the injured worker cannot engage in at least sedentary employment within a 50-mile radius of his/her residence, then the injured employee will be presumed to be permanently and totally disabled and entitled to bi-weekly benefit checks indefinitely. If not PTD, then we look to the PIR. If greater than 0%, the injured worker will be paid a percentage of the pre-accident average weekly wage for a number of weeks based on a statutory schedule. These are permanent partial disability benefits are commonly called Income Impairment Benefits (IIBs). For example, a 5% PIR would yield 10 weeks of IIBs. Once IIBs have been paid out, no more indemnity benefits are owed.

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Workers' Compensation Abbreviations

Because of all the abbreviations and acronyms that Florida workers' compensation lawyers and insurance adjusters use, outsiders (including other attorneys) tend to think that we speak a foreign language. I have, therefore, put together a list to help injured workers figure out exactly what we're saying. It is located at: http://www.FlaLaw.com/abbreviations.html, and it includes MMI, PTD, and others that are discussed in this guide.

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Additional Resources

Commonly Used Abbreviations in Florida Workers' Compensation

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