If you are an HR professional in The Sunshine State, then you are probably already familiar with the concept of workers’ compensation in Florida. But do you know how the claim process works and what your obligations are as an employer? And what happens if you need to file an appeal with the Florida Division of Workers’ Compensation?
In fact, there are quite a few aspects of the FL workers’ compensation law that businesses need to be aware of. This includes legal requirements, coverage eligibility, and how premiums are calculated. You also have to report all workplace injuries to the state within a specified timeframe.
That’s a lot to keep on top of.
Thankfully, we’re here to help you out with this handy employer’s guide to workers’ compensation in Florida. In today’s post, you will learn exactly what your rights and obligations are in terms of occupational health and safety. We will also explore how using the right technology can help you meet the requirements of this essential labor law.
Overview of Workers’ Compensation Laws in Florida
Let’s start with the basics: What is workers’ compensation in Florida?
As with all states in the U.S., Florida has a law in place to help out employees who suffer from a work-related injury or illness. In the event that an employee has a workplace accident or gets sick as a direct result of their work duties, the state will ensure that they receive medical treatment and compensation for lost wages, provided the employee was not at fault.
For example, if an employee at a manufacturing company has an accident while working the production line, and they were following all safety protocols and not engaging in any misconduct at the time, Florida’s workers’ compensation system will cover all medical expenses and reimburse a portion of the employee’s lost wages while they are recovering. However, if the same employee from this example was intoxicated whilst carrying out their duties or they weren’t wearing the correct PPE, then they would not be entitled to claim this benefit. Eligibility ultimately comes down to compliance with established safety protocols and company policies.
The aim of this no-fault system is to:
- Serve as a safety net so that employees don’t get behind with their bills while they recover.
- Encourage workplace safety and an environment of awareness and responsibility.
- Limit the financial risk to employers, as providing prompt medical assistance means that the injured worker is likely to return to work a lot faster.
- Protect employers from costly litigation from employees who might claim that the injuries occured as a result of employer negligence.
However, there are several legal obligations that employers must meet to ensure that they are in compliance with Florida’s workers’ compensation laws.
Legal Requirements for Florida Employers
Along with unemployment compensation and Florida employee tax, employers in Florida have several responsibilities when it comes to employee benefits. One of the most important labor laws in the state of Florida, especially for industries with higher risks of workplace injuries, is workers’ compensation.
So, what are your legal obligations as an employer in terms of workers’ compensation in Florida? Who needs to carry workers’ compensation insurance? Are there any exemptions and special considerations?
Let’s start with the basics.
Here’s a breakdown of everything you need to know:
- Eligibility. Firstly, most employers in Florida need to carry workers’ compensation insurance. This includes:
- Construction businesses. All employees must be covered, including the owner of the company.
- Non-construction businesses with 4 or more employees (full or part time).
- Businesses operating in the agricultural industry with at least 6 regular employees and/or at least 12 seasonal employees who work more than 30 days in a season (up to a maximum of 45 days in a calendar year).
- Insurance. Secondly, you must obtain your FL workers’ compensation insurance through a licensed insurance company. If you qualify, you can also self-insure.
- Poster. Thirdly, as an employer, you must display a poster in your place of work that explains how employee coverage works. This poster, which must be placed in a public area that all employees can access, also needs to detail the steps that an employee needs to take if they get injured at work.
- Reporting. In addition, according to workers’ compensation in Florida laws, you must report all workplace injuries to your insurance carrier. You must do this within 7 days of the incident.
- Cooperation. Finally, you have a legal obligation to provide your insurance carrier with all the information they need to process and investigate a claim.
Exemptions and Special Considerations
As with most federal and state labor laws, there are certain exemptions and considerations that employers need to be aware of.
Exemptions and special considerations include:
- Sole proprietors and partnerships. Sole proprietors and partners in the non-construction sector are not classified as employees. They are therefore exempt from workers’ compensation in Florida. However, they can choose to cover their own insurance.
- Corporate officers and LLC members. Corporate officers and LLC members in the non-construction sector are classified as employees for the purpose of workers’ compensation. However, they can choose to be exempt, although at least one officer must be covered.
- Out-of-state employers. If a company has its legal headquarters in another state but has operations in Florida, it must still comply with Florida’s workers’ compensation laws.
Workers’ Compensation in Florida: Coverage and Premiums
Now on to the next important element of understanding workers’ compensation in Florida: coverage and premiums. Which benefits are employees entitled to if they are injured at work or become sick as a result of their work?
Here’s a breakdown for you:
- Medical benefits. Firstly, Florida state will cover all medical bills for eligible employees who have been injured at work. This includes doctor visits, hospitalization, physical therapy, and medication.
- Disability benefits. Secondly, employees in Florida can claim compensation for lost wages while they are recovering from a work-related injury or illness. There are 4 types of disability benefits that employees in Florida can claim. This includes:
- Temporary Total Disability (TTD),
- Temporary Partial Disability (TPD),
- Permanent Total Disability (PTD), and,
- Permanent Impairment Benefits (PIB).
- Death benefits. In addition, if an employee dies as a result of a work-related injury or illness, dependants are entitled to receive compensation. This covers funeral expenses and compensation for lost financial support.
- Vocational rehabilitation. Finally, if an employee needs support during their transition back to work, then they can claim benefits to help with the costs. For example, an injured employee can claim this benefit to cover the cost of retraining or job placement services.
How Premiums Are Calculated
Another important aspect of workers’ compensation in Florida is calculating insurance premiums. There are several factors that will impact how much you have to pay.
This includes:
- Your total payroll amount. For example, if you have a large workforce and employee salaries are relatively high, your insurance premiums will be higher as the insurance carrier will likely claim that there is a higher potential for workplace injuries.
- Classification codes. In the state of Florida, all employees are classified according to their job duties. This code is used to determine the level of risk (rate) associated with each job type. For example, the classification code for a clerical worker has a significantly lower rate than the one used with the code for a roofer, because the average workplace exposures of those two types of employment are obviously quite different. Naturally, jobs with higher risk levels will result in higher insurance premiums. You can find out more information about job classifications from the Florida Division of Workers’ Compensation.
- Experience Modification Factor (E-Mod). This is a numerical representation of a company’s claim history and safety record compared to other businesses in the same industry. An E-Mod greater than 1.0 indicates a claims history that is higher than average, resulting in higher premiums. An E-Mod less than 1.0, in turn, indicates a better-than-average history, leading to lower premiums.
- Discounts and surcharges. If your business is classed as high risk then you might incur a surcharge. However, if your company participates in a safety program or a drug-free workplace program then this can potentially lower your compensation insurance premiums. Other strategies for lowering premiums include improving workplace safety and implementing a return-to-work program.
Reporting Workplace Injuries: Timelines and Responsibilities
One of the most important responsibilities you have as an employer under the regulations governing workers’ compensation in Florida is reporting all workplace accidents and injuries to the state. There are also set deadlines for reporting all incidents so that they are handled in accordance with the law.
Timelines for Reporting
Here’s everything you need to know in terms of reporting timelines.
- Employee reporting. Employees must notify you of any and all workplace injuries or illnesses as soon as possible. This requirement ensures that employees receive medical attention as soon as an incident occurs. Make sure all your employees are aware of this requirement and that they understand the process for reporting workplace injuries and illnesses.
- Employer reporting. Once you have been notified of an employee workplace injury or illness, you have 7 calendar days to communicate this information to your workers’ compensation insurance carrier through a First Report of Injury or Illness form. The insurance carrier then has 3 days to send an informational brochure to the injured worker, outlining their rights and responsibilities.
Managing Workplace Injuries: Employer’s Responsibilities
And here’s everything you need to know in terms of your responsibilities as an employer:
Provide immediate assistance
Firstly, if an employee reports a workplace injury or illness, make sure they receive appropriate medical attention. This might mean calling emergency services or referring the employee to a healthcare provider that has been authorized by your workers’ compensation insurance policy.
Investigate the incident
Secondly, once the employee has received medical attention, your next responsibility is to make sure you conduct a full internal investigation of the workplace injury or illness. This will help you understand how the injury or illness occurred so that you can implement preventative measures to stop it from happening again.
Report the injury to the insurance carrier
Thirdly, as we mentioned above, you are responsible for completing and submitting a First Report of Injury or Illness form. You must do this within 7 days of being notified of a workplace injury or illness. You will need to include details about the employee, your business, the injury, and the circumstances surrounding the incident.
Maintain accurate records
In addition, the state of Florida also requires employers to maintain detailed records of the injury and the steps they have taken to prevent the incident from occurring again. You will also need to keep a record of all injury reports, medical reports, and communications with the insurance carrier, together with any changes to the employee’s work status that have occurred as a result of the injury.
Cooperate with the insurance carrier
Moreover, make sure you cooperate with your insurance carrier for the duration of an employee’s claim. For example, if the insurance carrier requests any additional information to process the claim then you must provide this within the established timeframe. You must also facilitate any communication between the injured worker and your insurer.
Inform the employee of their rights and responsibilities
Although the employee will receive information from your insurance carrier, it’s still important that you inform your employees of all their rights and responsibilities under the laws regulating workers’ compensation in Florida.
Non-Retaliation
Finally, employers cannot retaliate against an employee for filing a workers’ compensation claim. This includes any form of punishment or adverse employment action taken against an employee, such as termination, demotion, reduction in hours or pay, reassignment to a less desirable position, or any other form of discrimination.
Navigating Workers’ Compensation in Florida Disputes and Appeals
You might find that an employee files a claim for workers’ compensation in Florida that you do not agree with. In this event, then you are entitled to file a claim with the Florida Division of Workers’ Compensation. Common grounds for disputes include:
- If an employer believes that an injury or illness is not work related or there is not enough evidence to support the employee’s claim.
- If you do not agree with the type or amount of benefits being awarded to an employee. For example, you might not agree that an employee needs financial support for vocational rehabilitation.
- If you do not agree with the need for ongoing medical treatment or with the extent of the employee’s injuries.
- If you do not agree with the job classification code that has been assigned to an employee and it has a negative impact on your insurance premiums.
Process for Filing an Appeal
If any of the above applies, then you have a right to file an appeal with the Florida Division of Workers’ Compensation.
This is the process that you will need to follow:
- Informal negotiation. Firstly, it’s always best to try and resolve any dispute through informal negotiation between the employee, employer, and insurance carrier.
- Mediation. Secondly, if informal negotiation doesn’t resolve the issue, you might need to seek mediation. This is where a neutral third party helps both sides reach an agreement.
- File a notice of appeal. If mediation fails, the next step is to file a formal notice of appeal with the Florida Workers’ Compensation Appeals Board. This board handles appeals and provides a legal framework for the resolution of disputes.
- Pre-trial hearing. The Florida Division of Workers’ Compensation may choose to hold a pre-trial hearing before the final hearing. This is to determine the issues that you are disputing and the evidence that you will present.
- Final hearing. Your case is heard by a judge of compensation claims (JCC) at a final hearing. The judge will consider evidence from both sides before making a decision.
- Further appeals. If the JCC rejects your appeal, you can file a secondary appeal with the First District Court of Appeal. The appeal must focus on legal errors made during the final hearing process.
How Factorial Can Help You Manage Workers’ Compensation in Florida
And there you have it. By now you should have a clear idea of your rights and responsibilities under the laws governing workers’ compensation in Florida. But how can you ensure compliance with all requirements of this law?
Thankfully, at Factorial, we’ve got your back. Our comprehensive HRIS includes a range of features that can help you meet your legal obligations and build a safe, compliant and productive place of work.
This includes:
- Employee records. Firstly, centralize all your employee data, including personal information, employment history, and documentation with our employee record management software. That way, you will have all the information you need to hand when an employee files a claim for compensation.
- Accident reporting. Secondly, with our document management system, you can also maintain accurate and up-to-date records of all your occupational safety documents. This includes your workers’ compensation policies, safety training records, and claims documentation. Having easy access to these documents can speed up the claims processing and you comply with your obligations as an employer.
- Absence management. In addition, you can use our time off management software to track and report employee absences taken as a result of a workplace injury or illness. That way, you will have easy access to accurate records for workers’ compensation claims.
- Safety training. Finally, you can use our training needs analysis to establish what areas of occupational safety you need to focus on to ensure that your employees understand your safety protocols. Moreover, you can use our comprehensive employee onboarding toolkit to simplify the onboarding process and ensure that all new starters receive comprehensive safety training before they start working for you. That way, you can build a safe working environment and reduce the costs associated with workers’ compensation in Florida.
