Do I have to pay for any medical care while receiving workers’ comp benefits in Miami, FL?

One of the advantages of receiving workers’ compensation benefits in the State of Florida is that all of the medical care that is authorized for you to receive should be covered by your employer’s insurance policy. Essentially, what this means is that you should not be required to pay for any medical treatment rendered that is associated with your work-related injury. When an employer is properly insured and an employee qualifies for workers’ comp, it is important that they understand what benefits they are entitled to utilize so that they can take full advantage of them.

What type of medical care is covered?

According to Florida Statute § 440.13(2)(a), your employer is required to cover any treatment that is deemed medically necessary. When treatment is considered to be medically necessary, it refers to “any medical service or medical supply which is used to identify or treat an illness or injury, is appropriate to the patient’s diagnosis and status of recovery, and is consistent with the location of service, the level of care provided, and applicable practice parameters.” Because “treatment” is a very broad term that doesn’t exactly identify the types of medical care that is covered, below are a list of some of the things you can expect your employer’s insurer to pay for:

  • Routine visits to the doctor
  • Medicine
  • Medical supplies
  • Durable medical equipment
  • Orthoses
  • Prostheses
  • Other medically necessary apparatus

Furthermore, the law goes on to explain that workers’ comp insurance should cover any “medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require, which is in accordance with established practice parameters and protocols of treatment as provided for in [Chapter 440]” In addition to this, you should also understand the law does limit the type of care you can have rendered. Knowing what these limitations are can help prevent you from undergoing treatment for your injury that is not covered by your employer’s workers’ compensation insurance.

For instance, §440.13 states that you can only receive chiropractic services that do not exceed 24 treatments or go beyond 12 weeks from the date the initial chiropractic treatment began, whichever comes first. The only time an injured worker can continue having their chiropractic care paid for is when the carrier authorizes additional treatment, or the employee has suffered a catastrophic injury. The law also says that “remedial treatment, care, and attendance, including work-hardening programs or pain management programs that are accredited by an accrediting organization whose standards incorporate comparable regulations required by this state or pain-management programs affiliated with medical schools” is covered only when a physician has referred you to receive it.

Important: When a worker fails to attend the doctors’ visits that have been scheduled to monitor their progress or they decide to undergo treatment that hasn’t been authorized, they risk not having that medical care paid for.

What should I do if my employer will not report my injury to their insurer?

While you do hold the right to report your injury to the insurance carrier on your own, our Miami work injury attorneys encourage you to give us a call to ensure the issue gets resolved quickly. Sometimes, employers choose not to file a claim on behalf of an injured employee as they do not want to be held responsible for covering the costs associated with the accident. However, when you are rightfully entitled to receive workers’ comp benefits, yet your employer is denying you access to them, it’s better to consult with a Miami work injury lawyer who can advise you on how to address the situation.

What else will workers’ comp insurance pay for? 

If your injury has prevented you from working, you should receive a portion of your salary for the time you are unable to work. However, Florida law does say that you are not entitled to receive payment for the first seven days of disability. Now, if your disability were to extend over 21 days, you may then be eligible to receive payment from the insurance company for those first seven days. If you haven’t yet received payment from the insurer for the days you have missed work or feel you are being undercompensated, you can always contact our Miami work injury law firm to have an attorney review your claim and determine if you are being paid what you are due.

If you suffered an injury in a work-related accident in Miami and have questions regarding your workers’ compensation benefits, Mario Trespalacios P.A., a Miami work injury law firm, is here to answer them for you. In the event you think you aren’t receiving the benefits you are entitled to, give us a call to speak with one of our qualified Miami work injury lawyers.

Mario Trespalacios P.A.

9495 SW 72 Street, Suite B-275
Miami, FL 33173

Phone: 305-261-5800