Articles Posted in Workers’ Compensation

Florida workers face several important shifts in the workers’ compensation landscape heading into 2026. The Florida Office of Insurance Regulation recently approved a 6.9 percent rate decrease for workers’ compensation premiums, marking the ninth straight year of lower rates for employers. This change reflects statewide trends in claims, safety practices, and insurance costs. You still need a clear understanding of how these shifts affect wage-loss benefits, medical care, and claim handling in South Florida. Many workers seek legal guidance early in the process to avoid delays, missed documentation, or disputes with insurers.

Rate reductions may sound positive on paper, yet they also influence how insurers evaluate claims and manage medical authorizations. Understanding what changed for 2025–2026 helps you anticipate how your claim may unfold after a job injury in Miami, Broward, or the Keys.

How Florida’s 2026 Rate Reduction Fits Into The Broader System

Workers’ compensation rates determine the premiums that employers pay. Lower premiums can impact how insurers respond to claims, since each claim affects future costs. The 6.9 percent decrease for 2026 follows eight consecutive years of similar reductions. State regulators attribute these changes to fewer reported injuries in some industries, improved workplace safety programs, and stable costs for medical services covered by workers’ compensation.

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A restaurant worker in Florida sued her employer after an on-the-job assault caused severe psychological distress. The claim focused solely on mental health injuries, including post-traumatic stress disorder, with no physical harm alleged. The worker argued that management failed to protect her from a known threat and framed her lawsuit as a negligence claim. The trial court allowed the case to move forward. However, the appellate court reversed course, ruling that any remedy would need to come through Florida’s workers’ compensation system.

Mental Health Claims at Work Face High Legal Hurdles

Florida workers’ compensation law provides coverage for job-related injuries. While it generally addresses physical harm, it does allow claims based solely on psychological injury in minimal situations. The law requires either an accompanying physical injury or proof that the psychological harm resulted from a shock so extreme it would cause emotional damage to an average person.

Workers’ compensation laws in Florida provide injured employees with medical benefits, wage replacement, and necessary personal care when a work-related injury prevents them from performing daily tasks. However, disputes often arise when employers and insurance carriers challenge which services qualify for compensation. A recent Florida appellate ruling addressed whether a spouse’s care for an injured worker falls under attendant care benefits or constitutes routine household duties not covered under Florida law.

Court Overturns Attendant Care Award in Florida Workers’ Compensation Case

A Florida worker who suffered an injury filed for workers’ compensation benefits, including home modifications and attendant care services provided by a spouse. A judge awarded payment for 30 hours per week at the federal minimum wage, reasoning that certain tasks—such as carrying the injured worker upstairs and assisting with bathing—met the legal definition of attendant care under Florida law.

Workers’ compensation benefits provide essential support for employees recovering from work-related injuries. These benefits often include ongoing medical care, especially for permanent conditions requiring long-term supervision. However, disputes can arise when employers or insurance carriers claim that the statute of limitations bars further benefits, cutting off an injured worker’s access to care. A recent Florida appellate court decision highlights this issue, emphasizing the importance of understanding how the statute of limitations operates in workers’ compensation cases and the role of tolling periods in preserving an injured worker’s rights.

The Role of the Statute of Limitations in Workers’ Compensation

Under Florida’s workers’ compensation laws, an employee generally has two years from the date of their injury—or the date they knew or should have known the injury was work-related—to file a petition for benefits (PFB). However, this timeframe can be extended when an employer or insurance carrier provides authorized medical care related to the injury. Each instance of authorized treatment restarts the tolling period, effectively giving the injured worker additional time to file a claim.

In the recent case, the employer and its servicing agent argued that the statute of limitations had expired, barring the injured worker from filing a PFB for further care. The worker, who had suffered a compensable injury requiring the removal of a kidney, had been receiving ongoing follow-up care from an authorized urologist for years. When the urologist stopped billing the servicing agent, the employer claimed the tolling period had ended, making the worker’s PFB time-barred. However, the appellate court disagreed, finding that the worker’s visits to the authorized urologist constituted furnished care, which extended the statute of limitations.

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A recent Florida workers’ compensation case sheds light on the challenges injured workers face when seeking benefits for ongoing care. The case involved a cashier who suffered an electrical shock while plugging in a cash register at work. Although her initial injury was accepted as compensable, her employer and insurer later denied her claims for additional treatment, arguing that a preexisting genetic condition was the major contributing cause (MCC) of her medical needs. This case highlights the importance of understanding your rights and options when facing a denial in Florida’s workers’ compensation system.

Injured Worker’s Fight for Ongoing Care

The worker initially reached maximum medical improvement in 2020 after treatment for her workplace injury. However, in 2022, her symptoms worsened significantly, leading to issues such as balance problems, hand weakness, and bladder dysfunction. Further evaluation revealed a genetic condition, neurofibromatosis type I, which had caused tumors compressing her spinal cord. She underwent surgery to remove the most problematic tumor, but her doctor noted that additional tumors would require ongoing care.

Despite the severity of her symptoms and the connection to the initial work injury, her employer and insurer denied her claims for continued treatment. They argued that the genetic condition, not the work injury, was the MCC of her medical needs. The worker filed a petition for benefits to secure the necessary care, but the employer disputed her claim, relying on earlier medical opinions.

Florida’s Major Contributing Cause Standard

Under Florida Statutes § 440.09(1)(b), workers’ compensation benefits are only awarded if the workplace accident is the major contributing cause of the injury or need for treatment. This standard requires showing that the work injury is more than 50% responsible for the condition compared to any preexisting conditions.

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Workers’ compensation insurance is a crucial safety net for employees in Florida who are injured on the job. It provides essential benefits, including coverage for medical expenses and compensation for lost wages, to help injured workers recover and get back on their feet. However, while this system is designed to support workers, it also represents a significant cost to employers, who often look for ways to minimize their payouts. Recently, a Florida court decision highlighted the ongoing struggle workers face in securing these benefits, as it denied continued benefits to an employee following an accident.

In Florida, workers’ compensation insurance is intended to provide comprehensive support to employees injured in the course of their employment. This includes coverage for immediate medical treatment, ongoing care, and financial compensation for lost wages. The goal is to ensure that injured workers do not bear the financial burden of their recovery. However, obtaining these benefits can be challenging. Employers and their insurance companies often scrutinize claims to avoid paying out benefits whenever possible. This was shown in a recent court ruling that reversed a decision granting continued benefits to an injured worker, illustrating the obstacles employees may face in accessing the support they need.

The case involved an employee who sustained injuries to her right hand and wrist when a door slammed shut at her workplace. Initially, the employer and their insurance carrier accepted the injury as compensable and provided benefits for several months, including pain management and physical therapy. The worker, experiencing persistent pain more than a year after the accident, sought further medical treatment. The Judge of Compensation Claims (JCC) initially ruled in favor of the worker, approving the continuation of her medical treatment. However, the employer appealed this decision, arguing that the injury no longer required additional care.

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Seasonal employment is a major component of Florida’s economy, drawing thousands of workers each year to a variety of industries. From the bustling tourism sector, where theme parks and resorts require additional staff during peak travel times, to the construction industry, which often ramps up projects to take advantage of favorable weather, seasonal jobs are plentiful. Additionally, Florida’s professional and semi-professional sports teams, including baseball and football, rely heavily on seasonal workers to support their operations. These jobs, while offering valuable opportunities and income, come with risks. Many seasonal roles, especially those in physically demanding fields like construction and sports, can be hazardous, exposing workers to potential injuries.

In Florida, employers are mandated to carry workers’ compensation insurance to protect employees who get injured on the job, and this includes seasonal workers. Workers’ compensation provides essential benefits, such as medical care and wage replacement, to help injured employees recover and support themselves during their time off work. However, the amount of compensation a worker is entitled to can vary significantly. This calculation is often based on “full-time weekly wages,” but this baseline can be adjusted, and the interpretation of this amount can be contentious. Recently, a Florida district court addressed such an issue when an employer challenged the amount awarded to a seasonal professional baseball pitcher who was injured and unable to complete his employment contract.

The pitcher in question was under a contract with a minor league baseball team and earned a salary during the five-month championship season. However, his contract also required him to be available year-round for other activities, such as exhibition games and training. Unfortunately, during one of the championship games, the pitcher sustained a serious shoulder injury, which led him to file a workers’ compensation claim. Initially, the Judge of Compensation Claims (JCC) calculated his average weekly wage (AWW) based on a full-year salary, attributing his monthly earnings over 12 months, even though his contractual salary only covered the five months of the championship season.

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In a recent case, the Third District Court of Appeals in Florida issued an opinion in an appeal involving a tort lawsuit filed by the appellee-plaintiff, Giovanni Bastien, against the appellant-defendant, Bottling Group, LLC. Bottling Group appealed from a nonfinal order denying its motion for partial summary judgment in the tort lawsuit filed by Bastien. In their appeal, Bottling Group contends that the trial court erred in finding it was equitably estopped from presenting its workers’ compensation immunity defense. The appellate court was unconvinced, rejecting Bottling Group’s argument and affirming the trial court decision.

Bastien was employed by Bottling Group at a Pepsi packaging and distribution facility in Medley, Florida. He was seriously injured when a coworker, purportedly disgruntled over union activities, shot him several times. While Bastien was recovering in the hospital, he notified his manager that he intended to file a workers’ compensation claim. Bastien was informed that he was not entitled to benefits, and Bottling Group subsequently emailed the compensation carrier, Sedgwick, to oppose his claim. Bastien then received a notice of denial of benefits from the Florida Department of Financial Services Division of Workers’ Compensation. The notice stated that his “claim is denied in its entirety, as not a compensable accident or injury. Injury did not occur in the course or scope of employment. Accident/Injury occurred off premises . . .” Bastien then filed a tort lawsuit in the circuit court against Bottling Group’s parent company, PepsiCo, Inc. PepsiCo moved to dismiss, contending it was entitled to workers’ compensation immunity. Bastien argued that PepsiCo was equitably estopped from asserting immunity. Before the court rendered a ruling on the motion, the parties agreed to the filing of an amended complaint substituting PepsiCo with Bottling Group.

At trial, Bottling Group moved for partial summary judgment on the basis it was entitled to workers’ compensation immunity. Bastien opposed the motion, asserting that estoppel and the international tort exception precluded the operation of immunity. At the conclusion of the hearing, the trial court entered a reasoned order denying summary judgment and prohibiting Bottling Group from raising its immunity defense at trial. Bottling Group appealed shortly thereafter.