Florida workers’ compensation law is designed to allow for workplace injuries to be addressed and relieved efficiently and without undue difficulty for the injured employee who seeks treatment. In reality, offering functional workers’ compensation coverage costs employers and providers money, and they will often delay or deny coverage to prop up their bottom line and save money. The Florida Court of Appeals recently addressed a claim by an employee that their employer willfully ignored the legal requirements of state law in order to delay offering the plaintiff the care they were entitled to.
The plaintiff in the recently decided case was an employee of the defendant, a Florida car dealership when she was injured on the job. Under her employment contract, she was directed to seek treatment using her employer’s workers’ compensation coverage. After her initial care, the woman’s doctor prescribed a home health aide to assist her with everyday duties during her recovery. Although the plaintiff was prescribed a home health care assistant, the defendant repeatedly notified her that the prescription was not detailed or accurate enough, and refused to pay for the care.
Pursuant to Florida workers’ compensation claim procedure, the plaintiff brought her request for coverage to a Florida Judge of Compensation Claims (JCC), who agreed with her employer that the prescription was not detailed enough to warrant coverage for the home health assistant. After the procedural rejection, the plaintiff brought the case to the Florida Court of appeals. The plaintiff argued that the doctor prescribing the care to her was clear and specific that she needed home health assistance, and the only ambiguity was the amount of care she would need, which could be determined based on an evaluation by the provider.
The court agreed with the plaintiff, finding that the prescription was entirely adequate and that the defendant’s ignorance of the plaintiff’s needs appeared to be intended exclusively to delay/prevent the care and save the defendant money. As a result of their analysis and ruling, the plaintiff will receive the needed home health care, which will be covered by her employer’s workers’ compensation insurance.
Florida workers’ competition coverage is designed to quickly and easily direct injured employees to find needed medical care in the event of an accident or other workplace injury. In practice, employers and insurance companies have an incentive to delay or deny coverage, and it may be nee eerie for an injured employee to retain legal counsel and seek recourse for denied services. If your employer or workers’ compensation provider denies coverage for treatment from a work-related injury, you may have legal recourse to compel them to pay for your medical care.
Were You Injured on the Job?
If you or someone you know has been hurt while at work, you shouldn’t need to pay for any care out of pocket, and you shouldn’t have to wait an unreasonable amount of time to have your coverage approved. The experienced workers’ compensation attorneys at Friedman, Rodman, and Frank understand how to get employers and insurance companies to honor their policies and offer our clients the care and compensation that they are entitled to. If you’ve been hurt, schedule a consultation today. We accept clients in many Florida injury cases, including negligence and workers’ compensation (?) claims. Call our office at 877-448-8585 or contact us online to schedule your free consultation.