Understanding the Importance of Timely Compensation

In Florida, timely payment of workers' compensation benefits is crucial, going beyond being a mere legal obligation. These payments are vital for injured workers who depend on them for medical expenses and daily living costs. To emphasize the importance of these benefits, Florida enforces strict penalties on employers and insurers who miss payment deadlines.

Florida's Penalty Structure

The Florida Workers’ Compensation Act specifies penalties for late payments to ensure accountability. A typical penalty involves adding 20% to the unpaid benefit amount if not settled within set deadlines. Additionally, interest may accrue on these overdue payments, further escalating the cost for the responsible party. In cases where an injured worker’s family is receiving death benefits, the insurance carrier owes a 20% penalty on the total late payment if payment is not made within seven (7) days after any installment of indemnity benefits becomes due. However, the carrier may avoid this penalty if it can prove that the late or non-payment occurred due to circumstances beyond its control. Additionally, a penalty will not be owed if the insurance carrier invokes the right to "pay and investigate the claim", which allows for a 120-day period to pay and investigate the claim before a penalty applies.

Common Causes of Late Payments

Delays in payment can stem from various factors, including:

• Administrative Errors: These can include mistakes in processing claims, miscommunication between employers and insurers, or issues with the documentation required to process benefits. These errors are often out of the worker's control but can still delay the timely payment of benefits.

• Disputes About the Claim's Legitimacy: Sometimes, insurers or employers may challenge the validity of a claim, leading to delays in payment while the dispute is resolved.

• Intentional Actions: In some cases, employers or insurers may deliberately delay payments in an attempt to avoid financial responsibility. Regardless of the cause, Florida’s penalties are designed to protect workers’ rights and ensure they are compensated in a timely manner.

Regardless of the reason for the delay, workers should not have to bear the financial burden of missed payments. Penalties are in place to ensure that employers and insurers act quickly to avoid harming injured workers.

Florida’s Timely Payment Requirements

In Florida, employers and insurers must make workers' compensation payments within specific timeframes, which typically start from the date of the injury or the date the claim is accepted. For example, if benefits are owed to an injured worker, payments must usually begin within 14 days after the employer is notified of the injury.

However, for Temporary Partial Disability benefits, the first payment is due seven (7) days after the last date of the post-injury employer’s biweekly workweek if the worker is earning less than 80% of their pre-injury average weekly wage. Subsequent payments for temporary partial disability benefits must be made biweekly, no later than the seventh (7th) day following the last day of each biweekly work week. Note that this payment timeline starts when the insurer receives the Employee Earnings Report, which shows the worker’s loss of wages for the relevant period. For workers who reach Maximum Medical Improvement (MMI)—the point at which the doctor deems the worker to be "as good as they are going to get"—the first of the impairment benefits are due within 14 days after the insurance carrier has knowledge of the impairment rating, assuming the rating is greater than zero percent.

Steps to Take if Your Benefits Are Delayed

If you experience delays in receiving your workers' compensation benefits, taking prompt action is critical. Here are the steps you should take:

1. Contact the Insurer: Reach out to the insurance company to check the delay and find out an estimated timeframe for payment.

2. Consult an Attorney: Seek legal advice to better understand your rights and explore ways to expedite the payment process.

3. File a Complaint: If necessary, file a complaint with the Florida Division of Workers’ Compensation to formally address the issue.

4. Document Everything: Keep a record of all communications with the insurer, including any calls or written correspondence. This will help support your case if you need to take further action.

Timely payment of workers' compensation benefits is essential for the financial well-being and recovery of injured workers. Understanding Florida's penalties for late payments and the specific requirements for different types of benefits helps both employees and employers recognize the necessity of adhering to payment schedules. For workers, knowing these regulations provides a foundation for taking action if a delay occurs. If you're an injured worker facing payment delays, taking immediate steps and knowing your rights will help ensure you're compensated fairly and in a timely manner.