A work injury could sideline an employee for days, weeks, even months. Workers’ compensation happens in two ways. First, the injured employee reports their injury or occupational disease to their employer. Second, the employer reports the injury to their insurance provider, kickstarting the work comp process. While it sounds straightforward, it does not always work this way. As we often see, employers are not always keen to help their employees get their deserved benefits. Either they fail to report the work injury to their insurer or work to frustrate the process. The question is, are they allowed to do this? Read on to find out what you should do when your employer fails to report your work injury.
Notifying Your Employer of Your Work Injury
Before discussing what to do if your employer fails to report your work injury, we must first establish whether your employer is aware of the accident and the wound you sustained. Without knowledge of the workplace accident, they cannot commence the workers’ compensation claim process. Florida law places the onus on you to report a workplace accident or injury.
Typically, Florida law provides that injured workers notify their employer of their wound no later than 30 days from the date the accident happened, or within 30 days of the first date a doctor told you that you are suffering from a work-related injury or work-related condition. If it is a case of occupational exposure, you have 90 days. Failure to do this hinders the commencement of the claims process. In addition, your employer can deny you benefits on the grounds of late notice.
An employee who is hurt at work needs to report the injury to their employer as soon as possible. It is best to make the report to your employer in writing, even after you give it verbally. It is recommended that you send an email to document that you reported it to your manager or supervisor if you were not allowed to fill out a notice of injury or other form of the incident report. Make a note of the name of the manager or supervisor that was given the report of the injury and the day you reported your injury for your own records.
Commonly, your failure to report your work injury or work-related condition/illness within thirty (30) days of the accident may result in a denied claim by a workers’ compensation insurance carrier. If your employer does not cooperate and report your work-related injury to their insurance carrier, you can report the claim yourself.
Employer’s Obligations to Report Injuries
An employer’s obligation to report an injury to its insurance carrier is based on how severe the injury to the employee is initially determined to be. If an employee needs first aid only, employers do not need to report first aid cases to their carrier. However, first aid only cases require specific records/information to be kept by the employer regarding the accident. First aid cases involve injuries that are treated on-the-job without paid medical treatment and do not disable the injured employee for more than one shift.
The records that the employer must keep include:
- the employee’s name
- Social Security number or another ID number
- date and time of the accident/injury
- occupation of employee
- who took the report and when
- description and cause of the accident
- description of the injury that occurred and the affected body part
- location address of the accident, if different from the employer’s address.
One of the most common types of claims that must be reported by employers is the medical-only claim. Employers must report medical-only injuries to their insurance carrier within seven days after knowledge of the injury. By definition, to be a medical-only claim, an injured worker would need medical treatment from the accident, but they cannot not lose more than seven days of work because of the work accident. If an employer delays in timely reporting of the claim, they can be fined for late reporting.
Lost Time Claim
A claim becomes a lost time claim when it involves an injury that causes the employee to lose more than seven days from work. An employer must report within seven days after the employer knew of the employee’s injury. Once the employer enters into the reporting process, the employer must also file a 13-week wage statement within 14 days after the employer’s knowledge of the accident/injury once the claim involves lost time. This helps establish the average weekly wage and the corresponding compensation rate for the injured employee.
What Should You Do if Your Employer Does Not Report a Work Comp Claim?
Under Florida law, employers are obligated to report a work injury to their insurance provider. The law gives them seven days to file the report. The time starts counting from when they had “actual knowledge” of the work-related injury or illness. If the employer fails to do this, they face an administrative fine for each failure. But what are your options as the injured worker? We discuss them below.
- Contact the Insurance Provider Yourself: If your employer for any reason refuses to report your injury to their insurance carrier, you can contact the insurance company yourself. Typically, most Florida workplaces have posters that provide work comp insurance information. If you find one at your workplace, call the insurance company and file a claim with them. If such a poster does not exist, chances are your employer lacks work comp insurance. If this is the case, contact the Bureau of Employee Assistance and Ombudsman to get information on your employer’s insurance provider. The EAO will let you know if your employer has an existing policy or not.
- Contact an Experienced Attorney: Your employer failing to report your work injury to their insurer is a red flag that you should not ignore. Thus, you should lawyer up before taking any steps. A lawyer will take over the process and advise you on the steps to take to ensure you do not lose your benefits. Getting a lawyer is a crucial step to take, preferably before contacting the insurance company or EAO.
Why Would Your Employer Fail to Report Your Work Injury?
The aim of every business is to make money, and constantly paying work comp benefits may reduce your employer’s profit margin. Some of them decide not to pay workers’ compensation. However, there are instances when failure to report a work injury is legitimate or may seem legitimate to the employer. For example:
- Your injury did not require medical treatment.
- You did not take time off because of your wound.
- Your injury happened outside working hours.
- You filed a false claim.
- You did not notify your employer of the work injury within the stipulated time.
Keep in mind that these reasons are contestable. If your employer uses any of them as justification for their actions, have an attorney look over your case.
The underlying message is that timely reporting work-related injuries is very important for both parties. If you were injured or have fallen ill as a result of your workplace conditions, contact the Law Offices of Kirshner, Groff, and Diaz for a no-obligation consultation with one of our experienced attorneys. Our lawyers will make sure you get the maximum compensation to which you are entitled.
