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FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION For assistance call 1-800-342-1741 or contact your local EAO Office Report all deaths within 24 hours 1-800-219-8953 or (850) 922-8953 PLEASE PRINT OR TYPE NAME (First, Middle, Last) EMPLOYEE INFORMATION Social Security Number HOME ADDRESS EMPLOYEE'S DESCRIPTION OF ACCIDENT (Include Cause of Injury) Date of Accident (Month-Day-Year) Time of Accident AM PM Street/Apt #: City:.

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In order to apply for or renew an exemption from workers' compensation law, the exemption applicant must complete and submit a Notice of Election to be Exempt application online to the Florida Division of Workers' Compensation.

Steps to File a Workers' Compensation Claim in Florida Write Down Details of What Happened and Obtain Available Evidence. ... Get Medical Treatment. ... Report Your Injury to Your Employer. ... Follow Up. ... Document Everything. ... Be Careful when Talking to the Insurance Company. ... Try to Resolve Any Disputes, Then File a Petition.

ing to Florida law, your insurance carrier should start paying workers comp benefits within 21 days after you've reported your injury to your employer. This means that you can expect to receive your first workers' comp check within three weeks of reporting your injury.

Temporary Partial Disability Benefits Per Week This benefit is payable for as long as you are in a temporary light duty work status, for up to 104 weeks (including any weeks of temporary total benefits), or until you have reached Maximum Medical Improvement (MMI), whichever occurs earlier.

Workers' compensation covers employees who suffer an injury or illness caused by their work or working conditions. This includes injuries caused by accidents or illnesses caused by exposure to dangerous materials on the job. You may also get benefits if you travel for business, as well.

You should report it as soon as possible but no later than thirty (30) days or your claim may be denied. When should my employer report the injury to their insurance company? Your employer should report the injury as soon as possible, but no later than seven (7) days after their knowledge.

Workers' Compensation ing to Florida law (440.12 (2), Florida Statutes), the maximum weekly compensation rate for work-related injuries and illnesses shall be equal to 100 percent of the Statewide average weekly wage, rounded to the nearest dollar.

Florida's workers' compensation law provides, in most instances, that workers' compensation is the "exclusive remedy" for job-related injuries and deaths. This means injured employees are prohibited from suing their employers for accidents suffered while on the job.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232