Legal Question in Workers Comp in Florida

Re: medical attention

The 120 day rule is a "pay and investigate" rule. The carrier should still be paying for your medical benefits while they investigate the compensability of your claim. They are simply reserving their right to deny the claim at the conclusion of their investigation without being predjudiced by the fact they paid some of your bills. Depending on the insurance company and the facts of your case, this can be standard or you may need help right away. My firm handles cases in that area and I would be happy to speak with you in deatail. Feel free to email or call.

Re: medical attention

Under the Florida Law, the insurance company can decide to perform what is commonly referred to as a "120 day pay and investigate." However, if the insurance company told you it will take 120 days before they pay you, then you need a lawyer. In order for the insurance company to take the 120 days, they have to provide medical care and lost wage benefits during that 120 days. Then, after 120 days, if they conclude that the claim is not valid, the fact that they paid for 120 days is not held against them. Basically, when a claim is reported, the insurance company can do 1 of 3 things: accept the claim and provide lost wages and medical care for as long as there is a relationship between the injury and the need for care; deny the claim completely, or pay and investigate for 120 days. Many times if the employer doesn't report the injury timely, the insurance company needs time to decide what to do. But make no mistake, the insurance company does not have your back. They make money by saving money which means that your interests and the company's interest are exactly opposite. You probably need a lawyer, especially if you have an prior injuries. When you find a lawyer, make sure it is one that will fight for you as many lawyers are just settling files with little effort because the lawyers fees were slashed in 2003. Good luck and watch out for yourself.

Re: medical attention

I don't know what you mean when you say you have "applied for a lawyer"? If you hired a lawyer, let the lawyer respond for you. If you haven't hired a lawyer, get one. The '120 day rule' is supposed to require the insurance company to pay you and pay for your medical care while they investigate the claim. Most of the time they send out the 120 day letter and don't pay for the care or your weekly money benefits. That's why you need to get a board certified workers' compensation lawyer NOW.