Answers a common question of who actually provides for medical care and wage loss after a car accident.
In our practice, we regularly see clients who have been involved in car or truck accidents while occupying their employers' vehicle. Most people are confused about who is responsible for providing for their medical care and their rights of recovery. In some ways, it is analogous to having two separate claims running on parallel tracks, although the rights of recovery do not overlap. Many times choosing the best way to proceed is determined on a case-by-case basis. I'll point out some of the issues that must be considered.
I will assume for the purposes of this discussion that the other party was at fault in the accident. These accidents bring in to play the rights provided under Florida's Workers Compensation statute, Florida no-fault statute, as well as general principles of tort law which provides a right of recovery for damages against the party responsible for causing the accident. We'll only be discussing work comp and no-fault issues in this article.
When someone has been injured on the job, including injuries suffered in motor vehicle accidents occurring on the job, they have the rights provided for them under the worker's compensation statute. This article is not designed to explain all the rights existing under these various statutes. However, certain employers are required to provide Workers Compensation benefits to their employees. When these benefits are available, they generally provide coverage for medical care, as well as certain wage loss benefits, all of which are defined under the statute. An employee involved in the accident example we are considering would have the right to allow workers compensation to provide for their medical care, as well as any wage loss benefits they suffered if they were off work because of the injuries suffered in the accident. However, they are not required to use workers compensation.
One of the advantages of using workers compensation is that the total amount of medical care benefits are, potentially, far greater than what would be provided under the Florida no-fault statute. That is because the medical cost benefits are not capped in terms of what expenses may be incurred and they may be available over a much longer term of years in the most serious injury cases. In the less serious injury cases, these advantages must be weighed against some inherent disadvantages of using workers compensation. Those disadvantages include the fact that the workers compensation carrier has a right to control which doctors may treat the injured worker. No unauthorized treating physician is allowed to be reimbursed. Many workers find this to be a very frustrating disadvantage. Additionally, any medical expenses workers compensation pays must reimbursed to them from any settlement the injured worker receives from the responsible driver's insurance company. Many workers who've been involved in the workers compensation system for any length of time often express great frustration in how the system operates. For many of the most seriously injured clients however, there may be no practical alternative.
If the person in our example owns a motor vehicle insured with Florida's no-fault coverage, those no-fault benefits would be available to pay the medical expenses they incur from the accident. Our worker could choose to use no-fault benefits instead of work comp. No fault pays 80% of your medical expenses and/or 60% of wage loss up to a total of $10,000. It is generally not subject to a claim for reimbursement from the accident settlement. No preapproval for medical treatment need be obtained. There is no requirement that no-fault or workers compensation comp has priority over one another. It's generally up to the injured worker to decide which benefits they wish to pursue. Should our worker choose to treat under workers compensation, their no-fault benefits could be used as an offset against any right of reimbursement the workers compensation carrier may have from the settlement of their injury claim.
Of course, the circumstances of someone's specific accident, as well as the severity of their injury, are very important factors that they should discuss with their attorney before deciding whether they would be best served requesting workers compensation benefits or no-fault benefits to pay for their medical care and lost wages.
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