CHAPTER 1 - Chemical Make Up of the Skin, Hair & Nails
CHAPTER 2 - Chemical Texturizing
CHAPTER 3 - Environmental Issues
CHAPTER 4 - Florida Laws & Rules
CHAPTER 5 - HIV / AIDS
CHAPTER 6 - OSHA - Occupational Safety & Health Administration
CHAPTER 7 - Workers’ Compensation
CHAPTER 8 - Infection Control, Sterilization & Sanitation
10 HOUR CE. FOR COSMETOLOGY
COSMETOLOGY COURSE CHAPTERS
CHAPTER 7
Workers’s Compensation
SECTION 1 - New Rules
SECTION 2 - Fraud and Consumer Protection
SECTION 3 - Report Fraud
SECTION 4 - Detect Arson
SECTION 5 - Frequently Asked Questions
CHAPTER SECTIONS
The FAQ portion below answers the most common concerns regarding the worker’s rights to compensation and time limits for filing a claim.
Employers conducting work in the State of Florida are required to provide workers’ compensation insurance for their employees. Specific employer coverage requirements are based on the type of industry, number of employees and entity organization.
New Rules
Rules 69L-5.205 and 69L-5.217, Florida Administrative Code:
The Florida Department of Financial Services, Division of Workers' Compensation announces that Rule 69L-5.205 (Loss Data Reporting), F.A.C., and Rule 69L-5.217, (Civil Penalties and Fines), F.A.C., have been adopted with an effective date of December 29, 2011. Rule 69L-5.205, F.A.C., clarifies that former self-insurers must report loss data for the final period of authorization only once. Rule 69L-5.217, F.A.C., reduces the penalties assessed against self-insurers for late filing of required forms, reports and documents.
Both rules may also be found via http://www.myfloridacfo.com/wc/forms.html or https://www.flrules.org/gateway/ChapterHome.asp?Chapter=69L-5 .
Revisions to Rule 69L-7.100 Florida Administrative Code (F.A.C.) has been adopted with an effective date of November 13, 2011. This rule incorporates by reference the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASC Manual), 2011 Edition. The ASC Manual contains the Maximum Reimbursement Allowances determined by the Three-Member Panel, pursuant to Section 440.13(12), F.S. and establishes reimbursement policies, guidelines, codes, and maximum reimbursement allowances (MRAs) for items and services provided to an injured worker in connection with a surgical procedure performed in an Ambulatory Surgical Center. The official rule and ASC Manual can be viewed at http://www.flrules.org/Gateway/reference.asp?No=Ref-00686. Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers, 2011 Edition
FRAUD & CONSUMER PROTECTION
Consumer Services
The Division of Consumer Services helps consumers make informed insurance and financial decisions. Our dedicated and experienced staff are continuously trained and informed about any changes that occur in the 26 different categories of insurance. Consumer Assistance and Protection is Our Mission.
Strike Force
The 11-member Medicaid and Public Assistance Fraud Strike Force was created during the 2010 Legislative Session to increase the effectiveness of programs and initiatives that work to prevent, detect, and prosecute Medicaid and public assistance fraud.
Insurance Fraud
The Division of Insurance Fraud is the law enforcement arm of the Department of Financial Services and is responsible for investigating insurance fraud, crimes associated with claim fraud, insurance premium fraud, workers’ compensation claim fraud, workers’ compensation premium avoidance and diversions, insurer insolvency fraud, unauthorized insurance entity fraud and insurance agent crimes. The law enforcement detectives of the Division of Insurance Fraud also investigate viatical application fraud, defalcations of escrow funds held in trust by title insurance firms and non-Medicaid related health care fraud.
Money Service Business Workers’ Comp Fraud Work Group
The purpose of the work group is to review in depth the practices of the check cashing services industry that aid in workers’ compensation premium fraud. Through research and hearings, the work group shall identify the loopholes that allow “shell” construction companies to be established; evaluate the operation of check cashing services; identify any ambiguity related to enforcement of the laws governing these entities; and identify any potential revisions to the statutory framework to eliminate workers’ compensation premium fraud.
Report Fraud
The Department of Financial Services is proud of our accomplishments finding and prosecuting fraud, but we could use your help. If you are a victim of fraud or suspect fraud is occurring, we want to hear from you. Together we can work to put these criminals out of business and make sure that Floridians are protected from those who seek to defraud their fellow citizens.
Public Assistance Fraud
The Division of Public Assistance Fraud works to prevent, detect, and prosecute public assistance fraud. With field offices around the state, the Division of Public Assistance Fraud’s staff is well positioned to take a regional approach to identifying and addressing fraud.
Workers’ Compensation
The Division of Workers’ Compensation ensures that Florida’s workers’ compensation system is healthy and useful. The division’s duties include educating the public about their workers’ compensation rights and responsibilities, compiling, and monitoring system data and promoting and advocating accident prevention in the workplace.
Detect Arson
The Bureau of Fire and Arson Investigations is the law enforcement branch of the division, and is responsible for conducting fire, arson, and explosives investigations as well as other associated crimes (i.e., insurance fraud, homicide, motor vehicle theft, terrorism, etc.) across the state, “Suppression of arson and the investigation of the cause, origin, and circumstances of fire.”
Frequently Asked Questions about Workers’ Compensation
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You should report it as soon as possible but no later than 30 day or your claim may be denied.
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Your employer should report the injury as soon as possible, but no later than seven (7) days after knowledge of it. The insurance company must send you an information brochure within three days after receiving notice form your employer. The brochure will explain your rights and responsibilities, as well as provide additional information about the workers’ compensation law.
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You have the right to report the injury to their insurance company. However, if you need assistance, contact the Employee Assistance Office (EAO) at (800) 342-1741
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The medical provider, authorized by your employer or the insurance company, will provide the necessary medical care, treatment and prescriptions related to your injury.
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No, all authorized medical bill should be submitted by the medical provider to your employer’s insurance company for payment.
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Under Florida law, you are not paid for the first seven day of disability. However, if you lose time because your disability extends to over 21 days, you may be paid for the first seven day by the insurance company. How much will I be paid? In most cases, your benefit check, which is paid biweekly, will be 66 2/3 percent of your average weekly wage. If you were injured before October 1, 2003, this amount is calculated by using wages earned during the 91-day period immediately preceding the date of your injury, not to exceed the state limit. If you worked less that 90 percent of the 91 day period, the wages of a similar employee in the same employment who has worked the whole of the 91 day period or your full-time weekly wage may be used. If you were injured on or after October 1, 2003, your average wage is calculated using wages earned 13 weeks prior to your injury, not counting the week in which you were injured. In addition, if you worked less than 75 percent of the 13-week period, a similar employee in the same employment who has worked 75 percent of the 13-week period or your full time weekly wages shall be used.
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No. However, if you go back to work on light or limited duty and are still under the care of the authorized doctor, you will pay taxes on any wages earned while working. For additional information on income tax, you may want to visit the internal Revenue Service website at: www.irs.gov.
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You should receive the first check within 21 days after reporting your injury to your employer.
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You can receive temporary total, temporary partial disability payments or a combination of the two benefits during the continuance of your disability for no more than a maximum of 104 weeks.
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Yes. However an offset, or reduction in you workers’ compensation check, may be applied because the law states that the two combined may not exceed 0 percent of your average weekly wage earned prior to your injury. For further information on Social Security, you may contact the Social Security Administration at (800) 772-2323 or visit its website at www.ssa.gov.
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Call the insurance company and ask for the adjuster or claims representative. If you still have questions and don’t understand why the checks have stopped, call the EAO at (800) 342-1741.
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No, there is no provision in the law that requires your employers to hold the job open for you.
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No. It is against the law to fire you because you have filed or attempted to file a workers’ compensation claim.
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The law provides at no cost to you, reemployment services to help you return to work. Services include vocational counseling, transferable skills, analysis, job-seeking skills, job placement, on-the-job training, and formal retraining. To find out more about this program, you may contact the Department of Education, Division of Vocation Rehabilitation, Bureau of Rehabilitation and Reemployment Services at (850) 245-3470 or visit it website at: www.rehabworks.org
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It is your decision whether or not to hire an attorney. However, the EAO can assist you and attempt to resolve the dispute. If unable to resolve, the EAO can further assist you in completing and filing a petition for benefits. Visit myfloridacfo.com for more information.
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In general, there is a two-year period to file a petition. However, it depends on the type of issue in dispute. You may call the EAO at (800) 342-1741 or email wceao@myfloridacfo.com for specific information.
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If you were injured on o after January 1, 1994, the claim is closed one year from the date of your last medical treatment or payment of compensation. This period of time is referred to as the statute of limitations. If you were injured before January 1, 1994, the period is two years.
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Settlement may be made under certain circumstances and are voluntary, not automatic or mandatory.
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You are responsible for your future medical needs after your claim for medical benefits is settled.
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In Florida, an injured worker has the right to select a pharmacy or pharmacist. Florida law prohibits interference with your right to choose a pharmacy or pharmacist. However, a pharmacy is not required to participate in the workers’ compensation program. If at any time, your become dissatisfied with your pharmacy or pharmacist’s services, you can seek another pharmacy to fill your prescription.
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No. The “personal information” in s.119.071 (4) d), F.S. is defined as your address, telephone number, photographs, and Social Security number. Although photographs are not collected by out office, our Social Security number will always be redacted from any public record request pursuant to s.119.071 (5)5., F.S. However, s. 119.071 (4) (d) 2,. F.S., requires you or your employer to formally write to the custodial agency that is in possession of your personal information in order to claim the exempt status. Our office accepts emails, faxes or written correspondence when claiming the personal information exempt status. You must provide your full name, complete Social Security number, and occupation title. To request exemption of personal information maintained by our division, you should email, fax, or write to the follow person:
Regardless of what position you find yourself in, here are some questions that might help you.
200 East Gaines Street
Tallahassee, FL 32399-0318
Workers' Compensation Claims
(800) 342-1741
Workers' Compensation Exemption/ Compliance
(850) 413-1609
Employee Coverage & Eligibility
WC Overview & Summary
WORKS CITED
Division of Workers' Compensation. (n.d.). Retrieved September 9, 2022, from https://www.myfloridacfo.com/Division/WC/
CHAPTER SUMMARY
The goal is to ensure that any worker that is involved with the system; has all the tools needed for a positive outcome. Other government agencies may be enlisted to reach that goal. The FAQ portion answers the most common concerns regarding the worker’s rights to compensation and time limits for filing a claim.
CHAPTER 1 - Chemical Make Up of the Skin, Hair & Nails
CHAPTER 2 - Chemical Texturizing
CHAPTER 3 - Environmental Issues
CHAPTER 4 - Florida Laws & Rules
CHAPTER 5 - HIV / AIDS
CHAPTER 6 - OSHA - Occupational Safety & Health Administration
CHAPTER 7 - Workers’ Compensation
CHAPTER 8 - Infection Control, Sterilization & Sanitation