SELF-EXECUTED — Florida Workers’ Compensation Law

The week before last, I am sitting in the Florida Workers’ Compensation Forum, when one of the speakers quotes a court opinion stating that to require a certain act (irrelevant to this blog) on the part of the insurance carrier would defeat the “self-executing nature of the statute.”

I ponder this for a moment.  Self-executing?  The Florida Workers‘ Compensation Law?   In the immortal words of Borat:  “Not so much.”

The Florida Workers’ Compensation Law is supposed to be self-executing.  It says so right in the statute itself.  So, of course, that comment got my wheels turning.  Is any part of it “self-executing?”

What does “self-executing” mean?  Here is one common definition:  “anything that is effective immediately without the need of intervening court action.”

F.S. 440.015 states in relevant part that the intent of the Florida Workers’ Compensation Law is:

…to assure the quick and efficient delivery of disability and medical benefits to an injured worker.

So….the Florida Workers’ Compensation Law is supposed to be:

“effective immediately without the need of intervening court action,” and “to assure quick and efficient delivery of disability and medical benefits to an injured worker.”

What a great idea!  If only….

Before the Workers’ Compensation Law existed, employees who were injured by the negligence of their employer had to file a lawsuit, and were left to potentially protracted litigation in our civil justice system.  This delay and cost created an extreme hardship on the injured employee, who may have had no income and no access to medical care until their case either settled or they obtained a judgment.  Enter:  Workers’ Compensation.

Now, if you are injured on the job, your employer is required by law to provide you with medical and indemnity (disability) benefits — through a policy of workers’ compensation insurance.  In exchange for providing the injured worker these benefits, the injured worker gives up their constitutional right to sue their employer for negligence.  This Workers’ Compensation “trade off” is supposed to benefit both the employer — who does not get sued — and the employee — who (presumably) gets the income and medical care they need immediately without the need of intervening court action.

The State of Florida enacted the Workers’ Compensation Law to avoid the cost and delay associated with lawsuits and their accompanying litigation, and provide immediate benefits to injured workers.  Hence the intent of statute to be “self-executing.”

Let’s take a look at the “self-executing nature” of the Florida Workers’ Compensation statute!

If you are injured on the job in the State of Florida today, what benefits do you get “immediately without the need of intervening court action?”

1. Emergency medical care

(i.e. if you have an emergency, you can go to the emergency room).

(Caveat:  this is the only benefit that does not require some preauthorization from the insurance carrier, but that does not necessarily mean they will pay for it!)

Well, that was quick!  What a short list!  Nearly every other benefit under the Florida Workers’ Compensation Law requires some action on the part of an insurance company.  If they don’t act, you don’t get.

• Do you get disability benefits “immediately?”
• Do you get authorization of medical care “immediately?”
• Do either of these require “intervening court action?”
• If you are an injured worker, do you really need a lawyer to get these benefits?

You tell me.  Here is a picture of the Florida Workers’ Compensation Reference manual that explains what benefits you are entitled to and how to get them:

If you want to know whether or not the statute provides benefits “immediately without the need of intervening court action,” consider this:  I have been practicing workers’ compensation law for over 18 years.  I have this job because people call me when the insurance company is NOT giving them the benefits to which they are entitled, which, unsurprisingly, happens a lot.  The only way I can force the carrier to provide the benefits is through — you guessed it — “intervening court action.”

To make matters worse, with some limited exceptions, health insurance carriers will normally NOT pay for medical care related to a work injury, and medical providers are NOT allowed to place a “doctors’ lien” on your case so you can get the treatment now and argue about the bill later; so if you need surgery and the workers’ compensation carrier won’t authorize it, unless you pay cash, you may have to wait for a court order, which can take months, and even longer if there is an appeal.  Sound like immediate access to medical care to you?  How about quick and efficient delivery?  Me either.  The carrier gets to send you to the doctor of their choice and then can delay authorizing any treatment for months anyway.

So, what say you?  Self-executing?

The sad reality in the Florida Workers’ Compensation system:  the only thing being executed are the rights of injured workers.  These rights have been sent straight to the gallows by the Florida Legislature.  The original intent — to avoid a situation of costly litigation and delays wherein the employee has no income and no access to medical care — sleeps with the fishes.  An injured employee may as well file a lawsuit for negligence in Circuit Court.  At least then they can get prompt medical care with a doctor of their choice.  Oh, but they can’t!  That right has been sent to the gallows too.

Stay tuned for Part Two of this series, wherein we will analyze the portion of the Florida Workers’ Compensation Law that is NOT self-executing, but rather requires intervening court action.  On second thought, that would be impossible to do in a blog post.  You would need a book (see above picture).  Why do we have this system again?  Seems like something got thrown out with the bathwater!