Workers’ compensation is a system of no-fault insurance that provides monetary and medical benefits to employees (or their survivors) for work-related injuries, diseases and deaths.
The Florida Workers’ Compensation Law (WCL) prescribes eligibility requirements for workers' compensation benefits. The Division of Workers’ Compensation (DWC), which is part of the Florida Department of Financial Services (DFS), handles workers’ compensation claims and resolves any disputes over eligibility.
Workers Covered Under Florida State Law
Most workers in Florida are covered under state law. In general, workers’ compensation coverage applies to all individuals (whether lawfully or unlawfully employed) working for pay or receiving compensation for their services, including:
- Aliens and minors,
- Independent contractors working in the construction industry; and
- Volunteer firefighters (regardless of whether they are on duty).
Workers’ compensation coverage does not extend to people like casual employees not working in the employer’s trade, business, profession or occupation; real estate agents paid solely on commission, etc.
Corporate officers and members of an LLC who own at least 10 percent of their business may choose to be exempt from work comp coverage, even if they work in the construction industry. But to make this election, corporate officers and members of an LLC must file a Notice of Election to be Exempt with the DWC.
Independent Contractor or Employee?
Independent contractors who perform services in the construction industry are covered under workers’ compensation law. Individuals working in other industries may not be considered covered employees of the entities that hire them to perform work if they meet at least four of the following criteria:
- Deposit payments for services into a business (not a personal) account;
- Hold a federal employer identification number, unless the independent contractor is a sole proprietor;
- Maintain at least one bank account in the business’ name and use that account for paying business expenses;
- Maintain separate business work facilities, trucks, equipment, materials or similar accommodations;
- Receive payment for services through a bidding process or on a contractual agreement where no employment relationship exists; and
- Perform work or is able to perform work for more than one business or individual of their choice without submitting to an employment application or process.
Workers who do not meet at least four of the previous criteria may still be considered independent contractors after a full consideration of the nature of their situation.
Bottom line? The governing body — not the business owner — ultimately determines whether the worker is classified as an employee or independent contractor.
Additional evaluation criteria includes whether individuals:
- Are responsible for the satisfactory completion of the work or services they perform;
- Control the means of performing work or services;
- Have continuing or recurring business liabilities or obligations;
- Incur the principal expenses related to the work or service they perform;
- Realize a profit or suffer a loss in connection with performing work or services;
- Receive payment for their work or services on a commission or per-job basis and not on any other basis; or
- Run a business whose failure or success depends on the relationship of business receipts to expenditures.
Misclassifying an individual as an independent contractor may result in fines of up to $5,000 for each misclassification.
What’s Covered by a Workers’ Comp Policy?
To receive workers’ compensation benefits, an employee must sustain a compensable condition. A compensable condition is defined as harm or damage an employee sustains as the direct result of an accident or exposure to a hazardous environment in the normal course of his or her employment. In general, an injury is compensable if it if at least 50 percent of its cause is related to an employment duty. The gravity of the injury must be determined to a reasonable degree of medical certainty, based on relevant medical findings.
Pain and other subjective criteria are not sufficient to establish the existence of a compensable injury. Similarly, mental or nervous injuries caused by stress, fright or excitement are not compensable, unless they are accompanied by physical trauma. If a licensed psychiatrist can establish the existence of mental or nervous injury by clear and convincing medical evidence, compensation is regulated by supplementary provisions of the WCL.
What’s Not Covered
Even when an employee has a compensable condition, other factors may prevent him or her receiving workers’ compensation benefits. The WCL has provided guidance on how employee behavior, fraud, substance abuse and other events or activities may disqualify eligible individuals.
Additional Employee Responsibilities
Florida work comp law also sets additional employee expectations and responsibilities. Failing to satisfy these requirements may cause an individual to lose any benefits he or she is entitled to receive (in whole or in part). Among other things, employees are expected to:
- Inform a supervisor or manager of any work-related conditions as soon as possible but no later than 30 days after they happen;
- Report for treatment at a health care provider approved by their employers (unless the employee requires urgent medical care at the nearest health care facility);
- Follow any employer instructions on how and when to contact the employer’s insurance carrier;
- Follow all instructions received by a qualified and authorized health care provider (including submitting to disability evaluations); and
- Accept suitable employment offered by the employer in case of partial disability.
Still Have Questions?
Contact WorkCompOne or visit the DWC website for more information on workers’ compensation laws in Florida.