Treatment Delays

The time doesn't matter until the clock starts.

In the Workers' Compensation System, possibly the most important thing a claimant can do to expedite their case is to 1) hire a lawyer, and 2) get their Petition for Benefits ("PFB") filed.

This is because, unlike with late payment of compensation, the Employer/Carrier ("E/C") does not face penalties or interest for delaying surgeries, withholding authorization for a doctors visit, or otherwise delaying medical treatment. Even if they did, a 20% penalty on a $100 doctor's appointment would not be a very motivating possibility. However, two clocks start when the employee files a PFB:

30 Days | Attorney's Fees

If the E/C fails to furnish medical benefits demanded in a PFB before the 30th day after it was filed, they may be liable for the Employee's attorney's fees. In my experience, it's almost surprising how commonly benefits are provided on the 29th day.

Of course, this clock doesn't start until the PFB is filed and if the Employee is self-represented it likely doesn't matter.

210 Days | Final Hearing

Under Fla. Stat. ยง 440.25(4)(d), the final hearing on a PFB must generally be within 210 days of its filing. Equating to a timeline of about 7 months, this is substantially quicker than most civil litigation, while not exactly a "speedy trial."

However, while it may take 7 months to have a hearing (and longer if the parties agree) it takes another 30 days for the Judge of Compensation Claims' ("JCC")'s order to become final and enforceable. During that time the parties could appeal the decision, in which case the delay may continue for an extensive period.

Of course, this clock also does not start until the PFB is filed.

When a claimant needs medical treatment and has not retained a lawyer, the E/C may find itself with little reason to be proactive. Indeed, if it makes benefits appear too difficult to obtain, some claimants will procrastinate and allow the statute of limitations to lapse, losing valuable benefits that they may not even know.

Pressure to Settle

A delay does not always mean that the E/C is acting maliciously. Insurance carriers - in an attempt to save money - are often understaffed or lack the internal processes to keep up with every issues in every case. Adjusters may be focusing on "bigger fish" or otherwise have your case on their back burner. They may genuinely disagree about their liability.

With that said, looking desperate can substantially hurt any settlement negotiations. For many, hearing that a claimant can't wait sounds like leverage and a big savings.

Other options.

Depending on the facts of your case, there may be alternative methods of obtaining medical care. However, it is important to discuss the availability of alternatives with an attorney since many could have an adversely affect your rights or posture under the Workers' Compensation Law.

Updated: June 8, 2018