When a worker is injured on the job, the employer’s insurance company is required to pay 100% of the injured worker’s medical bills, surgical bills, pharmacy bills and hospital bills. In addition, the injured worker is to receive compensation based on his prior 13 week average weekly earnings history multiplied by 66 2/3% to determine his average weekly wage (AWW). The injured worker, under Florida law, gives up his right to sue the employer for his pain, suffering, inconvenience and mental anguish in exchange for the prompt payment of workers compensation benefits. Stated differently, the employer is immunized from any claim for non-economic damages if the employer has provided workers compensation coverage for its employees.

Payment of the injured worker’s wages and/or medical bills rarely happens without delay and attempts by the employer’s insurance company to get the injured worker back to work as soon as possible and without any restrictions or further need for medical treatment. This is done at the expense of the injured worker who is often denied much needed surgery or rehabilitative therapy that would continue to improve the worker’s health and well-being.

Injured workers are often confused, anxious and worried how the bills are going to be paid. The absence of full weekly wages leaves the family in financial difficulties and emotional distress. Often times, the injured worker overlooks the fact that he or she may be able to sue a non-immune person or entity which caused or contributed to the on-the-job injury. This is called a “third party claim” even though the  employee was injured while in the course and scope of employment. In some circumstances, the injured employee may be able to sue another motorist or the property owner where the employee was injured. Next, employee may be able to sue the employer for damages outside of the limited workers compensation schedule of benefits if the employee was injured by an activity where the employer knew or should have known that “serious injury or death was virtually certain to happen.”

Injured workers may be able to see doctors other than the workers compensation doctors on the workers compensation insurance company’s “short list” who are expected to favor getting the injured worker back to work as soon as possible, saving the insurance company money.

It is rare to find an injured worker who is not still in pain and still having physical problems when the doctor, hired by the workers compensation insurance company, says you are released back to work without restrictions and without any permanent impairment rating.

Mr. Rosello has successfully pursued third party claims outside of the workers compensation immunity in many cases. Is your injury case one where you can do the same thing? If you are asking whether you can see your own doctor after you are injured, call Mr. Rosello for a free consultation. Attorney’s fees are on a contingency basis, meaning no fee unless Mr. Rosello recovers on your behalf.

PAYING BACK THE WORKERS COMPENSATION INSURANCE COMPANY LIEN IS NOT PAINFUL

When money is recovered from a third party claim the workers’ compensation carrier has a statutory right to collect its money back. This is a workers’ compensation lien. The employer has paid a premium to the workers compensation insurance company which has paid the medical and wage loss for the worker. The employer’s insurance company  now wants to recover its money back if you are successful in securing money from a third party claim. Clients never want to pay it back, but there is no “free lunch” provided for in the law. Section 440.39 ( 2 ) requires payback to be determined by the Judge.

THE MANFREDO FORMULA — MANFREDO V. EMPLOYER’S CASUALTY INSURANCE COMPANY, 560 So.2d 1163 ( Fla. 1990 ).

The Florida Supreme Court clarified the method of how much an employee who successfully recovers money from a third party claim is going to pay the employer’s workers compensation insurance company in all cases. A motion for equitable distribution is heard by the Judge at a hearing where the lawyer for the insurance company and Mr. Rosello will present expert testimony as to the “full value of the case.” The Judge will be seeking to determine an “equitable distribution” which will be fair to both the injured worker and the workers’ compensation insurance company. This formula is the amount of the third party settlement less attorneys fees and costs divided by the full case value. This method provides a percentage of value the workers compensation lien will be reduced from its original total.  What does that all mean?

Lets assume that the workers compensation lien is $388,000.00

The recovery is $100,000.00 because of the limited insurance coverage on the wrongdoer’s automobile policy.

The attorneys’ fees paid from the third party recovery of $100,000.00 is $33,333.33 netting the client $66,666.67

Full case value is 1.75 million dollars

The net value of the case $66,666.67 divided by 1.75 million dollars equals .0380

.0380 multiplied times the total amount of the workers compensation lien of $388,000.00 equals $14,744.00

The amount of the net recovery paid back to the workers compensation carrier is $14,744.00 of the net recovery

In automobile cases PIP will pay the client $10,000.00 which is then added back into the client’s recovery, costing the client only $4744.00 from his net recovery to settle a $388,000.00 past lien.

Call Mr. Rosello today for more information about the Manfredo formula or whether you have a third party claim as well as a workers’ compensation claim.