Florida Request for Wage Loss / Temporary Partial Benefits
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How to fill out Florida Request For Wage Loss / Temporary Partial Benefits?
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FAQ
Florida workers' compensation law allows an injured worker to receive up to a maximum of 104 weeks of temporary compensation. The employee must remain on a "no work" statusor under limitations which an employer cannot accommodatein order for benefits to be claimed for the week. Medical benefits.
The amount of the benefit depends on how many dependents there are, but it cannot be more than two-thirds of the worker's average weekly wage (up to the same limits that apply to temporary total disability benefits) or $150,000 in total. Workers' comp will also pay up to $7,500 for funeral and burial expenses.
Florida's workers' compensation law requires insurance companies to pay lost wages to an injured worker if an authorized medical provider takes the employee out of work, assigns work restrictions that the employer cannot accommodate or the injured worker returns to work but makes less than a certain percentage of their
FLORIDA DEPARTMENT OF FINANCIAL SERVICES. RECEIVED BY CLAIMS- REQUEST FOR WAGE LOSS/TEMPORARY PARTIAL BENEFITS. 1-800-342-1741 or contact your local office for assistance. COMPLETE ALL APPLICABLE SECTIONS BEFORE FILING WITH THE DIVISION. EMPLOYEE: You must complete one of these forms every two weeks.
The good news is that quitting a job doesn't affect your right to receive continued medical care under workers' compensation. Payments for treatment of your injury under workers' compensation should continue whether you are unemployed, move to another job, or even relocate to another state.
The workers' compensation system in Florida does compensate injured workers for their lost wages if they are temporarily or permanently unable to work due to their injuries.
FLORIDA DEPARTMENT OF FINANCIAL SERVICES. RECEIVED BY CLAIMS- REQUEST FOR WAGE LOSS/TEMPORARY PARTIAL BENEFITS. 1-800-342-1741 or contact your local office for assistance. COMPLETE ALL APPLICABLE SECTIONS BEFORE FILING WITH THE DIVISION. EMPLOYEE: You must complete one of these forms every two weeks.
If you have questions or concerns, you can contact us at 1-866-487-9243 or visit www.dol.gov/agencies/whd.