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Avard Law Offices | Social Security Disability & Personal Injury Attorneys | South Florida
Avard Law Offices | Social Security Disability & Personal Injury Attorneys | South Florida
Frequently Asked Questions2023-09-29T05:11:30+00:00

Frequently Asked Questions

FAQS about Social Security Disability, Workers’ Compensation Claims, Veterans’ Disability Benefits and more.

When it comes to Social Security Disability, Workers’ Compensation and Veterans’ Benefits you want a knowledgeable attorney on your side who knows the intricate ins and outs of the system. We have compiled a list of frequently asked questions to give you answers about your case.

How long do I have after an accident to report an injury?2019-05-17T15:13:12+00:00

You must report your injury immediately. By law, you have thirty (30) days to report your injury, or your claim may be denied for failure to notify your employer. However, there are some exceptions to the notification requirement, those can be found in §440.185. Fla. Stat.

When does an Employer report an accident to its insurance company?2019-05-22T20:24:54+00:00

The employer should report your injury immediately, but no later than seven (7) days following the accident. The insurance company must send you an informational brochure, explaining your rights and responsibilities, under workers’ compensation law, within three (3) days. If the insurance company fails to provide the brochure, it may be stopped from raising certain defenses in subsequent litigation.

My Employer will not report the injury to its insurance company, what can I do?2019-05-23T16:59:06+00:00

You have the right to report the injury, and your employer is subject to a fine for failure to report the accident/injury. If you need assistance reporting your injury, contact the workers’ compensation attorneys at Avard Law, or the Employee Assistance Office of the State of Florida.

Do I have to pay for any medical bills related to the injury?2019-05-23T17:00:17+00:00

No, all authorized medical bills should be submitted to your employer, if self-insured, or your employer’s workers compensation insurance company. If you are required to pay any medical bills out of pocket, make sure to submit your expenses to the above entities for reimbursement. If the employer or carrier has authorized medical treatment, do not submit any bills relating to unauthorized providers or treatment. You are not entitled to seek payment or reimbursement from the employer or carrier for unauthorized medical treatment.

How much will I receive if I lose time from work due to my injury?2019-05-23T17:00:54+00:00

Most likely, you will receive 66 2/3 percent of your average weekly wage, which is calculated based upon your 13-week wage history immediately preceding your date of accident.

When will I receive the first Workers’ compensation check?2019-05-23T17:01:24+00:00

Expect to receive the first check within 8 to 21 days following the date of accident. You will not be paid for the first seven days following the date of accident unless the disability results in more than 21 days of lost time from work.

Are workers’ compensation benefits taxable?2019-05-23T17:01:55+00:00

No

What if I do not have transportation to get to my medical appointments?2019-05-23T17:02:38+00:00

Your employer or its insurance carrier is responsible for arranging and paying for transportation for medical appointments.

What happens if my doctor assigns work restrictions, but my employer cannot accommodate those restrictions?2019-05-23T17:03:11+00:00

You are entitled to temporary partial indemnity benefits until your employer can accommodate the restrictions, or your doctor releases you to return to work, under full duty.

Can I be terminated while I am out on Workers’ Compensation?2019-05-23T17:03:42+00:00

No, your employer cannot terminate your employer for filing a workers’ compensation claim. If they do, you may have a claim for coercion under §440.205 or a private cause of action for wrongful termination.

Does my employer have to hold my position for me while I am out on workers compensation?2019-05-23T17:04:18+00:00

Unfortunately, there is no provision requiring employers to hold your job until you return. Some employers have policies within your employment contract that state the actual amount of time you may miss from work prior to being terminated for an extended leave of absence.

What is the Statute of Limitations for Workers’ compensation benefits?2019-05-23T17:05:03+00:00

Depending on the type of injury you have sustained, the statute of limitations for filing your claim is two years from the date of accident, or alternatively, two years from the date you knew or should have known that your injury or illness was related to your employment. In addition, once a claim has been accepted and medical treatment has been authorized, you must treat once every year (365) calendar days with an authorized treating physician to keep your claim open.

Can my workers’ compensation case be settled for a lump sum of money?2019-05-23T17:05:32+00:00

Yes, there are two parts to every workers’ compensation claim: 1) the indemnity, or lost wages; and 2) future medical treatment. You are able to settle each part separately, or you can globally settle both parts simultaneously. Please keep in mind that settlement is completely voluntary for both parties.

The workers’ compensation insurance is not paying me any checks. What can I do?2019-05-23T17:06:18+00:00

You should seek the assistance of the Avard Law Workers’ compensation attorney, or you may find information provided by the State of Florida.

The insurance company is denying my case. What can I do?2019-05-23T17:07:06+00:00

You should seek the assistance of the Avard Law workers’ compensation attorney.

How often can I expect to receive my workers’ compensation checks?2019-05-23T17:07:36+00:00

Normally, workers’ compensation checks are paid bi-weekly.

Can I make a claim for workers’ compensation benefits and Social Security disability benefits at the same time?2019-05-23T17:08:27+00:00

Yes, the Social Security Disability and Florida Workers’ Compensation systems both provide disability benefits but each of them has their own definitions and procedures for obtaining those benefits. If an individual is awarded benefits under both programs at the same time, the combined benefits may not exceed a certain amount and the workers’ compensation carrier, or the social security administration, may “offset” or reduce the benefits.

Are Florida workers’ compensation benefits payable if I tested positive for drugs or alcohol right after my accident?2019-05-23T17:09:17+00:00

In Florida, compensation is not payable if the injury was occasioned primarily by the intoxication of the employee, the influence of any drugs, barbituates, or other stimulants not prescribed by a physician. A post-accident drug test creates a presumption that the injury was in fact caused by alcohol or drugs. This means the claimant will have the burden to demonstrate that injury was not caused by alcohol or drug use.

What types of disability are available under the Florida Disability Retirement System?2022-07-01T14:50:18+00:00

ELIGIBILITY FOR DISABILITY BENEFITS
Disability coverage is available for active members of the Pension Plan and Investment Plan. If you are a retiree of either plan with renewed membership or if you are in DROP, you are not eligible for disability benefits. To qualify for disability retirement under the Pension Plan or Investment Plan, you must be totally and permanently disabled, that is, prevented by reason of a medically diagnosed physical or mental impairment from performing useful and efficient service as an officer or employee. Your disabling injury or illness must have occurred or become symptomatic before you terminated covered employment.

Reference: Sections 121.091(4)(a)-(c), 121.4501(16), and 121.591(2),
Florida Statutes
Rule 60S-4.007, Florida Administrative Code

  1. In-line-of-duty disability retirement covers you from your first day of employment. But your injury or illness has to arise out of and in the actual performance of your job duties.  You have to apply and your doctors must say in writing that you are totally and permanently disabled due to an on-the-job injury or illness.  You also must give the Florida Retirement System a copy of the Notice of Injury, as filed with Workers Compensation.
  2. You must have eight years of creditable service to be eligible for regular disability retirement, unless you were terminated prior to July 1, 2001, when you needed ten years of creditable service to be eligible for regular disability. Generally, Pension Plan members initially enrolled prior to July 1, 2011, vest for service retirement with six years of creditable service. If the members were initially enrolled on or after July 1, 2011, the vesting requirement is eight years of creditable service. If you are vested for service retirement under the Pension Plan but have fewer than eight years of creditable service, you may be eligible to purchase optional service credit to meet the vesting requirement for regular disability retirement, such as credit for an approved leave of absence, military service, in-state service, or out-of-state public service.
How do they define Disability?2022-07-01T14:51:25+00:00

Disability is defined by FRS as being totally and permanently disabled from performing useful and efficient services as an officer or an employee upon termination from FRS covered employment. (See Section 121.091(4), Florida Statutes). It is similar but not exactly the same as the standards used for Social Security Disability and/or Workers Compensation.)

Tell me what types of evidence I should obtain to prove my disability claim?2022-07-01T14:54:16+00:00

Your medical condition had to occur or at least became symptomatic during the period when you were employed in an employee/employer relationship. Your total and permanent disability must be certified by two Florida-licensed physicians. You were not employed with any other employer after such termination; and you were totally and permanently disabled at the time you terminated employment. Furthermore, there are forms that have to be obtained and submitted to the Division of Retirement. You can ask your Personal Office for the forms or you can ask the Disability Determinations Section at the Division of Retirement Disability@FRS.state.fl.us. You can reach the Division of Retirement by calling 844-377-2888 (toll free) or 850-907-6500, or fax 850-4l0-20l0. The address if 3189 S. Blair Stone Rd., Tallahassee, FL 32301-6812

Can I collect FRS and social security or workers compensation?2022-07-01T15:02:35+00:00

Workers’ compensation benefits may be offset against other disability benefits you receive so that your combined benefits do not exceed a statutory threshold. If you get workers’ compensation, FRS or other disability benefits, and/or Social Security Disability benefits, your employer may be entitled to reduce your workers’ compensation if your combined benefits would provide you an income that is higher than that allowed by law, based on your pre-disability income.

Can I obtained Disability if caused by alcohol or drugs?2022-07-01T15:03:11+00:00

No, it is not considered suffered in the line of duty.

When are Firefighters disabilities presumed to have occurred in the line of duty?2022-07-01T15:05:35+00:00
  1. Your disability is presumed to have occurred in the line of duty if resulting from, or arising from the treatment of one of the 21 cancers defined in section 112.1816, Florida Statutes. The employer must
    provide verification of the firefighter’s full-time status and certify the employer is a fire department or public safety department whose primary responsibilities are the prevention and extinguishing of fires; the protection of life and property; and the enforcement of municipal, county, state fire prevention codes and laws pertaining to the prevention and control of fires. Disability retirement benefits under this provision must be effective on or after July 1, 2019.
  2. If you are a firefighter, paramedic, emergency medical technician, law enforcement officer, or correctional officer who is disabled because of hepatitis, meningococcal meningitis, or tuberculosis, your disability is presumed to have occurred in the line of duty unless competent evidence proves otherwise. You must have passed a pre-employment physical examination that failed to reveal any evidence of the communicable disease and must submit an affidavit attesting that you have not been exposed to the disease outside the scope of your employment. You may be required to establish that you have received a standard medically recognized vaccination, immunization, or other preventive measure, if available. You may also be asked to supply a copy of the accident report indicating suspected or known exposure.
  3. If you are a firefighter, law enforcement officer, or correctional officer who is disabled because of tuberculosis, heart disease, or hypertension,  your disability is presumed to have occurred in the line of duty unless competent evidence proves otherwise.  To qualify for the presumption, you must have successfully passed a pre-employment physical exam that filed to reveal evidence of the condition.
What is the DROP Program about?2022-07-01T15:07:39+00:00

The Deferred Retirement Option Program (DROP)

The DROP offered under the Pension Plan allows members who are eligible for normal service retirement to effectively retire and continue working for a limited time while their monthly retirement benefits, plus any applicable cost-of-living adjustment and interest, accumulate on a tax-deferred basis in the FRS Trust Fund. When a participant’s DROP period ends, the participant must terminate all employment with FRS participating employers to receive the DROP accumulation and begin receiving monthly retirement benefits in the amount determined at time DROP participation
began, plus any applicable cost-of-living adjustment.

Reference: Section 121.091(13)(c), Florida Statutes
Rule 60S-11.001, 11.002, and 11.004, Florida Administrative Code Disability Retirement and the DROP

DROP participants are not eligible for FRS disability benefits because they are considered retired under the FRS when DROP begins. Under the FRS, once you have retired, you may not change your type of retirement from a normal service retirement to a disability retirement. If you become disabled while in DROP, you will receive the funds accumulated in DROP up to the month you terminate employment and end your DROP participation and begin receiving your monthly service retirement benefit. Your employer might offer other disability benefits or provide disability insurance apart from your FRS retirement benefit. Check with your human resource officer to ensure that you are receiving all the benefits available to you.

Reference: Sections 121.091(4)(b) and (c) and (13)(c)7, Florida Statutes Rules 60S-4.002(4), 4.007, and 11.004(6), Florida Administrative Code.

Explain what an Investment Plan member is?2022-07-01T15:09:03+00:00

If an Investment Plan member or Hybrid1 member becomes totally and permanently disabled, monthly disability benefits may be available under section 121.591(2), Florida Statutes, instead of benefits that might otherwise be payable.

The Division of Retirement administers the disability program for the Investment Plan members who wish to receive monthly benefits through the Pension Plan. Any Investment Plan member who wishes to receive disability retirement benefits must, in addition to applying for benefits with the division:

  • Transfer all moneys accumulated under the member’s Investment Plan account to the FRS Trust Fund.
  • Receive creditable service towards the years of service required to vest for disability benefits for service credit under the Investment Plan.

Eligibility requirements for disability retirement are the same for Investment Plan members and Pension Plan members as
described elsewhere in this booklet.

Once an Investment Plan member’s application for disability
retirement has been approved, he or she will be paid monthly benefits as of the effective disability retirement date. The application for disability retirement may be cancelled as long as the cancellation request reaches the division before a disability retirement warrant has been deposited, cashed, or received by direct deposit. Upon timely cancellation of your disability retirement application, your active participation in the Investment Plan will be reinstated, and all transferred funds will be returned to your Investment Plan account.

Reference: Sections 121.091(4), 121.4501, 121.591(2), and 121.73, Florida Statutes Rules 19 and 60S-4.007, Florida Administrative Code

Where do I get the forms to apply for disability retirement benefits?2022-07-01T15:19:20+00:00

These forms can be obtained from the division’s website at http://frs.myflorida.com/

To apply for disability retirement under the Pension Plan or Investment Plan, you must submit the forms listed below. You may obtain these forms from your human resource office or by downloading them from FRS Online. You can locate these forms under Forms on the Members page of the division’s website at the link above. You may also write or call the Division of  Retirement to receive the forms.

  1. Members of the Pension Plan must complete an FRS Application for Disability Retirement, Form FR-13, and sign the application in the presence of a public notary. Your date of retirement  may depend, in
    part, on when the division receives this form. While you can send in the rest of the required forms and documents later, you should not delay in submitting your Form FR-13 while you gather other information.
  2. Members of the Investment Plan must complete an Investment Plan Application for Disability Retirement, Form PR-13, to apply for disability benefits.
  3. A Statement of Disability by Employer, Form FR-13a, must be completed by the person designated by your employer.
  4. Two copies of the Physician’s Report of Disability, Form FR-13b, must be completed by two different Florida-licensed physicians currently treating you who can attest that you are mentally or physically disabled from employment and that your disability is total and permanent. If you are employed in an FRS covered position and you are permanently assigned by your FRS employer to work outside the state of Florida but within the United States, then two licensed physicians of the state here you work may complete the form instead of two Florida-licensed physicians. Effective July 1, 2020, if you are receiving care at a federal Veterans Health Administration facility, two licensed physicians working at the facility may complete the form.
  5. Members of the Pension Plan must complete an Option Selection for FRS Members, Form FRS-11o, and sign the form in the presence of a notary public. Members of the Investment Plan must complete an Option Selection for Disability Retirement, Form PR-11o.
  6. Members of the Pension Plan must complete a Spousal acknowledgment Form, Form SA-1, verifying marital status and sign the form in the presence of a notary public. If you are married and select Option 1 or 2, your spouse must acknowledge your choice of option by signing the form in the presence of a notary public. Members of the Investment Plan must complete a Spousal Acknowledgment Form for Disability Retirement, Form SA-2. If you are married and select Option 3 or 4, you must submit a copy of your marriage certificate.
  7. If you are applying for in-line-of-duty disability benefits, you must also provide copies of each workers’ compensation Notice of Injury, as filed by your employer. If no such reports were filed, you should submit a written statement containing the following:
    • An explanation of why a Notice of Injury was not completed and why you did not apply for workers’ compensation benefits;
    • The dates, times, and circumstances surrounding each on-the-job accident or illness;
    • A statement from you explaining why you consider the accident or illness to have been suffered in the line of duty; and
    • A statement from your supervisor explaining why the accident or illness is considered to be job-related (suffered in the line of duty).
  8. The Division of Retirement will review your application and will let you know if additional information is needed from you, your employer, or your physicians. Examples of the types of additional information that could be required to determine your eligibility for disability benefits include the following:
    • Personal interviews with you, your employer, or your physicians;
    • An examination by a medical specialist;
    • A personal interview by a rehabilitation nurse; or
    • Workers’ compensation information from your employer or the third-party carrier administering workers’ compensation coverage for your employer.
  9. Once they receive the required information, the division will notify you in writing if your disability claim has been approved or denied. Reference: Sections 121.091(4)(c) and 121.591(2)(e), Florida Statutes Rule 60S-4.007, Florida Administrative Code
  10. Proof of Age: When you apply for disability retirement, you must provide proof of your age. If you choose benefit payment Option 3 or 4 you must also furnish proof of age for your joint annuitant. The division must receive any required proof of age before you can begin receiving benefits. A legible copy of one of the following documents will be accepted as proof of age:
    • Birth certificate issued by the state or country of birth;
    • Delayed birth certificate;
    • Census report more than 30 years old;
    • Life insurance policy more than 30 years old;
    • A state-issued driver’s license issued after Jan. 1, 2010, that indicates compliance with the federal REAL ID Act;
    • Certificate of Naturalization; or
    • Valid, unexpired U.S. passport.
  11. If you cannot furnish any of these documents, a legible copy of a document from two of the following categories will be required:
    • Birth certificate of child that displays your age or your joint annuitant’s age, as appropriate;
    • Baptismal certificate more than 30 years old;
    • Hospital record of birth; and/or
    • School record at the time which you or your joint annuitant entered grammar school.
    • Reference: Section 121.091(6), Florida Statutes
      Rule 60S-4.0035, Florida Administrative Code
What other provisions in the law apply if I die?2022-07-01T15:23:25+00:00
  • Automatic designation of spouse – If you die before your effective retirement date as a member of the Pension Plan, your spouse at the time of your death will automatically be your beneficiary unless you named a different beneficiary after your most recent marriage. If you die after you retire, your most recently designated beneficiary receives any benefits payable, regardless of any life changes that may have occurred since you retired (such as divorce, remarriage, or death of a beneficiary).
  • Death in the line of duty – If you die in the line of duty as a Pension Plan or Investment Plan member in the Special Risk Class on or after July 1, 2002, your surviving spouse eligible for a lifetime monthly benefit equal to 100 percent of your contracted salary, regardless of your length of service or whether you named someone else as your beneficiary. If you are not married and have a dependent child or children at the time of your death or if you are married and your spouse dies before your youngest child reaches age 18, the benefit may continue until the child reaches age 25 if the child is unmarried and enrolled in school full time.
    • If you die in the line of duty as a Pension Plan or Investment Plan member in a class other than the Special Risk Class on or after July 1, 2002, your surviving spouse is eligible for a lifetime monthly benefit equal to half of your contracted salary,
      regardless of your length of service or whether you named someone else as your beneficiary. If you are not married and have a dependent child or children at the time of your death or if you are married and your spouse dies before your youngest child reaches age 18, the benefit will be paid on behalf of your
      unmarried children until the youngest child reaches age 18.
    • This provision also applies if you are disabled in the line of duty as a member of the Pension Plan and are approved for disability retirement but die before your effective retirement date as a result of your illness or injury. If you are approved for disability retirement as a member of the Investment Plan but die before your disability retirement effective date, survivor benefits will be paid to your beneficiary as provided in section 121.591(3), Florida Statutes.
  • Changing your joint annuitant – When you retire under disability retirement and select an Option 3 or 4 benefit, you may change your joint annuitant up to two times after retirement. To make this change, you must file a notarized Change of Joint Annuitant Form, Form JA-1, with the division and notify, in writing, your surviving former joint annuitant of the change.  Changing your joint annuitant causes your benefit to be recalculated.
  • Joint annuitant nullification – If you retire under disability retirement, select Option 3 or 4, and name your spouse as your beneficiary (your joint annuitant) but you subsequently divorce, you may nullify your designation of your former spouse as your joint annuitant (unless a Qualified Domestic Relations Order prevents you from taking such action). To do this, you must submit to the division a notarized Joint Annuitant Nullification Form, Form JA-NUL, and a copy of your divorce papers. After nullification, your former spouse is considered by law to have died before you and, if you’ve chosen Option 4, your benefit payments will be reduced by one-third. You may not reverse a joint annuitant nullification, but you may a new joint annuitant designation, which causes your benefit to be recalculated. Nullification forms are available from the division.

Reference: Sections 121.021(28) and (46), 121.091(6)-(8) and (14), and 121.591(2) and (4), Florida Statutes
Rules 60S-4.008, 4.010, and 4.011, Florida Administrative Code.

When you nullify or otherwise change a joint annuitant designation after you have retired, your benefit will be recalculated. This nearly always results in reduced benefits. Disability Retirees of the Investment Plan-In some cases, an amount equal to the remaining vested Investment Plan account balance may be payable.

Rule 60S-4.007, Florida Administrative Code.

How do I provide Proof of Age?2022-07-01T15:25:08+00:00

When you apply for disability retirement, you must provide proof of your age. If you choose benefit payment Option 3 or 4 you must also furnish proof of age for your joint annuitant. The division must receive any required proof of age before you can begin receiving benefits. A legible copy of one of the following documents will be accepted as proof of age:

  • Birth certificate issued by the state or country of birth;
  • Delayed birth certificate;
  • Census report more than 30 years old;
  • Life insurance policy more than 30 years old;
  • A state-issued driver’s license issued after Jan. 1, 2010, that indicates compliance with the federal REAL ID Act;
  • Certificate of Naturalization; or
  • Valid, unexpired U.S. passport.

If you cannot furnish any of these documents, a legible copy of a document from two of the following categories will be required:

  • Birth certificate of child that displays your age or your joint annuitant’s age, as appropriate;
  • Baptismal certificate more than 30 years old;
  • Hospital record of birth; and/or
  • School record at the time which you or your joint annuitant entered grammar school.

Reference: Section 121.091(6), Florida Statutes
Rule 60S-4.0035, Florida Administrative Code

What is the Effective Retirement Date?2022-07-01T15:27:27+00:00

If you are approved for disability retirement benefits, your effective retirement date cannot be established until the division receives official documentation from your employer that you have terminated employment. Benefit payments will be retroactive to your effective retirement date. If your disability retirement application is submitted within 30 days of your termination date, your effective retirement date will be the first day of the month following your termination date. If you do not submit your application within 30 days of termination, your effective retirement date will be the first day of the month after the division receives your application. For example, if you terminate on June 30 and your application is received on July 5, your effective retirement date would be July 1. However, if the division doesn’t receive your application until Aug. 2, your effective retirement date would be Sept. 1.

An effective retirement date is always the first day of the month, and benefits are payable on the last working day of the month.

If salary is reported or creditable service is granted on your behalf after you have applied for disability benefits, your effective retirement date can be no earlier than the first day of the month following the last month that you earned salary or received service credit. If you were receiving workers’ compensation payments, your effective disability retirement date may also be affected.

Reference: Sections 121.091(4)(a) and 121.591(2)(c), Florida Statutes Rules 60S-4.0035(4) and 4.007, Florida Administrative Code 11 Form FR-13 for Pension Plan members or Form PR-13 for Investment Plan members.

What Can I Do When My Application for Disability is Denied?2022-07-01T15:32:07+00:00

If you fail to demonstrate total and permanent disability or in-line-of-duty disability, you will be notified by certified mail that the division intends to deny your application. The notice will include factual, legal, and policy grounds for the decision. You will then have 21 days to challenge the intended denial by submitting your written objections and evidence to the division, after which the division will have 21 days to respond.

You will be notified by certified mail, with a copy to your employer, if the division rejects your challenge. The final denial letter will explain the division’s final decision and will advise you regarding your appeal rights. The Division of Retirement will enclose an appeal form with your final disability denial letter.

What are my Appeal Rights?2022-07-01T15:34:55+00:00

If the division denies your disability claim, you may request a hearing before the State Retirement Commission. To receive a hearing before the commission, you must submit the appeal form to the State Retirement Commission within 21 days of receipt of the division’s final denial. If you appeal to the State Retirement Commission, you may elect to receive the service retirement benefits for which you are eligible while you wait for the commission’s decision on your appeal. If the application for disability benefits is approved on appeal, the service retirement will be converted to a disability retirement, but you will not be able to change your benefit payment option. If you choose to take an early service retirement and your appeal is denied, you cannot subsequently cancel or change this election. If the State Retirement Commission approves your application for disability retirement, the commission may cover your reasonable attorney’s fees and taxable costs up to an amount equal to half of your first year’s disability benefit payments. In order for the Commission to approve your petition,  testimony from a physician, either by deposition or at a final hearing, that you are permanently and totally disabled is required.  For in-the-line-of-duty cases the physician must also testify that the disability arose out of and in the actual performance of duties required by the covered employment.  A decision of the State Retirement Commission is considered a final agency action. However, you may petition the District Court of Appeal for review of the commission’s decision.

Should I ask for a Reapplication and Review?2022-07-01T15:35:45+00:00

If your initial application for disability retirement is denied, you may reapply for disability benefits. However, your disability claim will be reconsidered only if you present new medical evidence that was not available at the time of your initial application of a medical condition that existed before you terminated employment covered under the FRS. Your reapplication for disability retirement will be reviewed to determine if new information has been submitted.

Reference: Sections 121.091(4)(g), 121.23, and 121.591(2)(h), Florida Statutes Rules 60S-4.002(4) and 4.007(1), (3), and (10), Florida Administrative Code

What are the Various Benefits Payment Options?2022-07-01T16:59:31+00:00

If you are approved for disability retirement benefits, you must choose one of four benefit payment options. You will not begin receiving disability benefits until you have selected a benefit option. Although you may wait until you have an estimate of benefits before selecting an option, the division suggests that you complete your option selection form as soon as possible. If you were to die before filing your option selection form and you had no qualified joint annuitant, under Florida law, your selection would default to Option 1, providing no continuing benefit to your beneficiary. You may change your option selection at any time during the processing of your application, but your retirement option may not be changed once your benefit payment is cashed or deposited.

If you are married and you select Option 1 or 2, your spouse must acknowledge your option selection in writing. If you select Option 2, 3, or 4, your benefit will be actuarially reduced12 from the Option 1 amount, but the total benefit provided under each of these options is actuarially equal to what you alone would be expected to receive under Option 1. Continuing lifetime monthly benefits under Options 3 and 4 may be paid only to a person who qualifies as a joint annuitant.

The reduction is based on separate actuarial factors for disability retirement.

The actuarial factors used to calculate disability benefits can result in a lower Option 2, 3 or 4 retirement benefit as compared to the same optional benefit computed using the actuarial factors that apply to service retirement. The difference primarily results from different mortality rates and the value of not having disability benefits reduced for early retirement and may be offset by the existence of a minimum benefit. If your service retirement benefit is higher than your disability retirement benefit, you will be provided comparative benefit estimates based on both service and disability retirement and will have the option of selecting the benefit that is best for you.

Options 1 and 2

Option 1: Provides a monthly benefit payment to you for your lifetime and continued disability. This option does not provide a continuing benefit to a beneficiary. Upon your death, the monthly benefit will stop, and your beneficiary will be eligible to receive only a refund of contributions you paid, if any, which exceed the amount you received in benefits.

Option 2: Provides a reduced monthly benefit payment to you for your lifetime and continued disability. However, if you die within 10 years (120 months) of retiring, your beneficiary will receive a monthly benefit payment in the same amount you were receiving for the balance of the 120-month period. If you die after 10 years of disability retirement, no further benefits will be payable.

Options 3 and 4

Under Options 3 and 4, you may provide a continuing benefit for your spouse or other dependent beneficiary who is your joint annuitant. To qualify as your joint annuitant, an individual must meet the following criteria:

  • Be your spouse;
  • Be your parent or grandparent (as long as you provide at least half of the individual’s financial support);
  • Be your natural or legally adopted child who is either under age 25 or who is physically or mentally disabled and incapable of self-support
What is the Minimum Disability Benefit?2022-07-01T17:01:36+00:00

Because total and permanent disability is unpredictable and may occur at an early age, the FRS provides certain minimum disability benefits. However, with sufficient creditable service, you may be eligible for a higher benefit.

Regular Disability (25-Percent Minimum Benefit)

If you are approved for regular disability retirement, regardless of your class of membership, your Option 1 benefit will be at least 25 percent of your average final compensation. If your actual earned benefit based on your years of creditable service would be higher than the 25-percent minimum regular disability benefit, the higher amount will be paid.

In-Line-of-Duty Disability (42-Percent or 65-Percent Minimum
Benefit)

If you are a member of the Regular Class, Senior Management Service Class, or Elected Officers’ Class when you become disabled and you are approved for in-line-of-duty disability retirement, your Option 1 benefit will be at least 42 percent of your average final compensation. If your actual earned benefit based on your years of creditable service would be higher than 42 percent, the higher amount will be paid If you are a member of the Special Risk Class or Special Risk Administrative Support Class when you become disabled and you are approved for in-line-of-duty disability retirement, your Option 1 benefit will be at least 65 percent of your average final compensation.

Reference: Section 121.091(4)(f), Florida Statutes Rules 60S-4.004 and 6.001(6), Florida Administrative Code.

What steps should I take after a car accident?2022-07-29T11:44:05+00:00

If you suffer a personal injury, you should seek medical attention for your injuries. Some injuries get worse several days after the accident. If you feel any pain in any area as a results of your personal injury you should seek medical attention and if not available, go to the emergency room closest to where you live.

You should take photographs of the conditions that caused the accident and talk to any witnesses and get their names and phone numbers and document the road conditions.

Obtain the police report or other accident report and assess the damage to the vehicle.

Exchange insurance information with the other drivers.

Should I contact a personal injury attorney or car accident attorney?2022-07-29T11:44:46+00:00

You should contact an attorney who specializes in personal injury,  car or motorcycle accidents, or slip and falls. The attorney will be able to speak to the insurance company and focus on resolving all the legal issues so that you can spend time improving your medical condition by getting into treatment.

While an attorney will work hard to settle your case without having to go to trial,  make sure your attorney has trial experience in personal injury law so that if it becomes necessary your case will be properly developed to proceed to trial.

Avard Law Offices, P.A. has been handling Personal Injury and Accident cases for a very long time, since 1989, 33 years ago.  They have obtained substantial settlements over the years and are prepared to litigate until the case gets resolved.

What do I do if I have medical bills?2022-07-29T11:45:25+00:00

Florida Statute sec. 627.736 provides that you have 14 days to see a doctor after an accident.   Send these bills immediately for payment with assistance from your accident team attorneys.

What kind of attorney should I get to represent me on my personal injury case?2022-07-29T11:48:11+00:00

You need an attorney who knows the law and understands actual economic and non-economic damages.

You should ask your attorney how many trials the lawyer has handled during his/her career, and it would help if the attorney was also Board Certified so that he/she has knowledge about your particular injuries and/or disabilities.   At Avard Law Offices, PA, you will have a accident team working on your case that includes:  a trial attorney, administrative attorney, paralegal, and legal assistant.

You should contact an attorney as soon as possible after the accident.

What will your legal team do for you?2022-07-29T11:46:44+00:00

Your legal team will help you to obtain the documentation required to process your claim and that includes getting your medical records, the accident report, medical bills, pictures, witness statements and insurance policy information.  In addition, your accident legal team may hire videographers and other experts to supplement your case with good documentation.  Finally, your legal team will prepare a demand for settlement which you may review and assess your damages in order to make a proposal for compensation.

What are the fees for handling personal injury or accident cases?2022-07-29T11:47:21+00:00

Avard Law Offices, PA., does not charge a fee unless they win.  Therefore, it is only contingent on winning the case.

Who is eligible for veterans’ benefits?2022-07-29T15:47:16+00:00

One must be a “veteran” in order to qualify for veterans’ benefits. Generally speaking, a “veteran” is a person who served in the Army, Navy, Marine Corps, Air Force or Coast Guard and was discharged under conditions other than dishonorable. Such an individual may be eligible for veterans’ disability compensation. Certain National Guard and Reserve members may qualify for disability compensation. Benefits may also be available for a dependent or survivor of a veteran, such as a spouse, child or parent.

What type of benefits are available to a veteran who is disabled?2022-07-29T11:50:22+00:00

A veteran who suffers from a disabling medical condition may be eligible for disability compensation, pension, aid and attendance, housebound allowance, and special monthly compensation.  Survivors pension, burial benefits, and dependency and indemnity compensation (DIC) are available for survivors of a deceased veteran.

What is disability compensation?2022-07-29T11:50:58+00:00

Disability compensation is a benefit available to a veteran who was injured or incurred a disease during military service or for whom a pre-existing medical condition was aggravated by military service.  The veteran must have a current medical diagnosis which is related to military service in order to be deemed eligible for this so-called “service-connected disability compensation.”

What medical conditions are considered for disability compensation?2022-07-29T11:51:30+00:00

There is no defined set of conditions for which a veteran might qualify for disability compensation.  Some typical conditions handled in administering claims for benefits under this program include PTSD, traumatic brain injury, neck or back conditions, knee or ankle conditions, shoulder or wrist conditions, tropical diseases (such as malaria), hearing loss or tinnitus, toxic exposure (such as Agent Orange), and exposure to environmental hazards (such as burn pits or contaminated drinking water).  In certain situations, such as exposure to Agent Orange, burn pits or contaminated drinking water, the Department of Veterans Affairs has developed a list of presumptive conditions for which the claims process is more streamlined for a veteran suffering from such a condition.

What type of evidence do I need to prove my claim for disability compensation?2022-07-29T11:52:12+00:00

Initially, an applicant for benefits must prove that he or she is a “veteran” so a copy of the DD-214 should be included when a claim is filed.  Medical evidence to document a current diagnosis as well as course of treatment since discharge for the claimed condition is also required.  The veteran’s Military Personnel Record and Service Treatment Records should be obtained and submitted with a claim for benefits to support the event of injury or illness or aggravation of a pre-existing condition while serving in the military.  A medical opinion from a doctor confirming that the current medical condition is related to military service (known as a “nexus” opinion) should be part of the claim packet.  A “buddy statement” could also prove helpful as it might help document an event in service, a change to an individual following service, or a current medical condition and its effects on the veteran’s ability to function.

How do I apply for disability compensation?2022-07-29T11:52:46+00:00

Applying for disability compensation is simple.  To start the process, file Form 21-526ez which is available at www.va.gov.  A veteran can file the claim form on-line to start the process or work with a VA accredited attorney, such as the attorneys at Avard Law Offices, to request disability compensation.

What happens after I apply for disability compensation?2022-07-29T11:53:30+00:00

Once an application for disability compensation is filed, the VA starts to gather evidence to properly handle the claim.  Medical records from VA facilities or private medical providers will be requested.  Military personnel and treatment records will be requested and become part of the claim file.  In addition, the VA may request that you attend a medical exam to determine the status of each medical condition for which you are claiming benefits as well as to obtain its own “nexus” opinion as to whether a particular condition is linked to your service.  After the VA has finished its review of your claim, a rating decision will be issued advising you whether you have been found eligible for disability compensation.

What happens once I receive a rating decision?2022-07-29T11:54:18+00:00

If disability compensation has been granted for a particular medical condition, the VA will have assigned a percentage of disability (ranging from 0% to 100%) and an effective date of disability for that condition.  If there is a compensable rating assigned (10% or higher), the VA will calculate whether any retroactive benefit is due and also advise the current monthly benefit to be paid to you.  If you are satisfied with the decision, you need do nothing further.

If the VA has denied eligibility or if you are not satisfied with the percentage rating and/or effective date of an approved medical condition, you generally have one year from the date of the decision within which to file an appeal requesting further review of your claim.  Appeal options include:

  • Supplemental Claim (requires new evidence be submitted as part of the appeal)
  • Higher-Level Review Request (a senior reviewer examines the evidence of record)
  • Decision Review Request (considered by the Board of Veterans’ Appeals [BVA])
    • Direct Review Lane (evidence of record considered)
    • Evidence Submission Lane (90 days to submit new evidence for consideration)
    • Hearing Lane (hearing scheduled; new evidence can be submitted)

Note that review options also exist if you are not satisfied with a decision issued by the BVA, including filing a Supplemental Claim or an appeal to the United States Court of Appeals for Veterans Claims.

What about my dependents?2022-07-29T11:55:03+00:00

The spouse or dependent child of a veteran or service member may qualify for certain benefits, such as health care or education.  If you are granted service-connected disability compensation at a rate of 30% or higher, you can add your dependents to your claim by filing Form 21-686c which is available at www.va.gov.  The payment added to your disability compensation award due to adding your dependents is referred to as a “benefit rate.”

Why should I hire an attorney to help me with disability compensation?2022-07-29T11:56:25+00:00

An attorney accredited by the Department of Veterans Affairs can navigate the claim and appeals process in order to expeditiously obtain the maximum benefits available for you and your dependents.  Avard Law Offices has 6 VA accredited attorneys on staff, 2 of whom are members of the National Organization of Veterans’ Advocates, and 3 of whom are admitted to practice before the United States Court of Appeals for Veterans Claims.  Avard Law Offices has the ability to assist you in filing claims for disability compensation and handling the appeal of any adverse decisions issued by the VA in your case.

What is the difference between long-term disability (“LTD”) and short-term disability (“STD”)?2022-07-29T12:28:41+00:00

Short-term disability is for situations where you temporarily cannot work for health reasons. It usually only lasts a few months. Long-term disability is for situations where you can no longer perform your job for a longer term, usually a year or more.

Until when are LTD benefits paid?2022-07-29T12:29:21+00:00

Many policies will pay up until around the retirement age. Some policies will pay for life. If you are already nearly retirement age, many policies will have a set time limit, i.e. 12 to 24 months.

How much does long-term disability pay?2022-07-29T12:31:19+00:00

It depends on the policy. Many policies will pay 60 percent of your wages. Your policy will specify the amount or percentage of your wages that LTD benefits will replace.

Can I collect Social Security Disability Insurance (“SSDI”) benefits and LTD benefits at the same time?2022-07-29T12:31:53+00:00

Yes, although many policies will reduce monthly LTD benefits by the amount of monthly SSDI benefits. For example, if your LTD benefit is $2,000 per month and your SSDI benefit is $1,500, LTD company will pay you only $500 per month, instead of $2,000.

I have been receiving LTD benefits. Now I was awarded SSDI backpay and LTD company wants that money back. Is it legal for them to do that?2022-07-29T12:32:26+00:00

Yes, if you signed up for policy which requires reducing LTD benefits by the amount of SSDI benefits.

I already spent my SSDI backpay. Now I received a letter from LTD company asking for that money. What do I do?2022-07-29T12:33:04+00:00

Make sure that the policy you signed up for contemplates the offset with SSDI and verify whether the LTD carrier performed the calculations correctly. You can ask the LTD carrier for a copy of its calculations. LTD companies may partially or completely stop paying LTD monthly benefits to credit them against the amount owed.

I collect SSDI and my SSDI benefit is higher than LTD benefit. Can I still collect LTD?2022-07-29T12:33:31+00:00

Some companies will still pay a minimum LTD benefit amount. This minimum benefit could be a set amount, i.e. $100 per month, or a set percentage of your LTD benefit, i.e. 10 percent.

Can I collect Worker’s Compensation benefits and LTD benefits at the same time?2022-07-29T12:34:04+00:00

Yes, although many policies will impose an offset.

Are there any other benefit offsets?2022-07-29T12:34:36+00:00

Yes, policies usually provide a full list of the benefits which LTD company will offset against the LTD benefits.

Are LTD benefits taxable?2022-07-29T12:35:16+00:00

LTD benefits are usually taxable if your employer paid the whole or part of your LTD premium.

What is ERISA?2022-07-29T12:35:44+00:00

ERISA stands for the Employee Retirement Income Security Act of 1974. It governs many LTD policies, but not all of them.

Can I still work and collect LTD benefits?2022-07-29T12:36:15+00:00

It depends on the terms of the policy. Some policies will allow working so long as you are earning below a certain percentage threshold of the amount you earned when you became disabled.

What is Life Insurance Waiver of Premium?2022-07-29T12:36:47+00:00

Sometimes employers offer Life Insurance Waiver of Premium coverage along with the LTD plans. If you have such coverage and prove that you are disabled under the applicable policy, you will be able to keep the life insurance coverage without having to pay the premiums.

What is a “pre-existing condition”?2022-07-29T12:37:20+00:00

It is a condition for which you received treatment before the effective date of your LTD coverage. If you become disabled based on the “pre-existing condition”, some policies will require the coverage to be effective for a certain duration of time before you could become eligible for LTD benefits.

Can I sue the LTD company?2022-07-29T12:37:53+00:00

Yes, but policies usually require you to go through the administrative appeal process with the LTD carrier before you can file a lawsuit against it.

What is medical malpractice?2022-09-23T12:02:32+00:00

Any medical professional such as a nurse, medical doctor, surgeon, or dentist is expected to provide health care that meets the accepted standards for that profession and the patient’s specific circumstances. Treatment which deviates from the accepted standard of care according to similar healthcare professionals and that results in injury to the patient is called medical malpractice. In order to recover compensation in a subsequent lawsuit, however, one must be able to show that the healthcare professional provided subpar care and that their negligence resulted in an economic or non-economic loss of some kind. It is not enough to simply show that a doctor has made a mistake.

Can I file a medical malpractice suit if I signed a consent form?2022-10-14T11:26:39+00:00

A signed consent form does not relieve a doctor of his or her responsibility to provide an acceptable standard of care. The success of your claim for damages rests upon proving that you were injured as a result of the doctor’s negligence, so you should not be deterred from pursuing a case against them if you consented to a treatment that they suggested. They are still liable for any subsequent errors in judgment and/or mistakes caused by carelessness if you are injured as a result.

If I already have a settlement offer, why do I need an attorney?2022-10-14T11:27:12+00:00

Health insurance providers who have paid medical bills can place liens on any settlement amounts which you may receive. Our medical malpractice attorneys can negotiate with these providers to ensure you receive fair compensation and calculate the amount of compensation you are likely to receive after all liens have been satisfied. Hospital claims adjusters are intent on settling for the least amount possible. Most people who are represented by an attorney recover a greater amount in damages.

How do I know if my condition is the result of malpractice?2022-09-23T12:04:19+00:00

It can be difficult for the patient to know. Even if you consult with another doctor, you may not get a definite answer to your question. The best way to find out is to have a qualified medical malpractice lawyer investigate your case for instances of negligence. They will be able to review the circumstances that have led to your injury and/or illness and more accurately determine whether or not you have a valid case to pursue.

What should I look for if I suspect medical malpractice?2022-09-23T12:04:51+00:00

The most obvious indications are that the provider took too long to diagnose or begin treatment, a condition became worse after treatment, or an unexpected bad result occurred such as paralysis, brain damage or death. Be especially suspicious if the doctor or provider cannot give you a logical and satisfactory explanation for a worsened condition. If, at this point, you still believe that malpractice has occurred, the next step should be to contact an attorney. From there, they will be able to conduct a more thorough investigation of your case.

How long do I have to file a medical malpractice lawsuit?2022-10-14T11:28:06+00:00

In the State of Florida, a wrongfully injured patient has a limited amount of time to pursue a lawsuit. Since all medical malpractice cases are subject to a statute of limitations, legal action should be taken as soon as circumstances allow. Specifically, however, a victim will have two years from the date of their injury to file an official lawsuit and subsequently pursue compensation. If the injury was not immediately discovered, one would then have two years from the date of detection to take action but no more than four years can elapse from the date that the negligent act occurred.

Will I have to take my case to court?2022-10-14T11:28:56+00:00

Although most personal injury cases are settled outside of court, it may be necessary to pursue a medical malpractice case through trial. Since these cases are often complex in nature, you may have a more difficult time negotiating a fair settlement. This is not to say that this cannot be done, however, as a substantial number of claims are resolved through mediation. But at the end of the day, the nature of your allegations will dictate the course of the subsequent legal process.

What are some common examples of medical malpractice?2022-09-23T12:06:23+00:00

One of the most common types of malpractice is a misdiagnosis, which happens when a doctor diagnoses a patient with the wrong illness or does not diagnose them as promptly as a competent doctor would. Another situation in which malpractice can occur is during surgery. Errors in surgical procedures may include operating on the wrong body part or the wrong patient, leaving foreign objects in the patient’s body, lacerating or perforating surrounding organs, or improperly administering or monitoring anesthesia. Also, malpractice often happens when a doctor prescribes the wrong medication to a patient, or when a nurse provides them with the wrong medication or the wrong dose of a medication. Some of the most tragic malpractice incidents arise in the context of birth injuries, which affect a fetus or newborn. The child may cope with the effects of the malpractice for the rest of their life.

Whom can I sue in a medical malpractice claim?2022-09-23T12:06:52+00:00

You may sue any individual who committed the malpractice. Most often, the defendant will be a doctor, but sometimes a patient will sue a nurse, an anesthesiologist, or another hospital staff member. They may sue several different individuals who may have contributed to the error, especially if it is not immediately obvious who was responsible. If the person who committed the malpractice is an employee of a hospital or another entity, a patient likely can sue the entity as well. They would need to show that the employee was acting in the scope of their job duties when the malpractice occurred. A patient usually cannot sue a hospital if a doctor committed the malpractice, since most doctors are not employed by hospitals. However, there are some exceptions that may allow a patient to include the hospital in the lawsuit.

How much is my medical malpractice case worth?2022-09-23T12:07:22+00:00

This will depend on a combination of objective and subjective factors. Most damages in medical malpractice cases are compensatory damages, which means that they are intended to reimburse the patient for the financial, physical, and emotional consequences of the malpractice. Economic damages (also known as special damages) cover items such as medical costs, lost income, the costs of future treatment, and other losses that are relatively objective. Non-economic damages (also known as general damages) cover the subjective pain and suffering of the patient, as well as other types of harm that are challenging to quantify. Someone who suffered a permanent disability or loss of function is likely to recover a higher award of damages. A patient who can prove that the defendant acted intentionally or in another egregious manner may be able to receive punitive damages as well.

What is the standard of care in medical malpractice cases?2022-09-23T12:07:53+00:00

The standard of care in medical malpractice cases is specific to the professional context. It is different from the standard in ordinary personal injury cases, which is based on what a reasonable person would do. A health care provider is required to act as a competent health care provider in the same specialty would act when treating a similar patient. Since judges and juries would not understand this standard on their own, the patient will need to introduce expert testimony to explain the standard of care. The expert generally must be from the same specialty as the defendant, or at least be familiar with it.

What is the statute of limitations in a medical malpractice case?2022-09-23T12:08:19+00:00

The statute of limitations in a medical malpractice case defines the period in which a patient can bring a claim. It usually starts running when the incident occurs, but it may be extended when a patient is receiving a continuing course of treatment from the same provider. The statute of limitations also may be extended based on the discovery rule. This applies when a patient did not have an opportunity to discover the malpractice when it first happened. Finally, victims of birth injuries may benefit from a longer statute of limitations, which may even extend until they turn 18.

What are damages caps, and why do they exist?2022-09-23T12:08:51+00:00

A damages cap imposes a limit on the amount of compensation that a medical malpractice plaintiff can receive. It may apply to the total award or only to part of the award, such as the non-economic damages. These caps often but not always are adjusted for inflation. A damages cap is meant to restrain juries from awarding excessive amounts of compensation to a sympathetic plaintiff and excessively penalizing a negligent medical professional. Caps also are meant to keep the costs of medical malpractice insurance reasonable and prevent doctors from being driven out of the profession based on a single lawsuit.

Whom can I sue if a nurse gave me the wrong medication?2022-09-23T12:09:17+00:00

You can sue the individual nurse if their medication error fell below the standard of care that a competent nurse would have met. In addition, you may be able to sue the hospital that employs the nurse. You would need to show that the nurse was acting in the scope of the employment relationship and that they were not supervised by an independent doctor (a doctor who was not a hospital employee). If they were supervised by a doctor who was a hospital employee, you still may be able to sue the hospital.

Can I sue if my doctor did not tell me about the risks of a procedure?2022-09-23T12:09:45+00:00

Possibly, but not necessarily. A doctor has a duty to tell a patient about any significant risks involved in a procedure, but they do not need to tell a patient about every imaginable risk. Failing to tell a patient about a significant risk may result in liability under the theory that they did not get informed consent. (This rule does not apply in emergencies, since a doctor does not have time to get informed consent.) A patient bringing a claim based on a lack of informed consent will need to show that a competent doctor would have disclosed the risk, or that a reasonable patient would have made a different decision if they had known about the risk.

What are the reforms that have been proposed for medical malpractice laws?2022-09-23T12:10:15+00:00

Health care providers, insurers, and others have suggested imposing more rigorous damages caps, as well as limits on the fees that a plaintiff’s attorney can receive. Other reform proposals include initiatives to shorten the statute of limitations so that a patient cannot bring a lawsuit if a long time has passed since the malpractice. A more controversial proposal involves transferring these cases to a distinctive type of court, in which judges would be trained in the medical field. This potentially would eliminate a plaintiff’s right to a jury trial, so it seems unlikely to become a reality.

Do I need a lawyer for a medical malpractice case?2022-09-23T12:10:40+00:00

While you technically do not need a lawyer for most medical malpractice cases, you should strongly consider hiring a lawyer. Medical malpractice cases are more complex than car accident cases and many other personal injury claims. They require assembling and interpreting medical documents, as well as retaining experts to testify on your behalf. A plaintiff also needs to meet specific procedural requirements before their case even can be heard. It is easy for a litigant who is unfamiliar with the legal system to make mistakes during this process, which could result in the loss of their rights. At the very least, you should consult an attorney before bringing a claim to get a sense of the steps that you need to take, the pitfalls that you may encounter, and the overall strength of your case.

What is the Florida Patient’s Compensation Fund? Can I get compensation from/compensated by the Florida Patient’s Compensation Fund?2022-09-23T12:11:11+00:00

The Florida Patient’s Compensation Fund is a state-sponsored fund that operates similar to an excess insurance policy for doctors and hospitals. That is, if you get a jury verdict bigger than the insurance policy limits of the doctor or hospital that caused your injury, then the excess will be paid by the Florida Patient’s Compensation Fund.

Most hospitals are obligated to make annual payments into the fund. Any jury verdict above what the Florida Patient’s Compensation Fund will pay must be paid by the doctor or hospital that caused your injury. Additionally, the doctor or hospital whose malpractice or negligence caused your injury will have to pay any punitive damages that are awarded to you – as the Florida Patient’s Compensation Fund will not pay for punitive damages.

Before filing my medical malpractice or negligence case/lawsuit, do I have to give notice to the doctor, hospital, medical provider or health care provider who committed malpractice or negligence/whose malpractice or negligence injured/hurt me? What is the medical malpractice or negligence presuit screening period? What is a notice of intent?2022-10-14T11:34:55+00:00

Yes, before filing your medical malpractice or negligence lawsuit, you must give notice to each possible defendant in your case (called a notice of intent). This notice must:

  1. tell the defendant(s) all of the doctors, hospitals, health care providers or medical providers that you treated with in the two years prior to the malpractice or negligence
  2. provide copies of all of the medical records relied upon by the expert you used in your pre-suit investigation described above.

Along with this notice of intent, you must include an “authorization for release of protected health information” so that the defendant(s) can get your medical records in order to evaluate your case.

Do I need to make a complaint regarding the doctor, hospital, health care provider or medical provider who committed medical malpractice or negligence and injured or hurt me?2022-10-14T11:30:36+00:00

Yes, after filing a medical malpractice lawsuit, you are actually required to send a copy of the lawsuit to the Department of Health and, if the lawsuit involves a medical facility, the Agency for Health Care Administration. The Department of Health or the Agency for Health Care Administration may potentially decide to take disciplinary action against the doctor or hospital whose medical malpractice or negligence caused your injury. This requirement is based on Florida Statute 766.106.

What happens when your disability case goes to federal court?2023-04-21T02:43:35+00:00

Generally, the defendant (Social Security Administration) has 60 days after the plaintiff (disability claimant) files their complaint in District Court to file a complete transcript of the actions taken and testimony given before the agency.

After that, the plaintiff has 30 days to file a brief containing legal arguments and statements of fact.

After that, the Defendant has another 30 days to file their brief containing legal arguments and statements of fact.

Either party may ask the court for an extension of time to file their briefs.  Generally, the court will grant an extension of 30 days at least once.

Once all the briefs are filed, typically it takes the Court approximately 6 months or more to issue a decision.

What kind of a decision does the court make?2023-04-21T02:44:06+00:00

Generally, the court will either deny the claim or issue a remand (send the case back) to the administrative agency (Social Security’s Appeals Council).  The remand order will state what legal issues warranted the remand to the agency.

How long does it take after the Court’s order to remand before the Appeals Council issues a remand to the Administrative Law Judge?2023-04-21T02:44:57+00:00

It typically takes 90-180 days for the Appeals Council to issue a notice of remand.

Once the hearing office for that Administrative Law Judge is notified by the Appeals Council that a case has been remanded, it could take approximately 6 months or even 9 months before a new hearing is scheduled.

Once the hearing has been held, if nothing additional is needed for evidence, it typically takes 30-90 days for the hearing office to issue a decision.

Once the ALJ favorable decision is issue, it generally takes a couple of months before a check for monthly benefits is received.

All attorneys’ fees are approved by the ALJ in the ALJ’s decision.

How long does it take before you will receive a check for benefits after receiving the ALJ’s favorable decision?2023-04-21T02:45:40+00:00

If you receive a partially favorable or fully favorable decision by the Administrative Law Judge, Award Notice(s) will be issued by the payment center and/or the local Social Security office.  If your claim involves SSI, a financial update will be scheduled and once SSA receives all documents, it may take 30 – 60 days to issue the Award Notice and issue your first check.  SSI is typically paid before the disability benefits pursuant to Title II. The Title II Award Notices are issued by the payment center. If you have a disability claim pursuant to Title II only, an Award Notice and payment are typically issued in approximately 45-90 days or so. Could be less time or may take additional time. In the event that you are entitled to benefits under both Title XVI (SSI) Title II, the Title II benefits will not be paid until the SSI Award Notice and benefits have been calculated.   Keep in mind that it is imperative that SSA have your correct bank account information for direct deposit.

If there are additional documents needed, this may take longer to receive payment, i.e. workers compensation benefits information and anything additional that SSA may need to process the Award Notices and payment.

If the court denies the claim what may happen next?2023-04-21T02:46:10+00:00

The plaintiff may appeal if the attorney decides there is merit to an appeal.  Unless the claimant is from a different Circuit, the Appeal will generally go to the Eleventh Circuit Court of Appeals in Atlanta, Georgia.

What is the contact information for the Florida Department of Children and Families and other services?2025-02-24T21:57:04+00:00

DCF Headquarters

2415 North Monroe Street
Suite 400
Tallahassee, FL 32303-4190

Phone: (850) 487-1111
Fax: (850) 922-2993

Customer Call Center

Phone: (850) 300-4323
Florida Relay 711 or TTY 1-800-955-8771
Available 8:00 a.m. – 5:00 p.m., Monday-Friday

Public Benefits and Services
Office of Economic Self-Sufficiency Mail Center
P.O. Box 1770
Ocala, FL 34478-1770
Fax: 1-866-886-4342

Abuse Hotline: (800) 962-2873

Suicide Prevention: (800) 273-8255

Domestic Violence Hotline: (800) 500-1119

Background Screening: (888) 352-2849

For more contact information by county please visit https://www.myflfamilies.com/contact-us

What is SNAP or EBT?2025-02-24T21:57:48+00:00

SNAP, formerly known as the Food Stamp Program, is the nation’s most important anti-hunger program. SNAP provides nutritional support for low-income seniors, people with disabilities living on fixed incomes, and other individuals and families with low incomes. SNAP is a federal program administered by the Florida Department of Children and Families Office of Economic Self-Sufficiency (ESS). ESS is responsible for determining eligibility for SNAP using federal guidelines.

Ways to Protect Your EBT Benefits

What are SNAP Benefits?2025-02-24T21:58:28+00:00

Households can use food assistance benefits to buy breads, cereals, fruits, vegetables, meats, fish, poultry, dairy, and plants and seeds to grow food for your household to eat. Households cannot use food assistance benefits to buy nonfood items such as pet foods, soaps, paper products, household supplies, grooming items, alcoholic beverages, tobacco, vitamins, medicines, food to eat in the store, or hot foods. For more information on SNAP Benefits, go to Food Assistance Program Factsheet.

For Out of State Agencies seeking to verify information with Florida’s Department of Children and Families Economic Self Sufficiency Program regarding a client, please send an email to D11.SFL.CallCenter@myflfamilies.com.

What are the Eligibility requirements for SNAP?2025-02-24T21:59:14+00:00

SNAP eligibility rules and benefit levels are, for the most part, set at the federal level and uniform across the nation, though states have flexibility to tailor aspects of the program. Individuals must pass all eligibility rules to receive food assistance benefits.

SNAP eligibility rules and benefit levels are, for the most part, set at the federal level and uniform across the nation, though states have flexibility to tailor aspects of the program. Individuals must pass all eligibility rules to receive food assistance benefits. Some of the eligibility rules are:

  • Identity – Applicants must provide proof of their identity.
  • Work Rules – Individuals aged 16 – 59 must meet General Work Requirements for SNAP unless exempt, such as being unable to work, caring for young children or incapacitated persons, or being a student. Additionally, adults aged 18 – 59, unless exempt, must work or participate in the SNAP Employment and Training Program (SNAP E&T). For additional information on Work Rules or Able Bodied Adults without Dependents (ABAWDs) visit Frequently Asked Questions
  • Income – Most households must pass a gross income limit less than or equal to 200% of the Federal Poverty Level (FPL).
  • Deductions – Some household expenses may be subtracted from the total monthly income in the food assistance budget. The budget may subtract for shelter expenses, dependent care, medical expenses, child support paid, utility deductions, and earned income deduction.
  • Residency – Individuals must be a resident of Florida.
  • Citizenship – Individuals must be a U.S. citizen or have a qualified noncitizen status.
  • SSN – Individuals must provide a Social Security Number or proof they have applied for one.
  • Child Support Cooperation – Certain individuals must cooperate with the state’s child support enforcement agency to prove a child’s legal relationship to their parent and to get the court to order child support payments.
  • Assets – Most food assistance households may have assets such as vehicles, bank accounts, or property and still get help. Households with a disqualified member must meet an asset limit of $2,500 ($3,750 if the household contains an elderly or disabled member.

Reporting Changes – Households must report when their total monthly gross income exceeds 130% of the Federal Poverty Level for their household size and when work hours of able-bodied adults fall below 80 hours per month.  The household must report these changes within 10 days after the end of the month of the change.

What is ineligibility for SNAP Benefits?2025-02-24T21:59:51+00:00

Reasons for SNAP ineligibility include:

  • Conviction of drug trafficking,
  • Fleeing a felony warrant,
  • Breaking SNAP Program rules,
  • Noncitizens without a qualified status, or

Students attending an institution of higher education at least half time, in some circumstances.

What is Suncap?2025-02-24T22:00:46+00:00

SUNCAP

The SUNCAP Program is a special Food Assistance Program for individuals who receive Supplemental Security Income (SSI). You may be eligible to receive food assistance benefits through the SUNCAP Program without any additional application, paperwork, or interviews. If you already receive food assistance benefits in the regular Food Assistance Program, you may be automatically put in the SUNCAP Program when you become SSI eligible. If your food assistance benefits will go down because of SUNCAP, you may choose to continue receiving your food assistance benefits under the regular Food Assistance Program.

For more information, go to the SUNCAP Brochure

What is the online purchasing pilot for SNAP?2025-02-24T22:01:27+00:00

Did you know as of May 2021, Walmart, Amazon, Aldi, BJ’s Wholesale Club, Freshfields Farm, Hitchcock’s Markets, Publix, Mt. Plymouth IGA and Whole Foods are accepting SNAP payments online? More retailers may join the online purchasing pilot as it progresses. Updates and other important information will be shared with all SNAP benefit recipients as soon as it is available. You would place your order through the online retailer’s website. Upon check out there will be a section asking if you are using SNAP benefits and you would follow the prompts on the screen.

To determine if grocery delivery is available for your location, please visit the retailers’ websites. The available delivery zip codes indicate where retailers are able to provide their full line of groceries, including perishable items.

Please note: the use of EBT cards for the purchase of groceries is restricted for approved grocery items only and cannot be used for delivery fees.

The use of your EBT card online will still require your unique personal identification number (PIN). All retailers participating in the online purchasing pilot are using compliant methods of encrypted-PIN entry to ensure secure transactions.

What are Fresh Access Bucks?2025-02-24T22:02:00+00:00

Fresh Access Bucks (FAB), an initiative of Feeding Florida, is a USDA funded statewide nutrition incentive program that encourages SNAP recipients to redeem their benefits at farmers markets, produce stands, CSAs, mobile markets, and community grocery outlets to purchase fresh fruits and vegetables. Find out more about Fresh Access Bucks here: https://www.feedingflorida.org/food-access/fresh-access-bucks

What is SNAP Quality Control?2025-02-24T22:02:43+00:00

Thank you for visiting the Office of Economic Self-Sufficiency (ESS) Supplemental Nutritional Assistance Program (SNAP) Quality Control Webpage. If you received a letter in the mail regarding your SNAP case being reviewed by Quality Control, the questions and answers below will provide you with information regarding the Quality Control process.

The SNAP Quality Control Unit performs reviews for households receiving SNAP benefits and measures the program for correct eligibility determinations and payment accuracy (the amount of SNAP benefits approved per household).

Data collected by the Quality Control staff is analyzed and used for future program improvements.

Please note that participation in the Quality Control review is mandatory if your case is selected.  If you refuse to cooperate, your SNAP case will be sanctioned, and you will not be eligible for SNAP benefits until you complete the review.

What is the stolen SNAP Benefits Program?2025-02-24T22:03:20+00:00

Affidavit of Fraudulent Use of an EBT Card

The Stolen Supplemental Nutrition Assistance Program (SNAP) Benefits Program, implemented and funded by the United States Department of Agriculture (USDA) Food and Nutrition Services (FNS) ended December 20, 2024. If your benefits were stolen on or before December 20, 2024 due to skimming and/or cloning, you may be eligible for reimbursement. To submit a claim, you must report the theft within 90 days of the date the benefits were stolen. Claims must be submitted by March 20, 2025.

How to check your EBT history:

Please note, if your SNAP benefits have been skimmed and have not reported your EBT card lost or stolen, your account is likely still at risk. No replacement benefits may be issued until you have reported your compromised EBT card lost or stolen. To report your card stolen, request a new card, and change your PIN, please call EBT Customer Service at (888) 356-3281 or log in to your MyACCESS account.

The Department will review your claim. If your claim is approved, the stolen benefits will be reimbursed, either the exact amount stolen or the equivalent of two months of SNAP benefits before the theft, whichever is less. Once your claim is validated, the benefits will be available for use on your Electronic Benefit Transfer card the following day.

How do I report my stolen SNAP Benefits?2025-02-24T22:04:00+00:00

Please visit the Florida Department of Children and Families website at the following link for more information.

https://www.myflfamilies.com/services/public-assistance/supplemental-nutrition-assistance-program-snap/stolen-snap-faq

What is Temporary Cash Assistance (TCA)?2025-02-24T22:04:42+00:00

The TCA program provides cash assistance to families with children under the age of 18 or under age 19 if full time secondary (high school) school students, that meet the technical, income, and asset requirements. The program helps families become self-supporting while allowing children to remain in their own homes. Pregnant women may also receive TCA, either in the third trimester of pregnancy if unable to work, or in the 9th month of pregnancy. Parents, children and minor siblings who live together must apply together.

What are the eligibility requirements for Temporary Cash Assistance (TCA)?2025-02-24T22:05:47+00:00

A person must pass all eligibility rules to get TCA benefits. Some of the eligibility rules are:

  • Time Limits – Cash assistance is limited to a lifetime total of 48 months as an adult (except for child only cases, which have no time limit).
  • Work Rules – Some people must participate in work activities unless they meet an exemption. Regional Workforce Boards provide work activities and services needed to get or keep a job.
  • Income and Deductions – Gross income must be less than 185% of the Federal Poverty level and countable income can’t be higher than the payment standard for the family size. Individuals get a $90 deduction from their gross earned income.
  • Citizenship – Individuals must be U.S. citizens or qualified non-citizens.
  • Residency – Individuals must live in the state of Florida.
  • SSN – Individuals must provide a Social Security Number or proof they have applied for one.
  • Assets – A family’s countable assets must be equal to or less than $2,000. Licensed vehicles needed for individuals subject to the work requirement may not exceed a combined value of $8,500.
  • Relationship – A child must be living in the home maintained by a parent or a relative who is a blood relative of the child.
  • Child Support Cooperation – The parent or the caretaker relative of the children must cooperate with child support enforcement to identify and locate the parent(s) who do not live in the child’s home, to prove a child’s legal relationship to their parent and to get the court to order child support payments.
  • Immunization – Children under age 5 must be up to date with childhood immunizations (shots).
  • Learnfare – Children age 6 to 18 must attend school and parents/caretakers must attend school conferences.
What is the Temporary Cash Assistance (TCA) Relative Caregiver Program?2025-02-24T22:06:20+00:00

This program provides monthly cash assistance to relatives who meet eligibility rules and have custody of a child under age 18 who has been court ordered dependent by a Florida court and placed in their home by the Department of Children and Families Child Welfare/Community Based Care (CW/CBC) contracted provider. The monthly cash assistance amount is higher than the Temporary Cash Assistance for one child, but less than the amount paid for a child in the foster care program.

Only the child’s income and assets are counted when determining eligibility and payment amounts. Payments are based on the child’s age and any countable income. Monthly payments for children with no countable income are as follows:

  • Age 0 through 5 – $242 per child
  • Age 6 through 12 – $249 per child
  • Age 13 through 17 – $298 per child
What are the eligibility requirements for the Temporary Cash Assistance (TCA) Relative Caregiver Program?2025-02-24T22:06:58+00:00

Only the child must pass all eligibility rules to get Relative Caregiver benefits. Some of the eligibility rules are:

  • Citizenship – Individuals must be US citizens or qualified non-citizens.
  • Residency – Individuals must live in the state of Florida.
  • SSN – Child must have a social security number or prove they have applied for one.
  • Assets – Child’s countable assets must be equal to or less than $2000.
  • Relationship – Relative caregiver must be within the specified degree of relationship to the parent or stepparent of the child.
  • Income – Child’s net countable income cannot exceed the payment standard for the child’s age(see payment amounts above).
  • Child Support Cooperation – Relative caregiver must cooperate with child support enforcement to identify and locate the parents, to prove a child’s legal relationship to their parent and to get the court order child support payments.
  • Immunizations – Children under age 5 must be current with immunizations.
  • Learnfare – Child age 6 to 18 must attend school.

Detailed information about the Temporary Cash Assistance Program is available in the Temporary Cash Assistance Program Fact Sheet.

For information about other ACCESS Florida programs, visit Medicaid and Food Assistance.

What is optional State Supplementation?2025-02-24T22:07:32+00:00

The Optional State Supplementation (OSS) Program provides monthly cash payments to indigent elderly or disabled individuals who live in special non-institutional, residential living facilities, including assisted living facilities, adult family care homes and mental health residential treatment facilities.  To qualify for OSS, an individual must need assistance with the activities of daily living due to physical and/or mental conditions.  The program provides a monthly check that supplements the individual’s income so they can pay the facility a provider rate established by the Department.

Where can I use my EBT SNAP Benefit Card?2025-02-24T22:08:07+00:00

You can use your EBT card at locations that display the QUEST logo  and supported remarks such as “EBT Accepted Here”

What are Acceptable EBT Purchases?2025-02-24T22:08:33+00:00

Your EBT card can be used to buy breads, cereals, fruits, vegetables, meats, fish, poultry, dairy, and plants and seeds to grow food for your household to eat.

It cannot be used for food assistance benefits to buy nonfood items such as pet foods, soaps, paper products, household supplies, grooming items, alcoholic beverages, tobacco, vitamins, medicines, food to eat in the store, or hot foods.

What is an EBT PIN?2025-02-24T22:09:12+00:00

A PIN (personal identification number) is a secret numeric password shared between a user and the EBT system.

To select your PIN code call the EBT Customer Service at 1-888-356-3281. You have to have a PIN before you can use your card.

It is important to keep your PIN number secret, don’t write your PIN on your card, or on anything you keep with your card and/or share your PIN with anyone else.

If someone takes your card and knows your PIN, they can use ALL your benefits. These benefits cannot be replaced.

  • You have 3 attempts to enter your PIN correctly. After the third try, you will not be able to use your card until the next day.
  • If you cannot remember your PIN, or if someone knows your PIN, call EBT Customer Service immediately and select a new PIN.
  • If you need to update your DOB or SSN, you can do so by logging on to the ESS self-service portal.
Where can I Report Restricted Locations Accepting EBT Cards2025-02-24T22:09:49+00:00

Florida Law prohibits the use of EBT cards at Liquor Stores, Package Stores, Bars, Adult Entertainment establishments, pari-mutuel facilities, Slot Machine facilities, Commercial Bingo, Casinos, and Gambling facilities.

If you know of any location that accepts the Florida EBT card for payment  as described above, please report it!

Where can I find a surcharge-free ATM to withdraw my Temporary Cash Assistance (TCA) benefits?2025-02-24T22:11:12+00:00

Quest 

  • Sales tax cannot be charged on items bought with SNAP benefits.
  • Cash benefits can be withdrawn at ATM’s displaying the Quest Logo

Quest

  • Cash Benefits can be withdrawn with no ATM fees at the below locations:
    • Bank of America
    • Chase
    • Citibank
    • Bank of West
    • Capital One
    • Flagstar Bank
    • Presto
    • S Bank
    • Wells Fargo
  • Items can be purchased with cash and cash back with a purchase is allowed where available.
  • Cash benefits cannot be used outside of the State of Florida for more than 30 days
  • Food Assistance can be used in all 50 states
What are the Temporary Assistance for Needy Families (TANF) Maintenance of Effort (MOE) Resources?2025-02-24T22:11:43+00:00

This page provides informational resources for agencies required to report state expenditures that will be counted towards the Temporary Assistance for Needy Families Maintenance of Effort requirement.

What are additional resources and services of the Department of Children and Families?2025-02-24T22:12:24+00:00
Is Trafficking my Benefits illegal?2025-02-24T22:13:02+00:00

If you are convicted of trafficking in food assistance benefits of $500 or more, you will be disqualified permanently. Trafficking of food assistance includes:

  1. Buying, selling, stealing, or exchanging benefits for cash;
  2. Exchanging firearms, ammunition, explosives, or illegal drugs for benefits;
  3. Buying sodas, water, or other items in a container to get the cash deposit;
  4. Buying an item with food assistance and then purposely selling the item for cash; and
  5. Trading cash for items paid for with food assistance benefits.  If you are convicted of these acts, depending on the severity, you may be fined up to $250,000, imprisoned for up to 20 years, or both.
What is the Federal Poverty Level?2025-02-24T22:13:32+00:00

The average poverty level for one person is around 27,000.  More information in regards to the federal poverty levels can be found at the following link.

https://aspe.hhs.gov/sites/default/files/documents/dd73d4f00d8a819d10b2fdb70d254f7b/detailed-guidelines-2025.pdf

What is Medicaid?2025-02-24T22:14:01+00:00

Medicaid provides medical coverage to low-income individuals and families. The state and federal government share the cost of the Medicaid program. Medicaid services in Florida are administered by the Agency for Health Care Administration.

Medicaid eligibility in Florida is determined either by the Department of Children and Families (DCF) or the Social Security Administration (for SSI recipients).

What are the eligibility requirements for Medicaid?2025-02-24T22:15:25+00:00

Parents and other caretaker relatives of children

  • Children up to age 18 who live with them may be eligible for Medicaid if the family’s countable income does not exceed certain income limits.
  • Individuals who receive Temporary Cash Assistance (TCA) are eligible for Medicaid. Individuals who are eligible for TCA, but choose not to receive it, may still be eligible for Medicaid.
  • Families who lose Medicaid eligibility due to earned income may be eligible for up to twelve (12) additional months of Medicaid, if they meet certain requirements.
  • Families that lose Medicaid eligibility due to the receipt of alimony may be eligible for four (4) additional months of Medicaid.

Children

  • Parents and caretakers may apply for Medicaid on behalf of children under age 21 living in their home, if the family income is under the limit for the age of the child.  There is no requirement for a child to reside with an adult caretaker to qualify for Medicaid.
  • Children under age 19 who become ineligible for Medicaid may remain on Medicaid for up to twelve months after their last eligibility review.
  • Children eligible for Medicaid may enroll in the Child Health Check-up Program.  This program provides regularly scheduled health checkups, dental screenings, immunizations and other medical services for children.  For information on the Child Health Check-up Program, visit the Agency for Health Care Administration’s information page at https://ahca.myflorida.com/
  • Families may also apply for medical assistance for children through Florida KidCare.

Pregnant Woman

  • A pregnant woman may qualify for Medicaid if her family’s countable income does not exceed income limits.  Once eligible, a pregnant woman remains eligible throughout her pregnancy and for a twelve-month post-partum period, regardless of a change in income. For pregnant women who do not meet the citizenship requirements for Medicaid, see the information below about Emergency Medical Assistance for Non-Citizens.
  • Presumptively Eligible Pregnant Women (PEPW) is temporary coverage for prenatal care only and eligibility is determined by Qualified Designated Providers (QDP) based on limited information from the pregnant woman.  During the temporary coverage period, the pregnant woman will need to submit an application to have her ongoing Medicaid eligibility determined.
  • Women with family income over the limit for Medicaid may qualify for the Medically Needy Program.  For more information, see the Family-Related Medicaid Factsheet.

Foster Care Individual

Individuals who are under age 26 may receive Medicaid if they were in foster care under the responsibility of the State and receiving Florida Medicaid when they aged out of foster care.  There is no income limit for this program.

Non-Citizen with a medical emergency

Non-citizens, who are Medicaid eligible except for their citizenship status, may be eligible for Medicaid to cover a serious medical emergency.  This includes the emergency labor and delivery of a child.  Before Medicaid may be authorized, applicants must provide proof from a medical professional stating the treatment was due to an emergency condition.  The proof also must include the date(s) of the emergency.

Note: Applicants approved for emergency Medicaid are not eligible for post-partum coverage

Aged or Disabled individual not currently eligible

Medicaid for low-income individuals who are either aged (65 or older) or disabled is called SSI-Related Medicaid.

Florida residents who are eligible for Supplemental Security Income (SSI) are automatically eligible for Medicaid coverage from the Social Security Administration.  There is no need to file a separate ACCESS Florida Application unless nursing home services are needed.

Individuals may apply for regular Medicaid coverage and other services using the online ACCESS Florida Application and submitting it electronically.  If long-term care services in a nursing home or community setting are needed, the individual must check the box for HCBS/Waivers or Nursing Home on the Benefit Information screen.  HCBS/Waiver programs provide in-home or assisted living services that help prevent institutionalization.

Medicare Savings Programs (Medicare Buy-In) help Medicare beneficiaries with limited finances pay their Medicare premiums; and in some instances, deductibles and co-payments.  Medicare Buy-In provides different levels of assistance depending on the amount of an individual or couple’s income.  Individuals may apply for Medicare Buy-In coverage only by completing a Medicaid/Medicare Buy-In Application.

Print the form, complete it and mail or fax it to a local Customer Service Center.

Individuals eligible for Medicaid or a Medicare Savings Program are automatically enrolled in Social Security’s Extra Help with Part D (Low Income Subsidy) benefit for the remainder of the year.  An individual may also apply directly with Social Security for the Medicare Extra Help Program.  Individuals who do apply directly for the Medicare Extra Help Program have the option of having the same application consideration for the Medicare Savings Program.  If the individual takes the option of having the Medicare Extra Help Program application considered for the Medicare Savings Program, the Social Security Administration will send information electronically to Florida and the individual will be contacted.

More information about Medicaid programs for aged or disabled individuals is available in the SSI-Related Fact Sheets. Information for Medicaid providers who need to communicate with DCF about SSI-Related Medicaid eligibility status is contained in the SSI-Related Provider Communication Guide.

Income and asset limits may be found on the SSI-Related Programs Financial Eligibility Standards.  Important information for individuals seeking Medicaid for long-term care services in a nursing home or community setting is available in the Qualified Income Trust Fact Sheet.

How to Determine Your Monthly Maximum Income Limit (Family-Related Medicaid)?2025-02-24T22:16:42+00:00

To determine your monthly maximum income limit, you must first determine:

  • Your Coverage Group; and
  • Your Family Size.

Step 1: Determine Your Coverage Group

Which of these Coverage Groups describes the person applying for Medicaid?

  • Under age 1.
  • Ages 1 to 5.
  • Ages 6 to 18.
  • Age 19 or 20.
  • Parent or caretaker.
  • Pregnant woman.

Step 2: Determine Your Family Size

To determine your Family Size, answer the following questions:

  1. Are you a child who is not filing a tax return?

If yes, then your Family Size includes all of these individuals:

  • You, and
  • Your parents who live in the same household with you (including step-parents and adoptive parents), and
  • Your siblings who live in the same household with you and are under 19 or are full-time students under 21. This includes step-siblings, half-siblings, and adopted siblings.

Now go to Step 3.

If no, then go to the next question.

  1. Will a parent or spouse claim you as a dependent for the current tax year?

If yes, then your Family Size includes all of these individuals:

  • You, and
  • Your spouse, and
  • The individual filing the tax return (also called the tax filer), and
  • The tax filer’s spouse, and
  • All of the tax filer’s other tax dependents.

Now go to Step 3.

If no, then go to the next question.

  1. Do you expect to file a tax return for the current tax year?

If yes, then your Family Size includes all of these individuals:

  • You, and
  • Your spouse, and
  • Your tax dependents.

Now go to Step 3.

If no, then your Family Size includes all of these individuals:

  • You, and
  • Your spouse, if your spouse lives in the same household with you, and
  • Any of your children who live in the same household with you and are under 19 or are full-time students under 21. This includes step-children and adopted children.

Step 3: Determine Your Maximum Monthly Income Limit

Once you know your Coverage Group and your Family Size, you can use this table to determine your maximum monthly income limit:

Family Size Coverage Groups
Under Age 1 Ages 1 to 5 Ages 6 to 18 Ages 19 & 20 and Parents and Caretakers  Pregnant Women
1 $2,648 $1,821 $1,733 $352 $2,460
2 $3,594 $2,470 $2,351 $472 $3,339
3 $4,541 $3,121 $2,970 $594 $4,218
4 $5,486 $3,770 $3,588 $715 $5,096
5 $6,432 $4,420 $4,207 $836 $5,975
6 $7,379 $5,071 $4,826 $958 $6,854
7 $8,324 $5,720 $5,444 $1,079 $7,733
8 $9,271 $6,372 $6,064 $1,201 $8,612
9 $10,217 $7,021 $6,682 $1,321 $9,491
10 $11,162 $7,671 $7,301 $1,444 $10,369
11 $12,108 $8,321 $7,919 $1,566 $11,247
12 $13,054 $8,971 $8,538 $1,688 $12,126
13 $14,000 $9,621 $9,157 $1,811 $13,005
14 $14,946 $10,271 $9,775 $1,933 $13,884
15 $15,893 $10,922 $10,395 $2,056 $14,763
16 $16,838 $11,572 $11,013 $2,178 $15,641
17 $17,784 $12,221 $11,631 $2,300 $16,520
18 $18,731 $12,871 $12,250 $2,423 $17,399
19 $19,676 $13,522 $12,869 $2,545 $18,278
20 $20,622 $14,172 $13,488 $2,668 $19,156
21 $21,568 $14,822 $14,106 $2,790 $20,035
22 $22,514 $15,473 $14,726 $2,913 $20,914
23 $23,460 $16,122 $15,344 $3,035 $21,792
24 $24,406 $16,772 $15,962 $3,157 $22,671

Effective April 2024

How do I apply for assistance?2025-02-24T22:17:24+00:00

Applying for public assistance benefits is free. Clients can apply online for free by using the Office of Economic Self Sufficiency Self Service Portal or by visiting a DCF Community Partner. If you believe you have been charged a fee inappropriately or have suspected fraud to report, please do so here.

What is MyACCESS portal (benefit information)2025-02-24T22:18:33+00:00

The quickest way to make changes or check the status of your Government Assistance, while avoiding a wait time, is to use the MyACCESS Portal, which is available 24 hours a day, seven days a week. In addition to around the clock access to your case, you can also submit requested verification to the Department using the document upload feature on your MyACCESS account. Log into your account. If you have not registered for an account register here today

A variety of MyACCESS instructional videos are available on the Department’s YouTube Channel https://www.youtube.com/@MyFLFamilies. The channel features a range of tutorials, covering topics such as how to apply for Government Assistance, how to link a case, how to create an account, how to report a change, and more.

You can also get information about your application or benefits by using our automated response system at (850) 300-4323. Your case number or Social Security Number and date of birth are required to access your case information.

How long will it take to complete an application?2025-02-24T22:19:12+00:00

On average, it takes about 30 minutes for most of our customers to complete the online application. This is the quickest way to apply. Once you finish filling out the application, you may submit it to DCF automatically by using our e-signature option.

How long will it take to get a decision on my application?2025-02-24T22:19:50+00:00

It may take up to 30 days to process your application (longer if you need a disability determination). We encourage you to opt-in for email notifications. Once you opt in, you will receive an email alert when we post a notice in your account. If you do not sign up for email notification we will send your notices by post.

How is my application processed for my assistance needs (SNAP, Medicaid, etc.)?2025-02-24T22:20:43+00:00

STEP 1: Your application is reviewed to see if you need an interview.

  • If you need an interview:
    • Not every application will require an interview. If an interview is required, the Department will send you a pending notice based on your preferred method of communication, either electronically or to the address you provided. You can receive your pending notices faster by electing to receive electronic mail or by accessing notices in your MyACCESS account.
    • During your interview, you will be asked about your household situation and you may be asked questions to verify your identity
    • For additional information on preparing for your interview you may visit: Interview Tips.

STEP 2: You may need to provide additional information.

  • We will give or send a notice to you showing what is needed.
  • The notice will give you a deadline to provide the required information. Some examples are:
    • Proof of identity, citizenship, and noncitizen status.
    • Proof of earned and unearned income for each household member (such as last four weeks of check stubs, child support, notices from Social Security or Veteran’s Administration)
  • You can mail, fax, upload your documents in your MyACCESS Account, or turn in information at a local office or community partner. Please write your ACCESS # or case #, name, date of birth, phone number, etc., on all of the information you give us.
  • Allow 3 days for your account to show your information was received.

STEP 3: Your information has been received and your application is being processed.

  • Your needs are important to us and we want to ensure every family receives the correct benefit, but it may still take up to 30 days to finish your application (longer if you need a disability determination).

STEP 4: Your eligibility is determined.

  • Food Assistance or Cash Assistance:
    • If you are eligible for the first time, and your case is approved, you will be mailed an Electronic Benefits Transfer (EBT) card with a brochure that tells you how to use your card.
    • If you received benefits in the past 24 months and still have an EBT card, you can use that card if your case number is the same and the card is not expired (see Good Thru date on the card).
    • If you no longer have your EBT card or your card has expired, please contact EBT customer service at 1-888-356-3281 for a replacement.
    • If you are reapplying and it has been more than 24 months since you received food or cash assistance, a new EBT card will automatically be mailed to you.
  • Medicaid:
    • If you are eligible for Medicaid you will receive a gold card in the mail for eligible household members. The Agency for Health Care Administration (AHCA) will send Medicaid Choice Counseling information to you if you need to select a managed care plan.
  • If you are not eligible for one or all benefits (food or cash assistance or Medicaid):
    • You will receive a notice in the mail and in your ESS self-service portal with the reason(s) you are not eligible.
Are there any other places I can go to for help from my state or the federal government?2025-02-24T22:21:58+00:00

More services are available to you from other agencies and organizations. Click here to see a list of other state and federal programs you may find helpful.

Refugee Services2025-02-24T22:22:26+00:00

The Department of Children and Families’ Refugee Services Program is federally funded by the Office of Refugee Resettlement (ORR) within the Department of Health and Human Services to assist refugees to achieve economic self-sufficiency and social adjustment within the shortest possible time after their arrival in the United States.

While in recent years the number of arrivals has decreased nationwide, the State of Florida’s refugee program is the largest in the nation, receiving more than 5,000 refugees, asylees, and Cuban/Haitian entrants each year.

Refugee Services’ clients all have a legal immigration status. Some are admitted to the United States by the U.S. Department of State (DOS) through its refugee “Reception and Placement” program. DOS contracts with national refugee resettlement agencies to assist resettled refugees during their first three months in the United States. However, only about 8% of Florida’s refugee client population enters the U.S. through the DOS program. A majority of our refugee clients are Cuban entrants who enter the United States through other programs or channels.

Populations Eligible for Services through the Refugee program2025-02-24T22:23:10+00:00

Many people are not familiar with the different immigration classifications for individuals entering this country. The term “immigrant” encompasses a wide range of people who enter the United States through different channels, both regular and irregular, and who have different immigration statuses. Congress determines which groups are eligible for benefits and services provided through the Refugee Services program. All eligible Refugee Services clients have one of the following legal immigration statuses:

Refugees:

The U.S. Refugee Act of 1980 defines a refugee as:

  • a person who is outside his or her country
  • is unwilling or unable to return to his or her home country, and
  • is able to demonstrate persecution or a well-founded fear of persecution based on race, religion, nationality, political opinion, or membership in a particular social group.

Refugees who come to the United States through the State Department’s Refugee resettlement program were accorded refugee status by the United Nations in another country after fleeing their country of origin. They are interviewed and approved for resettlement by the U.S. State Department and vetted by the Department of Homeland Security. Less than one percent of the world’s refugees are resettled in the United States.

Asylees:

Persons who arrive to the United States through various channels and who apply from inside the U.S. for protection from persecution in their homeland (asylum). The U.S. Refugee Act of 1980 defines an asylee as a person who is:

  • physically present in the U.S. or a port of entry
  • able to meet the definition of refugee (see above)

Cuban/Haitian Entrants:

Persons from Cuba or Haiti who have been granted special immigration status by the U.S. (most often “humanitarian parole”) that makes them eligible for refugee benefits and services.

Foreign Victims of Human Trafficking:

Non U.S. citizens/residents who, through the use of force, fraud, or coercion, have performed a commercial sex act, or have been recruited, harbored, transported, provided or obtained for labor or services for the purpose of involuntary servitude, debt bondage, or slavery. To be eligible for services, an individual 18 years of age or older must be “certified” by the U.S. Office of Refugee Resettlement (ORR) or a T-visa holder. Child victims of human trafficking do NOT need to be “certified” or be a T-visa holder, but require a letter of eligibility from ORR.

Coordination of Services for Refugee program2025-02-24T22:23:42+00:00

The Director of Refugee Services is based in Tallahassee. Program staff are mostly located in Tallahassee and Miami; Refugee Services Community Liaisons, who are the program’s direct link to community partners and refugees, are located in each DCF Regional Office: Northeast (Jacksonville), Northwest (Tallahassee), Central (Orlando), SunCoast (Tampa), Southeast (West Palm Beach), and Southern (Miami). Community Liaisons facilitate Refugee Task Force meetings in each community with large numbers of refugees. The Task Forces meet bi-monthly and include refugee resettlement agencies, contracted providers, federal, state and local government agencies, refugee-led self-help organizations, and other entities and individuals concerned with refugees. The meetings provide opportunities to coordinate referrals and services, assess emerging needs of refugees, solve problems, and disseminate federal and state policies.

Benefits and Services for Refugee Program2025-02-24T22:24:47+00:00

Refugee cash and medical assistance benefits are available for a maximum of eight months following arrival to the United States to needy refugees who are not eligible for Temporary Assistance to Needy Families (TANF) or Medicaid. This refugee assistance is paid entirely from federal funds through the Department’s existing FLORIDA system within the ACCESS/Economic Self-Sufficiency program structure.

Support services are provided through contracts with nonprofit organizations, local government agencies, and private entities to assist refugees and entrants meet the goal of economic self-sufficiency and successful integration. Services are contracted within the state’s regulations governing the acquisition of services, including competitive bidding requirements. Current services include:

  • Employment Services
    Employment services are provided to assist eligible refugees/entrants in achieving economic self-sufficiency and effective resettlement through gainful employment. Services primarily target refugees in their first two years in the United States, but refugees remain eligible for up to 60 months. Employment services include pre-employment counseling and orientation, direct job preparation and placement, 90 and 180 day follow-up, On-the-Job Training (OJT), re-credentialing/recertification, and career laddering services for refugees with professional backgrounds.
  • Adult and Vocational Education
    Adult education services include English for Speakers of Other Languages (ESOL), Vocational Training, Vocational English for Speakers of Other Languages (VESOL), Adult Basic Education (ABE), and General Education Diploma (GED) preparation classes.
  • Employability Status Assistance (Legal) Services
    Services include: assistance with obtaining Employment Authorization Documents (EAD), permanent residency applications, and other employment-related immigration status issues.
  • Child Care
    Child Care services are provided to children of eligible refugee/entrants who are enrolled in Refugee Services-funded employment and adult education services. Services are limited to 12 months.
  • Comprehensive Refugee Services (CRS)
    CRS is an integrated service delivery system where a single provider coordinates services in a multi-county area that are essential to refugee/entrant families’ self-sufficiency, effective resettlement, and successful integration into the local community. Services offered may include but are not limited to employment, adult and vocational education, employability status assistance, youth, and child care services. These services are available in Northwest Region, Central Region and SunCoast Region of Florida.
  • Youth Services
    Tutoring, academic enrichment, and orientation services are provided to refugee youth to promote academic success and prevent school dropouts and juvenile delinquency. Services are available in Collier, Hillsborough, Miami-Dade, Broward, Orange, Duval, Pasco, Palm Beach, and Pinellas Counties.
  • Eligibility Training
    Refugee Program eligibility training is provided to local contracted service providers to ensure proper determination of program eligibility for all refugee program services based on the most up-to-date federal eligibility requirements.
  • Interpreter Services
    Telephonic interpreter services and vital document translation services are provided to Refugee Services contracted providers, departmental programs, and local Community Based Organizations to increase service access to refugee/entrants and other limited English proficient individuals.
  • Health Screenings
    Services are administered statewide to newly arrived refugees and entrants by the Department of Health, Refugee Health Services Office. Federally approved protocol for completing health screenings of refugees are followed and provided within 90 days of arriving to Florida. Health screenings include TB test(s), vaccinations, and vision and hearing screening.
  • Unaccompanied Refugee Minors (URM) Program
    Unaccompanied refugee minors are provided services equivalent to youth in foster care and services oriented toward the special needs of refugee youth (i.e. ESOL, cultural identity and adjustment, family tracing and trauma treatment services).
Eligibility for Refugee Program2025-02-24T22:25:32+00:00
  • Refugee Services is 100% federally funded.
  • Resettlement of refugees is governed by federal law – Refugee Act of 1980, Refugee Education Assistance Act of 1980, Regulated at 45 Code of Federal Regulations Part 400 and 401, 409.953, F.S. Admission to the U.S. of other categories of persons eligible for Refugee Services is also governed by Federal laws and policies.

Eligibility for programs of Refugee Services is determined by federal law and includes the following:

  • Refugees are individuals who have been forced to flee their home country due to persecution or a well-founded fear of persecution. Refugees are granted status before they arrive in the United States.
  • Cuban/Haitian Entrants is a term used to describe Cuban and Haitian nationals who enter the United States and are granted a parole upon entry, apply for asylum, or are in removal proceedings.
  • Asylees are persons already in the United States who, due to persecution or a well-founded fear of persecution in their home country, have been granted asylum by asylum officers or immigration judges in the United States.
  • Afghan and Iraqi Special Immigrants (SIV) are Iraqi and Afghani nationals who worked with the U.S. military and who were granted special immigrant status.
  • Certified Victims of Human Trafficking (VOT) are individuals from foreign countries who, through the use of force, fraud, or coercion, have been forced to perform a commercial sex act, or have been subjected to involuntary servitude, peonage, debt bondage, or slavery.
What are Services for Refugees?2025-02-24T22:26:12+00:00
  • Refugee Services currently manages more than a dozen refugee services contracts with state agencies, local governments, and community-based organizations. The Department of Health provides health screenings to ensure newly arrived refugee clients do not have communicable diseases and to identify health issues. AHCA provides payment for Refugee Medical Assistance services in accordance with Medicaid rules, with Federal Funding.
  • Benefits and services are provided as permitted under CFR 45 Part 400 and 401. Refugee clients who are eligible for TANF and Medicaid may apply for and receive those benefits. Those who are ineligible for those programs may apply for and receive Refugee Cash Assistance (RCA) and Refugee Medical Assistance (RMA). In FFY 2021, more than 14,989 clients received RCA, more than 16,301 received RMA and more than 3,720 received TANF. RCA and RMA are limited to eight months of assistance after arrival in the U.S.
  • In FFY 2021, Refugee Services provided an estimated 38,092 unduplicated clients with services including employment, adult education, Refugee Medical and Cash Assistance and health screening. In FFY 2021, Refugee Services provided 5,783 English language classes to 3,678 clients, 804 vocational training classes to 306 clients and childcare to 149 clients. Refugee Services helped 3,464 refugee clients obtain unsubsidized employment, with 83% retaining jobs for at least 90 days in FFY 2021.

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