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.
- Federal Court SSD
- Florida Retirement System Disability FRS
- Long Term Disability LTD
- Medical Malpractice
- Personal Injury
- Social Security Disability
- Veterans' Disability
- Workers' Compensation
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.
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.
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.
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.
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.
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.
Your employer or its insurance carrier is responsible for arranging and paying for transportation for medical appointments.
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.
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.
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.
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.
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.
You should seek the assistance of the Avard Law Workers’ compensation attorney, or you may find information provided by the State of Florida.
You should seek the assistance of the Avard Law workers’ compensation attorney.
Normally, workers’ compensation checks are paid bi-weekly.
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.
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.
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
- 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.
- 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.
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.)
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
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.
No, it is not considered suffered in the line of duty.
- 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. - 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.
- 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.
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.
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
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.
- 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. - Members of the Investment Plan must complete an Investment Plan Application for Disability Retirement, Form PR-13, to apply for disability benefits.
- A Statement of Disability by Employer, Form FR-13a, must be completed by the person designated by your employer.
- 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.
- 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.
- 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.
- 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).
- 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.
- 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
- 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.
- 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
- 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.
- 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,
- 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.
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
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.
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.
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.
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
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
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.
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.
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.
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.
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.
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.
Avard Law Offices, PA., does not charge a fee unless they win. Therefore, it is only contingent on winning the case.
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.
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.
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.”
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.
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.
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.
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.
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.
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.”
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.
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.
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.
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.
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.
Yes, if you signed up for policy which requires reducing LTD benefits by the amount of SSDI benefits.
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.
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.
Yes, although many policies will impose an offset.
Yes, policies usually provide a full list of the benefits which LTD company will offset against the LTD benefits.
LTD benefits are usually taxable if your employer paid the whole or part of your LTD premium.
ERISA stands for the Employee Retirement Income Security Act of 1974. It governs many LTD policies, but not all of them.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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:
- 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
- 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.
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.
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.
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.
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.
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.
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 if I feel my questions are not answered in this Q&A?
Please call your Avard Law case worker or attorney at (239) 945-0808 and tell them the question for which you do not understand the answer. Or ask a question not covered by the Q & A questions. Please note that your calls should be answered within 48 hours. Thank you for your assistance. We are working very hard to help you win your case.