Florida Workers' Compensation Medical Treatment
INJURED AT WORK? YOU MAY BE ENTITLED TO WORKERS' COMP MEDICAL BENEFITS
“Under Florida law, your employer and their insurance company are supposed to provide and pay for all medically necessary treatment related to your work injury. But in reality, insurers often push back on care, question doctor recommendations, or delay authorizations. At Graves Law, we help injured workers get the care they need and hold insurance carriers accountable.”
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Medical Treatment Under Florida Workers' Comp Law
Florida law entitles injured workers to all medically necessary care related to their workplace injury, at no cost to the employee. The employer (or their insurer) is required to furnish this treatment. This includes:
- Emergency medical care
- Follow-up treatment
- Prescription medications
- Surgeries
- Medical supplies and equipment
- Transportation to appointments
The law is outlined in Florida Statutes § 440.13(2)(a), which states: “Subject to the limitations specified elsewhere in this chapter, the employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require.” Let’s break down what that includes:
Ongoing Medical Treatment
Often after a workplace accident an injured worker is seen at a hospital or urgent care. Once your condition is stable, the carrier selects an authorized treating physician to manage your care. This includes:
- Primary physician visits
- Physical therapy
- Imaging (MRI, X-rays, CT scans)
- Referrals to specialists
- Pain management
All ongoing care must be authorized by the insurance company. However, under § 440.13(2)(a), if the treatment is medically necessary and related to the injury, they are required to approve it.
Prescription Medications
Surgeries and Specialist Referrals
If your treating physician recommends surgery, the carrier must authorize it if it’s deemed medically necessary. Common covered surgeries include:
- Spinal procedures (discectomy, laminectomy)
- Shoulder and knee repairs
- Carpal tunnel release
- Hernia repairs
Specialist care must also be authorized and paid for under § 440.13(2)(a). If the carrier denies authorization, a workers’ compensation lawyer can help you challenge it through a Petition for Benefits.
INJURED AT WORK?
Medical Supplies and Durable Medical Equipment (DME)
Florida workers comp also covers assistive devices and medical equipment such as:
- Crutches, walkers, and wheelchairs
- Orthopedic braces and supports
- CPAP machines, TENS units
- Hospital beds, wound care supplies
This is part of your entitlement under § 440.13(2)(a), and must be provided if the equipment is prescribed by your authorized doctor.
Emergency Treatment
Florida law provides for emergency treatment under Fla. Stat. § 440.13(3)(a), which states: “Emergency care may be rendered without the carrier’s authorization…”
After a workplace accident, you are entitled to emergency medical care, even if you haven’t yet filed a formal claim. The law ensures you can receive immediate treatment for life-threatening or urgent conditions. In most instances, if you require emergency treatment immediately after the accident the Carrier will pay for the treatment. Example: an ambulance is called to transport you to the hospital after a fall from a roof.
This also applies to emergency medical treatment after you have filed a claim. An injured worker can seek emergency medical treatment only if their authorized provider is unavailable and there is an actual emergency (health would be placed in jeoprady, serious impairment to bodily health, or serious dysfunction of bodily organ or part). Emergency treatment is often challenged by the insurance company.
Each time you receive authorized medical treatment or payment for lost wages, the statute of limitations is extended for one year from that date.
Example 1: An injured worker undergoes spine surgery due to an accident. The next day the injured worker is no longer able to move their legs. The worker calls their doctor but the office is closed. The injured worker goes to the emergency room for emergency revision surgery. In this instance, there was an emergency and the injured worker was unable to contact their doctor so the emergency treatment would likely be covered.
Example 2: An injured worker undergoes spine surgery due to an accident. The next day the injured worker is no longer able to move their legs. The injured worker calls their doctor and leaves a message during office hours, but does not attempt further contact such as calling again or going to the office. In this instance, the emergency treatment could be challenged based on failure to try to contact the doctor.
Example 3: An injured worker undergoes spine surgery due to an accident. The next day the injured worker discovers the doctor prescribed Advil instead of a stronger painkiller. The injured worker goes to the emergency room. In this instance, the emergency treatment would likely not be covered because it was not an emergency and the worker did not attempt to contact their doctor.
Transportation
Under § 440.13(13), injured workers are entitled to reimbursement for transportation to and from authorized medical appointments.
You may be reimbursed for:
- Mileage (usually at the state-approved rate)
- Parking and tolls
- Transportation services if you are unable to drive
Always keep records of your mileage and request reimbursement promptly.
Understanding MMI and Permanent Impairment Rating (PIR)
Eventually, your doctor may determine you’ve reached Maximum Medical Improvement (MMI). This means your condition has stabilized and is unlikely to improve further, even with continued treatment. After being placed at MMI, the insurance company will still pay for appointments with your authorized providers, but they will generally only offer palliative care and you will be required to pay a $10.00 copay. At that point, the physician will assign a Permanent Impairment Rating (PIR) based on the Florida Uniform Permanent Impairment Rating Schedule. This rating determines:
- If you’re entitled to Impairment Income Benefits (IIB)
- The amount and duration of those benefits
MMI is a major turning point in your claim, it ends your temporary wage loss benefits (TTD or TPD) and often leads to disputes over whether further care is needed. See § 440.15(3)(c) for the statute governing IIB and impairment ratings.