Qualifying for Permanent Total Disability in Florida

Work injuries can take you out of work on a temporary basis or potentially keep you from ever returning to work.  When your injury is permanent and total, you unsurprisingly might qualify for Permanent Total Disability (PTD), which can skip through questions and analysis of your condition that would come into play in a regular Workers’ Comp claim.

Injured workers qualify automatically for PTD if they have certain listed conditions.  If you have a different injury or condition, then you can still qualify if you can show that you truly cannot perform any work and have no suitable job available near you.  You will potentially need to undergo medical assessments to have your PTD approved.

Call the Florida Workers’ Comp lawyers at Graves Injury Law Firm today at (305) 614-2767 for a free case review.

Permanent Benefits vs. Temporary Benefits

When you qualify for Workers’ Comp, your benefits will cover medical care and a portion of lost wages (typically 66 2/3%).  If you get temporary benefits, they last only 104 weeks (2 years) or until you reach Maximum Medical Improvement (MMI).

At that point, benefits can continue on if it is still severely impacting your life 2 years in.  However, some injuries are so severe that we can tell from the beginning you aren’t going to get better in 2 years, and you can go straight on to Permanent Total Disability.

What Injuries Qualify for Permanent Total Disability?

If the injury is permanent, and we can tell that from the beginning, then you can get PTD straight away instead of waiting for MMI to determine how permanent the condition is

Automatic Qualifying Conditions

Florida law has a list of injuries that they recognize are always going to be serious enough to qualify you for PTD:

• Spinal cord injuries causing “severe paralysis” in at least one arm, one leg, or your torso/trunk
• Amputation or total lost function in a hand, foot, arm, or leg.
• Severe brain injuries
• Burns (second- or third-degree) covering at least 25% of your body
• Total blindness (or virtually total).

If there is evidence that you can still work despite these injuries, your employer can fight back against the PTD classification.

Other Qualifying Conditions

Other conditions can still qualify for PTD if they are severe enough to meet these two conditions:

1. You cannot perform even sedentary work (i.e., desk work).
2. No work is available within 50 miles of your home.

If you can still perform some work and it is available near where you live, then you might be left to the 104-week limit for temporary benefits instead.

How Are Permanent Total Disability Benefits (Permanent Impairment Benefits) Determined After Maximum Medical Improvement?

If you are not able to qualify for PTD out of the gate, you instead get temporary benefits (partial or total) for 2 years.  You may then be able to switch to Permanent Impairment Benefits if your condition is still severe enough that you cannot work.

Under the Workers’ Comp laws in Florida, an injury qualifies as “permanent impairment” if you reach MMI – as in, you will not improve further beyond that point – and you are still deemed to have a certain level of lost function, as a percentage of your full body function.

How long – and at what rate – your benefits continue will depend on how much you can work and what percentage your impairment rating is.  The state provides a calculator you can use to get an idea of your ongoing benefits, but you should always check with a Florida Workers’ Comp lawyer before settling anything or accepting this impairment rating.

How is Impairment Determined?

Medical exams are the main way any level of impairment or permanence is determined.  Some injuries – like amputations – are obvious enough, but you need a medical report to show precisely what injuries you have and how severe/permanent they are.

DWC-25 Form

The first important report is a form your doctor fills out.  This will explain your condition, your limitations, what activities and tasks you cannot perform, and other details about the injury.

This is part of any Workers’ Comp claim, permanent or not, and will inform the court of your injury.

Functional Capacity Evaluation

A Functional Capacity Evaluation is a more specific exam aimed at determining your impairment rating and what specific physical tasks you can and cannot perform.  This is vital in assessing what work accommodations you would need and whether light-duty/sedentary work is even realistic for you.

Final Decision

The insurance carrier makes the initial determinations about whether to continue ongoing benefits, but we can take the case for review before a Workers’ Comp Judge if they challenge your claims for permanent benefits.

FAQs for Permanent Disability Benefits in Florida

When Do They Determine Whether My Injury is Permanent or Not?

Whether your injury is temporary or permanent is part of the initial determination in your case.  If it is, you go straight on to Permanent Total Disability benefits and receive 66 2/3% of your pre-injury wage as long as the injury keeps you from working.

If you are put on temporary benefits because we don’t have the evidence for immediate PTD, you can get put on permanent impairment benefits after the 104 weeks of temporary benefits run out.

Who Determines My Impairment Rating?

Doctors make these assessments, and the courts and insurance carriers are usually beholden to those decisions.  However, multiple doctors could come up with different ratings, and a judge might need to decide which is more credible or accurate.

Why Would Permanent Total Disability Benefits Be Denied?

The insurance carrier could deny PTD or permanent impairment benefits for many reasons, but the following are the most common:

• Carriers believe you can do light-duty/sedentary work or a “desk job.”
• The insurance carrier’s doctor gives you work restrictions that say you can perform work (potentially with accommodations).
• Vocational experts say you can go back to certain jobs that might not actually be realistic.
• There isn’t enough medical evidence for the insurance carrier to accept that your condition is permanent.

If your PDT claim is initially denied, you can still potentially get permanent impairment benefits after your 104 weeks of benefits run out and an exam shows that, even after reaching MMI, you are still disabled.

Call Our Workers’ Comp Lawyers in Florida Today

For a free review of your potential permanent disability case, call the Florida Workers’ Comp attorneys at Graves Injury Law Firm today at (305) 614-2767.