Frequently Asked Questions - What Is the Statute Of Limitations On Workers Compensation Claims?
A statute of limitations is a law that bars claims after a certain period of time passes after an injury. The period of time varies depending on the jurisdiction and the type of claim.
For purposes of workers’ compensation cases in Florida, the statute of limitations would end a person’s right to claim benefits or seek compensation and/or damages unless the injured worker meets certain conditions. For any date of accident after January 1, 1994, a claim or Petition for Benefits is forever barred unless it is filed within 1) two years of the day of injury or 2) after the initial two years, within one year of the last payment of compensation or provision of remedial treatment, care or attendance.
In all cases, an injured worker has a minimum of two years from the date of injury to file a Petition for Benefits. This time period can be extended as long as the injured worker receives payment of compensation benefits or obtains authorized medical care at least once a year. A Petition for Benefits is barred unless it is filed within the longer of these two periods of time.
This limitation period begins when the employee knew or should have known that the injury or death arose out of work done in the course and scope of employment. There are two exceptions to this general rule. First, if an injured worker is a minor or mentally incompetent, the statute of limitations is tolled until a guardian or representative is appointed. In most situations, an injured worker’s only remedy when injured at work is to obtain workers’ compensation benefits. However, the second exception exists if the injured worker sues the employer directly arguing that no employer/employee relationship exists. In those situations, the statute of limitations does not begin to run until after the suit has concluded with a finding that the injured worker was, in fact, an employee.
Failing to inform an injured worker about their rights may toll the statute of limitations. Specifically, if an injured worker is not informed about the statute of limitations, the statute is NOT tolled unless the employer and their insurance company can prove that the worker had actual knowledge of the limitation period. The law requires a carrier to mail the injured worker an “informational brochure” outlining the the rights, benefits, and procedures for obtaining benefits including the statute of limitations requirements. This is often sent by both U.S and certified mail so the insurance company can later prove that they met this obligation if the claim is ultimately denied based on a statute of limitations defense. Also, the statute of limitations will not run if an injured worker did not timely file a claim because they were misled or lied to by the employer or their insurance carrier even if the misrepresentation was unintentional.
The continued use of a prosthetic device, with the employer’s knowledge, may be considered the use of a “medical device” furnished by an employer and their carrier could also toll the statute of limitations. Even using a prescribed back brace could potentially prevent the statute of limitations from expiring if the employer had actual knowledge that you were using the brace.
It is extremely important to note that even if the statute of limitations appears to have run on your case, this does not absolutely mean that your case will be denied or that you will be barred from receiving additional benefits. An injured worker cannot revive an expired claim, but an employer or carrier can, whether intentionally or not. Thus, if the insurance company later pays for medical care or sends you a compensation check, this would reopen the claim. It should also be noted if a Petition for Benefits is filed and your employer and their insurance company fails to deny the claim on a statute of limitations defense on its initial response, they are estopped (prohibited) from raising a statute of limitations defense later. In other words, if the employer and their carrier fail to raise a statute of limitations defense in their initial response to a claim, they would be barred from doing so later in the process.
The best way to ensure that the statute of limitations never runs on your case is very simple. Make sure to obtain medical care with your authorized doctor at least once every 12 months, if not sooner. As a general rule, you should really seek follow up care at least once every 6 months or so. Every time you see an authorized doctor (or receive a check from the workers’ compensation carrier), the statute of limitations would be tolled (extended) for at least another 12 months. Even if your treating doctor is simply ordering x-rays or renewing prescriptions, this is sufficient to avoid the statute of limitations from running. Simply attempting to get an appointment before the statute of limitations expires is insufficient to prevent the statute from running. Thus, if you are having issues obtaining a follow up visit with your treating doctor, ie. the doctor is refusing to see you or the insurance company is refusing to authorize the care, seek the advice of an attorney immediately. Once the statute of limitations actually runs, it is very unlikely that the claim can be revived. However, if you contact a lawyer before the statute runs, a claim can be filed with the court to prevent this from occurring.
In sum, the laws regarding the statute of limitations in a workers’ compensation claims can be extremely tricky. There are various exceptions to general rules and technical arguments that can be made on both sides. And, if you allow the statute of limitations to run, even just by one day, your case may be barred forever. Therefore, if you have concerns about the statute of limitations running on your case, you need to talk to a lawyer immediately. Call 1-800-TrialPro now for assistance. We will be happy to provide a free consultation to explain your options and rights.