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Employee Rights and Responsibilities
The claims process can be confusing and frustrating at times, but there are ways to make it easier on all involved. Communicating with all who have a stake in the game – your adjuster and nurse case manager, your supervisor and your clinicians – is the best way to make sure you are getting timely and appropriate medical care and benefits. You need to know your rights and responsibilities in order to make your recovery as smooth as possible.
Your Rights - As a Sarasota County Government employee you have the right to:
- File a workers’ compensation claim if you believe your injury or illness is work-related. You must file your claim within 30 days (90 days for occupational disease) for your claim to be considered. Your claim will be investigated in a prompt manner to determine if you are entitled to benefits. Call OptaComp at 888-763-1450 to report all injuries as soon as they occur.
- Receive appropriate medical care for your covered injury.
You will receive medical treatment from highly qualified local clinicians for your covered injury. When appropriate, you may see a specialist within 24-48 hours of your injury. You may request a one-time change of physician and/or an independent medical examination if you are unhappy with your medical care.
- Receive timely information about your claim and the claims process.
You will receive medical direction immediately upon calling OptaComp to notify them you have been injured. In addition, you will have a dedicated nurse case manager following your treatment and recovery. Your adjuster will contact you within 48 hours from receipt of your claim to gather the facts of the claim and explain your benefits.
- Receive disability benefits if your clinician limits your activities.
Disability benefits are payable within 14 days upon written notification from your clinician that you have restrictions preventing your return to work . Temporary Total Disability benefits are paid at 66 and two-thirds percent of your average weekly wage.
Your Responsibilities - When you have an occupational injury or illness it is your responsibility to:
- Report the injury to your supervisor and OptaComp (888-763-1450) as soon as possible.
If you need emergency care, call 911 or go to the nearest emergency room and call OptaComp as soon as you are able. If you do not need emergency care, report the injury to your supervisor and then call OptaComp to receive medical direction and provide injury details. Reporting the injury promptly is critical so that appropriate medical treatment can be provided and safety concerns can be addressed immediately.
- Inform your supervisor immediately if your clinician limits your activities.
Maintain open and frequent communication with your supervisor. Discuss modified/transitional duty return to work options. The county will make every effort to provide modified/transitional duty during your recovery.
- Accept modified/transitional duty work offered by the county.
Function is good! In most cases, the best rehabilitation is to be active. Physical demand stimulates healing and prevents complications. If you refuse to return to modified/transitional work within the limitations outlined by your clinicians, you will not be entitled to disability benefits.
- Keep your medical appointments and follow the treatment recommendations and limitations given by your clinician at all times.
The limitations your clinicians give you do not just apply to work; they are 24 hours a day unless he/she tells you otherwise. If you have concerns about your medical treatment notify your nurse case manager immediately.
- Communicate all changes in your condition and functional status to your nurse case manager and your supervisor.
You don’t necessarily need to give your supervisor every detail about your injury and treatment, but keep him or her advised of your progress and work status.
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