Workers' Compensation

• Investigate employers to determine civil compliance with Chapter 440, Florida Statutes.
• Enforce civil compliance when violations of Chapter 440, Florida Statutes are discovered.
• Refer suspected violations of other agency laws (state and federal) to proper agency.
• Process exemption applications in 11 offices throughout the state.
• Maintain exemption database in CCAS (on-line Compliance database).
• Maintain imaged exemption applications and make available to public via public records request.
• Process workers' compensation coverage data received from leasing companies.
• Maintain proof of coverage (POC) database for Florida.
• Efficiently respond to inquiries with reliable information about Bureau and other agency processes.

• Investigates disputes and facilitates resolution without undue expense, costly litigation or delay in the provision of benefits.
• Assists system participants in fulfilling their statutory responsibilities.
• Educates and disseminates information to all system participants.
• Initiates contacts with injured workers to discuss their rights and responsibilities and advise them of services available through EAO.
• Reviews claims in which injured workers' benefits have been denied, stopped, or suspended.
• Provides reemployment services to eligible injured employees who are unable to return to work as a result of their work place injuries or illnesses.

• Regulation of individual self-insurers to ensure financial resources are available to pay employee' s claims.
• Overall monitoring and auditing of carrier performance.
• Monitoring accuracy of benefit payments; initiating intervention efforts when appropriate.
• Establishing permanent total cases eligible for Division-paid supplemental benefits.
• Assessing penalties for late reporting, benefit payments, or medical payments.
• Providing technical assistance to customers through telephone contacts, training, and audit workshops.

• Collection, quality control, analysis and reporting of medical data provided under workers' compensation.
• Establishes and implements the rules, requirements, and processes for electronic reporting of the First Report of Injury, Subsequent Report of Injury and Proof of Coverage forms, using national EDI standardized file formats.
• Monitors accuracy and timeliness of benefit payments; initiating intervention efforts when appropriate.
• Provides for collection, distribution and archival of the division' s imaged records.
• Provides public record information.
• Produces the division' s annual report.
• Responds to requests for division data.

i. Assessments Unit

• Calculates the assessment rate for the Special Disability Trust Fund (SDTF) annually;
• Calculates the assessment rate for the Workers' Compensation Administration Trust Fund (WCATF) annually;
• Insurance companies, assessable mutual insurance companies, self-insurance funds and individual self-insurers are required to pay the Division assessments to support the Workers' Compensation Administration Trust Fund (WCATF) and the Special Disability Trust Fund (SDTF);
• Collects the assessment payments from insurance companies, self-insurance funds and individual self-insurers quarterly; and
• Conducts audits to validate the accuracy of the premium data that the carrier reported against other national premiums sources, such as the NAIC

ii. Financial Accountability Section

• Monitors the receipt of all payments submitted by check or made online related to Notices of Election to be Exempt and Employer penalty payments;
• Oversees the process of reinstating Stop-Work Orders when Employers default on their payments, pursuant to their periodic payment agreement schedule; and
• Refers delinquent accounts to the collection agency and files liens against those Employers

iii. IT Contract Management for Technology Services

• Manages the execution and tracking of the Division's IT contracts

iv. Project, Software, and Data Analysis Unit

• Supports the Division of Workers' Compensation's (Division) project, software, and data analysis needs;
• Provides data analysis services for the Division;
• Sponsors and develops new technology systems and modernizes older technology systems; and
• Provides project management services for the Division

v. Self-Insurance Regulation Unit

• Regulates individual self-insurers to ensure financial resources are available to pay employee' s claims;
• Contracts with FSIGA to actively manage private self-insurers;
• Issues notices of violation for late filing of forms, reports or documents as required by Section 440.38(2)(b), Florida Statutes;
• Issues notices of violation for delinquent payment of assessment to the Florida Self-Insurers Guaranty Association (FSIGA);
• Reviews Drug-Free and Safety Premium Credit Programs application to determine if it in compliance with sections 440.101 and 440.1025 Florida Statutes; and
• Promulgates experience modifications for all active individually self-insurered employers

vi. Special Disability Trust Fund Unit

• Reviews all filed Proofs of Claim to determine if the claim meets eligibility requirements for reimbursement of benefits paid by the carrier and subsequently notify the carrier whether the claim has been accepted or denied;
• Determines eligibility for reimbursement by the Fund through auditing Reimbursement Requests and supporting documentation submitted by the carrier on claims that have been accepted;
• Issues accurate reimbursements; and
• Disburses Permanent Total Supplemental Benefits to certain injured workers

• Health Care Provider certification pursuant to Section 440.13(3), Florida Statutes.
• Expert Medical Advisor certification pursuant to Section 440.13(9), Florida Statutes. Health Care Provider and Expert Medical Advisor database maintenance.
• Reimbursement dispute resolution pursuant to Section 440.13(7), Florida Statutes.
• Investigation and determination of healthcare provider utilization patterns, billing practices or violations of law or rules that may require penalties, pursuant to Section 440.13(8), (11) or (13), Florida Statutes.
• Development of Workers' Compensation Reimbursement Manuals, in collaboration with the three-member panel, pursuant to Section 440.13(12), Florida Statutes.
• Provision of educational and technical support regarding the aspects of medical services in response to inquiries.

• Phone: 850/413-1613
• Fax: 850/922-4475
• Email: Workers.MedService@MyFloridaCFO.com