Florida Administrative Code › 69 - DEPARTMENT OF FINANCIAL SERVICES › 69L - Division of Workers' Compensation › Chapter 69L-26 - EMPLOYEE ASSISTANCE AND OMBUDSMAN OFFICE › Section 69L-26.004 - Requesting Assistance

Current through Reg. 50, No. 138; July 16, 2024
(1) An injured
				worker or any other party to a dispute involving a workers' compensation issue
				shall contact and request assistance from the EAO, and make a good faith effort
				to participate in the informal dispute resolution proceedings of the
				EAO.
(2) A request for assistance
				shall be accepted by the EAO and shall constitute contact with the EAO only if
				the request for assistance is submitted on a completed Request for Assistance
				form (EAO-1) and is otherwise in accordance with these rules.
(3) The EAO shall, if requested to do so by
				an injured worker, or his or her legal guardian if the injured worker is a
				minor or is incompetent, or the personal representative of a deceased injured
				worker, or a health care provider that has provided authorized treatment to an
				injured worker when an employer or carrier fails or refuses to pay for the
				authorized treatment, complete a Request for Assistance form (EAO-1) for or on
				behalf of the party so requesting.
(4) An attorney representing an injured
				worker may submit a Request for Assistance form (EAO-1) on behalf of his or her
				client. An attorney wishing to file a Request for Assistance on behalf of
				another shall sign the form as the requestor on behalf of the client and mail
				or hand deliver the completed Request for Assistance form to the EAO at the
				address and during the business hours specified herein.
(5) Faxed copies of a Request for Assistance
				form (EAO-1) shall not be accepted by the EAO.
(6)
(a) In
				order to facilitate requesting assistance, employers or carriers must provide
				the notice required by Section
				 440.185(11),
				F.S. For the purpose of that section, the form and manner determined by the
				department is providing, by mail or hand-delivery, the following notification
				to the injured employee:
Dear Injured Employee:
Your employer's insurance carrier is providing this
				  information to you on behalf of the Employee Assistance Office of the Division
				  of Workers' Compensation.
The Employee Assistance Office of the Division of Workers'
				  Compensation is a state bureau within the Florida Department of Financial
				  Services. We provide the following services:
* Serves as a resource for injured workers and employers by
				  providing information about the workers' compensation system.
* Educates and informs injured workers, employers, carriers,
				  health care providers, and managed care arrangements about their
				  responsibilities under the law.
* Provides assistance in avoiding any problems or disputes
				  regarding your claim.
Within three (3) days after receiving notice that you have
				  been injured, the workers' compensation insurance carrier will mail you an
				  informational brochure explaining your rights and responsibilities, as well as
				  the carrier's obligations. It contains valuable information you need to know
				  about the workers' compensation system. You may have received the informational
				  brochure along with this letter. You can also obtain the brochure by calling us
				  at: 1(800)342-1741 or e-mailing us at: wceao@myfloridacfo.com.
You can also visit one of our local Employee Assistance
				  Offices to receive personal, one-on-one service. To locate the office nearest
				  you, call the toll free 1(800) number above or visit the Division's website at:
www.myfloridacfo.com/wc/organization/eao_offices.html
.
Sincerely,
Employee Assistance Office
Division of Workers' Compensation
Florida Department of Financial Services
(b) This notification shall be mailed to the
				injured employee within three (3) days after the carrier receives notice of the
				employee's injury. This notification shall be on Department of Financial
				Services letterhead and shall be of original or print quality. The notification
				is available in Adobe PDF format at
www.myfloridacfo.com/WC/publications.html
and is identified as the "Employee Notification
				Letter."