Florida Regulations 69L-26.004: Requesting Assistance
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(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 Florida Statutes § 440.185(11) 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.””
Rulemaking Authority 440.185(10), 440.191(1)(b), 440.591 FS. Law Implemented 440.185(10), 440.191 FS. History-New 9-29-94, Amended 11-25-96, Formerly 38F-26.004, 4L-26.004, Amended 5-12-04.
Terms Used In Florida Regulations 69L-26.004
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
(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 Florida Statutes § 440.185(11) 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.””
Rulemaking Authority 440.185(10), 440.191(1)(b), 440.591 FS. Law Implemented 440.185(10), 440.191 FS. History-New 9-29-94, Amended 11-25-96, Formerly 38F-26.004, 4L-26.004, Amended 5-12-04.