Understanding Florida’s 120 Day Rule in Workers’ Compensation
If you’ve been injured on the job in Florida, the workers’ compensation process can seem overwhelming. One of the most important protections for injured workers is the “120 Day Rule,” found in Florida Statutes section 440.20(4). This critical provision directly impacts how quickly an insurer must decide whether to accept or deny responsibility for a workplace injury, and—if missed—can mean long-term benefits and compensation for the injured worker.
What Exactly Is the 120 Day Rule?
Under Florida law, when a claim is filed, the employer’s insurance carrier is given 120 days from the first payment of any compensation or benefits to investigate the circumstances of the injury or illness. During that period, they can “pay and investigate”—providing benefits up front while they determine if the claim is indeed valid. The catch? If the insurer does not formally deny the claim within 120 days, they lose the right to contest that the injury is work-related for most purposes going forward.
This rule aims to prevent insurance companies from dragging their feet and leaving injured workers in limbo for months after an injury. It ensures timely action, financial stability, and the ability for workers to move forward with necessary medical treatment and wage loss benefits, with the peace of mind that their benefits cannot be abruptly stopped or challenged without good cause after 120 days.
Why Does the 120 Day Rule Matter?
Without the 120 Day Rule, insurance companies could approve benefits and then, months later, abruptly deny them—potentially leaving workers on the hook for medical bills and requiring them to repay wage loss benefits. This rule encourages prompt investigations, quick decisions, and accountability—all while protecting workers from financial whiplash.
The Importance of the 120 Day Letter
A key part of this process is the so-called “120-day letter.” Recent case law, including the Churchill v. DBI Services decision, has clarified that insurance carriers must send a clear letter, as close as possible to the very first benefit payment, putting the worker on notice that the investigation period is running. Courts have said this letter should be sent “upon commencement of payment, or as soon thereafter as reasonably practicable”—and delays (even of a couple months) can result in the insurer waiving its right to contest compensability.
Are There Exceptions to the Rule?
There are very limited exceptions: If the insurance company can show that it discovered new, material information only after the 120 days—facts it couldn’t have found with reasonable investigation, or if it uncovers fraud—the claim can still be denied after the deadline. But these exceptions are rare and hard for insurers to prove.
How This Protects Injured Workers
If you’ve been receiving benefits for more than 120 days and suddenly get a denial, Florida law is on your side. In these situations, the injury is considered compensable “by operation of law,” which makes it much harder for insurers to successfully cut off benefits down the road.
Injured workers should know: If the insurer didn’t provide a timely 120-day letter, their right to contest the injury may be lost even sooner. If you’re facing a sudden denial or have questions about your rights, consulting with an experienced workers’ compensation attorney is the best way to ensure your claim is protected.
If you or someone you know is navigating a work injury, don’t go it alone—having experienced legal guidance is critical to ensuring you receive the benefits and protections you deserve under Florida law. Call us at 800-536-8080 or email us at info@goebellawfirm.com to schedule a free consultation.