Luks Santaniello's Florida Workers Compensation blog

This January 13, 2012 1DCA decision overturned Judge Murphy's JCC Decision The 1DCA ruled that section 440.20(7) controls the payment of penalties and requires that a 20% penalty be paid if the compensation is not paid within seven days after the order is signed as opposed to after order becomes final. Click here to see the !DCA opinion

This February 23, 2012 1DCA decision affirmed in part and reversed in part Judge Hill's JCC decision. The issue at the JCC trial was a change in primary care physician. The JCC awarded the change of physician but also denied compensability of the accident. Both parties appealed. The E/C argued that the Claimant was not entitled to a change of physician because her condition was non-occupational. The Claimant cross-appealed arguing that the JCC’s finding of noncompensability is legally inconsistent with the  award of a change of physician.  The 1DCA addressed the cross-appeal first. The 1DCA affirmed the JCC's decision denying compensability of the accident. The 1DCA indicated that the claimant did not show that the JCC erred in ruling the accident not compensable. "The sole basis of Claimant’s challenge on compensability is that the order is incongruous with the award of a change of physician. Claimant did not present this argument ...

14 arrested.  Florida CFO Arrests 14 In Undercover Sting At Fraud Clinic. Click here to see the article

FBI gets another sentence in the pill mill investigation, Operation Oxy Alley, Gino Marquez sentenced to 84 months.   click here to see the article

Technology is making it easier to catch companies that do not have WC insurance   click here to see the article

In CA, a worker can't recover for physical manifestations that directly and solely result from a psychological injury.  click here to see the article

Maine places a 10-year cap on benefits for most injured workers. The current law has no limit. click here to see the article

This March 6, 2012 1DCA opinion affirmed in part and reversed in part the JCC decision of Judge Sojourner. In this case, the claimant filed several petitions for benefits after injuring his right knee and left wrist in a workplace fall.  Among other things, Claimant sought authorization for a total knee replacement and TPD benefits related to the wrist injury that the Employer/Carrier had accepted as compensable.  The 1DCA held that the  JCC correctly held that the workplace accident was not the major contributing cause of Claimant’s need for knee surgery, and therefore, denied all related claims. The 1DCA affirmed that portion of the order. However, the 1DCA opined that the JCC did not rule on the TPD claim for the claimant's compensable wrist injury.  The 1DCA held that "Failure to rule on a fully tried issue is reversible error". To support their position, the 1 DCA cited the 1997 Betancourt v. Sears Roebuck & Co. Case.  The 1DCA...

Click here to see the article.

This February 2, 2012 1DCA decision reversed Judge Kuker. The claimant appealed Judge Kuker’s Order denying benefits on the ground the statute of limitations had run. The facts were undisputed and were pretty straight forward. The claimant filed a petition for benefits on March 30, 2009 requesting an appointment with an orthopedist and attorney fees and costs. The Employer/Carrier had set the appointment but since the claimant did not bring her films, the doctor send her away. The doctor opined in deposition that given the claimant's failure to bring her films, he treated it as a no show. On July 22, 2009, both parties requested that the July 23, 2009 mediation be cancelled. A letter was sent to the mediator indicating that the issues had been resolved and that there were no other outstanding issues besides attorney fees and costs. The letter went on to read that the JCC retained jurisdiction over the fees and costs. On March 3, 2010, the claimant filed another petition reque...

Here is an interesting article on the cost of prescription medications and the extra moneys that workers compensation insurance companies are spending. I've been harping on this same issue for years. There has to tighter control on the medications that are paid for insurance companies. Click here to see the article

An April 12, 2012 1DCA decision reversing Judge Murphy. The 1DCA reversed the JCC's decision finding that the JCC erred: 1 In making a finding on the Claimant’s PIR; 2 That the Claimant had reached maximum medical improvement; and 3 In denying the Claimant’s claim for temporary indemnity benefits. PIR The issue of the Claimant’s PIR was not properly before the JCC. The PIR claim had not been mediated, listed in the Uniform Pretrial Stipulation, or addressed by either party, and was not ripe for adjudication. The 1DCA found that the JCC erred in making a finding on Claimant’s PIR because that issue was beyond the scope of the hearing. Ruling on an issue that is not properly before the JCC is a violation of a party’s due process rights. MMI and TEMPORARY BENEFITS Claimant also argues the JCC erred in finding that Claimant had reached maximum medical improvement (MMI) and further erred in relying upon that erroneous determination to deny the Claimant’s claims f...

This April 12, 2012 1DCA decision affirmed a JCC decision of Judge Remsnyder. This case shows the relative ease that a claimant can get an initial $2,000 advance. At the JCC level, the claimant was awarded a $2,000 advance because there was competent substantial evidence to support that the Claimant had been unable to return to the same or equivalent employment. The employer/carrier disagreed with the JCC ruling and appealed. The first DCA affirmed the JCC's ruling concerning the advance. The 1DCA held that there was competent substantial evidence to support the JCC’s finding that the Claimant has been unable to return to the same or equivalent employment,and was eligible for an advance of $2,000 under § 440.20(12)(c), Fla. Stat. (2010). FYI Under 440.20(12)(c), there are 3 requisites for an award of an advance of $2,000 or less: 1:  The Claimant has been unable to return to the same or equivalent employment with no substantial reduction in wages;or 2: The claiman...

This March 12, 2012 1DCA decision reversed a JCC decision of Judge Pitts. The claimant argued that the Judge of Compensation Claims (JCC) erred in dismissing his petitions for benefits as a sanction for nonpayment of an earlier award of prevailing party costs to the Employer/Carrier. The claimant was indigent, unemployed, and homeless. The JCC found that the claimant simply did not have the financial ability to pay the outstanding costs and that the claimant was not willfully refusing to comply with the Order Taxing cost. The 1DCA  held that in exercising his or her discretion, the JCC may not dismiss a petition for benefits absent a specific finding that a party or its attorney has willfully refused to comply with an order. Based on the above, the 1DCA found that the JCC did not find that the claimant’s conduct was willful, deliberate or contumacious, and reversed the JCC decision. Click to see 1DCA opinion

A March 26, 2012 1DCA decision that reversed JCC D'Ambrosio. This case continues to show the importance that the 1DCA is putting on Expert Medical Advisors (EMA). Judges of Compensation Claims have less and less control In a case where there are conflicting medical opinions. In this case, there was a conflicting medical opinion and Judge of Compensation Claims appointed an EMA to address “the issues of 1) whether the Claimant has gynecomastia, 2) the cause of the gynecomastia, and 3) what treatment is recommended.” However, before the claimant was seen by the EMA physician, the claimant had an unauthorized surgery. The claimant wanted to give copies of the unauthorized medical records to the EMA. The Employer/Carrier filed a motion to dismiss the Claimant's claims arguing that Claimant’s unilateral decision to undergo surgery prevented the EMA from answering the questions put to him and that the E/C had been prejudiced in its ability to defend the claims. The JCC fou...

Welcome. My name is Rey Alvarez. This blog will keep you aware of what's going on in Florida workers' compensation.