In Giraldo v. AHCA, the Florida Supreme Court addressed the vexing question regarding whether the Agency for Health Care Administration (AHCA) may lien the future medical expenses portion of a Florida Medicaid recipient’s tort recovery. In an opinion favoring individuals who have sustained personal injuries through the fault of third parties, the…
Every type of legal matter has a time bar to when legal proceedings can be maintained to address a dispute. The time bar is known as the statute of limitations. The Florida workers’ compensation statute of limitations is contained in section 440.19, Florida Statutes. Especially in the area of workers’ compensation, the courts have formulated ways of overcoming…
For the most part, workers’ compensation insurance companies limit their payment of medical expenses to conditions caused by work-related accidents. In some instances, however, carriers may be required to cover expenses for unrelated conditions. The primary instances are when (1) diagnostic testing is required to determine the compensability of an injury, (2) an unrelated condition presents a hindrance to…
By demonstrating that particular physical restrictions are responsible for lost wages or lack of employment, an employee with functional limitations less than a total disability may be eligible for temporary partial disability benefits (TPD) pursuant to section 440.15(4), Florida Statutes. The claims-handling entity may impose a further burden by requiring the injured employee to complete, sign, and return…
Under Florida law, only individuals meeting the definition of “Survivors” under Florida’s Wrongful Death Act may be compensated for losses resulting from the death of another person. (See this blog, Florida Wrongful Death Survivors Chart, for a handy reference to benefits available under the Act.) Under section 768.18(1) of the Act, survivors are defined as: the decedent’s spouse,…
The current definition of “attendant care,” which is not significantly different than in past versions of the statute, is as follows: Florida Statute 440.13(1)(b). “Attendant care” means care rendered by trained professional attendants which is beyond the scope of household duties. Family members may provide nonprofessional attendant care, but may not be…
Uninsured/Underinsured motor vehicle insurance (UM/UIM) – Florida Statute 627.727 — covers losses covered by bodily injury liability insurance (BI) but not available because the at-fault party did not maintain BI (UM) or the BI limit is insufficient to cover the full extent of the damages (UIM). Subsection (2) of the UM/UIM statute provides that…
Florida Statute 440.02(1), which is contained in the definitions section of Florida’s workers’ compensation system, defines “Accident” as “an unexpected or unusual event or result that happens suddenly.” Can an injury resulting from an event that is not unexpected or unusual be compensable under Florida’s workers’ compensation system? Yes. In Bryant v. David…
Florida’s workers’ compensation system has two distinct time bars for filing petitions to seek benefits. Most people are at least vaguely aware of one of the concepts, known as the statute of limitations (SOL). Florida’s workers’ compensation SOL is enunciated in section 440.19, Florida Statutes. The other time bar is laid out in Florida…
Individuals receiving Florida workers’ compensation benefits for serious medical conditions must give deep thought and consideration to the role of Medicare in their future medical plans. This is especially so for those who are eligible or soon to be eligible for Medicare. Because workers’ compensation has primary responsibility [for covering medical care associated with work-related injuries] versus Medicare’s secondary…