Articles Posted in Workers’ Compensation

As I have blogged here before, Florida’s workers’ compensation laws have become progressively less friendly to injured workers in direct proportion to the power gained by state Republican lawmakers. As their power has grown — today, they control the governor’s office and both chambers of the legislature — the value of workers’ compensation benefits has declined.

One way in which the significant decline has taken hold is in the apportionment of benefits. Apportionment is the means by which employers and their workers’ compensation insurance companies now limit the payment of medical and indemnity benefits to injured workers. In short, their obligation is discounted by the share an injured workers’ preexisting medical condition — the term is defined in Pearson v. Paradise Ford, 951 So.2d 12 (Fla. 1st DCA 2007) and Pizza Hut v. Proctor, 955 So.2d 637 (Fla. 1st DCA 2007) and made applicable to apportionment through Staffmark v. Merrell, 43 So. 3d 792 (Fla. 1st DCA 2010) — contributes to his or her current medical state. (Caveat: do not confuse this concept with the concept of major contributing cause contained in Florida Statute 440.09(1)(b). See these blogs to understand that concept: Florida’s Workers’ Compensation System’s Steady Decline Into the Abyss; and Florida Workers’ Compensation Law: Proving Medical Causation.) Put another way, only the disabilities and medical treatment associated with a compensable injury shall be payable
“Apportionment is an affirmative defense; thus, the E/C has the burden of proving each element of the defense.” See

The only long term wage loss compensation available under Florida’s Workers’ Compensation system is permanent total disability (PTD). The benefit is defined in Florida Statute Section 440.15(1).

Unless the claimant sustains one of the scheduled injuries outlined in 440.15(1)(b), the only way to qualify for PTD is for a Claimant to “establish that he or she is not able to engage in at least sedentary employment, within a 50-mile radius of the employee’s residence.” See the paragraph below the scheduled injuries in 440.15(1)(b).

The determination is made after, not before, the claimant reaches maximum medical improvement (MMI) – defined in 440.02(10) as follows: “‘Date of maximum medical improvement'” means the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated, based upon reasonable medical probability.”
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It is customary in Florida for those wishing to settle workers’ compensation cases to be required to execute a voluntary resignation document. Typical resignation language will make it virtually impossible for the former employee to maintain a viable claim for unemployment compensation benefits. To avoid this consequence, language must be added to the effect that entitlement to unemployment compensation is not being waived,

This action led to a positive outcome for the applicant in Sullivan v. Florida Unemployment Appeals Commission (1st DCA; opinion filed May 15, 2012). In its initial form, the resignation language associated with the workers’ compensation settlement was silent on the issue of unemployment compensation. Ms. Sullivan refused to sign the form. Accordingly, her lawyer added the following language:

“Employer/Carrier will not contest Claimant’s application or request for unemployment benefits.”

The employer did not contest the language, allowing it to become part of the overall workers’ compensation settlement agreement. Thereafter, Ms. Sullivan applied for UC benefits. She was denied at the hearing level and by the Unemployment Compensation Appeals Commission. However, the 1st DCA reversed those holdings, siding, instead, with Ms. Sullivan.

The reasoning behind the holding in Sullivan is set forth in Rodriguez v. Florida Unemployment Appeals Commission, 851 So. 2d 247 (Fla. 3d DCA 2003):

Employers are to be held accountable for their actions and representations to employees, particularly when modifying terms of at-will employment and when seeking participation in voluntary layoffs, buyouts or other company initiated programs. Here [the claimant] received verbal and written representations from [the employer] about the uncertainty of her job and of a buyout package with a list of benefits, as well as assurances of eligibility for other benefits, i.e., unemployment compensation. These assurances by [the employer] were not wrongful but were designed to encourage or induce the acceptance of the voluntary buyout. Given the circumstances here and the liberal purpose of the statute authorizing unemployment benefits, the requirement of “good cause attributable to the employer” was satisfied.

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One of the most difficult concepts for our workers’ compensation clients to understand is that they will not receive any monetary compensation through Florida’s workers’ compensation system for pain and suffering. None. Zero. Nada. Zilch.

The notion is counterintuitive. Compounding the difficulty in understanding, much less accepting the concept, is that pain and suffering damages are payable in other types of injury cases – e.g., premises liability, medical malpractice, products liability.

To make sure our clients understand the concept, we begin the discussion at the initial conference and keep it going until the case is brought to a successful conclusion. Even then, the concept never sinks in fully with some of our clients.
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During the past 12 months we have represented a handful of former Southern Bell linemen injured in the course and scope of their employment. Each was hired by Southern Bell (subsequently Bellsouth, now AT&T) in the 1970s to repair and install telecommunication cable. They started working for Southern Bell in their 20s and stayed until being forced by orthopedic conditions to retire in 2010 and later.

Their orthopedic conditions were caused by years of wear and tear from climbing telephone polls while toting heavy equipment and cable. Instead of being allowed to use ladders or hydraulic lifts, the linemen were forced to shimmy the poles like island natives gathering coconuts from tall palm trees. Boot hooks, jammed into the wood poles, kept them from falling.

Our first Southern Bell lineman case involved a 61 year old gentleman who retired after 39 years, done in by bad knees. His orthopedist was recommending total knee replacement surgery.

Common sense and experience told us that his knee problems were job related. Unless there has been acute trauma, like a football injury, repetitive trauma beyond the ordinary is the usual cause for damage of this severity at such a relatively young age. 39 years of pole climbing qualifies as beyond ordinary wear and tear.
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Two legislative sessions have passed since State Senator Chris Smith, a Democrat, whose District 29 encompasses parts of Broward and Palm counties, voted with Republicans to eliminate reasonable fees from the state’s workers’ compensation system for claimants’ attorneys. The purpose of the bill was to keep injured workers from being able to fight for their rights. It has worked as expected.

The bill approved by Senator Smith replaced a statute that required employers and their insurance carriers to pay claimants’ attorneys a “reasonable attorney’s fee” for successfully securing wrongly denied workers’ compensation benefits. This was done very simply by removing the word reasonable from the statute, then imposing arbitrarily low caps on fees regardless of the time, effort, and cost invested to win the case.

Not surprisingly, the legislature placed no caps on defense attorney fees, the amount employers and insurance carriers could paid their attorneys to defend cases, win, lose, or draw. A good example of this happened in Jennifer Kauffman v. Community Inclusions, Inc./Guarantee Insurance Company, a case in which the insurance company paid its attorney $14,720 in a losing cause, while the successful claimant’s attorney was limited by the statute to a fee of $648.41 for 100.3 hours of work, or $6.48 per hour. (Inexplicably, the Florida Supreme Court refused to consider on appeal the challenge to the constitutionality of the fee.)

This is the type of outcome the bill was designed to create. This bill was supported by Senator Smith, the only Democrat Senator to do so. Even some moderate Republicans voted against it!!!

Hardly a ringing endorsement for the rights of Florida’s working men and women.

The vote came on the last day of the 2009 legislative session. Because of the votes against by some moderate Republicans, two votes were needed from Democrats to gain passage. Those votes were obtained. However, within minutes of the vote, the other Senator changed her mind and expressed a desire to vote against the bill. Procedurally, this could be accomplished, however, it required Senator Smith to vote to allow a re-vote. He refused to do it. In essence, then, Senator Chris Smith was the deciding vote for the law that has eviscerated the rights of injured Florida workers.

Not surprisiningly, then Governor Charlie Crist failed to veto the bill.

Following this debacle on the Senate floor, I engaged in email communications with Senator Smith. He asked for my views on the subject of carrier-paid attorneys fees in workers’ compensation cases. I told him what I thought. He indicated that he would work with his colleagues to gain passage of legislation to moderate the harsh consequences of the 2009 law. I told him that his chance to do the right thing was in 2009, that the odds of getting Republicans to back off from their major victory, one that set back the rights of injured workers more than any other in the 80+ years since a workers’ compensation system was instituted in Florida, were slim to none.

My assessment has proved correct.

Periodically after our initial communications, I would ask Senator Smith how his efforts to even the playing field were going. I never received a response. Not surprisingly, nothing was accomplished in 2010 or 2011 to moderate the bill, and, to my knowledge, nothing is on the 2012 legislative agenda either.

(For what it’s worth, at the time of his vote in 2009, Senator Smith was employed by a law firm which derived a good portion of its income from representing workers’ compensation insurance companies, although Mr. Smith was not himself a workers’ compensation practitioner. As of the posting of this blog, he remained an employee of the same law firm.)

This is the reality: as long as Republicans control the Florida Legislature, nothing will be done legislatively to change the law. If change is to come, it must come from the courts, the Florida Supreme Court, in particular. Sadly, this court seems to be cowed by the overbearing might of right-wing politics.
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