Articles Posted in Workers’ Compensation

Many scenarios arise that bring into question the applicability of Florida’s workers’ compensation system for accidents that occur in other states. The general rule is that a worker injured outside of the state is eligible for Florida’s workers’ compensation benefits if:

(1) The employer and the employee entered the contract of employment in Florida; or (2) If the principal location of the employment is in Florida.

(Only one of the two elements must be met, not both.)

The statutory language, located at 440.09(1)(d), reads as follows: “If an accident happens while the employee is employed elsewhere than in this state, which would entitle the employee or his or her dependents to compensation if it had happened in this state, the employee or his or her dependents are entitled to compensation if the contract of employment was made in this state, or the employment was principally localized in this state. However, if an employee receives compensation or damages under the laws of any other state, the total compensation for the injury may not be greater than is provided in this chapter.”
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A statute of limitations is a provision that ends a person’s right to claim benefits or sue for compensation and damages. A Florida workers’ compensation claim or petition for benefits is forever barred unless it is filed within (1) two years of the date of injury, or (2) after the initial two years, within one year of the last payment of compensation or provision of medical treatment, care or attendance. Florida Statute Sections 440.19(1) & (2).

The two years from the date of injury element does not begin to run until the injured worker, as a reasonable person, knew or should have recognized the “nature, seriousness, and probable compensable character of his injury or disease.” See Herb’s Exxon v. Whatmough, 487 So. 2d 1169, 1172 (Fla. 1st DCA 1986) and 440.19(1). The practical application of this rule is that the statute of limitations (SOL) begins to run in most cases, but not all, from the date of the actual accident. Examples of when the SOL does not begin to run on the date of the accident include conditions of unknown cause, such as hepatitis and HIV infection (where the diagnosis comes well after the infecting mechanism, e.g., needle stick, occurred), a minor injury, e.g., tinge of back pain from lifting a box, that is diagnosed a few weeks later as a serious condition, and injuries resulting from repetitive trauma (see this blog). If the issue of knowledge goes to trial, a Judge of Workers’ Compensation Claims will make the final determination based on the “reasonable man” standard (a standard frequently used in law to denote a hypothetical person in society who exercises average care, skill, and judgment in conduct and who serves as a comparative standard for determining a particular issue).
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Florida employees injured in the course and scope of their employment may be eligible for workers’ compensation wage loss benefits. Florida’s workers’ compensation system offers three types of wage loss benefits – Temporary Partial Disability (TPD) (Florida Statute 440.15(4)), Temporary Total Disability (TTD) (440.15(2)), and Permanent Total Disability (PTD) (440.15(1)). Of the three types of benefits, only TPD and TTD are available during the recovery stage, or before maximum medical improvement (440.02(10)). Of the two, only TPD is payable while the injured employee is able to work. This blog will discuss what evidence injured workers must present to make a prima facie case to receive TPD.

Under 440.15(4)(a), TPD benefits are payable “if overall maximum medical improvement has not been reached and the medical conditions resulting from the accident create restrictions on the injured employee’s ability to return to work.” For years, the second clause of this simple sentence has resulted in extensive litigation. With the recent decision in

There are three primary types of lost wage, or indemnity, benefits available to injured workers under Florida’s workers’ compensation system. They are: Temporary Partial Disability (440.15(4)); Temporary Total Disability (440.15(2)); and Permanent Total Disability (440.15(1)). Each of the temporary benefits is available for a limited period of time – not to exceed 104 weeks (see 440.15(2) & (4) – while the injured worker is actively receiving medical care prior to reaching maximum medical improvement (440.02(10). PTD is the only one of the three available after maximum medical improvement (Section 440.15) … and the most difficult to receive.

For the most part, TTD and TPD benefits are available upon a simple showing that the wage loss is the consequence of the injury. Much more is required to establish entitlement to PTD.

To qualify for PTD, one must show that he/she is not physically capable of engaging in at least sedentary duty work within a 50-mile radius of his/her residence or have sustained one or more of the catastrophic injuries listed in 440.15(1)(b). Not surprisingly, qualifying is not as easy as it may seem from a simple reading of the statute.

The sedentary work referenced in the statute can be any job in the national economy, not just the injured worker’s former job. Many claimants believe that unless they are able to return to their former employment, they are PTD. This is rarely the case. (Former employment has relevance in PTD cases, but not in the way most lay people think. Examples of sedentary work include security guard and toll booth attendant. A qualified vocational expert will come to court with a list of 200+ so-called sedentary jobs that exist in the national economy for individuals with limited educations and office skills.)
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Most work-related injuries are caused by acute, single incident accidents. Absent the accident being the result of horseplay, injuries caused this way are typically compensable under Florida’s workers’ compensation system.

Are injuries caused by repetitive trauma over a period of time compensable? So long as the injured worker’s evidence establishes the following elements, the answer is Yes: (1) prolonged exposure; (2) the cumulative effect of which is injury or aggravation of a preexisting condition; and (3) the job subjected the injured worker to a hazard greater than that to which the public is exposed. See Festa v. Teleflex, Inc., 382 So.2d 122, 124 (Fla. 1st DCA 1980). (See, however, Rodriguez v. Frito-Lay, Inc., 600 So. 2d 1167 (Fla. 1st DCA 1992) which seems to do away with the requirement that the job subjected them to a hazard greater than that to which the public is exposed.) (See, also, University of Florida v. Massie, 602 So. 2d 516 (Fla, 1992), a Supreme Court case which provides that for a preexisting condition to be compensable, the condition must be aggravated by some non-routine, job related physical condition, or by some form of repeated physical trauma. By requiring physical stress, this case is aimed at limiting, if not altogether eliminating, mental stress as being enough to establish entitlement for aggravation of a preexisting condition.)

Significantly, in repetitive trauma cases the proof required to overcome the non-compensable presumption in 440.02(1), Fla. Stat., “clear and convincing evidence,” rather than the lower “preponderance of the evidence” standard. “Clear and convincing evidence” is evidence of a quality and character designed to produce in the judge of compensation claims’ mind a firm belief or conviction, without hesitation, as to the truth of the allegations.

The facts of the first workers’ compensation case I took to final merit hearing illustrate the law well. My client was a 60+ year old woman, who, we alleged, developed inververtebral cervical disc herniations through years of repetitive trauma from lifting box spring mattress frames. She worked in a warehouse and her job was to construct the frames, ranging in size from single to king, then physically lift and place each frame, one on top of the other, onto a dolly located beside her work station. She slowly developed severe cervical pain that forced her to retire. The employer and its insurance company denied responsibility for her injuries. Unable to point to a single incident to explain the disc herniations, we brought a Festa repetitive trauma claim against the employer/carrier.
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