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Our law firm was recently hired by a military veteran who claims to have been infected with the liver disease Hepatitis C by equipment used to perform colonoscopies at the Veterans Administration (VA) hospital in Miami, Florida.

Last year the VA acknowledged contamination issues with endoscopic equipment used to perform colonoscopies in its Miami facility between 2004 and 2009. It has notified more than 3000 patients of the potential for infection and recommended testing, one of whom is our client. To her great disappointment, she tested positive for Hepatitis C.

Although the VA admits to the contamination problem, it does not so readily admit to it being the cause of infection in every veteran who has been tested positive for the virus (or HIV; there have been reported cases of HIV infection). Because Hepatitis C, among serious and sometimes fatal medical conditions, is relatively easy to contract, the refusal of the VA to take responsibility for every case of infection is understandable. (However, shouldn’t there be a rebutable presumption in favor of the veterans that the virus was caused by the VA?)

We expect the government to conduct comprehensive discovery in our case in an effort to establish other risk factors, such as intravenous drug use, blood transfusions, promiscuous sex, etc. From past experience, we know that the government’s lawyers and even the FBI will attempt to look into every relevant aspect of our client’s history for evidence to blame for the infecton other than its contaminated equipment.
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In my 25 years of representing accident victims, I have found rotator cuff injuries to be about the most debilitating of all traumatic injuires for those employed as manual laborers. Unfortunately, it is a very common injury – for example, shoulder pain is second to back pain as the bases for workers’ compensation claims.

The rotator cuff is made up of 4 tendons, and they cover the top of the humerus. A rotator cuff injury involves a tear to one or more of these tendons. Tears can be full or partial thickness.

Tears can be acute, when a sudden force is applied to the shoulder, or chronic, which is deterioration over a long period of time. Common symptoms of acute tears include a tearing sensation, sudden pain, and sudden weakness. The symptoms of chronic tearing include gradual progression of shoulder pain and weakness, and difficulty sleeping on the affected side.

Rotator cuff tears are diagnosed clinically, by the orthopedist through examination, and by MRI. The best type of MRI to accurately diagnose the presence of a rotator cuff tear is the MRI arthrogram.

Treatment for rotator cuff injuries includes conservative care and surgery. Conservative care includes rest, non-steroidal anti-inflammatory medication (Motrin, Aleve, Celebrex) and physical therapy, and sometimes proves valuable with partial tears. Complete tears and partial tears that have not responded well to conservative care, usually will require surgery.
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Proving compensability of heart attacks and strokes under Florida’s workers’ compensation system has always been difficult. Even when the law allowed the award of “reasonable” carrier-paid hourly attorney’s fees to the successful Claimant’s attorney, whether or not to accept a case required serious thoughtful consideration. Now that Florida’s new attorney’s fee statute, Section 440.34 (effective July 1, 2009), drastically reduces Claimants’ attorneys’ fees, the practical financial viability of these cases for Claimants’ attorneys is in serious question.

Heart Attack and Stroke cases are fact-intensive, require numerous medical opinions, and involve several complex legal issues. This translates into time consuming and costly cases for Claimants’ attorneys.

The primary issue in these cases is whether or not the medical event was occasioned by a preexisting condition. The outcome will determine the type of evidence that is required to prevail, which is often the difference between winning and losing. If a preexisting condition exists, the Claimant must show that the heart attack or stroke was caused by unusual physical strain not routine to the type of work the employee was accustomed to performing. If no evidence exists of a preexisting condition, the Claimant need only show that the event was caused by any amount of exertion. See Zundell v. Dade County School Bd., 636 So.2d 8 (Fla. 1994).

As everyone knows, heart attacks and strokes are frequently occasioned by preexisting conditions.
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Compensation for pain and suffering is available in most types of accident cases. It is not available in Florida workers’ compensation cases.

Florida’s workers’ compensation system was instituted so that employees injured at work would not have to prove fault in order to receive benefits. Entitlement to compensation was to be as simple as proving that injuries resulted from an accident that occurred in the course and scope of one’s employment. In theory, at least, the system remains in place today.

In exchange for the creation of this no-fault system, injured employees lost the right to be compensated for pain and suffering. Injured workers’ are entitled to lost wages and medical benefits, but not compensation for pain and suffering.

Understandably so, this is a difficult concept for most lay people to comprehend. It is a concept that I must explain again and again to my workers’ compensation clients.

It is such a difficult issue, in fact, that I have devised an exercise to make the point. I begin by asking my clients, ‘how much money do you expect to receive in your workers’ compensation case for pain & suffering?’ Invariably, the answer is, “I don’t know.” I then ask them to close their eyes. Once this is done, I ask the question, “What do you see?” When the answer is “Nothing,” I tell them that nothing is exactly how much they will receive as compensation for pain and suffering in the workers’ compensation case. Point understood.
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Florida’s maze of motor vehicle insurance laws can be difficult to comprehend.

A case in point: Personal Injury Protection (PIP) and Property Damage – Liability are the only required coverages for an owner to lawfully operate his/her vehicle on Florida’s streets and highways. (PIP pays 80% of medical bills and 60% of lost wages for the insured up to $10,000, while Property Damage – Liability pays to repair or replace the other owner’s motor vehicle.) With these coverages, the vehicle owner is able to purchase a license plate and a vehicle registration.

Surprisingly, however, in the event of a motor vehicle accident involving injury or death, having the minimum mandatory coverages will not prevent the at-fault party from having her drivers license and all vehicle registrations from being suspended. Sections 316.066(3)(a)1 and 324.051(2)(a) Florida Statutes.

The type of insurance coverage that will prevent the suspensiong is Bodily Injury (a/k/a liability insurance) in the minimum amounts of $10,000 per person/$20,000 per accident. Section 324.021 (7) Florida Statutes.
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After being terminated from a job, an employee may apply for Unemployment Compensation benefits through the State of Florida Agency of Workforce Administration. The employer will be notified of the application and given a chance to respond. An agency administrator will then make a decision based on the paperwork submitted by the two parties. The losing party will be advised of the decision and given the right to appeal. If an appeal is taken, the matter will be set for an evidentiary hearing before an appeals referee.

Hearings are usually conducted by telephone, with the appeals referee contacting the parties from his or her office in Tallahassee, Florida. If the employee will be represented at the hearing by an attorney, the appeals referee should be provided with this information in writing in advance, including where to contact the employee (usually at the attorney’s office).

Importantly, no matter which party is the appellant, i.e., the party challenging the administrative ruling, at the evidentiary hearing the burden of proving misconduct* to deny benefits is always on the employer. Cullen v. Neighborly Senior Services, 775 So.2d 392 (Fla. 2d DCA 2000). Not only is the burden of proof on the employer, but the proof must be by a preponderance of the evidence. Tallahassee Housing Authority v. Unemployment Appeals Commission, 483 So.2d 413 (Fla. 1986).
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Frequently, employees hurt on the job can be compensated for their damages by third persons (i.e., someone other than the employer). This is so when the employee is injured or killed in the course of his or her employment by the negligence or wrongful act of a third-party tortfeasor.

Regardless of fault, Florida employees hurt while working are entitled to receive workers’ compensaiton benefits. Typically, those benefits, medical and indemnity (i.e., lost wages), are furnished by a workers’ compensation insurance company or a self-insured employer. When they are, Section 440.39(2) Florida Statutes gives the provider subrogation rights against the third party tortfeasor to the extent of the amount of compensation benefits paid. This is commonly referred to as a workers’ compensation lien.

Very rarely is the amount recovered through the lien equal to 100% of the benefits paid. The lien formula, outlined in 440.39(3)(a), is explained in Manfredo v. Employer’s Casualty Insurance Company, 560 So.2d 1162 (Fla 1990).

Here is the formula in a nutshell, along with an example: Third party settlement amount less (-) attorney fees and costs divided by (/) full case value = the % value of the wc lien.

Example:

  • WC lien (medical, indemnity, settlement, etc.): $ 100,000
  • $ 250,000 third party settlement less fees (40%) and costs = $ 135,000
  • Full case value: $ 1,000,000. (Settled for less due to tough liability, coverage limits, etc.)
  • $ 135,000 divided by $ 1,000,000 = 13.5%
  • 13.5% of $ 100,000 = $ 13,500.

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auto accident.jpg

  • Contact fire rescue (for injuries) and the police from the accident scene.
  • Take photographs of the vehicles – damage and location.
  • Photograph visible injuries.
  • Obtain names and contact information of independent eyewitnesses.
  • Cooperate with law enforcement. Describe the accident and provide your motor vehicle insurance information.
  • Before leaving the scene, obtain a copy of the short form police report or other police report identifying information.
  • If your vehicle must be towed from the accident, determine by whom and to where. Remove personal belongings before the vehicle is towed away.
  • If necessary, allow fire rescue to transport you to the hospital.
  • Provide fire rescue and the hospital with your vehicle and health insurance information.(The “PIP” coverage under your own insurance policy is primarily responsible for paying for a limited dollar amount of your medical care.)
  • Report the accident to your insurance company.
  • Obtain claim number from your insurance carrier.
  • If necessary, seek follow up medical care.
  • Provide medical providers with your vehicle and health insurance information.
  • The at-fault party’s Florida insurance company should pay for your vehicle damage. In some instances, it is easier to have your own insurance company handle the repairs. However, not every insurance policy covers the cost of such repairs. It is not required coverage. Check your policy to see if you have “Collision” coverage. (Be careful of what you say to the at-fault party’s insurance company. The company will be looking for ways to deny your claim.)
  • If your injuries are serious, contact a personal injury lawyer as soon as possible. The lawyer will handle a myriad of issues associated with your accident, including medical matters, insurance coverage, vehicle repair or total loss payments, etc.

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The standard in Florida for determining fault for injuries caused by harmful substances in food is known as the “reasonable expectation” test. Examples of harmful substances include bones, shells, and pits, not only substances completely foreign to food products such as metal, human nails, and bugs.

Obviously, claims resulting from foreign objects are easier to win than claims involving substances natural to the basic food product, but the “reasonable expectation” test nevertheless provides a basis for prevailing in the latter situation.

Not every jurisdiction within the United States follows the “reasonable expectation” test. Some jurisdictions represent the view that as a matter of law a harmful substance present in food which is natural to it cannot be common law negligence or a legal defect or breach of the implied warranty of reasonable fitness of such food. Florida has rejected this test as not being logical or desirable. Zabner v. Howard Johnson’s, Inc., 201 So.2d 824 (Fla. App. 4 Dist., 1967).
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To the surprise of many, Florida employees justly terminated from their jobs may nevertheless be entitled to receive unemployment compensation benefits. In other words, although an employee’s actions may justify discharge, the same conduct does not necessarily preclude entitlement to unemployment benefits. Betancourt v. Sun Bank Miami, N.A., 672 So.2d 37 (Fla. 3rd DCA 1996).

For Unemployment Compensation benefits to be denied, an employee’s behavior must rise to the level of “misconduct,” defined as acting willfully, wantonly, or be in substantial disregard of the employer’s interest. See §§ 443.036(29), and 443.101, Fla. Stat.
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Palm Beach Gardens, FL 33410
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Email: jgale@jeffgalelaw.com

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