HOUSE AMENDMENT Bill No. SB 50A
1	CHAMBER ACTION
2	Senate House
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12	Representative Goodlette offered the following:
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14	Amendment (with title amendment)
15	Remove everything after the enacting clause
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17	and insert:
18	Section 1. Effective upon this act becoming a law,
19	subsections (1), (15), (29), (38), (39), (40), (41), and (42) of
20	section 440.02, Florida Statutes, are amended to read:
21	440.02 Definitions.--When used in this chapter, unless the
22	context clearly requires otherwise, the following terms shall
23	have the following meanings:
24	(1) "Accident" means only an unexpected or unusual event
25	or result that happens suddenly. A mental or nervous injury due
26	to stress, fright, or excitement only, orDisability or death
27	due to the accidental acceleration or aggravation of a venereal
28	disease or of a disease due to the habitual use of alcohol or
29	controlled substances or narcotic drugs, or a disease that
30	manifests itself in the fear of or dislike for an individual
31	because of the individual's race, color, religion, sex, national
32	origin, age, or handicap is not an injury by accident arising
33	out of the employment. Subject to s. 440.15(5),if a preexisting
34	disease or anomaly is accelerated or aggravated by an accident
35	arising out of and in the course of employment, only
36	acceleration of death or acceleration or aggravation of the
37	preexisting condition reasonably attributable to the accident is
38	compensable, with respect to any compensation otherwise payable
39	under this chapterdeath or permanent impairment. An injury or
40	disease caused by exposure to a toxic substance, including, but
41	not limited to, fungus or mold, is not an injury by accident
42	arising out of the employment unless there is clear and
43	convincing evidence establishing that exposure to the specific
44	substance involved, at the levels to which the employee was
45	exposed, can cause the injury or disease sustained by the
46	employee.
47	(15)(a) "Employee" means any person engaged in any
48	employment under any appointment or contract of hire or
49	apprenticeship, express or implied, oral or written, whether
50	lawfully or unlawfully employed, and includes, but is not
51	limited to, aliens and minors.
52	(b) "Employee" includes any person who is an officer of a
53	corporation and who performs services for remuneration for such
54	corporation within this state, whether or not such services are
55	continuous.
56	1. Any officer of a corporation may elect to be exempt
57	from this chapter by filing written notice of the election with
58	the department as provided in s. 440.05.
59	2. As to officers of a corporation who are actively
60	engaged in the construction industry, no more than three
61	officers may elect to be exempt from this chapter by filing
62	written notice of the election with the department as provided
63	in s. 440.05. However, any exemption obtained by a corporate
64	officer of a corporation actively engaged in the construction
65	industry is not applicable with respect to any commercial
66	building project estimated to be valued at $250,000 or greater.
67	3. An officer of a corporation who elects to be exempt
68	from this chapter by filing a written notice of the election
69	with the department as provided in s. 440.05 is not an employee.
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71	Services are presumed to have been rendered to the corporation
72	if the officer is compensated by other than dividends upon
73	shares of stock of the corporation which the officer owns.
74	(c)1."Employee" includes a sole proprietor or a partner
75	who devotes full time to the proprietorship or partnership and,
76	except as provided in this paragraph, elects to be included in
77	the definition of employee by filing notice thereof as provided
78	in s. 440.05. Partners or sole proprietors actively engaged in
79	the construction industry are considered employees unless they
80	elect to be excluded from the definition of employee by filing
81	written notice of the election with the department as provided
82	in s. 440.05. However, no more than three partners in a
83	partnership that is actively engaged in the construction
84	industry may elect to be excluded. A sole proprietor or partner
85	who is actively engaged in the construction industry and who
86	elects to be exempt from this chapter by filing a written notice
87	of the election with the department as provided in s. 440.05 is
88	not an employee. For purposes of this chapter, an independent
89	contractor is an employee unless he or she meets all of the
90	conditions set forth in subparagraph (d)1.
91	2. Notwithstanding the provisions of subparagraph 1., the
92	term "employee" includes a sole proprietor or partner actively
93	engaged in the construction industry with respect to any
94	commercial building project estimated to be valued at $250,000
95	or greater. Any exemption obtained is not applicable, with
96	respect to work performed at such a commercial building project.
97	(d) "Employee" does not include:
98	1. An independent contractor, if:
99	a. The independent contractor maintains a separate
100	business with his or her own work facility, truck, equipment,
101	materials, or similar accommodations;
102	b. The independent contractor holds or has applied for a
103	federal employer identification number, unless the independent
104	contractor is a sole proprietor who is not required to obtain a
105	federal employer identification number under state or federal
106	requirements;
107	c. The independent contractor performs or agrees to
108	perform specific services or work for specific amounts of money
109	and controls the means of performing the services or work;
110	d. The independent contractor incurs the principal
111	expenses related to the service or work that he or she performs
112	or agrees to perform;
113	e. The independent contractor is responsible for the
114	satisfactory completion of work or services that he or she
115	performs or agrees to perform and is or could be held liable for
116	a failure to complete the work or services;
117	f. The independent contractor receives compensation for
118	work or services performed for a commission or on a per-job or
119	competitive-bid basis and not on any other basis;
120	g. The independent contractor may realize a profit or
121	suffer a loss in connection with performing work or services;
122	h. The independent contractor has continuing or recurring
123	business liabilities or obligations; and
124	i. The success or failure of the independent contractor's
125	business depends on the relationship of business receipts to
126	expenditures.
127
128	However, the determination as to whether an individual included
129	in the Standard Industrial Classification Manual of 1987,
130	Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762, 0781, 0782,
131	0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436, 2448, or 2449,
132	or a newspaper delivery person, is an independent contractor is
133	governed not by the criteria in this paragraph but by common-law
134	principles, giving due consideration to the business activity of
135	the individual. Notwithstanding the provisions of this paragraph
136	or any other provision of this chapter, with respect to any
137	commercial building project estimated to be valued at $250,000
138	or greater, a person who is actively engaged in the construction
139	industry is not an independent contractor and is either an
140	employer or an employee who may not be exempt from the coverage
141	requirements of this chapter.
142	2. A real estate salesperson or agent, if that person
143	agrees, in writing, to perform for remuneration solely by way of
144	commission.
145	3. Bands, orchestras, and musical and theatrical
146	performers, including disk jockeys, performing in licensed
147	premises as defined in chapter 562, if a written contract
148	evidencing an independent contractor relationship is entered
149	into before the commencement of such entertainment.
150	4. An owner-operator of a motor vehicle who transports
151	property under a written contract with a motor carrier which
152	evidences a relationship by which the owner-operator assumes the
153	responsibility of an employer for the performance of the
154	contract, if the owner-operator is required to furnish the
155	necessary motor vehicle equipment and all costs incidental to
156	the performance of the contract, including, but not limited to,
157	fuel, taxes, licenses, repairs, and hired help; and the owner-
158	operator is paid a commission for transportation service and is
159	not paid by the hour or on some other time-measured basis.
160	5. A person whose employment is both casual and not in the
161	course of the trade, business, profession, or occupation of the
162	employer.
163	6. A volunteer, except a volunteer worker for the state or
164	a county, municipality, or other governmental entity. A person
165	who does not receive monetary remuneration for services is
166	presumed to be a volunteer unless there is substantial evidence
167	that a valuable consideration was intended by both employer and
168	employee. For purposes of this chapter, the term "volunteer"
169	includes, but is not limited to:
170	a. Persons who serve in private nonprofit agencies and who
171	receive no compensation other than expenses in an amount less
172	than or equivalent to the standard mileage and per-diem expenses
173	provided to salaried employees in the same agency or, if such
174	agency does not have salaried employees who receive mileage and
175	per diem, then such volunteers who receive no compensation other
176	than expenses in an amount less than or equivalent to the
177	customary mileage and per diem paid to salaried workers in the
178	community as determined by the department; and
179	b. Volunteers participating in federal programs
180	established under Pub. L. No. 93-113.
181	7. Any officer of a corporation who elects to be exempt
182	from this chapter.
183	8. A sole proprietor or officer of a corporation who
184	actively engages in the construction industry, and a partner in
185	a partnership that is actively engaged in the construction
186	industry, who elects to be exempt from the provisions of this
187	chapter. Such sole proprietor, officer, or partner is not an
188	employee for any reason until the notice of revocation of
189	election filed pursuant to s. 440.05 is effective.
190	9. An exercise rider who does not work for a single horse
191	farm or breeder, and who is compensated for riding on a case-by-
192	case basis, provided a written contract is entered into prior to
193	the commencement of such activity which evidences that an
194	employee/employer relationship does not exist.
195	10. A taxicab, limousine, or other passenger vehicle-for-
196	hire driver who operates said vehicles pursuant to a written
197	agreement with a company which provides any dispatch, marketing,
198	insurance, communications, or other services under which the
199	driver and any fees or charges paid by the driver to the company
200	for such services are not conditioned upon, or expressed as a
201	proportion of, fare revenues.
202	11. A person who performs services as a sports official
203	for an entity sponsoring an interscholastic sports event or for
204	a public entity or private, nonprofit organization that sponsors
205	an amateur sports event. For purposes of this subparagraph, such
206	a person is an independent contractor. For purposes of this
207	subparagraph, the term "sports official" means any person who is
208	a neutral participant in a sports event, including, but not
209	limited to, umpires, referees, judges, linespersons,
210	scorekeepers, or timekeepers. This subparagraph does not apply
211	to any person employed by a district school board who serves as
212	a sports official as required by the employing school board or
213	who serves as a sports official as part of his or her
214	responsibilities during normal school hours.
215	(29) "Weekly compensation rate" means and refers to the
216	amount of compensation payable for a period of 7 consecutive
217	calendardays, including any Saturdays, Sundays, holidays, and
218	other nonworking days which fall within such period of 7
219	consecutive calendardays. When Saturdays, Sundays, holidays, or
220	other nonworking days immediately follow the first 7 calendar
221	days of disability or occur at the end of a period of disability
222	as the last day or days of such period, such nonworking days
223	constitute a part of the period of disability with respect to
224	which compensation is payable.
225	(38) "Catastrophic injury" means a permanent impairment
226	constituted by:
227	(a) Spinal cord injury involving severe paralysis of an
228	arm, a leg, or the trunk;
229	(b) Amputation of an arm, a hand, a foot, or a leg
230	involving the effective loss of use of that appendage;
231	(c) Severe brain or closed-head injury as evidenced by:
232	1. Severe sensory or motor disturbances;
233	2. Severe communication disturbances;
234	3. Severe complex integrated disturbances of cerebral
235	function;
236	4. Severe episodic neurological disorders; or
237	5. Other severe brain and closed-head injury conditions at
238	least as severe in nature as any condition provided in
239	subparagraphs 1.-4.;
240	(d) Second-degree or third-degree burns of 25 percent or
241	more of the total body surface or third-degree burns of 5
242	percent or more to the face and hands;
243	(e) Total or industrial blindness; or
244	(f) Any other injury that would otherwise qualify under
245	this chapter of a nature and severity that would qualify an
246	employee to receive disability income benefits under Title II or
247	supplemental security income benefits under Title XVI of the
248	federal Social Security Act as the Social Security Act existed
249	on July 1, 1992, without regard to any time limitations provided
250	under that act.
251	(38)(39)"Insurer" means a group self-insurers' fund
252	authorized by s. 624.4621, an individual self-insurer authorized
253	by s. 440.38, a commercial self-insurance fund authorized by s.
254	624.462, an assessable mutual insurer authorized by s. 628.6011,
255	and an insurer licensed to write workers' compensation and
256	employer's liability insurance in this state. The term
257	"carrier," as used in this chapter, means an insurer as defined
258	in this subsection.
259	(39)(40)"Statement," for the purposes of ss. 440.105 and
260	440.106, shall include the exact fraud statement language in s.
261	440.105(7). This requirementincludes, but is not limited to,
262	any notice, representation, statement, proof of injury, bill for
263	services, diagnosis, prescription, hospital or doctor record, X
264	ray, test result, or other evidence of loss, injury, or expense.
265	(40)(41)"Specificity" means information on the petition
266	for benefits sufficient to put the employer or carrier on notice
267	of the exact statutory classification and outstanding time
268	period of benefits being requested and includes a detailed
269	explanation of any benefits received that should be increased,
270	decreased, changed, or otherwise modified. If the petition is
271	for medical benefits, the information shall include specific
272	details as to why such benefits are being requested, why such
273	benefits are medically necessary, and why current treatment, if
274	any, is not sufficient. Any petition requesting alternate or
275	other medical care, including, but not limited to, petitions
276	requesting psychiatric or psychological treatment, must
277	specifically identify the physician, as defined in s. 440.13(1),
278	that is recommending such treatment. A copy of a report from
279	such physician making the recommendation for alternate or other
280	medical care shall also be attached to the petition. A judge of
281	compensation claims shall not order such treatment if a
282	physician is not recommending such treatment."Commercial
283	building" means any building or structure intended for
284	commercial or industrial use, or any building or structure
285	intended for multifamily use of more than four dwelling units,
286	as well as any accessory use structures constructed in
287	conjunction with the principal structure. The term, "commercial
288	building," does not include the conversion of any existing
289	residential building to a commercial building.
290	(42) "Residential building" means any building or
291	structure intended for residential use containing four or fewer
292	dwelling units and any structures intended as an accessory use
293	to the residential structure.
294	Section 2. Effective January 1, 2004, subsections (8),
295	(15), and (16) of section 440.02, Florida Statutes, as amended
296	by this act, are amended to read:
297	440.02 Definitions.--When used in this chapter, unless the
298	context clearly requires otherwise, the following terms shall
299	have the following meanings:
300	(8) "Construction industry" means for-profit activities
301	involving the carrying out ofany building, clearing, filling,
302	excavation, or substantial improvement in the size or use of any
303	structure or the appearance of any land. When appropriate to the
304	context, "construction" refers to the act of construction or the
305	result of construction. However, "construction" doesshallnot
306	mean a homeowner'slandowner'sact of construction or the result
307	of a construction upon his or her own premises, provided such
308	premises are not intended to be sold,or resold, or leased by
309	the owner within 1 year after the commencement of construction.
310	The division may, by rule, establish standard industrial
311	classification codes and definitions thereof which meet the
312	criteria of the term "construction industry" as set forth in
313	this section.
314	(15)(a) "Employee" means any person who receives
315	remuneration from an employer for the performance of any work or
316	service whileengaged in any employment under any appointment or
317	contract forofhire or apprenticeship, express or implied, oral
318	or written, whether lawfully or unlawfully employed, and
319	includes, but is not limited to, aliens and minors.
320	(b) "Employee" includes any person who is an officer of a
321	corporation and who performs services for remuneration for such
322	corporation within this state, whether or not such services are
323	continuous.
324	1. Any officer of a corporation may elect to be exempt
325	from this chapter by filing written notice of the election with
326	the department as provided in s. 440.05.
327	2. As to officers of a corporation who are actively
328	engaged in the construction industry, no more than three
329	officers of a corporation or of any group of affiliated
330	corporationsmay elect to be exempt from this chapter by filing
331	written notice of the election with the department as provided
332	in s. 440.05. Officers must be shareholders, each owning at
333	least 10 percent of the stock of such corporation and listed as
334	an officer of such corporation with the Division of Corporations
335	of the Department of State, in order to elect exemptions under
336	this chapter. For purposes of this subparagraph, the term
337	"affiliated" means and includes one or more corporations or
338	entities, any one of which is a corporation engaged in the
339	construction industry, under the same or substantially the same
340	control of a group of business entities which are connected or
341	associated so that one entity controls or has the power to
342	control each of the other business entities. The term
343	"affiliated" includes, but is not limited to, the officers,
344	directors, executives, shareholders active in management,
345	employees, and agents of the affiliated corporation. The
346	ownership by one business entity of a controlling interest in
347	another business entity or a pooling of equipment or income
348	among business entities shall be prima facie evidence that one
349	business is affiliated with the other.
350	3. An officer of a corporation who elects to be exempt
351	from this chapter by filing a written notice of the election
352	with the department as provided in s. 440.05 is not an employee.
353
354	Services are presumed to have been rendered to the corporation
355	if the officer is compensated by other than dividends upon
356	shares of stock of the corporation which the officer owns.
357	(c) "Employee" includes:
358	1. A sole proprietor or a partner who is not engaged in
359	the construction industry,devotes full time to the
360	proprietorship or partnership, and, except as provided in this
361	paragraph,elects to be included in the definition of employee
362	by filing notice thereof as provided in s. 440.05. Partners or
363	sole proprietors actively engaged in the construction industry
364	are considered employees unless they elect to be excluded from
365	the definition of employee by filing written notice of the
366	election with the department as provided in s. 440.05. However,
367	no more than three partners in a partnership that is actively
368	engaged in the construction industry may elect to be excluded. A
369	sole proprietor or partner who is actively engaged in the
370	construction industry and who elects to be exempt from this
371	chapter by filing a written notice of the election with the
372	department as provided in s. 440.05 is not an employee. For
373	purposes of this chapter, an independent contractor is an
374	employee unless he or she meets all of the conditions set forth
375	in subparagraph (d)1.
376	2. All persons who are being paid by a construction
377	contractor as a subcontractor, unless the subcontractor has
378	validly elected an exemption as permitted by this chapter, or
379	has otherwise secured the payment of compensation coverage as a
380	subcontractor, consistent with s. 440.10, for work performed by
381	or as a subcontractor.
382	3. An independent contractor working or performing
383	services in the construction industry.
384	4. A sole proprietor who engages in the construction
385	industry and a partner or partnership that is engaged in the
386	construction industry.
387	(d) "Employee" does not include:
388	1. An independent contractor who is not engaged in the
389	construction industry., if:
390	a. In order to meet the definition of independent
391	contractor, at least four of the following criteria must be met:
392	(I) The independent contractor maintains a separate
393	business with his or her own work facility, truck, equipment,
394	materials, or similar accommodations;
395	(II) The independent contractor holds or has applied for a
396	federal employer identification number, unless the independent
397	contractor is a sole proprietor who is not required to obtain a
398	federal employer identification number under state or federal
399	regulations;
400	(III) The independent contractor receives compensation for
401	services rendered or work performed and such compensation is
402	paid to a business rather than to an individual;
403	(IV) The independent contractor holds one or more bank
404	accounts in the name of the business entity for purposes of
405	paying business expenses or other expenses related to services
406	rendered or work performed for compensation;
407	(V) The independent contractor performs work or is able to
408	perform work for any entity in addition to or besides the
409	employer at his or her own election without the necessity of
410	completing an employment application or process; or
411	(VI) The independent contractor receives compensation for
412	work or services rendered on a competitive-bid basis or
413	completion of a task or a set of tasks as defined by a
414	contractual agreement, unless such contractual agreement
415	expressly states that an employment relationship exists.The
416	independent contractor maintains a separate business with his or
417	her own work facility, truck, equipment, materials, or similar
418	accommodations;
419	b. If four of the criteria listed in sub-subparagraph a.
420	do not exist, an individual may still be presumed to be an
421	independent contractor and not an employee based on full
422	consideration of the nature of the individual situation with
423	regard to satisfying any of the following conditions:
424	(I) The independent contractor performs or agrees to
425	perform specific services or work for a specific amount of money
426	and controls the means of performing the services or work.
427	(II) The independent contractor incurs the principal
428	expenses related to the service or work that he or she performs
429	or agrees to perform.
430	(III) The independent contractor is responsible for the
431	satisfactory completion of the work or services that he or she
432	performs or agrees to perform.
433	(IV) The independent contractor receives compensation for
434	work or services performed for a commission or on a per-job
435	basis and not on any other basis.
436	(V) The independent contractor may realize a profit or
437	suffer a loss in connection with performing work or services.
438	(VI) The independent contractor has continuing or
439	recurring business liabilities or obligations.
440	(VII) The success or failure of the independent
441	contractor's business depends on the relationship of business
442	receipts to expenditures.The independent contractor holds or
443	has applied for a federal employer identification number, unless
444	the independent contractor is a sole proprietor who is not
445	required to obtain a federal employer identification number
446	under state or federal requirements;
447	c. Notwithstanding anything to the contrary in this
448	subparagraph, an individual claiming to be an independent
449	contractor has the burden of proving that he or she is an
450	independent contractor for purposes of this chapter.The
451	independent contractor performs or agrees to perform specific
452	services or work for specific amounts of money and controls the
453	means of performing the services or work;
454	d. The independent contractor incurs the principal
455	expenses related to the service or work that he or she performs
456	or agrees to perform;
457	e. The independent contractor is responsible for the
458	satisfactory completion of work or services that he or she
459	performs or agrees to perform and is or could be held liable for
460	a failure to complete the work or services;
461	f. The independent contractor receives compensation for
462	work or services performed for a commission or on a per-job or
463	competitive-bid basis and not on any other basis;
464	g. The independent contractor may realize a profit or
465	suffer a loss in connection with performing work or services;
466	h. The independent contractor has continuing or recurring
467	business liabilities or obligations; and
468	i. The success or failure of the independent contractor's
469	business depends on the relationship of business receipts to
470	expenditures.
471
472	However, the determination as to whether an individual included
473	in the Standard Industrial Classification Manual of 1987,
474	Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762, 0781, 0782,
475	0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436, 2448, or 2449,
476	or a newspaper delivery person, is an independent contractor is
477	governed not by the criteria in this paragraph but by common-law
478	principles, giving due consideration to the business activity of
479	the individual.
480	2. A real estate salesperson or agent, if that person
481	agrees, in writing, to perform for remuneration solely by way of
482	commission.
483	3. Bands, orchestras, and musical and theatrical
484	performers, including disk jockeys, performing in licensed
485	premises as defined in chapter 562, if a written contract
486	evidencing an independent contractor relationship is entered
487	into before the commencement of such entertainment.
488	4. An owner-operator of a motor vehicle who transports
489	property under a written contract with a motor carrier which
490	evidences a relationship by which the owner-operator assumes the
491	responsibility of an employer for the performance of the
492	contract, if the owner-operator is required to furnish the
493	necessary motor vehicle equipment and all costs incidental to
494	the performance of the contract, including, but not limited to,
495	fuel, taxes, licenses, repairs, and hired help; and the owner-
496	operator is paid a commission for transportation service and is
497	not paid by the hour or on some other time-measured basis.
498	5. A person whose employment is both casual and not in the
499	course of the trade, business, profession, or occupation of the
500	employer.
501	6. A volunteer, except a volunteer worker for the state or
502	a county, municipality, or other governmental entity. A person
503	who does not receive monetary remuneration for services is
504	presumed to be a volunteer unless there is substantial evidence
505	that a valuable consideration was intended by both employer and
506	employee. For purposes of this chapter, the term "volunteer"
507	includes, but is not limited to:
508	a. Persons who serve in private nonprofit agencies and who
509	receive no compensation other than expenses in an amount less
510	than or equivalent to the standard mileage and per diem expenses
511	provided to salaried employees in the same agency or, if such
512	agency does not have salaried employees who receive mileage and
513	per diem, then such volunteers who receive no compensation other
514	than expenses in an amount less than or equivalent to the
515	customary mileage and per diem paid to salaried workers in the
516	community as determined by the department; and
517	b. Volunteers participating in federal programs
518	established under Pub. L. No. 93-113.
519	7. Unless otherwise prohibited by this chapter,any
520	officer of a corporation who elects to be exempt from this
521	chapter. Such officer is not an employee for any reason under
522	this chapter until the notice of revocation of election filed
523	pursuant to s. 440.05 is effective.
524	8. Ana sole proprietor or officer of a corporation who
525	actively engages in the construction industry, and a partner in
526	a partnership that is activelyengaged in the construction
527	industry,who elects to be exempt from the provisions of this
528	chapter, as otherwise permitted by this chapter. Such sole
529	proprietor, officer, or partneris not an employee for any
530	reason until the notice of revocation of election filed pursuant
531	to s. 440.05 is effective.
532	9. An exercise rider who does not work for a single horse
533	farm or breeder, and who is compensated for riding on a case-by-
534	case basis, provided a written contract is entered into prior to
535	the commencement of such activity which evidences that an
536	employee/employer relationship does not exist.
537	10. A taxicab, limousine, or other passenger vehicle-for-
538	hire driver who operates said vehicles pursuant to a written
539	agreement with a company which provides any dispatch, marketing,
540	insurance, communications, or other services under which the
541	driver and any fees or charges paid by the driver to the company
542	for such services are not conditioned upon, or expressed as a
543	proportion of, fare revenues.
544	11. A person who performs services as a sports official
545	for an entity sponsoring an interscholastic sports event or for
546	a public entity or private, nonprofit organization that sponsors
547	an amateur sports event. For purposes of this subparagraph, such
548	a person is an independent contractor. For purposes of this
549	subparagraph, the term "sports official" means any person who is
550	a neutral participant in a sports event, including, but not
551	limited to, umpires, referees, judges, linespersons,
552	scorekeepers, or timekeepers. This subparagraph does not apply
553	to any person employed by a district school board who serves as
554	a sports official as required by the employing school board or
555	who serves as a sports official as part of his or her
556	responsibilities during normal school hours.
557	12. Medicaid-enrolled clients under chapter 393 who are
558	excluded from the definition of employment under s.
559	443.036(21)(d)5. and served by Adult Day Training Services under
560	the Home and Community-Based Medicaid Waiver program in a
561	sheltered workshop setting licensed by the United States
562	Department of Labor for the purpose of training and earning less
563	than the federal hourly minimum wage.
564	(16)(a)"Employer" means the state and all political
565	subdivisions thereof, all public and quasi-public corporations
566	therein, every person carrying on any employment, and the legal
567	representative of a deceased person or the receiver or trustees
568	of any person. "Employer" also includes employment agencies,
569	employee leasing companies, and similar agents who provide
570	employees to other persons.If the employer is a corporation,
571	parties in actual control of the corporation, including, but not
572	limited to, the president, officers who exercise broad corporate
573	powers, directors, and all shareholders who directly or
574	indirectly own a controlling interest in the corporation, are
575	considered the employer for the purposes of ss. 440.105,and
576	440.106, and 440.107.
577	(b) A homeowner shall not be considered the employer of
578	persons hired by the homeowner to carry out construction on the
579	homeowner's own premises if those premises are not intended for
580	immediate lease, sale, or resale.
581	(c) Facilities serving individuals under subparagraph
582	(15)(d)12. shall be considered agents of the Agency for Health
583	Care Administration as it relates to providing Adult Day
584	Training Services under the Home and Community-Based Medicaid
585	Waiver program and not employers or third parties for the
586	purpose of limiting or denying Medicaid benefits.
587	Section 3. Effective January 1, 2004, subsections (3),
588	(4), (6), (10), (11), and (12) of section 440.05, Florida
589	Statutes, are amended, present subsection (13) is renumbered as
590	subsection (11) and amended, and new subsections (12), (13),
591	(14), and (15) are added to said section, to read:
592	440.05 Election of exemption; revocation of election;
593	notice; certification.--
594	(3) Each sole proprietor, partner, orofficer of a
595	corporation who is activelyengaged in the construction industry
596	and who elects an exemption from this chapter or who, after
597	electing such exemption, revokes that exemption, must mail a
598	written notice to such effect to the department on a form
599	prescribed by the department. The notice of election to be
600	exempt from the provisions of this chapter must be notarized and
601	under oath. The notice of election to be exempt which is
602	submitted to the department by the sole proprietor, partner, or
603	officer of a corporation who is allowed to claim an exemption as
604	provided by this chaptermust list the name, federal tax
605	identification number, social security number, all certified or
606	registered licenses issued pursuant to chapter 489 held by the
607	person seeking the exemption, a copy of relevant documentation
608	as to employment status filed with the Internal Revenue Service
609	as specified by the department, a copy of the relevant
610	occupational license in the primary jurisdiction of the
611	business, and, for corporate officers and partners,the
612	registration number of the corporation or partnershipfiled with
613	the Division of Corporations of the Department of State along
614	with a copy of the stock certificate evidencing the required
615	ownership under this chapter. The notice of election to be
616	exempt must identify each sole proprietorship, partnership, or
617	corporation that employs the person electing the exemption and
618	must list the social security number or federal tax
619	identification number of each such employer and the additional
620	documentation required by this section. In addition, the notice
621	of election to be exempt must provide that the sole proprietor,
622	partner, orofficer electing an exemption is not entitled to
623	benefits under this chapter, must provide that the election does
624	not exceed exemption limits for officers and partnerships
625	provided in s. 440.02, and must certify that any employees of
626	the corporation whosesole proprietor, partner, or officer
627	electselectingan exemption are covered by workers'
628	compensation insurance. Upon receipt of the notice of the
629	election to be exempt, receipt of all application fees, and a
630	determination by the department that the notice meets the
631	requirements of this subsection, the department shall issue a
632	certification of the election to the sole proprietor, partner,
633	orofficer, unless the department determines that the
634	information contained in the notice is invalid. The department
635	shall revoke a certificate of election to be exempt from
636	coverage upon a determination by the department that the person
637	does not meet the requirements for exemption or that the
638	information contained in the notice of election to be exempt is
639	invalid. The certificate of election must list the namenamesof
640	the sole proprietorship, partnership, orcorporation listed in
641	the request for exemption. A new certificate of election must be
642	obtained each time the person is employed by a new sole
643	proprietorship, partnership, or differentcorporation that is
644	not listed on the certificate of election. A copy of the
645	certificate of election must be sent to each workers'
646	compensation carrier identified in the request for exemption.
647	Upon filing a notice of revocation of election, ana sole
648	proprietor, partner, or officer who is a subcontractor or an
649	officer of a corporate subcontractormust notify her or his
650	contractor. Upon revocation of a certificate of election of
651	exemption by the department, the department shall notify the
652	workers' compensation carriers identified in the request for
653	exemption.
654	(4) The notice of election to be exempt from the
655	provisions of this chapter must contain a notice that clearly
656	states in substance the following: "Any person who, knowingly
657	and with intent to injure, defraud, or deceive the department or
658	any employer or employee, insurance company, or any other person
659	purposes program, files a notice of election to be exempt
660	containing any false or misleading information is guilty of a
661	felony of the third degree." Each person filing a notice of
662	election to be exempt shall personally sign the notice and
663	attest that he or she has reviewed, understands, and
664	acknowledges the foregoing notice.
665	(6) A construction industry certificate of election to be
666	exempt which is issued in accordance with this section shall be
667	valid for 2 years after the effective date stated thereon. Both
668	the effective date and the expiration date must be listed on the
669	face of the certificate by the department. The construction
670	industry certificate must expire at midnight, 2 years from its
671	issue date, as noted on the face of the exemption certificate.
672	Any person who has received from the division a construction
673	industry certificate of election to be exempt which is in effect
674	on December 31, 1998, shall file a new notice of election to be
675	exempt by the last day in his or her birth month following
676	December 1, 1998. A construction industry certificate of
677	election to be exempt may be revoked before its expiration by
678	the sole proprietor, partner, orofficer for whom it was issued
679	or by the department for the reasons stated in this section. At
680	least 60 days prior to the expiration date of a construction
681	industry certificate of exemption issued after December 1, 1998,
682	the department shall send notice of the expiration date and an
683	application for renewal to the certificateholder at the address
684	on the certificate.
685	(10) Each sole proprietor, partner, orofficer of a
686	corporation who is actively engaged in the construction industry
687	and who elects an exemption from this chapter shall maintain
688	business records as specified by the division by rule, which
689	rules must include the provision that any corporation with
690	exempt officers and any partnership activelyengaged in the
691	construction industry with exempt partnersmust maintain written
692	statements of those exempted persons affirmatively acknowledging
693	each such individual's exempt status.
694	(11) Any sole proprietor or partner actively engaged in
695	the construction industry claiming an exemption under this
696	section shall maintain a copy of his or her federal income tax
697	records for each of the immediately previous 3 years in which he
698	or she claims an exemption. Such federal income tax records must
699	include a complete copy of the following for each year in which
700	an exemption is claimed:
701	(a) For sole proprietors, a copy of Federal Income Tax
702	Form 1040 and its accompanying Schedule C;
703	(b) For partners, a copy of the partner's Federal Income
704	Tax Schedule K-1 (Form 1065) and Federal Income Tax Form 1040
705	and its accompanying Schedule E.
706
707	A sole proprietor or partner shall produce, upon request by the
708	division, a copy of those documents together with a statement by
709	the sole proprietor or partner that the tax records provided are
710	true and accurate copies of what the sole proprietor or partner
711	has filed with the federal Internal Revenue Service. The
712	statement must be signed under oath by the sole proprietor or
713	partner and must be notarized. The division shall issue a stop-
714	work order under s. 440.107(5) to any sole proprietor or partner
715	who fails or refuses to produce a copy of the tax records and
716	affidavit required under this paragraph to the division within 3
717	business days after the request is made.
718	(12) For those sole proprietors or partners that have not
719	been in business long enough to provide the information required
720	of an established business, the division shall require such sole
721	proprietor or partner to provide copies of the most recently
722	filed Federal Income Tax Form 1040. The division shall establish
723	by rule such other criteria to show that the sole proprietor or
724	partner intends to engage in a legitimate enterprise within the
725	construction industry and is not otherwiseattempting to evade
726	the requirements of this section. The division shall establish
727	by rule the form and format of financial information required to
728	be submitted by such employers.
729	(11)(13) Any corporate officer permitted by this chapter
730	to claimclaiming an exemption under this sectionmust be listed
731	on the records of this state's Secretary of State, Division of
732	Corporations, as a corporate officer. If the person who claims
733	an exemption as a corporate officer is not so listed on the
734	records of the Secretary of State, the individual must provide
735	to the division, upon request by the division, a notarized
736	affidavit stating that the individual is a bona fide officer of
737	the corporation and stating the date his or her appointment or
738	election as a corporate officer became or will become effective.
739	The statement must be signed under oath by both the officer and
740	the president or chief operating officer of the corporation and
741	must be notarized.The division shall issue a stop-work order
742	under s. 440.107(1) to any corporation who employs a person who
743	claims to be exempt as a corporate officer but who fails or
744	refuses to produce the documents required under this subsection
745	to the division within 3 business days after the request is
746	made.
747	(12) Certificates of election to be exempt issued under
748	subsection (3) shall apply only to the corporate officer named
749	on the notice of election to be exempt and apply only within the
750	scope of the business or trade listed on the notice of election
751	to be exempt.
752	(13) Notices of election to be exempt and certificates of
753	election to be exempt shall be subject to revocation if, at any
754	time after the filing of the notice or the issuance of the
755	certificate, the person named on the notice or certificate no
756	longer meets the requirements of this section for issuance of a
757	certificate. The department shall revoke a certificate at any
758	time for failure of the person named on the certificate to meet
759	the requirements of this section.
760	(14) An officer of a corporation who elects exemption from
761	this chapter by filing a certificate of election under this
762	section may not recover benefits or compensation under this
763	chapter. For purposes of determining the appropriate premium for
764	workers' compensation coverage, carriers may not consider any
765	officer of a corporation who validly meets the requirements of
766	this section to be an employee.
767	(15) Any corporate officer who is an affiliated person
768	of a person who is delinquent in paying a stop-work order and
769	penalty assessment order issued pursuant to s. 440.107, or owed
770	pursuant to a court order, is ineligible for an election of
771	exemption. The stop-work order and penalty assessment shall be
772	in effect against any such affiliated person. As used in this
773	subsection, the term "affiliated person" means:
774	(a) The spouse of such other person;
775	(b) Any person who directly or indirectly owns or
776	controls, or holds with the power to vote, 10 percent or more of
777	the outstanding voting securities of such other person;
778	(c) Any person who directly or indirectly owns 10 percent
779	or more of the outstanding voting securities that are directly
780	or indirectly owned, controlled, or held with the power to vote
781	by such other person;
782	(d) Any person or group of persons who directly or
783	indirectly control, are controlled by, or are under common
784	control with such other person;
785	(e) Any person who directly or indirectly acquires all or
786	substantially all of the other assets of such other person;
787	(f) Any officer, director, trustee, partner, owner,
788	manager, joint venturer, or employee of such other person or a
789	person performing duties similar to persons in such positions;
790	or
791	(g) Any person who has an officer, director, trustee,
792	partner, or joint venturer in common with such person.
793	Section 4. Section 440.06, Florida Statutes, is amended to
794	read:
795	440.06 Failure to secure compensation; effect.--Every
796	employer who fails to secure the payment of compensation, as
797	provided in s. 440.10, by failing to meet the requirements of
798	under this chapter as provided ins. 440.38 may not, in any suit
799	brought against him or her by an employee subject to this
800	chapter to recover damages for injury or death, defend such a
801	suit on the grounds that the injury was caused by the negligence
802	of a fellow servant, that the employee assumed the risk of his
803	or her employment, or that the injury was due to the comparative
804	negligence of the employee.
805	Section 5. Effective January 1, 2004, section 440.077,
806	Florida Statutes, is amended to read:
807	440.077 When a corporatesole proprietor, partner, or
808	officer rejects chapter, effect.--AnA sole proprietor, partner,
809	or officer of a corporation who is permitted to elect an
810	exemption under this chapteractively engaged in the
811	construction industryand who elects to be exempt from the
812	provisions of this chapter may not recover benefits under this
813	chapter.
814	Section 6. Subsections (1) and (4) of section 440.09,
815	Florida Statutes, are amended and paragraph (e) is added to
816	subsection (7) of said section, to read:
817	440.09 Coverage.--
818	(1) The employer mustshallpay compensation or furnish
819	benefits required by this chapter if the employee suffers an
820	accidental compensableinjury or death arising out of work
821	performed in the course and the scope of employment. The injury,
822	its occupational cause, and any resulting manifestations or
823	disability mustshallbe established to a reasonable degree of
824	medical certainty, based onand by objective relevantmedical
825	findings, and the accidental compensable injury must be the
826	major contributing cause of any resulting injuries. For purposes
827	of this section, "major contributing cause" means the cause
828	which is more than 50 percent responsible for the injury as
829	compared to all other causes combined for which treatment or
830	benefits are sought. In cases involving occupational disease or
831	repetitive exposure, both causation and sufficient exposure to
832	support causation must be proven by clear and convincing
833	evidence. Pain or other subjective complaints alone, in the
834	absence of objective relevant medical findings, are not
835	compensable. For purposes of this section, "objective relevant
836	medical findings" are those objective findings that correlate to
837	the subjective complaints of the injured employee and are
838	confirmed by physical examination findings or diagnostic
839	testing. Establishment of the causal relationship between a
840	compensable accident and injuries for conditions that are not
841	readily observable must be by medical evidence only, as
842	demonstrated by physical examination findings or diagnostic
843	testing. Major contributing cause must be demonstrated by
844	medical evidence only. Mental or nervous injuries occurring as a
845	manifestation of an injury compensable under this section shall
846	be demonstrated by clear and convincing evidence.
847	(a) This chapter does not require any compensation or
848	benefits for any subsequent injury the employee suffers as a
849	result of an original injury arising out of and in the course of
850	employment unless the original injury is the major contributing
851	cause of the subsequent injury. Major contributing cause must be
852	demonstrated by medical evidence only.
853	(b) If an injury arising out of and in the course of
854	employment combines with a preexisting disease or condition to
855	cause or prolong disability or need for treatment, the employer
856	must pay compensation or benefits required by this chapter only
857	to the extent that the injury arising out of and in the course
858	of employment is and remains more than 50 percent responsible
859	for the injury as compared to all other causes combined and
860	thereafter remainsthe major contributing cause of the
861	disability or need for treatment. Major contributing cause must
862	be demonstrated by medical evidence only.
863	(c) Death resulting from an operation by a surgeon
864	furnished by the employer for the cure of hernia as required in
865	s. %_%0%_%[F.S. 1981]shall for the purpose of this chapter be
866	considered to be a death resulting from the accident causing the
867	hernia.
868	(d) If an accident happens while the employee is employed
869	elsewhere than in this state, which would entitle the employee
870	or his or her dependents to compensation if it had happened in
871	this state, the employee or his or her dependents are entitled
872	to compensation if the contract of employment was made in this
873	state, or the employment was principally localized in this
874	state. However, if an employee receives compensation or damages
875	under the laws of any other state, the total compensation for
876	the injury may not be greater than is provided in this chapter.
877	(4)(a)An employee shall not be entitled to compensation
878	or benefits under this chapter if any judge of compensation
879	claims, administrative law judge, court, or jury convened in
880	this state determines that the employee has knowingly or
881	intentionally engaged in any of the acts described in s. 440.105
882	or any criminal actfor the purpose of securing workers'
883	compensation benefits. For purposes of this section, the term
884	"intentional" shall include, but is not limited to, pleas of
885	guilty or nolo contendere in criminal matters. This section
886	shall apply to accidents, regardless of the date of the
887	accident. For injuries occurring prior to January 1, 1994, this
888	section shall pertain to the acts of the employee described in
889	s. 440.105 or criminal activities occurring subsequent to
890	January 1, 1994.
891	(b) A judge of compensation claims, administrative law
892	judge, or court of this state shall take judicial notice of a
893	finding of insurance fraud by a court of competent jurisdiction
894	and terminate or otherwise disallow benefits.
895	(c) Upon the denial of benefits in accordance with this
896	section, a judge of compensation claims shall have the
897	jurisdiction to order any benefits payable to the employee to be
898	paid into the court registry or an escrow account during the
899	pendency of an appeal or until such time as the time in which to
900	file an appeal has expired.
901	(7)
902	(e) As a part of rebutting any presumptions under
903	paragraph (b), the injured worker must prove the actual
904	quantitative amounts of the drug or its metabolites as measured
905	on the initial and confirmation post-accident drug tests of the
906	injured worker's urine sample and provide additional evidence
907	regarding the absence of drug influence other than the worker's
908	denial of being under the influence of a drug. No drug test
909	conducted on a urine sample shall be rejected as to its results
910	or the presumption imposed under paragraph (b) on the basis of
911	the urine being bodily fluid tested.
912	Section 7. Section 440.093, Florida Statutes, is created
913	to read:
914	440.093 Mental and nervous injuries.--
915	(1) A mental or nervous injury due to stress, fright, or
916	excitement only is not an injury by accident arising out of the
917	employment. Nothing in this section shall be construed to allow
918	for the payment of benefits under this chapter for mental or
919	nervous injuries without an accompanying physical injury
920	requiring medical treatment. A physical injury resulting from
921	mental or nervous injuries unaccompanied by physical trauma
922	requiring medical treatment shall not be compensable under this
923	chapter.
924	(2) Mental or nervous injuries occurring as a
925	manifestation of an injury compensable under this chapter shall
926	be demonstrated by clear and convincing medical evidence by a
927	licensed psychiatrist meeting criteria established in the most
928	recent edition of the diagnostic and statistical manual of
929	mental disorders published by the American Psychiatric
930	Association. The compensable physical injury must be and remain
931	the major contributing cause of the mental or nervous condition
932	and the compensable physical injury as determined by reasonable
933	medical certainty must be at least 50 percent responsible for
934	the mental or nervous condition as compared to all other
935	contributing causes combined. Compensation is not payable for
936	the mental, psychological, or emotional injury arising out of
937	depression from being out of work or losing employment
938	opportunities, resulting from a preexisting mental,
939	psychological, or emotional condition or due to pain or other
940	subjective complaints that cannot be substantiated by objective,
941	relevant medical findings.
942	(3) Subject to the payment of permanent benefits under s.
943	440.15, in no event shall temporary benefits for a compensable
944	mental or nervous injury be paid for more than 6 months after
945	the date of maximum medical improvement for the injured
946	employee's physical injury or injuries, which shall be included
947	in the period of 104 weeks as provided in s. 440.15(2) and (4).
948	Mental or nervous injuries are compensable only in accordance
949	with the terms of this section.
950	Section 8. Effective January 1, 2004, subsection (1) of
951	section 440.10, Florida Statutes, is amended to read:
952	440.10 Liability for compensation.--
953	(1)(a) Every employer coming within the provisions of this
954	chapter, including any brought within the chapter by waiver of
955	exclusion or of exemption,shall be liable for, and shall
956	secure, the payment to his or her employees, or any physician,
957	surgeon, or pharmacist providing services under the provisions
958	of s. 440.13, of the compensation payable under ss. 440.13,
959	440.15, and 440.16. Any contractor or subcontractor who engages
960	in any public or private construction in the state shall secure
961	and maintain compensation for his or her employees under this
962	chapter as provided in s. 440.38.
963	(b) In case a contractor sublets any part or parts of his
964	or her contract work to a subcontractor or subcontractors, all
965	of the employees of such contractor and subcontractor or
966	subcontractors engaged on such contract work shall be deemed to
967	be employed in one and the same business or establishment,;and
968	the contractor shall be liable for, and shall secure, the
969	payment of compensation to all such employees, except to
970	employees of a subcontractor who has secured such payment.
971	(c) A contractor shallmayrequire a subcontractor to
972	provide evidence of workers' compensation insurance or a copy of
973	his or her certificate of election. A subcontractor who is a
974	corporation and has an officer who electselectingto be exempt
975	as permitted under this chaptera sole proprietor, partner, or
976	officer of a corporationshall provide a copy of his or her
977	certificate of exemptionelectionto the contractor.
978	(d)1. If a contractor becomes liable for the payment of
979	compensation to the employees of a subcontractor who has failed
980	to secure such payment in violation of s. 440.38, the contractor
981	or other third-party payor shall be entitled to recover from the
982	subcontractor all benefits paid or payable plus interest unless
983	the contractor and subcontractor have agreed in writing that the
984	contractor will provide coverage.
985	2. If a contractor or third-party payor becomes liable for
986	the payment of compensation to the corporate officeremployeeof
987	a subcontractor who is activelyengaged in the construction
988	industry and has elected to be exempt from the provisions of
989	this chapter, but whose election is invalid, the contractor or
990	third-party payor may recover from the claimant, partnership,or
991	corporation all benefits paid or payable plus interest, unless
992	the contractor and the subcontractor have agreed in writing that
993	the contractor will provide coverage.
994	(e) A subcontractor providing services in conjunction with
995	a contractor on the same project or contract workis not liable
996	for the payment of compensation to the employees of another
997	subcontractor or the contractor on such contract work and is not
998	protected by the exclusiveness-of-liability provisions of s.
999	440.11 from anyaction at law or in admiralty on account of
1000	injury to anof such employee of another subcontractor, or of
1001	the contractor, provided that:
1002	1. The subcontractor has secured workers' compensation
1003	insurance for its employees or the contractor has secured such
1004	insurance on behalf of the subcontractor and its employees in
1005	accordance with paragraph (b); and
1006	2. The subcontractor's own gross negligence was not the
1007	major contributing cause of the injury.
1008	(f) If an employer fails to secure compensation as
1009	required by this chapter, the department shallmayassess
1010	against the employer a penalty not to exceed $5,000 for each
1011	employee of that employer who is classified by the employer as
1012	an independent contractor but who is found by the department to
1013	not meet the criteria for an independent contractor that are set
1014	forth in s. 440.02. The division shall adopt rules to administer
1015	the provisions of this paragraph.
1016	(g) Subject to s. 440.38, any employer who has employees
1017	engaged in work in this state shall obtain a Florida policy or
1018	endorsement for such employees which utilizes Florida class
1019	codes, rates, rules, and manuals that are in compliance with and
1020	approved under the provisions of this chapter and the Florida
1021	Insurance Code. Failure to comply with this paragraph is a
1022	felony of the second degree, punishable as provided in s.
1023	775.082, s. 775.083, or s. 775.084. The department shall adopt
1024	rules for construction industry and nonconstruction-industry
1025	employers with regard to the activities that define what
1026	constitutes being "engaged in work" in this state, using the
1027	following standards:
1028	1. For employees of nonconstruction-industry employers who
1029	have their headquarters outside of Florida and also operate in
1030	Florida and who are routinely crossing state lines, but usually
1031	return to their homes each night, the employee shall be assigned
1032	to the headquarters' state. However, the construction industry
1033	employees performing new construction or alterations in Florida
1034	shall be assigned to Florida even if the employees return to
1035	their home state each night.
1036	2. The payroll of executive supervisors who may visit a
1037	Florida location but who are not in direct charge of a Florida
1038	location shall be assigned to the state in which the
1039	headquarters is located.
1040	3. For construction contractors who maintain a permanent
1041	staff of employees and superintendents, if any of these
1042	employees or superintendents are assigned to a job that is
1043	located in Florida, either for the duration of the job or any
1044	portion thereof, their payroll shall be assigned to Florida
1045	rather than headquarters' state.
1046	4. Employees who are hired for a specific project in
1047	Florida shall be assigned to Florida.For purposes of this
1048	section, a person is conclusively presumed to be an independent
1049	contractor if:
1050	1. The independent contractor provides the general
1051	contractor with an affidavit stating that he or she meets all
1052	the requirements of s. 440.02; and
1053	2. The independent contractor provides the general
1054	contractor with a valid certificate of workers' compensation
1055	insurance or a valid certificate of exemption issued by the
1056	department.
1057
1058	A sole proprietor, partner, or officer of a corporation who
1059	elects exemption from this chapter by filing a certificate of
1060	election under s. 440.05 may not recover benefits or
1061	compensation under this chapter. An independent contractor who
1062	provides the general contractor with both an affidavit stating
1063	that he or she meets the requirements of s. 440.02 and a
1064	certificate of exemption is not an employee under s. 440.02 and
1065	may not recover benefits under this chapter. For purposes of
1066	determining the appropriate premium for workers' compensation
1067	coverage, carriers may not consider any person who meets the
1068	requirements of this paragraph to be an employee.
1069	Section 9. Section 440.1025, Florida Statutes, is amended
1070	to read:
1071	440.1025 Consideration of publicEmployer workplace safety
1072	program in rate-setting; program requirements; rulemaking.—
1073	(1) For a public or privateemployer to be eligible for
1074	receipt of specific identifiable consideration under s. 627.0915
1075	for a workplace safety program in the setting of rates, the
1076	publicemployer must have a workplace safety program. At a
1077	minimum, the program must include a written safety policy and
1078	safety rules, and make provision for safety inspections,
1079	preventative maintenance, safety training, first-aid, accident
1080	investigation, and necessary recordkeeping. For purposes of this
1081	section, "public employer" means any agency within state,
1082	county, or municipal government employing individuals for
1083	salary, wages, or other remuneration. The division may adopt
1084	promulgate rules for insurers to utilize in determining public
1085	employer compliance with the requirements of this section.
1086	(2) The division shall publicize on the Internet, and
1087	shall encourage insurers to publicize, the availability of free
1088	safety consultation services and safety program resources.
1089	Section 10. Section 440.103, Florida Statutes, is amended
1090	to read:
1091	440.103 Building permits; identification of minimum
1092	premium policy.--Except as otherwise provided in this chapter,
1093	Every employer shall, as a condition to applying for and
1094	receiving a building permit, show proof and certify to the
1095	permit issuerthat it has secured compensation for its employees
1096	under this chapter as provided in ss. 440.10 and 440.38. Such
1097	proof of compensation must be evidenced by a certificate of
1098	coverage issued by the carrier, a valid exemption certificate
1099	approved by the department or the former Division of Workers'
1100	Compensation of the Department of Labor and Employment Security,
1101	or a copy of the employer's authority to self-insure and shall
1102	be presented each time the employer applies for a building
1103	permit. As provided in s. 627.413(5), each certificate of
1104	coverage must show, on its face, whether or not coverage is
1105	secured under the minimum premium provisions of rules adopted by
1106	rating organizations licensed by the department. The words
1107	"minimum premium policy" or equivalent language shall be typed,
1108	printed, stamped, or legibly handwritten.
1109	Section 11. Section 440.105, Florida Statutes, is amended
1110	to read:
1111	440.105 Prohibited activities; reports; penalties;
1112	limitations.--
1113	(1)(a) Any insurance carrier, any individual self-insured,
1114	any commercial or group self-insurance fund, any professional
1115	practitioner licensed or regulated by the Department of Health
1116	Business and Professional Regulation, except as otherwise
1117	provided by law, any medical review committee as defined in s.
1118	766.101, any private medical review committee, and any insurer,
1119	agent, or other person licensed under the insurance code, or any
1120	employee thereof, having knowledge or who believes that a
1121	fraudulent act or any other act or practice which, upon
1122	conviction, constitutes a felony or misdemeanor under this
1123	chapter is being or has been committed shall send to the
1124	Division of Insurance Fraud, Bureau of Workers' Compensation
1125	Fraud, a report or information pertinent to such knowledge or
1126	belief and such additional information relative thereto as the
1127	bureau may require. The bureau shall review such information or
1128	reports and select such information or reports as, in its
1129	judgment, may require further investigation. It shall then cause
1130	an independent examination of the facts surrounding such
1131	information or report to be made to determine the extent, if
1132	any, to which a fraudulent act or any other act or practice
1133	which, upon conviction, constitutes a felony or a misdemeanor
1134	under this chapter is being committed. The bureau shall report
1135	any alleged violations of law which its investigations disclose
1136	to the appropriate licensing agency and state attorney or other
1137	prosecuting agency having jurisdiction with respect to any such
1138	violations of this chapter. If prosecution by the state attorney
1139	or other prosecuting agency having jurisdiction with respect to
1140	such violation is not begun within 60 days of the bureau's
1141	report, the state attorney or other prosecuting agency having
1142	jurisdiction with respect to such violation shall inform the
1143	bureau of the reasons for the lack of prosecution.
1144	(b) In the absence of fraud or bad faith, a person is not
1145	subject to civil liability for libel, slander, or any other
1146	relevant tort by virtue of filing reports, without malice, or
1147	furnishing other information, without malice, required by this
1148	section or required by the bureau, and no civil cause of action
1149	of any nature shall arise against such person:
1150	1. For any information relating to suspected fraudulent
1151	acts furnished to or received from law enforcement officials,
1152	their agents, or employees;
1153	2. For any information relating to suspected fraudulent
1154	acts furnished to or received from other persons subject to the
1155	provisions of this chapter; or
1156	3. For any such information relating to suspected
1157	fraudulent acts furnished in reports to the bureau, or the
1158	National Association of Insurance Commissioners.
1159	(2) Whoever violates any provision of this subsection
1160	commits a misdemeanor of the firstseconddegree, punishable as
1161	provided in s. 775.082 or s. 775.083.
1162	(a) It shall be unlawful for any employer to knowingly:
1163	1. Coerce or attempt to coerce, as a precondition to
1164	employment or otherwise, an employee to obtain a certificate of
1165	election of exemption pursuant to s. 440.05.
1166	2. Discharge or refuse to hire an employee or job
1167	applicant because the employee or applicant has filed a claim
1168	for benefits under this chapter.
1169	3. Discharge, discipline, or take any other adverse
1170	personnel action against any employee for disclosing information
1171	to the department or any law enforcement agency relating to any
1172	violation or suspected violation of any of the provisions of
1173	this chapter or rules promulgated hereunder.
1174	4. Violate a stop-work order issued by the department
1175	pursuant to s. 440.107.
1176	(b) It shall be unlawful for any insurance entity to
1177	revoke or cancel a workers' compensation insurance policy or
1178	membership because an employer has returned an employee to work
1179	or hired an employee who has filed a workers' compensation
1180	claim.
1181	(3) Whoever violates any provision of this subsection
1182	commits a misdemeanor of the first degree, punishable as
1183	provided in s. 775.082 or s. 775.083.
1184	(a) It shall be unlawful for any employer to knowingly
1185	fail to update applications for coverage as required by s.
1186	440.381(1) and department of Insurance rules within 7 days after
1187	the reporting date for any change in the required information,
1188	or to post notice of coverage pursuant to s. 440.40.
1189	(b) It shall be unlawful for any employer to knowingly
1190	participate in the creation of the employment relationship in
1191	which the employee has used any false, fraudulent, or misleading
1192	oral or written statement as evidence of identity.
1193	(c)(b)It is unlawful for any attorney or other person, in
1194	his or her individual capacity or in his or her capacity as a
1195	public or private employee, or for any firm, corporation,
1196	partnership, or association to receive any fee or other
1197	consideration or any gratuity from a person on account of
1198	services rendered for a person in connection with any
1199	proceedings arising under this chapter, unless such fee,
1200	consideration, or gratuity is approved by a judge of
1201	compensation claims or by the Deputy Chief Judge of Compensation
1202	Claims.
1203	(4) Whoever violates any provision of this subsection
1204	commits insurance fraud, punishable as provided in paragraph
1205	(f).
1206	(a) It shall be unlawful for any employer to knowingly:
1207	1. Present or cause to be presented any false, fraudulent,
1208	or misleading oral or written statement to any person as
1209	evidence of compliance with s. 440.38.
1210	2. Make a deduction from the pay of any employee entitled
1211	to the benefits of this chapter for the purpose of requiring the
1212	employee to pay any portion of premium paid by the employer to a
1213	carrier or to contribute to a benefit fund or department
1214	maintained by such employer for the purpose of providing
1215	compensation or medical services and supplies as required by
1216	this chapter.
1217	3. Fail to secure payment of compensation if required to
1218	do so by this chapter.
1219	(b) It shall be unlawful for any person:
1220	1. To knowingly make, or cause to be made, any false,
1221	fraudulent, or misleading oral or written statement for the
1222	purpose of obtaining or denying any benefit or payment under
1223	this chapter.
1224	2. To present or cause to be presented any written or oral
1225	statement as part of, or in support of, a claim for payment or
1226	other benefit pursuant to any provision of this chapter, knowing
1227	that such statement contains any false, incomplete, or
1228	misleading information concerning any fact or thing material to
1229	such claim.
1230	3. To prepare or cause to be prepared any written or oral
1231	statement that is intended to be presented to any employer,
1232	insurance company, or self-insured program in connection with,
1233	or in support of, any claim for payment or other benefit
1234	pursuant to any provision of this chapter, knowing that such
1235	statement contains any false, incomplete, or misleading
1236	information concerning any fact or thing material to such claim.
1237	4. To knowingly assist, conspire with, or urge any person
1238	to engage in activity prohibited by this section.
1239	5. To knowingly make any false, fraudulent, or misleading
1240	oral or written statement, or to knowingly omit or conceal
1241	material information, required by s. 440.185 or s. 440.381, for
1242	the purpose of obtaining workers' compensation coverage or for
1243	the purpose of avoiding, delaying, or diminishing the amount of
1244	payment of any workers' compensation premiums.
1245	6. To knowingly misrepresent or conceal payroll,
1246	classification of workers, or information regarding an
1247	employer's loss history which would be material to the
1248	computation and application of an experience rating modification
1249	factor for the purpose of avoiding or diminishing the amount of
1250	payment of any workers' compensation premiums.
1251	7. To knowingly present or cause to be presented any
1252	false, fraudulent, or misleading oral or written statement to
1253	any person as evidence of compliance with s. 440.38, as evidence
1254	of eligibility for a certificate of exemption under s. 440.05.
1255	8. To knowingly violate a stop-work order issued by the
1256	department pursuant to s. 440.107.
1257	9. To knowingly present or cause to be presented any
1258	false, fraudulent, or misleading oral or written statement to
1259	any person as evidence of identity for the purpose of obtaining
1260	employment or filing or supporting a claim for workers'
1261	compensation benefits.
1262	(c) It shall be unlawful for any physician licensed under
1263	chapter 458, osteopathic physician licensed under chapter 459,
1264	chiropractic physician licensed under chapter 460, podiatric
1265	physician licensed under chapter 461, optometric physician
1266	licensed under chapter 463, or any other practitioner licensed
1267	under the laws of this state to knowingly and willfully assist,
1268	conspire with, or urge any person to fraudulently violate any of
1269	the provisions of this chapter.
1270	(d) It shall be unlawful for any person or governmental
1271	entity licensed under chapter 395 to maintain or operate a
1272	hospital in such a manner so that such person or governmental
1273	entity knowingly and willfully allows the use of the facilities
1274	of such hospital by any person, in a scheme or conspiracy to
1275	fraudulently violate any of the provisions of this chapter.
1276	(e) It shall be unlawful for any attorney or other person,
1277	in his or her individual capacity or in his or her capacity as a
1278	public or private employee, or any firm, corporation,
1279	partnership, or association, to knowingly assist, conspire with,
1280	or urge any person to fraudulently violate any of the provisions
1281	of this chapter.
1282	(f) If the monetary valueamount of any claim or workers'
1283	compensation insurance premium involved in anyviolation of this
1284	subsection:
1285	1. Is less than $20,000, the offender commits a felony of
1286	the third degree, punishable as provided in s. 775.082, s.
1287	775.083, or s. 775.084.
1288	2. Is $20,000 or more, but less than $100,000, the
1289	offender commits a felony of the second degree, punishable as
1290	provided in s. 775.082,. 775.083, or s. 775.084.
1291	3. Is $100,000 or more, the offender commits a felony of
1292	the first degree, punishable as provided in s. 775.082, s.
1293	775.083, or s. 775.084.
1294	(5) It shall be unlawful for any attorney or other person,
1295	in his or her individual capacity or in his or her capacity as a
1296	public or private employee or for any firm, corporation,
1297	partnership, or association, to unlawfully solicit any business
1298	in and about city or county hospitals, courts, or any public
1299	institution or public place; in and about private hospitals or
1300	sanitariums; in and about any private institution; or upon
1301	private property of any character whatsoever for the purpose of
1302	making workers' compensation claims. Whoever violates any
1303	provision of this subsection commits a felony of the second
1304	thirddegree, punishable as provided in s. 775.082, s. 775.083,
1305	or s. 775.085.
1306	(6) This section shall not be construed to preclude the
1307	applicability of any other provision of criminal law that
1308	applies or may apply to any transaction.
1309	(7) For the purpose of the section, the term "statement"
1310	includes, but is not limited to, any notice, representation,
1311	statement, proof of injury, bill for services, diagnosis,
1312	prescription, hospital or doctor records, X ray, test result, or
1313	other evidence of loss, injury, or expense.
1314	(7)(8)An injured employee or any other party making a
1315	claim under this chapter shall provide his or her personal
1316	signature attesting that he or she has reviewed, understands,
1317	and acknowledgesAll claim forms as provided for in this chapter
1318	shall contain a notice that clearly states in substancethe
1319	following statement: "Any person who, knowingly and with intent
1320	to injure, defraud, or deceive any employer or employee,
1321	insurance company, or self-insured program, files a statement of
1322	claim containing any false or misleading information commits
1323	insurance fraud, punishable as provided in s. 817.234." If the
1324	injured employee or other party refuses to sign the document
1325	attestingEach claimant shall personally sign the claim form and
1326	attestthat he or she has reviewed, understands, and
1327	acknowledges the statement, benefits or payments under this
1328	chapter shall be suspended until such signature is obtained
1329	foregoing notice.
1330	Section 12. Subsection (3) of section 440.1051, Florida
1331	Statutes, is amended to read:
1332	440.1051 Fraud reports; civil immunity; criminal
1333	penalties.--
1334	(2) Any person who reports workers' compensation fraud to
1335	the division under subsection (1) is immune from civil liability
1336	for doing so, and the person or entity alleged to have committed
1337	the fraud may not retaliate against him or her for providing
1338	such report, unless the person making the report knows it to be
1339	false.
1340	(3) A person who calls and, knowingly and falsely, reports
1341	workers' compensation fraud or who, in violation of subsection
1342	(2) retaliates against a person for making such report, commits
1343	is guilty of a felonymisdemeanor of the thirdfirstdegree,
1344	punishable as provided in s. 775.082,or s. 775.083, or s.
1345	775.084both.
1346	Section 13. Section 440.107, Florida Statutes, is amended
1347	to read:
1348	440.107 Department powers to enforce employer compliance
1349	with coverage requirements.--
1350	(1) The Legislature finds that the failure of an employer
1351	to comply with the workers' compensation coverage requirements
1352	under this chapter poses an immediate danger to public health,
1353	safety, and welfare. The Legislature authorizes the department
1354	to secure employer compliance with the workers' compensation
1355	coverage requirements and authorizes the department to conduct
1356	investigations for the purpose of ensuring employer compliance.
1357	(2) For the purposes of this section, "securing the
1358	payment of workers' compensation" means obtaining coverage that
1359	meets the requirements of this chapter and the Florida Insurance
1360	Code. However, if at any time an employer materially understates
1361	or conceals payroll, materially misrepresents or conceals
1362	employee duties so as to avoid proper classification for premium
1363	calculations, or materially misrepresents or conceals
1364	information pertinent to the computation and application of an
1365	experience rating modification factor, such employer shall be
1366	deemed to have failed to secure payment of workers' compensation
1367	and shall be subject to the sanctions set forth in this section.
1368	A stop-work order issued because an employer is deemed to have
1369	failed to secure the payment of workers' compensation required
1370	under this chapter because the employer has materially
1371	understated or concealed payroll, materially misrepresented or
1372	concealed employee duties so as to avoid proper classification
1373	for premium calculations, or materially misrepresented or
1374	concealed information pertinent to the computation and
1375	application of an experience rating modification factor shall
1376	have no effect upon an employer's or carrier's duty to provide
1377	benefits under this chapter or upon any of the employer's or
1378	carrier's rights and defenses under this chapter, including
1379	exclusive remedy.The department and its authorized
1380	representatives may enter and inspect any place of business at
1381	any reasonable time for the limited purpose of investigating
1382	compliance with workers' compensation coverage requirements
1383	under this chapter. Each employer shall keep true and accurate
1384	business records that contain such information as the department
1385	prescribes by rule. The business records must contain
1386	information necessary for the department to determine compliance
1387	with workers' compensation coverage requirements and must be
1388	maintained within this state by the business, in such a manner
1389	as to be accessible within a reasonable time upon request by the
1390	department. The business records must be open to inspection and
1391	be available for copying by the department at any reasonable
1392	time and place and as often as necessary. The department may
1393	require from any employer any sworn or unsworn reports,
1394	pertaining to persons employed by that employer, deemed
1395	necessary for the effective administration of the workers'
1396	compensation coverage requirements.
1397	(3) The department shall enforce workers' compensation
1398	coverage requirements, including the requirement that the
1399	employer secure the payment of workers' compensation, and the
1400	requirement that the employer provide the carrier with
1401	information to accurately determine payroll and correctly assign
1402	classification codes. In addition to any other powers under this
1403	chapter, the department shall have the power to:
1404	(a) Conduct investigations for the purpose of ensuring
1405	employer compliance.
1406	(b) Enter and inspect any place of business at any
1407	reasonable time for the purpose of investigating employer
1408	compliance.
1409	(c) Examine and copy business records.
1410	(d) Administer oaths and affirmations.
1411	(e) Certify to official acts.
1412	(f) Issue and serve subpoenas for attendance of witnesses
1413	or production of business records, books, papers,
1414	correspondence, memoranda, and other records.
1415	(g) Issue stop-work orders, penalty assessment orders, and
1416	any other orders necessary for the administration of this
1417	section.
1418	(h) Enforce the terms of a stop-work order.
1419	(i) Levy and pursue actions to recover penalties.
1420	(j) Seek injunctions and other appropriate relief.In
1421	discharging its duties, the department may administer oaths and
1422	affirmations, certify to official acts, issue subpoenas to
1423	compel the attendance of witnesses and the production of books,
1424	papers, correspondence, memoranda, and other records deemed
1425	necessary by the department as evidence in order to ensure
1426	proper compliance with the coverage provisions of this chapter.
1427	(4) The department shall designate representatives who may
1428	serve subpoenas and other process of the department issued under
1429	this section.
1430	(5) The department shall specify by rule the business
1431	records that employers must maintain and produce to comply with
1432	this section.
1433	(6)(4)If a person has refused to obey a subpoena to
1434	appear before the department or its authorized representative or
1435	andproduce evidence requested by the department or to give
1436	testimony about the matter that is under investigation, a court
1437	has jurisdiction to issue an order requiring compliance with the
1438	subpoena if the court has jurisdiction in the geographical area
1439	where the inquiry is being carried on or in the area where the
1440	person who has refused the subpoena is found, resides, or
1441	transacts business. Failure to obey such a court order may be
1442	punished by the court as contempt, either civilly or criminally.
1443	Costs, including reasonable attorney's fees, incurred by the
1444	department to obtain an order granting, in whole or in part, a
1445	petition to enforce a subpoena or a subpoena duces tecum shall
1446	be taxed against the subpoenaed party.
1447	(7)(a)(5)Whenever the department determines that an
1448	employer who is required to secure the payment to his or her
1449	employees of the compensation provided for by this chapter has
1450	failed to secure the payment of workers' compensation required
1451	by this chapter or to produce the required business records
1452	under subsection (5) within 5 business days after receipt of the
1453	written request of the departmentdo so, such failure shall be
1454	deemed an immediate serious danger to public health, safety, or
1455	welfare sufficient to justify service by the department of a
1456	stop-work order on the employer, requiring the cessation of all
1457	business operations at the place of employment or job site. If
1458	the departmentdivision makes such a determination, the
1459	departmentdivisionshall issue a stop-work order within 72
1460	hours. The order shall take effect when served upon the date of
1461	service upon the employer or, for a particular employer work
1462	site, when served at that work site, unless the employer
1463	provides evidence satisfactory to the department of having
1464	secured any necessary insurance or self-insurance and pays a
1465	civil penalty to the department, to be deposited by the
1466	department into the Workers' Compensation Administration Trust
1467	Fund, in the amount of $100 per day for each day the employer
1468	was not in compliance with this chapter. In addition to serving
1469	a stop-work order at a particular work site which shall be
1470	effective immediately, the department shall immediately proceed
1471	with service upon the employer which shall be effective upon all
1472	employer work sites in the state for which the employer is not
1473	in compliance. A stop-work order may be served with regard to an
1474	employer’s work site by posting a copy of the stop-work order in
1475	a conspicuous location at the work site. The order shall remain
1476	in effect until the department issues an order releasing the
1477	stop-work order upon a finding that the employer has come into
1478	compliance with the coverage requirements of this chapter and
1479	has paid any penalty assessed under this section. The department
1480	may require an employer who is found to have failed to comply
1481	with the coverage requirements of s. 440.38 to file with the
1482	department, as a condition of release from a stop-work order,
1483	periodic reports for a probationary period that shall not exceed
1484	2 years that demonstrate the employer’s continued compliance
1485	with this chapter. The department shall by rule specify the
1486	reports required and the time for filing under this subsection.
1487	(b) Stop-work orders and penalty assessment orders issued
1488	under this section against a corporation, partnership, or sole
1489	proprietorship shall be in effect against any successor
1490	corporation or business entity that has one or more of the same
1491	principals or officers as the corporation or partnership against
1492	which the stop-work order was issued and are engaged in the same
1493	or equivalent trade or activity.
1494	(c) The department shall assess a penalty of $1,000 per
1495	day against an employer for each day that the employer conducts
1496	business operations that are in violation of a stop-work order.
1497	(d)1. In addition to any penalty, stop-work order, or
1498	injunction, the department shall assess against any employer who
1499	has failed to secure the payment of compensation as required by
1500	this chapter a penalty equal to 1.5 times the amount the
1501	employer would have paid in premium when applying approved
1502	manual rates to the employer's payroll during periods for which
1503	it failed to secure the payment of workers' compensation
1504	required by this chapter within the preceding 3-year period or
1505	$1,000, whichever is greater.
1506	2. Any subsequent violation within 5 years after the most
1507	recent violation shall, in addition to the penalties set forth
1508	in this subsection, be deemed a knowing act within the meaning
1509	of s. 440.105.
1510	(e) When an employer fails to provide business records
1511	sufficient to enable the department to determine the employer's
1512	payroll for the period requested for the calculation of the
1513	penalty provided in paragraph (d), for penalty calculation
1514	purposes, the imputed weekly payroll for each employee,
1515	corporate officer, sole proprietor, or partner shall be the
1516	statewide average weekly wage as defined in s. 440.12(2)
1517	multiplied by 1.5.
1518	(f) In addition to any other penalties provided for in
1519	this chapter, the department may assess against the employer a
1520	penalty of $5,000 for each employee of that employer who the
1521	employer represents to the department or carrier as an
1522	independent contractor but who is determined by the department
1523	not to be an independent contractor as defined in s. 440.02.
1524	(8)(6)In addition to the issuance of a stop-work order
1525	under subsection (7),the department may file a complaint in the
1526	circuit court in and for Leon County to enjoin any employer,who
1527	has failed to secure the payment of workers' compensation as
1528	required by this chapter,from employing individuals and from
1529	conducting business until the employer presents evidence
1530	satisfactory to the department of having secured the payment of
1531	workers'for compensation required by this chapterand pays a
1532	civil penalty assessed byto the department under this section,
1533	to be deposited by the department into the Workers' Compensation
1534	Administration Trust Fund, in the amount of $100 per day for
1535	each day the employer was not in compliance with this chapter.
1536	(9)(7) In addition to any penalty, stop-work order, or
1537	injunction, the department shall assess against any employer,
1538	who has failed to secure the payment of compensation as required
1539	by this chapter, a penalty in the following amount:
1540	(a) An amount equal to at least the amount that the
1541	employer would have paid or up to twice the amount the employer
1542	would have paid during periods it illegally failed to secure
1543	payment of compensation in the preceding 3-year period based on
1544	the employer's payroll during the preceding 3-year period; or
1545	(b) One thousand dollars, whichever is greater. Any
1546	penalty assessed under this subsection is due within 30 days
1547	after the date on which the employer is notified, except that,
1548	if the department has posted a stop-work order or obtained
1549	injunctive relief against the employer, payment is due, in
1550	addition to those conditions set forth in this section, as a
1551	condition to relief from a stop-work order or an injunction.
1552	Interest shall accrue on amounts not paid when due at the rate
1553	of 1 percent per month. The departmentdivisionshall adopt
1554	rules to administer this section.
1555	(10)(8)The department may bring an action in circuit
1556	court to recover penalties assessed under this section,
1557	including any interest owed to the department pursuant to this
1558	section. In any action brought by the department pursuant to
1559	this section in which it prevails, the circuit court shall award
1560	costs, including the reasonable costs of investigation and a
1561	reasonable attorney's fee.
1562	(11)(9)Any judgment obtained by the department and any
1563	penalty due pursuant to the service of a stop-work order or
1564	otherwise due under this section shall, until collected,
1565	constitute a lien upon the entire interest of the employer,
1566	legal or equitable, in any property, real or personal, tangible
1567	or intangible; however, such lien is subordinate to claims for
1568	unpaid wages and any prior recorded liens, and a lien created by
1569	this section is not valid against any person who, subsequent to
1570	such lien and in good faith and for value, purchases real or
1571	personal property from such employer or becomes the mortgagee on
1572	real or personal property of such employer, or against a
1573	subsequent attaching creditor, unless, with respect to real
1574	estate of the employer, a notice of the lien is recorded in the
1575	public records of the county where the real estate is located,
1576	and with respect to personal property of the employer, the
1577	notice is recorded with the Secretary of State.
1578	(12)(10)Any law enforcement agency in the state may, at
1579	the request of the department, render any assistance necessary
1580	to carry out the provisions of this section, including, but not
1581	limited to, preventing any employee or other person from
1582	remaining at a place of employment or job site after a stop-work
1583	order or injunction has taken effect.
1584	(13)(11)Agency actionActionsby the department under
1585	this section, if contested,must be contested as provided in
1586	chapter 120. All civilpenalties assessed by the department must
1587	be paid into the Workers' Compensation Administration Trust
1588	Fund. The department shall return any sums previously paid, upon
1589	conclusion of an action, if the department fails to prevail and
1590	if so directed by an order of court or an administrative hearing
1591	officer. The requirements of this subsection may be met by
1592	posting a bond in an amount equal to twice the penalty and in a
1593	form approved by the department.
1594	(14)(12) If the departmentdivisionfinds that an employer
1595	who is certified or registered under part I or part II of
1596	chapter 489 and who is required to secure the payment of
1597	workers'the compensation underprovided for bythis chapter to
1598	his or her employees has failed to do so, the department
1599	divisionshall immediately notify the Department of Business and
1600	Professional Regulation.
1601	Section 14. Subsections (1) and (3) of section 440.11,
1602	Florida Statutes, are amended to read:
1603	440.11 Exclusiveness of liability.--
1604	(1) The liability of an employer prescribed in s. 440.10
1605	shall be exclusive and in place of all other liability,
1606	including vicarious liability,of such employer to any third-
1607	party tortfeasor and to the employee, the legal representative
1608	thereof, husband or wife, parents, dependents, next of kin, and
1609	anyone otherwise entitled to recover damages from such employer
1610	at law or in admiralty on account of such injury or death,
1611	except as follows:that
1612	(a)If an employer fails to secure payment of compensation
1613	as required by this chapter, an injured employee, or the legal
1614	representative thereof in case death results from the injury,
1615	may elect to claim compensation under this chapter or to
1616	maintain an action at law or in admiralty for damages on account
1617	of such injury or death. In such action the defendant may not
1618	plead as a defense that the injury was caused by negligence of a
1619	fellow employee, that the employee assumed the risk of the
1620	employment, or that the injury was due to the comparative
1621	negligence of the employee.
1622	(b) When an employer commits an intentional tort that
1623	causes the injury or death of the employee. For purposes of this
1624	paragraph, an employer's actions shall be deemed to constitute
1625	an intentional tort and not an accident only when the employee
1626	proves, by clear and convincing evidence, that:
1627	1. The employer deliberately intended to injure the
1628	employee; or
1629	2. The employer engaged in conduct that the employer knew,
1630	based on prior similar accidents or on explicit warnings
1631	specifically identifying a known danger, was virtually certain
1632	to result in injury or death to the employee, and the employee
1633	was not aware of the risk because the danger was not apparent
1634	and the employer deliberately concealed or misrepresented the
1635	danger so as to prevent the employee from exercising informed
1636	judgment about whether to perform the work.
1637
1638	The same immunities from liability enjoyed by an employer shall
1639	extend as well to each employee of the employer when such
1640	employee is acting in furtherance of the employer's business and
1641	the injured employee is entitled to receive benefits under this
1642	chapter. Such fellow-employee immunities shall not be applicable
1643	to an employee who acts, with respect to a fellow employee, with
1644	willful and wanton disregard or unprovoked physical aggression
1645	or with gross negligence when such acts result in injury or
1646	death or such acts proximately cause such injury or death, nor
1647	shall such immunities be applicable to employees of the same
1648	employer when each is operating in the furtherance of the
1649	employer's business but they are assigned primarily to unrelated
1650	works within private or public employment. The same immunity
1651	provisions enjoyed by an employer shall also apply to any sole
1652	proprietor, partner, corporate officer or director, supervisor,
1653	or other person who in the course and scope of his or her duties
1654	acts in a managerial or policymaking capacity and the conduct
1655	which caused the alleged injury arose within the course and
1656	scope of said managerial or policymaking duties and was not a
1657	violation of a law, whether or not a violation was charged, for
1658	which the maximum penalty which may be imposed does not exceed
1659	60 days' imprisonment as set forth in s. 775.082. The immunity
1660	from liability provided in this subsection extends to county
1661	governments with respect to employees of county constitutional
1662	officers whose offices are funded by the board of county
1663	commissioners.
1664	(3) An employer's workers' compensation carrier, service
1665	agent, or safety consultant shall not be liable as a third-party
1666	tortfeasor to employees of the employer or employees of its
1667	subcontractors for assisting the employer and its
1668	subcontractors, if any,in carrying out the employer's rights
1669	and responsibilities under this chapter by furnishing any safety
1670	inspection, safety consultative service, or other safety service
1671	incidental to the workers' compensation or employers' liability
1672	coverage or to the workers' compensation or employer's liability
1673	servicing contract. Without limitation, a safety consultant may
1674	include an owner, as defined in chapter 713, or an owner's
1675	related, affiliated, or subsidiary companies and the employees
1676	of each.The exclusion from liability under this subsection
1677	shall not apply in any case in which injury or death is
1678	proximately caused by the willful and unprovoked physical
1679	aggression, or by the negligent operation of a motor vehicle, by
1680	employees, officers, or directors of the employer's workers'
1681	compensation carrier, service agent, or safety consultant.
1682	Section 15. Section 440.13, Florida Statutes, is amended
1683	to read:
1684	440.13 Medical services and supplies; penalty for
1685	violations; limitations.--
1686	(1) DEFINITIONS.--As used in this section, the term:
1687	(a) "Alternate medical care" means a change in treatment
1688	or health care provider.
1689	(b) "Attendant care" means care rendered by trained
1690	professional attendants which is beyond the scope of household
1691	duties. Family members may provide nonprofessional attendant
1692	care, but may not be compensated under this chapter for care
1693	that falls within the scope of household duties and other
1694	services normally and gratuitously provided by family members.
1695	"Family member" means a spouse, father, mother, brother, sister,
1696	child, grandchild, father-in-law, mother-in-law, aunt, or uncle.
1697	(c) "Carrier" means, for purposes of this section,
1698	insurance carrier, self-insurance fund or individually self-
1699	insured employer, or assessable mutual insurer.
1700	(d) "Catastrophic injury" means an injury as defined in s.
1701	440.02.
1702	(d)(e)"Certified health care provider" means a health
1703	care provider who has been certified by the agency or who has
1704	entered an agreement with a licensed managed care organization
1705	to provide treatment to injured workers under this section.
1706	Certification of such health care provider must include
1707	documentation that the health care provider has read and is
1708	familiar with the portions of the statute, impairment guides,
1709	practice parameters, protocols of treatment,and rules which
1710	govern the provision of remedial treatment, care, and
1711	attendance.
1712	(e)(f)"Compensable" means a determination by a carrier or
1713	judge of compensation claims that a condition suffered by an
1714	employee results from an injury arising out of and in the course
1715	of employment.
1716	(f)(g)"Emergency services and care" means emergency
1717	services and care as defined in s. 395.002.
1718	(g)(h)"Health care facility" means any hospital licensed
1719	under chapter 395 and any health care institution licensed under
1720	chapter 400.
1721	(h)(i)"Health care provider" means a physician or any
1722	recognized practitioner who provides skilled services pursuant
1723	to a prescription or under the supervision or direction of a
1724	physician and who has been certified by the agency as a health
1725	care provider. The term "health care provider" includes a health
1726	care facility.
1727	(i)(j)"Independent medical examiner" means a physician
1728	selected by either an employee or a carrier to render one or
1729	more independent medical examinations in connection with a
1730	dispute arising under this chapter.
1731	(j)(k)"Independent medical examination" means an
1732	objective evaluation of the injured employee's medical
1733	condition, including, but not limited to, impairment or work
1734	status, performed by a physician or an expert medical advisor at
1735	the request of a party, a judge of compensation claims, or the
1736	agency to assist in the resolution of a dispute arising under
1737	this chapter.
1738	(k)(l)"Instance of overutilization" means a specific
1739	inappropriate service or level of service provided to an injured
1740	employee that includes the provision of treatment in excess of
1741	established practice parameters and protocols of treatment
1742	established in accordance with this chapter.
1743	(l)(m) "Medically necessary" or "medical necessity"means
1744	any medical service or medical supply which is used to identify
1745	or treat an illness or injury, is appropriate to the patient's
1746	diagnosis and status of recovery, and is consistent with the
1747	location of service, the level of care provided, and applicable
1748	practice parameters. The service should be widely accepted among
1749	practicing health care providers, based on scientific criteria,
1750	and determined to be reasonably safe. The service must not be of
1751	an experimental, investigative, or research nature, except in
1752	those instances in which prior approval of the Agency for Health
1753	Care Administration has been obtained. The Agency for Health
1754	Care Administration shall adopt rules providing for such
1755	approval on a case-by-case basis when the service or supply is
1756	shown to have significant benefits to the recovery and well-
1757	being of the patient.
1758	(m)(n)"Medicine" means a drug prescribed by an authorized
1759	health care provider and includes only generic drugs or single-
1760	source patented drugs for which there is no generic equivalent,
1761	unless the authorized health care provider writes or states that
1762	the brand-name drug as defined in s. 465.025 is medically
1763	necessary, or is a drug appearing on the schedule of drugs
1764	created pursuant to s. 465.025(6), or is available at a cost
1765	lower than its generic equivalent.
1766	(n)(o)"Palliative care" means noncurative medical
1767	services that mitigate the conditions, effects, or pain of an
1768	injury.
1769	(o)(p)"Pattern or practice of overutilization" means
1770	repetition of instances of overutilization within a specific
1771	medical case or multiple cases by a single health care provider.
1772	(p)(q)"Peer review" means an evaluation by two or more
1773	physicians licensed under the same authority and with the same
1774	or similar specialty as the physician under review, of the
1775	appropriateness, quality, and cost of health care and health
1776	services provided to a patient, based on medically accepted
1777	standards.
1778	(q)(r)"Physician" or "doctor" means a physician licensed
1779	under chapter 458, an osteopathic physician licensed under
1780	chapter 459, a chiropractic physician licensed under chapter
1781	460, a podiatric physician licensed under chapter 461, an
1782	optometrist licensed under chapter 463, or a dentist licensed
1783	under chapter 466, each of whom must be certified by the agency
1784	as a health care provider.
1785	(r)(s)"Reimbursement dispute" means any disagreement
1786	between a health care provider or health care facility and
1787	carrier concerning payment for medical treatment.
1788	(s)(t)"Utilization control" means a systematic process of
1789	implementing measures that assure overall management and cost
1790	containment of services delivered, including compliance with
1791	practice parameters and protocols of treatment as provided for
1792	in this chapter.
1793	(t)(u)"Utilization review" means the evaluation of the
1794	appropriateness of both the level and the quality of health care
1795	and health services provided to a patient, including, but not
1796	limited to, evaluation of the appropriateness of treatment,
1797	hospitalization, or office visits based on medically accepted
1798	standards. Such evaluation must be accomplished by means of a
1799	system that identifies the utilization of medical services based
1800	on practice parameters and protocols of treatment as provided
1801	for in this chaptermedically accepted standards as established
1802	by medical consultants with qualifications similar to those
1803	providing the care under review, and that refers patterns and
1804	practices of overutilization to the agency.
1805	(2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.--
1806	(a) Subject to the limitations specified elsewhere in this
1807	chapter, the employer shall furnish to the employee such
1808	medically necessary remedial treatment, care, and attendance for
1809	such period as the nature of the injury or the process of
1810	recovery may require, which is in accordance with established
1811	practice parameters and protocols of treatment as provided for
1812	in this chapter, including medicines, medical supplies, durable
1813	medical equipment, orthoses, prostheses, and other medically
1814	necessary apparatus. Remedial treatment, care, and attendance,
1815	including work-hardening programs or pain-management programs
1816	accredited by the Commission on Accreditation of Rehabilitation
1817	Facilities or Joint Commission on the Accreditation of Health
1818	Organizations or pain-management programs affiliated with
1819	medical schools, shall be considered as covered treatment only
1820	when such care is given based on a referral by a physician as
1821	defined in this chapter. Each facility shall maintain outcome
1822	data, including work status at discharges, total program
1823	charges, total number of visits, and length of stay. The
1824	department shall utilize such data and report to the President
1825	of the Senate and the Speaker of the House of Representatives
1826	regarding the efficacy and cost-effectiveness of such program,
1827	no later than October 1, 1994.Medically necessary treatment,
1828	care, and attendance does not include chiropractic services in
1829	excess of 2418 treatments or rendered 128weeks beyond the
1830	date of the initial chiropractic treatment, whichever comes
1831	first, unless the carrier authorizes additional treatment or the
1832	employee is catastrophically injured.
1833	(b) The employer shall provide appropriate professional or
1834	nonprofessional attendant care performed only at the direction
1835	and control of a physician when such care is medically
1836	necessary. The physician shall prescribe such care in writing.
1837	The employer or carrier shall not be responsible for such care
1838	until the prescription for attendant care is received by the
1839	employer and carrier, which shall specify the time periods for
1840	such care, the level of care required, and the type of
1841	assistance required. A prescription for attendant care shall not
1842	prescribe such care retroactively.The value of nonprofessional
1843	attendant care provided by a family member must be determined as
1844	follows:
1845	1. If the family member is not employed or if the family
1846	member is employed and is providing attendant care services
1847	during hours that he or she is not engaged in employment, the
1848	per-hour value equals the federal minimum hourly wage.
1849	2. If the family member is employed and elects to leave
1850	that employment to provide attendant or custodial care, the per-
1851	hour value of that care equals the per-hour value of the family
1852	member's former employment, not to exceed the per-hour value of
1853	such care available in the community at large. A family member
1854	or a combination of family members providing nonprofessional
1855	attendant care under this paragraph may not be compensated for
1856	more than a total of 12 hours per day.
1857	3. If the family member remains employed while providing
1858	attendant or custodial care, the per-hour value of that care
1859	equals the per-hour value of the family member's employment, not
1860	to exceed the per-hour value of such care available in the
1861	community at large.
1862	(c) If the employer fails to provide initialtreatment or
1863	care required by this section after request by the injured
1864	employee, the employee may obtain such initialtreatment at the
1865	expense of the employer, if the initial treatment or careis
1866	compensable and medically necessary and is in accordance with
1867	established practice parameters and protocols of treatment as
1868	provided for in this chapter. There must be a specific request
1869	for the initial treatment or care, and the employer or carrier
1870	must be given a reasonable time period within which to provide
1871	the initialtreatment or care. However, the employee is not
1872	entitled to recover any amount personally expended for the
1873	initial treatment or careserviceunless he or she has requested
1874	the employer to furnish that initialtreatment or service and
1875	the employer has failed, refused, or neglected to do so within a
1876	reasonable time or unless the nature of the injury requires such
1877	initialtreatment, nursing, and services and the employer or his
1878	or her superintendent or foreman, having knowledge of the
1879	injury, has neglected to provide the initial treatment or care
1880	service.
1881	(d) The carrier has the right to transfer the care of an
1882	injured employee from the attending health care provider if an
1883	independent medical examination determines that the employee is
1884	not making appropriate progress in recuperation.
1885	(e) Except in emergency situations and for treatment
1886	rendered by a managed care arrangement, after any initial
1887	examination and diagnosis by a physician providing remedial
1888	treatment, care, and attendance, and before a proposed course of
1889	medical treatment begins, each insurer shall review, in
1890	accordance with the requirements of this chapter, the proposed
1891	course of treatment, to determine whether such treatment would
1892	be recognized as reasonably prudent. The review must be in
1893	accordance with all applicable workers' compensation practice
1894	parameters and protocols of treatment established in accordance
1895	with this chapter. The insurer must accept any such proposed
1896	course of treatment unless the insurer notifies the physician of
1897	its specific objections to the proposed course of treatment by
1898	the close of the tenth business day after notification by the
1899	physician, or a supervised designee of the physician, of the
1900	proposed course of treatment.
1901	(f) Upon the written request of the employee, the carrier
1902	shall give the employee the opportunity for one change of
1903	physician during the course of treatment for any one accident.
1904	Upon the granting of a change of physician, the originally
1905	authorized physician in the same specialty as the changed
1906	physician shall become deauthorized upon written notification by
1907	the employer or carrier. The carrier shall authorize an
1908	alternative physician who shall not be professionally affiliated
1909	with the previous physician within 5 days after receipt of the
1910	request. If the carrier fails to provide a change of physician
1911	as requested by the employee, the employee may select the
1912	physician and such physician shall be considered authorized if
1913	the treatment being provided is compensable and medically
1914	necessary.
1915
1916	Failure of the carrier to timely comply with this subsection
1917	shall be a violation of this chapter and the carrier shall be
1918	subject to penalties as provided for in s. 440.525.The employee
1919	shall be entitled to select another physician from among not
1920	fewer than three carrier-authorized physicians who are not
1921	professionally affiliated.
1922	(3) PROVIDER ELIGIBILITY; AUTHORIZATION.--
1923	(a) As a condition to eligibility for payment under this
1924	chapter, a health care provider who renders services must be a
1925	certified health care provider and must receive authorization
1926	from the carrier before providing treatment. This paragraph does
1927	not apply to emergency care. The agency shall adopt rules to
1928	implement the certification of health care providers.
1929	(b) A health care provider who renders emergency care must
1930	notify the carrier by the close of the third business day after
1931	it has rendered such care. If the emergency care results in
1932	admission of the employee to a health care facility, the health
1933	care provider must notify the carrier by telephone within 24
1934	hours after initial treatment. Emergency care is not compensable
1935	under this chapter unless the injury requiring emergency care
1936	arose as a result of a work-related accident. Pursuant to
1937	chapter 395, all licensed physicians and health care providers
1938	in this state shall be required to make their services available
1939	for emergency treatment of any employee eligible for workers'
1940	compensation benefits. To refuse to make such treatment
1941	available is cause for revocation of a license.
1942	(c) A health care provider may not refer the employee to
1943	another health care provider, diagnostic facility, therapy
1944	center, or other facility without prior authorization from the
1945	carrier, except when emergency care is rendered. Any referral
1946	must be to a health care provider that has been certified by the
1947	agency, unless the referral is for emergency treatment, and the
1948	referral must be made in accordance with practice parameters and
1949	protocols of treatment as provided for in this chapter.
1950	(d) A carrier must respond, by telephone or in writing, to
1951	a request for authorization from an authorized health care
1952	providerby the close of the third business day after receipt of
1953	the request. A carrier who fails to respond to a written request
1954	for authorization for referral for medical treatment by the
1955	close of the third business day after receipt of the request
1956	consents to the medical necessity for such treatment. All such
1957	requests must be made to the carrier. Notice to the carrier does
1958	not include notice to the employer.
1959	(e) Carriers shall adopt procedures for receiving,
1960	reviewing, documenting, and responding to requests for
1961	authorization. Such procedures shall be for a health care
1962	provider certified under this section.
1963	(f) By accepting payment under this chapter for treatment
1964	rendered to an injured employee, a health care provider consents
1965	to the jurisdiction of the agency as set forth in subsection
1966	(11) and to the submission of all records and other information
1967	concerning such treatment to the agency in connection with a
1968	reimbursement dispute, audit, or review as provided by this
1969	section. The health care provider must further agree to comply
1970	with any decision of the agency rendered under this section.
1971	(g) The employee is not liable for payment for medical
1972	treatment or services provided pursuant to this section except
1973	as otherwise provided in this section.
1974	(h) The provisions of s. 456.053 are applicable to
1975	referrals among health care providers, as defined in subsection
1976	(1), treating injured workers.
1977	(i) Notwithstanding paragraph (d), a claim for specialist
1978	consultations, surgical operations, physiotherapeutic or
1979	occupational therapy procedures, X-ray examinations, or special
1980	diagnostic laboratory tests that cost more than $1,000 and other
1981	specialty services that the agency identifies by rule is not
1982	valid and reimbursable unless the services have been expressly
1983	authorized by the carrier, or unless the carrier has failed to
1984	respond within 10 days to a written request for authorization,
1985	or unless emergency care is required. The insurer shall not
1986	refuse toauthorize such consultation or procedure unless the
1987	health care provider or facility is not authorized or certified,
1988	unless such treatment is not in accordance with practice
1989	parameters and protocols of treatment established in this
1990	chapter, or unless a judge of compensation claimsan expert
1991	medical advisorhas determined that the consultation or
1992	procedure is not medically necessary, not in accordance with the
1993	practice parameters and protocols of treatment established in
1994	this chapter, or otherwise notcompensable under this chapter.
1995	Authorization of a treatment plan does not constitute express
1996	authorization for purposes of this section, except to the extent
1997	the carrier provides otherwise in its authorization procedures.
1998	This paragraph does not limit the carrier's obligation to
1999	identify and disallow overutilization or billing errors.
2000	(j) Notwithstanding anything in this chapter to the
2001	contrary, a sick or injured employee shall be entitled, at all
2002	times, to free, full, and absolute choice in the selection of
2003	the pharmacy or pharmacist dispensing and filling prescriptions
2004	for medicines required under this chapter. It is expressly
2005	forbidden for the agency, an employer, or a carrier, or any
2006	agent or representative of the agency, an employer, or a carrier
2007	to select the pharmacy or pharmacist which the sick or injured
2008	employee must use; condition coverage or payment on the basis of
2009	the pharmacy or pharmacist utilized; or to otherwise interfere
2010	in the selection by the sick or injured employee of a pharmacy
2011	or pharmacist.
2012	(4) NOTICE OF TREATMENT TO CARRIER; FILING WITH
2013	DEPARTMENT.--
2014	(a) Any health care provider providing necessary remedial
2015	treatment, care, or attendance to any injured worker shall
2016	submit treatment reports to the carrier in a format prescribed
2017	by the department in consultation with the agency. A claim for
2018	medical or surgical treatment is not valid or enforceable
2019	against such employer or employee, unless, by the close of the
2020	third business day following the first treatment, the physician
2021	providing the treatment furnishes to the employer or carrier a
2022	preliminary notice of the injury and treatment in a formaton
2023	forms prescribed by the department in consultation with the
2024	agencyand, within 15 days thereafter, furnishes to the employer
2025	or carrier a complete report, and subsequent thereto furnishes
2026	progress reports, if requested by the employer or insurance
2027	carrier, at intervals of not less than 3 weeks apart or at less
2028	frequent intervals if requested in a formaton formsprescribed
2029	by the department in consultation with the agency.
2030	(b) Upon the request of the department or agency, each
2031	medical report or bill obtained or received by the employer, the
2032	carrier, or the injured employee, or the attorney for the
2033	employer, carrier, or injured employee, with respect to the
2034	remedial treatment, care, and attendance of the injured
2035	employee, including any report of an examination, diagnosis, or
2036	disability evaluation, must be produced by the health care
2037	provider tofiled with the department or agencypursuant to
2038	rules adopted by the department in consultation with the agency.
2039	The health care provider shall also furnish to the injured
2040	employee or to his or her attorney and the employer or carrier
2041	or its attorney, on demand, a copy of his or her office chart,
2042	records, and reports, and may charge the injured employee no
2043	more than 50 cents per page for copying the records and the
2044	actual direct cost to the health care provider or health care
2045	facility for X rays, microfilm, or other nonpaper recordsan
2046	amount authorized by the department for the copies. Each such
2047	health care provider shall provide to the agency ordepartment
2048	information about the remedial treatment, care, and attendance
2049	which the agency ordepartment reasonably requests.
2050	(c) It is the policy for the administration of the
2051	workers' compensation system that there shallbe reasonable
2052	access to medical information by all parties to facilitate the
2053	self-executing features of the law. An employee who reports an
2054	injury or illness alleged to be work-related waives any
2055	physician-patient privilege with respect to any condition or
2056	complaint reasonably related to the condition for which the
2057	employee claims compensation.Notwithstanding the limitations in
2058	s. 456.057 and subject to the limitations in s. 381.004, upon
2059	the request of the employer, the carrier, an authorized
2060	qualified rehabilitation provider, or the attorney for the
2061	employer or carrier, the medical records, reports, and
2062	information of an injured employee relevant to the particular
2063	injury or illness for which compensation is soughtmust be
2064	furnished to those persons and the medical condition of the
2065	injured employee must be discussed with those persons, if the
2066	records and the discussions are restricted to conditions
2067	relating to the workplace injury. Release of medical information
2068	by the health care provider or other physician does not require
2069	the authorization of the injured employee. If medical records,
2070	reports, and information of an injured employee are sought from
2071	health care providers who are not subject to the jurisdiction of
2072	the state, the injured employee shall sign an authorization
2073	allowing for the employer or carrier to obtain the medical
2074	records, reports, or information. Any such discussions or
2075	release of informationmay be held before or after the filing of
2076	a claim or petition for benefitswithout the knowledge, consent,
2077	or presence of any other party or his or her agent or
2078	representative. A health care provider who willfully refuses to
2079	provide medical records or to discuss the medical condition of
2080	the injured employee, after a reasonable request is made for
2081	such information pursuant to this subsection, shall be subject
2082	by the departmentagencyto one or more of the penalties set
2083	forth in paragraph (8)(b). The department may adopt rules to
2084	carry out this subsection.
2085	(5) INDEPENDENT MEDICAL EXAMINATIONS.--
2086	(a) In any dispute concerning overutilization, medical
2087	benefits, compensability, or disability under this chapter, the
2088	carrier or the employee may select an independent medical
2089	examiner. If the parties agree,the examiner may be a health
2090	care provider treating or providing other care to the employee.
2091	An independent medical examiner may not render an opinion
2092	outside his or her area of expertise, as demonstrated by
2093	licensure and applicable practice parameters. The employer and
2094	employee shall be entitled to only one independent medical
2095	examination per accident and not one independent medical
2096	examination per medical specialty. The party requesting and
2097	selecting the independent medical examination shall be
2098	responsible for all expenses associated with said examination,
2099	including, but not limited to, medically necessary diagnostic
2100	testing performed and physician or medical care provider fees
2101	for the evaluation. The party selecting the independent medical
2102	examination shall identify the choice of the independent medical
2103	examiner to all other parties within 15 days after the date the
2104	independent medical examination is to take place. Failure to
2105	timely provide such notification shall preclude the requesting
2106	party from submitting the findings of such independent medical
2107	examiner in a proceeding before a judge of compensation claims.
2108	The independent medical examiner may not provide followup care
2109	if such recommendation for care is found to be medically
2110	necessary. If the employee prevails in a medical dispute as
2111	determined in an order by a judge of compensation claims or if
2112	benefits are paid or treatment provided after the employee has
2113	obtained an independent medical examination based upon the
2114	examiner's findings, the costs of such examination shall be paid
2115	by the employer or carrier.
2116	(b) Each party is bound by his or her selection of an
2117	independent medical examiner, including the selection of the
2118	independent medical examiner in accordance with s. 440.134 and
2119	the opinions of such independent medical examiner. Each party
2120	andis entitled to an alternate examiner only if:
2121	1. The examiner is not qualified to render an opinion upon
2122	an aspect of the employee's illness or injury which is material
2123	to the claim or petition for benefits;
2124	2. The examiner ceases to practice in the specialty
2125	relevant to the employee's condition;
2126	3. The examiner is unavailable due to injury, death, or
2127	relocation outside a reasonably accessible geographic area; or
2128	4. The parties agree to an alternate examiner.
2129
2130	Any party may request, or a judge of compensation claims may
2131	require, designation of an agency medical advisor as an
2132	independent medical examiner. The opinion of the advisors acting
2133	as examiners shall not be afforded the presumption set forth in
2134	paragraph (9)(c).
2135	(c) The carrier may, at its election, contact the claimant
2136	directly to schedule a reasonable time for an independent
2137	medical examination. The carrier must confirm the scheduling
2138	agreement in writing with the claimant and thewithin 5 days and
2139	notifyclaimant's counsel, if any, at least 7 days before the
2140	date upon which the independent medical examination is scheduled
2141	to occur. An attorney representing a claimant is not authorized
2142	to schedule the self-insured employer's or carrier'sindependent
2143	medical evaluations under this subsection. Neither the self-
2144	insured employer nor the carrier shall be responsible for
2145	scheduling any independent medical examination other than an
2146	employer or carrier independent medical examination.
2147	(d) If the employee fails to appear for the independent
2148	medical examination scheduled by the employer or carrierwithout
2149	good cause and fails to advise the physician at least 24 hours
2150	before the scheduled date for the examination that he or she
2151	cannot appear, the employee is barred from recovering
2152	compensation for any period during which he or she has refused
2153	to submit to such examination. Further, the employee shall
2154	reimburse the employer orcarrier 50 percent of the physician's
2155	cancellation or no-show fee unless the employer orcarrier that
2156	schedules the examination fails to timely provide to the
2157	employee a written confirmation of the date of the examination
2158	pursuant to paragraph (c) which includes an explanation of why
2159	he or she failed to appear. The employee may appeal to a judge
2160	of compensation claims for reimbursement when the employer or
2161	carrier withholds payment in excess of the authority granted by
2162	this section.
2163	(e) No medical opinion other than the opinion of a medical
2164	advisor appointed by the judge of compensation claims or the
2165	departmentagency, an independent medical examiner, or an
2166	authorized treating provider is admissible in proceedings before
2167	the judges of compensation claims.
2168	(f) Attorney's fees incurred by an injured employee in
2169	connection with delay of or opposition to an independent medical
2170	examination, including, but not limited to, motions for
2171	protective orders, are not recoverable under this chapter.
2172	(g) When a medical dispute arises, the parties may
2173	mutually agree to refer the employee to a licensed physician
2174	specializing in the diagnosis and treatment of the medical
2175	condition at issue for an independent medical examination and
2176	report. Such medical examination shall be referred to as a
2177	"consensus independent medical examination." The findings and
2178	conclusions of such mutually agreed upon consensus independent
2179	medical examination shall be binding on the parties and shall
2180	constitute resolution of the medical dispute addressed in the
2181	independent consensus medical examination and in any proceeding.
2182	Agreement by the parties to a consensus independent medical
2183	examination shall not affect the employer's, carrier's, or
2184	employee's entitlement to one independent medical examination
2185	per accident as provided for in this subsection.
2186	(6) UTILIZATION REVIEW.--Carriers shall review all bills,
2187	invoices, and other claims for payment submitted by health care
2188	providers in order to identify overutilization and billing
2189	errors, including compliance with practice parameters and
2190	protocols of treatment established in accordance with this
2191	chapter, and may hire peer review consultants or conduct
2192	independent medical evaluations. Such consultants, including
2193	peer review organizations, are immune from liability in the
2194	execution of their functions under this subsection to the extent
2195	provided in s. 766.101. If a carrier finds that overutilization
2196	of medical services or a billing error has occurred, or there is
2197	a violation of the practice parameters and protocols of
2198	treatment established in accordance with this chapter, it must
2199	disallow or adjust payment for such services or error without
2200	order of a judge of compensation claims or the agency, if the
2201	carrier, in making its determination, has complied with this
2202	section and rules adopted by the agency.
2203	(7) UTILIZATION AND REIMBURSEMENT DISPUTES.--
2204	(a) Any health care provider, carrier, or employer who
2205	elects to contest the disallowance or adjustment of payment by a
2206	carrier under subsection (6) must, within 30 days after receipt
2207	of notice of disallowance or adjustment of payment, petition the
2208	agency to resolve the dispute. The petitioner must serve a copy
2209	of the petition on the carrier and on all affected parties by
2210	certified mail. The petition must be accompanied by all
2211	documents and records that support the allegations contained in
2212	the petition. Failure of a petitioner to submit such
2213	documentation to the agency results in dismissal of the
2214	petition.
2215	(b) The carrier must submit to the agency within 10 days
2216	after receipt of the petition all documentation substantiating
2217	the carrier's disallowance or adjustment. Failure of the carrier
2218	to timelysubmit the requested documentation to the agency
2219	within 10 days constitutes a waiver of all objections to the
2220	petition.
2221	(c) Within 60 days after receipt of all documentation, the
2222	agency must provide to the petitioner, the carrier, and the
2223	affected parties a written determination of whether the carrier
2224	properly adjusted or disallowed payment. The agency must be
2225	guided by standards and policies set forth in this chapter,
2226	including all applicable reimbursement schedules, practice
2227	parameters, and protocols of treatment,in rendering its
2228	determination.
2229	(d) If the agency finds an improper disallowance or
2230	improper adjustment of payment by an insurer, the insurer shall
2231	reimburse the health care provider, facility, insurer, or
2232	employer within 30 days, subject to the penalties provided in
2233	this subsection.
2234	(e) The agency shall adopt rules to carry out this
2235	subsection. The rules may include provisions for consolidating
2236	petitions filed by a petitioner and expanding the timetable for
2237	rendering a determination upon a consolidated petition.
2238	(f) Any carrier that engages in a pattern or practice of
2239	arbitrarily or unreasonably disallowing or reducing payments to
2240	health care providers may be subject to one or more of the
2241	following penalties imposed by the agency:
2242	1. Repayment of the appropriate amount to the health care
2243	provider.
2244	2. An administrative fine assessed by the agency in an
2245	amount not to exceed $5,000 per instance of improperly
2246	disallowing or reducing payments.
2247	3. Award of the health care provider's costs, including a
2248	reasonable attorney's fee, for prosecuting the petition.
2249	(8) PATTERN OR PRACTICE OF OVERUTILIZATION.--
2250	(a) Carriers must report to the agency all instances of
2251	overutilization including, but not limited to, all instances in
2252	which the carrier disallows or adjusts payment or a
2253	determination has been made that the provided or recommended
2254	treatment is in excess of the practice parameters and protocols
2255	of treatment established in this chapter. The agency shall
2256	determine whether a pattern or practice of overutilization
2257	exists.
2258	(b) If the agency determines that a health care provider
2259	has engaged in a pattern or practice of overutilization or a
2260	violation of this chapter or rules adopted by the agency,
2261	including a pattern or practice of providing treatment in excess
2262	of the practice parameters or protocols of treatment, it may
2263	impose one or more of the following penalties:
2264	1. An order of the agency barring the provider from
2265	payment under this chapter;
2266	2. Deauthorization of care under review;
2267	3. Denial of payment for care rendered in the future;
2268	4. Decertification of a health care provider certified as
2269	an expert medical advisor under subsection (9) or of a
2270	rehabilitation provider certified under s. 440.49;
2271	5. An administrative fine assessed by the agency in an
2272	amount not to exceed $5,000 per instance of overutilization or
2273	violation; and
2274	6. Notification of and review by the appropriate licensing
2275	authority pursuant to s. 440.106(3).
2276	(9) EXPERT MEDICAL ADVISORS.--
2277	(a) The agency shall certify expert medical advisors in
2278	each specialty to assist the agency and the judges of
2279	compensation claims within the advisor's area of expertise as
2280	provided in this section. The agency shall, in a manner
2281	prescribed by rule, in certifying, recertifying, or decertifying
2282	an expert medical advisor, consider the qualifications,
2283	training, impartiality, and commitment of the health care
2284	provider to the provision of quality medical care at a
2285	reasonable cost. As a prerequisite for certification or
2286	recertification, the agency shall require, at a minimum, that
2287	an expert medical advisor have specialized workers' compensation
2288	training or experience under the workers' compensation system of
2289	this state and board certification or board eligibility.
2290	(b) The agency shall contract with one or more entities
2291	that employ, contract with, or otherwise secureor employexpert
2292	medical advisors to provide peer review or expertmedical
2293	consultation, opinions, and testimonyto the agency or to a
2294	judge of compensation claims in connection with resolving
2295	disputes relating to reimbursement, differing opinions of health
2296	care providers, and health care and physician services rendered
2297	under this chapter, including utilization issues. The agency
2298	shall by rule establish the qualifications of expert medical
2299	advisors, including training and experience in the workers'
2300	compensation system in the state and the expert medical
2301	advisor's knowledge of and commitment to the standards of care,
2302	practice parameters, and protocols established pursuant to this
2303	chapter. Expert medical advisors contracting with the agency
2304	shall, as a term of such contract, agree to provide consultation
2305	or services in accordance with the timetables set forth in this
2306	chapter and to abide by rules adopted by the agency, including,
2307	but not limited to, rules pertaining to procedures for review of
2308	the services rendered by health care providers and preparation
2309	of reports and testimony orrecommendations for submission to
2310	the agency or the judge of compensation claims.
2311	(c) If there is disagreement in the opinions of the health
2312	care providers, if two health care providers disagree on medical
2313	evidence supporting the employee's complaints or the need for
2314	additional medical treatment, or if two health care providers
2315	disagree that the employee is able to return to work, the agency
2316	may, and the judge of compensation claims shall, upon his or her
2317	own motion or within 15 days after receipt of a written request
2318	by either the injured employee, the employer, or the carrier,
2319	order the injured employee to be evaluated by an expert medical
2320	advisor. The opinion of the expert medical advisor is presumed
2321	to be correct unless there is clear and convincing evidence to
2322	the contrary as determined by the judge of compensation claims.
2323	The expert medical advisor appointed to conduct the evaluation
2324	shall have free and complete access to the medical records of
2325	the employee. An employee who fails to report to and cooperate
2326	with such evaluation forfeits entitlement to compensation during
2327	the period of failure to report or cooperate.
2328	(d) The expert medical advisor must complete his or her
2329	evaluation and issue his or her report to the agency or to the
2330	judge of compensation claims within 1545days after receipt of
2331	all medical records. The expert medical advisor must furnish a
2332	copy of the report to the carrier and to the employee.
2333	(e) An expert medical advisor is not liable under any
2334	theory of recovery for evaluations performed under this section
2335	without a showing of fraud or malice. The protections of s.
2336	766.101 apply to any officer, employee, or agent of the agency
2337	and to any officer, employee, or agent of any entity with which
2338	the agency has contracted under this subsection.
2339	(f) If the agency or a judge of compensation claims orders
2340	determines thatthe services of a certified expert medical
2341	advisor are requiredto resolve a dispute under this section,
2342	the party requesting such examinationcarriermust compensate
2343	the advisor for his or her time in accordance with a schedule
2344	adopted by the agency. If the employee prevails in a dispute as
2345	determined in an order by a judge of compensation claims based
2346	upon the expert medical advisor's findings, the employer or
2347	carrier shall pay for the costs of such expert medical advisor.
2348	If a judge of compensation claims, upon his or her motion, finds
2349	that an expert medical advisor is needed to resolve the dispute,
2350	the carrier must compensate the advisor for his or her time in
2351	accordance with a schedule adopted by the agency.The agency may
2352	assess a penalty not to exceed $500 against any carrier that
2353	fails to timely compensate an advisor in accordance with this
2354	section.
2355	(10) WITNESS FEES.--Any health care provider who gives a
2356	deposition shall be allowed a witness fee. The amount charged by
2357	the witness may not exceed $200 per hour. An expert witness who
2358	has never provided direct professional services to a party but
2359	has merely reviewed medical records and provided an expert
2360	opinion or has provided only direct professional services that
2361	were unrelated to the workers' compensation case may not be
2362	allowed a witness fee in excess of $200 per day.
2363	(11) AUDITS BY AGENCY FOR HEALTH CARE ADMINISTRATION AND
2364	THE DEPARTMENT OF INSURANCE; JURISDICTION.--
2365	(a) The Agency for Health Care Administration may
2366	investigate health care providers to determine whether providers
2367	are complying with this chapter and with rules adopted by the
2368	agency, whether the providers are engaging in overutilization,
2369	andwhether providers are engaging in improper billing
2370	practices, and whether providers are adhering to practice
2371	parameters and protocols established in accordance with this
2372	chapter. If the agency finds that a health care provider has
2373	improperly billed, overutilized, or failed to comply with agency
2374	rules or the requirements of this chapter, including, but not
2375	limited to, practice parameters and protocols established in
2376	accordance with this chapter,it must notify the provider of its
2377	findings and may determine that the health care provider may not
2378	receive payment from the carrier or may impose penalties as set
2379	forth in subsection (8) or other sections of this chapter. If
2380	the health care provider has received payment from a carrier for
2381	services that were improperly billed, that constitute
2382	overutilization, or that were outside practice parameters or
2383	protocols established in accordance with this chapteror for
2384	overutilization, it must return those payments to the carrier.
2385	The agency may assess a penalty not to exceed $500 for each
2386	overpayment that is not refunded within 30 days after
2387	notification of overpayment by the agency or carrier.
2388	(b) The department shall monitor and audit carriers as
2389	provided in s. 624.3161, to determine if medical bills are paid
2390	in accordance with this section and department rules. Any
2391	employer, if self-insured, or carrier found by the division not
2392	to be within 90 percent compliance as to the payment of medical
2393	bills after July 1, 1994, must be assessed a fine not to exceed
2394	1 percent of the prior year's assessment levied against such
2395	entity under s. 440.51 for every quarter in which the entity
2396	fails to attain 90-percent compliance. The department shall fine
2397	or otherwise discipline an employer or carrier, pursuant to this
2398	chapter, the insurance code, or rules adopted by the department,
2399	for each late payment of compensation that is below the minimum
2400	95-percent90-percentperformance standard. Any carrier that is
2401	found to be not in compliance in subsequent consecutive quarters
2402	must implement a medical-bill review program approved by the
2403	division, and the carrier is subject to disciplinary action by
2404	the Department of Insurance.
2405	(c) The agency has exclusive jurisdiction to decide any
2406	matters concerning reimbursement, to resolve any overutilization
2407	dispute under subsection (7), and to decide any question
2408	concerning overutilization under subsection (8), which question
2409	or dispute arises after January 1, 1994.
2410	(d) The following agency actions do not constitute agency
2411	action subject to review under ss. 120.569 and 120.57 and do not
2412	constitute actions subject to s. 120.56: referral by the entity
2413	responsible for utilization review; a decision by the agency to
2414	refer a matter to a peer review committee; establishment by a
2415	health care provider or entity of procedures by which a peer
2416	review committee reviews the rendering of health care services;
2417	and the review proceedings, report, and recommendation of the
2418	peer review committee.
2419	(12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
2420	REIMBURSEMENT ALLOWANCES.--
2421	(a) A three-member panel is created, consisting of the
2422	Insurance Commissioner, or the Insurance Commissioner's
2423	designee, and two members to be appointed by the Governor,
2424	subject to confirmation by the Senate, one member who, on
2425	account of present or previous vocation, employment, or
2426	affiliation, shall be classified as a representative of
2427	employers, the other member who, on account of previous
2428	vocation, employment, or affiliation, shall be classified as a
2429	representative of employees. The panel shall determine statewide
2430	schedules of maximum reimbursement allowances for medically
2431	necessary treatment, care, and attendance provided by
2432	physicians, hospitals, ambulatory surgical centers, work-
2433	hardening programs, pain programs, and durable medical
2434	equipment. The maximum reimbursement allowances for inpatient
2435	hospital care shall be based on a schedule of per diem rates, to
2436	be approved by the three-member panel no later than March 1,
2437	1994, to be used in conjunction with a precertification manual
2438	as determined by the department, including maximum hours in
2439	which an outpatient may remain in observation status, which
2440	shall not exceed 23 hoursagency. All compensable charges for
2441	hospital outpatient care shall be reimbursed at 75 percent of
2442	usual and customary charges, except as otherwise provided by
2443	this subsection. Until the three-member panel approves a
2444	schedule of per diem rates for inpatient hospital care and it
2445	becomes effective, all compensable charges for hospital
2446	inpatient care must be reimbursed at 75 percent of their usual
2447	and customary charges.Annually, the three-member panel shall
2448	adopt schedules of maximum reimbursement allowances for
2449	physicians, hospital inpatient care, hospital outpatient care,
2450	ambulatory surgical centers, work-hardening programs, and pain
2451	programs. However, the maximum percentage of increase in the
2452	individual reimbursement allowance may not exceed the percentage
2453	of increase in the Consumer Price Index for the previous year.
2454	An individual physician, hospital, ambulatory surgical center,
2455	pain program, or work-hardening program shall be reimbursed
2456	either the usual and customary charge for treatment, care, and
2457	attendance, the agreed-upon contract price,or the maximum
2458	reimbursement allowance in the appropriate schedule, whichever
2459	is less.
2460	(b) It is the intent of the Legislature to increase the
2461	schedule of maximum reimbursement allowances for selected
2462	physicians effective January 1, 2004, and to pay for the
2463	increases through reductions in payments to hospitals. Revisions
2464	developed pursuant to this subsection are limited to the
2465	following:
2466	1. Payments for outpatient physical, occupational, and
2467	speech therapy provided by hospitals shall be reduced to the
2468	schedule of maximum reimbursement allowances for these services
2469	which applies to nonhospital providers.
2470	2. Payments for scheduled outpatient nonemergency
2471	radiological and clinical laboratory services that are not
2472	provided in conjunction with a surgical procedure shall be
2473	reduced to the schedule of maximum reimbursement allowances for
2474	these services which applies to nonhospital providers.
2475	3. Outpatient reimbursement for scheduled surgeries shall
2476	be reduced from 75 percent of charges to 60 percent of charges.
2477	4. Maximum reimbursement for a physician licensed under
2478	chapter 458 or chapter 459 shall be increased to 110 percent of
2479	the reimbursement allowed by Medicare, using appropriate codes
2480	and modifiers or the medical reimbursement level adopted by the
2481	three-member panel as of January 1, 2003, whichever is greater.
2482	5. Maximum reimbursement for surgical procedures shall be
2483	increased to 140 percent of the reimbursement allowed by
2484	Medicare or the medical reimbursement level adopted by the
2485	three-member panel as of January 1, 2003, whichever is greater.
2486	(c)(b)As to reimbursement for a prescription medication,
2487	the reimbursement amount for a prescription shall be the average
2488	wholesale price times 1.2plus $4.18 for the dispensing fee,
2489	except where the carrier has contracted for a lower amount. Fees
2490	for pharmaceuticals and pharmaceutical services shall be
2491	reimbursable at the applicable fee schedule amount. Where the
2492	employer or carrier has contracted for such services and the
2493	employee elects to obtain them through a provider not a party to
2494	the contract, the carrier shall reimburse at the schedule,
2495	negotiated, or contract price, whichever is lower. No such
2496	contract shall rely on a provider that is not reasonably
2497	accessible to the employee.
2498	(d)(c)Reimbursement for all fees and other charges for
2499	such treatment, care, and attendance, including treatment, care,
2500	and attendance provided by any hospital or other health care
2501	provider, ambulatory surgical center, work-hardening program, or
2502	pain program, must not exceed the amounts provided by the
2503	uniform schedule of maximum reimbursement allowances as
2504	determined by the panel or as otherwise provided in this
2505	section. This subsection also applies to independent medical
2506	examinations performed by health care providers under this
2507	chapter. Until the three-member panel approves a uniform
2508	schedule of maximum reimbursement allowances and it becomes
2509	effective, all compensable charges for treatment, care, and
2510	attendance provided by physicians, ambulatory surgical centers,
2511	work-hardening programs, or pain programs shall be reimbursed at
2512	the lowest maximum reimbursement allowance across all 1992
2513	schedules of maximum reimbursement allowances for the services
2514	provided regardless of the place of service.In determining the
2515	uniform schedule, the panel shall first approve the data which
2516	it finds representative of prevailing charges in the state for
2517	similar treatment, care, and attendance of injured persons. Each
2518	health care provider, health care facility, ambulatory surgical
2519	center, work-hardening program, or pain program receiving
2520	workers' compensation payments shall maintain records verifying
2521	their usual charges. In establishing the uniform schedule of
2522	maximum reimbursement allowances, the panel must consider:
2523	1. The levels of reimbursement for similar treatment,
2524	care, and attendance made by other health care programs or
2525	third-party providers;
2526	2. The impact upon cost to employers for providing a level
2527	of reimbursement for treatment, care, and attendance which will
2528	ensure the availability of treatment, care, and attendance
2529	required by injured workers;
2530	3. The financial impact of the reimbursement allowances
2531	upon health care providers and health care facilities, including
2532	trauma centers as defined in s. 395.4001, and its effect upon
2533	their ability to make available to injured workers such
2534	medically necessary remedial treatment, care, and attendance.
2535	The uniform schedule of maximum reimbursement allowances must be
2536	reasonable, must promote health care cost containment and
2537	efficiency with respect to the workers' compensation health care
2538	delivery system, and must be sufficient to ensure availability
2539	of such medically necessary remedial treatment, care, and
2540	attendance to injured workers; and
2541	4. The most recent average maximum allowable rate of
2542	increase for hospitals determined by the Health Care Board under
2543	chapter 408.
2544	(e)(d)In addition to establishing the uniform schedule of
2545	maximum reimbursement allowances, the panel shall:
2546	1. Take testimony, receive records, and collect data to
2547	evaluate the adequacy of the workers' compensation fee schedule,
2548	nationally recognized fee schedules and alternative methods of
2549	reimbursement to certified health care providers and health care
2550	facilities for inpatient and outpatient treatment and care.
2551	2. Survey certified health care providers and health care
2552	facilities to determine the availability and accessibility of
2553	workers' compensation health care delivery systems for injured
2554	workers.
2555	3. Survey carriers to determine the estimated impact on
2556	carrier costs and workers' compensation premium rates by
2557	implementing changes to the carrier reimbursement schedule or
2558	implementing alternative reimbursement methods.
2559	4. Submit recommendations on or before January 1, 2003,
2560	and biennially thereafter, to the President of the Senate and
2561	the Speaker of the House of Representatives on methods to
2562	improve the workers' compensation health care delivery system.
2563
2564	The division shall provide data to the panel, including but not
2565	limited to, utilization trends in the workers' compensation
2566	health care delivery system. The division shall provide the
2567	panel with an annual report regarding the resolution of medical
2568	reimbursement disputes and any actions pursuant to s. 440.13(8).
2569	The division shall provide administrative support and service to
2570	the panel to the extent requested by the panel.
2571	(13) REMOVAL OF PHYSICIANS FROM LISTS OF THOSE AUTHORIZED
2572	TO RENDER MEDICAL CARE.--The agency shall remove from the list
2573	of physicians or facilities authorized to provide remedial
2574	treatment, care, and attendance under this chapter the name of
2575	any physician or facility found after reasonable investigation
2576	to have:
2577	(a) Engaged in professional or other misconduct or
2578	incompetency in connection with medical services rendered under
2579	this chapter;
2580	(b) Exceeded the limits of his or her or its professional
2581	competence in rendering medical care under this chapter, or to
2582	have made materially false statements regarding his or her or
2583	its qualifications in his or her application;
2584	(c) Failed to transmit copies of medical reports to the
2585	employer or carrier, or failed to submit full and truthful
2586	medical reports of all his or her or its findings to the
2587	employer or carrier as required under this chapter;
2588	(d) Solicited, or employed another to solicit for himself
2589	or herself or itself or for another, professional treatment,
2590	examination, or care of an injured employee in connection with
2591	any claim under this chapter;
2592	(e) Refused to appear before, or to answer upon request
2593	of, the agency or any duly authorized officer of the state, any
2594	legal question, or to produce any relevant book or paper
2595	concerning his or her conduct under any authorization granted to
2596	him or her under this chapter;
2597	(f) Self-referred in violation of this chapter or other
2598	laws of this state; or
2599	(g) Engaged in a pattern of practice of overutilization or
2600	a violation of this chapter or rules adopted by the agency,
2601	including failure to adhere to practice parameters and protocols
2602	established in accordance with this chapter.
2603	(14) PAYMENT OF MEDICAL FEES.--
2604	(a) Except for emergency care treatment, fees for medical
2605	services are payable only to a health care provider certified
2606	and authorized to render remedial treatment, care, or attendance
2607	under this chapter. Carriers shall pay, disallow, or deny
2608	payment to health care providers in the manner and at times set
2609	forth in this chapter.A health care provider may not collect or
2610	receive a fee from an injured employee within this state, except
2611	as otherwise provided by this chapter. Such providers have
2612	recourse against the employer or carrier for payment for
2613	services rendered in accordance with this chapter. Payment to
2614	health care providers or physicians shall be subject to the
2615	medical fee schedule and applicable practice parameters and
2616	protocols, regardless of whether the health care provider or
2617	claimant is asserting that the payment should be made.
2618	(b) Fees charged for remedial treatment, care, and
2619	attendance, except for independent medical examinations and
2620	consensus independent medical examinations, may not exceed the
2621	applicable fee schedules adopted under this chapter and
2622	department rule. Notwithstanding any other provision in this
2623	chapter, if a physician or health care provider specifically
2624	agrees in writing to follow identified procedures aimed at
2625	providing quality medical care to injured workers at reasonable
2626	costs, deviations from established fee schedules shall be
2627	permitted. Written agreements warranting deviations may include,
2628	but are not limited to, the timely scheduling of appointments
2629	for injured workers, participating in return-to-work programs
2630	with injured workers' employers, expediting the reporting of
2631	treatments provided to injured workers, and agreeing to
2632	continuing education, utilization review, quality assurance,
2633	precertification, and case management systems that are designed
2634	to provide needed treatment for injured workers.
2635	(c) Notwithstanding any other provision of this chapter,
2636	following overall maximum medical improvement from an injury
2637	compensable under this chapter, the employee is obligated to pay
2638	a copayment of $10 per visit for medical services. The copayment
2639	shall not apply to emergency care provided to the employee.
2640	(15) PRACTICE PARAMETERS.--The practice parameters and
2641	protocols mandated under this chapter shall be the practice
2642	parameters and protocols adopted by the United States Agency for
2643	Healthcare Research and Quality in effect on January 1, 2003.
2644	(a) The Agency for Health Care Administration, in
2645	conjunction with the department and appropriate health
2646	professional associations and health-related organizations shall
2647	develop and may adopt by rule scientifically sound practice
2648	parameters for medical procedures relevant to workers'
2649	compensation claimants. Practice parameters developed under this
2650	section must focus on identifying effective remedial treatments
2651	and promoting the appropriate utilization of health care
2652	resources. Priority must be given to those procedures that
2653	involve the greatest utilization of resources either because
2654	they are the most costly or because they are the most frequently
2655	performed. Practice parameters for treatment of the 10 top
2656	procedures associated with workers' compensation injuries
2657	including the remedial treatment of lower-back injuries must be
2658	developed by December 31, 1994.
2659	(b) The guidelines may be initially based on guidelines
2660	prepared by nationally recognized health care institutions and
2661	professional organizations but should be tailored to meet the
2662	workers' compensation goal of returning employees to full
2663	employment as quickly as medically possible, taking into
2664	consideration outcomes data collected from managed care
2665	providers and any other inpatient and outpatient facilities
2666	serving workers' compensation claimants.
2667	(c) Procedures must be instituted which provide for the
2668	periodic review and revision of practice parameters based on the
2669	latest outcomes data, research findings, technological
2670	advancements, and clinical experiences, at least once every 3
2671	years.
2672	(d) Practice parameters developed under this section must
2673	be used by carriers and the agency in evaluating the
2674	appropriateness and overutilization of medical services provided
2675	to injured employees.
2676	(16) STANDARDS OF CARE.--The following standards of care
2677	shall be followed in providing medical care under this chapter:
2678	(a) Abnormal anatomical findings alone, in the absence of
2679	objective relevant medical findings, shall not be an indicator
2680	of injury or illness, a justification for the provision of
2681	remedial medical care or the assignment of restrictions, or a
2682	foundation for limitations.
2683	(b) At all times during evaluation and treatment, the
2684	provider shall act on the premise that returning to work is an
2685	integral part of the treatment plan. The goal of removing all
2686	restrictions and limitations as early as appropriate shall be
2687	part of the treatment plan on a continuous basis. The assignment
2688	of restrictions and limitations shall be reviewed with each
2689	patient exam and upon receipt of new information, such as
2690	progress reports from physical therapists and other providers.
2691	Consideration shall be given to upgrading or removing the
2692	restrictions and limitations with each patient exam, based upon
2693	the presence or absence of objective relevant medical findings.
2694	(c) Reasonable necessary medical care of injured employees
2695	shall in all situations:
2696	1. Utilize a high intensity, short duration treatment
2697	approach that focuses on early activation and restoration of
2698	function whenever possible.
2699	2. Include reassessment of the treatment plans, regimes,
2700	therapies, prescriptions, and functional limitations or
2701	restrictions prescribed by the provider every 30 days.
2702	3. Be focused on treatment of the individual employee's
2703	specific clinical dysfunction or status and shall not be based
2704	upon nondescript diagnostic labels.
2705
2706	All treatment shall be inherently scientifically logical and the
2707	evaluation or treatment procedure must match the documented
2708	physiologic and clinical problem. Treatment shall match the
2709	type, intensity, and duration of service required by the problem
2710	identified.
2711	(17) Failure to comply with this section shall be
2712	considered a violation of this chapter and is subject to
2713	penalties as provided for in s. 440.525.
2714	Section 16. Paragraphs (d) and (i) of subsection (1) and
2715	subsections (2), (6), (7), (8), (9), (10), (11), (17), and (25)
2716	of section 440.134, Florida Statutes, are amended to read:
2717	440.134 Workers' compensation managed care arrangement.--
2718	(1) As used in this section, the term:
2719	(d) "Grievance" means a written complaint, other than a
2720	petition for benefits, filed by the injured worker pursuant to
2721	the requirements of the managed care arrangement, expressing
2722	dissatisfaction with the medical care provided by aninsurer's
2723	workers' compensation managed care arrangement's refusal to
2724	provide medical care or the medical care providedarrangement
2725	health care providers, expressed in writing by an injured
2726	worker.
2727	(i) "Medical care coordinator" means a primary care
2728	provider within a provider network who is responsible for
2729	managing the medical care of an injured worker including
2730	determining other health care providers and health care
2731	facilities to which the injured employee will be referred for
2732	evaluation or treatment. A medical care coordinator shall be a
2733	physician licensed under chapter 458,oran osteopathic
2734	physician licensed under chapter 459, a chiropractic physician
2735	licensed under chapter 460, or a podiatric physician licensed
2736	under chapter 461.
2737	(2)(a) The self-insured employer or carrier may, subject
2738	to the terms and limitations specified elsewhere in this section
2739	and chapter, furnish to the employee solely through managed care
2740	arrangements such medically necessary remedial treatment, care,
2741	and attendance for such period as the nature of the injury or
2742	the process of recovery requires and which shall be in
2743	accordance with practice parameters and protocols established
2744	pursuant to this chapter. For any self-insured employer or
2745	carrier who elects to deliver the medical benefits required by
2746	this chapter through a method other than a workers' compensation
2747	managed care arrangement, the discontinuance of the use of the
2748	workers' compensation managed care arrangement shall be without
2749	regard to the date of the accident, notwithstanding any other
2750	provision of law or rule.
2751	(b) The agency shall authorize an insurer to offer or
2752	utilize a workers' compensation managed care arrangement after
2753	the insurer files a completed application along with the payment
2754	of a $1,000 application fee, and upon the agency's being
2755	satisfied that the applicant has the ability to provide quality
2756	of care consistent with the prevailing professional standards of
2757	care and the insurer and its workers' compensation managed care
2758	arrangement otherwise meets the requirements of this section. No
2759	insurer may offer or utilize a managed care arrangement without
2760	such authorization. The authorization, unless sooner suspended
2761	or revoked, shall automatically expire 2 years after the date of
2762	issuance unless renewed by the insurer. The authorization shall
2763	be renewed upon application for renewal and payment of a renewal
2764	fee of $1,000, provided that the insurer is in compliance with
2765	the requirements of this section and any rules adopted
2766	hereunder. An application for renewal of the authorization shall
2767	be made 90 days prior to expiration of the authorization, on
2768	forms provided by the agency. The renewal application shall not
2769	require the resubmission of any documents previously filed with
2770	the agency if such documents have remained valid and unchanged
2771	since their original filing.
2772	(6) The proposed managed care plan of operation must
2773	include:
2774	(a) A statement or map providing a clear description of
2775	the service area.
2776	(b) A description of the grievance procedure to be used.
2777	(c) A description of the quality assurance program which
2778	assures that the health care services provided to workers shall
2779	be rendered under reasonable standards of quality of care
2780	consistent with the prevailing standards of medical practice in
2781	the medical community. The program shall include, but not be
2782	limited to:
2783	1. A written statement of goals and objectives that
2784	stresses health and return-to-work outcomes as the principal
2785	criteria for the evaluation of the quality of care rendered to
2786	injured workers.
2787	2. A written statement describing how methodology has been
2788	incorporated into an ongoing system for monitoring of care that
2789	is individual case oriented and, when implemented, can provide
2790	interpretation and analysis of patterns of care rendered to
2791	individual patients by individual providers.
2792	3. Written procedures for taking appropriate remedial
2793	action whenever, as determined under the quality assurance
2794	program, inappropriate or substandard services have been
2795	provided or services that should have been furnished have not
2796	been provided.
2797	4. A written plan, which includes ongoing review, for
2798	providing review of physicians and other licensed medical
2799	providers.
2800	5. Appropriate financial incentives to reduce service
2801	costs and utilization without sacrificing the quality of
2802	service.
2803	6. Adequate methods of peer review and utilization review.
2804	The utilization review process shall include a health care
2805	facility'sfacilitiesprecertification mechanism, including, but
2806	not limited to, all elective admissions and nonemergency
2807	surgeries and adherence to practice parameters and protocols
2808	established in accordance with this chapter.
2809	7. Provisions for resolution of disputes arising between a
2810	health care provider and an insurer regarding reimbursements and
2811	utilization review.
2812	8. Availability of a process for aggressive medical care
2813	coordination, as well as a program involving cooperative efforts
2814	by the workers, the employer, and the workers' compensation
2815	managed care arrangement to promote early return to work for
2816	injured workers.
2817	9. A written plan allowing for the independent medical
2818	examination provided for in s. 440.13(5). Notwithstanding any
2819	provision to the contrary, the costs for the independent medical
2820	examination shall be paid by the carrier if such examination is
2821	performed by a physician in the provider network. Otherwise,
2822	such costs shall be paid in accordance with s. 440.13(5). An
2823	independent medical examination requested by a claimant and paid
2824	for by the carrier shall constitute the claimant's one
2825	independent medical examination per accident under s. 440.13(5).
2826	A process allowing employees to obtain one second medical
2827	opinion in the same specialty and within the provider network
2828	during the course of treatment for a work-related injury.
2829	10. A provision for the selection of a primary care
2830	provider by the employee from among primary providers in the
2831	provider network.
2832	11. The written information proposed to be used by the
2833	insurer to comply with subparagraph 8.
2834	(7) Written procedures to provide the insurer with timely
2835	medical records and information including, but not limited to,
2836	work status, work restrictions, date of maximum medical
2837	improvement, permanent impairment ratings, and other information
2838	as required, including information demonstrating compliance with
2839	the practice parameters and protocols of treatment established
2840	pursuant to this chapter.
2841	(8) Evidence that appropriate health care providers and
2842	administrative staff of the insurer's workers' compensation
2843	managed care arrangement have received training and education on
2844	the provisions of this chapter;andthe administrative rules
2845	that govern the provision of remedial treatment, care, and
2846	attendance of injured workers; and the practice parameters and
2847	protocols of treatment established pursuant to this chapter.
2848	(9) Written procedures and methods to prevent
2849	inappropriate or excessive treatment that are in accordance with
2850	the practice parameters and protocols of treatment established
2851	pursuant to this chapter.
2852	(10) Written procedures and methods for the management of
2853	an injured worker's medical care by a medical care coordinator
2854	including:
2855	(a) The mechanism for assuring that covered employees
2856	receive all initial covered services from a primary care
2857	provider participating in the provider network, except for
2858	emergency care.
2859	(b) The mechanism for assuring that all continuing covered
2860	services be received from the same primary care provider
2861	participating in the provider network that provided the initial
2862	covered services, except when services from another provider are
2863	authorized by the medical care coordinator pursuant to paragraph
2864	(d).
2865	(c) The policies and procedures for allowing an employee
2866	one change to another provider within the same specialty and
2867	provider network as the authorized treating physician during the
2868	course of treatment for a work-related injury, in accordance
2869	with the procedures provided in s. 440.13(2)(f), if a request is
2870	made to the medical care coordinator by the employee; and
2871	requiring that special provision be made for more than one such
2872	referral through the arrangement's grievance procedures.
2873	(d) The process for assuring that all referrals authorized
2874	by a medical care coordinator, in accordance with the practice
2875	parameters and protocols of treatment established pursuant to
2876	this chapter,are made to the participating network providers,
2877	unless medically necessary treatment, care, and attendance are
2878	not available and accessible to the injured worker in the
2879	provider network.
2880	(e) Assignment of a medical care coordinator licensed
2881	under chapter 458 or chapter 459 to manage care by physicians
2882	licensed under chapter 458 or chapter 459, a medical care
2883	coordinator licensed under chapter 460 to manage care by
2884	physicians licensed under chapter 460, and a medical care
2885	coordinator licensed under chapter 461 to manage care by
2886	physicians licensed under chapter 461 upon request by an injured
2887	employee for care by a physician licensed under chapter 458,
2888	chapter 459, chapter 460, or chapter 461.
2889	(11) A description of the use of workers' compensation
2890	practice parameters and protocols of treatmentfor health care
2891	services when adopted by the agency.
2892	(17) Notwithstanding any other provisions of this chapter,
2893	when a carrier provides medical care through a workers'
2894	compensation managed care arrangement, pursuant to this section,
2895	those workers who are subject to the arrangement must receive
2896	medical services for work-related injuries and diseases as
2897	prescribed in the contract, provided the employer and carrier
2898	have provided notice to the employees of the arrangement in a
2899	manner approved by the agency and the medical services are in
2900	accordance with the practice parameters and protocols
2901	established pursuant to this chapter. Treatment received outside
2902	the workers' compensation managed care arrangement is not
2903	compensable, regardless of the purpose of the treatment,
2904	including, but not limited to, evaluations, examinations, or
2905	diagnostic studies to determine causation between medical
2906	findings and a compensable accident, the existence or extent of
2907	impairments or disabilities, and whether the injured employee
2908	has reached maximum medical improvement,unless authorized by
2909	the carrier prior to the treatment date.
2910	(25) The agency shall adopt rules that specify:
2911	(a) Procedures for authorization and examination of
2912	workers' compensation managed care arrangements by the agency.
2913	(b) Requirements and procedures for authorization of
2914	workers' compensation arrangement provider networks and
2915	procedures for the agency to grant exceptions from accessibility
2916	of services.
2917	(c) Requirements and procedures for case management,
2918	utilization management, and peer review.
2919	(d) Requirements and procedures for quality assurance and
2920	medical records.
2921	(e) Requirements and procedures for dispute resolution in
2922	conformance with this chapter.
2923	(f) Requirements and procedures for employee and provider
2924	education.
2925	(g) Requirements and procedures for reporting data
2926	regarding grievances, return-to-work outcomes, and provider
2927	networks.
2928	Section 17. Subsections (1) and (4)and paragraph (b) of
2929	subsection (5) of section 440.14, Florida Statutes, are amended
2930	to read:
2931	440.14 Determination of pay.--
2932	(1) Except as otherwise provided in this chapter, the
2933	average weekly wages of the injured employee on the date of the
2934	accidentat the time of the injuryshall be taken as the basis
2935	upon which to compute compensation and shall be determined,
2936	subject to the limitations of s. 440.12(2), as follows:
2937	(a) If the injured employee has worked in the employment
2938	in which she or he was working on the date of the accidentat
2939	the time of the injury, whether for the same or another
2940	employer, during substantially the whole of 13 weeks immediately
2941	preceding the accidentinjury, her or his average weekly wage
2942	shall be one-thirteenth of the total amount of wages earned in
2943	such employment during the 13 weeks. As used in this paragraph,
2944	the term "substantially the whole of 13 weeks" means the
2945	calendarshall be deemed to mean and refer to a constructive
2946	period of 13 weeks as a whole, which shall be defined as the 13
2947	calendar weeks before the date of the accident, excluding the
2948	week during which the accident occurred.a consecutive period of
2949	91 days, andThe term "during substantially the whole of 13
2950	weeks" shall be deemed to mean during not less than 7590
2951	percent of the total customary full-timehours of employment
2952	within such period considered as a whole.
2953	(b) If the injured employee has not worked in such
2954	employment during substantially the whole of 13 weeks
2955	immediately preceding the accidentinjury, the wages of a
2956	similar employee in the same employment who has worked
2957	substantially the whole of such 13 weeks shall be used in making
2958	the determination under the preceding paragraph.
2959	(c) If an employee is a seasonal worker and the foregoing
2960	method cannot be fairly applied in determining the average
2961	weekly wage, then the employee may use, instead of the 13 weeks
2962	immediately preceding the accidentinjury, the calendar year or
2963	the 52 weeks immediately preceding the accidentinjury. The
2964	employee will have the burden of proving that this method will
2965	be more reasonable and fairer than the method set forth in
2966	paragraphs (a) and (b) and, further, must document prior
2967	earnings with W-2 forms, written wage statements, or income tax
2968	returns. The employer shall have 30 days following the receipt
2969	of this written proof to adjust the compensation rate, including
2970	the making of any additional payment due for prior weekly
2971	payments, based on the lower rate compensation.
2972	(d) If any of the foregoing methods cannot reasonably and
2973	fairly be applied, the full-time weekly wages of the injured
2974	employee shall be used, except as otherwise provided in
2975	paragraph (e) or paragraph (f).
2976	(e) If it is established that the injured employee was
2977	under 22 years of age when the accident occurredinjuredand
2978	that under normal conditions her or his wages should be expected
2979	to increase during the period of disability, the fact may be
2980	considered in arriving at her or his average weekly wages.
2981	(f) If it is established that the injured employee was a
2982	part-time worker on the date of the accidentat the time of the
2983	injury, that she or he had adopted part-time employment as a
2984	customary practice, and that under normal working conditions she
2985	or he probably would have remained a part-time worker during the
2986	period of disability, these factors shall be considered in
2987	arriving at her or his average weekly wages. For the purpose of
2988	this paragraph, the term "part-time worker" means an individual
2989	who customarily works less than the full-time hours or full-time
2990	workweek of a similar employee in the same employment.
2991	(g) If compensation is due for a fractional part of the
2992	week, the compensation for such fractional part shall be
2993	determined by dividing the weekly compensation rate by the
2994	number of days employed per week to compute the amount due for
2995	each day.
2996	(4) Upon termination of the employee or upon termination
2997	of the payment of fringe benefits of any employee who is
2998	collecting indemnity benefits pursuant to s. 440.15(2) or
2999	(3)(b), the employer shall within 7 days of such termination
3000	file a corrected 13-week wage statement reflecting the wages
3001	paid and the fringe benefits that had been paid to the injured
3002	employee, as provided in s. 440.02(27).
3003	(5)
3004	(b) The employee waives any entitlement to interest,
3005	penalties, and attorney's fees during the period in which the
3006	employee has not provided information concerning the loss of
3007	earnings from concurrent employment. Carriers are not subject to
3008	penalties by the division under s. 440.20(8)(b) and (c)for
3009	unpaid compensation related to concurrent employment during the
3010	period in which the employee has not provided information
3011	concerning the loss of earnings from concurrent employment.
3012	Section 18. Section 440.15, Florida Statutes, is amended
3013	to read:
3014	440.15 Compensation for disability.--Compensation for
3015	disability shall be paid to the employee, subject to the limits
3016	provided in s. 440.12(2), as follows:
3017	(1) PERMANENT TOTAL DISABILITY.--
3018	(a) In case of total disability adjudged to be permanent,
3019	66 2/3 percent of the average weekly wages shall be paid to the
3020	employee during the continuance of such total disability. No
3021	compensation shall be payable under this section if the employee
3022	is engaged in, or is physically capable of engaging in, at least
3023	sedentary employment.
3024	(b) In the following cases, an injured employee is
3025	presumed to be permanently and totally disabled unless the
3026	employer or carrier establishes that the employee is physically
3027	capable of engaging in at least sedentary employment within a
3028	50-mile radius of the employee’s residence:
3029	1. Spinal cord injury involving severe paralysis of an
3030	arm, a leg, or the trunk;
3031	2. Amputation of an arm, a hand, a foot, or a leg
3032	involving the effective loss of use of that appendage;
3033	3. Severe brain or closed-head injury as evidenced by:
3034	a. Severe sensory or motor disturbances;
3035	b. Severe communication disturbances;
3036	c. Severe complex integrated disturbances of cerebral
3037	function;
3038	d. Severe episodic neurological disorders; or
3039	e. Other severe brain and closed-head injury conditions at
3040	least as severe in nature as any condition provided in sub-
3041	subparagraphs a.-d.;
3042	4. Second-degree or third-degree burns of 25 percent or
3043	more of the total body surface or third-degree burns of 5
3044	percent or more to the face and hands; or
3045	5. Total or industrial blindness.
3046
3047	In all other cases, in order to obtain permanent total
3048	disability benefits, the employee must establish that he or she
3049	is not able to engage in at least sedentary employment, within a
3050	50-mile radius of the employee's residence, due to his or her
3051	physical limitation. Entitlement to such benefits shall cease
3052	when the employee reaches age 75, unless the employee is not
3053	eligible for social security benefits under 42 U.S.C. s. 402 or
3054	s. 423 because the employee’s compensable injury has prevented
3055	the employee from working sufficient quarters to be eligible for
3056	such benefits, notwithstanding any age limits. If the accident
3057	occurred on or after the employee reaches age 70, benefits shall
3058	be payable during the continuance of permanent total disability,
3059	not to exceed 5 years following the determination of permanent
3060	total disability.Only a catastrophic injury as defined in s.
3061	440.02 shall, in the absence of conclusive proof of a
3062	substantial earning capacity, constitute permanent total
3063	disability. Only claimants with catastrophic injuries or
3064	claimants who are incapable of engaging in employment, as
3065	described in this paragraph,are eligible for permanent total
3066	benefits. In no other case may permanent total disability be
3067	awarded.
3068	(c) In cases of permanent total disability resulting from
3069	injuries that occurred prior to July 1, 1955, such payments
3070	shall not be made in excess of 700 weeks.
3071	(d) If an employee who is being paid compensation for
3072	permanent total disability becomes rehabilitated to the extent
3073	that she or he establishes an earning capacity, the employee
3074	shall be paid, instead of the compensation provided in paragraph
3075	(a), benefits pursuant to subsection (3). The department shall
3076	adopt rules to enable a permanently and totally disabled
3077	employee who may have reestablished an earning capacity to
3078	undertake a trial period of reemployment without prejudicing her
3079	or his return to permanent total status in the case that such
3080	employee is unable to sustain an earning capacity.
3081	(e)1. The employer's or carrier's right to conduct
3082	vocational evaluations or testing by the employer's or carrier's
3083	chosen rehabilitation advisor or providerpursuant to s. 440.491
3084	continues even after the employee has been accepted or
3085	adjudicated as entitled to compensation under this chapter and
3086	costs for such evaluations and testing shall be borne by the
3087	employer or carrier, respectively. This right includes, but is
3088	not limited to, instances in which such evaluations or tests are
3089	recommended by a treating physician or independent medical-
3090	examination physician, instances warranted by a change in the
3091	employee's medical condition, or instances in which the employee
3092	appears to be making appropriate progress in recuperation. This
3093	right may not be exercised more than once every calendar year.
3094	2. The carrier must confirm the scheduling of the
3095	vocational evaluation or testing in writing, and must notify the
3096	employee and theemployee's counsel, if any, at least 7 days
3097	before the date on which vocational evaluation or testing is
3098	scheduled to occur.
3099	3. Pursuant to an order of the judge of compensation
3100	claims,The employer or carrier may withhold payment of benefits
3101	for permanent total disability or supplements for any period
3102	during which the employee willfully fails or refuses to appear
3103	without good cause for the scheduled vocational evaluation or
3104	testing.
3105	(f)1. If permanent total disability results from injuries
3106	that occurred subsequent to June 30, 1955, and for which the
3107	liability of the employer for compensation has not been
3108	discharged under s. 440.20(11), the injured employee shall
3109	receive additional weekly compensation benefits equal to 35
3110	percent of her or his weekly compensation rate, as established
3111	pursuant to the law in effect on the date of her or his injury,
3112	multiplied by the number of calendar years since the date of
3113	injury. The weekly compensation payable and the additional
3114	benefits payable under this paragraph, when combined, may not
3115	exceed the maximum weekly compensation rate in effect at the
3116	time of payment as determined pursuant to s. 440.12(2).
3117	Entitlement to These supplemental payments shall not be paid or
3118	payable after the employee attainscease at age 62, regardless
3119	of whetherif the employee has applied for or is eligible to
3120	applyis eligible for social security benefits under 42 U.S.C.
3121	s.ss. 402 or s.and 423, unless the employee is not eligible
3122	for social security benefits under 42 U.S.C. s. 402 or s. 423
3123	because the employee’s compensable injury has prevented the
3124	employee from working sufficient quarters to be eligible for
3125	such benefitswhether or not the employee has applied forsuch
3126	benefits. These supplemental benefits shall be paid by the
3127	department out of the Workers' Compensation Administration Trust
3128	Fund when the injury occurred subsequent to June 30, 1955, and
3129	before July 1, 1984. These supplemental benefits shall be paid
3130	by the employer when the injury occurred on or after July 1,
3131	1984. Supplemental benefits are not payable for any period prior
3132	to October 1, 1974.
3133	2.a. The department shall provide by rule for the periodic
3134	reporting to the department of all earnings of any nature and
3135	social security income by the injured employee entitled to or
3136	claiming additional compensation under subparagraph 1. Neither
3137	the department nor the employer or carrier shall make any
3138	payment of those additional benefits provided by subparagraph 1.
3139	for any period during which the employee willfully fails or
3140	refuses to report upon request by the department in the manner
3141	prescribed by such rules.
3142	b. The department shall provide by rule for the periodic
3143	reporting to the employer or carrier of all earnings of any
3144	nature and social security income by the injured employee
3145	entitled to or claiming benefits for permanent total disability.
3146	The employer or carrier is not required to make any payment of
3147	benefits for permanent total disability for any period during
3148	which the employee willfully fails or refuses to report upon
3149	request by the employer or carrier in the manner prescribed by
3150	such rules or if any employee who is receiving permanent total
3151	disability benefits refuses to apply for or cooperate with the
3152	employer or carrier in applying for social security benefits.
3153	3. When an injured employee receives a full or partial
3154	lump-sum advance of the employee's permanent total disability
3155	compensation benefits, the employee's benefits under this
3156	paragraph shall be computed on the employee's weekly
3157	compensation rate as reduced by the lump-sum advance.
3158	(2) TEMPORARY TOTAL DISABILITY.--
3159	(a) Subject to subsection (7),in case of disability total
3160	in character but temporary in quality, 66 2/3 percent of the
3161	average weekly wages shall be paid to the employee during the
3162	continuance thereof, not to exceed 104 weeks except as provided
3163	in this subsection, s. 440.12(1), and s. 440.14(3). Once the
3164	employee reaches the maximum number of weeks allowed, or the
3165	employee reaches the date of maximum medical improvement,
3166	whichever occurs earlier, temporary disability benefits shall
3167	cease and the injured worker's permanent impairment shall be
3168	determined.
3169	(b) Notwithstanding the provisions of paragraph (a), an
3170	employee who has sustained the loss of an arm, leg, hand, or
3171	foot, has been rendered a paraplegic, paraparetic, quadriplegic,
3172	or quadriparetic, or has lost the sight of both eyes shall be
3173	paid temporary total disability of 80 percent of her or his
3174	average weekly wage. The increased temporary total disability
3175	compensation provided for in this paragraph must not extend
3176	beyond 6 months from the date of the accident; however, such
3177	benefits shall not be due or payable if the employee is eligible
3178	for, entitled to, or collecting permanent total disability
3179	benefits. The compensation provided by this paragraph is not
3180	subject to the limits provided in s. 440.12(2), but instead is
3181	subject to a maximum weekly compensation rate of $700. If, at
3182	the conclusion of this period of increased temporary total
3183	disability compensation, the employee is still temporarily
3184	totally disabled, the employee shall continue to receive
3185	temporary total disability compensation as set forth in
3186	paragraphs (a) and (c). The period of time the employee has
3187	received this increased compensation will be counted as part of,
3188	and not in addition to, the maximum periods of time for which
3189	the employee is entitled to compensation under paragraph (a) but
3190	not paragraph (c).
3191	(c) Temporary total disability benefits paid pursuant to
3192	this subsection shall include such period as may be reasonably
3193	necessary for training in the use of artificial members and
3194	appliances, and shall include such period as the employee may be
3195	receiving training and education under a program pursuant to s.
3196	440.491. Notwithstanding s. 440.02, the date of maximum medical
3197	improvement for purposes of paragraph (3)(b) shall be no earlier
3198	than the last day for which such temporary disability benefits
3199	are paid.
3200	(d) The department shall, by rule, provide for the
3201	periodic reporting to the department, employer, or carrier of
3202	all earned income, including income from social security, by the
3203	injured employee who is entitled to or claiming benefits for
3204	temporary total disability. The employer or carrier is not
3205	required to make any payment of benefits for temporary total
3206	disability for any period during which the employee willfully
3207	fails or refuses to report upon request by the employer or
3208	carrier in the manner prescribed by the rules. The rule must
3209	require the claimant to personally sign the claim form and
3210	attest that she or he has reviewed, understands, and
3211	acknowledges the foregoing.
3212	(3) PERMANENT IMPAIRMENT AND WAGE-LOSSBENEFITS.--
3213	(a) Impairment benefits.--
3214	1.Once the employee has reached the date of maximum
3215	medical improvement, impairment benefits are due and payable
3216	within 1420days after the carrier has knowledge of the
3217	impairment.
3218	(b)2.The three-member panel, in cooperation with the
3219	department, shall establish and use a uniform permanent
3220	impairment rating schedule. This schedule must be based on
3221	medically or scientifically demonstrable findings as well as the
3222	systems and criteria set forth in the American Medical
3223	Association's Guides to the Evaluation of Permanent Impairment;
3224	the Snellen Charts, published by American Medical Association
3225	Committee for Eye Injuries; and the Minnesota Department of
3226	Labor and Industry Disability Schedules. The schedule must
3227	shouldbe based upon objective findings. The schedule shall be
3228	more comprehensive than the AMA Guides to the Evaluation of
3229	Permanent Impairment and shall expand the areas already
3230	addressed and address additional areas not currently contained
3231	in the guides. On August 1, 1979, and pending the adoption, by
3232	rule, of a permanent schedule, Guides to the Evaluation of
3233	Permanent Impairment, copyright 1977, 1971, 1988, by the
3234	American Medical Association, shall be the temporary schedule
3235	and shall be used for the purposes hereof. For injuries after
3236	July 1, 1990, pending the adoption by rule of a uniform
3237	disability rating agency schedule, the Minnesota Department of
3238	Labor and Industry Disability Schedule shall be used unless that
3239	schedule does not address an injury. In such case, the Guides to
3240	the Evaluation of Permanent Impairment by the American Medical
3241	Association shall be used. Determination of permanent impairment
3242	under this schedule must be made by a physician licensed under
3243	chapter 458, a doctor of osteopathic medicine licensed under
3244	chapters 458 and 459, a chiropractic physician licensed under
3245	chapter 460, a podiatric physician licensed under chapter 461,
3246	an optometrist licensed under chapter 463, or a dentist licensed
3247	under chapter 466, as appropriate considering the nature of the
3248	injury. No other persons are authorized to render opinions
3249	regarding the existence of or the extent of permanent
3250	impairment.
3251	(c)3.All impairment income benefits shall be based on an
3252	impairment rating using the impairment schedule referred to in
3253	paragraph (b)subparagraph 2. Impairment income benefits are
3254	paid biweeklyweekly at the rate of 7550percent of the
3255	employee's average weekly temporary total disability benefit not
3256	to exceed the maximum weekly benefit under s. 440.12; provided,
3257	however, that such benefits shall be reduced by 50 percent for
3258	each week in which the employee has earned income equal to or in
3259	excess of the employee's average weekly wage. An employee's
3260	entitlement to impairment income benefits begins the day after
3261	the employee reaches maximum medical improvement or the
3262	expiration of temporary benefits, whichever occurs earlier, and
3263	continues until the earlier of:
3264	1.a.The expiration of a period computed at the rate of 3
3265	weeks for each percentage point of impairment; or
3266	2.b.The death of the employee.
3267
3268	Impairment income benefits as defined by this subsection are
3269	payable only for impairment ratings for physical impairments. If
3270	objective medical findings can substantiate a permanent
3271	psychiatric impairment resulting from the accident, permanent
3272	impairment benefits are limited for the permanent psychiatric
3273	impairment to 1-percent permanent impairment.
3274	(d)4.After the employee has been certified by a doctor as
3275	having reached maximum medical improvement or 6 weeks before the
3276	expiration of temporary benefits, whichever occurs earlier, the
3277	certifying doctor shall evaluate the condition of the employee
3278	and assign an impairment rating, using the impairment schedule
3279	referred to in paragraph (b)subparagraph 2. Compensation is not
3280	payable for the mental, psychological, or emotional injury
3281	arising out of depression from being out of work.If the
3282	certification and evaluation are performed by a doctor other
3283	than the employee's treating doctor, the certification and
3284	evaluation must be submitted to the treating doctor, the
3285	employee, and the carrier within 10 days after the evaluation.
3286	and The treating doctor must indicate to the carrieragreement
3287	or disagreement with the other doctor'scertification and
3288	evaluation.
3289	1.The certifying doctor shall issue a written report to
3290	the department, the employee,and the carrier certifying that
3291	maximum medical improvement has been reached, stating the
3292	impairment rating to the body as a whole, and providing any
3293	other information required by the department by rule. The
3294	carrier shall establish an overall maximum medical improvement
3295	date and permanent impairment rating, based upon all such
3296	reports.
3297	2. Within 14 days after the carrier's knowledge of each
3298	maximum medical improvement date and impairment rating to the
3299	body as a whole upon which the carrier is paying benefits, the
3300	carrier shall report such maximum medical improvement date and,
3301	when determined, the overall maximum medical improvement date
3302	and associated impairment rating to the department in a format
3303	as set forth in department rule.If the employee has not been
3304	certified as having reached maximum medical improvement before
3305	the expiration of 98102 weeks after the date temporary total
3306	disability benefits begin to accrue, the carrier shall notify
3307	the treating doctor of the requirements of this section.
3308	(e)5. The carrier shall pay the employee impairment income
3309	benefits for a period based on the impairment rating.
3310	(f)6. The department may by rule specify forms and
3311	procedures governing the method of payment of wage loss and
3312	impairment benefits under this sectionfor dates of accidents
3313	before January 1, 1994, and for dates of accidents on or after
3314	January 1, 1994.
3315	(b) Supplemental benefits.--
3316	1. All supplemental benefits must be paid in accordance
3317	with this subsection. An employee is entitled to supplemental
3318	benefits as provided in this paragraph as of the expiration of
3319	the impairment period, if:
3320	a. The employee has an impairment rating from the
3321	compensable injury of 20 percent or more as determined pursuant
3322	to this chapter;
3323	b. The employee has not returned to work or has returned
3324	to work earning less than 80 percent of the employee's average
3325	weekly wage as a direct result of the employee's impairment; and
3326	c. The employee has in good faith attempted to obtain
3327	employment commensurate with the employee's ability to work.
3328	2. If an employee is not entitled to supplemental benefits
3329	at the time of payment of the final weekly impairment income
3330	benefit because the employee is earning at least 80 percent of
3331	the employee's average weekly wage, the employee may become
3332	entitled to supplemental benefits at any time within 1 year
3333	after the impairment income benefit period ends if:
3334	a. The employee earns wages that are less than 80 percent
3335	of the employee's average weekly wage for a period of at least
3336	90 days;
3337	b. The employee meets the other requirements of
3338	subparagraph 1.; and
3339	c. The employee's decrease in earnings is a direct result
3340	of the employee's impairment from the compensable injury.
3341	3. If an employee earns wages that are at least 80 percent
3342	of the employee's average weekly wage for a period of at least
3343	90 days during which the employee is receiving supplemental
3344	benefits, the employee ceases to be entitled to supplemental
3345	benefits for the filing period. Supplemental benefits that have
3346	been terminated shall be reinstated when the employee satisfies
3347	the conditions enumerated in subparagraph 2. and files the
3348	statement required under subparagraph 4. Notwithstanding any
3349	other provision, if an employee is not entitled to supplemental
3350	benefits for 12 consecutive months, the employee ceases to be
3351	entitled to any additional income benefits for the compensable
3352	injury. If the employee is discharged within 12 months after
3353	losing entitlement under this subsection, benefits may be
3354	reinstated if the employee was discharged at that time with the
3355	intent to deprive the employee of supplemental benefits.
3356	4. After the initial determination of supplemental
3357	benefits, the employee must file a statement with the carrier
3358	stating that the employee has earned less than 80 percent of the
3359	employee's average weekly wage as a direct result of the
3360	employee's impairment, stating the amount of wages the employee
3361	earned in the filing period, and stating that the employee has
3362	in good faith sought employment commensurate with the employee's
3363	ability to work. The statement must be filed quarterly on a form
3364	and in the manner prescribed by the department. The department
3365	may modify the filing period as appropriate to an individual
3366	case. Failure to file a statement relieves the carrier of
3367	liability for supplemental benefits for the period during which
3368	a statement is not filed.
3369	5. The carrier shall begin payment of supplemental
3370	benefits not later than the seventh day after the expiration
3371	date of the impairment income benefit period and shall continue
3372	to timely pay those benefits. The carrier may request a
3373	mediation conference for the purpose of contesting the
3374	employee's entitlement to or the amount of supplemental income
3375	benefits.
3376	6. Supplemental benefits are calculated quarterly and paid
3377	monthly. For purposes of calculating supplemental benefits, 80
3378	percent of the employee's average weekly wage and the average
3379	wages the employee has earned per week are compared quarterly.
3380	For purposes of this paragraph, if the employee is offered a
3381	bona fide position of employment that the employee is capable of
3382	performing, given the physical condition of the employee and the
3383	geographic accessibility of the position, the employee's weekly
3384	wages are considered equivalent to the weekly wages for the
3385	position offered to the employee.
3386	7. Supplemental benefits are payable at the rate of 80
3387	percent of the difference between 80 percent of the employee's
3388	average weekly wage determined pursuant to s. 440.14 and the
3389	weekly wages the employee has earned during the reporting
3390	period, not to exceed the maximum weekly income benefit under s.
3391	440.12.
3392	8. The department may by rule define terms that are
3393	necessary for the administration of this section and forms and
3394	procedures governing the method of payment of supplemental
3395	benefits for dates of accidents before January 1, 1994, and for
3396	dates of accidents on or after January 1, 1994.
3397	(c) Duration of temporary impairment and supplemental
3398	income benefits.--The employee's eligibility for temporary
3399	benefits, impairment income benefits, and supplemental benefits
3400	terminates on the expiration of 401 weeks after the date of
3401	injury.
3402	(g) Notwithstanding paragraph (c), for accidents occurring
3403	on or after October 1, 2003, an employee's entitlement to
3404	impairment income benefits begins the day after the employee
3405	reaches maximum medical improvement or the expiration of
3406	temporary benefits, whichever occurs earlier, and continues for
3407	the following periods:
3408	1. Two weeks of benefits are to be paid to the employee
3409	for each percentage point of impairment from 1 percent up to and
3410	including 10 percent.
3411	2. For each percentage point of impairment from 11 percent
3412	up to and including 15 percent, 3 weeks of benefits are to be
3413	paid.
3414	3. For each percentage point of impairment from 16 percent
3415	up to and including 20 percent, 4 weeks of benefits are to be
3416	paid.
3417	4. For each percentage point of impairment from 21 percent
3418	and higher, 6 weeks of benefits are to be paid.
3419	(4) TEMPORARY PARTIAL DISABILITY.--
3420	(a) Subject to subsection (7),in case of temporary
3421	partial disability, compensation shall be equal to 80 percent of
3422	the difference between 80 percent of the employee's average
3423	weekly wage and the salary, wages, and other remuneration the
3424	employee is able to earn post injury, as compared weekly;
3425	however, the weekly temporary partial disabilitybenefits may
3426	not exceed an amount equal to 66 2/3 percent of the employee's
3427	average weekly wage at the time of accidentinjury. In order to
3428	simplify the comparison of the preinjury average weekly wage
3429	with the salary, wages, and other remuneration the employee is
3430	able to earn post injury, the department may by rule provide for
3431	payment of the initial installment of temporary partial
3432	disability benefits to be paid as a partial week so that payment
3433	for remaining weeks of temporary partial disability canthe
3434	modification of the weekly comparison so as tocoincide as
3435	closely as possible with the post injury employer's work week
3436	injured worker's pay periods. The amount determined to be the
3437	salary, wages, and other remuneration the employee is able to
3438	earn shall in no case be less than the sum actually being earned
3439	by the employee, including earnings from sheltered employment.
3440	Benefits shall be payable under this subsection only if overall
3441	maximum medical improvement has not been reached and the medical
3442	conditions resulting from the accident create restrictions on
3443	the injured employee's ability to return to work.
3444	(b) Within 5 business days after the carrier's knowledge
3445	of the employee's release to restricted work, the carrier shall
3446	mail to the employee and employer an informational letter,
3447	adopted by department rule, explaining the employee's possible
3448	eligibility and responsibilities for temporary partial
3449	disability benefits.
3450	(c) When an employee returns to work with the restrictions
3451	resulting from the accident and is earning wages less than 80
3452	percent of the preinjury average weekly wage, the first
3453	installment of temporary partial disability benefits is due 7
3454	days after the last date of the post injury employer's first
3455	biweekly work week. Thereafter, payment for temporary partial
3456	benefits shall be paid biweekly no later than the 7th day
3457	following the last day of each biweekly work week.
3458	(d) If the employee is unable to return to work with the
3459	restrictions resulting from the accident and is not earning
3460	wages, salary, or other remuneration, temporary partial
3461	disability benefits shall be paid no later than the last day of
3462	each biweekly period. The employee shall notify the carrier
3463	within 5 business days after returning to work. Failure to
3464	notify the carrier of the establishment of an earning capacity
3465	in the required time shall result in a suspension or nonpayment
3466	of temporary partial disability benefits until the proper
3467	notification is provided.
3468	(e)(b)Such benefits shall be paid during the continuance
3469	of such disability, not to exceed a period of 104 weeks, as
3470	provided by this subsection and subsection (2). Once the injured
3471	employee reaches the maximum number of weeks, temporary
3472	disability benefits cease and the injured worker's permanent
3473	impairment must be determined. If the employee is terminated
3474	from post injury employment based on the employee's misconduct,
3475	temporary partial disability benefits are not payable as
3476	provided for in this section. The department shallmayby rule
3477	specify forms and procedures governing the method and time for
3478	ofpayment of temporary disability benefits for dates of
3479	accidents before January 1, 1994, and for dates of accidents on
3480	or after January 1, 1994.
3481	(5) SUBSEQUENT INJURY.--
3482	(a) The fact that an employee has suffered previous
3483	disability, impairment, anomaly, or disease, or received
3484	compensation therefor, shall not preclude her or him from
3485	benefits, as specified in paragraph (b),for a subsequent
3486	aggravation or acceleration of the preexisting condition ornor
3487	preclude benefits for death resulting therefrom, except that no
3488	benefits shall be payable if the employee, at the time of
3489	entering into the employment of the employer by whom the
3490	benefits would otherwise be payable, falsely represents herself
3491	or himself in writing as not having previously been disabled or
3492	compensated because of such previous disability, impairment,
3493	anomaly, or disease and the employer detrimentally relies on the
3494	misrepresentation. Compensation for temporary disability,
3495	medical benefits, and wage-loss benefitsshall not be subject to
3496	apportionment.
3497	(b) If a compensable injury, disability, or need for
3498	medical carepermanent impairment, or any portion thereof, is a
3499	result of aggravation or acceleration of a preexisting
3500	condition, or is the result of merger with a preexisting
3501	condition, only the disabilities and medical treatment
3502	associated with such compensable injury shall be payable under
3503	this chapter, excluding the degree of disability or medical
3504	conditions existing at the time of the impairment rating or at
3505	the time of the accident, regardless of whether the preexisting
3506	condition was disabling at the time of the accident or at the
3507	time of the impairment rating and without considering whether
3508	the preexisting condition would be disabling without the
3509	compensable accidentimpairment, an employee eligible to receive
3510	impairment benefits under paragraph (3)(a) shall receive such
3511	benefits for the total impairment found to result, excluding the
3512	degree of impairment existing at the time of the subject
3513	accident or injury or which would have existed by the time of
3514	the impairment rating without the intervention of the
3515	compensable accident or injury. The degree of permanent
3516	impairment or disabilityattributable to the accident or injury
3517	shall be compensated in accordance with this section,
3518	apportioning out the preexisting condition based on the
3519	anatomical impairment rating attributable to the preexisting
3520	condition. Medical benefits shall be paid apportioning out the
3521	percentage of the need for such care attributable to the
3522	preexisting conditionparagraph (3)(a). As used in this
3523	paragraph, "merger" means the combining of a preexisting
3524	permanent impairment or disabilitywith a subsequent compensable
3525	permanent impairment or disabilitywhich, when the effects of
3526	both are considered together, result in a permanent impairment
3527	or disabilityrating which is greater than the sum of the two
3528	permanent impairment or disability ratings when each impairment
3529	or disability is considered individually.
3530	(6) OBLIGATION TO REHIRE.--If the employer has not in good
3531	faith made available to the employee, within a 100-mile radius
3532	of the employee's residence, work appropriate to the employee's
3533	physical limitations within 30 days after the carrier notifies
3534	the employer of maximum medical improvement and the employee's
3535	physical limitations, the employer shall pay to the department
3536	for deposit into the Workers' Compensation Administration Trust
3537	Fund a fine of $250 for every $5,000 of the employer's workers'
3538	compensation premium or payroll, not to exceed $2,000 per
3539	violation, as the department requires by rule. The employer is
3540	not subject to this subsection if the employee is receiving
3541	permanent total disability benefits or if the employer has 50 or
3542	fewer employees.
3543	(6)(7)EMPLOYEE REFUSES EMPLOYMENT.--If an injured
3544	employee refuses employment suitable to the capacity thereof,
3545	offered to or procured therefor, such employee shall not be
3546	entitled to any compensation at any time during the continuance
3547	of such refusal unless at any time in the opinion of the judge
3548	of compensation claims such refusal is justifiable. Time periods
3549	for the payment of benefits in accordance with this section
3550	shall be counted in determining the limitation of benefits as
3551	provided for in paragraphs (2)(a), (3)(c), and (4)(b).
3552	(7)(8)EMPLOYEE LEAVES EMPLOYMENT.--If an injured
3553	employee, when receiving compensation for temporary partial
3554	disability, leaves the employment of the employer by whom she or
3555	he was employed at the time of the accident for which such
3556	compensation is being paid, the employee shall, upon securing
3557	employment elsewhere, give to such former employer an affidavit
3558	in writing containing the name of her or his new employer, the
3559	place of employment, and the amount of wages being received at
3560	such new employment; and, until she or he gives such affidavit,
3561	the compensation for temporary partial disability will cease.
3562	The employer by whom such employee was employed at the time of
3563	the accident for which such compensation is being paid may also
3564	at any time demand of such employee an additional affidavit in
3565	writing containing the name of her or his employer, the place of
3566	her or his employment, and the amount of wages she or he is
3567	receiving; and if the employee, upon such demand, fails or
3568	refuses to make and furnish such affidavit, her or his right to
3569	compensation for temporary partial disability shall cease until
3570	such affidavit is made and furnished. If the employee leaves her
3571	or his employment while receiving temporary partial benefits
3572	without just cause as determined by the judge of compensation
3573	claims, temporary partial benefits shall be payable based on the
3574	deemed earnings of the employee as if she or he had remained
3575	employed.
3576	(8)(9)EMPLOYEE BECOMES INMATE OF INSTITUTION.--In case an
3577	employee becomes an inmate of a public institution, then no
3578	compensation shall be payable unless she or he has dependent
3579	upon her or him for support a person or persons defined as
3580	dependents elsewhere in this chapter, whose dependency shall be
3581	determined as if the employee were deceased and to whom
3582	compensation would be paid in case of death; and such
3583	compensation as is due such employee shall be paid such
3584	dependents during the time she or he remains such inmate.
3585	(9)(10)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER
3586	AND FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE ACT.--
3587	(a) Weekly compensation benefits payable under this
3588	chapter for disability resulting from injuries to an employee
3589	who becomes eligible for benefits under 42 U.S.C. s. 423 shall
3590	be reduced to an amount whereby the sum of such compensation
3591	benefits payable under this chapter and such total benefits
3592	otherwise payable for such period to the employee and her or his
3593	dependents, had such employee not been entitled to benefits
3594	under this chapter, under 42 U.S.C. ss. 402 and 423, does not
3595	exceed 80 percent of the employee's average weekly wage.
3596	However, this provision shall not operate to reduce an injured
3597	worker's benefits under this chapter to a greater extent than
3598	such benefits would have otherwise been reduced under 42 U.S.C.
3599	s. 424(a). This reduction of compensation benefits is not
3600	applicable to any compensation benefits payable for any week
3601	subsequent to the week in which the injured worker reaches the
3602	age of 62 years.
3603	(b) If the provisions of 42 U.S.C. s. 424(a) are amended
3604	to provide for a reduction or increase of the percentage of
3605	average current earnings that the sum of compensation benefits
3606	payable under this chapter and the benefits payable under 42
3607	U.S.C. ss. 402 and 423 can equal, the amount of the reduction of
3608	benefits provided in this subsection shall be reduced or
3609	increased accordingly. The department may by rule specify forms
3610	and procedures governing the method for calculating and
3611	administering the offset of benefits payable under this chapter
3612	and benefits payable under 42 U.S.C. ss. 402 and 423. The
3613	department shall have first priority in taking any available
3614	social security offsets on dates of accidents occurring before
3615	July 1, 1984.
3616	(c) No disability compensation benefits payable for any
3617	week, including those benefits provided by paragraph (1)(f),
3618	shall be reduced pursuant to this subsection until the Social
3619	Security Administration determines the amount otherwise payable
3620	to the employee under 42 U.S.C. ss. 402 and 423 and the employee
3621	has begun receiving such social security benefit payments. The
3622	employee shall, upon demand by the department, the employer, or
3623	the carrier, authorize the Social Security Administration to
3624	release disability information relating to her or him and
3625	authorize the Division of Unemployment Compensation to release
3626	unemployment compensation information relating to her or him, in
3627	accordance with rules to be adopted by the department
3628	prescribing the procedure and manner for requesting the
3629	authorization and for compliance by the employee. Neither the
3630	department nor the employer or carrier shall make any payment of
3631	benefits for total disability or those additional benefits
3632	provided by paragraph (1)(f) for any period during which the
3633	employee willfully fails or refuses to authorize the release of
3634	information in the manner and within the time prescribed by such
3635	rules. The authority for release of disability information
3636	granted by an employee under this paragraph shall be effective
3637	for a period not to exceed 12 months, such authority to be
3638	renewable as the department may prescribe by rule.
3639	(d) If compensation benefits are reduced pursuant to this
3640	subsection, the minimum compensation provisions of s. 440.12(2)
3641	do not apply.
3642	(10)(11)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER
3643	WHO HAS RECEIVED OR IS ENTITLED TO RECEIVE UNEMPLOYMENT
3644	COMPENSATION.--
3645	(a) No compensation benefits shall be payable for
3646	temporary total disability or permanent total disability under
3647	this chapter for any week in which the injured employee has
3648	received, or is receiving, unemployment compensation benefits.
3649	(b) If an employee is entitled to temporary partial
3650	benefits pursuant to subsection (4) and unemployment
3651	compensation benefits, such unemployment compensation benefits
3652	shall be primary and the temporary partial benefits shall be
3653	supplemental only, the sum of the two benefits not to exceed the
3654	amount of temporary partial benefits which would otherwise be
3655	payable.
3656	(11)(12)FULL-PAY STATUS FOR CERTAIN LAW ENFORCEMENT
3657	OFFICERS.--Any law enforcement officer as defined in s.
3658	943.10(1), (2), or (3) who, while acting within the course of
3659	employment as provided by s. 440.091, is maliciously or
3660	intentionally injured and who thereby sustains a job-connected
3661	disability compensable under this chapter shall be carried in
3662	full-pay status rather than being required to use sick, annual,
3663	or other leave. Full-pay status shall be granted only after
3664	submission to the employing agency's head of a medical report
3665	which gives a current diagnosis of the employee's recovery and
3666	ability to return to work. In no case shall the employee's
3667	salary and workers' compensation benefits exceed the amount of
3668	the employee's regular salary requirements.
3669	(12)(13)REPAYMENT.--If an employee has received a sum as
3670	an indemnity benefit under any classification or category of
3671	benefit under this chapter to which she or he is not entitled,
3672	the employee is liable to repay that sum to the employer or the
3673	carrier or to have that sum deducted from future benefits,
3674	regardless of the classification of benefits, payable to the
3675	employee under this chapter; however, a partial payment of the
3676	total repayment may not exceed 20 percent of the amount of the
3677	biweekly payment.
3678	Section 19. Subsections (1), (2), and (3) of section
3679	440.151, Florida Statutes, are amended to read:
3680	440.151 Occupational diseases.--
3681	(1)(a) Where the employer and employee are subject to the
3682	provisions of the Workers' Compensation Law, the disablement or
3683	death of an employee resulting from an occupational disease as
3684	hereinafter defined shall be treated as the happening of an
3685	injury by accident, notwithstanding any other provisions of this
3686	chapter, and the employee or, in case of death, the employee's
3687	dependents shall be entitled to compensation as provided by this
3688	chapter, except as hereinafter otherwise provided; and the
3689	practice and procedure prescribed by this chapter shall apply to
3690	all proceedings under this section, except as hereinafter
3691	otherwise provided. Provided, however, that in no case shall an
3692	employer be liable for compensation under the provisions of this
3693	section unless such disease has resulted from the nature of the
3694	employment in which the employee was engaged under such
3695	employer,and was actually contracted while so engaged, and the
3696	nature of the employment was the major contributing cause of the
3697	disease. Major contributing cause must be shown by medical
3698	evidence only, as demonstrated by physical examination findings
3699	and diagnostic testing.meaning by "Nature of the employment"
3700	means that intothe occupation in which the employee was so
3701	engaged there is attached a particular hazard of such disease
3702	that distinguishes it from the usual run of occupations, or the
3703	incidence of such disease is substantially higher in the
3704	occupation in which the employee was so engaged than in the
3705	usual run of occupations. In claims for death under s. 440.16,
3706	death must occuror, in case of death, unless death follows
3707	continuous disability from such disease, commencing within the
3708	period above limited, for which compensation has been paid or
3709	awarded, or timely claim made as provided in this section, and
3710	results within 350 weeks after such last exposure. Both
3711	causation and sufficient exposure to a specific harmful
3712	substance shown to be present in the workplace to support
3713	causation shall be proven by clear and convincing evidence.
3714	(b) No compensation shall be payable for an occupational
3715	disease if the employee, at the time of entering into the
3716	employment of the employer by whom the compensation would
3717	otherwise be payable, falsely represents herself or himself in
3718	writing as not having previously been disabled, laid off or
3719	compensated in damages or otherwise, because of such disease.
3720	(c) Where an occupational disease is aggravated by any
3721	other disease or infirmity, not itself compensable, or where
3722	disability or death from any other cause, not itself
3723	compensable, is aggravated, prolonged, accelerated or in anywise
3724	contributed to by an occupational disease, the compensation
3725	shall be payable only if the occupational disease is the major
3726	contributing cause of the injury. Any compensationshall be
3727	reduced and limited to such proportion only of the compensation
3728	that would be payable if the occupational disease were the sole
3729	cause of the disability or death as such occupational disease,
3730	as a causative factor, bears to all the causes of such
3731	disability or death, such reduction in compensation to be
3732	effected by reducing the number of weekly or monthly payments or
3733	the amounts of such payments, as under the circumstances of the
3734	particular case may be for the best interest of the claimant or
3735	claimants. Major contributing cause must be demonstrated by
3736	medical evidence based on physical examination findings and
3737	diagnostic testing.
3738	(d) No compensation for death from an occupational disease
3739	shall be payable to any person whose relationship to the
3740	deceased, which under the provisions of this Workers'
3741	Compensation Law would give right to compensation, arose
3742	subsequent to the beginning of the first compensable disability,
3743	save only to afterborn children of a marriage existing at the
3744	beginning of such disability.
3745	(e) No compensation shall be payable for disability or
3746	death resulting from tuberculosis arising out of and in the
3747	course of employment by the Department of Health at a state
3748	tuberculosis hospital, or aggravated by such employment, when
3749	the employee had suffered from said disease at any time prior to
3750	the commencement of such employment.
3751	(2) Whenever used in this section the term "occupational
3752	disease" shall be construed to mean only a disease which is due
3753	to causes and conditions which are characteristic of and
3754	peculiar to a particular trade, occupation, process, or
3755	employment, and to exclude all ordinary diseases of life to
3756	which the general public is exposed, unless the incidence of the
3757	disease is substantially higher in the particular trade,
3758	occupation, process, or employment than for the general public.
3759	"Occupational disease" means only a disease for which there are
3760	epidemiological studies showing that exposure to the specific
3761	substance involved, at the levels to which the employee was
3762	exposed, may cause the precise disease sustained by the
3763	employee.
3764	(3) Except as hereinafterotherwise provided in this
3765	section, "disablement" means disability as described in s.
3766	440.02(13)the event of an employee's becoming actually
3767	incapacitated, partially or totally, because of an occupational
3768	disease, from performing her or his work in the last occupation
3769	in which injuriously exposed to the hazards of such disease; and
3770	"disability" means the state of being so incapacitated.
3771	Section 20. Subsections (1) and (7) of section 440.16,
3772	Florida Statutes, are amended to read:
3773	440.16 Compensation for death.--
3774	(1) If death results from the accident within 1 year
3775	thereafter or follows continuous disability and results from the
3776	accident within 5 years thereafter, the employer shall pay:
3777	(a) Within 14 days after receiving the bill, actual
3778	funeral expenses not to exceed $7,500$5,000.
3779	(b) Compensation, in addition to the above, in the
3780	following percentages of the average weekly wages to the
3781	following persons entitled thereto on account of dependency upon
3782	the deceased, and in the following order of preference, subject
3783	to the limitation provided in subparagraph 2., but such
3784	compensation shall be subject to the limits provided in s.
3785	440.12(2), shall not exceed $150,000$100,000, and may be less
3786	than, but shall not exceed, for all dependents or persons
3787	entitled to compensation, 66 2/3 percent of the average wage:
3788	1. To the spouse, if there is no child, 50 percent of the
3789	average weekly wage, such compensation to cease upon the
3790	spouse's death.
3791	2. To the spouse, if there is a child or children, the
3792	compensation payable under subparagraph 1. and, in addition, 16
3793	2/3 percent on account of the child or children. However, when
3794	the deceased is survived by a spouse and also a child or
3795	children, whether such child or children are the product of the
3796	union existing at the time of death or of a former marriage or
3797	marriages, the judge of compensation claims may provide for the
3798	payment of compensation in such manner as may appear to the
3799	judge of compensation claims just and proper and for the best
3800	interests of the respective parties and, in so doing, may
3801	provide for the entire compensation to be paid exclusively to
3802	the child or children; and, in the case of death of such spouse,
3803	33 1/3 percent for each child. However, upon the surviving
3804	spouse's remarriage, the spouse shall be entitled to a lump-sum
3805	payment equal to 26 weeks of compensation at the rate of 50
3806	percent of the average weekly wage as provided in s. 440.12(2),
3807	unless the $150,000$100,000limit provided in this paragraph is
3808	exceeded, in which case the surviving spouse shall receive a
3809	lump-sum payment equal to the remaining available benefits in
3810	lieu of any further indemnity benefits. In no case shall a
3811	surviving spouse's acceptance of a lump-sum payment affect
3812	payment of death benefits to other dependents.
3813	3. To the child or children, if there is no spouse, 33 1/3
3814	percent for each child.
3815	4. To the parents, 25 percent to each, such compensation
3816	to be paid during the continuance of dependency.
3817	5. To the brothers, sisters, and grandchildren, 15 percent
3818	for each brother, sister, or grandchild.
3819	(c) To the surviving spouse, payment of postsecondary
3820	student fees for instruction at any area technical center
3821	established under s. 1001.44 for up to 1,800 classroom hours or
3822	payment of student fees at any community college established
3823	under part III of chapter 1004 for up to 80 semester hours. The
3824	spouse of a deceased state employee shall be entitled to a full
3825	waiver of such fees as provided in ss. 1009.22 and 1009.23 in
3826	lieu of the payment of such fees. The benefits provided for in
3827	this paragraph shall be in addition to other benefits provided
3828	for in this section and shall terminate 7 years after the death
3829	of the deceased employee, or when the total payment in eligible
3830	compensation under paragraph (b) has been received. To qualify
3831	for the educational benefit under this paragraph, the spouse
3832	shall be required to meet and maintain the regular admission
3833	requirements of, and be registered at, such area technical
3834	center or community college, and make satisfactory academic
3835	progress as defined by the educational institution in which the
3836	student is enrolled.
3837	(7) Compensation under this chapter to aliens not
3838	residents (or about to become nonresidents) of the United States
3839	or Canada shall be the same in amount as provided for residents,
3840	except that dependents in any foreign country shall be limited
3841	to surviving spouse and child or children, or if there be no
3842	surviving spouse or child or children, to surviving father or
3843	mother whom the employee has supported, either wholly or in
3844	part, for the period of 1 year prior to the date of the injury,
3845	and except that the judge of compensation claims may, at the
3846	option of the judge of compensation claims, or upon the
3847	application of the insurance carrier, commute all future
3848	installments of compensation to be paid to such aliens by paying
3849	or causing to be paid to them one-half of the commuted amount of
3850	such future installments of compensation as determined by the
3851	judge of compensation claims, and provided further that
3852	compensation to dependents referred to in this subsection shall
3853	in no case exceed $75,000$50,000.
3854	Section 21. Subsection (9) of section 440.185, Florida
3855	Statutes, is amended, and subsection (12) is added to said
3856	section, to read:
3857	440.185 Notice of injury or death; reports; penalties for
3858	violations.--
3859	(9) Any employer or carrier who fails or refuses to timely
3860	send any form, report, or notice required by this section shall
3861	be subject to an administrative fine by the departmenta civil
3862	penalty not to exceed $1,000$500for each such failure or
3863	refusal. If, within 1 calendar year, an employer fails to timely
3864	submit to the carrier more than 10 percent of its notices of
3865	injury or death, the employer shall be subject to an
3866	administrative fine by the department not to exceed $2,000 for
3867	each such failure or refusal.However, any employer who fails to
3868	notify the carrier of the injury on the prescribed form or by
3869	letter within the 7 days required in subsection (2) shall be
3870	liable for the administrative finecivil penalty, which shall be
3871	paid by the employer and not the carrier. Failure by the
3872	employer to meet its obligations under subsection (2) shall not
3873	relieve the carrier from liability for the administrative fine
3874	civil penaltyif it fails to comply with subsections (4) and
3875	(5).
3876	(12) Upon receiving notice of an injury from an employee
3877	under subsection (1), the employer or carrier shall provide the
3878	employee with a written notice, in the form and manner
3879	determined by the department by rule, of the availability of
3880	services from the Employee Assistance and Ombudsman Office. The
3881	substance of the notice to the employee shall include:
3882	(a) A description of the scope of services provided by the
3883	office.
3884	(b) A listing of the toll-free telephone number of, the
3885	email address, and the postal address of the office.
3886	(c) A statement that the informational brochure referred
3887	to in subsection (4) will be mailed to the employee within 3
3888	days after the carrier receives notice of the injury.
3889	(d) Any other information regarding access to assistance
3890	that the department finds is immediately necessary for an
3891	injured employee.
3892	Section 22. Subsections (1) and (2) of section 440.192,
3893	Florida Statutes, are amended, and subsection (9) is added to
3894	said section, to read:
3895	440.192 Procedure for resolving benefit disputes.—
3896	(1) Subject to s. 440.191, Any employee may, for any
3897	benefit that is ripe, due, and owing,who has not received a
3898	benefit to which the employee believes she or he is entitled
3899	under this chapter shallfile by certified mail, or by
3900	electronic means approved by the Deputy Chief Judge, with the
3901	Office of the Judges of Compensation Claims a petition for
3902	benefits which meets the requirements of this section and the
3903	definition of specificity in s. 440.02. The department shall
3904	inform employees of the location of the Office of the Judges of
3905	Compensation Claims for purposes of filing a petition for
3906	benefits. The employee shall also serve copies of the petition
3907	for benefits by certified mail, or by electronic means approved
3908	by the Deputy Chief Judge, upon the employer and the employer's
3909	carrier. The DeputyChief Judge shall refer the petitions to the
3910	judges of compensation claims.
3911	(2) Upon receipt, the Office of the Judges of Compensation
3912	Claims shall review each petition and shall dismiss each
3913	petition or any portion of such a petition, upon the judge's own
3914	motion or upon the motion of any party,that does not on its
3915	face specifically identify or itemize the following:
3916	(a) Name, address, telephone number, and social security
3917	number of the employee.
3918	(b) Name, address, and telephone number of the employer.
3919	(c) A detailed description of the injury and cause of the
3920	injury, including the location of the occurrence and the date or
3921	dates of the accident.
3922	(d) A detailed description of the employee's job, work
3923	responsibilities, and work the employee was performing when the
3924	injury occurred.
3925	(e) The time period for which compensation and the
3926	specific classification of compensation were not timely
3927	provided.
3928	(f) Date of maximum medical improvement, character of
3929	disability, and specific statement of all benefits or
3930	compensation that the employee is seeking.
3931	(g) All specific travel costs to which the employee
3932	believes she or he is entitled, including dates of travel and
3933	purpose of travel, means of transportation, and mileage and
3934	including the date the request for mileage was filed with the
3935	carrier and a copy of the request filed with the carrier.
3936	(h) Specific listing of all medical charges alleged
3937	unpaid, including the name and address of the medical provider,
3938	the amounts due, and the specific dates of treatment.
3939	(i) The type or nature of treatment care or attendance
3940	sought and the justification for such treatment. If the employee
3941	is under the care of a physician for an injury identified under
3942	paragraph (c), a copy of the physician's request, authorization,
3943	or recommendation for treatment, care, or attendance must
3944	accompany the petition.
3945	(j) Specific explanation of any other disputed issue that
3946	a judge of compensation claims will be called to rule upon.
3947
3948	The dismissal of any petition or portion of such a petition
3949	under this section is without prejudice and does not require a
3950	hearing.
3951	(9) A petition for benefits must contain claims for all
3952	benefits that are ripe, due, and owing on the date the petition
3953	is filed. Unless stipulated in writing by the parties, only
3954	claims which have been properly raised in a petition for
3955	benefits and have undergone mediation may be considered for
3956	adjudication by a judge of compensation claims.
3957	Section 23. Section 440.1926, Florida Statutes, is created
3958	to read:
3959	440.1926 Alternate dispute resolution; claim
3960	arbitration.--Notwithstanding any other provision of this
3961	chapter, the employer, carrier, and employee may mutually agree
3962	to seek consent from a judge of compensation claims to enter
3963	into binding claim arbitration in lieu of any other remedy
3964	provided for in this chapter to resolve all issues in dispute
3965	regarding an injury. Arbitrations agreed to pursuant to this
3966	section shall be governed by chapter 682, the Florida
3967	Arbitration Code, except that, notwithstanding any provision in
3968	chapter 682, the term "court" shall mean a judge of compensation
3969	claims. An arbitration award in accordance with this section
3970	shall be enforceable in the same manner and with the same powers
3971	as any final compensation order.
3972	Section 24. Subsections (2), (3), (4), (6), and (8) and
3973	paragraph (d) of subsection (11) of section 440.20, Florida
3974	Statutes, are amended to read:
3975	440.20 Time for payment of compensation and medical bills;
3976	penalties for late payment.--
3977	(2)(a)The carrier must pay the first installment of
3978	compensation for total disability or death benefitsor deny
3979	compensability no later than the 14th calendarday after the
3980	employer receives notificationnotice of the injury or death,
3981	when disability is immediate and continuous for 8 calendar days
3982	or more after the injury. If the first 7 days after disability
3983	are nonconsecutive or delayed, the first installment of
3984	compensation is due on the 6th day after the first 8 calendar
3985	days of disability. The carrier shall thereafter pay
3986	compensation in biweekly installments or as otherwise provided
3987	in s. 440.15, unless the judge of compensation claims determines
3988	or the parties agree that an alternate installment schedule is
3989	in the best interests of the employee.
3990	(b) The carrier must pay, disallow, or deny all medical,
3991	dental, pharmacy, and hospital bills submitted to the carrier in
3992	accordance with department rule no later than 45 calendar days
3993	after the carrier's receipt of the bill.
3994	(3) Upon making initial payment of indemnity benefits, or
3995	upon suspension or cessation of payment for any reason, the
3996	carrier shall immediately notify the injured employee, the
3997	employer, and thedepartment that it has commenced, suspended,
3998	or ceased payment of compensation. The department may require
3999	such notification to the injured employee, employer, and the
4000	department in aanyformat and manner it deems necessary to
4001	obtain accurate and timely notificationreporting.
4002	(4) If the carrier is uncertain of its obligation to
4003	provide all benefits or compensation, it may initiate payment
4004	without prejudice and without admitting liability. the carrier
4005	shall immediately and in good faith commence investigation of
4006	the employee's entitlement to benefits under this chapter and
4007	shall admit or deny compensability within 120 days after the
4008	initial provision of compensation or benefits as required under
4009	subsection (2) or s. 440.192(8). Additionally, the carrier shall
4010	initiate payment and continue the provision of all benefits and
4011	compensation as if the claim had been accepted as compensable,
4012	without prejudice and without admitting liability.Upon
4013	commencement of payment as required under subsection (2) or s.
4014	440.192 (8), the carrier shall provide written notice to the
4015	employee that it has elected to pay all or part ofthe claim
4016	pending further investigation, and that it will advise the
4017	employee of claim acceptance or denial within 120 days. A
4018	carrier that fails to deny compensability within 120 days after
4019	the initial provision of benefits or payment of compensation as
4020	required under subsection (2) or s. 440.192(8) waives the right
4021	to deny compensability, unless the carrier can establish
4022	material facts relevant to the issue of compensability that it
4023	could not have discovered through reasonable investigation
4024	within the 120-day period. The initial provision of compensation
4025	or benefits, for purposes of this subsection, means the first
4026	installment of compensation or benefits to be paid by the
4027	carrier under subsection (2) or pursuant to a petition for
4028	benefits under s. 440.192(8).
4029	(6)(a)If any installment of compensation for death or
4030	dependency benefits, or compensation for disability benefits,
4031	permanent impairment, or wage losspayable without an award is
4032	not paid within 7 days after it becomes due, as provided in
4033	subsection (2), subsection (3), or subsection (4), there shall
4034	be added to such unpaid installment a punitivepenalty of an
4035	amount equal to 20 percent of the unpaid installment or $5,
4036	which shall be paid at the same time as, but in addition to,
4037	such installment of compensation. This penalty shall not apply
4038	for late payments resulting, unless notice is filed under
4039	subsection (4) or unless such nonpayment resultsfrom conditions
4040	over which the employer or carrier had no control. When any
4041	installment of compensation payable without an award has not
4042	been paid within 7 days after it became due and the claimant
4043	concludes the prosecution of the claim before a judge of
4044	compensation claims without having specifically claimed
4045	additional compensation in the nature of a penalty under this
4046	section, the claimant will be deemed to have acknowledged that,
4047	owing to conditions over which the employer or carrier had no
4048	control, such installment could not be paid within the period
4049	prescribed for payment and to have waived the right to claim
4050	such penalty. However, during the course of a hearing, the judge
4051	of compensation claims shall on her or his own motion raise the
4052	question of whether such penalty should be awarded or excused.
4053	The department may assess without a hearing the punitivepenalty
4054	against either the employer or the insurancecarrier, depending
4055	upon who was at fault in causing the delay. The insurance policy
4056	cannot provide that this sum will be paid by the carrier if the
4057	department or the judge of compensation claims determines that
4058	the punitive penalty should be paidmadeby the employer rather
4059	than the carrier. Any additional installment of compensation
4060	paid by the carrier pursuant to this section shall be paid
4061	directly to the employee by check or, if authorized by the
4062	employee, by direct deposit into the employee's account at a
4063	financial institution. As used in this subsection, the term
4064	"financial institution" means a financial institution as defined
4065	in s. 655.005(1)(h).
4066	(b) For medical services provided on or after January 1,
4067	2004, the department shall require that all medical, hospital,
4068	pharmacy, or dental bills properly submitted by the provider,
4069	except for bills that are disallowed or denied by the carrier or
4070	its authorized vendor in accordance with department rule, are
4071	timely paid within 45 calendar days after the carrier's receipt
4072	of the bill. The department shall impose penalties for late
4073	payments or disallowances or denials of medical, hospital,
4074	pharmacy, or dental bills that are below a minimum 95 percent
4075	timely performance standard. The carrier shall pay to the
4076	Workers' Compensation Administration Trust Fund a penalty of:
4077	1. Twenty-five dollars for each bill below the 95 percent
4078	timely performance standard, but meeting a 90 percent timely
4079	standard.
4080	2. Fifty dollars for each bill below a 90 percent timely
4081	performance standard.
4082	(8)(a)In addition to any other penalties provided by this
4083	chapter for late payment, if any installment of compensation is
4084	not paid when it becomes due, the employer, carrier, or
4085	servicing agent shall pay interest thereon at the rate of 12
4086	percent per year from the date the installment becomes due until
4087	it is paid, whether such installment is payable without an order
4088	or under the terms of an order. The interest payment shall be
4089	the greater of the amount of interest due or $5.
4090	(a) Within 30 days after final payment of compensation has
4091	been made, the employer, carrier, or servicing agent shall send
4092	to the department a notice, in accordance with a format and
4093	manner prescribed by the department, stating that such final
4094	payment has been made and stating the total amount of
4095	compensation paid, the name of the employee and of any other
4096	person to whom compensation has been paid, the date of the
4097	injury or death, and the date to which compensation has been
4098	paid.
4099	(b) If the employer, carrier, or servicing agent fails to
4100	so notify the department within such time, the department shall
4101	assess against such employer, carrier, or servicing agent a
4102	civil penalty in an amount not over $100.
4103	(b)(c)In order to ensure carrier compliance under this
4104	chapter and provisions of the Florida Insurance Code, the office
4105	department shall monitor, audit, and investigatethe performance
4106	of carriers by conducting market conduct examinations, as
4107	provided in s. 624.3161, and conducting investigations, as
4108	provided in s. 624.317. The officedepartment shall require
4109	establish by rule minimum performance standards for carriers to
4110	ensure that a minimum of 90 percent ofall compensation benefits
4111	are timely paid in accordance with this section. The office
4112	department shall impose penaltiesfine a carrier as provided in
4113	s. 440.13(11)(b) up to $50 for each late paymentspaymentof
4114	compensation that areis below athe minimum 9590 percent
4115	timely payment performance standard. The carrier shall pay to
4116	the Workers' Compensation Administration Trust Fund a penalty
4117	of:
4118	1. Fifty dollars per number of installments of
4119	compensation below the 95 percent timely payment performance
4120	standard and equal to or greater than a 90 percent timely
4121	payment performance standard.
4122	2. One hundred dollars per number of installments of
4123	compensation below a 90 percent timely payment performance
4124	standard.
4125
4126	This section does not affect the imposition of any penalties or
4127	interest due to the claimant. If a carrier contracts with a
4128	servicing agent to fulfill its administrative responsibilities
4129	under this chapter, the payment practices of the servicing agent
4130	are deemed the payment practices of the carrier for the purpose
4131	of assessing penalties against the carrier.
4132	(11)
4133	(d)1. With respect to any lump-sum settlement under this
4134	subsection, a judge of compensation claims must consider at the
4135	time of the settlement, whether the settlement allocation
4136	provides for the appropriate recovery of child support
4137	arrearages. An employer or carrier does not have a duty to
4138	investigate or collect information regarding child support
4139	arrearages.
4140	2. When reviewing any settlement of lump-sum payment
4141	pursuant to this subsection, judges of compensation claims shall
4142	consider the interests of the worker and the worker's family
4143	when approving the settlement, which must consider and provide
4144	for appropriate recovery of past due support.
4145	3. With respect to any lump-sum settlement under this
4146	subsection, any correspondence to a clerk of the circuit court
4147	of this state regarding child support documentation shall be
4148	exempt from any fees or costs ordinarily assessed by the clerk’s
4149	office.
4150	Section 25. Section 440.25, Florida Statutes, is amended
4151	to read:
4152	440.25 Procedures for mediation and hearings.--
4153	(1) Forty daysWithin 90 daysafter a petition for
4154	benefits is filed under s. 440.192, a mediation conference
4155	concerning such petition shall be held. Within 40 days after
4156	such petition is filed,the judge of compensation claims shall
4157	notify the interested parties by order that a mediation
4158	conference concerning such petition has been scheduledwill be
4159	held unless the parties have notified the judgeOffice of the
4160	Judges of compensation claims that a privatemediation has been
4161	held or is scheduled to be held. A mediation, whether private or
4162	public, shall be held within 130 days after the filing of the
4163	petition. Such order must give the date by whichthe mediation
4164	conference is tomustbe held. Such order may be served
4165	personally upon the interested parties or may be sent to the
4166	interested parties by mail. If multiple petitions are pending,
4167	or if additional petitions are filed after the scheduling of a
4168	mediation, the judge of compensation claims shall consolidate
4169	all petitions into one mediation.The claimant or the adjuster
4170	of the employer or carrier may, at the mediator's discretion,
4171	attend the mediation conference by telephone or, if agreed to by
4172	the parties, other electronic means. A continuance may be
4173	granted upon the agreement of the parties orif the requesting
4174	party demonstrates to the judge of compensation claims that the
4175	reason for requesting the continuance arises from circumstances
4176	beyond the party's control. Any order granting a continuance
4177	must set forth the date of the rescheduled mediation conference.
4178	A mediation conference may not be used solely for the purpose of
4179	mediating attorney's fees.
4180	(2) Any party who participates in a mediation conference
4181	shall not be precluded from requesting a hearing following the
4182	mediation conference should both parties not agree to be bound
4183	by the results of the mediation conference. A mediation
4184	conference is required to be held unless this requirement is
4185	waived by the Deputy Chief Judge. No later than 3 days prior to
4186	the mediation conference, all parties must submit any applicable
4187	motions, including, but not limited to, a motion to waive the
4188	mediation conference, to the judge of compensation claims.
4189	(3)(a)Such mediation conference shall be conducted
4190	informally and does not require the use of formal rules of
4191	evidence or procedure. Any information from the files, reports,
4192	case summaries, mediator's notes, or other communications or
4193	materials, oral or written, relating to a mediation conference
4194	under this section obtained by any person performing mediation
4195	duties is privileged and confidential and may not be disclosed
4196	without the written consent of all parties to the conference.
4197	Any research or evaluation effort directed at assessing the
4198	mediation program activities or performance must protect the
4199	confidentiality of such information. Each party to a mediation
4200	conference has a privilege during and after the conference to
4201	refuse to disclose and to prevent another from disclosing
4202	communications made during the conference whether or not the
4203	contested issues are successfully resolved. This subsection and
4204	paragraphs (4)(a) and (b) shall not be construed to prevent or
4205	inhibit the discovery or admissibility of any information that
4206	is otherwise subject to discovery or that is admissible under
4207	applicable law or rule of procedure, except that any conduct or
4208	statements made during a mediation conference or in negotiations
4209	concerning the conference are inadmissible in any proceeding
4210	under this chapter.
4211	(a)1. Unless the parties conduct a private mediation under
4212	paragraph (b)subparagraph 2., mediation shall be conducted by a
4213	mediator selected by the Director of the Division of
4214	Administrative Hearings from among mediators employed on a full-
4215	time basis by the Office of the Judges of Compensation Claims. A
4216	mediator must be a member of The Florida Bar for at least 5
4217	years and must complete a mediation training program approved by
4218	the Deputy Chief JudgeDirector of the Division of
4219	Administrative Hearings. Adjunct mediators may be employed by
4220	the Office of the Judges of Compensation Claims on an as-needed
4221	basis and shall be selected from a list prepared by the Director
4222	of the Division of Administrative Hearings. An adjunct mediator
4223	must be independent of all parties participating in the
4224	mediation conference. An adjunct mediator must be a member of
4225	The Florida Bar for at least 5 years and must complete a
4226	mediation training program approved by the Office of the Judges
4227	of Compensation ClaimsDirector of the Division of
4228	Administrative Hearings. An adjunct mediator shall have access
4229	to the office, equipment, and supplies of the judge of
4230	compensation claims in each district.
4231	(b)2. With respect to any private mediation occurring on
4232	or after January 1, 2003, if the parties agree or if mediators
4233	are not available under paragraph (a), pursuant to notice from
4234	the judge of compensation claims,subparagraph 1.to conduct the
4235	required mediation within the period specified in this section,
4236	the parties shall hold a mediation conference at the carrier's
4237	expense within the 130-day90-dayperiod set for mediation. The
4238	mediation conference shall be conducted by a mediator certified
4239	under s. 44.106. If the parties do not agree upon a mediator
4240	within 10 days after the date of the order, the claimant shall
4241	notify the judge in writing and the judge shall appoint a
4242	mediator under this subparagraph within 7 days. In the event
4243	both parties agree, the results of the mediation conference
4244	shall be binding and neither party shall have a right to appeal
4245	the results. In the event either party refuses to agree to the
4246	results of the mediation conference, the results of the
4247	mediation conference as well as the testimony, witnesses, and
4248	evidence presented at the conference shall not be admissible at
4249	any subsequent proceeding on the claim. The mediator shall not
4250	be called in to testify or give deposition to resolve any claim
4251	for any hearing before the judge of compensation claims. The
4252	employer may be represented by an attorney at the mediation
4253	conference if the employee is also represented by an attorney at
4254	the mediation conference.
4255	(b) The parties shall complete the pretrial stipulations
4256	before the conclusion of the mediation conference if the claims,
4257	except for attorney's fees and costs, have not been settled and
4258	if any claims in any filed petition remain unresolved. The judge
4259	of compensation claims may impose sanctions against a party or
4260	both parties for failing to complete the pretrial stipulations
4261	before the conclusion of the mediation conference.
4262	(4)(a) If the parties fail to agree touponwritten
4263	submission of pretrial stipulations at the mediation conference,
4264	the judge of compensation claims shall conduct a liveorder a
4265	pretrial hearing to occur within 14 days after the date of
4266	mediation ordered by the judge of compensation claims. The judge
4267	of compensation claims shall give the interested parties at
4268	least 147 days' advance notice of the pretrial hearing by mail.
4269	At the pretrial hearing, the judge of compensation claims shall,
4270	subject to paragraph (b), set a date for the final hearing that
4271	allows the parties at least 60 days to conduct discovery unless
4272	the parties consent to an earlier hearing date.
4273	(b) The final hearing must be held and concluded within 90
4274	days after the mediation conference is held, allowing the
4275	parties sufficient time to complete discovery. Except as set
4276	forth in this section,continuances may be granted only if the
4277	requesting party demonstrates to the judge of compensation
4278	claims that the reason for requesting the continuance arises
4279	from circumstances beyond the party's control. The written
4280	consent of the claimant must be obtained before any request from
4281	a claimant's attorney is granted for an additional continuance
4282	after the initial continuance has been granted. Any order
4283	granting a continuance must set forth the date and time of the
4284	rescheduled hearing. A continuance may be granted only if the
4285	requesting party demonstrates to the judge of compensation
4286	claims that the reason for requesting the continuance arises
4287	from circumstances beyond the control of the parties. The judge
4288	of compensation claims shall report any grant of two or more
4289	continuances to the Deputy Chief Judge.
4290	(c) The judge of compensation claims shall give the
4291	interested parties at least 147days' advance notice of the
4292	final hearing, served upon the interested parties by mail.
4293	(d) The final hearing shall be held within 210 days after
4294	receipt of the petition for benefits in the county where the
4295	injury occurred, if the injury occurred in this state, unless
4296	otherwise agreed to between the parties and authorized by the
4297	judge of compensation claims in the county where the injury
4298	occurred. However, the claimant may waive the timeframes within
4299	this section for good cause shown.If the injury occurred
4300	outside the state and is one for which compensation is payable
4301	under this chapter, then the final hearing may be held in the
4302	county of the employer's residence or place of business, or in
4303	any other county of the state that will, in the discretion of
4304	the Deputy Chief Judge, be the most convenient for a hearing.
4305	The final hearing shall be conducted by a judge of compensation
4306	claims, who shall, within 30 days after final hearing or closure
4307	of the hearing record, unless otherwise agreed by the parties,
4308	enter a final order on the merits of the disputed issues. The
4309	judge of compensation claims may enter an abbreviated final
4310	order in cases in which compensability is not disputed. Either
4311	party may request separate findings of fact and conclusions of
4312	law. At the final hearing, the claimant and employer may each
4313	present evidence with respect to the claims presented by the
4314	petition for benefits and may be represented by any attorney
4315	authorized in writing for such purpose. When there is a conflict
4316	in the medical evidence submitted at the hearing, the provisions
4317	of s. 440.13 shall apply. The report or testimony of the expert
4318	medical advisor shall be admitted into evidence in amade a part
4319	of the record of the proceeding and shall be given the same
4320	consideration by the judge of compensation claims as is accorded
4321	other medical evidence submitted in the proceeding;and all
4322	costs incurred in connection with such examination and testimony
4323	may be assessed as costs in the proceeding, subject to the
4324	provisions of s. 440.13. No judge of compensation claims may
4325	make a finding of a degree of permanent impairment that is
4326	greater than the greatest permanent impairment rating given the
4327	claimant by any examining or treating physician,except upon
4328	stipulation of the parties. Any benefit due but not raised at
4329	the final hearing which was ripe, due, or owing at the time of
4330	the final hearing is waived.
4331	(e) The order making an award or rejecting the claim,
4332	referred to in this chapter as a "compensation order," shall set
4333	forth the findings of ultimate facts and the mandate; and the
4334	order need not include any other reason or justification for
4335	such mandate. The compensation order shall be filed in the
4336	Office of the Judges of Compensation Claims at Tallahassee. A
4337	copy of such compensation order shall be sent by mail to the
4338	parties and attorneys of record at the last known address of
4339	each, with the date of mailing noted thereon.
4340	(f) Each judge of compensation claims is required to
4341	submit a special report to the Deputy Chief Judge in each
4342	contested workers' compensation case in which the case is not
4343	determined within 30 days of final hearing or closure of the
4344	hearing record. Said form shall be provided by the director of
4345	the Division of Administrative Hearings and shall contain the
4346	names of the judge of compensation claims and of the attorneys
4347	involved and a brief explanation by the judge of compensation
4348	claims as to the reason for such a delay in issuing a final
4349	order.
4350	(f)(g)Notwithstanding any other provision of this
4351	section, the judge of compensation claims may require the
4352	appearance of the parties and counsel before her or him without
4353	written notice for an emergency conference where there is a bona
4354	fide emergency involving the health, safety, or welfare of an
4355	employee. An emergency conference under this section may result
4356	in the entry of an order or the rendering of an adjudication by
4357	the judge of compensation claims.
4358	(g)(h)To expedite dispute resolution and to enhance the
4359	self-executing features of the Workers' Compensation Law, the
4360	Deputy Chief Judge shall make provision by rule or order for the
4361	resolution of appropriate motions by judges of compensation
4362	claims without oral hearing upon submission of brief written
4363	statements in support and opposition, and for expedited
4364	discovery and docketing. Unless the judge of compensation
4365	claims, for good cause, orders a hearing under paragraph (h)(i),
4366	each claim in a petition relating to the determination of the
4367	average weekly wagepayunder s. 440.14 shall be resolved under
4368	this paragraph without oral hearing.
4369	(h)(i)To further expedite dispute resolution and to
4370	enhance the self-executing features of the system, those
4371	petitions filed in accordance with s. 440.192 that involve a
4372	claim for benefits of $5,000 or less shall, in the absence of
4373	compelling evidence to the contrary, be presumed to be
4374	appropriate for expedited resolution under this paragraph; and
4375	any other claim filed in accordance with s. 440.192, upon the
4376	written agreement of both parties and application by either
4377	party, may similarly be resolved under this paragraph. A claim
4378	in a petition or $5,000 or less for medical benefits only or a
4379	petition for reimbursement for mileage for medical purposes
4380	shall, in the absence of compelling evidence to the contrary, be
4381	resolved through the expedited dispute resolution process
4382	provided in this paragraph. For purposes of expedited resolution
4383	pursuant to this paragraph, the Deputy Chief Judge shall make
4384	provision by rule or order for expedited and limited discovery
4385	and expedited docketing in such cases. At least 15 days prior to
4386	hearing, the parties shall exchange and file with the judge of
4387	compensation claims a pretrial outline of all issues, defenses,
4388	and witnesses on a form adopted by the Deputy Chief Judge;
4389	provided, in no event shall such hearing be held without 15
4390	days' written notice to all parties. No pretrial hearing shall
4391	be held and no mediation scheduled unless requested by a party.
4392	The judge of compensation claims shall limit all argument and
4393	presentation of evidence at the hearing to a maximum of 30
4394	minutes, and such hearings shall not exceed 30 minutes in
4395	length. Neither party shall be required to be represented by
4396	counsel. The employer or carrier may be represented by an
4397	adjuster or other qualified representative. The employer or
4398	carrier and any witness may appear at such hearing by telephone.
4399	The rules of evidence shall be liberally construed in favor of
4400	allowing introduction of evidence.
4401	(i)(j)A judge of compensation claims may, upon the motion
4402	of a party or the judge's own motion, dismiss a petition for
4403	lack of prosecution if a petition, response, motion, order,
4404	request for hearing, or notice of deposition has not been filed
4405	during the previous 12 months unless good cause is shown. A
4406	dismissal for lack of prosecution is without prejudice and does
4407	not require a hearing.
4408	(j)(k)A judge of compensation claims may not award
4409	interest on unpaid medical bills and the amount of such bills
4410	may not be used to calculate the amount of interest awarded.
4411	Regardless of the date benefits were initially requested,
4412	attorney's fees do not attach under this subsection until 30
4413	days after the date the carrier or self-insured employer
4414	receives the petition.
4415	(5)(a) Procedures with respect to appeals from orders of
4416	judges of compensation claims shall be governed by rules adopted
4417	by the Supreme Court. Such an order shall become final 30 days
4418	after mailing of copies of such order to the parties, unless
4419	appealed pursuant to such rules.
4420	(b) An appellant may be relieved of any necessary filing
4421	fee by filing a verified petition of indigency for approval as
4422	provided in s. 57.081(1) and may be relieved in whole or in part
4423	from the costs for preparation of the record on appeal if,
4424	within 15 days after the date notice of the estimated costs for
4425	the preparation is served, the appellant files with the judge of
4426	compensation claims a copy of the designation of the record on
4427	appeal, and a verified petition to be relieved of costs. A
4428	verified petition filed prior to the date of service of the
4429	notice of the estimated costs shall be deemed not timely filed.
4430	The verified petition relating to record costs shall contain a
4431	sworn statement that the appellant is insolvent and a complete,
4432	detailed, and sworn financial affidavit showing all the
4433	appellant's assets, liabilities, and income. Failure to state in
4434	the affidavit all assets and income, including marital assets
4435	and income, shall be grounds for denying the petition with
4436	prejudice. The Office of the Judges of Compensation Claims shall
4437	adopt rules as may be required pursuant to this subsection,
4438	including forms for use in all petitions brought under this
4439	subsection. The appellant's attorney, or the appellant if she or
4440	he is not represented by an attorney, shall include as a part of
4441	the verified petition relating to record costs an affidavit or
4442	affirmation that, in her or his opinion, the notice of appeal
4443	was filed in good faith and that there is a probable basis for
4444	the District Court of Appeal, First District, to find reversible
4445	error, and shall state with particularity the specific legal and
4446	factual grounds for the opinion. Failure to so affirm shall be
4447	grounds for denying the petition. A copy of the verified
4448	petition relating to record costs shall be served upon all
4449	interested parties. The judge of compensation claims shall
4450	promptly conduct a hearing on the verified petition relating to
4451	record costs, giving at least 15 days' notice to the appellant,
4452	the department, and all other interested parties, all of whom
4453	shall be parties to the proceedings. The judge of compensation
4454	claims may enter an order without such hearing if no objection
4455	is filed by an interested party within 20 days from the service
4456	date of the verified petition relating to record costs. Such
4457	proceedings shall be conducted in accordance with the provisions
4458	of this section and with the workers' compensation rules of
4459	procedure, to the extent applicable. In the event an insolvency
4460	petition is granted, the judge of compensation claims shall
4461	direct the department to pay record costs and filing fees from
4462	the Workers' Compensation Administration Trust Fund pending
4463	final disposition of the costs of appeal. The department may
4464	transcribe or arrange for the transcription of the record in any
4465	proceeding for which it is ordered to pay the cost of the
4466	record.
4467	(c) As a condition of filing a notice of appeal to the
4468	District Court of Appeal, First District, an employer who has
4469	not secured the payment of compensation under this chapter in
4470	compliance with s. 440.38 shall file with the notice of appeal a
4471	good and sufficient bond, as provided in s. 59.13, conditioned
4472	to pay the amount of the demand and any interest and costs
4473	payable under the terms of the order if the appeal is dismissed,
4474	or if the District Court of Appeal, First District, affirms the
4475	award in any amount. Upon the failure of such employer to file
4476	such bond with the judge of compensation claims orthe District
4477	Court of Appeal, First District, along with the notice of
4478	appeal, the District Court of Appeal, First District, shall
4479	dismiss the notice of appeal.
4480	(6) An award of compensation for disability may be made
4481	after the death of an injured employee.
4482	(7) An injured employee claiming or entitled to
4483	compensation shall submit to such physical examination by a
4484	certified expert medical advisor approved by the agency or the
4485	judge of compensation claims as the agency or the judge of
4486	compensation claims may require. The place or places shall be
4487	reasonably convenient for the employee. Such physician or
4488	physicians as the employee, employer, or carrier may select and
4489	pay for may participate in an examination if the employee,
4490	employer, or carrier so requests. Proceedings shall be suspended
4491	and no compensation shall be payable for any period during which
4492	the employee may refuse to submit to examination.Any interested
4493	party shall have the right in any case of death to require an
4494	autopsy, the cost thereof to be borne by the party requesting
4495	it; and the judge of compensation claims shall have authority to
4496	order and require an autopsy and may, in her or his discretion,
4497	withhold her or his findings and award until an autopsy is held.
4498	Section 26. Subsections (1), (2), and (3) of section
4499	440.34, Florida Statutes, are amended, and subsection (7) is
4500	added to said section, to read:
4501	440.34 Attorney's fees; costs.--
4502	(1) A fee, gratuity, or other consideration may not be
4503	paid for services rendered fora claimant in connection with any
4504	proceedings arising under this chapter, unless approved as
4505	reasonable by the judge of compensation claims or court having
4506	jurisdiction over such proceedings. Except as provided by this
4507	subsection,Any attorney's fee approved by a judge of
4508	compensation claims for benefits secured on behalf ofservices
4509	rendered toa claimant must equal to 20 percent of the first
4510	$5,000 of the amount of the benefits secured, 15 percent of the
4511	next $5,000 of the amount of the benefits secured, 10 percent of
4512	the remaining amount of the benefits secured to be provided
4513	during the first 10 years after the date the claim is filed, and
4514	5 percent of the benefits secured after 10 years. The judge of
4515	compensation claims shall not approve a compensation order, a
4516	joint stipulation for lump-sum settlement, a stipulation or
4517	agreement between a claimant and his or her attorney, or any
4518	other agreement related to benefits under this chapter that
4519	provides for an attorney's fee in excess of the amount permitted
4520	by this section. The judge of compensation claims is not
4521	required to approve any retainer agreement between the claimant
4522	and his or her attorney. The retainer agreement as to fees and
4523	costs may not be for compensation in excess of the amount
4524	allowed under this section.However, The judge of compensation
4525	claims shall consider the following factors in each case and may
4526	increase or decrease the attorney's fee if, in her or his
4527	judgment, the circumstances of the particular case warrant such
4528	action:
4529	(a) The time and labor required, the novelty and
4530	difficulty of the questions involved, and the skill requisite to
4531	perform the legal service properly.
4532	(b) The fee customarily charged in the locality for
4533	similar legal services.
4534	(c) The amount involved in the controversy and the
4535	benefits resulting to the claimant.
4536	(d) The time limitation imposed by the claimant or the
4537	circumstances.
4538	(e) The experience, reputation, and ability of the lawyer
4539	or lawyers performing services.
4540	(f) The contingency or certainty of a fee.
4541	(2) In awarding a reasonableclaimant's attorney's fee,
4542	the judge of compensation claims shall consider only those
4543	benefits secured byto the claimant that the attorney is
4544	responsible for securing. An attorney is not entitled to
4545	attorney's fees for representation in any issue that was ripe,
4546	due, and owing and that reasonably could have been addressed,
4547	but was not addressed, during the pendency of other issues for
4548	the same injury.The amount, statutory basis, and type of
4549	benefits obtained through legal representation shall be listed
4550	on all attorney's fees awarded by the judge of compensation
4551	claims. For purposes of this section, the term "benefits
4552	secured" means benefits obtained as a result of the claimant's
4553	attorney's legal services rendered in connection with the claim
4554	for benefits. However, such termdoes not include future
4555	medical benefits to be provided on any date more than 5 years
4556	after the date the claim is filed. In the event an offer to
4557	settle an issue pending before a judge of compensation claims,
4558	including attorney’s fees as provided for in this section, is
4559	communicated in writing to the claimant or the claimant's
4560	attorney at least 30 days prior to the trial date on such issue,
4561	for purposes of calculating the amount of attorney’s fees to be
4562	taxed against the employer or carrier, the term “benefits
4563	secured” shall be deemed to include only that amount awarded to
4564	the claimant above the amount specified in the offer to settle.
4565	If multiple issues are pending before the judge of compensation
4566	claims, said offer of settlement shall address each issue
4567	pending and shall state explicitly whether or not the offer on
4568	each issue is severable. The written offer shall also
4569	unequivocally state whether or not it includes medical witness
4570	fees and expenses and all other costs associated with the claim.
4571	(3) If any partythe claimantshould prevail in any
4572	proceedings before a judge of compensation claims or court,
4573	there shall be taxed against the nonprevailing partyemployer
4574	the reasonable costs of such proceedings, not to include the
4575	attorney's fees of the claimant. A claimant shall be
4576	responsible for the payment of her or his own attorney's fees,
4577	except that a claimant shall be entitled to recover a reasonable
4578	attorney's fee from a carrier or employer:
4579	(a) Against whom she or he successfully asserts a petition
4580	for medical benefits only, if the claimant has not filed or is
4581	not entitled to file at such time a claim for disability,
4582	permanent impairment, wage-loss, or death benefits, arising out
4583	of the same accident;
4584	(b) In any case in which the employer or carrier files a
4585	response to petition denying benefits with the Office of the
4586	Judges of Compensation Claims and the injured person has
4587	employed an attorney in the successful prosecution of the
4588	petition;
4589	(c) In a proceeding in which a carrier or employer denies
4590	that an accident occurred for which compensation benefits are
4591	payable, and the claimant prevails on the issue of
4592	compensability; or
4593	(d) In cases where the claimant successfully prevails in
4594	proceedings filed under s. 440.24 or s. 440.28.
4595
4596	Regardless of the date benefits were initially requested,
4597	attorney's fees shall not attach under this subsection until 30
4598	days after the date the carrier or employer, if self-insured,
4599	receives the petition. In applying the factors set forth in
4600	subsection (1) to cases arising under paragraphs (a), (b), (c),
4601	and (d), the judge of compensation claims must only consider
4602	only such benefits and the time reasonably spent in obtaining
4603	them as were secured for the claimant within the scope of
4604	paragraphs (a), (b), (c), and (d).
4605	(7) If an attorney's fee is owed under paragraph (3)(a),
4606	the judge of compensation claims may approve an alternative
4607	attorney's fee not to exceed $1,500 only once per accident,
4608	based on a maximum hourly rate of $150 per hour, if the judge of
4609	compensation claims expressly finds that the attorney's fee
4610	amount provided for in subsection (1), based on benefits
4611	secured, fails to fairly compensate the attorney for disputed
4612	medical-only claims as provided in paragraph (3)(a) and the
4613	circumstances of the particular case warrant such action.
4614	Section 27. Subsection (7) is added to section 440.38,
4615	Florida Statutes, to read:
4616	440.38 Security for compensation; insurance carriers and
4617	self-insurers.—
4618	(7) Any employer who meets the requirements of subsection
4619	(1) through a policy of insurance issued outside of this state
4620	must at all times, with respect to all employees working in this
4621	state, maintain the required coverage under a Florida
4622	endorsement using Florida rates and rules pursuant to payroll
4623	reporting that accurately reflects the work performed in this
4624	state by such employees.
4625	Section 28. Subsections (2) and (6) of section 440.381,
4626	Florida Statutes, are amended to read:
4627	440.381 Application for coverage; reporting payroll;
4628	payroll audit procedures; penalties.--
4629	(2) Submission of an application that contains false,
4630	misleading, or incomplete information provided with the purpose
4631	of avoiding or reducing the amount of premiums for workers'
4632	compensation coverage is a felony of the second degree,
4633	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
4634	The application must contain a statement that the filing of an
4635	application containing false, misleading, or incomplete
4636	information providedwith the purpose of avoiding or reducing
4637	the amount of premiums for workers' compensation coverage is a
4638	felony of the third degree, punishable as provided in s.
4639	775.082, s. 775.083, or s. 775.084. The application must contain
4640	a sworn statement by the employer attesting to the accuracy of
4641	the information submitted and acknowledging the provisions of
4642	former s. 440.37(4). The application must contain a sworn
4643	statement by the agent attesting that the agent explained to the
4644	employer or officer the classification codes that are used for
4645	premium calculations.
4646	(6)(a)If an employer understates or conceals payroll, or
4647	misrepresents or conceals employee duties so as to avoid proper
4648	classification for premium calculations, or misrepresents or
4649	conceals information pertinent to the computation and
4650	application of an experience rating modification factor, the
4651	employer, or the employer's agent or attorney, shall pay to the
4652	insurance carrier a penalty of 10 times the amount of the
4653	difference in premium paid and the amount the employer should
4654	have paid and reasonable attorney's fees. The penalty may be
4655	enforced in the circuit courts of this state.
4656	(b) If the department determines that an employer has
4657	materially understated or concealed payroll, has materially
4658	misrepresented or concealed employee duties so as to avoid
4659	proper classification for premium calculations, or has
4660	materially misrepresented or concealed information pertinent to
4661	the computation and application of an experience rating
4662	modification factor, the department shall immediately notify the
4663	employer's carrier of such determination. The carrier shall
4664	commence a physical onsite audit of the employer within 30 days
4665	after receiving notification from the department. If the carrier
4666	fails to commence the audit as required by this section, the
4667	department shall contract with auditing professionals to conduct
4668	the audit at the carrier's expense. A copy of the carrier's
4669	audit of the employer shall be provided to the department upon
4670	completion. The carrier is not required to conduct the physical
4671	onsite audit of the employer as set forth in this paragraph if
4672	the carrier gives written notice of cancellation to the employer
4673	within 30 days after receiving notification from the department
4674	of the material misrepresentation, understatement, or
4675	concealment and an audit is conducted in conjunction with the
4676	cancellation.
4677	Section 29. Subsection (3) of section 440.42, Florida
4678	Statutes, is amended to read:
4679	440.42 Insurance policies; liability.--
4680	(3) No contract or policy of insurance issued by a carrier
4681	under this chapter shall expire or be canceled until at least 30
4682	days have elapsed after a notice of cancellation has been sent
4683	to the department and to the employer in accordance with the
4684	provisions of s. 440.185(7). For cancellation due to nonpayment
4685	of premium, the insurer shall mail notification to the employer
4686	at least 10 days prior to the effective date of the
4687	cancellation.However, when duplicate or dual coverage exists by
4688	reason of two different carriers having issued policies of
4689	insurance to the same employer securing the same liability, it
4690	shall be presumed that only that policy with the later effective
4691	date shall be in force and that the earlier policy terminated
4692	upon the effective date of the latter. In the event that both
4693	policies carry the same effective date, one of the policies may
4694	be canceled instanter upon filing a notice of cancellation with
4695	the department and serving a copy thereof upon the employer in
4696	such manner as the department prescribes by rule. The department
4697	may by rule prescribe the content of the notice of retroactive
4698	cancellation and specify the time, place, and manner in which
4699	the notice of cancellation is to be served.
4700	Section 30. Paragraph (a) of subsection (4) of section
4701	440.49, Florida Statutes, is amended to read:
4702	440.49 Limitation of liability for subsequent injury
4703	through Special Disability Trust Fund.--
4704	(4) PERMANENT IMPAIRMENT OR PERMANENT TOTAL DISABILITY,
4705	TEMPORARY BENEFITS, MEDICAL BENEFITS, OR ATTENDANT CARE AFTER
4706	OTHER PHYSICAL IMPAIRMENT.--
4707	(a) Permanent impairment.--If an employee who has a
4708	preexisting permanent physical impairment incurs a subsequent
4709	permanent impairment from injury or occupational disease arising
4710	out of, and in the course of, her or his employment which merges
4711	with the preexisting permanent physical impairment to cause a
4712	permanent impairment, the employer shall, in the first instance,
4713	pay all benefits provided by this chapter; but, subject to the
4714	limitations specified in subsection (6), such employer shall be
4715	reimbursed from the Special Disability Trust Fund created by
4716	subsection (9) for 50 percent of all impairment benefits which
4717	the employer has been required to provide pursuant to s.
4718	440.15(3)(a)as a result of the subsequent accident or
4719	occupational disease.
4720	Section 31. Subsection (6) of section 440.491, Florida
4721	Statutes, is amended to read:
4722	440.491 Reemployment of injured workers; rehabilitation.--
4723	(6) TRAINING AND EDUCATION.--
4724	(a) Upon referral of an injured employee by the carrier,
4725	or upon the request of an injured employee, the department shall
4726	conduct a training and education screening to determine whether
4727	it should refer the employee for a vocational evaluation and, if
4728	appropriate, approve training and education or other vocational
4729	services for the employee. The department may not approve formal
4730	training and education programs unless it determines, after
4731	consideration of the reemployment assessment, pertinent
4732	reemployment status reviews or reports, and such other relevant
4733	factors as it prescribes by rule, that the reemployment plan is
4734	likely to result in return to suitable gainful employment. The
4735	department is authorized to expend moneys from the Workers'
4736	Compensation Administration Trust Fund, established by s.
4737	440.50, to secure appropriate training and education at a
4738	community college established under part III of chapter 240 or
4739	at a vocational-technical school established under s. 230.63, or
4740	to secureother vocational services when necessary to satisfy
4741	the recommendation of a vocational evaluator. As used in this
4742	paragraph, "appropriate training and education" includes
4743	securing a general education diploma (GED), if necessary.The
4744	department shall establish training and education standards
4745	pertaining to employee eligibility, course curricula and
4746	duration, and associated costs.
4747	(b) When it appears thatan employee who has attained
4748	maximum medical improvement is unable to earn at least 80
4749	percent of the compensation rate andrequires training and
4750	education to obtain suitable gainful employment, the employer or
4751	carrier shall pay the employee additional training and education
4752	temporary total compensation benefitswhile the employee
4753	receives such training and education for a period not to exceed
4754	26 weeks, which period may be extended for an additional 26
4755	weeks or less, if such extended period is determined to be
4756	necessary and proper by a judge of compensation claims. The
4757	benefits provided under this paragraph shall not be in addition
4758	to the 104 weeks as specified in s. 440.15(2).However, a
4759	carrier or employer is not precluded from voluntarily paying
4760	additional temporary total disability compensation beyond that
4761	period. If an employee requires temporary residence at or near a
4762	facility or an institution providing training and education
4763	which is located more than 50 miles away from the employee's
4764	customary residence, the reasonable cost of board, lodging, or
4765	travel must be borne by the department from the Workers'
4766	Compensation Administration Trust Fund established by s. 440.50.
4767	An employee who refuses to accept training and education that is
4768	recommended by the vocational evaluator and considered necessary
4769	by the department will forfeit any additional training and
4770	education benefits and any additional payment for lost wages
4771	under this chapter. The department shall adopt rules to
4772	implement this section, which shall include requirements placed
4773	upon the carrier to notify the injured employee of the
4774	availability of training and education benefits as specified in
4775	this chapter. The department shall also include information
4776	regarding the eligibility for training and education benefits in
4777	informational materials specified in ss. 440.207 and 440.40is
4778	subject to a 50-percent reduction in weekly compensation
4779	benefits, including wage-loss benefits, as determined under s.
4780	440.15(3)(b).
4781	Section 32. Section 440.525, Florida Statutes, is amended
4782	to read:
4783	440.525 Examination and investigation of carriers and
4784	claims-handling entities.--
4785	(1) The department may examine, or investigate anyeach
4786	carrier, third-party administrator, servicing agent, or other
4787	claims-handling entity as often as is warranted to ensure that
4788	it iscarriers are fulfilling itstheir obligations under this
4789	chapterthe law. The examination may cover any period of the
4790	carrier's operations since the last previous examination.
4791	(2) An examination may cover any period of the carrier's,
4792	third-party administrator's, servicing agent's, or other claims-
4793	handling entity's operations since the last previous
4794	examination. An investigation based upon a reasonable belief by
4795	the department that a material violation of this chapter has
4796	occurred may cover any time period, but may not predate the last
4797	examination by more than 5 years. The department may by rule
4798	establish procedures, standards, and protocols for examinations
4799	and investigations. If the department finds any violation of
4800	this chapter, it may impose administrative penalties pursuant to
4801	this chapter. If the department finds any self-insurer in
4802	violation of this chapter, it may take action pursuant s.
4803	440.38(3). Examinations or investigations by the department may
4804	address, but are not limited to addressing, patterns or
4805	practices of unreasonable delay in claims handling; timeliness
4806	and accuracy of payments and reports under ss. 440.13, 440.16,
4807	and 440.185; or patterns or practices of harassment, coercion,
4808	or intimidation of claimants. The department may also specify by
4809	rule the documentation to be maintained for each claim file.
4810	(3) As to any examination or investigation conducted under
4811	this chapter, the department shall have the power to conduct
4812	onsite inspections of claims records and documentation of a
4813	carrier, third-party administrator, servicing agent, or other
4814	claims-handling entity, and conduct interviews, both sworn and
4815	unsworn, of claims-handling personnel. Carriers, third-party
4816	administrators, servicing agents, and other claims-handling
4817	entities shall make all claims records, documentation,
4818	communication, and correspondence available to department
4819	personnel during regular business hours. If any person fails to
4820	comply with a request for production of records or documents or
4821	fails to produce an employee for interview, the department may
4822	compel production or attendance by subpoena. The results of an
4823	examination or investigation shall be provided to the carrier,
4824	third-party administrator, servicing agent, or other claims-
4825	handling entity in a written report setting forth the basis for
4826	any violations that are asserted. Such report is agency action
4827	for purposes of chapter 120, and the aggrieved party may request
4828	a proceeding under s. 120.57 with regard to the findings and
4829	conclusion of the report.
4830	(4) If the department finds that violations of this
4831	chapter have occurred, the department may impose an
4832	administrative penalty upon the offending entity or entities.
4833	For each offending entity, such penalties shall not exceed
4834	$2,500 for each pattern or practice constituting nonwillful
4835	violation and shall not exceed an aggregate amount of $10,000
4836	for all nonwillful violations arising out of the same action. If
4837	the department finds a pattern of practice that constitutes a
4838	willful violation, the department may impose an administrative
4839	penalty upon each offending entity not to exceed $20,000 for
4840	each willful pattern or practice. Such fines shall not exceed
4841	$100,000 for all willful violations arising out of the same
4842	action. No penalty assessed under this section may be recouped
4843	by any carrier in the rate base, the premium, or any rate
4844	filing. Any administrative penalty imposed under this section
4845	for a nonwillful violation shall not duplicate an administrative
4846	penalty imposed under another provision of this chapter or the
4847	Insurance Code. The department may adopt rules to implement this
4848	section. The department shall adopt penalty guidelines by rule
4849	to set penalties under this chapter.
4850	Section 33. Subsection (2) of section 627.162, Florida
4851	Statutes, is amended to read:
4852	627.162 Requirements for premium installments;
4853	delinquency, collection, and check return charges; attorney's
4854	fees.--
4855	(2) Insurers providing workers' compensation coverage
4856	under chapter 440 may charge the insured a delinquency and
4857	collection fee on each installment in default for a period of
4858	not less than 5 days in an amount not to exceed $25$10or 5
4859	percent of the delinquent installment, whichever is greater.
4860	Only one such delinquency and collection fee may be collected on
4861	any such installment regardless of the period during which it
4862	remains in default.
4863	Section 34. Section 627.285, Florida Statutes, is created
4864	to read:
4865	627.285 Independent actuarial peer review of workers'
4866	compensation rating organization.--The Financial Services
4867	Commission shall at least once every other year contract for an
4868	independent actuarial peer review and analysis of the ratemaking
4869	processes of any licensed rating organization that makes rate
4870	filings for workers' compensation insurance and the rating
4871	organization shall fully cooperate in the peer review. The
4872	contract shall require submission of a final report to the
4873	commission, the President of the Senate, and the Speaker of the
4874	House of Representatives by February 1. The first report shall
4875	be submitted by February 1, 2004. The costs of the independent
4876	actuarial peer review shall be paid from the Workers'
4877	Compensation Administration Trust Fund.
4878	Section 35. Effective July, 1, 2003, paragraphs (b), (c),
4879	and (d) of subsection (4) of section 627.311, Florida Statutes,
4880	are amended to read
4881	627.311 Joint underwriters and joint reinsurers.--
4882	(4)
4883	(b) The operation of the plan is subject to the
4884	supervision of a 9-member13-memberboard of governors. The
4885	board of governors shall be comprised of:
4886	1. Three members appointed by the Financial Services
4887	Commission. Each member appointed by the commission shall serve
4888	at the pleasure of the commission;
4889	2.1.TwoFiveof the 20 domestic insurers, as defined in
4890	s. 624.06(1), having the largest voluntary direct premiums
4891	written in this state for workers' compensation and employer's
4892	liability insurance, which shall be elected by those 20 domestic
4893	insurers;
4894	3.2.TwoFiveof the 20 foreign insurers as defined in s.
4895	624.06(2) having the largest voluntary direct premiums written
4896	in this state for workers' compensation and employer's liability
4897	insurance, which shall be elected by those 20 foreign insurers;
4898	3. One person, who shall serve as the chair, appointed by
4899	the Insurance Commissioner;
4900	4. One person appointed by the largest property and
4901	casualty insurance agents' association in this state; and
4902	5. The consumer advocate appointed under s. 627.0613 or
4903	the consumer advocate's designee.
4904
4905	Each board member shall serve a 4-year term and may serve
4906	consecutive terms. A vacancy on the board shall be filled in the
4907	same manner as the original appointment for the unexpired
4908	portion of the term. The Financial Services Commission shall
4909	designate a member of the board to serve as chair.No board
4910	member shall be an insurer which provides service to the plan or
4911	which has an affiliate which provides services to the plan or
4912	which is serviced by a service company or third-party
4913	administrator which provides services to the plan or which has
4914	an affiliate which provides services to the plan. The minutes,
4915	audits, and procedures of the board of governors are subject to
4916	chapter 119.
4917	(c) The operation of the plan shall be governed by a plan
4918	of operation that is prepared at the direction of the board of
4919	governors. The plan of operation may be changed at any time by
4920	the board of governors or upon request of the department. The
4921	plan of operation and all changes thereto are subject to the
4922	approval of the department. The plan of operation shall:
4923	1. Authorize the board to engage in the activities
4924	necessary to implement this subsection, including, but not
4925	limited to, borrowing money.
4926	2. Develop criteria for eligibility for coverage by the
4927	plan, including, but not limited to, documented rejection by at
4928	least two insurers which reasonably assures that insureds
4929	covered under the plan are unable to acquire coverage in the
4930	voluntary market. Any insured may voluntarily elect to accept
4931	coverage from an insurer for a premium equal to or greater than
4932	the plan premium if the insurer writing the coverage adheres to
4933	the provisions of s. 627.171.
4934	3. Require notice from the agent to the insured at the
4935	time of the application for coverage that the application is for
4936	coverage with the plan and that coverage may be available
4937	through an insurer, group self-insurers' fund, commercial self-
4938	insurance fund, or assessable mutual insurer through another
4939	agent at a lower cost.
4940	4. Establish programs to encourage insurers to provide
4941	coverage to applicants of the plan in the voluntary market and
4942	to insureds of the plan, including, but not limited to:
4943	a. Establishing procedures for an insurer to use in
4944	notifying the plan of the insurer's desire to provide coverage
4945	to applicants to the plan or existing insureds of the plan and
4946	in describing the types of risks in which the insurer is
4947	interested. The description of the desired risks must be on a
4948	form developed by the plan.
4949	b. Developing forms and procedures that provide an insurer
4950	with the information necessary to determine whether the insurer
4951	wants to write particular applicants to the plan or insureds of
4952	the plan.
4953	c. Developing procedures for notice to the plan and the
4954	applicant to the plan or insured of the plan that an insurer
4955	will insure the applicant or the insured of the plan, and notice
4956	of the cost of the coverage offered; and developing procedures
4957	for the selection of an insuring entity by the applicant or
4958	insured of the plan.
4959	d. Provide for a market-assistance plan to assist in the
4960	placement of employers. All applications for coverage in the
4961	plan received 45 days before the effective date for coverage
4962	shall be processed through the market-assistance plan. A market-
4963	assistance plan specifically designed to serve the needs of
4964	small good policyholders as defined by the board must be
4965	finalized by January 1, 1994.
4966	5. Provide for policy and claims services to the insureds
4967	of the plan of the nature and quality provided for insureds in
4968	the voluntary market.
4969	6. Provide for the review of applications for coverage
4970	with the plan for reasonableness and accuracy, using any
4971	available historic information regarding the insured.
4972	7. Provide for procedures for auditing insureds of the
4973	plan which are based on reasonable business judgment and are
4974	designed to maximize the likelihood that the plan will collect
4975	the appropriate premiums.
4976	8. Authorize the plan to terminate the coverage of and
4977	refuse future coverage for any insured that submits a fraudulent
4978	application to the plan or provides fraudulent or grossly
4979	erroneous records to the plan or to any service provider of the
4980	plan in conjunction with the activities of the plan.
4981	9. Establish service standards for agents who submit
4982	business to the plan.
4983	10. Establish criteria and procedures to prohibit any
4984	agent who does not adhere to the established service standards
4985	from placing business with the plan or receiving, directly or
4986	indirectly, any commissions for business placed with the plan.
4987	11. Provide for the establishment of reasonable safety
4988	programs for all insureds in the plan. All insureds of the plan
4989	must participate in the safety program.
4990	12. Authorize the plan to terminate the coverage of and
4991	refuse future coverage to any insured who fails to pay premiums
4992	or surcharges when due; who, at the time of application, is
4993	delinquent in payments of workers' compensation or employer's
4994	liability insurance premiums or surcharges owed to an insurer,
4995	group self-insurers' fund, commercial self-insurance fund, or
4996	assessable mutual insurer licensed to write such coverage in
4997	this state; or who refuses to substantially comply with any
4998	safety programs recommended by the plan.
4999	13. Authorize the board of governors to provide the
5000	services required by the plan through staff employed by the
5001	plan, through reasonably compensated service providers who
5002	contract with the plan to provide services as specified by the
5003	board of governors, or through a combination of employees and
5004	service providers.
5005	14. Provide for service standards for service providers,
5006	methods of determining adherence to those service standards,
5007	incentives and disincentives for service, and procedures for
5008	terminating contracts for service providers that fail to adhere
5009	to service standards.
5010	15. Provide procedures for selecting service providers and
5011	standards for qualification as a service provider that
5012	reasonably assure that any service provider selected will
5013	continue to operate as an ongoing concern and is capable of
5014	providing the specified services in the manner required.
5015	16. Provide for reasonable accounting and data-reporting
5016	practices.
5017	17. Provide for annual review of costs associated with the
5018	administration and servicing of the policies issued by the plan
5019	to determine alternatives by which costs can be reduced.
5020	18. Authorize the acquisition of such excess insurance or
5021	reinsurance as is consistent with the purposes of the plan.
5022	19. Provide for an annual report to the department on a
5023	date specified by the department and containing such information
5024	as the department reasonably requires.
5025	20. Establish multiple rating plans for various
5026	classifications of risk which reflect risk of loss, hazard
5027	grade, actual losses, size of premium, and compliance with loss
5028	control. At least one of such plans must be a preferred-rating
5029	plan to accommodate small-premium policyholders with good
5030	experience as defined in sub-subparagraph 22.a.
5031	21. Establish agent commission schedules.
5032	22. Establish fourthreesubplans as follows:
5033	a. Subplan "A" must include those insureds whose annual
5034	premium does not exceed $2,500 and who have neither incurred any
5035	lost-time claims nor incurred medical-only claims exceeding 50
5036	percent of their premium for the immediate 2 years.
5037	b. Subplan "B" must include insureds that are employers
5038	identified by the board of governors as high-risk employers due
5039	solely to the nature of the operations being performed by those
5040	insureds and for whom no market exists in the voluntary market,
5041	and whose experience modifications are less than 1.00.
5042	c. Subplan "C" must include all otherinsureds within the
5043	plan that are not eligible for subplan "A," subplan "B," or
5044	subplan "D."
5045	d. Subplan "D" must include any employer, regardless of
5046	the length of time for which it has conducted business
5047	operations, which has an experience modification factor of 1.10
5048	or less and either employs 15 or fewer employees or is an
5049	organization that is exempt from federal income tax pursuant to
5050	s. 501(c)(3) of the Internal Revenue Code and receives more than
5051	50 percent of its funding from gifts, grants, endowments, or
5052	federal or state contracts. The rate plan for subplan "D" shall
5053	be the same rate plan as the plan approved under ss. 627.091-
5054	627.151 and each participant in subplan "D" shall pay the
5055	premium determined under such rate plan, plus a surcharge
5056	determined by the board to be sufficient to ensure that the plan
5057	does not compete with the voluntary market rate for any
5058	participant, but not to exceed 25 percent. However, the
5059	surcharge shall not exceed 10 percent for an organization that
5060	is exempt from federal income tax pursuant to s. 501(c)(3) of
5061	the Internal Revenue Code.
5062	23. Provide for a depopulation program to reduce the
5063	number of insureds in subplan "D." If an employer insured
5064	through subplan "D" is offered coverage from a voluntary market
5065	carrier:
5066	a. During the first 30 days of coverage under the subplan;
5067	b. Before a policy is issued under the subplan;
5068	c. By issuance of a policy upon expiration or cancellation
5069	of the policy under the subplan; or
5070	d. By assumption of the subplan's obligation with respect
5071	to an in-force policy,
5072
5073	that employer is no longer eligible for coverage through the
5074	plan. The premium for risks assumed by the voluntary market
5075	carrier must be the same premium plus, for the first 2 years,
5076	the surcharge as determined in sub-subparagraph 22.d. A premium
5077	under this subparagraph, including surcharge, is deemed approved
5078	and is not an excess premium for purposes of s. 627.171.
5079	24. Require that policies issued under subplan "D" and
5080	applications for such policies must include a notice that the
5081	policy issued under subplan "D" could be replaced by a policy
5082	issued from a voluntary market carrier and that, if an offer of
5083	coverage is obtained from a voluntary market carrier, the
5084	policyholder is no longer eligible for coverage through subplan
5085	"D." The notice must also specify that acceptance of coverage
5086	under subplan "D" creates a conclusive presumption that the
5087	applicant or policyholder is aware of this potential.
5088	(d)1.The plan must be funded through actuarially sound
5089	premiums charged to insureds of the plan.
5090	2.The plan may issue assessable policies only to those
5091	insureds in subplan "C." and subplan "D." Subject to
5092	verification by the department, the board may levy assessments
5093	against insureds in subplan "C" or subplan "D," on a pro rata
5094	earned premium basis, to fund any deficits that exist in those
5095	subplans. Assessments levied against subplan "C" participants
5096	shall cover only the deficits attributable to subplan "C," and
5097	assessments levied against subplan "D" participants shall cover
5098	only the deficits attributable to subplan "D." In no event may
5099	the plan levy assessments against any person or entity, except
5100	as authorized by this paragraph.Those assessable policies must
5101	be clearly identified as assessable by containing, in
5102	contrasting color and in not less than 10-point type, the
5103	following statements: "This is an assessable policy. If the plan
5104	is unable to pay its obligations, policyholders will be required
5105	to contribute on a pro rata earned premium basis the money
5106	necessary to meet any assessment levied."
5107	3.The plan may issue assessable policies with differing
5108	terms and conditions to different groups within subplans "C" and
5109	"D"the planwhen a reasonable basis exists for the
5110	differentiation.
5111	4.The plan may offer rating, dividend plans, and other
5112	plans to encourage loss prevention programs.
5113	Section 36. Paragraphs (c) and (e) of subsection (3) of
5114	section 921.0022, Florida Statutes, are amended to read:
5115	921.0022 Criminal Punishment Code; offense severity
5116	ranking chart.--
5117	(3) OFFENSE SEVERITY RANKING CHART
5118	FloridaStatute FelonyDegree Description
5119	(c) LEVEL 3
5120	316.193(2)(b) 3rd Felony DUI, 3rd conviction.
5121	316.1935(2) 3rd Fleeing or attempting to elude law enforcement officer in marked patrol vehicle with siren and lights activated.
5122	319.30(4) 3rd Possession by junkyard of motor vehicle with identification number plate removed.
5123	319.33(1)(a) 3rd Alter or forge any certificate of title to a motor vehicle or mobile home.
5124	319.33(1)(c) 3rd Procure or pass title on stolen vehicle.
5125	319.33(4) 3rd With intent to defraud, possess, sell, etc., a blank, forged, or unlawfully obtained title or registration.
5126	327.35(2)(b) 3rd Felony BUI.
5127	328.05(2) 3rd Possess, sell, or counterfeit fictitious, stolen, or fraudulent titles or bills of sale of vessels.
5128	328.07(4) 3rd Manufacture, exchange, or possess vessel with counterfeit or wrong ID number.
5129	376.302(5) 3rd Fraud related to reimbursement for cleanup expenses under the Inland Protection Trust Fund.
5130	440.105(3)(b) 3rd Receipt of fee or consideration without approval by judge of compensation claims.
5131	440.1051(3) 3rd False report of workers' compensation fraud or retaliation for making such a report.
5132	501.001(2)(b) 2nd Tampers with a consumer product or the container using materially false/misleading information.
5133	697.08 3rd Equity skimming.
5134	790.15(3) 3rd Person directs another to discharge firearm from a vehicle.
5135	796.05(1) 3rd Live on earnings of a prostitute.
5136	806.10(1) 3rd Maliciously injure, destroy, or interfere with vehicles or equipment used in firefighting.
5137	806.10(2) 3rd Interferes with or assaults firefighter in performance of duty.
5138	810.09(2)(c) 3rd Trespass on property other than structure or conveyance armed with firearm or dangerous weapon.
5139	812.014(2)(c)2. 3rd Grand theft; $5,000 or more but less than $10,000.
5140	812.0145(2)(c) 3rd Theft from person 65 years of age or older; $300 or more but less than $10,000.
5141	815.04(4)(b) 2nd Computer offense devised to defraud or obtain property.
5142	817.034(4)(a)3. 3rd Engages in scheme to defraud (Florida Communications Fraud Act), property valued at less than $20,000.
5143	817.233 3rd Burning to defraud insurer.
5144	817.234(8)&(9) 3rd Unlawful solicitation of persons involved in motor vehicle accidents.
5145	817.234(11)(a) 3rd Insurance fraud; property value less than $20,000.
5146	817.505(4) 3rd Patient brokering.
5147	828.12(2) 3rd Tortures any animal with intent to inflict intense pain, serious physical injury, or death.
5148	831.28(2)(a) 3rd Counterfeiting a payment instrument with intent to defraud or possessing a counterfeit payment instrument.
5149	831.29 2nd Possession of instruments for counterfeiting drivers' licenses or identification cards.
5150	838.021(3)(b) 3rd Threatens unlawful harm to public servant.
5151	843.19 3rd Injure, disable, or kill police dog or horse.
5152	870.01(2) 3rd Riot; inciting or encouraging.
5153	893.13(1)(a)2. 3rd Sell, manufacture, or deliver cannabis (or other s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs).
5154	893.13(1)(d)2. 2nd Sell, manufacture, or deliver s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs within 200 feet of university or public park.
5155	893.13(1)(f)2. 3rd Sell, manufacture, or deliver s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs within 200 feet of public housing facility.
5156	893.13(6)(a) 3rd Possession of any controlled substance other than felony possession of cannabis.
5157	893.13(7)(a)8. 3rd Withhold information from practitioner regarding previous receipt of or prescription for a controlled substance.
5158	893.13(7)(a)9. 3rd Obtain or attempt to obtain controlled substance by fraud, forgery, misrepresentation, etc.
5159	893.13(7)(a)10. 3rd Affix false or forged label to package of controlled substance.
5160	893.13(7)(a)11. 3rd Furnish false or fraudulent material information on any document or record required by chapter 893.
5161	893.13(8)(a)1. 3rd Knowingly assist a patient, other person, or owner of an animal in obtaining a controlled substance through deceptive, untrue, or fraudulent representations in or related to the practitioner's practice.
5162	893.13(8)(a)2. 3rd Employ a trick or scheme in the practitioner's practice to assist a patient, other person, or owner of an animal in obtaining a controlled substance.
5163	893.13(8)(a)3. 3rd Knowingly write a prescription for a controlled substance for a fictitious person.
5164	893.13(8)(a)4. 3rd Write a prescription for a controlled substance for a patient, other person, or an animal if the sole purpose of writing the prescription is a monetary benefit for the practitioner.
5165	918.13(1)(a) 3rd Alter, destroy, or conceal investigation evidence.
5166	944.47(1)(a)1.-2. 3rd Introduce contraband to correctional facility.
5167	944.47(1)(c) 2nd Possess contraband while upon the grounds of a correctional institution.
5168	985.3141 3rd Escapes from a juvenile facility (secure detention or residential commitment facility).
5169	(e) LEVEL 5
5170	316.027(1)(a) 3rd Accidents involving personal injuries, failure to stop; leaving scene.
5171	316.1935(4) 2nd Aggravated fleeing or eluding.
5172	322.34(6) 3rd Careless operation of motor vehicle with suspended license, resulting in death or serious bodily injury.
5173	327.30(5) 3rd Vessel accidents involving personal injury; leaving scene.
5174	381.0041(11)(b) 3rd Donate blood, plasma, or organs knowing HIV positive.
5175
5176	440.10(1)(g) 2nd Failure to obtain workers' compensation coverage.
5177	440.105(5) 2nd Unlawful solicitation for the purpose of making workers' compensation claims.
5178	440.381(2) 2nd Submission of false, misleading, or incomplete information with the purpose of avoiding or reducing workers' compensation premiums.
5179	790.01(2) 3rd Carrying a concealed firearm.
5180	790.162 2nd Threat to throw or discharge destructive device.
5181	790.163(1) 2nd False report of deadly explosive or weapon of mass destruction.
5182	790.221(1) 2nd Possession of short-barreled shotgun or machine gun.
5183	790.23 2nd Felons in possession of firearms or electronic weapons or devices.
5184	800.04(6)(c) 3rd Lewd or lascivious conduct; offender less than 18 years.
5185	800.04(7)(c) 2nd Lewd or lascivious exhibition; offender 18 years or older.
5186	806.111(1) 3rd Possess, manufacture, or dispense fire bomb with intent to damage any structure or property.
5187	812.0145(2)(b) 2nd Theft from person 65 years of age or older; $10,000 or more but less than $50,000.
5188	812.015(8) 3rd Retail theft; property stolen is valued at $300 or more and one or more specified acts.
5189	812.019(1) 2nd Stolen property; dealing in or trafficking in.
5190	812.131(2)(b) 3rd Robbery by sudden snatching.
5191	812.16(2) 3rd Owning, operating, or conducting a chop shop.
5192	817.034(4)(a)2. 2nd Communications fraud, value $20,000 to $50,000.
5193	817.234(11)(b) 2nd Insurance fraud; property value $20,000 or more but less than $100,000.
5194	817.568(2)(b) 2nd Fraudulent use of personal identification information; value of benefit, services received, payment avoided, or amount of injury or fraud, $75,000 or more.
5195	817.625(2)(b) 2nd Second or subsequent fraudulent use of scanning device or reencoder.
5196	825.1025(4) 3rd Lewd or lascivious exhibition in the presence of an elderly person or disabled adult.
5197	827.071(4) 2nd Possess with intent to promote any photographic material, motion picture, etc., which includes sexual conduct by a child.
5198	839.13(2)(b) 2nd Falsifying records of an individual in the care and custody of a state agency involving great bodily harm or death.
5199	843.01 3rd Resist officer with violence to person; resist arrest with violence.
5200	874.05(2) 2nd Encouraging or recruiting another to join a criminal street gang; second or subsequent offense.
5201	893.13(1)(a)1. 2nd Sell, manufacture, or deliver cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4. drugs).
5202	893.13(1)(c)2. 2nd Sell, manufacture, or deliver cannabis (or other s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs) within 1,000 feet of a child care facility or school.
5203	893.13(1)(d)1. 1st Sell, manufacture, or deliver cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4. drugs) within 200 feet of university or public park.
5204	893.13(1)(e)2. 2nd Sell, manufacture, or deliver cannabis or other drug prohibited under s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) within 1,000 feet of property used for religious services or a specified business site.
5205	893.13(1)(f)1. 1st Sell, manufacture, or deliver cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), or (2)(a), (2)(b), or (2)(c)4. drugs) within 200 feet of public housing facility.
5206	893.13(4)(b) 2nd Deliver to minor cannabis (or other s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs).
5207	Section 37. Report to the Legislature regarding
5208	outstanding enforcement issues.--The Department of Financial
5209	Services shall, no later than January 1, 2004, provide a report
5210	to the President of the Senate, the Speaker of the House of
5211	Representatives, the minority leaders of the Senate and the
5212	House of Representatives, and the chairs of the standing
5213	committees of the Senate and the House of Representatives having
5214	jurisdiction over insurance issues, containing the following
5215	information:
5216	(1) Any provision of chapter 440, Florida Statutes,
5217	relating to workers' compensation carrier compliance and
5218	enforcement, that the department finds it is unable to enforce.
5219	(2) Any administrative rule relating to workers'
5220	compensation carrier compliance and enforcement that the
5221	department finds it is unable to enforce.
5222	(3) Any other impediment to enforcement of chapter 440,
5223	Florida Statutes, resulting from the transfer of activities from
5224	the former Department of Labor and Employment Security to the
5225	department or the reorganization of the former Department of
5226	Insurance into the department.
5227	Section 38. Subsection (2) of section 946.523, Florida
5228	Statutes, is amended to read:
5229	946.523 Prison industry enhancement (PIE) programs.--
5230	(2) Notwithstanding any other law to the contrary,
5231	including s. 440.15(8)(9), private sector employers shall
5232	provide workers' compensation coverage to inmates who
5233	participate in prison industry enhancement (PIE) programs under
5234	subsection (1). However, inmates are not entitled to
5235	unemployment compensation.
5236	Section 39. Paragraph (c) of subsection (5) of section
5237	985.315, Florida Statutes, is amended to read:
5238	985.315 Educational/technical and vocational work-related
5239	programs.--
5240	(5)
5241	(c) Notwithstanding any other law to the contrary,
5242	including s. 440.15(8)(9), private sector employers shall
5243	provide juveniles participating in juvenile work programs under
5244	paragraph (b) with workers' compensation coverage, and juveniles
5245	shall be entitled to the benefits of such coverage. Nothing in
5246	this subsection shall be construed to allow juveniles to
5247	participate in unemployment compensation benefits.
5248	Section 40. (1) There is established a Joint Select
5249	Committee on Workers’ Compensation Rating Reform. The committee
5250	shall study the merits of requiring each workers’ compensation
5251	insurer to individually file its expense and profit portion of a
5252	rate filing, while permitting each insurer to use a lost cost
5253	filing made by a licensed rating organization. The committee
5254	shall also study options for the current prior approval system
5255	for workers’ compensation rate filings, including, but not
5256	limited to, rate filing procedures that would promote greater
5257	competition and would encourage insurers to write workers'
5258	compensation coverage in the state while protecting employers
5259	from rates that are excessive, inadequate, or unfairly
5260	discriminatory.
5261	(2) The committee shall be composed of three Senators
5262	appointed by the President of the Senate and three
5263	Representatives appointed by the Speaker of the House of
5264	Representatives. The appointed members of the committee shall
5265	elect a chair and vice chair. The Department of Financial
5266	Services shall provide information and assistance as requested
5267	by the committee.
5268	(3) The committee shall issue its final report and
5269	recommendations to the President of the Senate and the Speaker
5270	of the House of Representatives by December 1, 2003. The
5271	committee shall terminate on December 1, 2003.
5272	Section 41. The board of governors of the joint
5273	underwriting plan for workers’ compensation insurance created by
5274	s. 627.311(4), Florida Statutes, shall, by January 1, 2005,
5275	submit a report to the President of the Senate, the Speaker of
5276	the House of Representatives, the minority party leaders of the
5277	Senate and the House of Representatives, and the chairs of the
5278	standing committees of the Senate and the House of
5279	Representatives having jurisdiction over matters relating to
5280	workers’ compensation. The report shall include the board’s
5281	findings and recommendations on the following issues:
5282	(1) The number of policies and the aggregate premium of
5283	the workers’ compensation joint underwriting plan, before and
5284	after enactment of this act, and projections for future policy
5285	and premium growth.
5286	(2) Increases or decreases in availability of workers’
5287	compensation coverage in the voluntary market and the
5288	effectiveness of this act in improving the availability of
5289	workers’ compensation coverage in the state.
5290	(3) The board’s efforts to depopulate the plan and the
5291	willingness of insurers in the voluntary market to avail
5292	themselves of depopulation incentives.
5293	(4) Further actions that could be taken by the Legislature
5294	to improve availability of workers’ compensation coverage in the
5295	voluntary and residual markets.
5296	(5) Actions that the board has taken to restructure the
5297	joint underwriting plan and recommendations for legislative
5298	action to restructure the plan.
5299	(6) Projected surpluses or deficits and possible means of
5300	providing funding to ensure the continued solvency of the plan.
5301	(7) An independent actuarial review of all rates under the
5302	plan. The costs of the independent actuarial review shall be
5303	paid from the Workers' Compensation Administration Trust Fund,
5304	pursuant to a budget amendment approved by the Legislative
5305	Budget Commission. The board shall submit a plan for such review
5306	to the Legislative Budget Commission by October 1, 2003.
5307	(8) Such other issues as the board determines are worthy
5308	of the Legislature’s consideration.
5309	Section 42. Subsections (1) and (2) of section 443.1715,
5310	Florida Statutes, are amended to read:
5311	443.1715 Disclosure of information; confidentiality.--
5312	(1) RECORDS AND REPORTS.--Information revealing the
5313	employing unit's or individual's identity obtained from the
5314	employing unit or from any individual pursuant to the
5315	administration of this chapter, and any determination revealing
5316	such information, except to the extent necessary for the proper
5317	presentation of a claim or upon written authorization of the
5318	claimant who has a workers’ compensation claim pending or is
5319	receiving compensation benefits, must be held confidential and
5320	exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I
5321	of the State Constitution. Such information may be made
5322	available only to public employees in the performance of their
5323	public duties, including employees of the Department of
5324	Education in obtaining information for the Florida Education and
5325	Training Placement Information Program and the Office of
5326	Tourism, Trade, and Economic Development in its administration
5327	of the qualified defense contractor tax refund program
5328	authorized by s. 288.1045 and the qualified target industry tax
5329	refund program authorized by s. 288.106. Except as otherwise
5330	provided by law, public employees receiving such information
5331	must retain the confidentiality of such information. Any
5332	claimant, or the claimant's legal representative, at a hearing
5333	before an appeals referee or the commission shall be supplied
5334	with information from such records to the extent necessary for
5335	the proper presentation of her or his claim. Any employee or
5336	member of the commission or any employee of the division, or any
5337	other person receiving confidential information, who violates
5338	any provision of this subsection commits a misdemeanor of the
5339	second degree, punishable as provided in s. 775.082 or s.
5340	775.083. However, the division may furnish to any employer
5341	copies of any report previously submitted by such employer, upon
5342	the request of such employer, and may furnish to any claimant
5343	copies of any report previously submitted by such claimant, upon
5344	the request of such claimant, and the division is authorized to
5345	charge therefor such reasonable fee as the division may by rule
5346	prescribe not to exceed the actual reasonable cost of the
5347	preparation of such copies. Fees received by the division for
5348	copies as provided in this subsection must be deposited to the
5349	credit of the Employment Security Administration Trust Fund.
5350	(2) DISCLOSURE OF INFORMATION.—
5351	(a)Subject to such restrictions as the division
5352	prescribes by rule, information declared confidential under this
5353	section may be made available to any agency of this or any other
5354	state, or any federal agency, charged with the administration of
5355	any unemployment compensation law or the maintenance of a system
5356	of public employment offices, or the Bureau of Internal Revenue
5357	of the United States Department of the Treasury, or the Florida
5358	Department of Revenue and information obtained in connection
5359	with the administration of the employment service may be made
5360	available to persons or agencies for purposes appropriate to the
5361	operation of a public employment service or a job-preparatory or
5362	career education or training program. The division shall on a
5363	quarterly basis, furnish the National Directory of New Hires
5364	with information concerning the wages and unemployment
5365	compensation paid to individuals, by such dates, in such format
5366	and containing such information as the Secretary of Health and
5367	Human Services shall specify in regulations. Upon request
5368	therefor, the division shall furnish any agency of the United
5369	States charged with the administration of public works or
5370	assistance through public employment, and may furnish to any
5371	state agency similarly charged, the name, address, ordinary
5372	occupation, and employment status of each recipient of benefits
5373	and such recipient's rights to further benefits under this
5374	chapter. Except as otherwise provided by law, the receiving
5375	agency must retain the confidentiality of such information as
5376	provided in this section. The division may request the
5377	Comptroller of the Currency of the United States to cause an
5378	examination of the correctness of any return or report of any
5379	national banking association rendered pursuant to the provisions
5380	of this chapter and may in connection with such request transmit
5381	any such report or return to the Comptroller of the Currency of
5382	the United States as provided in s. 3305(c) of the federal
5383	Internal Revenue Code.
5384	(b)1. The employer or the employer’s workers’ compensation
5385	carrier against whom a claim for benefits under chapter 440 has
5386	been made, or a representative of either, may request from the
5387	division records of wages of the employee reported to the
5388	division by any employer for the quarter that includes the date
5389	of the accident that is the subject of such claim and for
5390	subsequent quarters. The request must be made with the
5391	authorization or consent of the employee or any employer who
5392	paid wages to the employee subsequent to the date of the
5393	accident.
5394	2. The employer or carrier shall make the request on a
5395	form prescribed by rule for such purpose by the division. Such
5396	form shall contain a certification by the requesting party that
5397	it is a party entitled to the information requested as
5398	authorized by this paragraph.
5399	3. The division shall provide the most current information
5400	readily available within 15 days after receiving the request.
5401	Section 43. Subsection (9) of section 626.989, Florida
5402	Statutes, is amended to read:
5403	626.989 Investigation by department or Division of
5404	Insurance Fraud; compliance; immunity; confidential information;
5405	reports to division; division investigator's power of arrest.--
5406	(9) In recognition of the complementary roles of
5407	investigating instances of workers' compensation fraud and
5408	enforcing compliance with the workers' compensation coverage
5409	requirements under chapter 440, the Department of Financial
5410	Services shallInsurance is directed toprepare and submit a
5411	joint performance report to the President of the Senate and the
5412	Speaker of the House of Representatives by November 1, 2003, and
5413	then by January 1 of each yearNovember 1 every 3 years
5414	thereafter, describing the results obtained in achieving
5415	compliance with the workers' compensation coverage requirements
5416	and reducing the incidence of workers' compensation fraud. The
5417	annual report must include, but need not be limited to:
5418	(a) The total number of initial referrals received, cases
5419	opened, cases presented for prosecution, cases closed, and
5420	convictions resulting from cases presented for prosecution by
5421	the Bureau of Workers’ Compensation Insurance Fraud by type of
5422	workers’ compensation fraud and circuit.
5423	(b) The number of referrals received from insurers and the
5424	Division of Workers’ Compensation and the outcome of those
5425	referrals.
5426	(c) The number of investigations undertaken by the office
5427	which were not the result of a referral from an insurer or the
5428	Division of Workers’ Compensation.
5429	(d) The number of investigations that resulted in a
5430	referral to a regulatory agency and the disposition of those
5431	referrals.
5432	(e) The number and reasons provided by local prosecutors
5433	or the statewide prosecutor for declining prosecution of a case
5434	presented by the office by circuit.
5435	(f) The total number of employees assigned to the office
5436	and the Division of Workers’ Compliance unit delineated by
5437	location of staff assigned and the number and location of
5438	employees assigned to the office who were assigned to work other
5439	types of fraud cases.
5440	(g) The average caseload and turnaround time by type of
5441	case for each investigator and division compliance employee.
5442	(h) The training provided during the year to workers’
5443	compensation fraud investigators and the division’s compliance
5444	employees.
5445	Section 44. Section 626.9891, Florida Statutes, is amended
5446	to read:
5447	626.9891 Insurer anti-fraud investigative units; reporting
5448	requirements; penalties for noncompliance.--
5449	(1) Every insurer admitted to do business in this state
5450	who in the previous calendar year, at any time during that year,
5451	had $10 million or more in direct premiums written shall:
5452	(a) Establish and maintain a unit or division within the
5453	company to investigate possible fraudulent claims by insureds or
5454	by persons making claims for services or repairs against
5455	policies held by insureds; or
5456	(b) Contract with others to investigate possible
5457	fraudulent claims for services or repairs against policies held
5458	by insureds.
5459
5460	An insurer subject to this subsection shall file with the
5461	Division of Insurance Fraud of the department on or before July
5462	1, 1996, a detailed description of the unit or division
5463	established pursuant to paragraph (a) or a copy of the contract
5464	and related documents required by paragraph (b).
5465	(2) Every insurer admitted to do business in this state,
5466	which in the previous calendar year had less than $10 million in
5467	direct premiums written, must adopt an anti-fraud plan and file
5468	it with the Division of Insurance Fraud of the department on or
5469	before July 1, 1996. An insurer may, in lieu of adopting and
5470	filing an anti-fraud plan, comply with the provisions of
5471	subsection (1).
5472	(3) Each insurers anti-fraud plans shall include:
5473	(a) A description of the insurer's procedures for
5474	detecting and investigating possible fraudulent insurance acts;
5475	(b) A description of the insurer's procedures for the
5476	mandatory reporting of possible fraudulent insurance acts to the
5477	Division of Insurance Fraud of the department;
5478	(c) A description of the insurer's plan for anti-fraud
5479	education and training of its claims adjusters or other
5480	personnel; and
5481	(d) A written description or chart outlining the
5482	organizational arrangement of the insurer's anti-fraud personnel
5483	who are responsible for the investigation and reporting of
5484	possible fraudulent insurance acts.
5485	(4) Any insurer who obtains a certificate of authority
5486	after July 1, 1995, shall have 18 months in which to comply with
5487	the requirements of this section.
5488	(5) For purposes of this section, the term "unit or
5489	division" includes the assignment of fraud investigation to
5490	employees whose principal responsibilities are the investigation
5491	and disposition of claims. If an insurer creates a distinct unit
5492	or division, hires additional employees, or contracts with
5493	another entity to fulfill the requirements of this section, the
5494	additional cost incurred must be included as an administrative
5495	expense for ratemaking purposes.
5496	(6) Each insurer writing workers’ compensation insurance
5497	shall report to the department, on or before August 1 of each
5498	year, on its experience in implementing and maintaining an anti-
5499	fraud investigative unit or an anti-fraud plan. The report must
5500	include, at a minimum:
5501	(a) The dollar amount of recoveries and losses
5502	attributable to workers’ compensation fraud delineated by the
5503	type of fraud: claimant, employer, provider, agent, or other.
5504	(b) The number of referrals to the Bureau of Workers’
5505	Compensation Fraud for the prior year.
5506	(c) A description of the organization of the anti-fraud
5507	investigative unit, if applicable, including the position titles
5508	and descriptions of staffing.
5509	(d) The rationale for the level of staffing and resources
5510	being provided for the anti-fraud investigative unit, which may
5511	include objective criteria such as number of policies written,
5512	number of claims received on an annual basis, volume of
5513	suspected fraudulent claims currently being detected, other
5514	factors, and an assessment of optimal caseload that can be
5515	handled by an investigator on an annual basis.
5516	(e) The in-service education and training provided to
5517	underwriting and claims personnel to assist in identifying and
5518	evaluating instances of suspected fraudulent activity in
5519	underwriting or claims activities.
5520	(f) A description of a public awareness program focused on
5521	the costs and frequency of insurance fraud and methods by which
5522	the public can prevent it.
5523	(7) If an insurer fails to submit a final anti-fraud plan
5524	or otherwise fails to submit a plan, fails to implement the
5525	provisions of a plan or an anti-fraud investigative unit, or
5526	otherwise refuses to comply with the provisions of this section,
5527	the department may:
5528	(a) Impose an administrative fine of not more than $2,000
5529	per day for such failure by an insurer, until the department
5530	deems the insurer to be in compliance;
5531	(b) Impose upon the insurer a fraud detection and
5532	prevention plan that is deemed to be appropriate by the
5533	department and that must be implemented by the insurer; or
5534	(c) Impose the provisions of both paragraphs (a) and (b).
5535	(8) The department may adopt rules to administer this
5536	section.
5537	Section 45. Section 440.1925, Florida Statutes, is
5538	repealed.
5539	Section 46. Paragraph (h) of subsection (2) of section
5540	112.19, Florida Statutes, is amended to read:
5541	112.19 Law enforcement, correctional, and correctional
5542	probation officers; death benefits.--
5543	(2)
5544	(h)1. Any employer who employs a full-time law
5545	enforcement, correctional, or correctional probation officer
5546	who, on or after January 1, 1995, suffers a catastrophic injury,
5547	as defined in s. 440.02, Florida Statutes 2002,in the line of
5548	duty shall pay the entire premium of the employer's health
5549	insurance plan for the injured employee, the injured employee's
5550	spouse, and for each dependent child of the injured employee
5551	until the child reaches the age of majority or until the end of
5552	the calendar year in which the child reaches the age of 25 if
5553	the child continues to be dependent for support, or the child is
5554	a full-time or part-time student and is dependent for support.
5555	The term "health insurance plan" does not include supplemental
5556	benefits that are not part of the basic group health insurance
5557	plan. If the injured employee subsequently dies, the employer
5558	shall continue to pay the entire health insurance premium for
5559	the surviving spouse until remarried, and for the dependent
5560	children, under the conditions outlined in this paragraph.
5561	However:
5562	a. Health insurance benefits payable from any other source
5563	shall reduce benefits payable under this section.
5564	b. It is unlawful for a person to willfully and knowingly
5565	make, or cause to be made, or to assist, conspire with, or urge
5566	another to make, or cause to be made, any false, fraudulent, or
5567	misleading oral or written statement to obtain health insurance
5568	coverage as provided under this paragraph. A person who violates
5569	this sub-subparagraph commits a misdemeanor of the first degree,
5570	punishable as provided in s. 775.082 or s. 775.083.
5571	c. In addition to any applicable criminal penalty, upon
5572	conviction for a violation as described in sub-subparagraph b.,
5573	a law enforcement, correctional, or correctional probation
5574	officer or other beneficiary who receives or seeks to receive
5575	health insurance benefits under this paragraph shall forfeit the
5576	right to receive such health insurance benefits, and shall
5577	reimburse the employer for all benefits paid due to the fraud or
5578	other prohibited activity. For purposes of this sub-
5579	subparagraph, "conviction" means a determination of guilt that
5580	is the result of a plea or trial, regardless of whether
5581	adjudication is withheld.
5582	2. In order for the officer, spouse, and dependent
5583	children to be eligible for such insurance coverage, the injury
5584	must have occurred as the result of the officer's response to
5585	fresh pursuit, the officer's response to what is reasonably
5586	believed to be an emergency, or an unlawful act perpetrated by
5587	another. Except as otherwise provided herein, nothing in this
5588	paragraph shall be construed to limit health insurance coverage
5589	for which the officer, spouse, or dependent children may
5590	otherwise be eligible, except that a person who qualifies under
5591	this section shall not be eligible for the health insurance
5592	subsidy provided under chapter 121, chapter 175, or chapter 185.
5593	Section 47. Paragraph (g) of subsection (2) of section
5594	112.191, Florida Statutes, is amended to read:
5595	112.191 Firefighters; death benefits.--
5596	(2)
5597	(g)1. Any employer who employs a full-time firefighter
5598	who, on or after January 1, 1995, suffers a catastrophic injury,
5599	as defined in s. 440.02, Florida Statutes 2002,in the line of
5600	duty shall pay the entire premium of the employer's health
5601	insurance plan for the injured employee, the injured employee's
5602	spouse, and for each dependent child of the injured employee
5603	until the child reaches the age of majority or until the end of
5604	the calendar year in which the child reaches the age of 25 if
5605	the child continues to be dependent for support, or the child is
5606	a full-time or part-time student and is dependent for support.
5607	The term "health insurance plan" does not include supplemental
5608	benefits that are not part of the basic group health insurance
5609	plan. If the injured employee subsequently dies, the employer
5610	shall continue to pay the entire health insurance premium for
5611	the surviving spouse until remarried, and for the dependent
5612	children, under the conditions outlined in this paragraph.
5613	However:
5614	a. Health insurance benefits payable from any other source
5615	shall reduce benefits payable under this section.
5616	b. It is unlawful for a person to willfully and knowingly
5617	make, or cause to be made, or to assist, conspire with, or urge
5618	another to make, or cause to be made, any false, fraudulent, or
5619	misleading oral or written statement to obtain health insurance
5620	coverage as provided under this paragraph. A person who violates
5621	this sub-subparagraph commits a misdemeanor of the first degree,
5622	punishable as provided in s. 775.082 or s. 775.083.
5623	c. In addition to any applicable criminal penalty, upon
5624	conviction for a violation as described in sub-subparagraph b.,
5625	a firefighter or other beneficiary who receives or seeks to
5626	receive health insurance benefits under this paragraph shall
5627	forfeit the right to receive such health insurance benefits, and
5628	shall reimburse the employer for all benefits paid due to the
5629	fraud or other prohibited activity. For purposes of this sub-
5630	subparagraph, "conviction" means a determination of guilt that
5631	is the result of a plea or trial, regardless of whether
5632	adjudication is withheld.
5633	2. In order for the firefighter, spouse, and dependent
5634	children to be eligible for such insurance coverage, the injury
5635	must have occurred as the result of the firefighter's response
5636	to what is reasonably believed to be an emergency involving the
5637	protection of life or property, or an unlawful act perpetrated
5638	by another. Except as otherwise provided herein, nothing in this
5639	paragraph shall be construed to limit health insurance coverage
5640	for which the firefighter, spouse, or dependent children may
5641	otherwise be eligible, except that a person who qualifies for
5642	benefits under this section shall not be eligible for the health
5643	insurance subsidy provided under chapter 121, chapter 175, or
5644	chapter 185.
5645	Section 48. The amendments to ss. 440.02 and 440.15,
5646	Florida Statutes, which are made by this act shall not be
5647	construed to affect any determination of disability under s.
5648	112.18, s. 112.181, or s. 112.19, Florida Statutes.
5649	Section 49. If any law amended by this act was also
5650	amended by a law enacted at the 2003 Regular Session of the
5651	Legislature, such laws shall be construed as if they had been
5652	enacted at the same session of the Legislature, and full effect
5653	shall be given to each if possible.
5654	Section 50. Except as otherwise provided herein, this act
5655	shall take effect October 1, 2003.
5656
5657	================= T I T L E A M E N D M E N T =================
5658	Remove the entire title
5659
5660	and insert:
5661	A bill to be entitled
5662	An act relating to workers' compensation; amending s.
5663	440.02, F.S.; providing, revising, and deleting
5664	definitions; amending s. 440.05, F.S.; revising
5665	authorization to claim exemptions and requirements
5666	relating to submitting notice of election of exemption;
5667	specifying effect of exemption; providing a definition;
5668	amending s. 440.06, F.S.; revising provisions relating to
5669	failure to secure compensation; amending s. 440.077, F.S.;
5670	providing that a corporate officer electing to be exempt
5671	may not receive benefits; amending s. 440.09, F.S.;
5672	revising provisions relating to compensation for
5673	subsequent injuries; providing definitions; revising
5674	provisions relating to drug testing; specifying effect of
5675	criminal acts; creating s. 440.093, F.S.; providing for
5676	compensability of mental and nervous injuries; amending s.
5677	440.10, F.S.; revising provisions relating to contractors
5678	and subcontractors with regard to liability for
5679	compensation; requiring subcontractors to provide evidence
5680	of workers' compensation coverage or proof of exemption to
5681	a contractor; deleting provisions relating to independent
5682	contractors; amending s. 440.1025, F.S.; revising
5683	requirements relating to workplace safety programs;
5684	amending s. 440.103, F.S.; providing conditions for
5685	applying for building permits; amending s. 440.105, F.S.;
5686	increasing criminal penalties for certain violations;
5687	providing sanctions for violation of stop-work orders and
5688	presentation of certain false or misleading statements as
5689	evidence; amending s. 440.1051, F.S.; increasing criminal
5690	penalty for false reports; amending s. 440.107, F.S.;
5691	providing additional powers to the Department of Financial
5692	Services relating to compliance and enforcement; providing
5693	a definition; providing penalties; amending s. 440.11,
5694	F.S.; providing exclusiveness of liability; revising
5695	provisions relating to employer and safety consultant
5696	immunity from liability; amending s. 440.13, F.S.;
5697	providing for practice parameters and treatment protocols;
5698	revising provisions relating to provider reimbursement;
5699	requiring revision of specified reimbursement schedules;
5700	providing for release of information; providing additional
5701	criteria for independent medical examinations; providing a
5702	definition; providing standards for medical care under ch.
5703	440, F.S.; providing penalties; amending s. 440.134, F.S.;
5704	revising provisions relating to managed care arrangements;
5705	revising definitions; providing for assignment of a
5706	medical care coordinator; amending s. 440.14, F.S.;
5707	revising provisions relating to calculation of average
5708	weekly wage for injured employees; conforming cross
5709	references; amending s. 440.15, F.S.; providing additional
5710	limitations on compensation for permanent total
5711	disability; providing a definition; specifying impairment
5712	benefits and providing for partial reduction under certain
5713	circumstances; deleting provisions relating to
5714	supplemental benefits; amending s. 440.151, F.S.;
5715	specifying compensability of occupational disease;
5716	providing a definition; amending s. 440.16, F.S.;
5717	increasing the limits on the amount of certain benefits
5718	paid as compensation for death; amending s. 440.185, F.S.;
5719	specifying duty of employer upon receipt of notice of
5720	injury or death; increasing penalties for noncompliance;
5721	amending s. 440.192, F.S.; revising procedure for
5722	resolving benefit disputes; requiring a petition for
5723	benefits to include all claims which are ripe, due, and
5724	owing; providing that the Chief Judge, rather than the
5725	Deputy Chief Judge, shall refer petitions for benefits;
5726	creating s. 440.1926, F.S.; providing for alternative
5727	dispute resolution and arbitration of claims; amending s.
5728	440.20, F.S.; revising provisions relating to timely
5729	payment of compensation and medical bills and penalties
5730	for late payment; prohibiting the clerk of the circuit
5731	court from assessing certain fees or costs; amending s.
5732	440.25, F.S.; revising procedures for mediation and
5733	hearings; amending s. 440.34, F.S.; revising provisions
5734	relating to the award of attorney's fees; amending s.
5735	440.38, F.S.; providing requirement for employers with
5736	coverage provided by insurers from outside the state;
5737	amending s. 440.381, F.S.; providing criminal penalty for
5738	unlawful applications; requiring on-site audits of
5739	employers under certain circumstances; amending s. 440.42,
5740	F.S.; revising provision relating to notice of
5741	cancellation of coverage; amending s. 440.49, F.S., to
5742	conform cross references; amending s. 440.491, F.S.;
5743	providing training and education requirements and benefits
5744	relating to reemployment of injured workers; providing for
5745	rules; amending s. 440.525, F.S.; providing for the Office
5746	of Insurance Regulation of the Financial Services
5747	Commission to conduct examinations and investigations of
5748	claims-handing entities; providing penalties; providing
5749	for rules; amending s. 627.162, F.S.; revising delinquency
5750	and collection fee for late payment of premium
5751	installments; creating s. 627.285, F.S.; providing for
5752	annual actuarial peer review of rating organization
5753	processes; requiring a report; amending s. 627.311, F.S.;
5754	revising membership of the board of governors of the
5755	workers’ compensation joint underwriting plan; requiring
5756	participation in safety programs; providing for an
5757	additional subplan within the joint underwriting plan for
5758	workers' compensation insurance; providing for rates,
5759	surcharges, and assessments; limiting assessment powers;
5760	amending s. 921.0022, F.S.; revising the offense severity
5761	ranking chart to reflect changes in penalties under the
5762	act; requiring a report to the Legislature from the
5763	Department of Financial Services regarding provisions of
5764	law relating to enforcement; amending ss. 946.523 and
5765	985.315, F.S., to conform cross references; establishing a
5766	Joint Select Committee on Workers’ Compensation Rating
5767	Reform and specifying duties thereof; providing for
5768	termination of the committee; requiring the board of
5769	governors of the workers’ compensation joint underwriting
5770	plan to submit a report to the Legislature; amending s.
5771	443.1715, F.S.; revising provisions relating to records
5772	and reports; providing for disclosure of specified
5773	information; amending s. 625.989, F.S.; providing that the
5774	Department of Financial Services shall prepare an annual
5775	report relating to workers’ compensation fraud and
5776	compliance; amending s. 626.9891, F.S.; amending reporting
5777	requirements for insurers; providing penalties for
5778	noncompliance; providing for rules; repealing s. 440.1925,
5779	F.S., relating to procedure for resolving maximum medical
5780	improvement or permanent impairment disputes; amending ss.
5781	112.19 and 112.191, F.S., to conform references to changes
5782	made by the act; providing that amendments to ss. 440.02
5783	and 440.15, F.S., do not affect certain disability,
5784	determination, and benefits; providing for construction of
5785	the act in pari materia with laws enacted during the 2003
5786	Regular Session of the Legislature; providing effective
5787	dates.
5788