House Bill hb1643er

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    2002 Legislature                   CS/HB 1643, First Engrossed



  1

  2         An act relating to transferring and reassigning

  3         divisions, functions, and responsibilities of

  4         the Department of Labor and Employment

  5         Security; providing for a type two transfer of

  6         the Division of Workers' Compensation to the

  7         Department of Insurance; providing for a type

  8         two transfer of workers' compensation medical

  9         services to the Agency for Health Care

10         Administration; providing for a type two

11         transfer of workers' compensation

12         rehabilitation and reemployment services to the

13         Department of Education; providing for a type

14         two transfer of the administration of child

15         labor laws to the Department of Business and

16         Professional Regulation; providing for

17         comparable pay grades for the transferred

18         positions; authorizing the Department of

19         Insurance to reclassify and reorganize

20         positions within the department and establish

21         regional offices; authorizing the Department of

22         Insurance to enter into contracts; providing

23         for existing contracts to be subject to review

24         and cancellation; providing for a type two

25         transfer of certain functions of the Office of

26         the Secretary and the Office of Administrative

27         Services of the Department of Labor and

28         Employment Security relating to labor

29         organizations and migrant and farm labor

30         registration to the Department of Business and

31         Professional Regulation; providing for a type


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  1         two transfer of other workplace regulation

  2         functions to the Department of Business and

  3         Professional Regulation; providing for the

  4         transfer of the Unemployment Appeals Commission

  5         to the Agency for Workforce Innovation by a

  6         type two transfer; providing for the transfer

  7         of the Office of Information Systems to the

  8         State Technology Office by a type two transfer;

  9         requiring the State Technology Office and the

10         Department of Insurance to determine whether it

11         is feasible to transfer ownership of the

12         Workers' Compensation Integrated System to the

13         Department of Insurance; providing for the

14         continuation of contracts or agreements of the

15         Department of Labor and Employment Security;

16         providing for a successor department, agency,

17         or entity to be substituted for the Department

18         of Labor and Employment Security as a party in

19         interest in pending proceedings; exempting

20         specified state agencies, on a temporary basis,

21         from provisions relating to procurement of

22         property and services and leasing of space;

23         authorizing specified state agencies to develop

24         temporary emergency rules relating to the

25         implementation of the act; amending s. 20.13,

26         F.S.; establishing the Division of Workers'

27         Compensation within the Department of

28         Insurance; amending s. 20.50, F.S.; revising

29         provisions relating to the Agency for Workforce

30         Innovation to conform; revising

31         responsibilities of certain offices within the


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  1         agency; specifying that the Unemployment

  2         Appeals Commission is not subject to the

  3         agency; amending ss. 110.205, 112.19, 112.191,

  4         121.125, 122.03, 238.06, and 440.015, F.S., to

  5         conform; amending s. 440.02, F.S.; providing a

  6         definition for the term "agency"; conforming

  7         definitions of "department" and "division" to

  8         the transfer of the Division of Workers'

  9         Compensation; amending ss. 440.021, 440.05,

10         440.09, 440.10, 440.102, 440.103, 440.104,

11         440.105, 440.106, 440.107, 440.108, 440.12, and

12         440.125, F.S.; conforming provisions to reflect

13         the transfer of the Division of Workers'

14         Compensation; amending s. 440.13, F.S.,

15         relating to medical services and supplies under

16         the workers' compensation law; reassigning

17         certain functions from the Division of Workers'

18         Compensation to the Agency for Health Care

19         Administration; conforming agency references to

20         reflect the transfer of the Division of

21         Workers' Compensation; amending ss. 440.134 and

22         440.14, F.S.; conforming provisions to changes

23         made by the act; amending s. 440.15, F.S.;

24         providing for the agency to specify certain

25         forms and procedures governing wage loss and

26         impairment benefits; conforming a cross

27         reference; amending ss. 440.185, 440.191,

28         440.192, and 440.1925, F.S.; conforming

29         provisions to changes made by the act; amending

30         ss. 440.20, 440.207, and 440.211, F.S.,

31         relating to payment of compensation; conforming


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  1         provisions to changes made by the act; amending

  2         s. 440.24, F.S.; providing for the sale of

  3         securities on deposit to satisfy a compensation

  4         order; amending ss. 440.25 and 440.271, F.S.,

  5         relating to mediation, hearings, and appeals;

  6         conforming provisions to changes made by the

  7         act; amending ss. 440.345 and 440.35, F.S.,

  8         relating to the reporting of attorney's fees

  9         and employer records of injury or death;

10         conforming provisions to changes made by the

11         act; amending s. 440.381, F.S., relating to

12         audits of payroll and classifications;

13         conforming provisions to reflect the transfer

14         of the Division of Workers' Compensation;

15         amending ss. 440.40, 440.41, and 440.42, F.S.,

16         relating to employers posting notice of

17         compensation, substitution of carriers for

18         employers with respect to notice and the effect

19         of an order, and expiration of insurance

20         policies, to conform; amending s. 440.44, F.S.,

21         relating to the administration of the Workers'

22         Compensation Law; conforming provisions to

23         reflect the transfer of the Division of

24         Workers' Compensation; amending s. 440.45,

25         F.S., relating to the Office of the Judges of

26         Compensation Claims; clarifying the

27         responsibilities of the director of the

28         Division of Administrative Hearings as agency

29         head of the Office of the Judges of

30         Compensation Claims; amending s. 440.49, F.S.,

31         relating to the Special Disability Trust Fund;


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  1         conforming provisions to reflect the transfer

  2         of the Division of Workers' Compensation;

  3         reassigning responsibility for a report on the

  4         Special Disability Trust Fund to the Department

  5         of Insurance; amending s. 440.491, F.S.,

  6         relating to the reemployment of injured

  7         workers; conforming provisions to the transfer

  8         of rehabilitation and reemployment services to

  9         the Department of Education; amending ss.

10         440.50, 440.51, and 440.52, F.S., relating to

11         the Workers' Compensation Administration Trust

12         Fund, expenses of administration, and certain

13         responsibilities of insurance carriers;

14         conforming references to reflect the transfer

15         of the Division of Workers' Compensation;

16         amending s. 440.525, F.S., relating to the

17         examination of carriers; conforming agency

18         references to the transfer of programs from the

19         Department of Labor and Employment Security to

20         the Department of Insurance; amending s.

21         440.572, F.S., to conform; amending s. 440.59,

22         F.S., relating to division reporting

23         requirements; eliminating unnecessary reporting

24         requirements; amending ss. 440.591 and 440.593,

25         F.S., relating to authorization to self-insure,

26         reporting requirements, and rulemaking

27         authority; conforming provisions to changes

28         made by the act; amending s. 443.012, F.S.;

29         providing for the Unemployment Appeals

30         Commission to be created within the Agency for

31         Workforce Innovation rather than the Department


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  1         of Labor and Employment Security; conforming

  2         provisions; amending s. 443.036, F.S.;

  3         conforming the definition of "commission" to

  4         the transfer of the Unemployment Appeals

  5         Commission to the Agency for Workforce

  6         Innovation; amending s. 447.02, F.S.;

  7         conforming the definition of "department" to

  8         the transfer of the regulation of labor

  9         organizations to the Department of Business and

10         Professional Regulation; amending s. 447.305,

11         F.S.; providing that notification of

12         registrations and renewals of registration

13         shall be furnished to the Department of

14         Business and Professional Regulation, to

15         conform; amending s. 450.012, F.S.; conforming

16         the definition of "department" to the transfer

17         of the regulation of child labor to the

18         Department of Business and Professional

19         Regulation; amending s. 450.191, F.S., relating

20         to the duties of the Executive Office of the

21         Governor with respect to migrant labor;

22         conforming provisions to changes made by the

23         act; amending s. 450.28, F.S.; conforming the

24         definition of "department" to the transfer of

25         the regulation of farm labor to the Department

26         of Business and Professional Regulation;

27         amending s. 624.3161, F.S., relating to

28         insurance market conduct examinations;

29         conforming provisions to changes made by the

30         act; amending s. 626.88, F.S., relating to

31         self-insurance definitions; conforming


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  1         provisions to changes made by the act; amending

  2         s. 626.989, F.S., relating to Division of

  3         Insurance Fraud reporting requirements;

  4         conforming provisions to changes made by the

  5         act and establishing reporting deadlines;

  6         amending s. 627.0915, F.S.; conforming

  7         departmental references to changes made by the

  8         act; amending s. 627.914, F.S., relating to

  9         reporting requirements by self-insurers;

10         conforming provisions to changes made by the

11         act; repealing s. 20.171, F.S., relating to the

12         establishment and the authority and

13         organizational structure of the Department of

14         Labor and Employment Security; repealing s.

15         440.4416, F.S., relating to the Workers'

16         Compensation Oversight Board; providing for

17         severability; providing effective dates.

18

19  Be It Enacted by the Legislature of the State of Florida:

20

21         Section 1.  (1)  All powers, duties, functions, rules,

22  records, personnel, property, and unexpended balances of

23  appropriations, allocations, and other funds of the Division

24  of Workers' Compensation are transferred by a type two

25  transfer, as defined in s. 20.06(2), Florida Statutes, from

26  the Department of Labor and Employment Security to the

27  Department of Insurance, except as otherwise provided in this

28  subsection, as follows: the full-time equivalent positions and

29  the associated funding for salaries, benefits, other capital

30  outlay, and expenses related to oversight of medical services

31  in workers' compensation provider relations, dispute and


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  1  complaint resolution, program evaluation, data management, and

  2  review of carrier medical bill payments are transferred by a

  3  type two transfer, as defined in s. 20.06(2), Florida

  4  Statutes, from the Department of Labor and Employment Security

  5  to the Agency for Health Care Administration; the full-time

  6  equivalent positions and the associated funding for salaries,

  7  benefits, other capital outlay, and expenses related to the

  8  rehabilitation and reemployment of injured workers are

  9  transferred by a type two transfer, as defined in s. 20.06(2),

10  Florida Statutes, from the Department of Labor and Employment

11  Security to the Department of Education; and the full-time

12  equivalent positions and the associated funding for salaries,

13  benefits, other capital outlay, and expenses related to the

14  administration of child labor laws under chapter 450, Florida

15  Statutes, are transferred by a type two transfer, as defined

16  in s. 20.06(2), Florida Statutes, from the Department of Labor

17  and Employment Security to the Department of Business and

18  Professional Regulation. To the extent feasible, the positions

19  transferred to the Department of Insurance will be

20  reclassified to pay grades comparable to the positions

21  established by the Department of Labor and Employment

22  Security, based on the classification codes and specifications

23  of the positions for work to be performed at the Department of

24  Insurance. The number of positions the department establishes

25  may not exceed the number of authorized positions and the

26  salary and benefits that were authorized for the Division of

27  Workers' Compensation within the Department of Labor and

28  Employment Security prior to the transfer. The Department of

29  Insurance is further authorized to reassign, reorganize,

30  reclassify, or otherwise transfer positions to appropriate

31  administrative subdivisions within the department and to


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  1  establish such regional offices as are necessary to properly

  2  enforce and administer its responsibilities under the Florida

  3  Insurance Code and chapter 440, Florida Statutes. The

  4  department may also enter into contracts with public or

  5  private entities to administer its duties and responsibilities

  6  associated with the transfer of the Division of Workers'

  7  Compensation.

  8         (2)  All powers, duties, functions, rules, records,

  9  personnel, property, and unexpended balances of

10  appropriations, allocations, and other funds of the Office of

11  the Secretary and the Office of Administrative Services of the

12  Department of Labor and Employment Security related to the

13  regulation of labor organizations under chapter 447, Florida

14  Statutes, and the administration of migrant labor and farm

15  labor laws under chapter 450, Florida Statutes, are

16  transferred by a type two transfer, as defined in s. 20.06(2),

17  Florida Statutes, from the Department of Labor and Employment

18  Security to the Department of Business and Professional

19  Regulation.

20         (3)  Any other powers, duties, functions, rules,

21  records, property, and unexpended balances of appropriations,

22  allocations, and other funds of the Department of Labor and

23  Employment Security not otherwise transferred by this act

24  relating to workplace regulation and enforcement, including,

25  but not limited to, those under chapter 448, Florida Statutes,

26  are transferred by a type two transfer, as defined in s.

27  20.06(2), Florida Statutes, from the Department of Labor and

28  Employment Security to the Department of Business and

29  Professional Regulation. The Department of Business and

30  Professional Regulation is authorized to reassign, reorganize,

31  reclassify, or otherwise transfer positions to appropriate


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  1  administrative subdivisions within the department to

  2  accomplish its workplace regulation responsibilities.

  3         (4)  All powers, duties, functions, rules, records,

  4  personnel, property, and unexpended balances of

  5  appropriations, allocations, and other funds of the

  6  Unemployment Appeals Commission relating to the commission's

  7  specified authority, powers, duties, and responsibilities are

  8  transferred by a type two transfer, as defined in s. 20.06(2),

  9  Florida Statutes, to the Agency for Workforce Innovation.

10         (5)  The Office of Information Systems is transferred

11  by a type two transfer, as defined in s. 20.06(2), Florida

12  Statutes, from the Department of Labor and Employment Security

13  to the State Technology Office. Upon completion of this

14  transfer, the State Technology Office and the Department of

15  Insurance shall enter into discussions to determine whether it

16  would be technologically feasible and cost effective to

17  separate the workers' compensation related systems and

18  transfer ownership of these systems to the Department of

19  Insurance. If the Department of Insurance determines that it

20  would be technologically feasible and cost effective to

21  transfer ownership of the workers' compensation related

22  systems from the State Technology Office to the Department of

23  Insurance, the Department of Insurance shall submit a transfer

24  plan and budget amendment requesting the transfer of these

25  systems. The transfer plan and budget amendment must be

26  approved by the Legislative Budget Commission.

27         (6)(a)  The records, property, and unexpended balances

28  of appropriations, allocations, and other funds and resources

29  of the Office of the Secretary and the Office of

30  Administrative Services of the Department of Labor and

31  Employment Security which support the activities and functions


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  1  transferred under subsection (1) to the Department of

  2  Insurance are transferred as provided in s. 20.06(2), Florida

  3  Statutes, to the Department of Insurance.

  4         (b)  The records, property, and unexpended balances of

  5  appropriations, allocations, and other funds and resources of

  6  the Office of the Secretary and the Office of Administrative

  7  Services of the Department of Labor and Employment Security

  8  which support the activities and functions transferred under

  9  subsection (1) to the Agency for Health Care Administration

10  are transferred as provided in s. 20.06(2), Florida Statutes,

11  to the Agency for Health Care Administration.

12         (c)  The records, property, and unexpended balances of

13  appropriations, allocations, and other funds and resources of

14  the Office of the Secretary and the Office of Administrative

15  Services of the Department of Labor and Employment Security

16  which support the activities and functions transferred under

17  subsection (1) to the Department of Education are transferred

18  as provided in s. 20.06(2), Florida Statutes, to the

19  Department of Education.

20         (d)  The records, property, and unexpended balances of

21  appropriations, allocations, and other funds and resources of

22  the Office of the Secretary and the Office of Administrative

23  Services of the Department of Labor and Employment Security

24  which support the activities and functions transferred under

25  subsections (1), (2), and (3) to the Department of Business

26  and Professional Regulation are transferred as provided in s.

27  20.06(2), Florida Statutes, to the Department of Business and

28  Professional Regulation.

29         (e)  The records, property, and unexpended balances of

30  appropriations, allocations, and other funds and resources of

31  the Office of the Secretary and the Office of Administrative


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  1  Services of the Department of Labor and Employment Security

  2  which support the activities and functions transferred under

  3  subsection (4) to the Agency for Workforce Innovation are

  4  transferred as provided in s. 20.06(2), Florida Statutes, to

  5  the Agency for Workforce Innovation.

  6         (f)  The records, property, and unexpended balances of

  7  appropriations, allocations, and other funds and resources of

  8  the Office of the Secretary and the Office of Administrative

  9  Services of the Department of Labor and Employment Security

10  which support the activities and functions transferred under

11  subsection (5) to the State Technology Office are transferred

12  as provided in s. 20.06(2), Florida Statutes, to the State

13  Technology Office.

14         (7)  The Department of Management Services shall become

15  the custodian of any property of the Department of Labor and

16  Employment Security which is not otherwise transferred for the

17  purposes of chapter 273, Florida Statutes. The Department of

18  Management Services is authorized to permit the use of such

19  property by organizations as necessary to implement the

20  provisions of this act.

21         (8)  Any binding contract or interagency agreement

22  existing on or before July 1, 2002, between the Department of

23  Labor and Employment Security, or an entity or agent of the

24  department, and any other agency, entity, or person shall

25  continue as a binding contract or agreement for the remainder

26  of the term of such contract or agreement with the successor

27  department, agency, or entity responsible for the program,

28  activity, or functions relative to the contract or agreement.

29         (9)  This act does not affect the validity of any

30  judicial or administrative proceeding involving the Department

31  of Labor and Employment Security which is pending as of the


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  1  effective date of any transfer under this act. The successor

  2  department, agency, or entity responsible for the program,

  3  activity, or function relative to the proceeding shall be

  4  substituted, as of the effective date of the applicable

  5  transfer under this act, for the Department of Labor and

  6  Employment Security as a party in interest in any such

  7  proceedings.

  8         (10)  So that the farm labor, child labor, and

  9  workplace regulation programs may be fully integrated into the

10  mission of the Department of Business and Professional

11  Regulation in an effective manner, notwithstanding the

12  provisions of ss. 216.292 and 216.351, Florida Statutes, upon

13  this act becoming a law, the Department of Business and

14  Professional Regulation is authorized to transfer resources

15  between services and make revisions to the authorized budget

16  as necessary to reengineer business processes for the purpose

17  of reducing costs and increasing program efficiencies. These

18  actions are subject to the review and approval provisions in

19  s. 216.177, Florida Statutes.

20         Section 2.  Paragraph (k) is added to subsection (2) of

21  section 20.13, Florida Statutes, to read:

22         20.13  Department of Insurance.--There is created a

23  Department of Insurance.

24         (2)  The following divisions of the Department of

25  Insurance are established:

26         (k)  Division of Workers' Compensation.

27         Section 3.  Subsections (2) and (3) of section 20.50,

28  Florida Statutes, are amended to read:

29         20.50  Agency for Workforce Innovation.--There is

30  created the Agency for Workforce Innovation within the

31  Department of Management Services. The agency shall be a


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  1  separate budget entity, and the director of the agency shall

  2  be the agency head for all purposes. The agency shall not be

  3  subject to control, supervision, or direction by the

  4  Department of Management Services in any manner, including,

  5  but not limited to, personnel, purchasing, transactions

  6  involving real or personal property, and budgetary matters.

  7         (2)  The Agency for Workforce Innovation shall be the

  8  designated administrative agency for receipt of federal

  9  workforce development grants and other federal funds, and

10  shall carry out the duties and responsibilities assigned by

11  the Governor under each federal grant assigned to the agency.

12  The agency shall be a separate budget entity and shall expend

13  each revenue source as provided by federal and state law and

14  as provided in plans developed by and agreements with

15  Workforce Florida, Inc. The agency shall prepare and submit as

16  a separate budget entity a unified budget request for

17  workforce development, in accordance with chapter 216 for, and

18  in conjunction with, Workforce Florida, Inc., and its board.

19  The head of the agency is the director of Workforce

20  Innovation, who shall be appointed by the Governor.

21  Accountability and reporting functions of the agency shall be

22  administered by the director or his or her designee. Included

23  in these functions are budget management, financial

24  management, audit, performance management standards and

25  controls, assessing outcomes of service delivery, and

26  financial administration of workforce programs pursuant to s.

27  445.004(5) and (9). Within the agency's overall organizational

28  structure, the agency shall include the following offices

29  which shall have the specified responsibilities:

30         (a)  The Office of Workforce Services shall administer

31  state merit system program staff within the unemployment


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  1  compensation program, the Rapid Response program, the Work

  2  Opportunity Tax Credit program, the Alien Labor Certification

  3  program, and any other programs that are delivered directly by

  4  agency staff rather than through the one-stop workforce

  5  service delivery system, pursuant to policies of Workforce

  6  Florida, Inc. The office shall be responsible for delivering

  7  services through the one-stop delivery system and for ensuring

  8  that participants in welfare transition programs receive case

  9  management services, diversion assistance, support services,

10  including subsidized child care and transportation services,

11  Medicaid services, and transition assistance to enable them to

12  succeed in the workforce.  The office shall be directed by the

13  Deputy Director for Workforce Services, who shall be appointed

14  by and serve at the pleasure of the director.

15         (b)  The Office of Program Support Workforce Investment

16  and Accountability shall administer state merit system program

17  staff within the workforce service delivery system, pursuant

18  to policies of Workforce Florida, Inc. The office shall be

19  responsible for delivering services through the one-stop

20  delivery system and for ensuring that participants in welfare

21  transition programs receive case management services,

22  diversion assistance, support services, including subsidized

23  child care and transportation services, Medicaid services, and

24  transition assistance to enable them to succeed in the

25  workforce.  The office shall also be responsible for program

26  quality assurance, grants and contract management procurement,

27  contracting, financial management, accounting, audits, and

28  reporting verification. The office shall be directed by the

29  Deputy Director for Program Support Workforce Investment and

30  Accountability, who shall be appointed by and serve at the

31


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  1  pleasure of the director.  The office shall be responsible

  2  for:

  3         1.  Establishing standards and controls for reporting

  4  budgeting, expenditure, and performance information for

  5  assessing outcomes, service delivery, and financial

  6  administration of workforce programs pursuant to s. 445.004(5)

  7  and (9).

  8         1.2.  Establishing monitoring, quality assurance, and

  9  quality improvement systems that routinely assess the quality

10  and effectiveness of contracted programs and services.

11         2.3.  Annual review of each regional workforce board

12  and administrative entity to ensure adequate systems of

13  reporting and control are in place, and monitoring, quality

14  assurance, and quality improvement activities are conducted

15  routinely, and corrective action is taken to eliminate

16  deficiencies.

17         (c)  The Office of Agency Support Workforce Information

18  Services shall be responsible for procurement, human resource

19  services, and information services including delivering

20  deliver information on labor markets, employment, occupations,

21  and performance, and shall implement and maintain information

22  systems that are required for the effective operation of the

23  one-stop delivery system and the school readiness services

24  system, including, but not limited to, those systems described

25  in s. 445.009. The office will be under the direction of the

26  Deputy Director for Agency Support Workforce Information

27  Services, who shall be appointed by and serve at the pleasure

28  of the director.  The office shall be responsible for

29  establishing:

30         1.  Information systems and controls that report

31  reliable, timely and accurate fiscal and performance data for


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  1  assessing outcomes, service delivery, and financial

  2  administration of workforce programs pursuant to s. 445.004(5)

  3  and (9).

  4         2.  Information systems that support service

  5  integration and case management by providing for case tracking

  6  for participants in welfare transition programs.

  7         3.  Information systems that support school readiness

  8  services.

  9         (d)  The Unemployment Appeals Commission, authorized by

10  s. 443.012, shall not be subject to the control, supervision,

11  or direction by the Agency for Workforce Innovation in the

12  performance of its powers and duties but shall receive any and

13  all support and assistance from the agency that may be

14  required for the performance of its duties.

15         (3)  The Agency for Workforce Innovation shall serve as

16  the designated agency for purposes of each federal workforce

17  development grant assigned to it for administration. The

18  agency shall carry out the duties assigned to it by the

19  Governor, under the terms and conditions of each grant. The

20  agency shall have the level of authority and autonomy

21  necessary to be the designated recipient of each federal grant

22  assigned to it, and shall disperse such grants pursuant to the

23  plans and policies of Workforce Florida, Inc. The director

24  may, upon delegation from the Governor and pursuant to

25  agreement with Workforce Florida, Inc., sign contracts,

26  grants, and other instruments as necessary to execute

27  functions assigned to the agency. Notwithstanding other

28  provisions of law, the following federal grants and other

29  funds are assigned for administration to the Agency for

30  Workforce Innovation:

31


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  1         (a)  Programs authorized under Title I of the Workforce

  2  Investment Act of 1998, Pub. L. No. 105-220, except for

  3  programs funded directly by the United States Department of

  4  Labor under Title I, s. 167.

  5         (b)  Programs authorized under the Wagner-Peyser Act of

  6  1933, as amended, 29 U.S.C. ss. 49 et seq.

  7         (c)  Welfare-to-work grants administered by the United

  8  States Department of Labor under Title IV, s. 403, of the

  9  Social Security Act, as amended.

10         (d)  Activities authorized under Title II of the Trade

11  Act of 1974, as amended, 2 U.S.C. ss. 2271 et seq., and the

12  Trade Adjustment Assistance Program.

13         (e)  Activities authorized under chapter 41 of Title 38

14  U.S.C., including job counseling, training, and placement for

15  veterans.

16         (f)  Employment and training activities carried out

17  under the Community Services Block Grant Act, 42 U.S.C. ss.

18  9901 et seq.

19         (g)  Employment and training activities carried out

20  under funds awarded to this state by the United States

21  Department of Housing and Urban Development.

22         (h)  Designated state and local program expenditures

23  under part A of Title IV of the Social Security Act for

24  welfare transition workforce services associated with the

25  Temporary Assistance for Needy Families Program.

26         (i)  Programs authorized under the National and

27  Community Service Act of 1990, 42 U.S.C. ss. 12501 et seq.,

28  and the Service-America programs, the National Service Trust

29  programs, the Civilian Community Corps, the Corporation for

30  National and Community Service, the American Conservation and

31


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  1  Youth Service Corps, and the Points of Light Foundation

  2  programs, if such programs are awarded to the state.

  3         (j)  The Unemployment Compensation program provided

  4  pursuant to chapter 443.

  5         (k)(j)  Other programs funded by federal or state

  6  appropriations, as determined by the Legislature in the

  7  General Appropriations Act or by law.

  8         Section 4.  Paragraph (m) of subsection (2) of section

  9  110.205, Florida Statutes, is amended to read:

10         110.205  Career service; exemptions.--

11         (2)  EXEMPT POSITIONS.--The exempt positions that are

12  not covered by this part include the following:

13         (m)  All assistant division director, deputy division

14  director, and bureau chief positions in any department, and

15  those positions determined by the department to have

16  managerial responsibilities comparable to such positions,

17  which positions include, but are not limited to, positions in

18  the Department of Health, the Department of Children and

19  Family Services, and the Department of Corrections that are

20  assigned primary duties of serving as the superintendent or

21  assistant superintendent, or warden or assistant warden, of an

22  institution; positions in the Department of Corrections that

23  are assigned primary duties of serving as the circuit

24  administrator or deputy circuit administrator; positions in

25  the Department of Transportation that are assigned primary

26  duties of serving as regional toll managers and managers of

27  offices as defined in s. 20.23(3)(d)3. and (4)(d); positions

28  in the Department of Environmental Protection that are

29  assigned the duty of an Environmental Administrator or program

30  administrator; those positions described in s. 20.171 as

31  included in the Senior Management Service; and positions in


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  1  the Department of Health that are assigned the duties of

  2  Environmental Administrator, Assistant County Health

  3  Department Director, and County Health Department Financial

  4  Administrator. Unless otherwise fixed by law, the department

  5  shall set the salary and benefits of these positions in

  6  accordance with the rules established for the Selected Exempt

  7  Service.

  8         Section 5.  Paragraph (h) of subsection (2) of section

  9  112.19, Florida Statutes, is amended to read:

10         112.19  Law enforcement, correctional, and correctional

11  probation officers; death benefits.--

12         (2)

13         (h)1.  Any employer who employs a full-time law

14  enforcement, correctional, or correctional probation officer

15  who, on or after January 1, 1995, suffers a catastrophic

16  injury, as defined in s. 440.02 s. 440.02(37), in the line of

17  duty shall pay the entire premium of the employer's health

18  insurance plan for the injured employee, the injured

19  employee's spouse, and for each dependent child of the injured

20  employee until the child reaches the age of majority or until

21  the end of the calendar year in which the child reaches the

22  age of 25 if the child continues to be dependent for support,

23  or the child is a full-time or part-time student and is

24  dependent for support.  The term "health insurance plan" does

25  not include supplemental benefits that are not part of the

26  basic group health insurance plan.  If the injured employee

27  subsequently dies, the employer shall continue to pay the

28  entire health insurance premium for the surviving spouse until

29  remarried, and for the dependent children, under the

30  conditions outlined in this paragraph. However:

31


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  1         a.  Health insurance benefits payable from any other

  2  source shall reduce benefits payable under this section.

  3         b.  It is unlawful for a person to willfully and

  4  knowingly make, or cause to be made, or to assist, conspire

  5  with, or urge another to make, or cause to be made, any false,

  6  fraudulent, or misleading oral or written statement to obtain

  7  health insurance coverage as provided under this paragraph.  A

  8  person who violates this sub-subparagraph commits a

  9  misdemeanor of the first degree, punishable as provided in s.

10  775.082 or s. 775.083.

11         c.  In addition to any applicable criminal penalty,

12  upon conviction for a violation as described in

13  sub-subparagraph b., a law enforcement, correctional, or

14  correctional probation officer or other beneficiary who

15  receives or seeks to receive health insurance benefits under

16  this paragraph shall forfeit the right to receive such health

17  insurance benefits, and shall reimburse the employer for all

18  benefits paid due to the fraud or other prohibited activity.

19  For purposes of this sub-subparagraph, "conviction" means a

20  determination of guilt that is the result of a plea or trial,

21  regardless of whether adjudication is withheld.

22         2.  In order for the officer, spouse, and dependent

23  children to be eligible for such insurance coverage, the

24  injury must have occurred as the result of the officer's

25  response to fresh pursuit, the officer's response to what is

26  reasonably believed to be an emergency, or an unlawful act

27  perpetrated by another.  Except as otherwise provided herein,

28  nothing in this paragraph shall be construed to limit health

29  insurance coverage for which the officer, spouse, or dependent

30  children may otherwise be eligible, except that a person who

31  qualifies under this section shall not be eligible for the


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  1  health insurance subsidy provided under chapter 121, chapter

  2  175, or chapter 185.

  3         Section 6.  Paragraph (g) of subsection (2) of section

  4  112.191, Florida Statutes, is amended to read:

  5         112.191  Firefighters; death benefits.--

  6         (2)

  7         (g)1.  Any employer who employs a full-time firefighter

  8  who, on or after January 1, 1995, suffers a catastrophic

  9  injury, as defined in s. 440.02 s. 440.02(37), in the line of

10  duty shall pay the entire premium of the employer's health

11  insurance plan for the injured employee, the injured

12  employee's spouse, and for each dependent child of the injured

13  employee until the child reaches the age of majority or until

14  the end of the calendar year in which the child reaches the

15  age of 25 if the child continues to be dependent for support,

16  or the child is a full-time or part-time student and is

17  dependent for support. The term "health insurance plan" does

18  not include supplemental benefits that are not part of the

19  basic group health insurance plan.  If the injured employee

20  subsequently dies, the employer shall continue to pay the

21  entire health insurance premium for the surviving spouse until

22  remarried, and for the dependent children, under the

23  conditions outlined in this paragraph. However:

24         a.  Health insurance benefits payable from any other

25  source shall reduce benefits payable under this section.

26         b.  It is unlawful for a person to willfully and

27  knowingly make, or cause to be made, or to assist, conspire

28  with, or urge another to make, or cause to be made, any false,

29  fraudulent, or misleading oral or written statement to obtain

30  health insurance coverage as provided under this paragraph.  A

31  person who violates this sub-subparagraph commits a


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  1  misdemeanor of the first degree, punishable as provided in s.

  2  775.082 or s. 775.083.

  3         c.  In addition to any applicable criminal penalty,

  4  upon conviction for a violation as described in

  5  sub-subparagraph b., a firefighter or other beneficiary who

  6  receives or seeks to receive health insurance benefits under

  7  this paragraph shall forfeit the right to receive such health

  8  insurance benefits, and shall reimburse the employer for all

  9  benefits paid due to the fraud or other prohibited activity.

10  For purposes of this sub-subparagraph, "conviction" means a

11  determination of guilt that is the result of a plea or trial,

12  regardless of whether adjudication is withheld.

13         2.  In order for the firefighter, spouse, and dependent

14  children to be eligible for such insurance coverage, the

15  injury must have occurred as the result of the firefighter's

16  response to what is reasonably believed to be an emergency

17  involving the protection of life or property, or an unlawful

18  act perpetrated by another.  Except as otherwise provided

19  herein, nothing in this paragraph shall be construed to limit

20  health insurance coverage for which the firefighter, spouse,

21  or dependent children may otherwise be eligible, except that a

22  person who qualifies for benefits under this section shall not

23  be eligible for the health insurance subsidy provided under

24  chapter 121, chapter 175, or chapter 185.

25

26  Notwithstanding any provision of this section to the contrary,

27  the death benefits provided in paragraphs (b), (c), and (f)

28  shall also be applicable and paid in cases where a firefighter

29  received bodily injury prior to July 1, 1993, and subsequently

30  died on or after July 1, 1993, as a result of such

31  in-line-of-duty injury.


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  1         Section 7.  Section 121.125, Florida Statutes, is

  2  amended to read:

  3         121.125  Credit for workers' compensation payment

  4  periods.--A member of the retirement system created by this

  5  chapter who has been eligible or becomes eligible to receive

  6  workers' compensation payments for an injury or illness

  7  occurring during his or her employment while a member of any

  8  state retirement system shall, upon return to active

  9  employment with a covered employer for 1 calendar month or

10  upon approval for disability retirement in accordance with s.

11  121.091(4), receive full retirement credit for the period

12  prior to such return to active employment or disability

13  retirement for which the workers' compensation payments were

14  received.  However, no member may receive retirement credit

15  for any such period occurring after the earlier of the date of

16  maximum medical improvement has been attained as defined in s.

17  440.02 s. 440.02(9) or the date termination has occurred as

18  defined in s. 121.021(39). The employer of record at the time

19  of the worker's compensation injury or illness shall make the

20  required retirement contributions based on the member's rate

21  of monthly compensation immediately prior to his or her

22  receiving workers' compensation payments for retirement credit

23  received by the member.

24         Section 8.  Subsection (7) of section 122.03, Florida

25  Statutes, is amended to read:

26         122.03  Contributions; participants; prior service

27  credit.--

28         (7)  A member of the retirement system created by this

29  chapter who has been eligible or becomes eligible to receive

30  workers' compensation payments for an injury or illness

31  occurring during his or her employment while a member of any


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  1  state retirement system shall, upon his or her return to

  2  active employment with a covered employer for 1 calendar month

  3  or upon his or her approval for disability retirement in

  4  accordance with s. 122.09, receive full retirement credit for

  5  the period prior to such return to active employment or

  6  disability retirement for which the workers' compensation

  7  payments were received.  However, no member may receive

  8  retirement credit for any such period occurring after the

  9  earlier of the date of maximum medical improvement has been

10  attained as defined in s. 440.02 s. 440.02(9) or the date

11  termination has occurred as defined in s. 121.021(39). The

12  employer of record at the time of the worker's compensation

13  injury or illness shall make the required employee and

14  employer retirement contributions based on the member's rate

15  of monthly compensation immediately prior to receipt of

16  workers' compensation payments.

17         Section 9.  Subsection (10) of section 238.06, Florida

18  Statutes, is amended to read:

19         238.06  Membership application, creditable service, and

20  time for making contributions.--

21         (10)  A member of the retirement system created by this

22  chapter who has been eligible or becomes eligible to receive

23  workers' compensation payments for an injury or illness

24  occurring during his or her employment while a member of any

25  state retirement system shall, upon his or her return to

26  active employment with a covered employer for 1 calendar month

27  or upon his or her approval for disability retirement in

28  accordance with s. 238.07, receive full retirement credit for

29  the period prior to such return to active employment or

30  disability retirement for which the workers' compensation

31  payments were received.  However, no member may receive


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  1  retirement credit for any such period occurring after the

  2  earlier of the date of maximum medical improvement has been

  3  attained as defined in s. 440.02 s. 440.02(9) or the date

  4  termination has occurred as defined in s. 121.021(39). The

  5  employer of record at the time of the worker's compensation

  6  injury or illness shall make the required employee and

  7  employer retirement contributions based on the member's rate

  8  of monthly compensation immediately prior to his or her

  9  receiving workers' compensation payments.

10         Section 10.  Section 440.015, Florida Statutes, is

11  amended to read:

12         440.015  Legislative intent.--It is the intent of the

13  Legislature that the Workers' Compensation Law be interpreted

14  so as to assure the quick and efficient delivery of disability

15  and medical benefits to an injured worker and to facilitate

16  the worker's return to gainful reemployment at a reasonable

17  cost to the employer. It is the specific intent of the

18  Legislature that workers' compensation cases shall be decided

19  on their merits. The workers' compensation system in Florida

20  is based on a mutual renunciation of common-law rights and

21  defenses by employers and employees alike. In addition, it is

22  the intent of the Legislature that the facts in a workers'

23  compensation case are not to be interpreted liberally in favor

24  of either the rights of the injured worker or the rights of

25  the employer. Additionally, the Legislature hereby declares

26  that disputes concerning the facts in workers' compensation

27  cases are not to be given a broad liberal construction in

28  favor of the employee on the one hand or of the employer on

29  the other hand, and the laws pertaining to workers'

30  compensation are to be construed in accordance with the basic

31  principles of statutory construction and not liberally in


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  1  favor of either employee or employer. It is the intent of the

  2  Legislature to ensure the prompt delivery of benefits to the

  3  injured worker. Therefore, an efficient and self-executing

  4  system must be created which is not an economic or

  5  administrative burden. The department, agency, the Department

  6  of Education, and the Division of Administrative Hearings

  7  Division of Workers' Compensation shall administer the

  8  Workers' Compensation Law in a manner which facilitates the

  9  self-execution of the system and the process of ensuring a

10  prompt and cost-effective delivery of payments.

11         Section 11.  Subsections (3) through (39) of section

12  440.02, Florida Statutes, are renumbered as subsections (4)

13  through (40), respectively, a new subsection (3) is added to

14  that section, and present subsections (11), (13), and (14) of

15  said section are amended, to read:

16         440.02  Definitions.--When used in this chapter, unless

17  the context clearly requires otherwise, the following terms

18  shall have the following meanings:

19         (3)  "Agency" means the Agency for Health Care

20  Administration.

21         (12)(11)  "Department" means the Department of

22  Insurance Labor and Employment Security.

23         (14)(13)  "Division" means the Division of Workers'

24  Compensation of the Department of Insurance Labor and

25  Employment Security.

26         (15)(14)(a)  "Employee" means any person engaged in any

27  employment under any appointment or contract of hire or

28  apprenticeship, express or implied, oral or written, whether

29  lawfully or unlawfully employed, and includes, but is not

30  limited to, aliens and minors.

31


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  1         (b)  "Employee" includes any person who is an officer

  2  of a corporation and who performs services for remuneration

  3  for such corporation within this state, whether or not such

  4  services are continuous.

  5         1.  Any officer of a corporation may elect to be exempt

  6  from this chapter by filing written notice of the election

  7  with the department division as provided in s. 440.05.

  8         2.  As to officers of a corporation who are actively

  9  engaged in the construction industry, no more than three

10  officers may elect to be exempt from this chapter by filing

11  written notice of the election with the department division as

12  provided in s. 440.05.

13         3.  An officer of a corporation who elects to be exempt

14  from this chapter by filing a written notice of the election

15  with the department division as provided in s. 440.05 is not

16  an employee.

17

18  Services are presumed to have been rendered to the corporation

19  if the officer is compensated by other than dividends upon

20  shares of stock of the corporation which the officer owns.

21         (c)  "Employee" includes a sole proprietor or a partner

22  who devotes full time to the proprietorship or partnership

23  and, except as provided in this paragraph, elects to be

24  included in the definition of employee by filing notice

25  thereof as provided in s. 440.05. Partners or sole proprietors

26  actively engaged in the construction industry are considered

27  employees unless they elect to be excluded from the definition

28  of employee by filing written notice of the election with the

29  department division as provided in s. 440.05. However, no more

30  than three partners in a partnership that is actively engaged

31  in the construction industry may elect to be excluded. A sole


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  1  proprietor or partner who is actively engaged in the

  2  construction industry and who elects to be exempt from this

  3  chapter by filing a written notice of the election with the

  4  department division as provided in s. 440.05 is not an

  5  employee. For purposes of this chapter, an independent

  6  contractor is an employee unless he or she meets all of the

  7  conditions set forth in subparagraph (d)1.

  8         (d)  "Employee" does not include:

  9         1.  An independent contractor, if:

10         a.  The independent contractor maintains a separate

11  business with his or her own work facility, truck, equipment,

12  materials, or similar accommodations;

13         b.  The independent contractor holds or has applied for

14  a federal employer identification number, unless the

15  independent contractor is a sole proprietor who is not

16  required to obtain a federal employer identification number

17  under state or federal requirements;

18         c.  The independent contractor performs or agrees to

19  perform specific services or work for specific amounts of

20  money and controls the means of performing the services or

21  work;

22         d.  The independent contractor incurs the principal

23  expenses related to the service or work that he or she

24  performs or agrees to perform;

25         e.  The independent contractor is responsible for the

26  satisfactory completion of work or services that he or she

27  performs or agrees to perform and is or could be held liable

28  for a failure to complete the work or services;

29         f.  The independent contractor receives compensation

30  for work or services performed for a commission or on a

31  per-job or competitive-bid basis and not on any other basis;


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  1         g.  The independent contractor may realize a profit or

  2  suffer a loss in connection with performing work or services;

  3         h.  The independent contractor has continuing or

  4  recurring business liabilities or obligations; and

  5         i.  The success or failure of the independent

  6  contractor's business depends on the relationship of business

  7  receipts to expenditures.

  8

  9  However, the determination as to whether an individual

10  included in the Standard Industrial Classification Manual of

11  1987, Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762,

12  0781, 0782, 0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436,

13  2448, or 2449, or a newspaper delivery person, is an

14  independent contractor is governed not by the criteria in this

15  paragraph but by common-law principles, giving due

16  consideration to the business activity of the individual.

17         2.  A real estate salesperson or agent, if that person

18  agrees, in writing, to perform for remuneration solely by way

19  of commission.

20         3.  Bands, orchestras, and musical and theatrical

21  performers, including disk jockeys, performing in licensed

22  premises as defined in chapter 562, if a written contract

23  evidencing an independent contractor relationship is entered

24  into before the commencement of such entertainment.

25         4.  An owner-operator of a motor vehicle who transports

26  property under a written contract with a motor carrier which

27  evidences a relationship by which the owner-operator assumes

28  the responsibility of an employer for the performance of the

29  contract, if the owner-operator is required to furnish the

30  necessary motor vehicle equipment and all costs incidental to

31  the performance of the contract, including, but not limited


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  1  to, fuel, taxes, licenses, repairs, and hired help; and the

  2  owner-operator is paid a commission for transportation service

  3  and is not paid by the hour or on some other time-measured

  4  basis.

  5         5.  A person whose employment is both casual and not in

  6  the course of the trade, business, profession, or occupation

  7  of the employer.

  8         6.  A volunteer, except a volunteer worker for the

  9  state or a county, municipality, or other governmental entity.

10  A person who does not receive monetary remuneration for

11  services is presumed to be a volunteer unless there is

12  substantial evidence that a valuable consideration was

13  intended by both employer and employee. For purposes of this

14  chapter, the term "volunteer" includes, but is not limited to:

15         a.  Persons who serve in private nonprofit agencies and

16  who receive no compensation other than expenses in an amount

17  less than or equivalent to the standard mileage and per diem

18  expenses provided to salaried employees in the same agency or,

19  if such agency does not have salaried employees who receive

20  mileage and per diem, then such volunteers who receive no

21  compensation other than expenses in an amount less than or

22  equivalent to the customary mileage and per diem paid to

23  salaried workers in the community as determined by the

24  department division; and

25         b.  Volunteers participating in federal programs

26  established under Pub. L. No. 93-113.

27         7.  Any officer of a corporation who elects to be

28  exempt from this chapter.

29         8.  A sole proprietor or officer of a corporation who

30  actively engages in the construction industry, and a partner

31  in a partnership that is actively engaged in the construction


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  1  industry, who elects to be exempt from the provisions of this

  2  chapter. Such sole proprietor, officer, or partner is not an

  3  employee for any reason until the notice of revocation of

  4  election filed pursuant to s. 440.05 is effective.

  5         9.  An exercise rider who does not work for a single

  6  horse farm or breeder, and who is compensated for riding on a

  7  case-by-case basis, provided a written contract is entered

  8  into prior to the commencement of such activity which

  9  evidences that an employee/employer relationship does not

10  exist.

11         10.  A taxicab, limousine, or other passenger

12  vehicle-for-hire driver who operates said vehicles pursuant to

13  a written agreement with a company which provides any

14  dispatch, marketing, insurance, communications, or other

15  services under which the driver and any fees or charges paid

16  by the driver to the company for such services are not

17  conditioned upon, or expressed as a proportion of, fare

18  revenues.

19         11.  A person who performs services as a sports

20  official for an entity sponsoring an interscholastic sports

21  event or for a public entity or private, nonprofit

22  organization that sponsors an amateur sports event.  For

23  purposes of this subparagraph, such a person is an independent

24  contractor. For purposes of this subparagraph, the term

25  "sports official" means any person who is a neutral

26  participant in a sports event, including, but not limited to,

27  umpires, referees, judges, linespersons, scorekeepers, or

28  timekeepers. This subparagraph does not apply to any person

29  employed by a district school board who serves as a sports

30  official as required by the employing school board or who

31


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  1  serves as a sports official as part of his or her

  2  responsibilities during normal school hours.

  3         Section 12.  Section 440.021, Florida Statutes, is

  4  amended to read:

  5         440.021  Exemption of workers' compensation from

  6  chapter 120.--Workers' compensation adjudications by judges of

  7  compensation claims are exempt from chapter 120, and no judge

  8  of compensation claims shall be considered an agency or a part

  9  thereof. Communications of the result of investigations by the

10  department division pursuant to s. 440.185(4) are exempt from

11  chapter 120. In all instances in which the department division

12  institutes action to collect a penalty or interest which may

13  be due pursuant to this chapter, the penalty or interest shall

14  be assessed without hearing, and the party against which such

15  penalty or interest is assessed shall be given written notice

16  of such assessment and shall have the right to protest within

17  20 days of such notice. Upon receipt of a timely notice of

18  protest and after such investigation as may be necessary, the

19  department division shall, if it agrees with such protest,

20  notify the protesting party that the assessment has been

21  revoked.  If the department division does not agree with the

22  protest, it shall refer the matter to the judge of

23  compensation claims for determination pursuant to s.

24  440.25(2)-(5).  Such action of the department division is

25  exempt from the provisions of chapter 120.

26         Section 13.  Section 440.05, Florida Statutes, is

27  amended to read:

28         440.05  Election of exemption; revocation of election;

29  notice; certification.--

30         (1)  Each corporate officer who elects not to accept

31  the provisions of this chapter or who, after electing such


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  1  exemption, revokes that exemption shall mail to the department

  2  division in Tallahassee notice to such effect in accordance

  3  with a form to be prescribed by the department division.

  4         (2)  Each sole proprietor or partner who elects to be

  5  included in the definition of "employee" or who, after such

  6  election, revokes that election must mail to the department

  7  division in Tallahassee notice to such effect, in accordance

  8  with a form to be prescribed by the department division.

  9         (3)  Each sole proprietor, partner, or officer of a

10  corporation who is actively engaged in the construction

11  industry and who elects an exemption from this chapter or who,

12  after electing such exemption, revokes that exemption, must

13  mail a written notice to such effect to the department

14  division on a form prescribed by the department division. The

15  notice of election to be exempt from the provisions of this

16  chapter must be notarized and under oath. The notice of

17  election to be exempt which is submitted to the department

18  division by the sole proprietor, partner, or officer of a

19  corporation must list the name, federal tax identification

20  number, social security number, all certified or registered

21  licenses issued pursuant to chapter 489 held by the person

22  seeking the exemption, a copy of relevant documentation as to

23  employment status filed with the Internal Revenue Service as

24  specified by the department division, a copy of the relevant

25  occupational license in the primary jurisdiction of the

26  business, and, for corporate officers and partners, the

27  registration number of the corporation or partnership filed

28  with the Division of Corporations of the Department of State.

29  The notice of election to be exempt must identify each sole

30  proprietorship, partnership, or corporation that employs the

31  person electing the exemption and must list the social


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  1  security number or federal tax identification number of each

  2  such employer and the additional documentation required by

  3  this section. In addition, the notice of election to be exempt

  4  must provide that the sole proprietor, partner, or officer

  5  electing an exemption is not entitled to benefits under this

  6  chapter, must provide that the election does not exceed

  7  exemption limits for officers and partnerships provided in s.

  8  440.02, and must certify that any employees of the sole

  9  proprietor, partner, or officer electing an exemption are

10  covered by workers' compensation insurance. Upon receipt of

11  the notice of the election to be exempt, receipt of all

12  application fees, and a determination by the department

13  division that the notice meets the requirements of this

14  subsection, the department division shall issue a

15  certification of the election to the sole proprietor, partner,

16  or officer, unless the department division determines that the

17  information contained in the notice is invalid. The department

18  division shall revoke a certificate of election to be exempt

19  from coverage upon a determination by the department division

20  that the person does not meet the requirements for exemption

21  or that the information contained in the notice of election to

22  be exempt is invalid. The certificate of election must list

23  the names of the sole proprietorship, partnership, or

24  corporation listed in the request for exemption. A new

25  certificate of election must be obtained each time the person

26  is employed by a new sole proprietorship, partnership, or

27  corporation that is not listed on the certificate of election.

28  A copy of the certificate of election must be sent to each

29  workers' compensation carrier identified in the request for

30  exemption. Upon filing a notice of revocation of election, a

31  sole proprietor, partner, or officer who is a subcontractor


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  1  must notify her or his contractor.  Upon revocation of a

  2  certificate of election of exemption by the department

  3  division, the department division shall notify the workers'

  4  compensation carriers identified in the request for exemption.

  5         (4)  The notice of election to be exempt from the

  6  provisions of this chapter must contain a notice that clearly

  7  states in substance the following: "Any person who, knowingly

  8  and with intent to injure, defraud, or deceive the department

  9  division or any employer or employee, insurance company, or

10  purposes program, files a notice of election to be exempt

11  containing any false or misleading information is guilty of a

12  felony of the third degree." Each person filing a notice of

13  election to be exempt shall personally sign the notice and

14  attest that he or she has reviewed, understands, and

15  acknowledges the foregoing notice.

16         (5)  A notice given under subsection (1), subsection

17  (2), or subsection (3) shall become effective when issued by

18  the department division or 30 days after an application for an

19  exemption is received by the department division, whichever

20  occurs first. However, if an accident or occupational disease

21  occurs less than 30 days after the effective date of the

22  insurance policy under which the payment of compensation is

23  secured or the date the employer qualified as a self-insurer,

24  such notice is effective as of 12:01 a.m. of the day following

25  the date it is mailed to the department division in

26  Tallahassee.

27         (6)  A construction industry certificate of election to

28  be exempt which is issued in accordance with this section

29  shall be valid for 2 years after the effective date stated

30  thereon. Both the effective date and the expiration date must

31  be listed on the face of the certificate by the department


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  1  division. The construction industry certificate must expire at

  2  midnight, 2 years from its issue date, as noted on the face of

  3  the exemption certificate. Any person who has received from

  4  the division a construction industry certificate of election

  5  to be exempt which is in effect on December 31, 1998, shall

  6  file a new notice of election to be exempt by the last day in

  7  his or her birth month following December 1, 1998. A

  8  construction industry certificate of election to be exempt may

  9  be revoked before its expiration by the sole proprietor,

10  partner, or officer for whom it was issued or by the

11  department division for the reasons stated in this section.

12  At least 60 days prior to the expiration date of a

13  construction industry certificate of exemption issued after

14  December 1, 1998, the department division shall send notice of

15  the expiration date and an application for renewal to the

16  certificateholder at the address on the certificate.

17         (7)  Any contractor responsible for compensation under

18  s. 440.10 may register in writing with the workers'

19  compensation carrier for any subcontractor and shall

20  thereafter be entitled to receive written notice from the

21  carrier of any cancellation or nonrenewal of the policy.

22         (8)(a)  The department division must assess a fee of

23  $50 with each request for a construction industry certificate

24  of election to be exempt or renewal of election to be exempt

25  under this section.

26         (b)  The funds collected by the department division

27  shall be used to administer this section, to audit the

28  businesses that pay the fee for compliance with any

29  requirements of this chapter, and to enforce compliance with

30  the provisions of this chapter.

31


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  1         (9)  The department division may by rule prescribe

  2  forms and procedures for filing an election of exemption,

  3  revocation of election to be exempt, and notice of election of

  4  coverage for all employers and require specified forms to be

  5  submitted by all employers in filing for the election of

  6  exemption. The department division may by rule prescribe forms

  7  and procedures for issuing a certificate of the election of

  8  exemption.

  9         Section 14.  Paragraph (d) of subsection (7) of section

10  440.09, Florida Statutes, is amended to read:

11         440.09  Coverage.--

12         (7)

13         (d)  The agency division shall provide by rule for the

14  authorization and regulation of drug-testing policies,

15  procedures, and methods. Testing of injured employees shall

16  not commence until such rules are adopted.

17         Section 15.  Paragraphs (f) and (g) of subsection (1)

18  of section 440.10, Florida Statutes, are amended to read:

19         440.10  Liability for compensation.--

20         (1)

21         (f)  If an employer willfully fails to secure

22  compensation as required by this chapter, the department

23  division may assess against the employer a penalty not to

24  exceed $5,000 for each employee of that employer who is

25  classified by the employer as an independent contractor but

26  who is found by the department division to not meet the

27  criteria for an independent contractor that are set forth in

28  s. 440.02.

29         (g)  For purposes of this section, a person is

30  conclusively presumed to be an independent contractor if:

31


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  1         1.  The independent contractor provides the general

  2  contractor with an affidavit stating that he or she meets all

  3  the requirements of s. 440.02(14)(d); and

  4         2.  The independent contractor provides the general

  5  contractor with a valid certificate of workers' compensation

  6  insurance or a valid certificate of exemption issued by the

  7  department division.

  8

  9  A sole proprietor, partner, or officer of a corporation who

10  elects exemption from this chapter by filing a certificate of

11  election under s. 440.05 may not recover benefits or

12  compensation under this chapter.  An independent contractor

13  who provides the general contractor with both an affidavit

14  stating that he or she meets the requirements of s.

15  440.02(14)(d) and a certificate of exemption is not an

16  employee under s. 440.02(14)(c) and may not recover benefits

17  under this chapter.  For purposes of determining the

18  appropriate premium for workers' compensation coverage,

19  carriers may not consider any person who meets the

20  requirements of this paragraph to be an employee.

21         Section 16.  Subsection (2), paragraph (a) of

22  subsection (3), and paragraph (g) of subsection (7) of section

23  440.102, Florida Statutes, are amended to read:

24         440.102  Drug-free workplace program requirements.--The

25  following provisions apply to a drug-free workplace program

26  implemented pursuant to law or to rules adopted by the Agency

27  for Health Care Administration:

28         (2)  DRUG TESTING.--An employer may test an employee or

29  job applicant for any drug described in paragraph (1)(c). In

30  order to qualify as having established a drug-free workplace

31  program which affords an employer the ability to qualify for


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  1  the discounts provided under s. 627.0915 and deny medical and

  2  indemnity benefits, under this chapter all drug testing

  3  conducted by employers shall be in conformity with the

  4  standards and procedures established in this section and all

  5  applicable rules adopted pursuant to this section. However, an

  6  employer does not have a legal duty under this section to

  7  request an employee or job applicant to undergo drug testing.

  8  If an employer fails to maintain a drug-free workplace program

  9  in accordance with the standards and procedures established in

10  this section and in applicable rules, the employer shall not

11  be eligible for discounts under s. 627.0915. All employers

12  qualifying for and receiving discounts provided under s.

13  627.0915 must be reported annually by the insurer to the

14  department division.

15         (3)  NOTICE TO EMPLOYEES AND JOB APPLICANTS.--prior to

16  his or her receiving workers' compensation payments.

17         (a)  One time only, prior to testing, an employer shall

18  give all employees and job applicants for employment a written

19  policy statement which contains:

20         1.  A general statement of the employer's policy on

21  employee drug use, which must identify:

22         a.  The types of drug testing an employee or job

23  applicant may be required to submit to, including

24  reasonable-suspicion drug testing or drug testing conducted on

25  any other basis.

26         b.  The actions the employer may take against an

27  employee or job applicant on the basis of a positive confirmed

28  drug test result.

29         2.  A statement advising the employee or job applicant

30  of the existence of this section.

31         3.  A general statement concerning confidentiality.


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  1         4.  Procedures for employees and job applicants to

  2  confidentially report to a medical review officer the use of

  3  prescription or nonprescription medications to a medical

  4  review officer both before and after being tested.

  5         5.  A list of the most common medications, by brand

  6  name or common name, as applicable, as well as by chemical

  7  name, which may alter or affect a drug test. A list of such

  8  medications as developed by the Agency for Health Care

  9  Administration shall be available to employers through the

10  Division of Workers' Compensation of the department of Labor

11  and Employment Security.

12         6.  The consequences of refusing to submit to a drug

13  test.

14         7.  A representative sampling of names, addresses, and

15  telephone numbers of employee assistance programs and local

16  drug rehabilitation programs.

17         8.  A statement that an employee or job applicant who

18  receives a positive confirmed test result may contest or

19  explain the result to the medical review officer within 5

20  working days after receiving written notification of the test

21  result; that if an employee's or job applicant's explanation

22  or challenge is unsatisfactory to the medical review officer,

23  the medical review officer shall report a positive test result

24  back to the employer; and that a person may contest the drug

25  test result pursuant to law or to rules adopted by the Agency

26  for Health Care Administration.

27         9.  A statement informing the employee or job applicant

28  of his or her responsibility to notify the laboratory of any

29  administrative or civil action brought pursuant to this

30  section.

31


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  1         10.  A list of all drugs for which the employer will

  2  test, described by brand name or common name, as applicable,

  3  as well as by chemical name.

  4         11.  A statement regarding any applicable collective

  5  bargaining agreement or contract and the right to appeal to

  6  the Public Employees Relations Commission or applicable court.

  7         12.  A statement notifying employees and job applicants

  8  of their right to consult with a medical review officer for

  9  technical information regarding prescription or

10  nonprescription medication.

11         (7)  EMPLOYER PROTECTION.--

12         (g)  This section does not prohibit an employer from

13  conducting medical screening or other tests required,

14  permitted, or not disallowed by any statute, rule, or

15  regulation for the purpose of monitoring exposure of employees

16  to toxic or other unhealthy substances in the workplace or in

17  the performance of job responsibilities. Such screening or

18  testing is limited to the specific substances expressly

19  identified in the applicable statute, rule, or regulation,

20  unless prior written consent of the employee is obtained for

21  other tests. Such screening or testing need not be in

22  compliance with the rules adopted by the Agency for Health

23  Care Administration under this chapter or under s. 112.0455. A

24  public employer may, through the use of an unbiased selection

25  procedure, conduct random drug tests of employees occupying

26  safety-sensitive or special-risk positions if the testing is

27  performed in accordance with drug-testing rules adopted by the

28  Agency for Health Care Administration and the department of

29  Labor and Employment Security. If applicable, random drug

30  testing must be specified in a collective bargaining agreement

31


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  1  as negotiated by the appropriate certified bargaining agent

  2  before such testing is implemented.

  3         Section 17.  Section 440.103, Florida Statutes, is

  4  amended to read:

  5         440.103  Building permits; identification of minimum

  6  premium policy.--Except as otherwise provided in this chapter,

  7  every employer shall, as a condition to receiving a building

  8  permit, show proof that it has secured compensation for its

  9  employees under this chapter as provided in ss. 440.10 and

10  440.38. Such proof of compensation must be evidenced by a

11  certificate of coverage issued by the carrier, a valid

12  exemption certificate approved by the department or the former

13  Division of Workers' Compensation of the Department of Labor

14  and Employment Security, or a copy of the employer's authority

15  to self-insure and shall be presented each time the employer

16  applies for a building permit. As provided in s. 627.413(5),

17  each certificate of coverage must show, on its face, whether

18  or not coverage is secured under the minimum premium

19  provisions of rules adopted by rating organizations licensed

20  by the department of Insurance. The words "minimum premium

21  policy" or equivalent language shall be typed, printed,

22  stamped, or legibly handwritten.

23         Section 18.  Subsection (1) of section 440.104, Florida

24  Statutes, is amended to read:

25         440.104  Competitive bidder; civil actions.--

26         (1)  Any person engaged in the construction industry,

27  as provided in s. 440.02 s. 440.02(7), who loses a competitive

28  bid for a contract shall have a cause of action for damages

29  against the person awarded the contract for which the bid was

30  made, if the person making the losing bid establishes that the

31  winning bidder knew or should have known that he or she was in


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  1  violation of s. 440.10, s. 440.105, or s. 440.38 while

  2  performing the work under the contract.

  3         Section 19.  Paragraph (a) of subsection (2) of section

  4  440.105, Florida Statutes, is amended to read:

  5         440.105  Prohibited activities; reports; penalties;

  6  limitations.--

  7         (2)  Whoever violates any provision of this subsection

  8  commits a misdemeanor of the second degree, punishable as

  9  provided in s. 775.082 or s. 775.083.

10         (a)  It shall be unlawful for any employer to

11  knowingly:

12         1.  Coerce or attempt to coerce, as a precondition to

13  employment or otherwise, an employee to obtain a certificate

14  of election of exemption pursuant to s. 440.05.

15         2.  Discharge or refuse to hire an employee or job

16  applicant because the employee or applicant has filed a claim

17  for benefits under this chapter.

18         3.  Discharge, discipline, or take any other adverse

19  personnel action against any employee for disclosing

20  information to the department division or any law enforcement

21  agency relating to any violation or suspected violation of any

22  of the provisions of this chapter or rules promulgated

23  hereunder.

24         4.  Violate a stop-work order issued by the department

25  division pursuant to s. 440.107.

26         Section 20.  Subsections (3) and (4) of section

27  440.106, Florida Statutes, are amended to read:

28         440.106  Civil remedies; administrative penalties.--

29         (3)  Whenever any group or individual self-insurer,

30  carrier, rating bureau, or agent or other representative of

31  any carrier or rating bureau is determined to have violated s.


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  1  440.105, the department of Insurance may revoke or suspend the

  2  authority or certification of any group or individual

  3  self-insurer, carrier, agent, or broker.

  4         (4)  The department division shall report any

  5  contractor determined in violation of requirements of this

  6  chapter to the appropriate state licensing board for

  7  disciplinary action.

  8         Section 21.  Section 440.107, Florida Statutes, is

  9  amended to read:

10         440.107  Department Division powers to enforce employer

11  compliance with coverage requirements.--

12         (1)  The Legislature finds that the failure of an

13  employer to comply with the workers' compensation coverage

14  requirements under this chapter poses an immediate danger to

15  public health, safety, and welfare. The Legislature authorizes

16  the department division to secure employer compliance with the

17  workers' compensation coverage requirements and authorizes the

18  department division to conduct investigations for the purpose

19  of ensuring employer compliance.

20         (2)  The department division and its authorized

21  representatives may enter and inspect any place of business at

22  any reasonable time for the limited purpose of investigating

23  compliance with workers' compensation coverage requirements

24  under this chapter. Each employer shall keep true and accurate

25  business records that contain such information as the

26  department division prescribes by rule. The business records

27  must contain information necessary for the department division

28  to determine compliance with workers' compensation coverage

29  requirements and must be maintained within this state by the

30  business, in such a manner as to be accessible within a

31  reasonable time upon request by the department division. The


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  1  business records must be open to inspection and be available

  2  for copying by the department division at any reasonable time

  3  and place and as often as necessary. The department division

  4  may require from any employer any sworn or unsworn reports,

  5  pertaining to persons employed by that employer, deemed

  6  necessary for the effective administration of the workers'

  7  compensation coverage requirements.

  8         (3)  In discharging its duties, the department division

  9  may administer oaths and affirmations, certify to official

10  acts, issue subpoenas to compel the attendance of witnesses

11  and the production of books, papers, correspondence,

12  memoranda, and other records deemed necessary by the

13  department division as evidence in order to ensure proper

14  compliance with the coverage provisions of this chapter.

15         (4)  If a person has refused to obey a subpoena to

16  appear before the department division or its authorized

17  representative and produce evidence requested by the

18  department division or to give testimony about the matter that

19  is under investigation, a court has jurisdiction to issue an

20  order requiring compliance with the subpoena if the court has

21  jurisdiction in the geographical area where the inquiry is

22  being carried on or in the area where the person who has

23  refused the subpoena is found, resides, or transacts business.

24  Failure to obey such a court order may be punished by the

25  court as contempt.

26         (5)  Whenever the department division determines that

27  an employer who is required to secure the payment to his or

28  her employees of the compensation provided for by this chapter

29  has failed to do so, such failure shall be deemed an immediate

30  serious danger to public health, safety, or welfare sufficient

31  to justify service by the department division of a stop-work


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  1  order on the employer, requiring the cessation of all business

  2  operations at the place of employment or job site. The order

  3  shall take effect upon the date of service upon the employer,

  4  unless the employer provides evidence satisfactory to the

  5  department division of having secured any necessary insurance

  6  or self-insurance and pays a civil penalty to the department

  7  division, to be deposited by the department division into the

  8  Workers' Compensation Administration Trust Fund, in the amount

  9  of $100 per day for each day the employer was not in

10  compliance with this chapter.

11         (6)  The department division may file a complaint in

12  the circuit court in and for Leon County to enjoin any

13  employer, who has failed to secure compensation as required by

14  this chapter, from employing individuals and from conducting

15  business until the employer presents evidence satisfactory to

16  the department division of having secured payment for

17  compensation and pays a civil penalty to the department

18  division, to be deposited by the department division into the

19  Workers' Compensation Administration Trust Fund, in the amount

20  of $100 per day for each day the employer was not in

21  compliance with this chapter.

22         (7)  In addition to any penalty, stop-work order, or

23  injunction, the department division may assess against any

24  employer, who has failed to secure the payment of compensation

25  as required by this chapter, a penalty in the amount of:

26         (a)  Twice the amount the employer would have paid

27  during periods it illegally failed to secure payment of

28  compensation in the preceding 3-year period based on the

29  employer's payroll during the preceding 3-year period; or

30         (b)  One thousand dollars, whichever is greater.

31


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  1  Any penalty assessed under this subsection is due within 30

  2  days after the date on which the employer is notified, except

  3  that, if the department division has posted a stop-work order

  4  or obtained injunctive relief against the employer, payment is

  5  due, in addition to those conditions set forth in this

  6  section, as a condition to relief from a stop-work order or an

  7  injunction. Interest shall accrue on amounts not paid when due

  8  at the rate of 1 percent per month.

  9         (8)  The department division may bring an action in

10  circuit court to recover penalties assessed under this

11  section, including any interest owed to the department

12  division pursuant to this section. In any action brought by

13  the department division pursuant to this section in which it

14  prevails, the circuit court shall award costs, including the

15  reasonable costs of investigation and a reasonable attorney's

16  fee.

17         (9)  Any judgment obtained by the department division

18  and any penalty due pursuant to the service of a stop-work

19  order or otherwise due under this section shall, until

20  collected, constitute a lien upon the entire interest of the

21  employer, legal or equitable, in any property, real or

22  personal, tangible or intangible; however, such lien is

23  subordinate to claims for unpaid wages and any prior recorded

24  liens, and a lien created by this section is not valid against

25  any person who, subsequent to such lien and in good faith and

26  for value, purchases real or personal property from such

27  employer or becomes the mortgagee on real or personal property

28  of such employer, or against a subsequent attaching creditor,

29  unless, with respect to real estate of the employer, a notice

30  of the lien is recorded in the public records of the county

31  where the real estate is located, and with respect to personal


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  1  property of the employer, the notice is recorded with the

  2  Secretary of State.

  3         (10)  Any law enforcement agency in the state may, at

  4  the request of the department division, render any assistance

  5  necessary to carry out the provisions of this section,

  6  including, but not limited to, preventing any employee or

  7  other person from remaining at a place of employment or job

  8  site after a stop-work order or injunction has taken effect.

  9         (11)  Actions by the department division under this

10  section must be contested as provided in chapter 120. All

11  civil penalties assessed by the department division must be

12  paid into the Workers' Compensation Administration Trust Fund.

13  The department division shall return any sums previously paid,

14  upon conclusion of an action, if the department division fails

15  to prevail and if so directed by an order of court or an

16  administrative hearing officer. The requirements of this

17  subsection may be met by posting a bond in an amount equal to

18  twice the penalty and in a form approved by the department

19  division.

20         Section 22.  Subsection (1) of section 440.108, Florida

21  Statutes, is amended to read:

22         440.108  Investigatory records relating to workers'

23  compensation employer compliance; confidentiality.--

24         (1)  All investigatory records of the department

25  Division of Workers' Compensation made or received pursuant to

26  s. 440.107 and any records necessary to complete an

27  investigation are confidential and exempt from the provisions

28  of s. 119.07(1) and s. 24(a), Art. I of the State Constitution

29  until the investigation is completed or ceases to be active.

30  For purposes of this section, an investigation is considered

31  "active" while such investigation is being conducted by the


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  1  department division with a reasonable, good faith belief that

  2  it may lead to the filing of administrative, civil, or

  3  criminal proceedings. An investigation does not cease to be

  4  active if the agency is proceeding with reasonable dispatch

  5  and there is a good faith belief that action may be initiated

  6  by the agency or other administrative or law enforcement

  7  agency. After an investigation is completed or ceases to be

  8  active, records relating to the investigation remain

  9  confidential and exempt from the provisions of s. 119.07(1)

10  and s. 24(a), Art. I of the State Constitution if disclosure

11  would:

12         (a)  Jeopardize the integrity of another active

13  investigation;

14         (b)  Reveal a trade secret, as defined in s. 688.002;

15         (c)  Reveal business or personal financial information;

16         (d)  Reveal the identity of a confidential source;

17         (e)  Defame or cause unwarranted damage to the good

18  name or reputation of an individual or jeopardize the safety

19  of an individual; or

20         (f)  Reveal investigative techniques or procedures.

21         Section 23.  Subsection (2) of section 440.12, Florida

22  Statutes, is amended to read:

23         440.12  Time for commencement and limits on weekly rate

24  of compensation.--

25         (2)  Compensation for disability resulting from

26  injuries which occur after December 31, 1974, shall not be

27  less than $20 per week.  However, if the employee's wages at

28  the time of injury are less than $20 per week, he or she shall

29  receive his or her full weekly wages.  If the employee's wages

30  at the time of the injury exceed $20 per week, compensation

31  shall not exceed an amount per week which is:


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  1         (a)  Equal to 100 percent of the statewide average

  2  weekly wage, determined as hereinafter provided for the year

  3  in which the injury occurred; however, the increase to 100

  4  percent from 66 2/3 percent of the statewide average weekly

  5  wage shall apply only to injuries occurring on or after August

  6  1, 1979; and

  7         (b)  Adjusted to the nearest dollar.

  8

  9  For the purpose of this subsection, the "statewide average

10  weekly wage" means the average weekly wage paid by employers

11  subject to the Florida Unemployment Compensation Law as

12  reported to the Agency for Workforce Innovation department for

13  the four calendar quarters ending each June 30, which average

14  weekly wage shall be determined by the Agency for Workforce

15  Innovation department on or before November 30 of each year

16  and shall be used in determining the maximum weekly

17  compensation rate with respect to injuries occurring in the

18  calendar year immediately following. The statewide average

19  weekly wage determined by the Agency for Workforce Innovation

20  department shall be reported annually to the Legislature.

21         Section 24.  Section 440.125, Florida Statutes, is

22  amended to read:

23         440.125  Medical records and reports; identifying

24  information in employee medical bills; confidentiality.--

25         (1)  Any medical records and medical reports of an

26  injured employee and any information identifying an injured

27  employee in medical bills which are provided to the

28  department, Division of Workers' Compensation of the

29  Department of Labor and Employment Security pursuant to s.

30  440.13 are confidential and exempt from the provisions of s.

31  119.07(1) and s. 24(a), Art. I of the State Constitution,


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  1  except as otherwise provided by this chapter. The department

  2  may share any such confidential and exempt records, reports,

  3  or information received pursuant to s. 440.13 with the Agency

  4  for Health Care Administration and the Department of Education

  5  in furtherance of their official duties under ss. 440.13 and

  6  440.134. The agency and the department shall maintain the

  7  confidential and exempt status of such records, reports, and

  8  information received.

  9         (2)  The Legislature finds that it is a public

10  necessity that an injured employee's medical records and

11  medical reports and information identifying the employee in

12  medical bills held by the Division of Workers' Compensation

13  pursuant to s. 440.13 be confidential and exempt from the

14  public records law. Public access to such information is an

15  invasion of the injured employee's right to privacy in that

16  personal, sensitive information would be revealed, and public

17  knowledge of such information could lead to discrimination

18  against the employee by coworkers and others. Additionally,

19  there is little utility in providing public access to such

20  information in that the effectiveness and efficiency of the

21  workers' compensation program can be otherwise adequately

22  monitored and evaluated.

23         Section 25.  Subsections (1), (3), (4), (5), (6), (7),

24  (8), (9), (11), (12), (13), and (15) of section 440.13,

25  Florida Statutes, are amended to read:

26         440.13  Medical services and supplies; penalty for

27  violations; limitations.--

28         (1)  DEFINITIONS.--As used in this section, the term:

29         (a)  "Alternate medical care" means a change in

30  treatment or health care provider.

31


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  1         (b)  "Attendant care" means care rendered by trained

  2  professional attendants which is beyond the scope of household

  3  duties. Family members may provide nonprofessional attendant

  4  care, but may not be compensated under this chapter for care

  5  that falls within the scope of household duties and other

  6  services normally and gratuitously provided by family members.

  7  "Family member" means a spouse, father, mother, brother,

  8  sister, child, grandchild, father-in-law, mother-in-law, aunt,

  9  or uncle.

10         (c)  "Carrier" means, for purposes of this section,

11  insurance carrier, self-insurance fund or individually

12  self-insured employer, or assessable mutual insurer.

13         (d)  "Catastrophic injury" means an injury as defined

14  in s. 440.02.

15         (e)  "Certified health care provider" means a health

16  care provider who has been certified by the agency division or

17  who has entered an agreement with a licensed managed care

18  organization to provide treatment to injured workers under

19  this section. Certification of such health care provider must

20  include documentation that the health care provider has read

21  and is familiar with the portions of the statute, impairment

22  guides, and rules which govern the provision of remedial

23  treatment, care, and attendance.

24         (f)  "Compensable" means a determination by a carrier

25  or judge of compensation claims that a condition suffered by

26  an employee results from an injury arising out of and in the

27  course of employment.

28         (g)  "Emergency services and care" means emergency

29  services and care as defined in s. 395.002.

30

31


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  1         (h)  "Health care facility" means any hospital licensed

  2  under chapter 395 and any health care institution licensed

  3  under chapter 400.

  4         (i)  "Health care provider" means a physician or any

  5  recognized practitioner who provides skilled services pursuant

  6  to a prescription or under the supervision or direction of a

  7  physician and who has been certified by the agency division as

  8  a health care provider. The term "health care provider"

  9  includes a health care facility.

10         (j)  "Independent medical examiner" means a physician

11  selected by either an employee or a carrier to render one or

12  more independent medical examinations in connection with a

13  dispute arising under this chapter.

14         (k)  "Independent medical examination" means an

15  objective evaluation of the injured employee's medical

16  condition, including, but not limited to, impairment or work

17  status, performed by a physician or an expert medical advisor

18  at the request of a party, a judge of compensation claims, or

19  the agency division to assist in the resolution of a dispute

20  arising under this chapter.

21         (l)  "Instance of overutilization" means a specific

22  inappropriate service or level of service provided to an

23  injured employee.

24         (m)  "Medically necessary" means any medical service or

25  medical supply which is used to identify or treat an illness

26  or injury, is appropriate to the patient's diagnosis and

27  status of recovery, and is consistent with the location of

28  service, the level of care provided, and applicable practice

29  parameters. The service should be widely accepted among

30  practicing health care providers, based on scientific

31  criteria, and determined to be reasonably safe. The service


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  1  must not be of an experimental, investigative, or research

  2  nature, except in those instances in which prior approval of

  3  the Agency for Health Care Administration has been obtained.

  4  The Agency for Health Care Administration shall adopt rules

  5  providing for such approval on a case-by-case basis when the

  6  service or supply is shown to have significant benefits to the

  7  recovery and well-being of the patient.

  8         (n)  "Medicine" means a drug prescribed by an

  9  authorized health care provider and includes only generic

10  drugs or single-source patented drugs for which there is no

11  generic equivalent, unless the authorized health care provider

12  writes or states that the brand-name drug as defined in s.

13  465.025 is medically necessary, or is a drug appearing on the

14  schedule of drugs created pursuant to s. 465.025(6), or is

15  available at a cost lower than its generic equivalent.

16         (o)  "Palliative care" means noncurative medical

17  services that mitigate the conditions, effects, or pain of an

18  injury.

19         (p)  "Pattern or practice of overutilization" means

20  repetition of instances of overutilization within a specific

21  medical case or multiple cases by a single health care

22  provider.

23         (q)  "Peer review" means an evaluation by two or more

24  physicians licensed under the same authority and with the same

25  or similar specialty as the physician under review, of the

26  appropriateness, quality, and cost of health care and health

27  services provided to a patient, based on medically accepted

28  standards.

29         (r)  "Physician" or "doctor" means a physician licensed

30  under chapter 458, an osteopathic physician licensed under

31  chapter 459, a chiropractic physician licensed under chapter


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  1  460, a podiatric physician licensed under chapter 461, an

  2  optometrist licensed under chapter 463, or a dentist licensed

  3  under chapter 466, each of whom must be certified by the

  4  agency division as a health care provider.

  5         (s)  "Reimbursement dispute" means any disagreement

  6  between a health care provider or health care facility and

  7  carrier concerning payment for medical treatment.

  8         (t)  "Utilization control" means a systematic process

  9  of implementing measures that assure overall management and

10  cost containment of services delivered.

11         (u)  "Utilization review" means the evaluation of the

12  appropriateness of both the level and the quality of health

13  care and health services provided to a patient, including, but

14  not limited to, evaluation of the appropriateness of

15  treatment, hospitalization, or office visits based on

16  medically accepted standards. Such evaluation must be

17  accomplished by means of a system that identifies the

18  utilization of medical services based on medically accepted

19  standards as established by medical consultants with

20  qualifications similar to those providing the care under

21  review, and that refers patterns and practices of

22  overutilization to the agency division.

23         (3)  PROVIDER ELIGIBILITY; AUTHORIZATION.--

24         (a)  As a condition to eligibility for payment under

25  this chapter, a health care provider who renders services must

26  be a certified health care provider and must receive

27  authorization from the carrier before providing treatment.

28  This paragraph does not apply to emergency care. The agency

29  division shall adopt rules to implement the certification of

30  health care providers.

31


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  1         (b)  A health care provider who renders emergency care

  2  must notify the carrier by the close of the third business day

  3  after it has rendered such care. If the emergency care results

  4  in admission of the employee to a health care facility, the

  5  health care provider must notify the carrier by telephone

  6  within 24 hours after initial treatment. Emergency care is not

  7  compensable under this chapter unless the injury requiring

  8  emergency care arose as a result of a work-related accident.

  9  Pursuant to chapter 395, all licensed physicians and health

10  care providers in this state shall be required to make their

11  services available for emergency treatment of any employee

12  eligible for workers' compensation benefits. To refuse to make

13  such treatment available is cause for revocation of a license.

14         (c)  A health care provider may not refer the employee

15  to another health care provider, diagnostic facility, therapy

16  center, or other facility without prior authorization from the

17  carrier, except when emergency care is rendered. Any referral

18  must be to a health care provider that has been certified by

19  the agency division, unless the referral is for emergency

20  treatment.

21         (d)  A carrier must respond, by telephone or in

22  writing, to a request for authorization by the close of the

23  third business day after receipt of the request. A carrier who

24  fails to respond to a written request for authorization for

25  referral for medical treatment by the close of the third

26  business day after receipt of the request consents to the

27  medical necessity for such treatment. All such requests must

28  be made to the carrier. Notice to the carrier does not include

29  notice to the employer.

30         (e)  Carriers shall adopt procedures for receiving,

31  reviewing, documenting, and responding to requests for


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  1  authorization. Such procedures shall be for a health care

  2  provider certified under this section.

  3         (f)  By accepting payment under this chapter for

  4  treatment rendered to an injured employee, a health care

  5  provider consents to the jurisdiction of the agency division

  6  as set forth in subsection (11) and to the submission of all

  7  records and other information concerning such treatment to the

  8  agency division in connection with a reimbursement dispute,

  9  audit, or review as provided by this section. The health care

10  provider must further agree to comply with any decision of the

11  agency division rendered under this section.

12         (g)  The employee is not liable for payment for medical

13  treatment or services provided pursuant to this section except

14  as otherwise provided in this section.

15         (h)  The provisions of s. 456.053 are applicable to

16  referrals among health care providers, as defined in

17  subsection (1), treating injured workers.

18         (i)  Notwithstanding paragraph (d), a claim for

19  specialist consultations, surgical operations,

20  physiotherapeutic or occupational therapy procedures, X-ray

21  examinations, or special diagnostic laboratory tests that cost

22  more than $1,000 and other specialty services that the agency

23  division identifies by rule is not valid and reimbursable

24  unless the services have been expressly authorized by the

25  carrier, or unless the carrier has failed to respond within 10

26  days to a written request for authorization, or unless

27  emergency care is required. The insurer shall not refuse to

28  authorize such consultation or procedure unless the health

29  care provider or facility is not authorized or certified or

30  unless an expert medical advisor has determined that the

31  consultation or procedure is not medically necessary or


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  1  otherwise compensable under this chapter. Authorization of a

  2  treatment plan does not constitute express authorization for

  3  purposes of this section, except to the extent the carrier

  4  provides otherwise in its authorization procedures. This

  5  paragraph does not limit the carrier's obligation to identify

  6  and disallow overutilization or billing errors.

  7         (j)  Notwithstanding anything in this chapter to the

  8  contrary, a sick or injured employee shall be entitled, at all

  9  times, to free, full, and absolute choice in the selection of

10  the pharmacy or pharmacist dispensing and filling

11  prescriptions for medicines required under this chapter. It is

12  expressly forbidden for the agency division, an employer, or a

13  carrier, or any agent or representative of the agency

14  division, an employer, or a carrier to select the pharmacy or

15  pharmacist which the sick or injured employee must use;

16  condition coverage or payment on the basis of the pharmacy or

17  pharmacist utilized; or to otherwise interfere in the

18  selection by the sick or injured employee of a pharmacy or

19  pharmacist.

20         (4)  NOTICE OF TREATMENT TO CARRIER; FILING WITH

21  DEPARTMENT DIVISION.--

22         (a)  Any health care provider providing necessary

23  remedial treatment, care, or attendance to any injured worker

24  shall submit treatment reports to the carrier in a format

25  prescribed by the department in consultation with the agency

26  division. A claim for medical or surgical treatment is not

27  valid or enforceable against such employer or employee,

28  unless, by the close of the third business day following the

29  first treatment, the physician providing the treatment

30  furnishes to the employer or carrier a preliminary notice of

31  the injury and treatment on forms prescribed by the department


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  1  in consultation with the agency division and, within 15 days

  2  thereafter, furnishes to the employer or carrier a complete

  3  report, and subsequent thereto furnishes progress reports, if

  4  requested by the employer or insurance carrier, at intervals

  5  of not less than 3 weeks apart or at less frequent intervals

  6  if requested on forms prescribed by the department in

  7  consultation with the agency division.

  8         (b)  Upon the request of the department or agency

  9  Division of Workers' Compensation, each medical report or bill

10  obtained or received by the employer, the carrier, or the

11  injured employee, or the attorney for the employer, carrier,

12  or injured employee, with respect to the remedial treatment,

13  care, and attendance of the injured employee, including any

14  report of an examination, diagnosis, or disability evaluation,

15  must be filed with the department or agency Division of

16  Workers' Compensation pursuant to rules adopted by the

17  department in consultation with the agency division. The

18  health care provider shall also furnish to the injured

19  employee or to his or her attorney, on demand, a copy of his

20  or her office chart, records, and reports, and may charge the

21  injured employee an amount authorized by the department

22  division for the copies. Each such health care provider shall

23  provide to the agency or department division information about

24  the remedial treatment, care, and attendance which the agency

25  or department division reasonably requests.

26         (c)  It is the policy for the administration of the

27  workers' compensation system that there be reasonable access

28  to medical information by all parties to facilitate the

29  self-executing features of the law. Notwithstanding the

30  limitations in s. 456.057 and subject to the limitations in s.

31  381.004, upon the request of the employer, the carrier, an


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  1  authorized qualified rehabilitation provider, or the attorney

  2  for the employer or carrier, the medical records of an injured

  3  employee must be furnished to those persons and the medical

  4  condition of the injured employee must be discussed with those

  5  persons, if the records and the discussions are restricted to

  6  conditions relating to the workplace injury. Any such

  7  discussions may be held before or after the filing of a claim

  8  without the knowledge, consent, or presence of any other party

  9  or his or her agent or representative. A health care provider

10  who willfully refuses to provide medical records or to discuss

11  the medical condition of the injured employee, after a

12  reasonable request is made for such information pursuant to

13  this subsection, shall be subject by the agency division to

14  one or more of the penalties set forth in paragraph (8)(b).

15         (5)  INDEPENDENT MEDICAL EXAMINATIONS.--

16         (a)  In any dispute concerning overutilization, medical

17  benefits, compensability, or disability under this chapter,

18  the carrier or the employee may select an independent medical

19  examiner. The examiner may be a health care provider treating

20  or providing other care to the employee. An independent

21  medical examiner may not render an opinion outside his or her

22  area of expertise, as demonstrated by licensure and applicable

23  practice parameters.

24         (b)  Each party is bound by his or her selection of an

25  independent medical examiner and is entitled to an alternate

26  examiner only if:

27         1.  The examiner is not qualified to render an opinion

28  upon an aspect of the employee's illness or injury which is

29  material to the claim or petition for benefits;

30         2.  The examiner ceases to practice in the specialty

31  relevant to the employee's condition;


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  1         3.  The examiner is unavailable due to injury, death,

  2  or relocation outside a reasonably accessible geographic area;

  3  or

  4         4.  The parties agree to an alternate examiner.

  5

  6  Any party may request, or a judge of compensation claims may

  7  require, designation of an agency a division medical advisor

  8  as an independent medical examiner. The opinion of the

  9  advisors acting as examiners shall not be afforded the

10  presumption set forth in paragraph (9)(c).

11         (c)  The carrier may, at its election, contact the

12  claimant directly to schedule a reasonable time for an

13  independent medical examination. The carrier must confirm the

14  scheduling agreement in writing within 5 days and notify

15  claimant's counsel, if any, at least 7 days before the date

16  upon which the independent medical examination is scheduled to

17  occur. An attorney representing a claimant is not authorized

18  to schedule independent medical evaluations under this

19  subsection.

20         (d)  If the employee fails to appear for the

21  independent medical examination without good cause and fails

22  to advise the physician at least 24 hours before the scheduled

23  date for the examination that he or she cannot appear, the

24  employee is barred from recovering compensation for any period

25  during which he or she has refused to submit to such

26  examination. Further, the employee shall reimburse the carrier

27  50 percent of the physician's cancellation or no-show fee

28  unless the carrier that schedules the examination fails to

29  timely provide to the employee a written confirmation of the

30  date of the examination pursuant to paragraph (c) which

31  includes an explanation of why he or she failed to appear. The


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  1  employee may appeal to a judge of compensation claims for

  2  reimbursement when the carrier withholds payment in excess of

  3  the authority granted by this section.

  4         (e)  No medical opinion other than the opinion of a

  5  medical advisor appointed by the judge of compensation claims

  6  or agency division, an independent medical examiner, or an

  7  authorized treating provider is admissible in proceedings

  8  before the judges of compensation claims.

  9         (f)  Attorney's fees incurred by an injured employee in

10  connection with delay of or opposition to an independent

11  medical examination, including, but not limited to, motions

12  for protective orders, are not recoverable under this chapter.

13         (6)  UTILIZATION REVIEW.--Carriers shall review all

14  bills, invoices, and other claims for payment submitted by

15  health care providers in order to identify overutilization and

16  billing errors, and may hire peer review consultants or

17  conduct independent medical evaluations. Such consultants,

18  including peer review organizations, are immune from liability

19  in the execution of their functions under this subsection to

20  the extent provided in s. 766.101. If a carrier finds that

21  overutilization of medical services or a billing error has

22  occurred, it must disallow or adjust payment for such services

23  or error without order of a judge of compensation claims or

24  the agency division, if the carrier, in making its

25  determination, has complied with this section and rules

26  adopted by the agency division.

27         (7)  UTILIZATION AND REIMBURSEMENT DISPUTES.--

28         (a)  Any health care provider, carrier, or employer who

29  elects to contest the disallowance or adjustment of payment by

30  a carrier under subsection (6) must, within 30 days after

31  receipt of notice of disallowance or adjustment of payment,


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  1  petition the agency division to resolve the dispute. The

  2  petitioner must serve a copy of the petition on the carrier

  3  and on all affected parties by certified mail. The petition

  4  must be accompanied by all documents and records that support

  5  the allegations contained in the petition. Failure of a

  6  petitioner to submit such documentation to the agency division

  7  results in dismissal of the petition.

  8         (b)  The carrier must submit to the agency division

  9  within 10 days after receipt of the petition all documentation

10  substantiating the carrier's disallowance or adjustment.

11  Failure of the carrier to submit the requested documentation

12  to the agency division within 10 days constitutes a waiver of

13  all objections to the petition.

14         (c)  Within 60 days after receipt of all documentation,

15  the agency division must provide to the petitioner, the

16  carrier, and the affected parties a written determination of

17  whether the carrier properly adjusted or disallowed payment.

18  The agency division must be guided by standards and policies

19  set forth in this chapter, including all applicable

20  reimbursement schedules, in rendering its determination.

21         (d)  If the agency division finds an improper

22  disallowance or improper adjustment of payment by an insurer,

23  the insurer shall reimburse the health care provider,

24  facility, insurer, or employer within 30 days, subject to the

25  penalties provided in this subsection.

26         (e)  The agency division shall adopt rules to carry out

27  this subsection. The rules may include provisions for

28  consolidating petitions filed by a petitioner and expanding

29  the timetable for rendering a determination upon a

30  consolidated petition.

31


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  1         (f)  Any carrier that engages in a pattern or practice

  2  of arbitrarily or unreasonably disallowing or reducing

  3  payments to health care providers may be subject to one or

  4  more of the following penalties imposed by the agency

  5  division:

  6         1.  Repayment of the appropriate amount to the health

  7  care provider.

  8         2.  An administrative fine assessed by the agency

  9  division in an amount not to exceed $5,000 per instance of

10  improperly disallowing or reducing payments.

11         3.  Award of the health care provider's costs,

12  including a reasonable attorney's fee, for prosecuting the

13  petition.

14         (8)  PATTERN OR PRACTICE OF OVERUTILIZATION.--

15         (a)  Carriers must report to the agency division all

16  instances of overutilization including, but not limited to,

17  all instances in which the carrier disallows or adjusts

18  payment. The agency division shall determine whether a pattern

19  or practice of overutilization exists.

20         (b)  If the agency division determines that a health

21  care provider has engaged in a pattern or practice of

22  overutilization or a violation of this chapter or rules

23  adopted by the agency division, it may impose one or more of

24  the following penalties:

25         1.  An order of the agency division barring the

26  provider from payment under this chapter;

27         2.  Deauthorization of care under review;

28         3.  Denial of payment for care rendered in the future;

29         4.  Decertification of a health care provider certified

30  as an expert medical advisor under subsection (9) or of a

31  rehabilitation provider certified under s. 440.49;


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  1         5.  An administrative fine assessed by the agency

  2  division in an amount not to exceed $5,000 per instance of

  3  overutilization or violation; and

  4         6.  Notification of and review by the appropriate

  5  licensing authority pursuant to s. 440.106(3).

  6         (9)  EXPERT MEDICAL ADVISORS.--

  7         (a)  The agency division shall certify expert medical

  8  advisors in each specialty to assist the agency division and

  9  the judges of compensation claims within the advisor's area of

10  expertise as provided in this section. The agency division

11  shall, in a manner prescribed by rule, in certifying,

12  recertifying, or decertifying an expert medical advisor,

13  consider the qualifications, training, impartiality, and

14  commitment of the health care provider to the provision of

15  quality medical care at a reasonable cost. As a prerequisite

16  for certification or recertification, the agency division

17  shall require, at a minimum, that an expert medical advisor

18  have specialized workers' compensation training or experience

19  under the workers' compensation system of this state and board

20  certification or board eligibility.

21         (b)  The agency division shall contract with or employ

22  expert medical advisors to provide peer review or medical

23  consultation to the agency division or to a judge of

24  compensation claims in connection with resolving disputes

25  relating to reimbursement, differing opinions of health care

26  providers, and health care and physician services rendered

27  under this chapter. Expert medical advisors contracting with

28  the agency division shall, as a term of such contract, agree

29  to provide consultation or services in accordance with the

30  timetables set forth in this chapter and to abide by rules

31  adopted by the agency division, including, but not limited to,


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  1  rules pertaining to procedures for review of the services

  2  rendered by health care providers and preparation of reports

  3  and recommendations for submission to the agency division.

  4         (c)  If there is disagreement in the opinions of the

  5  health care providers, if two health care providers disagree

  6  on medical evidence supporting the employee's complaints or

  7  the need for additional medical treatment, or if two health

  8  care providers disagree that the employee is able to return to

  9  work, the agency division may, and the judge of compensation

10  claims shall, upon his or her own motion or within 15 days

11  after receipt of a written request by either the injured

12  employee, the employer, or the carrier, order the injured

13  employee to be evaluated by an expert medical advisor. The

14  opinion of the expert medical advisor is presumed to be

15  correct unless there is clear and convincing evidence to the

16  contrary as determined by the judge of compensation claims.

17  The expert medical advisor appointed to conduct the evaluation

18  shall have free and complete access to the medical records of

19  the employee. An employee who fails to report to and cooperate

20  with such evaluation forfeits entitlement to compensation

21  during the period of failure to report or cooperate.

22         (d)  The expert medical advisor must complete his or

23  her evaluation and issue his or her report to the agency

24  division or to the judge of compensation claims within 45 days

25  after receipt of all medical records. The expert medical

26  advisor must furnish a copy of the report to the carrier and

27  to the employee.

28         (e)  An expert medical advisor is not liable under any

29  theory of recovery for evaluations performed under this

30  section without a showing of fraud or malice. The protections

31  of s. 766.101 apply to any officer, employee, or agent of the


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  1  agency division and to any officer, employee, or agent of any

  2  entity with which the agency division has contracted under

  3  this subsection.

  4         (f)  If the agency division or a judge of compensation

  5  claims determines that the services of a certified expert

  6  medical advisor are required to resolve a dispute under this

  7  section, the carrier must compensate the advisor for his or

  8  her time in accordance with a schedule adopted by the agency

  9  division. The agency division may assess a penalty not to

10  exceed $500 against any carrier that fails to timely

11  compensate an advisor in accordance with this section.

12         (11)  AUDITS BY AGENCY FOR HEALTH CARE ADMINISTRATION

13  AND THE DEPARTMENT OF INSURANCE DIVISION; JURISDICTION.--

14         (a)  The Agency for Health Care Administration Division

15  of Workers' Compensation of the Department of Labor and

16  Employment Security may investigate health care providers to

17  determine whether providers are complying with this chapter

18  and with rules adopted by the agency division, whether the

19  providers are engaging in overutilization, and whether

20  providers are engaging in improper billing practices. If the

21  agency division finds that a health care provider has

22  improperly billed, overutilized, or failed to comply with

23  agency division rules or the requirements of this chapter it

24  must notify the provider of its findings and may determine

25  that the health care provider may not receive payment from the

26  carrier or may impose penalties as set forth in subsection (8)

27  or other sections of this chapter. If the health care provider

28  has received payment from a carrier for services that were

29  improperly billed or for overutilization, it must return those

30  payments to the carrier. The agency division may assess a

31  penalty not to exceed $500 for each overpayment that is not


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  1  refunded within 30 days after notification of overpayment by

  2  the agency division or carrier.

  3         (b)  The department division shall monitor and audit

  4  carriers as provided in s. 624.3161, to determine if medical

  5  bills are paid in accordance with this section and department

  6  division rules. Any employer, if self-insured, or carrier

  7  found by the division not to be within 90 percent compliance

  8  as to the payment of medical bills after July 1, 1994, must be

  9  assessed a fine not to exceed 1 percent of the prior year's

10  assessment levied against such entity under s. 440.51 for

11  every quarter in which the entity fails to attain 90-percent

12  compliance. The department division shall fine or otherwise

13  discipline an employer or carrier, pursuant to this chapter,

14  the insurance code, or rules adopted by the department

15  division, for each late payment of compensation that is below

16  the minimum 90-percent performance standard. Any carrier that

17  is found to be not in compliance in subsequent consecutive

18  quarters must implement a medical-bill review program approved

19  by the division, and the carrier is subject to disciplinary

20  action by the Department of Insurance.

21         (c)  The agency division has exclusive jurisdiction to

22  decide any matters concerning reimbursement, to resolve any

23  overutilization dispute under subsection (7), and to decide

24  any question concerning overutilization under subsection (8),

25  which question or dispute arises after January 1, 1994.

26         (d)  The following agency division actions do not

27  constitute agency action subject to review under ss. 120.569

28  and 120.57 and do not constitute actions subject to s. 120.56:

29  referral by the entity responsible for utilization review; a

30  decision by the agency division to refer a matter to a peer

31  review committee; establishment by a health care provider or


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  1  entity of procedures by which a peer review committee reviews

  2  the rendering of health care services; and the review

  3  proceedings, report, and recommendation of the peer review

  4  committee.

  5         (12)  CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM

  6  REIMBURSEMENT ALLOWANCES.--

  7         (a)  A three-member panel is created, consisting of the

  8  Insurance Commissioner, or the Insurance Commissioner's

  9  designee, and two members to be appointed by the Governor,

10  subject to confirmation by the Senate, one member who, on

11  account of present or previous vocation, employment, or

12  affiliation, shall be classified as a representative of

13  employers, the other member who, on account of previous

14  vocation, employment, or affiliation, shall be classified as a

15  representative of employees. The panel shall determine

16  statewide schedules of maximum reimbursement allowances for

17  medically necessary treatment, care, and attendance provided

18  by physicians, hospitals, ambulatory surgical centers,

19  work-hardening programs, pain programs, and durable medical

20  equipment. The maximum reimbursement allowances for inpatient

21  hospital care shall be based on a schedule of per diem rates,

22  to be approved by the three-member panel no later than March

23  1, 1994, to be used in conjunction with a precertification

24  manual as determined by the agency division. All compensable

25  charges for hospital outpatient care shall be reimbursed at 75

26  percent of usual and customary charges. Until the three-member

27  panel approves a schedule of per diem rates for inpatient

28  hospital care and it becomes effective, all compensable

29  charges for hospital inpatient care must be reimbursed at 75

30  percent of their usual and customary charges. Annually, the

31  three-member panel shall adopt schedules of maximum


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  1  reimbursement allowances for physicians, hospital inpatient

  2  care, hospital outpatient care, ambulatory surgical centers,

  3  work-hardening programs, and pain programs. However, the

  4  maximum percentage of increase in the individual reimbursement

  5  allowance may not exceed the percentage of increase in the

  6  Consumer Price Index for the previous year. An individual

  7  physician, hospital, ambulatory surgical center, pain program,

  8  or work-hardening program shall be reimbursed either the usual

  9  and customary charge for treatment, care, and attendance, the

10  agreed-upon contract price, or the maximum reimbursement

11  allowance in the appropriate schedule, whichever is less.

12         (b)  As to reimbursement for a prescription medication,

13  the reimbursement amount for a prescription shall be the

14  average wholesale price times 1.2 plus $4.18 for the

15  dispensing fee, except where the carrier has contracted for a

16  lower amount. Fees for pharmaceuticals and pharmaceutical

17  services shall be reimbursable at the applicable fee schedule

18  amount. Where the employer or carrier has contracted for such

19  services and the employee elects to obtain them through a

20  provider not a party to the contract, the carrier shall

21  reimburse at the schedule, negotiated, or contract price,

22  whichever is lower.

23         (c)  Reimbursement for all fees and other charges for

24  such treatment, care, and attendance, including treatment,

25  care, and attendance provided by any hospital or other health

26  care provider, ambulatory surgical center, work-hardening

27  program, or pain program, must not exceed the amounts provided

28  by the uniform schedule of maximum reimbursement allowances as

29  determined by the panel or as otherwise provided in this

30  section. This subsection also applies to independent medical

31  examinations performed by health care providers under this


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  1  chapter. Until the three-member panel approves a uniform

  2  schedule of maximum reimbursement allowances and it becomes

  3  effective, all compensable charges for treatment, care, and

  4  attendance provided by physicians, ambulatory surgical

  5  centers, work-hardening programs, or pain programs shall be

  6  reimbursed at the lowest maximum reimbursement allowance

  7  across all 1992 schedules of maximum reimbursement allowances

  8  for the services provided regardless of the place of service.

  9  In determining the uniform schedule, the panel shall first

10  approve the data which it finds representative of prevailing

11  charges in the state for similar treatment, care, and

12  attendance of injured persons. Each health care provider,

13  health care facility, ambulatory surgical center,

14  work-hardening program, or pain program receiving workers'

15  compensation payments shall maintain records verifying their

16  usual charges. In establishing the uniform schedule of maximum

17  reimbursement allowances, the panel must consider:

18         1.  The levels of reimbursement for similar treatment,

19  care, and attendance made by other health care programs or

20  third-party providers;

21         2.  The impact upon cost to employers for providing a

22  level of reimbursement for treatment, care, and attendance

23  which will ensure the availability of treatment, care, and

24  attendance required by injured workers;

25         3.  The financial impact of the reimbursement

26  allowances upon health care providers and health care

27  facilities, including trauma centers as defined in s.

28  395.4001, and its effect upon their ability to make available

29  to injured workers such medically necessary remedial

30  treatment, care, and attendance. The uniform schedule of

31  maximum reimbursement allowances must be reasonable, must


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  1  promote health care cost containment and efficiency with

  2  respect to the workers' compensation health care delivery

  3  system, and must be sufficient to ensure availability of such

  4  medically necessary remedial treatment, care, and attendance

  5  to injured workers; and

  6         4.  The most recent average maximum allowable rate of

  7  increase for hospitals determined by the Health Care Board

  8  under chapter 408.

  9         (13)  REMOVAL OF PHYSICIANS FROM LISTS OF THOSE

10  AUTHORIZED TO RENDER MEDICAL CARE.--The agency division shall

11  remove from the list of physicians or facilities authorized to

12  provide remedial treatment, care, and attendance under this

13  chapter the name of any physician or facility found after

14  reasonable investigation to have:

15         (a)  Engaged in professional or other misconduct or

16  incompetency in connection with medical services rendered

17  under this chapter;

18         (b)  Exceeded the limits of his or her or its

19  professional competence in rendering medical care under this

20  chapter, or to have made materially false statements regarding

21  his or her or its qualifications in his or her application;

22         (c)  Failed to transmit copies of medical reports to

23  the employer or carrier, or failed to submit full and truthful

24  medical reports of all his or her or its findings to the

25  employer or carrier as required under this chapter;

26         (d)  Solicited, or employed another to solicit for

27  himself or herself or itself or for another, professional

28  treatment, examination, or care of an injured employee in

29  connection with any claim under this chapter;

30         (e)  Refused to appear before, or to answer upon

31  request of, the agency division or any duly authorized officer


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  1  of the state, any legal question, or to produce any relevant

  2  book or paper concerning his or her conduct under any

  3  authorization granted to him or her under this chapter;

  4         (f)  Self-referred in violation of this chapter or

  5  other laws of this state; or

  6         (g)  Engaged in a pattern of practice of

  7  overutilization or a violation of this chapter or rules

  8  adopted by the agency division.

  9         (15)  PRACTICE PARAMETERS.--

10         (a)  The Agency for Health Care Administration, in

11  conjunction with the department division and appropriate

12  health professional associations and health-related

13  organizations shall develop and may adopt by rule

14  scientifically sound practice parameters for medical

15  procedures relevant to workers' compensation claimants.

16  Practice parameters developed under this section must focus on

17  identifying effective remedial treatments and promoting the

18  appropriate utilization of health care resources. Priority

19  must be given to those procedures that involve the greatest

20  utilization of resources either because they are the most

21  costly or because they are the most frequently performed.

22  Practice parameters for treatment of the 10 top procedures

23  associated with workers' compensation injuries including the

24  remedial treatment of lower-back injuries must be developed by

25  December 31, 1994.

26         (b)  The guidelines may be initially based on

27  guidelines prepared by nationally recognized health care

28  institutions and professional organizations but should be

29  tailored to meet the workers' compensation goal of returning

30  employees to full employment as quickly as medically possible,

31  taking into consideration outcomes data collected from managed


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  1  care providers and any other inpatient and outpatient

  2  facilities serving workers' compensation claimants.

  3         (c)  Procedures must be instituted which provide for

  4  the periodic review and revision of practice parameters based

  5  on the latest outcomes data, research findings, technological

  6  advancements, and clinical experiences, at least once every 3

  7  years.

  8         (d)  Practice parameters developed under this section

  9  must be used by carriers and the agency division in evaluating

10  the appropriateness and overutilization of medical services

11  provided to injured employees.

12         Section 26.  Subsection (23) of section 440.134,

13  Florida Statutes, is amended to read:

14         440.134  Workers' compensation managed care

15  arrangement.--

16         (23)  The agency shall immediately notify the

17  department of Insurance and the Department of Labor and

18  Employment Security whenever it issues an administrative

19  complaint or an order or otherwise initiates legal proceedings

20  resulting in, or which may result in, suspension or revocation

21  of an insurer's authorization.

22         Section 27.  Subsections (3) and (4) of section 440.14,

23  Florida Statutes, are amended to read:

24         440.14  Determination of pay.--

25         (3)  The department division shall establish by rule a

26  form which shall contain a simplified checklist of those items

27  which may be included as "wage" for determining the average

28  weekly wage.

29         (4)  Upon termination of the employee or upon

30  termination of the payment of fringe benefits of any employee

31  who is collecting indemnity benefits pursuant to s. 440.15(2)


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  1  or (3)(b), the employer shall within 7 days of such

  2  termination file a corrected 13-week wage statement reflecting

  3  the wages paid and the fringe benefits that had been paid to

  4  the injured employee, as provided defined in s. 440.02(27).

  5         Section 28.  Paragraphs (d) and (f) of subsection (1),

  6  paragraphs (c) and (d) of subsection (2), subsections (3),

  7  (4), and (6), and paragraphs (b) and (c) of subsection (10) of

  8  section 440.15, Florida Statutes, are amended to read:

  9         440.15  Compensation for disability.--Compensation for

10  disability shall be paid to the employee, subject to the

11  limits provided in s. 440.12(2), as follows:

12         (1)  PERMANENT TOTAL DISABILITY.--

13         (d)  If an employee who is being paid compensation for

14  permanent total disability becomes rehabilitated to the extent

15  that she or he establishes an earning capacity, the employee

16  shall be paid, instead of the compensation provided in

17  paragraph (a), benefits pursuant to subsection (3). The

18  department division shall adopt rules to enable a permanently

19  and totally disabled employee who may have reestablished an

20  earning capacity to undertake a trial period of reemployment

21  without prejudicing her or his return to permanent total

22  status in the case that such employee is unable to sustain an

23  earning capacity.

24         (f)1.  If permanent total disability results from

25  injuries that occurred subsequent to June 30, 1955, and for

26  which the liability of the employer for compensation has not

27  been discharged under s. 440.20(11), the injured employee

28  shall receive additional weekly compensation benefits equal to

29  5 percent of her or his weekly compensation rate, as

30  established pursuant to the law in effect on the date of her

31  or his injury, multiplied by the number of calendar years


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  1  since the date of injury. The weekly compensation payable and

  2  the additional benefits payable under this paragraph, when

  3  combined, may not exceed the maximum weekly compensation rate

  4  in effect at the time of payment as determined pursuant to s.

  5  440.12(2). Entitlement to these supplemental payments shall

  6  cease at age 62 if the employee is eligible for social

  7  security benefits under 42 U.S.C. ss. 402 and 423, whether or

  8  not the employee has applied for such benefits. These

  9  supplemental benefits shall be paid by the department division

10  out of the Workers' Compensation Administration Trust Fund

11  when the injury occurred subsequent to June 30, 1955, and

12  before July 1, 1984. These supplemental benefits shall be paid

13  by the employer when the injury occurred on or after July 1,

14  1984. Supplemental benefits are not payable for any period

15  prior to October 1, 1974.

16         2.a.  The department division shall provide by rule for

17  the periodic reporting to the department division of all

18  earnings of any nature and social security income by the

19  injured employee entitled to or claiming additional

20  compensation under subparagraph 1. Neither the department

21  division nor the employer or carrier shall make any payment of

22  those additional benefits provided by subparagraph 1. for any

23  period during which the employee willfully fails or refuses to

24  report upon request by the department division in the manner

25  prescribed by such rules.

26         b.  The department division shall provide by rule for

27  the periodic reporting to the employer or carrier of all

28  earnings of any nature and social security income by the

29  injured employee entitled to or claiming benefits for

30  permanent total disability. The employer or carrier is not

31  required to make any payment of benefits for permanent total


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  1  disability for any period during which the employee willfully

  2  fails or refuses to report upon request by the employer or

  3  carrier in the manner prescribed by such rules or if any

  4  employee who is receiving permanent total disability benefits

  5  refuses to apply for or cooperate with the employer or carrier

  6  in applying for social security benefits.

  7         3.  When an injured employee receives a full or partial

  8  lump-sum advance of the employee's permanent total disability

  9  compensation benefits, the employee's benefits under this

10  paragraph shall be computed on the employee's weekly

11  compensation rate as reduced by the lump-sum advance.

12         (2)  TEMPORARY TOTAL DISABILITY.--

13         (c)  Temporary total disability benefits paid pursuant

14  to this subsection shall include such period as may be

15  reasonably necessary for training in the use of artificial

16  members and appliances, and shall include such period as the

17  employee may be receiving training and education under a

18  program pursuant to s. 440.491. Notwithstanding s. 440.02(9),

19  the date of maximum medical improvement for purposes of

20  paragraph (3)(b) shall be no earlier than the last day for

21  which such temporary disability benefits are paid.

22         (d)  The department division shall, by rule, provide

23  for the periodic reporting to the department division,

24  employer, or carrier of all earned income, including income

25  from social security, by the injured employee who is entitled

26  to or claiming benefits for temporary total disability. The

27  employer or carrier is not required to make any payment of

28  benefits for temporary total disability for any period during

29  which the employee willfully fails or refuses to report upon

30  request by the employer or carrier in the manner prescribed by

31  the rules. The rule must require the claimant to personally


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  1  sign the claim form and attest that she or he has reviewed,

  2  understands, and acknowledges the foregoing.

  3         (3)  PERMANENT IMPAIRMENT AND WAGE-LOSS BENEFITS.--

  4         (a)  Impairment benefits.--

  5         1.  Once the employee has reached the date of maximum

  6  medical improvement, impairment benefits are due and payable

  7  within 20 days after the carrier has knowledge of the

  8  impairment.

  9         2.  The three-member panel, in cooperation with the

10  department division, shall establish and use a uniform

11  permanent impairment rating schedule. This schedule must be

12  based on medically or scientifically demonstrable findings as

13  well as the systems and criteria set forth in the American

14  Medical Association's Guides to the Evaluation of Permanent

15  Impairment; the Snellen Charts, published by American Medical

16  Association Committee for Eye Injuries; and the Minnesota

17  Department of Labor and Industry Disability Schedules. The

18  schedule should be based upon objective findings. The schedule

19  shall be more comprehensive than the AMA Guides to the

20  Evaluation of Permanent Impairment and shall expand the areas

21  already addressed and address additional areas not currently

22  contained in the guides. On August 1, 1979, and pending the

23  adoption, by rule, of a permanent schedule, Guides to the

24  Evaluation of Permanent Impairment, copyright 1977, 1971,

25  1988, by the American Medical Association, shall be the

26  temporary schedule and shall be used for the purposes hereof.

27  For injuries after July 1, 1990, pending the adoption by

28  division rule of a uniform disability rating agency schedule,

29  the Minnesota Department of Labor and Industry Disability

30  Schedule shall be used unless that schedule does not address

31  an injury. In such case, the Guides to the Evaluation of


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  1  Permanent Impairment by the American Medical Association shall

  2  be used. Determination of permanent impairment under this

  3  schedule must be made by a physician licensed under chapter

  4  458, a doctor of osteopathic medicine licensed under chapters

  5  458 and 459, a chiropractic physician licensed under chapter

  6  460, a podiatric physician licensed under chapter 461, an

  7  optometrist licensed under chapter 463, or a dentist licensed

  8  under chapter 466, as appropriate considering the nature of

  9  the injury. No other persons are authorized to render opinions

10  regarding the existence of or the extent of permanent

11  impairment.

12         3.  All impairment income benefits shall be based on an

13  impairment rating using the impairment schedule referred to in

14  subparagraph 2. Impairment income benefits are paid weekly at

15  the rate of 50 percent of the employee's average weekly

16  temporary total disability benefit not to exceed the maximum

17  weekly benefit under s. 440.12. An employee's entitlement to

18  impairment income benefits begins the day after the employee

19  reaches maximum medical improvement or the expiration of

20  temporary benefits, whichever occurs earlier, and continues

21  until the earlier of:

22         a.  The expiration of a period computed at the rate of

23  3 weeks for each percentage point of impairment; or

24         b.  The death of the employee.

25         4.  After the employee has been certified by a doctor

26  as having reached maximum medical improvement or 6 weeks

27  before the expiration of temporary benefits, whichever occurs

28  earlier, the certifying doctor shall evaluate the condition of

29  the employee and assign an impairment rating, using the

30  impairment schedule referred to in subparagraph 2.

31  Compensation is not payable for the mental, psychological, or


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  1  emotional injury arising out of depression from being out of

  2  work. If the certification and evaluation are performed by a

  3  doctor other than the employee's treating doctor, the

  4  certification and evaluation must be submitted to the treating

  5  doctor, and the treating doctor must indicate agreement or

  6  disagreement with the certification and evaluation. The

  7  certifying doctor shall issue a written report to the

  8  department division, the employee, and the carrier certifying

  9  that maximum medical improvement has been reached, stating the

10  impairment rating, and providing any other information

11  required by the department by rule division. If the employee

12  has not been certified as having reached maximum medical

13  improvement before the expiration of 102 weeks after the date

14  temporary total disability benefits begin to accrue, the

15  carrier shall notify the treating doctor of the requirements

16  of this section.

17         5.  The carrier shall pay the employee impairment

18  income benefits for a period based on the impairment rating.

19         6.  The department division may by rule specify forms

20  and procedures governing the method of payment of wage loss

21  and impairment benefits for dates of accidents before January

22  1, 1994, and for dates of accidents on or after January 1,

23  1994.

24         (b)  Supplemental benefits.--

25         1.  All supplemental benefits must be paid in

26  accordance with this subsection. An employee is entitled to

27  supplemental benefits as provided in this paragraph as of the

28  expiration of the impairment period, if:

29         a.  The employee has an impairment rating from the

30  compensable injury of 20 percent or more as determined

31  pursuant to this chapter;


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  1         b.  The employee has not returned to work or has

  2  returned to work earning less than 80 percent of the

  3  employee's average weekly wage as a direct result of the

  4  employee's impairment; and

  5         c.  The employee has in good faith attempted to obtain

  6  employment commensurate with the employee's ability to work.

  7         2.  If an employee is not entitled to supplemental

  8  benefits at the time of payment of the final weekly impairment

  9  income benefit because the employee is earning at least 80

10  percent of the employee's average weekly wage, the employee

11  may become entitled to supplemental benefits at any time

12  within 1 year after the impairment income benefit period ends

13  if:

14         a.  The employee earns wages that are less than 80

15  percent of the employee's average weekly wage for a period of

16  at least 90 days;

17         b.  The employee meets the other requirements of

18  subparagraph 1.; and

19         c.  The employee's decrease in earnings is a direct

20  result of the employee's impairment from the compensable

21  injury.

22         3.  If an employee earns wages that are at least 80

23  percent of the employee's average weekly wage for a period of

24  at least 90 days during which the employee is receiving

25  supplemental benefits, the employee ceases to be entitled to

26  supplemental benefits for the filing period. Supplemental

27  benefits that have been terminated shall be reinstated when

28  the employee satisfies the conditions enumerated in

29  subparagraph 2. and files the statement required under

30  subparagraph 5. Notwithstanding any other provision, if an

31  employee is not entitled to supplemental benefits for 12


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  1  consecutive months, the employee ceases to be entitled to any

  2  additional income benefits for the compensable injury. If the

  3  employee is discharged within 12 months after losing

  4  entitlement under this subsection, benefits may be reinstated

  5  if the employee was discharged at that time with the intent to

  6  deprive the employee of supplemental benefits.

  7         4.  During the period that impairment income benefits

  8  or supplemental income benefits are being paid, the carrier

  9  has the affirmative duty to determine at least annually

10  whether any extended unemployment or underemployment is a

11  direct result of the employee's impairment. To accomplish this

12  purpose, the division may require periodic reports from the

13  employee and the carrier, and it may, at the carrier's

14  expense, require any physical or other examinations,

15  vocational assessments, or other tests or diagnoses necessary

16  to verify that the carrier is performing its duty. Not more

17  than once in each 12 calendar months, the employee and the

18  carrier may each request that the division review the status

19  of the employee and determine whether the carrier has

20  performed its duty with respect to whether the employee's

21  unemployment or underemployment is a direct result of

22  impairment from the compensable injury.

23         4.5.  After the initial determination of supplemental

24  benefits, the employee must file a statement with the carrier

25  stating that the employee has earned less than 80 percent of

26  the employee's average weekly wage as a direct result of the

27  employee's impairment, stating the amount of wages the

28  employee earned in the filing period, and stating that the

29  employee has in good faith sought employment commensurate with

30  the employee's ability to work. The statement must be filed

31  quarterly on a form and in the manner prescribed by the


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  1  department division. The department division may modify the

  2  filing period as appropriate to an individual case. Failure to

  3  file a statement relieves the carrier of liability for

  4  supplemental benefits for the period during which a statement

  5  is not filed.

  6         5.6.  The carrier shall begin payment of supplemental

  7  benefits not later than the seventh day after the expiration

  8  date of the impairment income benefit period and shall

  9  continue to timely pay those benefits. The carrier may request

10  a mediation conference for the purpose of contesting the

11  employee's entitlement to or the amount of supplemental income

12  benefits.

13         6.7.  Supplemental benefits are calculated quarterly

14  and paid monthly. For purposes of calculating supplemental

15  benefits, 80 percent of the employee's average weekly wage and

16  the average wages the employee has earned per week are

17  compared quarterly. For purposes of this paragraph, if the

18  employee is offered a bona fide position of employment that

19  the employee is capable of performing, given the physical

20  condition of the employee and the geographic accessibility of

21  the position, the employee's weekly wages are considered

22  equivalent to the weekly wages for the position offered to the

23  employee.

24         7.8.  Supplemental benefits are payable at the rate of

25  80 percent of the difference between 80 percent of the

26  employee's average weekly wage determined pursuant to s.

27  440.14 and the weekly wages the employee has earned during the

28  reporting period, not to exceed the maximum weekly income

29  benefit under s. 440.12.

30         8.9.  The department division may by rule define terms

31  that are necessary for the administration of this section and


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  1  forms and procedures governing the method of payment of

  2  supplemental benefits for dates of accidents before January 1,

  3  1994, and for dates of accidents on or after January 1, 1994.

  4         (c)  Duration of temporary impairment and supplemental

  5  income benefits.--The employee's eligibility for temporary

  6  benefits, impairment income benefits, and supplemental

  7  benefits terminates on the expiration of 401 weeks after the

  8  date of injury.

  9         (4)  TEMPORARY PARTIAL DISABILITY.--

10         (a)  In case of temporary partial disability,

11  compensation shall be equal to 80 percent of the difference

12  between 80 percent of the employee's average weekly wage and

13  the salary, wages, and other remuneration the employee is able

14  to earn, as compared weekly; however, the weekly benefits may

15  not exceed an amount equal to 66 2/3  percent of the

16  employee's average weekly wage at the time of injury. In order

17  to simplify the comparison of the preinjury average weekly

18  wage with the salary, wages, and other remuneration the

19  employee is able to earn, the department division may by rule

20  provide for the modification of the weekly comparison so as to

21  coincide as closely as possible with the injured worker's pay

22  periods. The amount determined to be the salary, wages, and

23  other remuneration the employee is able to earn shall in no

24  case be less than the sum actually being earned by the

25  employee, including earnings from sheltered employment.

26         (b)  Such benefits shall be paid during the continuance

27  of such disability, not to exceed a period of 104 weeks, as

28  provided by this subsection and subsection (2). Once the

29  injured employee reaches the maximum number of weeks,

30  temporary disability benefits cease and the injured worker's

31  permanent impairment must be determined. The department


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  1  division may by rule specify forms and procedures governing

  2  the method of payment of temporary disability benefits for

  3  dates of accidents before January 1, 1994, and for dates of

  4  accidents on or after January 1, 1994.

  5         (6)  OBLIGATION TO REHIRE.--If the employer has not in

  6  good faith made available to the employee, within a 100-mile

  7  radius of the employee's residence, work appropriate to the

  8  employee's physical limitations within 30 days after the

  9  carrier notifies the employer of maximum medical improvement

10  and the employee's physical limitations, the employer shall

11  pay to the department division for deposit into the Workers'

12  Compensation Administration Trust Fund a fine of $250 for

13  every $5,000 of the employer's workers' compensation premium

14  or payroll, not to exceed $2,000 per violation, as the

15  department division requires by rule. The employer is not

16  subject to this subsection if the employee is receiving

17  permanent total disability benefits or if the employer has 50

18  or fewer employees.

19         (10)  EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER

20  AND FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE

21  ACT.--

22         (b)  If the provisions of 42 U.S.C. s. 424(a) are

23  amended to provide for a reduction or increase of the

24  percentage of average current earnings that the sum of

25  compensation benefits payable under this chapter and the

26  benefits payable under 42 U.S.C. ss. 402 and 423 can equal,

27  the amount of the reduction of benefits provided in this

28  subsection shall be reduced or increased accordingly. The

29  department division may by rule specify forms and procedures

30  governing the method for calculating and administering the

31  offset of benefits payable under this chapter and benefits


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  1  payable under 42 U.S.C. ss. 402 and 423. The department

  2  division shall have first priority in taking any available

  3  social security offsets on dates of accidents occurring before

  4  July 1, 1984.

  5         (c)  No disability compensation benefits payable for

  6  any week, including those benefits provided by paragraph

  7  (1)(f), shall be reduced pursuant to this subsection until the

  8  Social Security Administration determines the amount otherwise

  9  payable to the employee under 42 U.S.C. ss. 402 and 423 and

10  the employee has begun receiving such social security benefit

11  payments. The employee shall, upon demand by the department

12  division, the employer, or the carrier, authorize the Social

13  Security Administration to release disability information

14  relating to her or him and authorize the Division of

15  Unemployment Compensation to release unemployment compensation

16  information relating to her or him, in accordance with rules

17  to be adopted promulgated by the department division

18  prescribing the procedure and manner for requesting the

19  authorization and for compliance by the employee. Neither the

20  department division nor the employer or carrier shall make any

21  payment of benefits for total disability or those additional

22  benefits provided by paragraph (1)(f) for any period during

23  which the employee willfully fails or refuses to authorize the

24  release of information in the manner and within the time

25  prescribed by such rules. The authority for release of

26  disability information granted by an employee under this

27  paragraph shall be effective for a period not to exceed 12

28  months, such authority to be renewable as the department

29  division may prescribe by rule.

30

31


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  1         Section 29.  Subsections (2), (3), (4), (5), (7), and

  2  (10) of section 440.185, Florida Statutes, are amended to

  3  read:

  4         440.185  Notice of injury or death; reports; penalties

  5  for violations.--

  6         (2)  Within 7 days after actual knowledge of injury or

  7  death, the employer shall report such injury or death to its

  8  carrier, in a format prescribed by the department division,

  9  and shall provide a copy of such report to the employee or the

10  employee's estate. The report of injury shall contain the

11  following information:

12         (a)  The name, address, and business of the employer;

13         (b)  The name, social security number, street, mailing

14  address, telephone number, and occupation of the employee;

15         (c)  The cause and nature of the injury or death;

16         (d)  The year, month, day, and hour when, and the

17  particular locality where, the injury or death occurred; and

18         (e)  Such other information as the department division

19  may require.

20

21  The carrier shall, within 14 days after the employer's receipt

22  of the form reporting the injury, file the information

23  required by this subsection with the department division in

24  Tallahassee. However, the department division may by rule

25  provide for a different reporting system for those types of

26  injuries which it determines should be reported in a different

27  manner and for those cases which involve minor injuries

28  requiring professional medical attention in which the employee

29  does not lose more than 7 days of work as a result of the

30  injury and is able to return to the job immediately after

31  treatment and resume regular work.


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  1         (3)  In addition to the requirements of subsection (2),

  2  the employer shall notify the department division within 24

  3  hours by telephone or telegraph of any injury resulting in

  4  death.  However, this special notice shall not be required

  5  when death results subsequent to the submission to the

  6  department division of a previous report of the injury

  7  pursuant to subsection (2).

  8         (4)  Within 3 days after the employer or the employee

  9  informs the carrier of an injury the carrier shall mail to the

10  injured worker an informational brochure approved by the

11  department division which sets forth in clear and

12  understandable language an explanation of the rights,

13  benefits, procedures for obtaining benefits and assistance,

14  criminal penalties, and obligations of injured workers and

15  their employers under the Florida Workers' Compensation Law.

16  Annually, the carrier or its third-party administrator shall

17  mail to the employer an informational brochure approved by the

18  department division which sets forth in clear and

19  understandable language an explanation of the rights,

20  benefits, procedures for obtaining benefits and assistance,

21  criminal penalties, and obligations of injured workers and

22  their employers under the Florida Workers' Compensation Law.

23  All such informational brochures shall contain a notice that

24  clearly states in substance the following: "Any person who,

25  knowingly and with intent to injure, defraud, or deceive any

26  employer or employee, insurance company, or self-insured

27  program, files a statement of claim containing any false or

28  misleading information commits a felony of the third degree."

29         (5)  Additional reports with respect to such injury and

30  of the condition of such employee, including copies of medical

31  reports, funeral expenses, and wage statements, shall be filed


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  1  by the employer or carrier to the department division at such

  2  times and in such manner as the department division may

  3  prescribe by rule.  In carrying out its responsibilities under

  4  this chapter, the department or agency division may by rule

  5  provide for the obtaining of any medical records relating to

  6  medical treatment provided pursuant to this chapter,

  7  notwithstanding the provisions of ss. 90.503 and 395.3025(4).

  8         (7)  Every carrier shall file with the department

  9  division within 21 days after the issuance of a policy or

10  contract of insurance such policy information as the

11  department division requires, including notice of whether the

12  policy is a minimum premium policy. Notice of cancellation or

13  expiration of a policy as set out in s. 440.42(3) shall be

14  mailed to the department division in accordance with rules

15  adopted by the department division under chapter 120. The

16  department division may contract with a private entity for the

17  collection of policy information required to be filed by

18  carriers under this subsection and the receipt of notices of

19  cancellation or expiration of a policy required to be filed by

20  carriers under s. 440.42(3). The submission of policy

21  information or notices of cancellation or expiration to the

22  contracted private entity satisfies the filing requirements of

23  this subsection and s. 440.42(3).

24         (10)  The department division may by rule prescribe

25  forms and procedures governing the submission of the change in

26  claims administration report and the risk class code and

27  standard industry code report for all lost time and denied

28  lost-time cases. The department division may by rule define

29  terms that are necessary for the effective administration of

30  this section.

31


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  1         Section 30.  Subsection (1) and paragraph (d) of

  2  subsection (2) of section 440.191, Florida Statutes, are

  3  amended to read:

  4         440.191  Employee Assistance and Ombudsman Office.--

  5         (1)(a)  In order to effect the self-executing features

  6  of the Workers' Compensation Law, this chapter shall be

  7  construed to permit injured employees and employers or the

  8  employer's carrier to resolve disagreements without undue

  9  expense, costly litigation, or delay in the provisions of

10  benefits. It is the duty of all who participate in the

11  workers' compensation system, including, but not limited to,

12  carriers, service providers, health care providers, attorneys,

13  employers, and employees, to attempt to resolve disagreements

14  in good faith and to cooperate with the department's

15  division's efforts to resolve disagreements between the

16  parties. The department division may by rule prescribe

17  definitions that are necessary for the effective

18  administration of this section.

19         (b)  An Employee Assistance and Ombudsman Office is

20  created within the department Division of Workers'

21  Compensation to inform and assist injured workers, employers,

22  carriers, and health care providers in fulfilling their

23  responsibilities under this chapter. The department division

24  may by rule specify forms and procedures for administering

25  requests for assistance provided by this section.

26         (c)  The Employee Assistance and Ombudsman Office,

27  Division of Workers' Compensation, shall be a resource

28  available to all employees who participate in the workers'

29  compensation system and shall take all steps necessary to

30  educate and disseminate information to employees and

31  employers.


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  1         (2)

  2         (d)  The Employee Assistance and Ombudsman Office may

  3  assign an ombudsman to assist the employee in resolving the

  4  dispute. If the dispute is not resolved within 30 days after

  5  the employee contacts the office, the ombudsman shall, at the

  6  employee's request, assist the employee in drafting a petition

  7  for benefits and explain the procedures for filing petitions.

  8  The department division may by rule determine the method used

  9  to calculate the 30-day period. The Employee Assistance and

10  Ombudsman Office may not represent employees before the judges

11  of compensation claims. An employer or carrier may not pay any

12  attorneys' fees on behalf of the employee for services

13  rendered or costs incurred in connection with this section,

14  unless expressly authorized elsewhere in this chapter.

15         Section 31.  Subsection (1) of section 440.192, Florida

16  Statutes, is amended to read:

17         440.192  Procedure for resolving benefit disputes.--

18         (1)  Subject to s. 440.191, any employee who has not

19  received a benefit to which the employee believes she or he is

20  entitled under this chapter shall file by certified mail, or

21  by electronic means approved by the Deputy Chief Judge, with

22  the Office of the Judges of Compensation Claims a petition for

23  benefits which meets the requirements of this section.  The

24  department division shall inform employees of the location of

25  the Office of the Judges of Compensation Claims for purposes

26  of filing a petition for benefits.  The employee shall also

27  serve copies of the petition for benefits by certified mail,

28  or by electronic means approved by the Deputy Chief Judge,

29  upon the employer and the employer's carrier. The Deputy Chief

30  Judge shall refer the petitions to the judges of compensation

31  claims.


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  1         Section 32.  Subsections (1), (3), and (4) of section

  2  440.1925, Florida Statutes, are amended to read:

  3         440.1925  Procedure for resolving maximum medical

  4  improvement or permanent impairment disputes.--

  5         (1)  Notwithstanding the limitations on carrier

  6  independent medical examinations in s. 440.13, an employee or

  7  carrier who wishes to obtain an opinion other than the opinion

  8  of the treating physician or an agency a division advisor on

  9  the issue of permanent impairment may obtain one independent

10  medical examination, except that the employee or carrier who

11  selects the treating physician is not entitled to obtain an

12  alternate opinion on the issue of permanent impairment, unless

13  the parties otherwise agree. This section and s. 440.13(2) do

14  not permit an employee or a carrier to obtain an additional

15  medical opinion on the issue of permanent impairment by

16  requesting an alternate treating physician pursuant to s.

17  440.13.

18         (3)  Disputes shall be resolved under this section

19  when:

20         (a)  A carrier that is entitled to obtain a

21  determination of an employee's date of maximum medical

22  improvement or permanent impairment has done so;

23         (b)  The independent medical examiner's opinion on the

24  date of the employee's maximum medical improvement and degree

25  or permanent impairment differs from the opinion of the

26  employee's treating physician on either of those issues, or

27  from the opinion of the expert medical advisor appointed by

28  the agency division on the degree of permanent impairment; or

29         (c)  The carrier denies any portion of an employee's

30  claim petition for benefits due to disputed maximum medical

31  improvement or permanent impairment issues.


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  1         (4)  Only opinions of the employee's treating

  2  physician, an agency a division medical advisor, or an

  3  independent medical examiner are admissible in proceedings

  4  before a judge of compensation claims to resolve maximum

  5  medical improvement or impairment disputes.

  6         Section 33.  Subsections (3), (6), (8), (9), (10),

  7  (11), (12), (15), (16), and (17) of section 440.20, Florida

  8  Statutes, are amended to read:

  9         440.20  Time for payment of compensation; penalties for

10  late payment.--

11         (3)  Upon making payment, or upon suspension or

12  cessation of payment for any reason, the carrier shall

13  immediately notify the department division that it has

14  commenced, suspended, or ceased payment of compensation. The

15  department division may require such notification in any

16  format and manner it deems necessary to obtain accurate and

17  timely reporting.

18         (6)  If any installment of compensation for death or

19  dependency benefits, disability, permanent impairment, or wage

20  loss payable without an award is not paid within 7 days after

21  it becomes due, as provided in subsection (2), subsection (3),

22  or subsection (4), there shall be added to such unpaid

23  installment a punitive penalty of an amount equal to 20

24  percent of the unpaid installment or $5, which shall be paid

25  at the same time as, but in addition to, such installment of

26  compensation, unless notice is filed under subsection (4) or

27  unless such nonpayment results from conditions over which the

28  employer or carrier had no control. When any installment of

29  compensation payable without an award has not been paid within

30  7 days after it became due and the claimant concludes the

31  prosecution of the claim before a judge of compensation claims


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  1  without having specifically claimed additional compensation in

  2  the nature of a penalty under this section, the claimant will

  3  be deemed to have acknowledged that, owing to conditions over

  4  which the employer or carrier had no control, such installment

  5  could not be paid within the period prescribed for payment and

  6  to have waived the right to claim such penalty. However,

  7  during the course of a hearing, the judge of compensation

  8  claims shall on her or his own motion raise the question of

  9  whether such penalty should be awarded or excused. The

10  department division may assess without a hearing the punitive

11  penalty against either the employer or the insurance carrier,

12  depending upon who was at fault in causing the delay. The

13  insurance policy cannot provide that this sum will be paid by

14  the carrier if the department division or the judge of

15  compensation claims determines that the punitive penalty

16  should be made by the employer rather than the carrier. Any

17  additional installment of compensation paid by the carrier

18  pursuant to this section shall be paid directly to the

19  employee.

20         (8)  In addition to any other penalties provided by

21  this chapter for late payment, if any installment of

22  compensation is not paid when it becomes due, the employer,

23  carrier, or servicing agent shall pay interest thereon at the

24  rate of 12 percent per year from the date the installment

25  becomes due until it is paid, whether such installment is

26  payable without an order or under the terms of an order. The

27  interest payment shall be the greater of the amount of

28  interest due or $5.

29         (a)  Within 30 days after final payment of compensation

30  has been made, the employer, carrier, or servicing agent shall

31  send to the department division a notice, in accordance with a


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  1  format and manner form prescribed by the department division,

  2  stating that such final payment has been made and stating the

  3  total amount of compensation paid, the name of the employee

  4  and of any other person to whom compensation has been paid,

  5  the date of the injury or death, and the date to which

  6  compensation has been paid.

  7         (b)  If the employer, carrier, or servicing agent fails

  8  to so notify the department division within such time, the

  9  department division shall assess against such employer,

10  carrier, or servicing agent a civil penalty in an amount not

11  over $100.

12         (c)  In order to ensure carrier compliance under this

13  chapter and provisions of the Florida Insurance Code, the

14  department division shall monitor the performance of carriers

15  by conducting market conduct examinations, as provided in s.

16  624.3161, and conducting investigations, as provided in s.

17  624.317. The department division shall establish by rule

18  minimum performance standards for carriers to ensure that a

19  minimum of 90 percent of all compensation benefits are timely

20  paid. The department division shall fine a carrier as provided

21  in s. 440.13(11)(b) up to $50 for each late payment of

22  compensation that is below the minimum 90 percent performance

23  standard.  This paragraph does not affect the imposition of

24  any penalties or interest due to the claimant. If a carrier

25  contracts with a servicing agent to fulfill its administrative

26  responsibilities under this chapter, the payment practices of

27  the servicing agent are deemed the payment practices of the

28  carrier for the purpose of assessing penalties against the

29  carrier.

30         (9)  The department division may upon its own

31  initiative at any time in a case in which payments are being


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  1  made without an award investigate same and shall, in any case

  2  in which the right to compensation is controverted, or in

  3  which payments of compensation have been stopped or suspended,

  4  upon receipt of notice from any person entitled to

  5  compensation or from the employer that the right to

  6  compensation is controverted or that payments of compensation

  7  have been stopped or suspended, make such investigations,

  8  cause such medical examination to be made, or hold such

  9  hearings, and take such further action as it considers will

10  properly protect the rights of all parties.

11         (10)  Whenever the department division deems it

12  advisable, it may require any employer to make a deposit with

13  the Treasurer to secure the prompt and convenient payments of

14  such compensation; and payments therefrom upon any awards

15  shall be made upon order of the department division or judge

16  of compensation claims.

17         (11)(a)  When a claimant is not represented by counsel,

18  upon joint petition of all interested parties, a lump-sum

19  payment in exchange for the employer's or carrier's release

20  from liability for future medical expenses, as well as future

21  payments of compensation expenses and any other benefits

22  provided under this chapter, shall be allowed at any time in

23  any case in which the employer or carrier has filed a written

24  notice of denial within 120 days after the employer receives

25  notice of the injury, and the judge of compensation claims at

26  a hearing to consider the settlement proposal finds a

27  justiciable controversy as to legal or medical compensability

28  of the claimed injury or the alleged accident.  The employer

29  or carrier may not pay any attorney's fees on behalf of the

30  claimant for any settlement under this section unless

31  expressly authorized elsewhere in this chapter. Upon the joint


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  1  petition of all interested parties and after giving due

  2  consideration to the interests of all interested parties, the

  3  judge of compensation claims may enter a compensation order

  4  approving and authorizing the discharge of the liability of

  5  the employer for compensation and remedial treatment, care,

  6  and attendance, as well as rehabilitation expenses, by the

  7  payment of a lump sum. Such a compensation order so entered

  8  upon joint petition of all interested parties is not subject

  9  to modification or review under s. 440.28. If the settlement

10  proposal together with supporting evidence is not approved by

11  the judge of compensation claims, it shall be considered void.

12  Upon approval of a lump-sum settlement under this subsection,

13  the judge of compensation claims shall send a report to the

14  Chief Judge of the amount of the settlement and a statement of

15  the nature of the controversy. The Chief Judge shall keep a

16  record of all such reports filed by each judge of compensation

17  claims and shall submit to the Legislature a summary of all

18  such reports filed under this subsection annually by September

19  15.

20         (b)  When a claimant is not represented by counsel,

21  upon joint petition of all interested parties, a lump-sum

22  payment in exchange for the employer's or carrier's release

23  from liability for future medical expenses, as well as future

24  payments of compensation and rehabilitation expenses, and any

25  other benefits provided under this chapter, may be allowed at

26  any time in any case after the injured employee has attained

27  maximum medical improvement. An employer or carrier may not

28  pay any attorney's fees on behalf of the claimant for any

29  settlement, unless expressly authorized elsewhere in this

30  chapter. A compensation order so entered upon joint petition

31  of all interested parties shall not be subject to modification


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  1  or review under s. 440.28. However, a judge of compensation

  2  claims is not required to approve any award for lump-sum

  3  payment when it is determined by the judge of compensation

  4  claims that the payment being made is in excess of the value

  5  of benefits the claimant would be entitled to under this

  6  chapter. The judge of compensation claims shall make or cause

  7  to be made such investigations as she or he considers

  8  necessary, in each case in which the parties have stipulated

  9  that a proposed final settlement of liability of the employer

10  for compensation shall not be subject to modification or

11  review under s. 440.28, to determine whether such final

12  disposition will definitely aid the rehabilitation of the

13  injured worker or otherwise is clearly for the best interests

14  of the person entitled to compensation and, in her or his

15  discretion, may have an investigation made by the

16  Rehabilitation Section of the Division of Workers'

17  Compensation. The joint petition and the report of any

18  investigation so made will be deemed a part of the proceeding.

19  An employer shall have the right to appear at any hearing

20  pursuant to this subsection which relates to the discharge of

21  such employer's liability and to present testimony at such

22  hearing. The carrier shall provide reasonable notice to the

23  employer of the time and date of any such hearing and inform

24  the employer of her or his rights to appear and testify. The

25  probability of the death of the injured employee or other

26  person entitled to compensation before the expiration of the

27  period during which such person is entitled to compensation

28  shall, in the absence of special circumstances making such

29  course improper, be determined in accordance with the most

30  recent United States Life Tables published by the National

31  Office of Vital Statistics of the United States Department of


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  1  Health and Human Services. The probability of the happening of

  2  any other contingency affecting the amount or duration of the

  3  compensation, except the possibility of the remarriage of a

  4  surviving spouse, shall be disregarded. As a condition of

  5  approving a lump-sum payment to a surviving spouse, the judge

  6  of compensation claims, in the judge of compensation claims'

  7  discretion, may require security which will ensure that, in

  8  the event of the remarriage of such surviving spouse, any

  9  unaccrued future payments so paid may be recovered or recouped

10  by the employer or carrier. Such applications shall be

11  considered and determined in accordance with s. 440.25.

12         (c)  Notwithstanding s. 440.21(2), when a claimant is

13  represented by counsel, the claimant may waive all rights to

14  any and all benefits under this chapter by entering into a

15  settlement agreement releasing the employer and the carrier

16  from liability for workers' compensation benefits in exchange

17  for a lump-sum payment to the claimant. The settlement

18  agreement requires approval by the judge of compensation

19  claims only as to the attorney's fees paid to the claimant's

20  attorney by the claimant. The parties need not submit any

21  information or documentation in support of the settlement,

22  except as needed to justify the amount of the attorney's fees.

23  Neither the employer nor the carrier is responsible for any

24  attorney's fees relating to the settlement and release of

25  claims under this section. Payment of the lump-sum settlement

26  amount must be made within 14 days after the date the judge of

27  compensation claims mails the order approving the attorney's

28  fees. Any order entered by a judge of compensation claims

29  approving the attorney's fees as set out in the settlement

30  under this subsection is not considered to be an award and is

31  not subject to modification or review. The judge of


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  1  compensation claims shall report these settlements to the

  2  Deputy Chief Judge in accordance with the requirements set

  3  forth in paragraphs (a) and (b). Settlements entered into

  4  under this subsection are valid and apply to all dates of

  5  accident.

  6         (d)1.  With respect to any lump-sum settlement under

  7  this subsection, a judge of compensation claims must consider

  8  at the time of the settlement, whether the settlement

  9  allocation provides for the appropriate recovery of child

10  support arrearages.

11         2.  When reviewing any settlement of lump-sum payment

12  pursuant to this subsection, judges of compensation claims

13  shall consider the interests of the worker and the worker's

14  family when approving the settlement, which must consider and

15  provide for appropriate recovery of past due support.

16         (e)  This section applies to all claims that the

17  parties have not previously settled, regardless of the date of

18  accident.

19         (12)(a)  Liability of an employer for future payments

20  of compensation may not be discharged by advance payment

21  unless prior approval of a judge of compensation claims or the

22  department division has been obtained as hereinafter provided.

23  The approval shall not constitute an adjudication of the

24  claimant's percentage of disability.

25         (b)  When the claimant has reached maximum recovery and

26  returned to her or his former or equivalent employment with no

27  substantial reduction in wages, such approval of a reasonable

28  advance payment of a part of the compensation payable to the

29  claimant may be given informally by letter by a judge of

30  compensation claims or, by the department division director,

31  or by the administrator of claims of the division.


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  1         (c)  In the event the claimant has not returned to the

  2  same or equivalent employment with no substantial reduction in

  3  wages or has suffered a substantial loss of earning capacity

  4  or a physical impairment, actual or apparent:

  5         1.  An advance payment of compensation not in excess of

  6  $2,000 may be approved informally by letter, without hearing,

  7  by any judge of compensation claims or the Chief Judge.

  8         2.  An advance payment of compensation not in excess of

  9  $2,000 may be ordered by any judge of compensation claims

10  after giving the interested parties an opportunity for a

11  hearing thereon pursuant to not less than 10 days' notice by

12  mail, unless such notice is waived, and after giving due

13  consideration to the interests of the person entitled thereto.

14  When the parties have stipulated to an advance payment of

15  compensation not in excess of $2,000, such advance may be

16  approved by an order of a judge of compensation claims, with

17  or without hearing, or informally by letter by any such judge

18  of compensation claims, or by the department division

19  director, if such advance is found to be for the best

20  interests of the person entitled thereto.

21         3.  When the parties have stipulated to an advance

22  payment in excess of $2,000, subject to the approval of the

23  department division, such payment may be approved by a judge

24  of compensation claims by order if the judge finds that such

25  advance payment is for the best interests of the person

26  entitled thereto and is reasonable under the circumstances of

27  the particular case. The judge of compensation claims shall

28  make or cause to be made such investigations as she or he

29  considers necessary concerning the stipulation and, in her or

30  his discretion, may have an investigation of the matter made

31  by the Rehabilitation Section of the division. The stipulation


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  1  and the report of any investigation shall be deemed a part of

  2  the record of the proceedings.

  3         (d)  When an application for an advance payment in

  4  excess of $2,000 is opposed by the employer or carrier, it

  5  shall be heard by a judge of compensation claims after giving

  6  the interested parties not less than 10 days' notice of such

  7  hearing by mail, unless such notice is waived. In her or his

  8  discretion, the judge of compensation claims may have an

  9  investigation of the matter made by the Rehabilitation Section

10  of the division, in which event the report and recommendation

11  of that section will be deemed a part of the record of the

12  proceedings. If the judge of compensation claims finds that

13  such advance payment is for the best interests of the person

14  entitled to compensation, will not materially prejudice the

15  rights of the employer and carrier, and is reasonable under

16  the circumstances of the case, she or he may order the same

17  paid. However, in no event may any such advance payment under

18  this paragraph be granted in excess of $7,500 or 26 weeks of

19  benefits in any 48-month period, whichever is greater, from

20  the date of the last advance payment.

21         (15)(a)  The department division shall examine on an

22  ongoing basis claims files in accordance with s. 624.3161 and

23  may impose fines pursuant to s. 624.310(5) and this chapter in

24  order to identify questionable claims-handling techniques,

25  questionable patterns or practices of claims, or a pattern of

26  repeated unreasonably controverted claims by employers,

27  carriers, as defined in s. 440.02, self-insurers, health care

28  providers, health care facilities, training and education

29  providers, or any others providing services to employees

30  pursuant to this chapter and may certify its findings to the

31  Department of Insurance. If the department finds such


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  1  questionable techniques, patterns, or repeated unreasonably

  2  controverted claims as constitute a general business practice

  3  of a carrier, as defined in s. 440.02 in the judgment of the

  4  division shall be certified in its findings by the division to

  5  the Department of Insurance or such other appropriate

  6  licensing agency. Such certification by the division is exempt

  7  from the provisions of chapter 120. Upon receipt of any such

  8  certification, the department of Insurance shall take

  9  appropriate action so as to bring such general business

10  practices to a halt pursuant to s. 440.38(3)(a) or may impose

11  penalties pursuant to s. 624.4211. The department division may

12  initiate investigations of questionable techniques, patterns,

13  practices, or repeated unreasonably controverted claims. The

14  department division may by rule establish forms and procedures

15  for corrective action plans and for auditing carriers.

16         (b)  As to any examination, investigation, or hearing

17  being conducted under this chapter, the Insurance Commissioner

18  or his or her Secretary of Labor and Employment Security or

19  the secretary's designee:

20         1.  May administer oaths, examine and cross-examine

21  witnesses, receive oral and documentary evidence; and

22         2.  Shall have the power to subpoena witnesses, compel

23  their attendance and testimony, and require by subpoena the

24  production of books, papers, records, files, correspondence,

25  documents, or other evidence which is relevant to the inquiry.

26         (c)  If any person refuses to comply with any such

27  subpoena or to testify as to any matter concerning which she

28  or he may be lawfully interrogated, the Circuit Court of Leon

29  County or of the county wherein such examination,

30  investigation, or hearing is being conducted, or of the county

31  wherein such person resides, may, on the application of the


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  1  department, issue an order requiring such person to comply

  2  with the subpoena and to testify.

  3         (d)  Subpoenas shall be served, and proof of such

  4  service made, in the same manner as if issued by a circuit

  5  court. Witness fees, costs, and reasonable travel expenses, if

  6  claimed, shall be allowed the same as for testimony in a

  7  circuit court.

  8         (e)  The department division shall publish annually a

  9  report which indicates the promptness of first payment of

10  compensation records of each carrier or self-insurer so as to

11  focus attention on those carriers or self-insurers with poor

12  payment records for the preceding year. A copy of such report

13  shall be certified to The department of Insurance which shall

14  take appropriate steps so as to cause such poor carrier

15  payment practices to halt pursuant to s. 440.38(3)(a). In

16  addition, the department division shall take appropriate

17  action so as to halt such poor payment practices of

18  self-insurers. "Poor payment practice" means a practice of

19  late payment sufficient to constitute a general business

20  practice.

21         (f)  The department division shall promulgate rules

22  providing guidelines to carriers, as defined in s. 440.02,

23  self-insurers, and employers to indicate behavior that may be

24  construed as questionable claims-handling techniques,

25  questionable patterns of claims, repeated unreasonably

26  controverted claims, or poor payment practices.

27         (16)  No penalty assessed under this section may be

28  recouped by any carrier or self-insurer in the rate base, the

29  premium, or any rate filing. In the case of carriers, The

30  Department of Insurance shall enforce this subsection; and in

31


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  1  the case of self-insurers, the  division shall enforce this

  2  subsection.

  3         (17)  The department division may by rule establish

  4  audit procedures and set standards for the Automated Carrier

  5  Performance System.

  6         Section 34.  Subsections (1) and (2) of section

  7  440.207, Florida Statutes, are amended to read:

  8         440.207  Workers' compensation system guide.--

  9         (1)  The department Division of Workers' Compensation

10  of the Department of Labor and Employment Security shall

11  educate all persons providing or receiving benefits pursuant

12  to this chapter as to their rights and responsibilities under

13  this chapter.

14         (2)  The department division shall publish an

15  understandable guide to the workers' compensation system which

16  shall contain an explanation of benefits provided; services

17  provided by the Employee Assistance and Ombudsman Office;

18  procedures regarding mediation, the hearing process, and civil

19  and criminal penalties; relevant rules of the department

20  division; and such other information as the department

21  division believes will inform employees, employers, carriers,

22  and those providing services pursuant to this chapter of their

23  rights and responsibilities under this chapter and the rules

24  of the department division. For the purposes of this

25  subsection, a guide is understandable if the text of the guide

26  is written at a level of readability not exceeding the eighth

27  grade level, as determined by a recognized readability test.

28         Section 35.  Subsection (1) of section 440.211, Florida

29  Statutes, is amended to read:

30         440.211  Authorization of collective bargaining

31  agreement.--


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  1         (1)  Subject to the limitation stated in subsection

  2  (2), a provision that is mutually agreed upon in any

  3  collective bargaining agreement filed with the department

  4  division between an individually self-insured employer or

  5  other employer upon consent of the employer's carrier and a

  6  recognized or certified exclusive bargaining representative

  7  establishing any of the following shall be valid and binding:

  8         (a)  An alternative dispute resolution system to

  9  supplement, modify, or replace the provisions of this chapter

10  which may include, but is not limited to, conciliation,

11  mediation, and arbitration. Arbitration held pursuant to this

12  section shall be binding on the parties.

13         (b)  The use of an agreed-upon list of certified health

14  care providers of medical treatment which may be the exclusive

15  source of all medical treatment under this chapter.

16         (c)  The use of a limited list of physicians to conduct

17  independent medical examinations which the parties may agree

18  shall be the exclusive source of independent medical examiners

19  pursuant to this chapter.

20         (d)  A light-duty, modified-job, or return-to-work

21  program.

22         (e)  A vocational rehabilitation or retraining program.

23         Section 36.  Subsections (1) and (2) of section 440.24,

24  Florida Statutes, are amended to read:

25         440.24  Enforcement of compensation orders;

26  penalties.--

27         (1)  In case of default by the employer or carrier in

28  the payment of compensation due under any compensation order

29  of a judge of compensation claims or other failure by the

30  employer or carrier to comply with such order within 10 days

31  after the order becomes final, any circuit court of this state


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  1  within the jurisdiction of which the employer or carrier

  2  resides or transacts business shall, upon application by the

  3  department division or any beneficiary under such order, have

  4  jurisdiction to issue a rule nisi directing such employer or

  5  carrier to show cause why a writ of execution, or such other

  6  process as may be necessary to enforce the terms of such

  7  order, shall not be issued, and, unless such cause is shown,

  8  the court shall have jurisdiction to issue a writ of execution

  9  or such other process or final order as may be necessary to

10  enforce the terms of such order of the judge of compensation

11  claims.

12         (2)  In any case where the employer is insured and the

13  carrier fails to comply with any compensation order of a judge

14  of compensation claims or court within 10 days after such

15  order becomes final, the division shall notify the department

16  of Insurance of such failure, and the Department of Insurance

17  shall thereupon suspend the license of such carrier to do an

18  insurance business in this state, until such carrier has

19  complied with such order.

20         Section 37.  Subsections (5) and (7) of section 440.25,

21  Florida Statutes, are amended to read:

22         440.25  Procedures for mediation and hearings.--

23         (5)(a)  Procedures with respect to appeals from orders

24  of judges of compensation claims shall be governed by rules

25  adopted by the Supreme Court. Such an order shall become final

26  30 days after mailing of copies of such order to the parties,

27  unless appealed pursuant to such rules.

28         (b)  An appellant may be relieved of any necessary

29  filing fee by filing a verified petition of indigency for

30  approval as provided in s. 57.081(1) and may be relieved in

31  whole or in part from the costs for preparation of the record


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  1  on appeal if, within 15 days after the date notice of the

  2  estimated costs for the preparation is served, the appellant

  3  files with the judge of compensation claims a copy of the

  4  designation of the record on appeal, and a verified petition

  5  to be relieved of costs. A verified petition filed prior to

  6  the date of service of the notice of the estimated costs shall

  7  be deemed not timely filed. The verified petition relating to

  8  record costs shall contain a sworn statement that the

  9  appellant is insolvent and a complete, detailed, and sworn

10  financial affidavit showing all the appellant's assets,

11  liabilities, and income. Failure to state in the affidavit all

12  assets and income, including marital assets and income, shall

13  be grounds for denying the petition with prejudice. The Office

14  of the Judges of Compensation Claims shall adopt rules as may

15  be required pursuant to this subsection, including forms for

16  use in all petitions brought under this subsection. The

17  appellant's attorney, or the appellant if she or he is not

18  represented by an attorney, shall include as a part of the

19  verified petition relating to record costs an affidavit or

20  affirmation that, in her or his opinion, the notice of appeal

21  was filed in good faith and that there is a probable basis for

22  the District Court of Appeal, First District, to find

23  reversible error, and shall state with particularity the

24  specific legal and factual grounds for the opinion. Failure to

25  so affirm shall be grounds for denying the petition. A copy of

26  the verified petition relating to record costs shall be served

27  upon all interested parties. The judge of compensation claims

28  shall promptly conduct a hearing on the verified petition

29  relating to record costs, giving at least 15 days' notice to

30  the appellant, the department division, and all other

31  interested parties, all of whom shall be parties to the


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  1  proceedings. The judge of compensation claims may enter an

  2  order without such hearing if no objection is filed by an

  3  interested party within 20 days from the service date of the

  4  verified petition relating to record costs. Such proceedings

  5  shall be conducted in accordance with the provisions of this

  6  section and with the workers' compensation rules of procedure,

  7  to the extent applicable. In the event an insolvency petition

  8  is granted, the judge of compensation claims shall direct the

  9  department division to pay record costs and filing fees from

10  the Workers' Compensation Administration Trust Fund pending

11  final disposition of the costs of appeal. The department

12  division may transcribe or arrange for the transcription of

13  the record in any proceeding for which it is ordered to pay

14  the cost of the record.

15         (c)  As a condition of filing a notice of appeal to the

16  District Court of Appeal, First District, an employer who has

17  not secured the payment of compensation under this chapter in

18  compliance with s. 440.38 shall file with the notice of appeal

19  a good and sufficient bond, as provided in s. 59.13,

20  conditioned to pay the amount of the demand and any interest

21  and costs payable under the terms of the order if the appeal

22  is dismissed, or if the District Court of Appeal, First

23  District, affirms the award in any amount. Upon the failure of

24  such employer to file such bond with the judge of compensation

25  claims or the District Court of Appeal, First District, along

26  with the notice of appeal, the District Court of Appeal, First

27  District, shall dismiss the notice of appeal.

28         (7)  An injured employee claiming or entitled to

29  compensation shall submit to such physical examination by a

30  certified expert medical advisor approved by the agency

31  division or the judge of compensation claims as the agency


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  1  division or the judge of compensation claims may require. The

  2  place or places shall be reasonably convenient for the

  3  employee. Such physician or physicians as the employee,

  4  employer, or carrier may select and pay for may participate in

  5  an examination if the employee, employer, or carrier so

  6  requests. Proceedings shall be suspended and no compensation

  7  shall be payable for any period during which the employee may

  8  refuse to submit to examination. Any interested party shall

  9  have the right in any case of death to require an autopsy, the

10  cost thereof to be borne by the party requesting it; and the

11  judge of compensation claims shall have authority to order and

12  require an autopsy and may, in her or his discretion, withhold

13  her or his findings and award until an autopsy is held.

14         Section 38.  Section 440.271, Florida Statutes, is

15  amended to read:

16         440.271  Appeal of order of judge of compensation

17  claims.--Review of any order of a judge of compensation claims

18  entered pursuant to this chapter shall be by appeal to the

19  District Court of Appeal, First District.  Appeals shall be

20  filed in accordance with rules of procedure prescribed by the

21  Supreme Court for review of such orders. The department

22  division shall be given notice of any proceedings pertaining

23  to s. 440.25, regarding indigency, or s. 440.49, regarding the

24  Special Disability Trust Fund, and shall have the right to

25  intervene in any proceedings.

26         Section 39.  Section 440.345, Florida Statutes, is

27  amended to read:

28         440.345  Reporting of attorney's fees.--All fees paid

29  to attorneys for services rendered under this chapter shall be

30  reported to the Office of the Judges of Compensation Claims as

31  the Division of Administrative Hearings Office of the Judges


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  1  of Compensation Claims requires by rule. The Office of the

  2  Judges of Compensation Claims shall annually summarize such

  3  data in a report to the Workers' Compensation Oversight Board.

  4         Section 40.  Section 440.35, Florida Statutes, is

  5  amended to read:

  6         440.35  Record of injury or death.--Every employer

  7  shall keep a record in respect of any injury to an employee.

  8  Such record shall contain such information of disability or

  9  death in respect of such injury as the department division may

10  by regulation require, and shall be available to inspection by

11  the department division or by any state authority at such time

12  and under such conditions as the department division may by

13  regulation prescribe.

14         Section 41.  Subsections (3) and (7) of section

15  440.381, Florida Statutes, are amended to read:

16         440.381  Application for coverage; reporting payroll;

17  payroll audit procedures; penalties.--

18         (3)  The department of Insurance and the Department of

19  Labor and Employment Security shall establish by rule minimum

20  requirements for audits of payroll and classifications in

21  order to ensure that the appropriate premium is charged for

22  workers' compensation coverage. The rules shall ensure that

23  audits performed by both carriers and employers are adequate

24  to provide that all sources of payments to employees,

25  subcontractors, and independent contractors have been reviewed

26  and that the accuracy of classification of employees has been

27  verified. The rules shall provide that employers in all

28  classes other than the construction class be audited not less

29  frequently than biennially and may provide for more frequent

30  audits of employers in specified classifications based on

31  factors such as amount of premium, type of business, loss


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  1  ratios, or other relevant factors. In no event shall employers

  2  in the construction class, generating more than the amount of

  3  premium required to be experience rated, be audited less than

  4  annually. The annual audits required for construction classes

  5  shall consist of physical onsite audits. Payroll verification

  6  audit rules must include, but need not be limited to, the use

  7  of state and federal reports of employee income, payroll and

  8  other accounting records, certificates of insurance maintained

  9  by subcontractors, and duties of employees.

10         (7)  If an employee suffering a compensable injury was

11  not reported as earning wages on the last quarterly earnings

12  report filed with the Division of Unemployment Compensation

13  before the accident, the employer shall indemnify the carrier

14  for all workers' compensation benefits paid to or on behalf of

15  the employee unless the employer establishes that the employee

16  was hired after the filing of the quarterly report, in which

17  case the employer and employee shall attest to the fact that

18  the employee was employed by the employer at the time of the

19  injury. It shall be the responsibility of the Division of

20  Workers' Compensation to collect all necessary data so as to

21  enable it to notify the carrier of the name of an injured

22  worker who was not reported as earning wages on the last

23  quarterly earnings report. The division is hereby authorized

24  to release such records to the carrier which will enable the

25  carrier to seek reimbursement as provided under this

26  subsection. Failure of the employer to indemnify the insurer

27  within 21 days after demand by the insurer shall constitute

28  grounds for the insurer to immediately cancel coverage.  Any

29  action for indemnification brought by the carrier shall be

30  cognizable in the circuit court having jurisdiction where the

31  employer or carrier resides or transacts business.  The


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  1  insurer shall be entitled to a reasonable attorney's fee if it

  2  recovers any portion of the benefits paid in such action.

  3         Section 42.  Section 440.40, Florida Statutes, is

  4  amended to read:

  5         440.40  Compensation notice.--Every employer who has

  6  secured compensation under the provisions of this chapter

  7  shall keep posted in a conspicuous place or places in and

  8  about her or his place or places of business typewritten or

  9  printed notices, in accordance with a form prescribed by the

10  department division, stating that such employer has secured

11  the payment of compensation in accordance with the provisions

12  of this chapter. Such notices shall contain the name and

13  address of the carrier, if any, with whom the employer has

14  secured payment of compensation and the date of the expiration

15  of the policy. The department division may by rule prescribe

16  the form of the notices and require carriers to provide the

17  notices to policyholders.

18         Section 43.  Section 440.41, Florida Statutes, is

19  amended to read:

20         440.41  Substitution of carrier for employer.--In any

21  case where the employer is not a self-insurer, in order that

22  the liability for compensation imposed by this chapter may be

23  most effectively discharged by the employer, and in order that

24  the administration of this chapter in respect of such

25  liability may be facilitated, the department division shall by

26  regulation provide for the discharge, by the carrier for such

27  employer, of such obligations and duties of the employer in

28  respect of such liability, imposed by this chapter upon the

29  employer, as it considers proper in order to effectuate the

30  provisions of this chapter.  For such purposes:

31


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  1         (1)  Notice to or knowledge of an employer of the

  2  occurrence of the injury shall be notice to or knowledge of

  3  the carrier.

  4         (2)  Jurisdiction of the employer by the judges of

  5  compensation claims, the department division, or any court

  6  under this chapter shall be jurisdiction of the carrier.

  7         (3)  Any requirement by the judges of compensation

  8  claims, the department division, or any court under any

  9  compensation order, finding, or decision shall be binding upon

10  the carrier in the same manner and to the same extent as upon

11  the employer.

12         Section 44.  Subsection (3) of section 440.42, Florida

13  Statutes, is amended to read:

14         440.42  Insurance policies; liability.--

15         (3)  No contract or policy of insurance issued by a

16  carrier under this chapter shall expire or be canceled until

17  at least 30 days have elapsed after a notice of cancellation

18  has been sent to the department division and to the employer

19  in accordance with the provisions of s. 440.185(7).  However,

20  when duplicate or dual coverage exists by reason of two

21  different carriers having issued policies of insurance to the

22  same employer securing the same liability, it shall be

23  presumed that only that policy with the later effective date

24  shall be in force and that the earlier policy terminated upon

25  the effective date of the latter.  In the event that both

26  policies carry the same effective date, one of the policies

27  may be canceled instanter upon filing a notice of cancellation

28  with the department division and serving a copy thereof upon

29  the employer in such manner as the department division

30  prescribes by rule. The department division may by rule

31  prescribe the content of the notice of retroactive


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  1  cancellation and specify the time, place, and manner in which

  2  the notice of cancellation is to be served.

  3         Section 45.  Section 440.44, Florida Statutes, is

  4  amended to read:

  5         440.44  Workers' compensation; staff organization.--

  6         (1)  INTERPRETATION OF LAW.--As a guide to the

  7  interpretation of this chapter, the Legislature takes due

  8  notice of federal social and labor acts and hereby creates an

  9  agency to administer such acts passed for the benefit of

10  employees and employers in Florida industry, and desires to

11  meet the requirements of such federal acts wherever not

12  inconsistent with the Constitution and laws of Florida.

13         (2)  INTENT.--It is the intent of the Legislature that

14  the department, the agency, the Department of Education, and

15  the Division of Administrative Hearings assume an active and

16  forceful role in its administration of this act, so as to

17  ensure that the system operates efficiently and with maximum

18  benefit to both employers and employees.

19         (3)  EXPENDITURES.--The department, the agency, the

20  Department of Education, division and the director of the

21  Division of Administrative Hearings shall make such

22  expenditures, including expenditures for personal services and

23  rent at the seat of government and elsewhere, for law books;

24  for telephone services and WATS lines; for books of reference,

25  periodicals, equipment, and supplies; and for printing and

26  binding as may be necessary in the administration of this

27  chapter.  All expenditures in the administration of this

28  chapter shall be allowed and paid as provided in s. 440.50

29  upon the presentation of itemized vouchers therefor approved

30  by the department, the agency, the Department of Education,

31


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  1  division or the director of the Division of Administrative

  2  Hearings.

  3         (4)  MERIT SYSTEM PRINCIPLE OF PERSONNEL

  4  ADMINISTRATION.--Subject to the other provisions of this

  5  chapter, the department, the agency, the Department of

  6  Education, and the Division of Administrative Hearings may

  7  division is authorized to appoint, and prescribe the duties

  8  and powers of, bureau chiefs, attorneys, accountants, medical

  9  advisers, technical assistants, inspectors, claims examiners,

10  and such other employees as may be necessary in the

11  performance of their its duties under this chapter.

12         (5)  OFFICE.--The department, the agency, the

13  Department of Education, division and the Deputy Chief Judge

14  shall maintain and keep open during reasonable business hours

15  an office, which shall be provided in the Capitol or some

16  other suitable building in the City of Tallahassee, for the

17  transaction of business under this chapter, at which office

18  the official records and papers shall be kept.  The office

19  shall be furnished and equipped.  The department, the agency

20  division, any judge of compensation claims, or the Deputy

21  Chief Judge may hold sessions and conduct hearings at any

22  place within the state. The Office of the Judges of

23  Compensation Claims shall maintain the 17 district offices, 31

24  judges of compensation claims, and 31 mediators as they exist

25  on June 30, 2001.

26         (6)  SEAL.--The department division and the judges of

27  compensation claims shall have a seal upon which shall be

28  inscribed the words "State of Florida Department of

29  Insurance--Seal" and "Division of Administrative

30  Hearings--Seal," respectively.

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  1         (7)  DESTRUCTION OF OBSOLETE RECORDS.--The department

  2  division is expressly authorized to provide by regulation for

  3  and to destroy obsolete records of the department division.

  4  The Division of Administrative Hearings is expressly

  5  authorized to provide by regulation for and to destroy

  6  obsolete records of the Office of the Judges of Compensation

  7  Claims.

  8         (8)  PROCEDURE.--In the exercise of their its duties

  9  and functions requiring administrative hearings, the

10  department and the agency division shall proceed in accordance

11  with the Administrative Procedure Act.  The authority of the

12  department and the agency division to issue orders resulting

13  from administrative hearings as provided for in this chapter

14  shall not infringe upon the jurisdiction of the judges of

15  compensation claims.

16         Section 46.  Subsection (1) of section 440.45, Florida

17  Statutes, is amended to read:

18         440.45  Office of the Judges of Compensation Claims.--

19         (1)(a)  There is created the Office of the Judges of

20  Compensation Claims within the Department of Management

21  Services. The Office of the Judges of Compensation Claims

22  shall be headed by the Deputy Chief Judge of Compensation

23  Claims. The Deputy Chief Judge shall report to the director of

24  the Division of Administrative Hearings. The Deputy Chief

25  Judge shall be appointed by the Governor for a term of 4 years

26  from a list of three names submitted by the statewide

27  nominating commission created under subsection (2). The Deputy

28  Chief Judge must demonstrate prior administrative experience

29  and possess the same qualifications for appointment as a judge

30  of compensation claims, and the procedure for reappointment of

31  the Deputy Chief Judge will be the same as for reappointment


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  1  of a judge of compensation claims. The office shall be a

  2  separate budget entity and the director of the Division of

  3  Administrative Hearings shall be its agency head for all

  4  purposes, including, but not limited to, rulemaking pursuant

  5  to subsection (4) and establishing agency policies and

  6  procedures.  The Department of Management Services shall

  7  provide administrative support and service to the office to

  8  the extent requested by the director of the Division of

  9  Administrative Hearings but shall not direct, supervise, or

10  control the Office of the Judges of Compensation Claims in any

11  manner, including, but not limited to, personnel, purchasing,

12  budgetary matters, or property transactions. The operating

13  budget of the Office of the Judges of Compensation Claims

14  shall be paid out of the Workers' Compensation Administration

15  Trust Fund established in s. 440.50.

16         (b)  The current term of the Chief Judge of

17  Compensation Claims shall expire October 1, 2001. Effective

18  October 1, 2001, the position of Deputy Chief Judge of

19  Compensation Claims is created.

20         Section 47.  Subsections (1), (2), (7), (8), (9), (10),

21  and (11) of section 440.49, Florida Statutes, are amended to

22  read:

23         440.49  Limitation of liability for subsequent injury

24  through Special Disability Trust Fund.--

25         (1)  LEGISLATIVE INTENT.--Whereas it is often difficult

26  for workers with disabilities to achieve employment or to

27  become reemployed following an injury, and it is the desire of

28  the Legislature to facilitate the return of these workers to

29  the workplace, it is the purpose of this section to encourage

30  the employment, reemployment, and accommodation of the

31  physically disabled by reducing an employer's insurance


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  1  premium for reemploying an injured worker, to decrease

  2  litigation between carriers on apportionment issues, and to

  3  protect employers from excess liability for compensation and

  4  medical expense when an injury to a physically disabled worker

  5  merges with, aggravates, or accelerates her or his preexisting

  6  permanent physical impairment to cause either a greater

  7  disability or permanent impairment, or an increase in

  8  expenditures for temporary compensation or medical benefits

  9  than would have resulted from the injury alone. The department

10  division or the administrator shall inform all employers of

11  the existence and function of the fund and shall interpret

12  eligibility requirements liberally. However, this subsection

13  shall not be construed to create or provide any benefits for

14  injured employees or their dependents not otherwise provided

15  by this chapter. The entitlement of an injured employee or her

16  or his dependents to compensation under this chapter shall be

17  determined without regard to this subsection, the provisions

18  of which shall be considered only in determining whether an

19  employer or carrier who has paid compensation under this

20  chapter is entitled to reimbursement from the Special

21  Disability Trust Fund.

22         (2)  DEFINITIONS.--As used in this section, the term:

23         (a)  "Permanent physical impairment" means and is

24  limited to the conditions listed in paragraph (6)(a).

25         (b)  "Preferred worker" means a worker who, because of

26  a permanent impairment resulting from a compensable injury or

27  occupational disease, is unable to return to the worker's

28  regular employment.

29         (c)  "Merger" describes or means that:

30

31


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  1         1.  If the permanent physical impairment had not

  2  existed, the subsequent accident or occupational disease would

  3  not have occurred;

  4         2.  The permanent disability or permanent impairment

  5  resulting from the subsequent accident or occupational disease

  6  is materially and substantially greater than that which would

  7  have resulted had the permanent physical impairment not

  8  existed, and the employer has been required to pay, and has

  9  paid, permanent total disability or permanent impairment

10  benefits for that materially and substantially greater

11  disability;

12         3.  The preexisting permanent physical impairment is

13  aggravated or accelerated as a result of the subsequent injury

14  or occupational disease, or the preexisting impairment has

15  contributed, medically and circumstantially, to the need for

16  temporary compensation, medical, or attendant care and the

17  employer has been required to pay, and has paid, temporary

18  compensation, medical, or attendant care benefits for the

19  aggravated preexisting permanent impairment; or

20         4.  Death would not have been accelerated if the

21  permanent physical impairment had not existed.

22         (d)  "Excess permanent compensation" means that

23  compensation for permanent impairment, or permanent total

24  disability or death benefits, for which the employer or

25  carrier is otherwise entitled to reimbursement from the

26  Special Disability Trust Fund.

27         (e)  "Administrator" means the entity selected by the

28  department division to review, allow, deny, compromise,

29  controvert, and litigate claims of the Special Disability

30  Trust Fund.

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  1  In addition to the definitions contained in this subsection,

  2  the department division may by rule prescribe definitions that

  3  are necessary for the effective administration of this

  4  section.

  5         (7)  REIMBURSEMENT OF EMPLOYER.--

  6         (a)  The right to reimbursement as provided in this

  7  section is barred unless written notice of claim of the right

  8  to such reimbursement is filed by the employer or carrier

  9  entitled to such reimbursement with the department division or

10  administrator at Tallahassee within 2 years after the date the

11  employee last reached maximum medical improvement, or within 2

12  years after the date of the first payment of compensation for

13  permanent total disability, wage loss, or death, whichever is

14  later. The notice of claim must contain such information as

15  the department division by rule requires or as established by

16  the administrator; and the employer or carrier claiming

17  reimbursement shall furnish such evidence in support of the

18  claim as the department division or administrator reasonably

19  may require.

20         (b)  For notice of claims on the Special Disability

21  Trust Fund filed on or after July 1, 1978, the Special

22  Disability Trust Fund shall, within 120 days after receipt of

23  notice that a carrier has paid, been required to pay, or

24  accepted liability for excess compensation, serve notice of

25  the acceptance of the claim for reimbursement.

26         (c)  A proof of claim must be filed on each notice of

27  claim on file as of June 30, 1997, within 1 year after July 1,

28  1997, or the right to reimbursement of the claim shall be

29  barred. A notice of claim on file on or before June 30, 1997,

30  may be withdrawn and refiled if, at the time refiled, the

31  notice of claim remains within the limitation period specified


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  1  in paragraph (a).  Such refiling shall not toll, extend, or

  2  otherwise alter in any way the limitation period applicable to

  3  the withdrawn and subsequently refiled notice of claim. Each

  4  proof of claim filed shall be accompanied by a proof-of-claim

  5  fee as provided in paragraph (9)(d). The Special Disability

  6  Trust Fund shall, within 120 days after receipt of the proof

  7  of claim, serve notice of the acceptance of the claim for

  8  reimbursement. This paragraph shall apply to all claims

  9  notwithstanding the provisions of subsection (12).

10         (d)  Each notice of claim filed or refiled on or after

11  July 1, 1997, must be accompanied by a notification fee as

12  provided in paragraph (9)(d).  A proof of claim must be filed

13  within 1 year after the date the notice of claim is filed or

14  refiled, accompanied by a proof-of-claim fee as provided in

15  paragraph (9)(d), or the claim shall be barred.  The

16  notification fee shall be waived if both the notice of claim

17  and proof of claim are submitted together as a single filing.

18  The Special Disability Trust Fund shall, within 180 days after

19  receipt of the proof of claim, serve notice of the acceptance

20  of the claim for reimbursement.  This paragraph shall apply to

21  all claims notwithstanding the provisions of subsection (12).

22         (e)  For dates of accident on or after January 1, 1994,

23  the Special Disability Trust Fund shall, within 120 days of

24  receipt of notice that a carrier has been required to pay, and

25  has paid over $10,000 in benefits, serve notice of the

26  acceptance of the claim for reimbursement. Failure of the

27  Special Disability Trust Fund to serve notice of acceptance

28  shall give rise to the right to request a hearing on the claim

29  for reimbursement. If the Special Disability Trust Fund

30  through its representative denies or controverts the claim,

31  the right to such reimbursement shall be barred unless an


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  1  application for a hearing thereon is filed with the department

  2  division or administrator at Tallahassee within 60 days after

  3  notice to the employer or carrier of such denial or

  4  controversion. When such application for a hearing is timely

  5  filed, the claim shall be heard and determined in accordance

  6  with the procedure prescribed in s. 440.25, to the extent that

  7  such procedure is applicable, and in accordance with the

  8  workers' compensation rules of procedure. In such proceeding

  9  on a claim for reimbursement, the Special Disability Trust

10  Fund shall be made the party respondent, and no findings of

11  fact made with respect to the claim of the injured employee or

12  the dependents for compensation, including any finding made or

13  order entered pursuant to s. 440.20(11), shall be res

14  judicata. The Special Disability Trust Fund may not be joined

15  or made a party to any controversy or dispute between an

16  employee and the dependents and the employer or between two or

17  more employers or carriers without the written consent of the

18  fund.

19         (f)  When it has been determined that an employer or

20  carrier is entitled to reimbursement in any amount, the

21  employer or carrier shall be reimbursed annually from the

22  Special Disability Trust Fund for the compensation and medical

23  benefits paid by the employer or carrier for which the

24  employer or carrier is entitled to reimbursement, upon filing

25  request therefor and submitting evidence of such payment in

26  accordance with rules prescribed by the department division,

27  which rules may include parameters for annual audits. The

28  Special Disability Trust Fund shall pay the approved

29  reimbursement requests on a first-in, first-out basis

30  reflecting the order in which the reimbursement requests were

31  received.


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  1         (g)  The department division may by rule require

  2  specific forms and procedures for the administration and

  3  processing of claims made through the Special Disability Trust

  4  Fund.

  5         (8)  PREFERRED WORKER PROGRAM.--The Department of

  6  Education division or administrator shall issue identity cards

  7  to preferred workers upon request by qualified employees and

  8  the Department of Insurance shall reimburse an employer, from

  9  the Special Disability Trust Fund, for the cost of workers'

10  compensation premium related to the preferred workers payroll

11  for up to 3 years of continuous employment upon satisfactory

12  evidence of placement and issuance of payroll and

13  classification records and upon the employee's certification

14  of employment. The department and the Department of Education

15  division may by rule prescribe definitions, forms, and

16  procedures for the administration of the preferred worker

17  program. The Department of Education division may by rule

18  prescribe the schedule for submission of forms for

19  participation in the program.

20         (9)  SPECIAL DISABILITY TRUST FUND.--

21         (a)  There is established in the State Treasury a

22  special fund to be known as the "Special Disability Trust

23  Fund," which shall be available only for the purposes stated

24  in this section; and the assets thereof may not at any time be

25  appropriated or diverted to any other use or purpose. The

26  Treasurer shall be the custodian of such fund, and all moneys

27  and securities in such fund shall be held in trust by such

28  Treasurer and shall not be the money or property of the state.

29  The Treasurer is authorized to disburse moneys from such fund

30  only when approved by the department division or corporation

31  and upon the order of the Comptroller. The Treasurer shall


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  1  deposit any moneys paid into such fund into such depository

  2  banks as the department division may designate and is

  3  authorized to invest any portion of the fund which, in the

  4  opinion of the department division, is not needed for current

  5  requirements, in the same manner and subject to all the

  6  provisions of the law with respect to the deposits of state

  7  funds by such Treasurer. All interest earned by such portion

  8  of the fund as may be invested by the Treasurer shall be

  9  collected by her or him and placed to the credit of such fund.

10         (b)1.  The Special Disability Trust Fund shall be

11  maintained by annual assessments upon the insurance companies

12  writing compensation insurance in the state, the commercial

13  self-insurers under ss. 624.462 and 624.4621, the assessable

14  mutuals under s. 628.601, and the self-insurers under this

15  chapter, which assessments shall become due and be paid

16  quarterly at the same time and in addition to the assessments

17  provided in s. 440.51. The department division shall estimate

18  annually in advance the amount necessary for the

19  administration of this subsection and the maintenance of this

20  fund and shall make such assessment in the manner hereinafter

21  provided.

22         2.  The annual assessment shall be calculated to

23  produce during the ensuing fiscal year an amount which, when

24  combined with that part of the balance in the fund on June 30

25  of the current fiscal year which is in excess of $100,000, is

26  equal to the average of:

27         a.  The sum of disbursements from the fund during the

28  immediate past 3 calendar years, and

29         b.  Two times the disbursements of the most recent

30  calendar year.

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  1  Such amount shall be prorated among the insurance companies

  2  writing compensation insurance in the state and the

  3  self-insurers. Provided however, for those carriers that have

  4  excluded ceded reinsurance premiums from their assessments on

  5  or before January 1, 2000, no assessments on ceded reinsurance

  6  premiums shall be paid by those carriers until such time as

  7  the former Division of Workers' Compensation of the Department

  8  of Labor and Employment Security or the department advises

  9  each of those carriers of the impact that the inclusion of

10  ceded reinsurance premiums has on their assessment. The

11  department division may not recover any past underpayments of

12  assessments levied against any carrier that on or before

13  January 1, 2000, excluded ceded reinsurance premiums from

14  their assessment prior to the point that the former Division

15  of Workers' Compensation of the Department of Labor and

16  Employment Security or the department advises of the

17  appropriate assessment that should have been paid.

18         3.  The net premiums written by the companies for

19  workers' compensation in this state and the net premium

20  written applicable to the self-insurers in this state are the

21  basis for computing the amount to be assessed as a percentage

22  of net premiums. Such payments shall be made by each carrier

23  and self-insurer to the department division for the Special

24  Disability Trust Fund in accordance with such regulations as

25  the department division prescribes.

26         4.  The Treasurer is authorized to receive and credit

27  to such Special Disability Trust Fund any sum or sums that may

28  at any time be contributed to the state by the United States

29  under any Act of Congress, or otherwise, to which the state

30  may be or become entitled by reason of any payments made out

31  of such fund.


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  1         (c)  Notwithstanding the Special Disability Trust Fund

  2  assessment rate calculated pursuant to this section, the rate

  3  assessed shall not exceed 4.52 percent.

  4         (d)  The Special Disability Trust Fund shall be

  5  supplemented by a $250 notification fee on each notice of

  6  claim filed or refiled after July 1, 1997, and a $500 fee on

  7  each proof of claim filed in accordance with subsection (7).

  8  Revenues from the fee shall be deposited into the Special

  9  Disability Trust Fund and are exempt from the deduction

10  required by s. 215.20. The fees provided in this paragraph

11  shall not be imposed upon any insurer which is in receivership

12  with the Department of Insurance.

13         (e)  The department of Labor and Employment Security or

14  administrator shall report annually on the status of the

15  Special Disability Trust Fund.  The report shall update the

16  estimated undiscounted and discounted fund liability, as

17  determined by an independent actuary, change in the total

18  number of notices of claim on file with the fund in addition

19  to the number of newly filed notices of claim, change in the

20  number of proofs of claim processed by the fund, the fee

21  revenues refunded and revenues applied to pay down the

22  liability of the fund, the average time required to reimburse

23  accepted claims, and the average administrative costs per

24  claim.  The department or administrator shall submit its

25  report to the Governor, the President of the Senate, and the

26  Speaker of the House of Representatives by December 1 of each

27  year.

28         (10)  DEPARTMENT DIVISION ADMINISTRATION OF FUND;

29  CLAIMS; EXPENSES.--The department division or administrator

30  shall administer the Special Disability Trust Fund with

31  authority to allow, deny, compromise, controvert, and litigate


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  1  claims made against it and to designate an attorney to

  2  represent it in proceedings involving claims against the fund,

  3  including negotiation and consummation of settlements,

  4  hearings before judges of compensation claims, and judicial

  5  review. The department division or administrator or the

  6  attorney designated by it shall be given notice of all

  7  hearings and proceedings involving the rights or obligations

  8  of such fund and shall have authority to make expenditures for

  9  such medical examinations, expert witness fees, depositions,

10  transcripts of testimony, and the like as may be necessary to

11  the proper defense of any claim. All expenditures made in

12  connection with conservation of the fund, including the salary

13  of the attorney designated to represent it and necessary

14  travel expenses, shall be allowed and paid from the Special

15  Disability Trust Fund as provided in this section upon the

16  presentation of itemized vouchers therefor approved by the

17  department division.

18         (11)  EFFECTIVE DATES.--This section does not apply to

19  any case in which the accident causing the subsequent injury

20  or death or the disablement or death from a subsequent

21  occupational disease occurred prior to July 1, 1955, or on or

22  after January 1, 1998.  In no event shall the Special

23  Disability Trust Fund be liable for, or reimburse employers or

24  carriers for, any case in which the accident causing the

25  subsequent injury or death or the disablement or death from a

26  subsequent occupational disease occurred on or after January

27  1, 1998.  The Special Disability Trust Fund shall continue to

28  reimburse employers or carriers for subsequent injuries

29  occurring prior to January 1, 1998, and the department

30  division shall continue to assess for and the department

31


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  1  division or administrator shall fund reimbursements as

  2  provided in subsection (9) for this purpose.

  3         Section 48.  Paragraphs (b) through (h) of subsection

  4  (1) of section 440.491, Florida Statutes, are redesignated as

  5  paragraphs (c) through (i), respectively, a new paragraph (b)

  6  is added to said subsection, and present paragraph (c) of

  7  subsection (1), paragraph (a) of subsection (3), paragraph (b)

  8  of subsection (4), paragraphs (b) and (c) of subsection (5),

  9  and subsections (6), (7), and (8) of said section are amended,

10  to read:

11         440.491  Reemployment of injured workers;

12  rehabilitation.--

13         (1)  DEFINITIONS.--As used in this section, the term:

14         (b)  "Department" means the Department of Education.

15         (d)(c)  "Qualified rehabilitation provider" means a

16  rehabilitation nurse, rehabilitation counselor, vocational

17  evaluator, rehabilitation facility, or agency approved by the

18  Department of Education division as qualified to provide

19  reemployment assessments, medical care coordination,

20  reemployment services, or vocational evaluations under this

21  chapter.

22         (3)  REEMPLOYMENT STATUS REVIEWS AND REPORTS.--

23         (a)  When an employee who has suffered an injury

24  compensable under this chapter is unemployed 60 days after the

25  date of injury and is receiving benefits for temporary total

26  disability, temporary partial disability, or wage loss, and

27  has not yet been provided medical care coordination and

28  reemployment services voluntarily by the carrier, the carrier

29  must determine whether the employee is likely to return to

30  work and must report its determination to the department

31  division. The carrier must thereafter determine the


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  1  reemployment status of the employee at 90-day intervals as

  2  long as the employee remains unemployed, is not receiving

  3  medical care coordination or reemployment services, and is

  4  receiving the benefits specified in this subsection.

  5         (4)  REEMPLOYMENT ASSESSMENTS.--

  6         (b)  The carrier shall authorize only a qualified

  7  rehabilitation provider to provide the reemployment

  8  assessment. The rehabilitation provider shall conduct its

  9  assessment and issue a report to the carrier, the employee,

10  and the department division within 30 days after the time such

11  assessment is complete.

12         (5)  MEDICAL CARE COORDINATION AND REEMPLOYMENT

13  SERVICES.--

14         (b)  If the rehabilitation provider concludes that

15  training and education are necessary to return the employee to

16  suitable gainful employment, or if the employee has not

17  returned to suitable gainful employment within 180 days after

18  referral for reemployment services or receives $2,500 in

19  reemployment services, whichever comes first, the carrier must

20  discontinue reemployment services and refer the employee to

21  the department division for a vocational evaluation.

22  Notwithstanding any provision of chapter 289 or chapter 627,

23  the cost of a reemployment assessment and the first $2,500 in

24  reemployment services to an injured employee must not be

25  treated as loss adjustment expense for workers' compensation

26  ratemaking purposes.

27         (c)  A carrier may voluntarily provide medical care

28  coordination or reemployment services to the employee at

29  intervals more frequent than those required in this section.

30  For the purpose of monitoring reemployment, the carrier or the

31  rehabilitation provider shall report to the department


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  1  division, in the manner prescribed by the department division,

  2  the date of reemployment and wages of the employee. The

  3  carrier shall report its voluntary service activity to the

  4  department division as required by rule. Voluntary services

  5  offered by the carrier for any of the following injuries must

  6  be considered benefits for purposes of ratemaking: traumatic

  7  brain injury; spinal cord injury; amputation, including loss

  8  of an eye or eyes; burns of 5 percent or greater of the total

  9  body surface.

10         (6)  TRAINING AND EDUCATION.--

11         (a)  Upon referral of an injured employee by the

12  carrier, or upon the request of an injured employee, the

13  department division shall conduct a training and education

14  screening to determine whether it should refer the employee

15  for a vocational evaluation and, if appropriate, approve

16  training and education or other vocational services for the

17  employee.  The department division may not approve formal

18  training and education programs unless it determines, after

19  consideration of the reemployment assessment, pertinent

20  reemployment status reviews or reports, and such other

21  relevant factors as it prescribes by rule, that the

22  reemployment plan is likely to result in return to suitable

23  gainful employment.  The department division is authorized to

24  expend moneys from the Workers' Compensation Administration

25  Trust Fund, established by s. 440.50, to secure appropriate

26  training and education or other vocational services when

27  necessary to satisfy the recommendation of a vocational

28  evaluator.  The department division shall establish training

29  and education standards pertaining to employee eligibility,

30  course curricula and duration, and associated costs.

31


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  1         (b)  When it appears that an employee who has attained

  2  maximum medical improvement requires training and education to

  3  obtain suitable gainful employment, the employer shall pay the

  4  employee additional temporary total compensation while the

  5  employee receives such training and education for a period not

  6  to exceed 26 weeks, which period may be extended for an

  7  additional 26 weeks or less, if such extended period is

  8  determined to be necessary and proper by a judge of

  9  compensation claims. However, a carrier or employer is not

10  precluded from voluntarily paying additional temporary total

11  disability compensation beyond that period. If an employee

12  requires temporary residence at or near a facility or an

13  institution providing training and education which is located

14  more than 50 miles away from the employee's customary

15  residence, the reasonable cost of board, lodging, or travel

16  must be borne by the department division from the Workers'

17  Compensation Administration Trust Fund established by s.

18  440.50. An employee who refuses to accept training and

19  education that is recommended by the vocational evaluator and

20  considered necessary by the department division is subject to

21  a 50-percent reduction in weekly compensation benefits,

22  including wage-loss benefits, as determined under s.

23  440.15(3)(b).

24         (7)  PROVIDER QUALIFICATIONS.--

25         (a)  The department division shall investigate and

26  maintain a directory of each qualified public and private

27  rehabilitation provider, facility, and agency, and shall

28  establish by rule the minimum qualifications, credentials, and

29  requirements that each rehabilitation service provider,

30  facility, and agency must satisfy to be eligible for listing

31  in the directory. These minimum qualifications and credentials


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  1  must be based on those generally accepted within the service

  2  specialty for which the provider, facility, or agency is

  3  approved.

  4         (b)  The department division shall impose a biennial

  5  application fee of $25 for each listing in the directory, and

  6  all such fees must be deposited in the Workers' Compensation

  7  Administration Trust Fund.

  8         (c)  The department division shall monitor and evaluate

  9  each rehabilitation service provider, facility, and agency

10  qualified under this subsection to ensure its compliance with

11  the minimum qualifications and credentials established by the

12  department division. The failure of a qualified rehabilitation

13  service provider, facility, or agency to provide the

14  department division with information requested or access

15  necessary for the department division to satisfy its

16  responsibilities under this subsection is grounds for

17  disqualifying the provider, facility, or agency from further

18  referrals.

19         (d)  A qualified rehabilitation service provider,

20  facility, or agency may not be authorized by an employer, a

21  carrier, or the department division to provide any services,

22  including expert testimony, under this section in this state

23  unless the provider, facility, or agency is listed or has been

24  approved for listing in the directory. This restriction does

25  not apply to services provided outside this state under this

26  section.

27         (e)  The department division, after consultation with

28  representatives of employees, employers, carriers,

29  rehabilitation providers, and qualified training and education

30  providers, shall adopt rules governing professional practices

31  and standards.


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  1         (8)  CARRIER PRACTICES.--The department division shall

  2  monitor the selection of providers and the provision of

  3  services by carriers under this section for consistency with

  4  legislative intent set forth in subsection (2).

  5         Section 49.  Section 440.50, Florida Statutes, is

  6  amended to read:

  7         440.50  Workers' Compensation Administration Trust

  8  Fund.--

  9         (1)(a)  There is established in the State Treasury a

10  special fund to be known as the "Workers' Compensation

11  Administration Trust Fund" for the purpose of providing for

12  the payment of all expenses in respect to the administration

13  of this chapter, including the vocational rehabilitation of

14  injured employees as provided in s. 440.49 and the payments

15  due under s. 440.15(1)(f), the funding of the fixed

16  administrative expenses of the plan, and the funding of the

17  Bureau of Workers' Compensation Fraud within the Department of

18  Insurance.  Such fund shall be administered by the department

19  division.

20         (b)  The department division is authorized to transfer

21  as a loan an amount not in excess of $250,000 from such

22  special fund to the Special Disability Trust Fund established

23  by s. 440.49(9), which amount shall be repaid to said special

24  fund in annual payments equal to not less than 10 percent of

25  moneys received for such Special Disability Trust Fund.

26         (2)  The Treasurer is authorized to disburse moneys

27  from such fund only when approved by the department division

28  and upon the order of the Comptroller.

29         (3)  The Treasurer shall deposit any moneys paid into

30  such fund into such depository banks as the department

31  division may designate and is authorized to invest any portion


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  1  of the fund which, in the opinion of the department division,

  2  is not needed for current requirements, in the same manner and

  3  subject to all the provisions of the law with respect to the

  4  deposit of state funds by such Treasurer.  All interest earned

  5  by such portion of the fund as may be invested by the

  6  Treasurer shall be collected by him or her and placed to the

  7  credit of such fund.

  8         (4)  All civil penalties provided in this chapter, if

  9  not voluntarily paid, may be collected by civil suit brought

10  by the department division and shall be paid into such fund.

11         Section 50.  Section 440.51, Florida Statutes, is

12  amended to read:

13         440.51  Expenses of administration.--

14         (1)  The department division shall estimate annually in

15  advance the amounts necessary for the administration of this

16  chapter, in the following manner.

17         (a)  The department division shall, by July 1 of each

18  year, notify carriers and self-insurers of the assessment

19  rate, which shall be based on the anticipated expenses of the

20  administration of this chapter for the next calendar year.

21  Such assessment rate shall take effect January 1 of the next

22  calendar year and shall be included in workers' compensation

23  rate filings approved by the Department of Insurance which

24  become effective on or after January 1 of the next calendar

25  year. Assessments shall become due and be paid quarterly.

26         (b)  The total expenses of administration shall be

27  prorated among the carriers writing compensation insurance in

28  the state and self-insurers.  The net premiums collected by

29  carriers and the amount of premiums calculated by the

30  department division for self-insured employers are the basis

31  for computing the amount to be assessed. When reporting


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  1  deductible policy premium for purposes of computing

  2  assessments levied after July 1, 2001, full policy premium

  3  value must be reported prior to application of deductible

  4  discounts or credits. This amount may be assessed as a

  5  specific amount or as a percentage of net premiums payable as

  6  the department division may direct, provided such amount so

  7  assessed shall not exceed 2.75 percent, beginning January 1,

  8  2001, except during the interim period from July 1, 2000,

  9  through December 31, 2000, such assessments shall not exceed 4

10  percent of such net premiums.  The carriers may elect to make

11  the payments required under s. 440.15(1)(f) rather than having

12  these payments made by the department division.  In that

13  event, such payments will be credited to the carriers, and the

14  amount due by the carrier under this section will be reduced

15  accordingly.

16         (2)  The department division shall provide by

17  regulation for the collection of the amounts assessed against

18  each carrier.  Such amounts shall be paid within 30 days from

19  the date that notice is served upon such carrier.  If such

20  amounts are not paid within such period, there may be assessed

21  for each 30 days the amount so assessed remains unpaid, a

22  civil penalty equal to 10 percent of the amount so unpaid,

23  which shall be collected at the same time and a part of the

24  amount assessed. For those carriers who excluded ceded

25  reinsurance premiums from their assessments prior to January

26  1, 2000, the department division shall not recover any past

27  underpayments of assessments related to ceded reinsurance

28  premiums prior to January 1, 2001, against such carriers.

29         (3)  If any carrier fails to pay the amounts assessed

30  against him or her under the provisions of this section within

31  60 days from the time such notice is served upon him or her,


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  1  the department of Insurance upon being advised by the division

  2  may suspend or revoke the authorization to insure compensation

  3  in accordance with the procedure in s. 440.38(3)(a). The

  4  department division may permit a carrier to remit any

  5  underpayment of assessments for assessments levied after

  6  January 1, 2001.

  7         (4)  All amounts collected under the provisions of this

  8  section shall be paid into the fund established in s. 440.50.

  9         (5)  Any amount so assessed against and paid by an

10  insurance carrier, self-insurer authorized pursuant to s.

11  624.4621, or commercial self-insurance fund authorized under

12  ss. 624.460-624.488 shall be allowed as a deduction against

13  the amount of any other tax levied by the state upon the

14  premiums, assessments, or deposits for workers' compensation

15  insurance on contracts or policies of said insurance carrier,

16  self-insurer, or commercial self-insurance fund. Any insurance

17  carrier claiming such a deduction against the amount of any

18  such tax shall not be required to pay any additional

19  retaliatory tax levied pursuant to s. 624.5091 as a result of

20  claiming such deduction. Because deductions under this

21  subsection are available to insurance carriers, s. 624.5091

22  does not limit such deductions in any manner.

23         (6)(a)  The department division may require from each

24  carrier, at such time and in accordance with such regulations

25  as the department division may prescribe, reports in respect

26  to all gross earned premiums and of all payments of

27  compensation made by such carrier during each prior period,

28  and may determine the amounts paid by each carrier and the

29  amounts paid by all carriers during such period.

30         (b)  The Department of Insurance may require from each

31  self-insurer, at such time and in accordance with such


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  1  regulations as the Department of Insurance prescribes, reports

  2  in respect to wages paid, the amount of premiums such

  3  self-insurer would have to pay if insured, and all payments of

  4  compensation made by such self-insurer during each prior

  5  period, and may determine the amounts paid by each

  6  self-insurer and the amounts paid by all self-insurers during

  7  such period. For the purposes of this section, the payroll

  8  records of each self-insurer shall be open to annual

  9  inspection and audit by the Department of Insurance or its

10  authorized representative, during regular business hours; and

11  if any audit of such records of a self-insurer discloses a

12  deficiency in the amounts reported to the Department of

13  Insurance or in the amounts paid to the Department of

14  Insurance by a self-insurer pursuant to this section, the

15  Department of Insurance may assess the cost of such audit

16  against the self-insurer.

17         (7)  The department division shall keep accumulated

18  cost records of all injuries occurring within the state coming

19  within the purview of this chapter on a policy and

20  calendar-year basis.  For the purpose of this chapter, a

21  "calendar year" is defined as the year in which the injury is

22  reported to the department division; "policy year" is defined

23  as that calendar year in which the policy becomes effective,

24  and the losses under such policy shall be chargeable against

25  the policy year so defined.

26         (8)  The department division shall assign an account

27  number to each employer under this chapter and an account

28  number to each insurance carrier authorized to write workers'

29  compensation insurance in the state; and it shall be the duty

30  of the department division under the account number so

31  assigned to keep the cost experience of each carrier and the


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  1  cost experience of each employer under the account number so

  2  assigned by calendar and policy year, as above defined.

  3         (9)  In addition to the above, it shall be the duty of

  4  the department division to keep the accident experience, as

  5  classified by the department division, by industry as follows:

  6         (a)  Cause of the injury;

  7         (b)  Nature of the injury; and

  8         (c)  Type of disability.

  9         (10)  In every case where the duration of disability

10  exceeds 30 days, the carrier shall establish a sufficient

11  reserve to pay all benefits to which the injured employee, or

12  in case of death, his or her dependents, may be entitled to

13  under the law.  In establishing the reserve, consideration

14  shall be given to the nature of the injury, the probable

15  period of disability, and the estimated cost of medical

16  benefits.

17         (11)  The department division shall furnish to any

18  employer or carrier, upon request, its individual experience.

19  The division shall furnish to the Department of Insurance,

20  upon request, the Florida experience as developed under

21  accident year or calendar year.

22         (12)  In addition to any other penalties provided by

23  this law, the failure to submit any report or other

24  information required by this law shall be just cause to

25  suspend the right of a self-insurer to operate as such, or,

26  upon certification by the division to the Department of

27  Insurance that a carrier has failed or refused to furnish such

28  reports, shall be just cause for the department of Insurance

29  to suspend or revoke the license of such carrier.

30         (13)  As used in s. 440.50 and this section, the term:

31


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  1         (a)  "Plan" means the workers' compensation joint

  2  underwriting plan provided for in s. 627.311(4).

  3         (b)  "Fixed administrative expenses" means the expenses

  4  of the plan, not to exceed $750,000, which are directly

  5  related to the plan's administration but which do not vary in

  6  direct relationship to the amount of premium written by the

  7  plan and which do not include loss adjustment premiums.

  8         (14)  Before July 1 in each year, the plan shall notify

  9  the department division of the amount of the plan's gross

10  written premiums for the preceding calendar year. Whenever the

11  plan's gross written premiums reported to the department

12  division are less than $30 million, the department division

13  shall transfer to the plan, subject to appropriation by the

14  Legislature, an amount not to exceed the plan's fixed

15  administrative expenses for the preceding calendar year.

16         Section 51.  Subsections (1) and (3) of section 440.52,

17  Florida Statutes, are amended to read:

18         440.52  Registration of insurance carriers; notice of

19  cancellation or expiration of policy; suspension or revocation

20  of authority.--

21         (1)  Each insurance carrier who desires to write such

22  compensation insurance in compliance with this chapter shall

23  be required, before writing such insurance, to register with

24  the department division and pay a registration fee of $100.

25  This shall be deposited by the department division in the fund

26  created by s. 440.50.

27         (3)  If the department division finds, after due notice

28  and a hearing at which the insurance carrier is entitled to be

29  heard in person or by counsel and present evidence, that the

30  insurance carrier has repeatedly failed to comply with its

31  obligations under this chapter, the department division may


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  1  request the Department of Insurance to suspend or revoke the

  2  authorization of such insurance carrier to write workers'

  3  compensation insurance under this chapter.  Such suspension or

  4  revocation shall not affect the liability of any such

  5  insurance carrier under policies in force prior to the

  6  suspension or revocation.

  7         Section 52.  Section 440.525, Florida Statutes, is

  8  amended to read:

  9         440.525  Examination of carriers.--Beginning July 1,

10  1994, The Division of Workers' Compensation of the department

11  of Labor and Employment Security may examine each carrier as

12  often as is warranted to ensure that carriers are fulfilling

13  their obligations under the law, and shall examine each

14  carrier not less frequently than once every 3 years. The

15  examination must cover the preceding 3 fiscal years of the

16  carrier's operations and must commence within 12 months after

17  the end of the most recent fiscal year being covered by the

18  examination. The examination may cover any period of the

19  carrier's operations since the last previous examination.

20         Section 53.  Section 440.572, Florida Statutes, is

21  amended to read:

22         440.572  Authorization for individual self-insurer to

23  provide coverage.--An individual self-insurer having a net

24  worth of not less than $250 million as authorized by s.

25  440.38(1)(f) may assume by contract the liabilities under this

26  chapter of contractors and subcontractors, or each of them,

27  employed by or on behalf of such individual self-insurer when

28  performing work on or adjacent to property owned or used by

29  the individual self-insurer by the department division. The

30  net worth of the individual self-insurer shall include the

31  assets of the self-insurer's parent company and its


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  1  subsidiaries, sister companies, affiliated companies, and

  2  other related entities, located within the geographic

  3  boundaries of the state.

  4         Section 54.  Section 440.59, Florida Statutes, is

  5  amended to read:

  6         440.59  Reporting requirements.--

  7         (1)  The department shall annually prepare a report of

  8  the administration of this chapter for the preceding calendar

  9  year, including a detailed statement of the receipts of and

10  expenditures from the fund established in s. 440.50 and a

11  statement of the causes of the accidents leading to the

12  injuries for which the awards were made, together with such

13  recommendations as the department considers advisable. On or

14  before September 15 of each year, the department shall submit

15  a copy of the report to the Governor, the President of the

16  Senate, the Speaker of the House of Representatives, the

17  Democratic and Republican Leaders of the Senate and the House

18  of Representatives, and the chairs of the legislative

19  committees having jurisdiction over workers' compensation.

20         (2)  The division shall annually prepare a closed claim

21  report for all claims for which the employee lost more than 7

22  days from work and shall submit a copy of the report to the

23  Governor, the President of the Senate, the Speaker of the

24  House of Representatives, the Democratic and Republican

25  Leaders of the Senate and the House of Representatives, and

26  the chairs of the legislative committees having jurisdiction

27  over workers' compensation on or before September 15 of each

28  year. The closed claim report shall include, but not be

29  limited to, an analysis of all claims closed during the

30  preceding year as to the date of accident, age of the injured

31  employee, occupation of the injured employee, type of injury,


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  1  body part affected, type and duration of indemnity benefits

  2  paid, permanent impairment rating, medical benefits identified

  3  by type of health care provider, and type and cost of any

  4  rehabilitation benefits provided.

  5         (3)  The division shall prepare an annual report for

  6  all claims for which the employee lost more than 7 days from

  7  work and shall submit a copy of the report to the Governor,

  8  the President of the Senate, the Speaker of the House of

  9  Representatives, the Democratic and Republican Leaders of the

10  Senate and the House of Representatives, and the chairs of the

11  legislative committees having jurisdiction over workers'

12  compensation, on or before September 15 of each year. The

13  annual report shall include a status report on all cases

14  involving work-related injuries in the previous 10 years. The

15  annual report shall include, but not be limited to, the number

16  of open and closed cases, the number of cases receiving

17  various types of benefits, and the cash and medical benefits

18  paid between the date of injury and the evaluation date in

19  each case.

20         Section 55.  Section 440.591, Florida Statutes, is

21  amended to read:

22         440.591  Administrative procedure; rulemaking

23  authority.--The department, the agency, and the Department of

24  Education may division has authority to adopt rules pursuant

25  to ss. 120.536(1) and 120.54 to implement the provisions of

26  this chapter conferring duties upon it.

27         Section 56.  Section 440.593, Florida Statutes, is

28  amended to read:

29         440.593  Electronic reporting.--

30         (1)  The department division may establish an

31  electronic reporting system requiring or authorizing an


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  1  employer or carrier to submit required forms, reports, or

  2  other information electronically rather than by other means.

  3  The department division may establish different deadlines for

  4  submitting forms, reports, or information to the department

  5  division, or to its authorized agent, via the electronic

  6  reporting system than are otherwise required when reporting

  7  information by other means.

  8         (2)  The department division may require any carrier to

  9  submit data electronically, either directly or through a

10  third-party vendor, and may require any carrier or vendor

11  submitting data to the department division electronically to

12  be certified by the department division.  The department

13  division may specify performance requirements for any carrier

14  or vendor submitting data electronically.

15         (3)  The department division may revoke the

16  certification of any carrier or vendor determined by the

17  department division to be in noncompliance with performance

18  standards prescribed by rule for electronic submissions.

19         (4)  The department division may assess a civil

20  penalty, not to exceed $500 for each violation, as prescribed

21  by rule.

22         (5)  The department may division is authorized to adopt

23  rules to administer this section.

24         Section 57.  Subsections (1), (4), and (5) of section

25  443.012, Florida Statutes, are amended to read:

26         443.012  Unemployment Appeals Commission.--

27         (1)  There is created within the Agency for Workforce

28  Innovation Department of Labor and Employment Security an

29  Unemployment Appeals Commission, hereinafter referred to as

30  the "commission."  The commission shall consist of a chair and

31  two other members to be appointed by the Governor, subject to


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  1  confirmation by the Senate.  Not more than one appointee must

  2  be a person who, on account of previous vocation, employment,

  3  or affiliation, is classified as a representative of

  4  employers; and not more than one such appointee must be a

  5  person who, on account of previous vocation, employment, or

  6  affiliation, is classified as a representative of employees.

  7         (a)  The chair shall devote his or her entire time to

  8  commission duties and shall be responsible for the

  9  administrative functions of the commission.

10         (b)  The chair shall have the authority to appoint a

11  general counsel and such other personnel as may be necessary

12  to carry out the duties and responsibilities of the

13  commission.

14         (c)  The chair shall have the qualifications required

15  by law for a judge of the circuit court and shall not engage

16  in any other business vocation or employment. Notwithstanding

17  any other provisions of existing law, the chair shall be paid

18  a salary equal to that paid under state law to a judge of the

19  circuit court.

20         (d)  The remaining members shall be paid a stipend of

21  $100 for each day they are engaged in the work of the

22  commission.  The chair and other members shall also be

23  reimbursed for travel expenses, as provided in s. 112.061.

24         (e)  The total salary and travel expenses of each

25  member of the commission shall be paid from the Employment

26  Security Administration Trust Fund.

27         (4)  The property, personnel, and appropriations

28  relating to the specified authority, powers, duties, and

29  responsibilities of the commission shall be provided to the

30  commission by the Agency for Workforce Innovation Department

31  of Labor and Employment Security.


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  1         (5)  The commission shall not be subject to control,

  2  supervision, or direction by the Agency for Workforce

  3  Innovation Department of Labor and Employment Security in the

  4  performance of its powers and duties under this chapter.

  5         Section 58.  Subsection (12) of section 443.036,

  6  Florida Statutes, is amended to read:

  7         443.036  Definitions.--As used in this chapter, unless

  8  the context clearly requires otherwise:

  9         (12)  COMMISSION.--"Commission" means the Unemployment

10  Appeals Commission of the Department of Labor and Employment

11  Security.

12         Section 59.  Subsection (3) of section 447.02, Florida

13  Statutes, is amended to read:

14         447.02  Definitions.--The following terms, when used in

15  this chapter, shall have the meanings ascribed to them in this

16  section:

17         (3)  The term "department" means the Department of

18  Business and Professional Regulation Labor and Employment

19  Security.

20         Section 60.  Subsection (4) of section 447.305, Florida

21  Statutes, is amended to read:

22         447.305  Registration of employee organization.--

23         (4)  Notification of registrations and renewals of

24  registration shall be furnished at regular intervals by the

25  commission to the Department of Business and Professional

26  Regulation Labor and Employment Security.

27         Section 61.  Subsection (4) of section 450.012, Florida

28  Statutes, is amended to read:

29         450.012  Definitions.--For the purpose of this chapter,

30  the word, phrase, or term:

31


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  1         (4)  "Department" means the Department of Business and

  2  Professional Regulation Labor and Employment Security.

  3         Section 62.  Paragraph (j) of subsection (1) of section

  4  450.191, Florida Statutes, is amended to read:

  5         450.191  Executive Office of the Governor; powers and

  6  duties.--

  7         (1)  The Executive Office of the Governor is authorized

  8  and directed to:

  9         (j)  Cooperate with the farm labor office of the

10  Department of Business and Professional Regulation Labor and

11  Employment Security in the recruitment and referral of migrant

12  laborers and other persons for the planting, cultivation, and

13  harvesting of agricultural crops in Florida.

14         Section 63.  Subsection (2) of section 450.28, Florida

15  Statutes, is amended to read:

16         450.28  Definitions.--

17         (2)  "Department" means the Department of Business and

18  Professional Regulation Labor and Employment Security.

19         Section 64.  Subsections (1) and (5) of section

20  624.3161, Florida Statutes, are amended to read:

21         624.3161  Market conduct examinations.--

22         (1)  As often as it deems necessary, the department

23  shall examine each licensed rating organization, each advisory

24  organization, each group, association, carrier, as defined in

25  s. 440.02, or other organization of insurers which engages in

26  joint underwriting or joint reinsurance, and each authorized

27  insurer transacting in this state any class of insurance to

28  which the provisions of chapter 627 are applicable.  The

29  examination shall be for the purpose of ascertaining

30  compliance by the person examined with the applicable

31  provisions of chapters 440, 624, 626, 627, and 635.


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  1         (5)  Such examinations shall also be subject to the

  2  applicable provisions of chapter 440 and ss. 624.318, 624.319,

  3  624.321, and 624.322.

  4         Section 65.  Paragraph (m) of subsection (1) of section

  5  626.88, Florida Statutes, is amended to read:

  6         626.88  Definitions of "administrator" and "insurer".--

  7         (1)  For the purposes of this part, an "administrator"

  8  is any person who directly or indirectly solicits or effects

  9  coverage of, collects charges or premiums from, or adjusts or

10  settles claims on residents of this state in connection with

11  authorized commercial self-insurance funds or with insured or

12  self-insured programs which provide life or health insurance

13  coverage or coverage of any other expenses described in s.

14  624.33(1), other than any of the following persons:

15         (m)  A person approved by the Division of Workers'

16  Compensation of the Department of Insurance Labor and

17  Employment Security who administers only self-insured workers'

18  compensation plans.

19         Section 66.  Subsection (9) of section 626.989, Florida

20  Statutes, is amended to read:

21         626.989  Investigation by department or Division of

22  Insurance Fraud; compliance; immunity; confidential

23  information; reports to division; division investigator's

24  power of arrest.--

25         (9)  In recognition of the complementary roles of

26  investigating instances of workers' compensation fraud and

27  enforcing compliance with the workers' compensation coverage

28  requirements under chapter 440, the Division of Insurance

29  Fraud of the Department of Insurance is and the Division of

30  Workers' Compensation of the Department of Labor and

31  Employment Security are directed to prepare and submit a joint


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  1  performance report to the President of the Senate and the

  2  Speaker of the House of Representatives by November 1, 2003 of

  3  each year for each of the next 2 years, and then by November 1

  4  every 3 years thereafter, describing the results obtained in

  5  achieving compliance with the workers' compensation coverage

  6  requirements and reducing the incidence of workers'

  7  compensation fraud.

  8         Section 67.  Section 627.0915, Florida Statutes, is

  9  amended to read:

10         627.0915  Rate filings; workers' compensation,

11  drug-free workplace, and safe employers.--The Department of

12  Insurance shall approve rating plans for workers' compensation

13  insurance that give specific identifiable consideration in the

14  setting of rates to employers that either implement a

15  drug-free workplace program pursuant to rules adopted by the

16  Division of Workers' Compensation of the Department of

17  Insurance Labor and Employment Security or implement a safety

18  program pursuant to provisions of the rating plan or implement

19  both a drug-free workplace program and a safety program. The

20  plans must be actuarially sound and must state the savings

21  anticipated to result from such drug-testing and safety

22  programs.

23         Section 68.  Subsection (3) of section 627.914, Florida

24  Statutes, is amended to read:

25         627.914  Reports of information by workers'

26  compensation insurers required.--

27         (3)  Individual self-insurers as defined in s. 440.02

28  shall report only Florida data as prescribed in paragraphs

29  (2)(a)-(e) to the Division of Workers' Compensation of the

30  department of Labor and Employment Security.

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  1         (a)  The department Division of Workers' Compensation

  2  shall publish the dates and forms necessary to enable

  3  individual self-insurers to comply with this section.

  4         (b)  A statistical or rating organization may be used

  5  by individual self-insurers for the purposes of reporting the

  6  data required by this section and calculating experience

  7  ratings.

  8         Section 69.  Sections 20.171 and 440.4416, Florida

  9  Statutes, are repealed.

10         Section 70.  If any provision of this act or its

11  application to any person or circumstance is held invalid, the

12  invalidity does not affect other provisions or applications of

13  the act which can be given effect without the invalid

14  provision or application, and to this end the provisions of

15  this act are severable.

16         Section 71.  Except as otherwise provided herein, this

17  act shall take effect July 1, 2002.

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