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A bill to be entitled |
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An act relating to workers' compensation; amending s. |
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440.02, F.S.; revising and adding definitions; amending s. |
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440.021, F.S.; correcting a cross reference; creating s. |
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440.115, F.S.; providing for employer's and carrier's |
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responsibilities for production of documents; requiring a |
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written explanation if benefits are denied; amending s. |
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440.125, F.S.; providing for waiver of employee |
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confidentiality with regard to medical records and reports |
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under certain circumstances; requiring the employee to |
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complete a prior injury questionnaire; amending s. 440.13, |
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F.S.; requiring certain medical reports to include |
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specified information; providing conditions for |
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independent medical examinations; providing for claims and |
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termination or suspension of claims for medical benefits |
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in compensability admitted cases; providing for requests |
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for authorization of medical treatment or testing in such |
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cases; providing procedures and sanctions when an |
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employees fails or refuses to attend a medical |
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appointment; creating s. 440.131, F.S.; transferring |
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provisions relating to utilization review, utilization |
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reimbursement disputes, and overutilization from s. |
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440.13, F.S., to s. 440.131, F.S.; creating s. 440.1312, |
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F.S.; transferring provisions relating to audits by and |
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jurisdiction of the Agency for Health Care Administration |
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and Department of Insurance from s. 440.13, F.S., to s. |
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440.1312, F.S.; creating s. 440.1313, F.S.; transferring |
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provisions relating to the three-member panel, maximum |
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reimbursement, physician removal, and payment of medical |
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fees from s. 440.13, F.S., to s. 440.1313, F.S.; revising |
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membership of panel to include the Chief Financial |
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Officer; creating s. 440.1314, F.S.; transferring |
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provisions relating to practice parameters from s. 440.13, |
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F.S., to s. 440.1314, F.S.; creating s. 440.1315, F.S.; |
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transferring provisions relating to attendant care |
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services from s. 440.13, F.S., to s. 440.1315, F.S.; |
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requiring the employee to provide certain information in a |
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petition for benefits; specifying circumstances under |
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which attendant care services may be suspended or |
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terminated and providing for notice thereof; providing for |
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hearings; creating s. 440.145, F.S.; establishing |
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procedures for disputes regarding average weekly wage and |
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corresponding compensation rate; amending s. 440.15, F.S.; |
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revising provisions relating to temporary total disability |
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benefits; providing for notice of termination of benefits |
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and objections thereto; creating s. 440.1501, F.S.; |
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transferring provisions relating to compensation for |
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catastrophic temporary total disability from s. 440.15, |
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F.S., to s. 440.1501, F.S.; providing conditions for |
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suspension or termination of catastrophic temporary total |
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disability benefits and objections thereto; providing for |
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hearings; requiring earned income reports to the |
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Department of Insurance, employer, and carrier; creating |
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s. 440.15015, F.S.; transferring provisions requiring |
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earned income reports to the Department of Insurance, |
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employer, and carrier from s. 440.15, F.S., to s. |
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440.15015, F.S.; creating s. 440.1502, F.S.; transferring |
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provisions relating to compensation for temporary partial |
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disability from s. 440.15, F.S., to s. 440.1502, F.S.; |
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providing conditions for an employee's return to work; |
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providing conditions for termination of temporary partial |
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disability benefits and objections thereto; providing for |
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hearings; creating s. 440.1503, F.S.; transferring |
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provisions relating to compensation for impairment from s. |
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440.15, F.S., to s. 440.1503, F.S.; providing conditions |
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for termination of permanent impairment benefits and |
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objections thereto; providing for hearings; creating s. |
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440.1504, F.S.; transferring provisions relating to |
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supplemental benefits from s. 440.15, F.S., to s. |
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440.1504, F.S.; providing conditions for termination of |
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supplemental benefits and objections thereto; providing |
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for hearings; creating s. 440.1505, F.S.; transferring |
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provisions relating to compensation for permanent total |
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disability from s. 440.15, F.S., to s. 440.1505, F.S.; |
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providing conditions for termination of permanent total |
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disability benefits and objections thereto; providing for |
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hearings; creating s. 440.1506, F.S.; transferring |
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provisions relating to compensation for subsequent injury |
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from s. 440.15, F.S., to s. 440.1506, F.S.; creating s. |
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440.1507, F.S.; transferring provisions relating to |
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eligibility for benefits from s. 440.15, F.S., to s. |
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440.1507, F.S.; requiring an employee who has applied for |
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social security benefits to notify the employer or carrier |
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within a specified time period; creating s. 440.1508, |
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F.S.; transferring provisions relating to repayment of |
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benefits from s. 440.15, F.S., to s. 440.1508, F.S.; |
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providing procedures in circumstances when a |
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miscalculation of benefits is alleged; amending s. 440.16, |
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F.S.; transferring provisions relating to compensation for |
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death from s. 440.25, F.S., to s. 440.16, F.S.; requiring |
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certain information to be provided with a petition for |
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benefits in cases of death; providing conditions for |
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denial of death benefits; providing for hearings; creating |
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s. 440.1855, F.S.; providing circumstances for denial of |
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benefits as a result of the tolling of the statute of |
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limitations; repealing s. 440.191, F.S., relating to the |
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Employee Assistance and Ombudsman Office; creating s. |
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440.1915, F.S.; providing for a stay pending criminal |
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investigation and prosecution of workers' compensation |
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fraud; amending s. 440.192, F.S., relating to procedure |
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for resolving benefit disputes; requiring additional |
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information to be provided in an answer to a petition for |
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benefits; providing for extension of time by which to file |
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an answer; correcting a reference, to conform; creating s. |
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440.1927, F.S.; providing procedures for expedited |
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hearings; providing for mediation conferences; amending s. |
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440.25, F.S.; revising provisions relating to procedures |
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for mediation and hearings; providing for state and |
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private mediation conferences; providing that mediators in |
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state mediation conferences be selected by the Chief Judge |
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of Compensation Claims; providing for pretrial hearings; |
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providing for consolidation of specified petitions for |
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benefits; creating s. 440.255, F.S.; transferring |
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provisions relating to procedures for appeals from s. |
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440.25, F.S., to s. 440.255, F.S.; amending s. 440.28, |
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F.S.; requiring an application for modification of an |
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order to include information specified in s. 440.192(2), |
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F.S., relating to a petition for benefits; amending s. |
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440.29, F.S.; providing sanctions for failure to comply |
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with the provisions of said section; creating s. 440.291, |
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F.S.; providing procedures relating to discovery; creating |
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s. 440.292, F.S.; providing for motions; creating s. |
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440.293, F.S.; providing for agreements and stipulations; |
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creating s. 440.295, F.S.; providing for summary judgment; |
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amending s. 440.42, F.S.; providing procedures for |
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resolving disputes between carriers; amending s. 440.442, |
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F.S.; providing for applicability of the Code of Judicial |
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Conduct to the Chief Judge of Compensation Claims and |
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deleting references to the Deputy Chief Judge of |
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Compensation Claims; amending s. 440.45, F.S.; |
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reorganizing the Office of the Judges of Compensation |
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Claims to provide for expiration of the term of the Deputy |
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Chief Judge and the creation of the position of Chief |
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Judge; requiring the Chief Judge to report to the |
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Secretary of Management Services; removing an exception |
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regarding who may serve on the nominating commission; |
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providing responsibilities of The Florida Bar with regard |
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to the conduct of the Chief Judge; requiring The Florida |
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Bar Rules Committee to promulgate the Workers' |
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Compensation Rules of Procedure; requiring a report; |
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amending s. 440.491, F.S.; providing conditions for |
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additional rehabilitation temporary total disability |
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benefits, denial of said benefits, and objections thereto; |
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providing for hearings; amending ss. 112.3145, 120.65, |
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121.055, 216.251, 440.105, 440.134, 440.14, 440.20, |
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440.207, 440.29, 440.44, 440.47, 440.49, 440.50, 440.51, |
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631.929, 946.523, 948.03, 960.13, 985.21, 985.231, and |
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985.315, F.S.; conforming references to changes made by |
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the act; providing an effective date. |
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Be It Enacted by the Legislature of the State of Florida: |
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Section 1. Paragraph (b) of subsection (35) of section |
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440.02, Florida Statutes, is amended, and subsection (43) is |
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added to said section, to read: |
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440.02 Definitions.--When used in this chapter, unless the |
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context clearly requires otherwise, the following terms shall |
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have the following meanings: |
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(35) "Insolvency" or "insolvent" means: |
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(b) With respect to an employee claiming insolvency |
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pursuant to s. 440.255s. 440.25(5), a person is insolvent who: |
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1. Has ceased to pay his or her debts in the ordinary |
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course of business and cannot pay his or her debts as they |
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become due; or |
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2. Has been adjudicated insolvent pursuant to the federal |
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bankruptcy law. |
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(43) "Certificate of mailing" means United States Postal |
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Service form number 3817.
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Section 2. Section 440.021, Florida Statutes, is amended |
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to read: |
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440.021 Exemption of workers' compensation from chapter |
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120.--Workers' compensation adjudications by judges of |
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compensation claims are exempt from chapter 120, and no judge of |
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compensation claims shall be considered an agency or a part |
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thereof. Communications of the result of investigations by the |
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department pursuant to s. 440.185(4) are exempt from chapter |
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120. In all instances in which the department institutes action |
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to collect a penalty or interest which may be due pursuant to |
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this chapter, the penalty or interest shall be assessed without |
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hearing, and the party against which such penalty or interest is |
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assessed shall be given written notice of such assessment and |
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shall have the right to protest within 20 days of such notice. |
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Upon receipt of a timely notice of protest and after such |
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investigation as may be necessary, the department shall, if it |
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agrees with such protest, notify the protesting party that the |
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assessment has been revoked. If the department does not agree |
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with the protest, it shall refer the matter to the judge of |
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compensation claims for determination pursuant to s. 440.25(2)- |
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(5). Such action of the department is exempt from the provisions |
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of chapter 120. |
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Section 3. Section 440.115, Florida Statutes, is created |
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to read: |
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440.115 Responsibility for continuing production of |
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documents.--
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(1) The employer and carrier shall each serve on the |
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employee, and the employee shall serve on the employer and |
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carrier, or their respective representatives, if any, the |
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information specified in paragraphs (a)-(i) within 7 days after |
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its receipt, or within 7 days after receipt of a written request |
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by certificate of mailing:
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(a) The first report of injury.
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(b) A 13-week wage statement, including any fringe benefit |
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and seasonal employment information.
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(c) Payout, excluding work product information, |
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investigative information, and payment of attorney's fees.
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(d) Medical reports or information received from any |
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source.
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(e) Social security information.
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(f) All offers of employment together with corresponding |
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job descriptions.
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(g) Vocational reports.
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(h) A copy of any statement made or given by the employee.
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(i) Post injury earnings on a biweekly basis through the |
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date of maximum medical improvement.
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(2) An insurer shall provide to the employee or his or her |
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representative, if any:
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(a) At the time of denial, a written statement of the |
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reasons that a claim is being denied with all supporting |
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documents in its possession or in the possession of its |
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representative, excluding work product and privileged material, |
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and including, but not limited to, medical reports, vocational |
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reports, or other material relevant to the denial. Any party’s |
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failure to comply with the requirements of this paragraph shall |
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bar the use of such documents in its possession or the |
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possession of its representative at any final hearing.
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(b) If the employer or carrier denies that an injury |
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occurred during the course and scope of employment or determines |
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that the employee falsified his or her employment application, |
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the employer or carrier shall furnish all pertinent records, |
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medical records, and documentation relating to the denial at the |
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time of the denial. The employer's or carrier’s failure to |
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comply with the requirements of this paragraph shall bar the use |
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of the supporting documents at any final hearing.
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(c) Whenever benefits requested by an employee are denied, |
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suspended, or terminated, a written explanation of the |
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employee’s rights and responsibilities, including the right to a |
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hearing, shall be sent simultaneously to the employee by |
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certificate of mailing. |
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(d) A party who has responded to a request for discovery |
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with a response that was complete when made is under a |
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continuing duty to supplement the response to include |
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information thereafter acquired. If, subsequent to compliance |
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with this chapter and the rules of procedure governing |
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discovery, a party discovers additional witnesses or material |
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that the party would have been under a duty to disclose or |
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produce at the time of the previous compliance, the party shall |
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promptly disclose or produce the witnesses or material in the |
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same manner as required under this chapter and the rules |
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governing discovery.
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Section 4. Section 440.125, Florida Statutes, is amended |
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to read: |
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440.125 Medical records and reports; identifying |
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information in employee medical bills; confidentiality.-- |
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(1)Any medical records and medical reports of an injured |
255
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employee and any information identifying an injured employee in |
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medical bills which are provided to the department, pursuant to |
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s. 440.13, are confidential and exempt from the provisions of s. |
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119.07(1) and s. 24(a), Art. I of the State Constitution, except |
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as otherwise provided by this chapter. The department may share |
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any such confidential and exempt records, reports, or |
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information received pursuant to s. 440.13 with the Agency for |
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Health Care Administration and the Department of Education in |
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furtherance of their official duties under ss. 440.13 and |
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440.134. The agency and the department shall maintain the |
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confidential and exempt status of such records, reports, and |
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information received. |
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(2) When an employee has submitted a claim for workers’ |
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compensation benefits or is receiving indemnity or medical |
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benefits:
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(a) The employee shall have waived any privilege of |
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confidentiality concerning any medical records and reports, |
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evaluations, bills, nonprivileged communications related to the |
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claim, or treatment for any similar condition that the employee |
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has received with any physician and health care provider, |
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including, but not limited to, communications with psychiatrists |
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or psychologists. Notwithstanding any other provision of law to |
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the contrary, when requested by the employer, carrier, or |
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employee, a health care provider and physician shall provide |
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within a reasonable time period and for a reasonable charge all |
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information and records in his or her possession relating to any |
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such examination, treatment, testing, or consultation concerning |
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the employee.
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(b) The employee shall provide the employer or carrier |
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with a signed release for all medical records and information |
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related to the claim and the history and treatment of the injury |
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arising from the incident, including information related to the |
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treatment of any mental condition or drug or alcohol abuse. The |
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release shall designate the provider and shall state that the |
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release shall expire no less than 1 year after the date the |
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release is signed. If the employer or carrier requests a release |
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of medical information, the employee must sign and return the |
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release to the employer or carrier by certificate of mailing |
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within 30 days after the employer or carrier requests the |
294
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information. If the employee refuses to provide a signed release |
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for medical information:
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1. Any compensation or medical benefits being received by |
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the employee shall be suspended and no hearing on compensation |
298
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or medical benefits shall be scheduled until such signed release |
299
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is provided. The disclosure applies to all medical information |
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relevant to the prosecution or defense of any claim for |
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compensation and medical benefits.
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2. The employee may request a hearing before the judge of |
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compensation claims who shall determine whether this information |
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will lead to discovery of admissible evidence and enter an order |
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accordingly.
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(c) The employee shall complete a sworn prior injury |
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questionnaire. If the employee refuses to provide a signed prior |
308
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injury questionnaire, as required by this section, any |
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compensation or medical benefits being received by the employee |
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shall be suspended and no hearing on compensation or medical |
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benefits shall be scheduled until such signed form is provided. |
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If the employee refuses to complete and provide the employer or |
313
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carrier with a prior injury questionnaire, the employee may |
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request a hearing before the judge of compensation claims who |
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shall determine whether this information will lead to discovery |
316
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of admissible evidence and enter an order accordingly.
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Section 5. Paragraphs (d), (e), and (f) of subsection (2), |
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paragraph (f) of subsection (3), and subsection (4) of section |
319
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440.13, Florida Statutes, are amended, present subsection (5) is |
320
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renumbered as subsection (8) and amended, present subsections |
321
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(9) and (10) are renumbered as subsections (10) and (11), |
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respectively, and new subsections (5), (6), (7), and (9) are |
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added to said section, to read: |
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440.13 Medical services and supplies; penalty for |
325
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violations; limitations.-- |
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(2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.-- |
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(b)(d)The carrier has the right to transfer the care of |
328
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an injured employee from the attending health care provider if |
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an independent medical examination determines that the employee |
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is not making appropriate progress in recuperation. |
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(c)(e)Except in emergency situations and for treatment |
332
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rendered by a managed care arrangement, after any initial |
333
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examination and diagnosis by a physician providing remedial |
334
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treatment, care, and attendance, and before a proposed course of |
335
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medical treatment begins, each insurer shall review, in |
336
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accordance with the requirements of this chapter, the proposed |
337
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course of treatment, to determine whether such treatment would |
338
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be recognized as reasonably prudent. The review must be in |
339
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accordance with all applicable workers' compensation practice |
340
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parameters. The insurer must accept any such proposed course of |
341
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treatment unless the insurer notifies the physician of its |
342
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specific objections to the proposed course of treatment by the |
343
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close of the tenth business day after notification by the |
344
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physician, or a supervised designee of the physician, of the |
345
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proposed course of treatment. |
346
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(d)(f)Upon the written request of the employee, the |
347
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carrier shall give the employee the opportunity for one change |
348
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of physician during the course of treatment for any one |
349
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accident. The employee shall be entitled to select another |
350
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physician from among not fewer than three carrier-authorized |
351
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physicians who are not professionally affiliated. |
352
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(3) PROVIDER ELIGIBILITY; AUTHORIZATION.-- |
353
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(f) By accepting payment under this chapter for treatment |
354
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rendered to an injured employee, a health care provider consents |
355
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to the jurisdiction of the agency as set forth in s. 440.1312 |
356
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subsection (11)and to the submission of all records and other |
357
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information concerning such treatment to the agency in |
358
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connection with a reimbursement dispute, audit, or review as |
359
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provided by this section. The health care provider must further |
360
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agree to comply with any decision of the agency rendered under |
361
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this section. |
362
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(4) NOTICE OF TREATMENT TO CARRIER; FILING WITH |
363
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DEPARTMENT.-- |
364
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(a)1.Any health care provider providing necessary |
365
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remedial treatment, care, or attendance to any injured worker |
366
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shall submit treatment reports to the carrier in a format |
367
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prescribed by the department in consultation with the agency. A |
368
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claim for medical or surgical treatment is not valid or |
369
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enforceable against such employer or employee, unless, by the |
370
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close of the third business day following the first treatment, |
371
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the physician providing the treatment furnishes to the employer |
372
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or carrier a preliminary notice of the injury and treatment on |
373
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forms prescribed by the department in consultation with the |
374
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agency and, within 15 days thereafter, furnishes to the employer |
375
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or carrier a complete report, and subsequent thereto furnishes |
376
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progress reports, if requested by the employer or insurance |
377
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carrier, at intervals of not less than 3 weeks apart or at less |
378
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frequent intervals if requested on forms prescribed by the |
379
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department in consultation with the agency. |
380
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2. All narrative medical reports shall include the |
381
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following information unless the physician accurately and |
382
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completely fills out a physician's report which shall include |
383
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the following information, if not previously provided:
|
384
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a. A complete history, including all prior injuries and |
385
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conditions, and a detailed description of the present injury.
|
386
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b. A list of the complaints of the claimant.
|
387
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c. The physician's examination findings, including a |
388
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description of the examination and interpretation or summary of |
389
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any other diagnostic tests.
|
390
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d. The date and cause of the alleged injury and whether, |
391
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in the physician's opinion, the claimant's accident and injuries |
392
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are causally related to the employee's employment with the |
393
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employer, and whether such employment with the employer is the |
394
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major contributing cause of the employee's accident and |
395
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injuries.
|
396
|
e. The period during which the claimant is unable to work.
|
397
|
f. Whether the claimant is capable of returning to work |
398
|
and, if so, what physical restrictions and limitations shall be |
399
|
imposed on the claimant, either temporarily or permanently, by |
400
|
completing the Doctor’s Estimate of Physical Capabilities form.
|
401
|
g. Whether the claimant has reached maximum medical |
402
|
improvement.
|
403
|
h. Whether the claimant is able to return to the job held |
404
|
as of the date of the accident or is a candidate for vocational |
405
|
rehabilitation.
|
406
|
i. Whether the claimant is in need of continuing medical |
407
|
care and, if so, the nature and extent of such medical care.
|
408
|
j. The nature and extent of any permanent impairment to |
409
|
the employee’s body as a whole in accordance with the Florida |
410
|
Impairment Rating Guide, including factors upon which the |
411
|
physician’s evaluation of permanent impairment is based.
|
412
|
k. A written declaration made under penalty of perjury |
413
|
that the report is a complete, true, and correct copy of the |
414
|
medical records of the claimant as kept by the physician in the |
415
|
regular course of the physician’s medical practice.
|
416
|
|
417
|
The report required by this subparagraph shall be submitted by |
418
|
mail or electronically and, if the report is not submitted with |
419
|
the bill on the proper Health Care Financing Administration form |
420
|
within the time prescribed, the physician shall not be entitled |
421
|
to payment at the expense of the employer, the carrier, or the |
422
|
employee.
|
423
|
(b) Upon the request of the department or agency, each |
424
|
medical report or bill obtained or received by the employer, the |
425
|
carrier, or the injured employee, or the attorney for the |
426
|
employer, carrier, or injured employee, with respect to the |
427
|
remedial treatment, care, and attendance of the injured |
428
|
employee, including any report of an examination, diagnosis, or |
429
|
disability evaluation, must be filed with the department or |
430
|
agency pursuant to rules adopted by the department in |
431
|
consultation with the agency. The health care provider shall |
432
|
also furnish to the injured employee or to his or her attorney, |
433
|
on demand, a copy of his or her office chart, records, and |
434
|
reports, and may charge the injured employee an amount |
435
|
authorized by the department for the copies. Each such health |
436
|
care provider shall provide to the agency or department |
437
|
information about the remedial treatment, care, and attendance |
438
|
which the agency or department reasonably requests. |
439
|
(c) It is the policy for the administration of the |
440
|
workers' compensation system that there be reasonable access to |
441
|
medical information by all parties to facilitate the self- |
442
|
executing features of the law. Notwithstanding the limitations |
443
|
in s. 456.057 and subject to the limitations in s. 381.004, upon |
444
|
the request of the employer, the carrier, an authorized |
445
|
qualified rehabilitation provider, or the attorney for the |
446
|
employer or carrier, the medical records of an injured employee |
447
|
must be furnished to those persons and the medical condition of |
448
|
the injured employee must be discussed with those persons, if |
449
|
the records and the discussions are restricted to conditions |
450
|
relating to the workplace injury. Any such discussions may be |
451
|
held before or after the filing of a claim without the |
452
|
knowledge, consent, or presence of any other party or his or her |
453
|
agent or representative. A health care provider who willfully |
454
|
refuses to provide medical records or to discuss the medical |
455
|
condition of the injured employee, after a reasonable request is |
456
|
made for such information pursuant to this subsection, shall be |
457
|
subject by the agency to one or more of the penalties set forth |
458
|
in s. 440.131(3)(b)paragraph (8)(b). |
459
|
(5) REQUEST FOR AUTHORIZATION OF MEDICAL BENEFITS BY |
460
|
AUTHORIZED MEDICAL PROVIDER IN COMPENSABILITY ADMITTED CASES.--
|
461
|
(a) A request for authorization of medical benefits shall |
462
|
be accomplished through a Request for Authorization of Medical |
463
|
Benefits by Authorized Medical Provider form sent by the |
464
|
employee to the employer or carrier by certificate of mailing. |
465
|
The employer or carrier shall respond to this request, in |
466
|
writing by certificate of mailing, within 20 days after its |
467
|
receipt by certificate of mailing. A written response to this |
468
|
request shall be sent by the carrier directly to the requesting |
469
|
authorized health care provider with a copy to the employee and |
470
|
employee’s counsel, if any, and shall advise the employee of his |
471
|
or her right to file a petition for benefits in the case of a |
472
|
response to the Request for Authorization of Medical Benefits by |
473
|
Authorized Medical Provider denying the request. The employer's |
474
|
or carrier’s failure to comply with the provisions of this |
475
|
subsection shall result in the waiver of any time period within |
476
|
which the employee must file a petition for benefits on the |
477
|
issue.
|
478
|
(b) The employee shall have 10 days after the date on |
479
|
which the response to a petition for benefits denying the |
480
|
request was mailed to file a petition for benefits. The employee |
481
|
shall complete the petition for benefits and shall state the |
482
|
reasons for the request and include any medical report from the |
483
|
authorized physician requesting authorization for such request. |
484
|
This matter shall be heard on an expedited basis as provided in |
485
|
this section and the employer or carrier shall be deemed to have |
486
|
waived any objection to an expedited hearing.
|
487
|
(6) CLAIM FOR MEDICAL BENEFITS IN COMPENSABILITY ADMITTED |
488
|
CASES.--When the employee claims medical benefits, the employee |
489
|
shall file a petition for benefits for medical benefits which |
490
|
shall include a statement of the benefits in dispute, copies of |
491
|
all medical records based on medical opinions pursuant to |
492
|
paragraph (9)(b) to be offered at trial, and copies of any |
493
|
medical bills, prescriptions, or mileage reimbursement forms in |
494
|
dispute. Copies of said reports shall be sent to the employer |
495
|
and carrier or its representative, if any, no later than 10 days |
496
|
after the date of the filing of the petition for benefits. |
497
|
Failure of the employee to provide all such documentation, which |
498
|
shall constitute the basis for filing the petition for benefits, |
499
|
within 10 days shall result in same being excluded at any trial.
|
500
|
(7) TERMINATION OR SUSPENSION OF MEDICAL BENEFITS IN |
501
|
COMPENSABILITY ADMITTED CLAIMS.--
|
502
|
(a) Before terminating or suspending the provision of |
503
|
medical benefits, the employer or carrier shall give the |
504
|
employee 7 days' written notice by certificate of mailing that |
505
|
medical benefits will be suspended or terminated, shall provide |
506
|
the employee with a copy of any supporting documentation for the |
507
|
denial, and advise the employee of his or her right to request a |
508
|
hearing on the provision of medical benefits by filing a |
509
|
petition for benefits. The employer's or carrier’s failure to |
510
|
comply with these timeframes shall result in the waiver of any |
511
|
time period within which the employee must file a petition for |
512
|
benefits on the issue. The evidence of any investigator, |
513
|
adjuster, or other witness in the nature of surveillance shall |
514
|
be subject to discovery when such evidence will be used at |
515
|
trial, provided the party intending to use such evidence is |
516
|
first given a reasonable opportunity to depose the party or |
517
|
witness who is the subject of the surveillance.
|
518
|
(b) If an employee objects to the termination or |
519
|
suspension of medical benefits, the employee shall have 21 days |
520
|
after the date on which the notice of termination was mailed to |
521
|
object to the termination by filing a petition for benefits for |
522
|
the provision of medical benefits. The claimant shall complete |
523
|
the petition for benefits for the provision of medical benefits |
524
|
and state the specific reason for the objection to the |
525
|
termination or suspension of medical benefits.
|
526
|
(c) If the employee’s objection to the termination or |
527
|
suspension of medical benefits is based on medical opinions |
528
|
pursuant to paragraph (9)(b) and is to be offered at trial, a |
529
|
copy of the record or report containing such medical opinions |
530
|
shall be served on the employer and carrier no later than 15 |
531
|
days after the date on which the petition for benefits was filed |
532
|
objecting to the termination or suspension of medical benefits. |
533
|
If the petition for benefits has been timely filed by the |
534
|
employee and medical reports or records containing medical |
535
|
opinions pursuant to paragraph (9)(b) is served no later than 10 |
536
|
days after the date on which the petition for benefits was filed |
537
|
on the employer or carrier and its counsel, the medical care |
538
|
shall continue until further order of the judge of compensation |
539
|
claims. If the employer or carrier fails to continue the |
540
|
provision of medical care, the petition for benefits shall be |
541
|
set for hearing under the procedure for expedited hearings and |
542
|
the employer or carrier is deemed to waive any objection to said |
543
|
procedure. If the judge of compensation claims awards the |
544
|
medical benefits being claimed, an attorney’s fee shall be due |
545
|
and owing pursuant to s. 440.34 and shall be enhanced by an |
546
|
additional fee of $2,500.
|
547
|
(8)(5)INDEPENDENT MEDICAL EXAMINATIONS.-- |
548
|
(a)1.In any dispute concerning overutilization, medical |
549
|
benefits, compensability, or disability under this chapter, the |
550
|
carrier or the employee may select an independent medical |
551
|
examiner. The examiner may be a health care provider treating or |
552
|
providing other care to the employee. An independent medical |
553
|
examiner may not render an opinion outside his or her area of |
554
|
expertise, as demonstrated by licensure and applicable practice |
555
|
parameters. |
556
|
2. An employee shall request an independent medical |
557
|
examination by filing a Request for an Independent Medical |
558
|
Examination form by certificate of mailing with the carrier, who |
559
|
shall respond in writing to this request within 20 days after |
560
|
its receipt by certificate of mailing. A written response to |
561
|
this request shall be sent by the carrier directly to the |
562
|
employee and the employee’s counsel and shall advise the |
563
|
employee of his or her right to file a petition for benefits in |
564
|
the case of a response to the Request for an Independent Medical |
565
|
Examination denying the request. The carrier's failure to comply |
566
|
with the provisions of this paragraph shall result in a waiver |
567
|
of the time period during which to file a petition for benefits |
568
|
on the issue.
|
569
|
3. The employee shall have 10 days after the date of |
570
|
response to the Request for an Independent Medical Examination |
571
|
denying the request to file a petition for benefits. The |
572
|
employee shall complete the petition for benefits stating the |
573
|
reasons for the Request for an Independent Medical Examination |
574
|
and include any medical report from the authorized physician |
575
|
regarding the issue. This matter shall be heard on an expedited |
576
|
basis as provided in this section and the employer or carrier |
577
|
shall be deemed to have waived any objection to an expedited |
578
|
hearing.
|
579
|
(b) Each party is bound by his or her selection of an |
580
|
independent medical examiner and is entitled to an alternate |
581
|
examiner only if: |
582
|
1. The examiner is not qualified to render an opinion upon |
583
|
an aspect of the employee's illness or injury which is material |
584
|
to the claim or petition for benefits; |
585
|
2. The examiner ceases to practice in the specialty |
586
|
relevant to the employee's condition; |
587
|
3. The examiner is unavailable due to injury, death, or |
588
|
relocation outside a reasonably accessible geographic area; or |
589
|
4. The parties agree to an alternate examiner. |
590
|
|
591
|
Any party may request, or a judge of compensation claims may |
592
|
require, designation of an agency medical advisor as an |
593
|
independent medical examiner. The opinion of the advisors acting |
594
|
as examiners shall not be afforded the presumption set forth in |
595
|
paragraph (10)(c)(9)(c). |
596
|
(c) The carrier may, at its election, contact the claimant |
597
|
directly to schedule a reasonable time for an independent |
598
|
medical examination. The carrier must confirm the scheduling |
599
|
agreement in writing within 5 days and notify claimant's |
600
|
counsel, if any, at least 7 days before the date upon which the |
601
|
independent medical examination is scheduled to occur. An |
602
|
attorney representing a claimant is not authorized to schedule |
603
|
independent medical evaluations under this subsection. |
604
|
(d) If the employee fails to appear for the independent |
605
|
medical examination without good cause and fails to advise the |
606
|
physician at least 24 hours before the scheduled date for the |
607
|
examination that he or she cannot appear, the employee is barred |
608
|
from recovering compensation for any period during which he or |
609
|
she has refused to submit to such examination. Further, the |
610
|
employee shall reimburse the carrier 50 percent of the |
611
|
physician's cancellation or no-show fee unless the carrier that |
612
|
schedules the examination fails to timely provide to the |
613
|
employee a written confirmation of the date of the examination |
614
|
pursuant to paragraph (c) which includes an explanation of why |
615
|
he or she failed to appear. The employee may appeal to a judge |
616
|
of compensation claims for reimbursement when the carrier |
617
|
withholds payment in excess of the authority granted by this |
618
|
section. |
619
|
(9) FAILURE OR REFUSAL TO ATTEND MEDICAL APPOINTMENT.--
|
620
|
(a) If the employee fails or refuses to attend a scheduled |
621
|
medical appointment with an authorized treating physician, the |
622
|
employer or carrier shall reschedule the appointment and provide |
623
|
the employee with at least 7 days' written notice of the |
624
|
rescheduled appointment, including the date and time of the |
625
|
appointment. If the employee fails or refuses to attend a |
626
|
rescheduled appointment, the employee shall be barred from |
627
|
recovering compensation benefits for any period during which he |
628
|
or she has refused to submit to such examination. Upon the |
629
|
employee subsequently attending a rescheduled appointment, he or |
630
|
she shall advise the employer or carrier of such attendance by |
631
|
certificate of mailing and the employer or carrier shall |
632
|
thereupon reinstate benefits within 14 days after receipt, |
633
|
effective upon the date of such attendance. |
634
|
(b)(e)No medical opinion other than the opinion of a |
635
|
medical advisor appointed by the judge of compensation claims or |
636
|
agency, an independent medical examiner, or an authorized |
637
|
treating provider is admissible in proceedings before the judges |
638
|
of compensation claims. |
639
|
(c)(f)Attorney's fees incurred by an injured employee in |
640
|
connection with delay of or opposition to an independent medical |
641
|
examination, including, but not limited to, motions for |
642
|
protective orders, are not recoverable under this chapter. |
643
|
Section 6. Subsections (6), (7), and (8) of section |
644
|
440.13, Florida Statutes, are renumbered as section 440.131, |
645
|
Florida Statutes, and amended to read: |
646
|
440.131 Utilization review; reimbursement disputes; |
647
|
overutilization.--
|
648
|
(1)(6)UTILIZATION REVIEW.--Carriers shall review all |
649
|
bills, invoices, and other claims for payment submitted by |
650
|
health care providers in order to identify overutilization and |
651
|
billing errors, and may hire peer review consultants or conduct |
652
|
independent medical evaluations. Such consultants, including |
653
|
peer review organizations, are immune from liability in the |
654
|
execution of their functions under this subsection to the extent |
655
|
provided in s. 766.101. If a carrier finds that overutilization |
656
|
of medical services or a billing error has occurred, it must |
657
|
disallow or adjust payment for such services or error without |
658
|
order of a judge of compensation claims or the agency, if the |
659
|
carrier, in making its determination, has complied with this |
660
|
section and rules adopted by the agency. |
661
|
(2)(7)UTILIZATION AND REIMBURSEMENT DISPUTES.-- |
662
|
(a) Any health care provider, carrier, or employer who |
663
|
elects to contest the disallowance or adjustment of payment by a |
664
|
carrier under subsection (1)(6)must, within 30 days after |
665
|
receipt of notice of disallowance or adjustment of payment, |
666
|
petition the agency to resolve the dispute. The petitioner must |
667
|
serve a copy of the petition on the carrier and on all affected |
668
|
parties by certified mail. The petition must be accompanied by |
669
|
all documents and records that support the allegations contained |
670
|
in the petition. Failure of a petitioner to submit such |
671
|
documentation to the agency results in dismissal of the |
672
|
petition. |
673
|
(b) The carrier must submit to the agency within 10 days |
674
|
after receipt of the petition all documentation substantiating |
675
|
the carrier's disallowance or adjustment. Failure of the carrier |
676
|
to submit the requested documentation to the agency within 10 |
677
|
days constitutes a waiver of all objections to the petition. |
678
|
(c) Within 60 days after receipt of all documentation, the |
679
|
agency must provide to the petitioner, the carrier, and the |
680
|
affected parties a written determination of whether the carrier |
681
|
properly adjusted or disallowed payment. The agency must be |
682
|
guided by standards and policies set forth in this chapter, |
683
|
including all applicable reimbursement schedules, in rendering |
684
|
its determination. |
685
|
(d) If the agency finds an improper disallowance or |
686
|
improper adjustment of payment by an insurer, the insurer shall |
687
|
reimburse the health care provider, facility, insurer, or |
688
|
employer within 30 days, subject to the penalties provided in |
689
|
this subsection. |
690
|
(e) The agency shall adopt rules to carry out this |
691
|
subsection. The rules may include provisions for consolidating |
692
|
petitions filed by a petitioner and expanding the timetable for |
693
|
rendering a determination upon a consolidated petition. |
694
|
(f) Any carrier that engages in a pattern or practice of |
695
|
arbitrarily or unreasonably disallowing or reducing payments to |
696
|
health care providers may be subject to one or more of the |
697
|
following penalties imposed by the agency: |
698
|
1. Repayment of the appropriate amount to the health care |
699
|
provider. |
700
|
2. An administrative fine assessed by the agency in an |
701
|
amount not to exceed $5,000 per instance of improperly |
702
|
disallowing or reducing payments. |
703
|
3. Award of the health care provider's costs, including a |
704
|
reasonable attorney's fee, for prosecuting the petition. |
705
|
(3)(8)PATTERN OR PRACTICE OF OVERUTILIZATION.-- |
706
|
(a) Carriers must report to the agency all instances of |
707
|
overutilization including, but not limited to, all instances in |
708
|
which the carrier disallows or adjusts payment. The agency shall |
709
|
determine whether a pattern or practice of overutilization |
710
|
exists. |
711
|
(b) If the agency determines that a health care provider |
712
|
has engaged in a pattern or practice of overutilization or a |
713
|
violation of this chapter or rules adopted by the agency, it may |
714
|
impose one or more of the following penalties: |
715
|
1. An order of the agency barring the provider from |
716
|
payment under this chapter; |
717
|
2. Deauthorization of care under review; |
718
|
3. Denial of payment for care rendered in the future; |
719
|
4. Decertification of a health care provider certified as |
720
|
an expert medical advisor under s. 440.13(10)subsection (9)or |
721
|
of a rehabilitation provider certified under s. 440.49; |
722
|
5. An administrative fine assessed by the agency in an |
723
|
amount not to exceed $5,000 per instance of overutilization or |
724
|
violation; and |
725
|
6. Notification of and review by the appropriate licensing |
726
|
authority pursuant to s. 440.106(3). |
727
|
Section 7. Subsection (11) of section 440.13, Florida |
728
|
Statutes, is renumbered as section 440.1312, Florida Statutes, |
729
|
and amended to read: |
730
|
440.1312(11)Audits by Agency for Health Care |
731
|
Administration and the Department of Insurance; jurisdiction.-- |
732
|
(1)(a)The Agency for Health Care Administration may |
733
|
investigate health care providers to determine whether providers |
734
|
are complying with this chapter and with rules adopted by the |
735
|
agency, whether the providers are engaging in overutilization, |
736
|
and whether providers are engaging in improper billing |
737
|
practices. If the agency finds that a health care provider has |
738
|
improperly billed, overutilized, or failed to comply with agency |
739
|
rules or the requirements of this chapter it must notify the |
740
|
provider of its findings and may determine that the health care |
741
|
provider may not receive payment from the carrier or may impose |
742
|
penalties as set forth in s. 440.131(3)subsection (8)or other |
743
|
sections of this chapter. If the health care provider has |
744
|
received payment from a carrier for services that were |
745
|
improperly billed or for overutilization, it must return those |
746
|
payments to the carrier. The agency may assess a penalty not to |
747
|
exceed $500 for each overpayment that is not refunded within 30 |
748
|
days after notification of overpayment by the agency or carrier. |
749
|
(2)(b)The department shall monitor and audit carriers as |
750
|
provided in s. 624.3161, to determine if medical bills are paid |
751
|
in accordance with this section and department rules. Any |
752
|
employer, if self-insured, or carrier found by the division not |
753
|
to be within 90 percent compliance as to the payment of medical |
754
|
bills after July 1, 1994, must be assessed a fine not to exceed |
755
|
1 percent of the prior year's assessment levied against such |
756
|
entity under s. 440.51 for every quarter in which the entity |
757
|
fails to attain 90-percent compliance. The department shall fine |
758
|
or otherwise discipline an employer or carrier, pursuant to this |
759
|
chapter, the insurance code, or rules adopted by the department, |
760
|
for each late payment of compensation that is below the minimum |
761
|
90-percent performance standard. Any carrier that is found to be |
762
|
not in compliance in subsequent consecutive quarters must |
763
|
implement a medical-bill review program approved by the |
764
|
division, and the carrier is subject to disciplinary action by |
765
|
the Department of Insurance. |
766
|
(3)(c)The agency has exclusive jurisdiction to decide any |
767
|
matters concerning reimbursement, to resolve any overutilization |
768
|
dispute under s. 440.131(2)subsection (7), and to decide any |
769
|
question concerning overutilization under s. 440.131(3) |
770
|
subsection (8), which question or dispute arises after January |
771
|
1, 1994. |
772
|
(4)(d)The following agency actions do not constitute |
773
|
agency action subject to review under ss. 120.569 and 120.57 and |
774
|
do not constitute actions subject to s. 120.56: referral by the |
775
|
entity responsible for utilization review; a decision by the |
776
|
agency to refer a matter to a peer review committee; |
777
|
establishment by a health care provider or entity of procedures |
778
|
by which a peer review committee reviews the rendering of health |
779
|
care services; and the review proceedings, report, and |
780
|
recommendation of the peer review committee. |
781
|
Section 8. Subsections (12), (13), and (14) of section |
782
|
440.13, Florida Statutes, are renumbered as section 440.1313, |
783
|
Florida Statutes, and amended to read: |
784
|
440.1313 Panel; maximum reimbursement; physician removal; |
785
|
payment of medical fees.--
|
786
|
(1)(12)CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM |
787
|
REIMBURSEMENT ALLOWANCES.-- |
788
|
(a) A three-member panel is created, consisting of the |
789
|
Chief Financial Officer or the Chief Financial Officer's |
790
|
Insurance Commissioner, or the Insurance Commissioner's |
791
|
designee, and two members to be appointed by the Governor, |
792
|
subject to confirmation by the Senate, one member who, on |
793
|
account of present or previous vocation, employment, or |
794
|
affiliation, shall be classified as a representative of |
795
|
employers, the other member who, on account of previous |
796
|
vocation, employment, or affiliation, shall be classified as a |
797
|
representative of employees. The panel shall determine statewide |
798
|
schedules of maximum reimbursement allowances for medically |
799
|
necessary treatment, care, and attendance provided by |
800
|
physicians, hospitals, ambulatory surgical centers, work- |
801
|
hardening programs, pain programs, and durable medical |
802
|
equipment. The maximum reimbursement allowances for inpatient |
803
|
hospital care shall be based on a schedule of per diem rates, to |
804
|
be approved by the three-member panel no later than March 1, |
805
|
1994, to be used in conjunction with a precertification manual |
806
|
as determined by the agency. All compensable charges for |
807
|
hospital outpatient care shall be reimbursed at 75 percent of |
808
|
usual and customary charges. Until the three-member panel |
809
|
approves a schedule of per diem rates for inpatient hospital |
810
|
care and it becomes effective, all compensable charges for |
811
|
hospital inpatient care must be reimbursed at 75 percent of |
812
|
their usual and customary charges. Annually, the three-member |
813
|
panel shall adopt schedules of maximum reimbursement allowances |
814
|
for physicians, hospital inpatient care, hospital outpatient |
815
|
care, ambulatory surgical centers, work-hardening programs, and |
816
|
pain programs. However, the maximum percentage of increase in |
817
|
the individual reimbursement allowance may not exceed the |
818
|
percentage of increase in the Consumer Price Index for the |
819
|
previous year. An individual physician, hospital, ambulatory |
820
|
surgical center, pain program, or work-hardening program shall |
821
|
be reimbursed either the usual and customary charge for |
822
|
treatment, care, and attendance, the agreed-upon contract price, |
823
|
or the maximum reimbursement allowance in the appropriate |
824
|
schedule, whichever is less. |
825
|
(b) As to reimbursement for a prescription medication, the |
826
|
reimbursement amount for a prescription shall be the average |
827
|
wholesale price times 1.2 plus $4.18 for the dispensing fee, |
828
|
except where the carrier has contracted for a lower amount. Fees |
829
|
for pharmaceuticals and pharmaceutical services shall be |
830
|
reimbursable at the applicable fee schedule amount. Where the |
831
|
employer or carrier has contracted for such services and the |
832
|
employee elects to obtain them through a provider not a party to |
833
|
the contract, the carrier shall reimburse at the schedule, |
834
|
negotiated, or contract price, whichever is lower. |
835
|
(c) Reimbursement for all fees and other charges for such |
836
|
treatment, care, and attendance, including treatment, care, and |
837
|
attendance provided by any hospital or other health care |
838
|
provider, ambulatory surgical center, work-hardening program, or |
839
|
pain program, must not exceed the amounts provided by the |
840
|
uniform schedule of maximum reimbursement allowances as |
841
|
determined by the panel or as otherwise provided in this |
842
|
section. This subsection also applies to independent medical |
843
|
examinations performed by health care providers under this |
844
|
chapter. Until the three-member panel approves a uniform |
845
|
schedule of maximum reimbursement allowances and it becomes |
846
|
effective, all compensable charges for treatment, care, and |
847
|
attendance provided by physicians, ambulatory surgical centers, |
848
|
work-hardening programs, or pain programs shall be reimbursed at |
849
|
the lowest maximum reimbursement allowance across all 1992 |
850
|
schedules of maximum reimbursement allowances for the services |
851
|
provided regardless of the place of service. In determining the |
852
|
uniform schedule, the panel shall first approve the data which |
853
|
it finds representative of prevailing charges in the state for |
854
|
similar treatment, care, and attendance of injured persons. Each |
855
|
health care provider, health care facility, ambulatory surgical |
856
|
center, work-hardening program, or pain program receiving |
857
|
workers' compensation payments shall maintain records verifying |
858
|
their usual charges. In establishing the uniform schedule of |
859
|
maximum reimbursement allowances, the panel must consider: |
860
|
1. The levels of reimbursement for similar treatment, |
861
|
care, and attendance made by other health care programs or |
862
|
third-party providers; |
863
|
2. The impact upon cost to employers for providing a level |
864
|
of reimbursement for treatment, care, and attendance which will |
865
|
ensure the availability of treatment, care, and attendance |
866
|
required by injured workers; |
867
|
3. The financial impact of the reimbursement allowances |
868
|
upon health care providers and health care facilities, including |
869
|
trauma centers as defined in s. 395.4001, and its effect upon |
870
|
their ability to make available to injured workers such |
871
|
medically necessary remedial treatment, care, and attendance. |
872
|
The uniform schedule of maximum reimbursement allowances must be |
873
|
reasonable, must promote health care cost containment and |
874
|
efficiency with respect to the workers' compensation health care |
875
|
delivery system, and must be sufficient to ensure availability |
876
|
of such medically necessary remedial treatment, care, and |
877
|
attendance to injured workers; and |
878
|
4. The most recent average maximum allowable rate of |
879
|
increase for hospitals determined by the Health Care Board under |
880
|
chapter 408. |
881
|
(d) In addition to establishing the uniform schedule of |
882
|
maximum reimbursement allowances, the panel shall: |
883
|
1. Take testimony, receive records, and collect data to |
884
|
evaluate the adequacy of the workers' compensation fee schedule, |
885
|
nationally recognized fee schedules and alternative methods of |
886
|
reimbursement to certified health care providers and health care |
887
|
facilities for inpatient and outpatient treatment and care. |
888
|
2. Survey certified health care providers and health care |
889
|
facilities to determine the availability and accessibility of |
890
|
workers' compensation health care delivery systems for injured |
891
|
workers. |
892
|
3. Survey carriers to determine the estimated impact on |
893
|
carrier costs and workers' compensation premium rates by |
894
|
implementing changes to the carrier reimbursement schedule or |
895
|
implementing alternative reimbursement methods. |
896
|
4. Submit recommendations on or before January 1, 2003, |
897
|
and biennially thereafter, to the President of the Senate and |
898
|
the Speaker of the House of Representatives on methods to |
899
|
improve the workers' compensation health care delivery system. |
900
|
|
901
|
The division shall provide data to the panel, including but not |
902
|
limited to, utilization trends in the workers' compensation |
903
|
health care delivery system. The division shall provide the |
904
|
panel with an annual report regarding the resolution of medical |
905
|
reimbursement disputes and any actions pursuant to s. 440.131(3) |
906
|
440.13(8). The division shall provide administrative support and |
907
|
service to the panel to the extent requested by the panel. |
908
|
(2)(13)REMOVAL OF PHYSICIANS FROM LISTS OF THOSE |
909
|
AUTHORIZED TO RENDER MEDICAL CARE.--The agency shall remove from |
910
|
the list of physicians or facilities authorized to provide |
911
|
remedial treatment, care, and attendance under this chapter the |
912
|
name of any physician or facility found after reasonable |
913
|
investigation to have: |
914
|
(a) Engaged in professional or other misconduct or |
915
|
incompetency in connection with medical services rendered under |
916
|
this chapter; |
917
|
(b) Exceeded the limits of his or her or its professional |
918
|
competence in rendering medical care under this chapter, or to |
919
|
have made materially false statements regarding his or her or |
920
|
its qualifications in his or her application; |
921
|
(c) Failed to transmit copies of medical reports to the |
922
|
employer or carrier, or failed to submit full and truthful |
923
|
medical reports of all his or her or its findings to the |
924
|
employer or carrier as required under this chapter; |
925
|
(d) Solicited, or employed another to solicit for himself |
926
|
or herself or itself or for another, professional treatment, |
927
|
examination, or care of an injured employee in connection with |
928
|
any claim under this chapter; |
929
|
(e) Refused to appear before, or to answer upon request |
930
|
of, the agency or any duly authorized officer of the state, any |
931
|
legal question, or to produce any relevant book or paper |
932
|
concerning his or her conduct under any authorization granted to |
933
|
him or her under this chapter; |
934
|
(f) Self-referred in violation of this chapter or other |
935
|
laws of this state; or |
936
|
(g) Engaged in a pattern of practice of overutilization or |
937
|
a violation of this chapter or rules adopted by the agency. |
938
|
(3)(14)PAYMENT OF MEDICAL FEES.-- |
939
|
(a) Except for emergency care treatment, fees for medical |
940
|
services are payable only to a health care provider certified |
941
|
and authorized to render remedial treatment, care, or attendance |
942
|
under this chapter. A health care provider may not collect or |
943
|
receive a fee from an injured employee within this state, except |
944
|
as otherwise provided by this chapter. Such providers have |
945
|
recourse against the employer or carrier for payment for |
946
|
services rendered in accordance with this chapter. |
947
|
(b) Fees charged for remedial treatment, care, and |
948
|
attendance, except for independent medical examinations, may not |
949
|
exceed the applicable fee schedules adopted under this chapter. |
950
|
(c) Notwithstanding any other provision of this chapter, |
951
|
following overall maximum medical improvement from an injury |
952
|
compensable under this chapter, the employee is obligated to pay |
953
|
a copayment of $10 per visit for medical services. The copayment |
954
|
shall not apply to emergency care provided to the employee. |
955
|
Section 9. Subsection (15) of section 440.13, Florida |
956
|
Statutes, is renumbered as section 440.1314, Florida Statutes, |
957
|
and amended to read: |
958
|
440.1314(15)Practice parameters.-- |
959
|
(1)(a)The Agency for Health Care Administration, in |
960
|
conjunction with the department and appropriate health |
961
|
professional associations and health-related organizations shall |
962
|
develop and may adopt by rule scientifically sound practice |
963
|
parameters for medical procedures relevant to workers' |
964
|
compensation claimants. Practice parameters developed under this |
965
|
section must focus on identifying effective remedial treatments |
966
|
and promoting the appropriate utilization of health care |
967
|
resources. Priority must be given to those procedures that |
968
|
involve the greatest utilization of resources either because |
969
|
they are the most costly or because they are the most frequently |
970
|
performed. Practice parameters for treatment of the 10 top |
971
|
procedures associated with workers' compensation injuries |
972
|
including the remedial treatment of lower-back injuries must be |
973
|
developed by December 31, 1994. |
974
|
(2)(b)The guidelines may be initially based on guidelines |
975
|
prepared by nationally recognized health care institutions and |
976
|
professional organizations but should be tailored to meet the |
977
|
workers' compensation goal of returning employees to full |
978
|
employment as quickly as medically possible, taking into |
979
|
consideration outcomes data collected from managed care |
980
|
providers and any other inpatient and outpatient facilities |
981
|
serving workers' compensation claimants. |
982
|
(3)(c)Procedures must be instituted which provide for the |
983
|
periodic review and revision of practice parameters based on the |
984
|
latest outcomes data, research findings, technological |
985
|
advancements, and clinical experiences, at least once every 3 |
986
|
years. |
987
|
(4)(d)Practice parameters developed under this section |
988
|
must be used by carriers and the agency in evaluating the |
989
|
appropriateness and overutilization of medical services provided |
990
|
to injured employees. |
991
|
Section 10. Paragraphs (b) and (c) of subsection (2) of |
992
|
section 440.13, Florida Statutes, are redesignated as section |
993
|
440.1315, Florida Statutes, and amended to read: |
994
|
440.1315 Attendant care services.--
|
995
|
(1)(b)The employer shall provide appropriate professional |
996
|
or nonprofessional attendant care performed only at the |
997
|
direction and control of a physician when such care is medically |
998
|
necessary. The value of nonprofessional attendant care provided |
999
|
by a family member must be determined as follows: |
1000
|
(a)1.If the family member is not employed, the per-hour |
1001
|
value equals the federal minimum hourly wage. |
1002
|
(b)2.If the family member is employed and elects to leave |
1003
|
that employment to provide attendant or custodial care, the per- |
1004
|
hour value of that care equals the per-hour value of the family |
1005
|
member's former employment, not to exceed the per-hour value of |
1006
|
such care available in the community at large. A family member |
1007
|
or a combination of family members providing nonprofessional |
1008
|
attendant care under this subsectionparagraphmay not be |
1009
|
compensated for more than a total of 12 hours per day. |
1010
|
(2)(c)If the employer fails to provide treatment or care |
1011
|
required by this section after request by the injured employee, |
1012
|
the employee may obtain such treatment at the expense of the |
1013
|
employer, if the treatment is compensable and medically |
1014
|
necessary. There must be a specific request for the treatment, |
1015
|
and the employer or carrier must be given a reasonable time |
1016
|
period within which to provide the treatment or care. However, |
1017
|
the employee is not entitled to recover any amount personally |
1018
|
expended for the treatment or service unless he or she has |
1019
|
requested the employer to furnish that treatment or service and |
1020
|
the employer has failed, refused, or neglected to do so within a |
1021
|
reasonable time or unless the nature of the injury requires such |
1022
|
treatment, nursing, and services and the employer or his or her |
1023
|
superintendent or foreman, having knowledge of the injury, has |
1024
|
neglected to provide the treatment or service. |
1025
|
(3)(a) When the employer or carrier has voluntarily |
1026
|
provided attendant care services without stipulation and order |
1027
|
of the judge of compensation claims and the employer or carrier |
1028
|
desires to terminate the attendant care services, the employer |
1029
|
or carrier shall give the employee 7 days' written notice of |
1030
|
termination by certificate of mailing that the employee’s |
1031
|
eligibility for attendant care services has been terminated, |
1032
|
provide the employee with a copy of any supporting documentation |
1033
|
for said termination, and advise the employee of his or her |
1034
|
right to file a petition for benefits on the issue. The |
1035
|
employer's or carrier’s failure to comply with these time |
1036
|
provisions shall result in a waiver of any time period in which |
1037
|
to file a petition for benefits on the issue. The evidence of |
1038
|
any investigator, adjuster, or other witness in the nature of |
1039
|
surveillance shall be subject to discovery when such evidence |
1040
|
will be used at trial, provided the party intending to use such |
1041
|
evidence is first given a reasonable opportunity to depose the |
1042
|
party or witness who is the subject of the surveillance.
|
1043
|
(b) If the employee objects to the employer's or carrier’s |
1044
|
termination or denial of attendant care services, the employee |
1045
|
shall have 21 days after the date the notice of termination or |
1046
|
notice of denial was mailed by certificate of mailing to object |
1047
|
to the termination or denial of attendant care services by |
1048
|
filing a petition for benefits for the provision of attendant |
1049
|
care services. The employee’s petition for benefits on the issue |
1050
|
of attendant care services shall include a statement of the |
1051
|
period in dispute, copies of all medical records related to the |
1052
|
alleged need for continues attendant care based on medical |
1053
|
opinions pursuant to s. 440.13(9)(b), employment, wage, |
1054
|
vocational reports, unemployment records, and the records |
1055
|
required by paragraph (c). Copies of said records and reports |
1056
|
shall be mailed to the opposing parties no later than 10 days |
1057
|
after the date of the filing of the petition for benefits.
|
1058
|
(c) When an employee seeks the provision of professional |
1059
|
or nonprofessional attendant care services, the employee shall |
1060
|
file a petition for benefits that sets forth the nature of the |
1061
|
attendant care benefits being sought, including, but not limited |
1062
|
to, a copy of the prescription which includes a medical opinion |
1063
|
pursuant to s. 440.13(9)(b) indicating the time period for which |
1064
|
services shall be provided, the nature of the services to be |
1065
|
provided, and the length of time they are to be provided. If the |
1066
|
employee seeks to have nonprofessional attendant care services |
1067
|
provided by a family member, the petition for benefits shall |
1068
|
contain the name and social security number of the family |
1069
|
member, the number of hours of nonprofessional attendant care |
1070
|
services being provided by the family member, and the per-hour |
1071
|
value of the family member's former employment. If the family |
1072
|
member remains employed and seeks payment for nonprofessional |
1073
|
attendant care services, the family member shall produce payroll |
1074
|
records documenting the hours worked in other employment during |
1075
|
the period for which nonprofessional attendant care services are |
1076
|
claimed. Any claim for nonprofessional attendant care shall |
1077
|
contain the fraud notice contained in s. 440.1051 and shall be |
1078
|
personally signed and attested to by the family member providing |
1079
|
such care.
|
1080
|
(d) When the employer or carrier denies the payment of |
1081
|
attendant care services, the employer or carrier shall give the |
1082
|
employee 7 days' written notice of denial by certificate of |
1083
|
mailing that the employee’s attendant care services are being |
1084
|
denied; provide the employee with a copy of any documentation |
1085
|
for said denial, including any medical reports, employment |
1086
|
information, wage documentation, and unemployment records; and |
1087
|
advise the employee of his or her right to request a hearing on |
1088
|
the issue of attendant care services by filing a petition for |
1089
|
benefits for the provision of attendant care services. The |
1090
|
employer's or carrier’s failure to comply with the requirements |
1091
|
of this subsection shall result in a waiver of any time period |
1092
|
in which to file a petition for benefits on the issue. The |
1093
|
evidence of any investigator, adjuster, or other witness in the |
1094
|
nature of surveillance shall be subject to discovery when such |
1095
|
evidence will be used at trial, provided the party intending to |
1096
|
use such evidence is first given a reasonable opportunity to |
1097
|
depose the party or witness who is the subject of the |
1098
|
surveillance.
|
1099
|
(4) The failure of the employer, carrier, or employee to |
1100
|
provide the documentation required by this section shall result |
1101
|
in the same being excluded from evidence at any trial of this |
1102
|
issue.
|
1103
|
Section 11. Section 440.145, Florida Statutes, is created |
1104
|
to read: |
1105
|
440.145 Average weekly wage; compensation rate.--
|
1106
|
(1) The employee shall prepare, sign, and return to the |
1107
|
employer and carrier, within 14 days after receipt of a written |
1108
|
request by the employer or carrier by certificate of mailing, a |
1109
|
release of information allowing the employer or carrier to |
1110
|
obtain any and all information regarding concurrent employment. |
1111
|
No petition for benefits may be filed on the average weekly |
1112
|
wage issue until the signed release of information is prepared |
1113
|
and provided to the employer and carrier by the employee and the |
1114
|
employee has produced the requisite information regarding |
1115
|
concurrent employment and applicable fringe benefits includable |
1116
|
in the average weekly wage and corresponding compensation rate |
1117
|
calculation. Information regarding wages earned by the employee |
1118
|
includable in the average weekly wage and corresponding |
1119
|
compensation rate calculation that has not been disclosed by the |
1120
|
employee prior to the filing of the petition for benefits on the |
1121
|
average weekly wage issue shall not be admissible evidence.
|
1122
|
(2) If at any time after the employee’s industrial |
1123
|
accident, the fringe benefits described in s. 440.02(28) are |
1124
|
suspended or terminated, the employer shall notify the employee, |
1125
|
the employee’s counsel, if any, and the carrier by filing an |
1126
|
amended wage statement by certificate of mailing within 7 days |
1127
|
after the date of the termination or suspension.
|
1128
|
(3) If the employer fails to provide an accurate and |
1129
|
complete wage statement or notify the employee or the employee’s |
1130
|
counsel by certificate of mailing of the suspension of any |
1131
|
applicable fringe benefits as provided in this section, any |
1132
|
period of compensation benefits paid to the employee during the |
1133
|
period of such failure shall be paid at the maximum compensation |
1134
|
rate pursuant to s. 440.12(2). Any period of compensation so |
1135
|
paid shall not be subject to repayment by the employer or |
1136
|
carrier pursuant to s. 440.1508(1).
|
1137
|
(4) When an employee disputes the average weekly wage and |
1138
|
corresponding compensation rate, the employer shall, within 14 |
1139
|
days after receipt of the written request by certificate of |
1140
|
mailing from the employee or the employee's counsel, provide the |
1141
|
employee with a complete and accurate 13-week wage statement, |
1142
|
including, but not limited to, gross wages as defined in s. |
1143
|
440.02(28), wages for overtime work, vacation pay, commissions, |
1144
|
bonuses, and gratuities. For weeks of zero earnings, the |
1145
|
employer shall state whether work was available for the |
1146
|
employee. If the employee received group health insurance |
1147
|
benefits at the expense of the employer, the employer shall note |
1148
|
the starting date of the benefits within such 13-week wage |
1149
|
statement and the amount of the employer’s contribution on a |
1150
|
weekly basis.
|
1151
|
(5) When an employee disputes the average weekly wage, the |
1152
|
employee shall comply with s. 440.115. The employee’s petition |
1153
|
for benefits disputing the average weekly wage shall include a |
1154
|
wage statement of the employee’s gross wages for the 13 weeks |
1155
|
prior to the accident, including the gross value of all employer |
1156
|
paid fringe benefits and gross wages from any concurrent |
1157
|
employment, together with the employee’s calculations as to what |
1158
|
the correct average weekly wage and corresponding compensation |
1159
|
rate should be. A copy of all such supporting wage and fringe |
1160
|
benefits records shall be attached to the petition for benefits |
1161
|
and made a part thereof. The failure of the employer or carrier |
1162
|
to produce a 13-week wage statement, as provided in s. 440.115, |
1163
|
constitutes a waiver of the employer's and carrier's right to |
1164
|
dispute the average weekly wage and corresponding compensation |
1165
|
rate.
|
1166
|
(6) In the event an employee claims the average weekly |
1167
|
wage and corresponding compensation rate has been miscalculated |
1168
|
because covered concurrent or seasonal wages have not been |
1169
|
included in the calculation, the employee’s concurrent or |
1170
|
seasonal employer shall, upon written request by certificate of |
1171
|
mailing by the employee, employer, or carrier or their counsel, |
1172
|
complete and provide to the requesting party a wage statement as |
1173
|
provided by this chapter. If the concurrent or seasonal employer |
1174
|
fails to provide the requested information within 14 days after |
1175
|
receipt of the request and the employee prevails on the |
1176
|
inclusion of the concurrent average weekly wage and |
1177
|
corresponding compensation rate, the concurrent or seasonal |
1178
|
employer's workers' compensation carrier or the employer, if |
1179
|
self-insured, shall be liable for any employee’s attorney’s fee |
1180
|
and taxable costs ordered by the judge of compensation claims |
1181
|
attributable to the need to compel concurrent or seasonal |
1182
|
employment information and inclusion of the concurrent or |
1183
|
seasonal wages in the average weekly wage calculation.
|
1184
|
(7) When an employee has submitted a petition for benefits |
1185
|
for a determination of the average weekly wage and corresponding |
1186
|
compensation rate, the employee shall produce, within 14 days |
1187
|
after receipt of a written request by the employer or carrier by |
1188
|
certificate of mailing, copies of any and all documentation in |
1189
|
the employee's possession regarding wages earned by the employee |
1190
|
during the 13 weeks prior to the date of the accident, including |
1191
|
all information regarding concurrent employment and applicable |
1192
|
fringe benefits includable in the average weekly wage and |
1193
|
corresponding compensation rate calculation. If the employee is |
1194
|
claiming that he or she is a seasonal employee, the employee |
1195
|
shall produce, within 14 days after receipt of a written request |
1196
|
by the employer or carrier by certificate of mailing, copies of |
1197
|
any and all documentation in the employee's possession regarding |
1198
|
wages earned by the employee during the 52 weeks prior to the |
1199
|
date of the accident, including all information regarding |
1200
|
concurrent employment and applicable fringe benefits includable |
1201
|
in the average weekly wage and corresponding compensation rate |
1202
|
calculation.
|
1203
|
Section 12. Section 440.15, Florida Statutes, consisting |
1204
|
of paragraphs (a) and (c) of subsection (2), is amended to read: |
1205
|
440.15 Compensation for temporary total |
1206
|
disability.--Compensation for temporary totaldisability shall |
1207
|
be paid to the employee, subject to the limits provided in s. |
1208
|
440.12(2), as follows: |
1209
|
(1)(2)TEMPORARY TOTAL DISABILITY.-- |
1210
|
(a) In case of disability total in character but temporary |
1211
|
in quality, 662/3 percent of the average weekly wages shall be |
1212
|
paid to the employee during the continuance thereof, not to |
1213
|
exceed 104 weeks except as provided in this subsection, s. |
1214
|
440.12(1), and s. 440.14(3). Once the employee reaches the |
1215
|
maximum number of weeks allowed, or the employee reaches the |
1216
|
date of maximum medical improvement, whichever occurs earlier, |
1217
|
temporary disability benefits shall cease and the injured |
1218
|
worker's permanent impairment shall be determined. |
1219
|
(b)(c)Temporary total disability benefits paid pursuant |
1220
|
to this subsection shall include such period as may be |
1221
|
reasonably necessary for training in the use of artificial |
1222
|
members and appliances, and shall include such period as the |
1223
|
employee may be receiving training and education under a program |
1224
|
pursuant to s. 440.491. Notwithstanding s. 440.02, the date of |
1225
|
maximum medical improvement for purposes of s. 440.1504 |
1226
|
paragraph (3)(b)shall be no earlier than the last day for which |
1227
|
such temporary disability benefits are paid. |
1228
|
(2) TERMINATION OF TEMPORARY TOTAL DISABILITY BENEFITS.--
|
1229
|
(a) Before terminating the payment of temporary total |
1230
|
disability benefits, the employer or carrier shall give the |
1231
|
employee 7 days' written notice by certificate of mailing that |
1232
|
the benefits are to be terminated, provide the employee with a |
1233
|
copy of any supporting documentation forming the basis for such |
1234
|
termination, and advise the employee of his or her right to |
1235
|
request a hearing on the issue of reinstatement of temporary |
1236
|
total disability by filing a petition for benefits for the |
1237
|
payment of temporary total disability. The employer's or |
1238
|
carrier’s failure to comply with this time provision shall |
1239
|
result in the waiver of the 21-day period provided in paragraph |
1240
|
(b) within which an employee must file a petition for benefits |
1241
|
on the issue.
|
1242
|
(b) If an employee objects to the employer’s termination |
1243
|
of temporary total disability, the employee shall have 21 days |
1244
|
after the date the notice of termination was mailed to object to |
1245
|
the termination of temporary total disability by filing a |
1246
|
petition for benefits for the payment of temporary total |
1247
|
disability benefits. The employee’s petition for benefits on |
1248
|
temporary total disability issues shall include a statement of |
1249
|
the period in dispute, and copies of all medical records and |
1250
|
reports based on a medical opinion pursuant to s. 440.13(9)(b) |
1251
|
establishing that the employee remains temporarily and totally |
1252
|
disabled. A copy of said petition for benefits and copies of |
1253
|
supporting records and reports shall be filed pursuant to s. |
1254
|
440.192(1) and shall also be mailed by certificate of mailing to |
1255
|
opposing counsel, if any, no later than 7 days after the date of |
1256
|
the filing of the petition for benefits.
|
1257
|
(c) If the petition for benefits has been filed by the |
1258
|
employee within the time period set forth in paragraph (b) and |
1259
|
all medical records and reports are served on the employer or |
1260
|
carrier and its counsel, if any, no later than 7 days after the |
1261
|
filing of the petition for benefits, temporary total disability |
1262
|
shall continue until further order of the judge of compensation |
1263
|
claims.
|
1264
|
(d) The employer or carrier shall be entitled to a credit |
1265
|
pursuant to s. 440.1508(2) for any overpayment of temporary |
1266
|
total disability as found by the judge of compensation claims. |
1267
|
If the employer fails to continue payment of temporary total |
1268
|
disability after the employee timely files the petition for |
1269
|
benefits and timely mails all medical records and reports, the |
1270
|
petition for benefits shall be heard under the procedure for |
1271
|
expedited hearings. The employer or carrier is deemed to waive |
1272
|
any objection to said proceedings. In addition to the |
1273
|
requirements set forth in s. 440.20(6), a 20-percent penalty on |
1274
|
all temporary total disability benefits paid as a result of the |
1275
|
successful prosecution of such petition for benefits shall be |
1276
|
assessed against the employer or carrier if the judge of |
1277
|
compensation claims finds that temporary total disability |
1278
|
benefits were due and owing.
|
1279
|
(e) When the employer or carrier denies the continued |
1280
|
payment of temporary total disability benefits, the employer or |
1281
|
carrier shall give the employee 7 days' written notice by |
1282
|
certificate of mailing that the temporary total disability |
1283
|
benefits are being denied, provide the employee with a copy of |
1284
|
any documentation supporting said denial, including any medical |
1285
|
records and reports based on a medical opinion pursuant to s. |
1286
|
440.13(9)(b), and advise the employee of his or her right to |
1287
|
request a hearing on the payment of temporary total disability |
1288
|
benefits by filing a petition for benefits. The employer's or |
1289
|
carrier’s failure to give the employee the required 7 days' |
1290
|
notice shall result in a waiver of any time period in which to |
1291
|
file a petition for benefits on this issue. The evidence of any |
1292
|
investigator, adjuster, or other witness in the nature of |
1293
|
surveillance shall be subject to discovery when such evidence |
1294
|
will be used at trial, provided the party intending to use such |
1295
|
evidence is first given a reasonable opportunity to depose the |
1296
|
party or witness who is the subject of the surveillance. A copy |
1297
|
of said petition for benefits and copies of supporting records |
1298
|
and reports shall be filed pursuant to s. 440.192(1) and shall |
1299
|
also be mailed by certificate of mailing to the employer and |
1300
|
carrier and its legal counsel, if represented, no later than 7 |
1301
|
days after the date of the filing of the petition for benefits.
|
1302
|
(f) The failure of the employer or carrier or the employee |
1303
|
to provide the documentation required by this section shall |
1304
|
result in the same being excluded at trial.
|
1305
|
Section 13. Paragraph (b) of subsection (2) of section |
1306
|
440.15, Florida Statutes, is redesignated as section 440.1501, |
1307
|
Florida Statutes, and amended to read: |
1308
|
440.1501 Compensation for catastrophic temporary total |
1309
|
disability.--Compensation for catastrophic temporary total |
1310
|
disability shall be paid to the employee, subject to the limits |
1311
|
provided in s. 440.12(2), as follows:
|
1312
|
(1)(b) Notwithstanding the provisions of s. 440.15(1)(a) |
1313
|
paragraph (a), an employee who has sustained the loss of an arm, |
1314
|
leg, hand, or foot, has been rendered a paraplegic, paraparetic, |
1315
|
quadriplegic, or quadriparetic, or has lost the sight of both |
1316
|
eyes shall be paid temporary total disability of 80 percent of |
1317
|
her or his average weekly wage. The increased temporary total |
1318
|
disability compensation provided for in this subsection |
1319
|
paragraphmust not extend beyond 6 months from the date of the |
1320
|
accident. The compensation provided by this subsectionparagraph |
1321
|
is not subject to the limits provided in s. 440.12(2), but |
1322
|
instead is subject to a maximum weekly compensation rate of |
1323
|
$700. If, at the conclusion of this period of increased |
1324
|
temporary total disability compensation, the employee is still |
1325
|
temporarily totally disabled, the employee shall continue to |
1326
|
receive temporary total disability compensation as set forth in |
1327
|
s. 440.15(1)(a) and (b)paragraphs (a) and (c). The period of |
1328
|
time the employee has received this increased compensation will |
1329
|
be counted as part of, and not in addition to, the maximum |
1330
|
periods of time for which the employee is entitled to |
1331
|
compensation under s. 440.15(1)(a)paragraph (a) but not s. |
1332
|
440.15(1)(b)paragraph (c). |
1333
|
(2) When an injured employee has been voluntarily paid |
1334
|
catastrophic temporary total disability benefits by the employer |
1335
|
or carrier and the employer or carrier desires to suspend or |
1336
|
terminate the payment of catastrophic temporary total disability |
1337
|
benefits, the employer or carrier shall give the employee 7 |
1338
|
days' written notice by certificate of mailing that the |
1339
|
employee’s eligibility for catastrophic temporary total |
1340
|
disability benefits will be terminated, provide the employee |
1341
|
with a copy of any supporting documentation for said |
1342
|
termination, and advise the employee of his or her right to |
1343
|
request a hearing on the issue of reinstatement of catastrophic |
1344
|
temporary total disability benefits by filing a petition for |
1345
|
benefits. The employer's or carrier’s failure to comply with |
1346
|
this time provision shall result in the waiver of the 21-day |
1347
|
period provided in subsection (8) in which to file for a hearing |
1348
|
on the issue. The evidence of any investigator, adjuster, or |
1349
|
other witness in the nature of surveillance shall be subject to |
1350
|
discovery when such evidence will be used at trial, provided the |
1351
|
party intending to use such evidence is first given a reasonable |
1352
|
opportunity to depose the party or witness who is the subject of |
1353
|
the surveillance.
|
1354
|
(3) If the petition for benefits has been filed by the |
1355
|
employee within the time period set forth in subsection (2) and |
1356
|
all medical records and reports are served on the employer or |
1357
|
carrier and its counsel, if any, no later than 7 days after the |
1358
|
filing of the petition for benefits, temporary total disability |
1359
|
shall continue until further order of the judge of compensation |
1360
|
claims.
|
1361
|
(4) The employer or carrier shall be entitled to a credit |
1362
|
pursuant to s. 440.1508(2) for any overpayment of temporary |
1363
|
total disability as found by the judge of compensation claims. |
1364
|
If the employer fails to continue payment of temporary total |
1365
|
disability after the employee timely files the petition for |
1366
|
benefits and timely mails all medical records and reports, the |
1367
|
petition for benefits shall be heard under the procedure for |
1368
|
expedited hearings. The employer or carrier is deemed to waive |
1369
|
any objection to said proceedings. In addition to the |
1370
|
requirements set forth in s. 440.20(6), a 20-percent penalty on |
1371
|
all temporary total disability benefits paid as a result of the |
1372
|
successful prosecution of such petition for benefits shall be |
1373
|
assessed against the employer or carrier.
|
1374
|
(5) When the employer or carrier denies the continued |
1375
|
payment of temporary total disability benefits, the employer or |
1376
|
carrier shall give the employee 7 days' written notice by |
1377
|
certificate of mailing that the temporary total disability |
1378
|
benefits are being denied, provide the employee with a copy of |
1379
|
any documentation supporting said denial, including any medical |
1380
|
records and reports based on a medical opinion pursuant to s. |
1381
|
440.13(9)(b), and advise the employee of his or her right to |
1382
|
request a hearing on the payment of temporary total disability |
1383
|
benefits by filing a petition for benefits. The employer's or |
1384
|
carrier’s failure to give the employee the required 7 days' |
1385
|
notice shall result in a waiver of any time period in which to |
1386
|
file a petition for benefits on this issue. The evidence of any |
1387
|
investigator, adjuster, or other witness in the nature of |
1388
|
surveillance shall be subject to discovery when such evidence |
1389
|
will be used at trial, provided the party intending to use such |
1390
|
evidence is first given a reasonable opportunity to depose the |
1391
|
party or witness who is the subject of the surveillance. A copy |
1392
|
of said petition for benefits and copies of supporting records |
1393
|
and reports shall be filed pursuant to s. 440.192(1) and shall |
1394
|
also be mailed by certificate of mailing to the employer and |
1395
|
carrier and its legal counsel, if any, no later than 7 days |
1396
|
after the date of the filing of the petition for benefits.
|
1397
|
(6) The failure of the employer, carrier, or employee to |
1398
|
provide the documentation required by this section shall result |
1399
|
in the same being excluded at trial.
|
1400
|
(7) When the employer or carrier denies the payment of |
1401
|
catastrophic temporary total disability benefits, the employer |
1402
|
or carrier shall give the employee 7 days' written notice by |
1403
|
certificate of mailing that the catastrophic temporary total |
1404
|
disability benefits are being denied, provide the employee with |
1405
|
a copy of any documentation supporting said denial, including |
1406
|
any medical records and reports based on a medical opinion |
1407
|
pursuant to s. 440.13(9)(b), employment, wage, and vocational |
1408
|
reports and unemployment records, and advise the employee of his |
1409
|
or her right to request a hearing on the payment of catastrophic |
1410
|
temporary total disability benefits by filing a petition for |
1411
|
benefits. The employer's or carrier’s failure to give the |
1412
|
employee the required 7 days' notice shall result in a waiver of |
1413
|
any time period in which to file a petition for benefits on this |
1414
|
issue. The evidence of any investigator, adjuster, or other |
1415
|
witness in the nature of surveillance shall be subject to |
1416
|
discovery when such evidence will be used at trial, provided the |
1417
|
party intending to use such evidence is first given a reasonable |
1418
|
opportunity to depose the party or witness who is the subject of |
1419
|
the surveillance.
|
1420
|
(8) If the employee objects to the employer's or carrier’s |
1421
|
denial or termination of the payment of catastrophic temporary |
1422
|
total disability benefits, the employee shall have 21 days after |
1423
|
the date the notice of termination was sent to object to the |
1424
|
termination or suspension of catastrophic temporary total |
1425
|
disability benefits by filing a petition for benefits for the |
1426
|
payment of catastrophic temporary total disability benefits. The |
1427
|
employee’s petition for benefits on catastrophic temporary total |
1428
|
disability issues shall include a statement of the period in |
1429
|
dispute, copies of all medical reports based on a medical |
1430
|
opinion pursuant to s. 440.13(9)(b), employment, wage, and |
1431
|
vocational reports and unemployment records. A copy of said |
1432
|
petition for benefits and copies shall be filed pursuant to s. |
1433
|
440.192(1) and shall also be mailed by certificate of mailing to |
1434
|
the employer, carrier and its legal counsel, if represented, no |
1435
|
later than 10 days after the date of the filing of the petition |
1436
|
for benefits.
|
1437
|
(9) The failure of the employer and carrier or the |
1438
|
employee to provide the documentation required by this section |
1439
|
shall result in the same being excluded at trial.
|
1440
|
(10) The department shall, by rule, provide for the |
1441
|
periodic reporting to the department, employer, and carrier of |
1442
|
all earned income, including social security benefits, by the |
1443
|
injured employee who is entitled to or claiming benefits for |
1444
|
temporary total disability. The employer and carrier are not |
1445
|
required to make any payment of benefits for temporary total |
1446
|
disability for any period during which the employee willfully |
1447
|
fails or refuses to report such earned income upon request by |
1448
|
the employer or carrier in the manner prescribed by rule. The |
1449
|
rule must require the claimant to personally sign the claim form |
1450
|
and attest that he or she has reviewed, understands, and |
1451
|
acknowledges the foregoing under penalty of perjury.
|
1452
|
Section 14. Paragraph (d) of subsection (2) of section |
1453
|
440.15, Florida Statutes, is redesignated as section 440.15015, |
1454
|
Florida Statutes, and amended to read: |
1455
|
440.15015 Reporting of income.--
|
1456
|
(d)The department shall, by rule, provide for the |
1457
|
periodic reporting to the department, employer, or carrier of |
1458
|
all earned income, including income from social security, by the |
1459
|
injured employee who is entitled to or claiming benefits for |
1460
|
temporary total disability. The employer or carrier is not |
1461
|
required to make any payment of benefits for temporary total |
1462
|
disability for any period during which the employee willfully |
1463
|
fails or refuses to report upon request by the employer or |
1464
|
carrier in the manner prescribed by the rules. The rule must |
1465
|
require the claimant to personally sign the claim form and |
1466
|
attest that she or he has reviewed, understands, and |
1467
|
acknowledges the foregoing. |
1468
|
Section 15. Subsection (4) of section 440.15, Florida |
1469
|
Statutes, is renumbered as section 440.1502, Florida Statutes, |
1470
|
and amended to read: |
1471
|
440.1502 Compensation for temporary partial |
1472
|
disability.--Compensation for temporary partial disability shall |
1473
|
be paid to the employee, subject to the limits provided in s. |
1474
|
440.12(2), as follows:
|
1475
|
(1)(4)TEMPORARY PARTIAL DISABILITY.-- |
1476
|
(a) In case of temporary partial disability, compensation |
1477
|
shall be equal to 80 percent of the difference between 80 |
1478
|
percent of the employee's average weekly wage and the salary, |
1479
|
wages, and other remuneration the employee is able to earn, as |
1480
|
compared weekly; however, the weekly benefits may not exceed an |
1481
|
amount equal to 662/3 percent of the employee's average weekly |
1482
|
wage at the time of injury. In order to simplify the comparison |
1483
|
of the preinjury average weekly wage with the salary, wages, and |
1484
|
other remuneration the employee is able to earn, the department |
1485
|
may by rule provide for the modification of the weekly |
1486
|
comparison so as to coincide as closely as possible with the |
1487
|
injured worker's pay periods. The amount determined to be the |
1488
|
salary, wages, and other remuneration the employee is able to |
1489
|
earn shall in no case be less than the sum actually being earned |
1490
|
by the employee, including earnings from sheltered employment. |
1491
|
(b) Such benefits shall be paid during the continuance of |
1492
|
such disability, not to exceed a period of 104 weeks, as |
1493
|
provided by this subsection and s. 440.15(1)subsection (2). |
1494
|
Once the injured employee reaches the maximum number of weeks, |
1495
|
temporary disability benefits cease and the injured worker's |
1496
|
permanent impairment must be determined. The department may by |
1497
|
rule specify forms and procedures governing the method of |
1498
|
payment of temporary disability benefits for dates of accidents |
1499
|
before January 1, 1994, and for dates of accidents on or after |
1500
|
January 1, 1994. |
1501
|
(c)1. If an employee has been released to return to work |
1502
|
based on a medical opinion pursuant to s. 440.13(9)(b), the |
1503
|
employer shall mail by certificate of mailing a Notice to |
1504
|
Employee of Offer of Suitable Employment to the employee and the |
1505
|
employee's attorney, if represented, at least 7 days prior to |
1506
|
the date the employee is expected to return to work, after which |
1507
|
benefits shall be suspended. The employer shall furnish a |
1508
|
written job description of the employee’s job at the time of the |
1509
|
accident or the job performed by the employee after the accident |
1510
|
and a job description that forms the basis for the offer of |
1511
|
suitable employment. The employer’s failure to produce this |
1512
|
material within the time period provided shall preclude its use |
1513
|
at any final hearing on a claim for temporary partial |
1514
|
disability.
|
1515
|
2. If the employee has returned to work for the employer |
1516
|
prior to maximum medical improvement and seeks payment of |
1517
|
temporary partial disability, the employer shall mail by |
1518
|
certificate of mailing the employee’s gross weekly wages to the |
1519
|
carrier and its legal representative within 14 days after the |
1520
|
employee submits a written request by certificate of mailing.
|
1521
|
(2) TERMINATION OF TEMPORARY PARTIAL DISABILITY |
1522
|
BENEFITS.--
|
1523
|
(a) When an injured employee reaches maximum medical |
1524
|
improvement and the employer or carrier desires to terminate the |
1525
|
payment of temporary partial disability, the employer or carrier |
1526
|
shall give the employee 7 days' written notice by certificate of |
1527
|
mailing that the employee’s eligibility for temporary partial |
1528
|
disability has been terminated, provide the employee with a copy |
1529
|
of any supporting documentation for said termination, and advise |
1530
|
the employee of his or her right to request a hearing on the |
1531
|
issue of reinstatement of temporary partial disability benefits |
1532
|
by filing a petition for benefits. The employer's or carrier’s |
1533
|
failure to comply with this time provision results in its waiver |
1534
|
of the 21-day period provided in paragraph (b) in which to file |
1535
|
a petition for benefits on the issue. The evidence of any |
1536
|
investigator, adjuster, or other witness in the nature of |
1537
|
surveillance shall be subject to discovery when such evidence |
1538
|
will be used at trial, provided the party intending to use such |
1539
|
evidence is first given a reasonable opportunity to depose the |
1540
|
party or witness who is the subject of the surveillance.
|
1541
|
(b) If the employee objects to the employer's or carrier’s |
1542
|
termination or suspension of temporary partial disability, the |
1543
|
employee shall have 21 days after the date the notice of |
1544
|
termination was mailed to object to the termination or |
1545
|
suspension of temporary partial disability benefits by filing a |
1546
|
petition for benefits for payment of temporary partial |
1547
|
disability benefits. The employee’s petition for benefits on |
1548
|
temporary partial disability issues shall include a statement of |
1549
|
the period in dispute, temporary partial disability forms for |
1550
|
said periods with supporting wage information, copies of all |
1551
|
medical reports establishing that the employee remains eligible |
1552
|
for temporary partial disability benefits based on a medical |
1553
|
opinion pursuant to s. 440.13(9)(b), and employment, wage, and |
1554
|
vocational reports and unemployment records. Copies of said |
1555
|
reports shall be sent to the opposing parties no later than 10 |
1556
|
days after the date of the filing of the petition for benefits.
|
1557
|
(c) When the employer or carrier denies the payment of |
1558
|
temporary partial disability benefits for any other reason, an |
1559
|
employer or carrier shall give the employee 7 days' written |
1560
|
notice of denial by certificate of mailing that the employee’s |
1561
|
temporary partial disability benefits are being denied, provide |
1562
|
the employee with a copy of any documentation for said denial, |
1563
|
including any medical reports based on a medical opinion |
1564
|
pursuant to s. 440.13(9)(b), employment information, wage |
1565
|
documentation, vocational reports, or unemployment records, and |
1566
|
advise the employee of his or her right to request a hearing on |
1567
|
the payment of temporary partial disability by filing a petition |
1568
|
for benefits for the payment of temporary partial disability. |
1569
|
The employer's or carrier’s failure to comply with the |
1570
|
provisions of this section shall result in a waiver of any time |
1571
|
period in which to file a petition for benefits on the issue of |
1572
|
temporary partial disability benefits. The evidence of any |
1573
|
investigator, adjuster, or other witness in the nature of |
1574
|
surveillance shall be subject to discovery when such evidence |
1575
|
will be used at trial, provided the party intending to use such |
1576
|
evidence is first given a reasonable opportunity to depose the |
1577
|
party or witness who is the subject of the surveillance.
|
1578
|
(d) The failure of the employer, carrier, or employee to |
1579
|
provide the documentation required by this subsection shall |
1580
|
result in the same being excluded at trial.
|
1581
|
Section 16. Paragraph (a) of subsection (3) of section |
1582
|
440.15, Florida Statutes, is redesignated as section 440.1503, |
1583
|
Florida Statutes, and amended to read: |
1584
|
440.1503 Compensation for impairment.--Compensation for |
1585
|
impairment shall be paid to the employee, subject to the limits |
1586
|
provided in s. 440.12(2), as follows:
|
1587
|
(1)(3)PERMANENT IMPAIRMENT AND WAGE-LOSS BENEFITS.-- |
1588
|
(a) Impairment benefits.--
|
1589
|
(a)1.Once the employee has reached the date of maximum |
1590
|
medical improvement, impairment benefits are due and payable |
1591
|
within 20 days after the carrier has knowledge of the |
1592
|
impairment. |
1593
|
(b)2.The three-member panel, in cooperation with the |
1594
|
department, shall establish and use a uniform permanent |
1595
|
impairment rating schedule. This schedule must be based on |
1596
|
medically or scientifically demonstrable findings as well as the |
1597
|
systems and criteria set forth in the American Medical |
1598
|
Association's Guides to the Evaluation of Permanent Impairment; |
1599
|
the Snellen Charts, published by American Medical Association |
1600
|
Committee for Eye Injuries; and the Minnesota Department of |
1601
|
Labor and Industry Disability Schedules. The schedule should be |
1602
|
based upon objective findings. The schedule shall be more |
1603
|
comprehensive than the AMA Guides to the Evaluation of Permanent |
1604
|
Impairment and shall expand the areas already addressed and |
1605
|
address additional areas not currently contained in the guides. |
1606
|
On August 1, 1979, and pending the adoption, by rule, of a |
1607
|
permanent schedule, Guides to the Evaluation of Permanent |
1608
|
Impairment, copyright 1977, 1971, 1988, by the American Medical |
1609
|
Association, shall be the temporary schedule and shall be used |
1610
|
for the purposes hereof. For injuries after July 1, 1990, |
1611
|
pending the adoption by rule of a uniform disability rating |
1612
|
agency schedule, the Minnesota Department of Labor and Industry |
1613
|
Disability Schedule shall be used unless that schedule does not |
1614
|
address an injury. In such case, the Guides to the Evaluation of |
1615
|
Permanent Impairment by the American Medical Association shall |
1616
|
be used. Determination of permanent impairment under this |
1617
|
schedule must be made by a physician licensed under chapter 458, |
1618
|
a doctor of osteopathic medicine licensed under chapters 458 and |
1619
|
459, a chiropractic physician licensed under chapter 460, a |
1620
|
podiatric physician licensed under chapter 461, an optometrist |
1621
|
licensed under chapter 463, or a dentist licensed under chapter |
1622
|
466, as appropriate considering the nature of the injury. No |
1623
|
other persons are authorized to render opinions regarding the |
1624
|
existence of or the extent of permanent impairment. |
1625
|
(c)3.All impairment income benefits shall be based on an |
1626
|
impairment rating using the impairment schedule referred to in |
1627
|
paragraph (b)subparagraph 2. Impairment income benefits are |
1628
|
paid weekly at the rate of 50 percent of the employee's average |
1629
|
weekly temporary total disability benefit not to exceed the |
1630
|
maximum weekly benefit under s. 440.12. An employee's |
1631
|
entitlement to impairment income benefits begins the day after |
1632
|
the employee reaches maximum medical improvement or the |
1633
|
expiration of temporary benefits, whichever occurs earlier, and |
1634
|
continues until the earlier of: |
1635
|
1.a.The expiration of a period computed at the rate of 3 |
1636
|
weeks for each percentage point of impairment; or |
1637
|
2.b.The death of the employee. |
1638
|
(d)4.After the employee has been certified by a doctor as |
1639
|
having reached maximum medical improvement or 6 weeks before the |
1640
|
expiration of temporary benefits, whichever occurs earlier, the |
1641
|
certifying doctor shall evaluate the condition of the employee |
1642
|
and assign an impairment rating, using the impairment schedule |
1643
|
referred to in paragraph (b)subparagraph 2. Compensation is not |
1644
|
payable for the mental, psychological, or emotional injury |
1645
|
arising out of depression from being out of work. If the |
1646
|
certification and evaluation are performed by a doctor other |
1647
|
than the employee's treating doctor, the certification and |
1648
|
evaluation must be submitted to the treating doctor, and the |
1649
|
treating doctor must indicate agreement or disagreement with the |
1650
|
certification and evaluation. The certifying doctor shall issue |
1651
|
a written report to the department, the employee, and the |
1652
|
carrier certifying that maximum medical improvement has been |
1653
|
reached, stating the impairment rating, and providing any other |
1654
|
information required by the department by rule. If the employee |
1655
|
has not been certified as having reached maximum medical |
1656
|
improvement before the expiration of 102 weeks after the date |
1657
|
temporary total disability benefits begin to accrue, the carrier |
1658
|
shall notify the treating doctor of the requirements of this |
1659
|
section. |
1660
|
(e)5.The carrier shall pay the employee impairment income |
1661
|
benefits for a period based on the impairment rating. |
1662
|
(f)6.The department may by rule specify forms and |
1663
|
procedures governing the method of payment of wage loss and |
1664
|
impairment benefits for dates of accidents before January 1, |
1665
|
1994, and for dates of accidents on or after January 1, 1994. |
1666
|
(2) TERMINATION OF IMPAIRMENT BENEFITS.--
|
1667
|
(a) When an injured employee reaches maximum medical |
1668
|
improvement and the employer or carrier desires to deny the |
1669
|
claimant’s entitlement to the payment of impairment benefits or |
1670
|
to terminate the continuing payment of impairment benefits, the |
1671
|
employer or carrier shall give the employee 7 days' written |
1672
|
notice by certificate of mailing that the employee’s entitlement |
1673
|
to impairment benefits has been denied or the continuing payment |
1674
|
of impairment benefits has been terminated, provide the employee |
1675
|
with a copy of any supporting documentation for said denial or |
1676
|
termination, and advise the employee of his or her right to |
1677
|
request a hearing on said issues. The employer's or carrier’s |
1678
|
failure to comply with this time provision shall result in the |
1679
|
waiver of the 21-day period provided in paragraph (b) in which |
1680
|
to file a petition for benefits on the issue. The evidence of |
1681
|
any investigator, adjuster, or other witness in the nature of |
1682
|
surveillance shall be subject to discovery when such evidence |
1683
|
will be used at trial, provided the party intending to use such |
1684
|
evidence is first given a reasonable opportunity to depose the |
1685
|
party or witness who is the subject of the surveillance.
|
1686
|
(b) If the employee objects to the denial of his or her |
1687
|
entitlement to the payment of impairment benefits or termination |
1688
|
of the payment of impairment benefits, the employee shall have |
1689
|
21 days after the date the notice of termination was mailed to |
1690
|
object to the termination of the payment of impairment benefits |
1691
|
by filing a petition for benefits for payment of impairment |
1692
|
benefits. The employee’s petition for benefits on the payment of |
1693
|
impairment benefits shall include a statement identifying all |
1694
|
injuries for which impairment benefits are claimed and all |
1695
|
medical records and reports documenting any permanent impairment |
1696
|
rating assigned pursuant to the Florida Impairment Rating Guides |
1697
|
based on medical opinions pursuant to s. 440.13(9)(b). Copies of |
1698
|
said medical records and reports shall be mailed by certificate |
1699
|
of mailing to the employer and carrier and its representative, |
1700
|
no later than 10 days after the date of the filing of the |
1701
|
petition for benefits for impairment benefits.
|
1702
|
(c) The failure of the employer, carrier, or employee to |
1703
|
provide documentation required by this subsection shall result |
1704
|
in the same being excluded at trial of this issue.
|
1705
|
Section 17. Paragraphs (b) and (c) of subsection (3) of |
1706
|
section 440.15, Florida Statutes, are redesignated as section |
1707
|
440.1504, Florida Statutes, and amended to read: |
1708
|
440.1504 Supplemental benefits.--Supplemental benefits |
1709
|
shall be paid to the employee, subject to the limits provided in |
1710
|
s. 440.12(2), as follows:
|
1711
|
(1)(b)SUPPLEMENTAL BENEFITS.-- |
1712
|
(a)1. All supplemental benefits must be paid in accordance |
1713
|
with this subsection.An employee is entitled to supplemental |
1714
|
benefits as provided in this sectionparagraphas of the |
1715
|
expiration of the impairment period, if: |
1716
|
1.a.The employee has an impairment rating from the |
1717
|
compensable injury of 20 percent or more as determined pursuant |
1718
|
to this chapter; |
1719
|
2.b.The employee has not returned to work or has returned |
1720
|
to work earning less than 80 percent of the employee's average |
1721
|
weekly wage as a direct result of the employee's impairment; and |
1722
|
3.c.The employee has in good faith attempted to obtain |
1723
|
employment commensurate with the employee's ability to work. |
1724
|
(b)2.If an employee is not entitled to supplemental |
1725
|
benefits at the time of payment of the final weekly impairment |
1726
|
income benefit because the employee is earning at least 80 |
1727
|
percent of the employee's average weekly wage, the employee may |
1728
|
become entitled to supplemental benefits at any time within 1 |
1729
|
year after the impairment income benefit period ends if: |
1730
|
1.a.The employee earns wages that are less than 80 |
1731
|
percent of the employee's average weekly wage for a period of at |
1732
|
least 90 days; |
1733
|
2.b. The employee meets the other requirements of |
1734
|
paragraph (a)subparagraph 1.; and |
1735
|
3.c.The employee's decrease in earnings is a direct |
1736
|
result of the employee's impairment from the compensable injury. |
1737
|
(c)3.If an employee earns wages that are at least 80 |
1738
|
percent of the employee's average weekly wage for a period of at |
1739
|
least 90 days during which the employee is receiving |
1740
|
supplemental benefits, the employee ceases to be entitled to |
1741
|
supplemental benefits for the filing period. Supplemental |
1742
|
benefits that have been terminated shall be reinstated when the |
1743
|
employee satisfies the conditions enumerated in paragraph (b) |
1744
|
subparagraph 2. and files the statement required under paragraph |
1745
|
(d)subparagraph 4. Notwithstanding any other provision, if an |
1746
|
employee is not entitled to supplemental benefits for 12 |
1747
|
consecutive months, the employee ceases to be entitled to any |
1748
|
additional income benefits for the compensable injury. If the |
1749
|
employee is discharged within 12 months after losing entitlement |
1750
|
under this sectionsubsection, benefits may be reinstated if the |
1751
|
employee was discharged at that time with the intent to deprive |
1752
|
the employee of supplemental benefits. |
1753
|
(d)4.After the initial determination of supplemental |
1754
|
benefits, the employee must file a statement with the carrier |
1755
|
stating that the employee has earned less than 80 percent of the |
1756
|
employee's average weekly wage as a direct result of the |
1757
|
employee's impairment, stating the amount of wages the employee |
1758
|
earned in the filing period, and stating that the employee has |
1759
|
in good faith sought employment commensurate with the employee's |
1760
|
ability to work. The statement must be filed quarterly on a form |
1761
|
and in the manner prescribed by the department. The department |
1762
|
may modify the filing period as appropriate to an individual |
1763
|
case. Failure to file a statement relieves the carrier of |
1764
|
liability for supplemental benefits for the period during which |
1765
|
a statement is not filed. |
1766
|
(e)5.The carrier shall begin payment of supplemental |
1767
|
benefits not later than the seventh day after the expiration |
1768
|
date of the impairment income benefit period and shall continue |
1769
|
to timely pay those benefits. The carrier may request a |
1770
|
mediation conference for the purpose of contesting the |
1771
|
employee's entitlement to or the amount of supplemental income |
1772
|
benefits. |
1773
|
(f)6.Supplemental benefits are calculated quarterly and |
1774
|
paid monthly. For purposes of calculating supplemental benefits, |
1775
|
80 percent of the employee's average weekly wage and the average |
1776
|
wages the employee has earned per week are compared quarterly. |
1777
|
For purposes of this sectionparagraph, if the employee is |
1778
|
offered a bona fide position of employment that the employee is |
1779
|
capable of performing, given the physical condition of the |
1780
|
employee and the geographic accessibility of the position, the |
1781
|
employee's weekly wages are considered equivalent to the weekly |
1782
|
wages for the position offered to the employee. |
1783
|
(g)7.Supplemental benefits are payable at the rate of 80 |
1784
|
percent of the difference between 80 percent of the employee's |
1785
|
average weekly wage determined pursuant to s. 440.14 and the |
1786
|
weekly wages the employee has earned during the reporting |
1787
|
period, not to exceed the maximum weekly income benefit under s. |
1788
|
440.12. |
1789
|
(h)8.The department may by rule define terms that are |
1790
|
necessary for the administration of this section and forms and |
1791
|
procedures governing the method of payment of supplemental |
1792
|
benefits for dates of accidents before January 1, 1994, and for |
1793
|
dates of accidents on or after January 1, 1994. |
1794
|
(i)(c) Duration of temporary impairment and supplemental |
1795
|
income benefits.--The employee's eligibility for temporary |
1796
|
benefits, impairment income benefits, and supplemental benefits |
1797
|
terminates on the expiration of 401 weeks after the date of |
1798
|
injury. |
1799
|
(2) TERMINATION OF SUPPLEMENTAL BENEFITS.--
|
1800
|
(a) When the employer or carrier desires to contest the |
1801
|
employee’s eligibility for supplemental benefits or to terminate |
1802
|
the payment of supplemental benefits, an employer or carrier |
1803
|
shall give the employee 7 days' written notice by certificate of |
1804
|
mailing that the employee’s entitlement to supplemental benefits |
1805
|
is being contested, provide the employee with a copy of any |
1806
|
supporting documentation for said denial, and advise the |
1807
|
employee of his or her right to request a hearing on the issue |
1808
|
of supplemental benefits by filing a petition for benefits. The |
1809
|
employer's or carrier’s failure to comply with this time |
1810
|
provision shall result in the waiver of the 21-day period |
1811
|
provided in paragraph (b) in which to file a petition for |
1812
|
benefits on the issue. The evidence of any investigator, |
1813
|
adjuster, or other witness in the nature of surveillance shall |
1814
|
be subject to discovery when such evidence will be used at |
1815
|
trial, provided the party intending to use such evidence is |
1816
|
first given a reasonable opportunity to depose the party or |
1817
|
witness who is the subject of the surveillance.
|
1818
|
(b) If the employee objects to the employer's or carrier’s |
1819
|
denial or termination of payment of supplemental benefits, the |
1820
|
employee shall have 21 days after the date the notice of |
1821
|
termination was mailed to object to the denial or termination of |
1822
|
supplemental benefits by filing a petition for benefits for |
1823
|
payment of supplemental benefits. The employee’s petition for |
1824
|
benefits for supplemental benefits shall include a statement of |
1825
|
the period in dispute and copies of all medical reports based on |
1826
|
medical opinions pursuant to s. 440.13(9)(b), employment, wage, |
1827
|
vocational reports, and unemployment records, or any other |
1828
|
information to be offered at trial. Copies of said reports shall |
1829
|
be sent to the employer and carrier and its representative no |
1830
|
later than 10 days after the date of the filing of the petition |
1831
|
for benefits.
|
1832
|
(c) When the employer or carrier denies the payment of |
1833
|
supplemental benefits for any other reason, an employer or |
1834
|
carrier shall give the employee 7 days' written notice of denial |
1835
|
by certificate of mailing that the employee’s supplemental |
1836
|
benefits are being denied, provide the employee with a copy of |
1837
|
any documentation for said denial, including any medical, |
1838
|
employment, wages, vocational reports, and unemployment records, |
1839
|
and advise the employee of his or her right to request a hearing |
1840
|
on the payment of supplemental benefits by filing a petition for |
1841
|
benefits. The employer's or carrier’s failure to comply with |
1842
|
this time provision shall result in a waiver of any time period |
1843
|
in which to file a petition for benefits on the issue. The |
1844
|
evidence of any investigator, adjuster, or other witness in the |
1845
|
nature of surveillance shall be subject to discovery when such |
1846
|
evidence will be used at trial, provided the party intending to |
1847
|
use such evidence is first given a reasonable opportunity to |
1848
|
depose the party or witness who is the subject of the |
1849
|
surveillance.
|
1850
|
(d) If the employer or carrier denies eligibility for the |
1851
|
payment of supplemental benefits or permanent total disability |
1852
|
benefits because the employer or carrier has a job available to |
1853
|
the employee, the employer or carrier shall provide the |
1854
|
information set forth in s. 440.1502(1)(c)1. within 10 days |
1855
|
after such job becomes available. The failure of the employer or |
1856
|
carrier to produce this information within the timeframe |
1857
|
provided shall preclude its use at any final hearing for |
1858
|
supplemental benefits claims.
|
1859
|
(e) The failure of the employer, carrier, or employee to |
1860
|
provide the documentation required by this section shall result |
1861
|
in the same being excluded from evidence at any trial of this |
1862
|
issue.
|
1863
|
Section 18. Subsection (1) of section 440.15, Florida |
1864
|
Statutes, is renumbered as section 440.1505, Florida Statutes, |
1865
|
and amended to read: |
1866
|
440.1505 Compensation for permanent total |
1867
|
disability.--Compensation for permanent total disability shall |
1868
|
be paid to the employee, subject to the limits provided in s. |
1869
|
440.12(2), as follows:
|
1870
|
(1) PERMANENT TOTAL DISABILITY.-- |
1871
|
(a) In case of total disability adjudged to be permanent, |
1872
|
662/3 percent of the average weekly wages shall be paid to the |
1873
|
employee during the continuance of such total disability. |
1874
|
(b) Only a catastrophic injury as defined in s. 440.02 |
1875
|
shall, in the absence of conclusive proof of a substantial |
1876
|
earning capacity, constitute permanent total disability. Only |
1877
|
claimants with catastrophic injuries are eligible for permanent |
1878
|
total benefits. In no other case may permanent total disability |
1879
|
be awarded. |
1880
|
(c) In cases of permanent total disability resulting from |
1881
|
injuries that occurred prior to July 1, 1955, such payments |
1882
|
shall not be made in excess of 700 weeks. |
1883
|
(d) If an employee who is being paid compensation for |
1884
|
permanent total disability becomes rehabilitated to the extent |
1885
|
that she or he establishes an earning capacity, the employee |
1886
|
shall be paid, instead of the compensation provided in paragraph |
1887
|
(a), benefits pursuant to ss. 440.1503 and 440.1504subsection |
1888
|
(3). The department shall adopt rules to enable a permanently |
1889
|
and totally disabled employee who may have reestablished an |
1890
|
earning capacity to undertake a trial period of reemployment |
1891
|
without prejudicing her or his return to permanent total status |
1892
|
in the case that such employee is unable to sustain an earning |
1893
|
capacity. |
1894
|
(e)1. The employer's or carrier's right to conduct |
1895
|
vocational evaluations or testing pursuant to s. 440.491 |
1896
|
continues even after the employee has been accepted or |
1897
|
adjudicated as entitled to compensation under this chapter. This |
1898
|
right includes, but is not limited to, instances in which such |
1899
|
evaluations or tests are recommended by a treating physician or |
1900
|
independent medical-examination physician, instances warranted |
1901
|
by a change in the employee's medical condition, or instances in |
1902
|
which the employee appears to be making appropriate progress in |
1903
|
recuperation. This right may not be exercised more than once |
1904
|
every calendar year. |
1905
|
2. The carrier must confirm the scheduling of the |
1906
|
vocational evaluation or testing in writing, and must notify |
1907
|
employee's counsel, if any, at least 7 days before the date on |
1908
|
which vocational evaluation or testing is scheduled to occur. |
1909
|
3. Pursuant to an order of the judge of compensation |
1910
|
claims, the employer or carrier may withhold payment of benefits |
1911
|
for permanent total disability or supplements for any period |
1912
|
during which the employee willfully fails or refuses to appear |
1913
|
without good cause for the scheduled vocational evaluation or |
1914
|
testing. |
1915
|
(f)1. If permanent total disability results from injuries |
1916
|
that occurred subsequent to June 30, 1955, and for which the |
1917
|
liability of the employer for compensation has not been |
1918
|
discharged under s. 440.20(11), the injured employee shall |
1919
|
receive additional weekly compensation benefits equal to 5 |
1920
|
percent of her or his weekly compensation rate, as established |
1921
|
pursuant to the law in effect on the date of her or his injury, |
1922
|
multiplied by the number of calendar years since the date of |
1923
|
injury. The weekly compensation payable and the additional |
1924
|
benefits payable under this paragraph, when combined, may not |
1925
|
exceed the maximum weekly compensation rate in effect at the |
1926
|
time of payment as determined pursuant to s. 440.12(2). |
1927
|
Entitlement to these supplemental payments shall cease at age 62 |
1928
|
if the employee is eligible for social security benefits under |
1929
|
42 U.S.C. ss. 402 and 423, whether or not the employee has |
1930
|
applied for such benefits. These supplemental benefits shall be |
1931
|
paid by the department out of the Workers' Compensation |
1932
|
Administration Trust Fund when the injury occurred subsequent to |
1933
|
June 30, 1955, and before July 1, 1984. These supplemental |
1934
|
benefits shall be paid by the employer when the injury occurred |
1935
|
on or after July 1, 1984. Supplemental benefits are not payable |
1936
|
for any period prior to October 1, 1974. |
1937
|
2.a. The department shall provide by rule for the periodic |
1938
|
reporting to the department of all earnings of any nature and |
1939
|
social security income by the injured employee entitled to or |
1940
|
claiming additional compensation under subparagraph 1. Neither |
1941
|
the department nor the employer or carrier shall make any |
1942
|
payment of those additional benefits provided by subparagraph 1. |
1943
|
for any period during which the employee willfully fails or |
1944
|
refuses to report upon request by the department in the manner |
1945
|
prescribed by such rules. |
1946
|
b. The department shall provide by rule for the periodic |
1947
|
reporting to the employer or carrier of all earnings of any |
1948
|
nature and social security income by the injured employee |
1949
|
entitled to or claiming benefits for permanent total disability. |
1950
|
The employer or carrier is not required to make any payment of |
1951
|
benefits for permanent total disability for any period during |
1952
|
which the employee willfully fails or refuses to report upon |
1953
|
request by the employer or carrier in the manner prescribed by |
1954
|
such rules or if any employee who is receiving permanent total |
1955
|
disability benefits refuses to apply for or cooperate with the |
1956
|
employer or carrier in applying for social security benefits. |
1957
|
3. When an injured employee receives a full or partial |
1958
|
lump-sum advance of the employee's permanent total disability |
1959
|
compensation benefits, the employee's benefits under this |
1960
|
paragraph shall be computed on the employee's weekly |
1961
|
compensation rate as reduced by the lump-sum advance. |
1962
|
(2) TERMINATION OF PERMANENT TOTAL DISABILITY BENEFITS.--
|
1963
|
(a) When an injured employee has been voluntarily accepted |
1964
|
as being permanently and totally disabled by the employer and |
1965
|
carrier without stipulation of the parties or order of the judge |
1966
|
of compensation claims, and the employer or carrier desires to |
1967
|
suspend or terminate the payment of permanent total disability |
1968
|
benefits, an employer or carrier shall give the employee 7 days' |
1969
|
written notice by certificate of mailing that the employee’s |
1970
|
eligibility for permanent total disability benefits has been |
1971
|
terminated, provide the employee with a copy of any supporting |
1972
|
documentation for said termination, and advise the employee of |
1973
|
his or her right to request a hearing on the issue of |
1974
|
reinstatement of permanent total disability benefits by filing a |
1975
|
petition for benefits. The employer's or carrier’s failure to |
1976
|
comply with this time provision shall result in the waiver of |
1977
|
the period provided in paragraph (d) in which to file a petition |
1978
|
for benefits on the issue. The evidence of any investigator, |
1979
|
adjuster, or other witness in the nature of surveillance shall |
1980
|
be subject to discovery when such evidence will be used at |
1981
|
trial, provided the party intending to use such evidence is |
1982
|
first given a reasonable opportunity to depose the party or |
1983
|
witness who is the subject of the surveillance.
|
1984
|
(b) If the employee objects to the employer's or carrier’s |
1985
|
termination of payment of permanent total disability benefits, |
1986
|
the employee shall have 21 days after the date the notice of |
1987
|
termination was mailed to object to the termination of permanent |
1988
|
total disability by filing a petition for benefits for payment |
1989
|
of permanent total disability. The employee’s petition for |
1990
|
benefits on permanent total disability issues shall include a |
1991
|
statement of the period in dispute, copies of all medical |
1992
|
records and reports based on medical opinions pursuant to s. |
1993
|
440.13(9)(b), and employment, wage, vocational, disability |
1994
|
reports, and unemployment records. Copies of said records shall |
1995
|
be mailed to the employer and carrier and its representative no |
1996
|
later than 10 days after the date of the filing of the petition |
1997
|
for benefits.
|
1998
|
(c) When the employer or carrier denies an employee's |
1999
|
eligibility for the payment of permanent total disability |
2000
|
benefits, an employer or carrier shall give the employee 7 days' |
2001
|
written notice of denial by certificate of mailing that the |
2002
|
employee’s permanent total disability benefits are being denied, |
2003
|
provide the employee with a copy of any documentation for said |
2004
|
denial, including any medical, employment, wages, vocational |
2005
|
reports, and unemployment records, and advise the employee of |
2006
|
his or her right to request a hearing on the payment of |
2007
|
permanent total disability by filing a petition for benefits. |
2008
|
The employer's or carrier’s failure to comply with this time |
2009
|
provision shall result in a waiver of any time period in which |
2010
|
to file a petition for benefits on this issue. The evidence of |
2011
|
any investigator, adjuster, or other witness in the nature of |
2012
|
surveillance shall be subject to discovery when such evidence |
2013
|
will be used at trial, provided the party intending to use such |
2014
|
evidence is first given a reasonable opportunity to depose the |
2015
|
party or witness who is the subject of the surveillance.
|
2016
|
(d) If the employer or carrier denies the entitlement to |
2017
|
permanent total disability benefits because the employer or |
2018
|
carrier has a job available to the employee, the employer or |
2019
|
carrier shall provide the information set forth in s. |
2020
|
440.1502(1)(c)1. within 10 days after such job becomes |
2021
|
available. The failure of the employer or carrier to produce |
2022
|
this information within the timeframe provided shall preclude |
2023
|
its use at any final hearing for permanent total disability |
2024
|
claims.
|
2025
|
(e) If the employer or carrier denies eligibility for the |
2026
|
payment of permanent total disability benefits because the |
2027
|
employer or carrier has a job available to the employee, the |
2028
|
employer or carrier shall provide the information set forth in |
2029
|
s. 440.1502(1)(c)1. within 10 days after such job becomes |
2030
|
available. The failure of the employer or carrier to produce |
2031
|
this information within the timeframe provided shall preclude |
2032
|
its use at any final hearing for permanent total disability |
2033
|
benefits claims.
|
2034
|
(f) The failure of the employer, carrier, or employee to |
2035
|
provide the documentation required by this subsection shall |
2036
|
result in the same being excluded from evidence at any trial of |
2037
|
this issue.
|
2038
|
Section 19. Subsections (5), (6), (7), (8), (9), and (12) |
2039
|
of section 440.15, Florida Statutes, are renumbered as section |
2040
|
440.1506, Florida Statutes, and amended to read: |
2041
|
440.1506 Compensation for subsequent injury.--Compensation |
2042
|
for subsequent injury shall be paid to the employee, subject to |
2043
|
the limits provided in s. 440.12(2), as follows:
|
2044
|
(1)(5)SUBSEQUENT INJURY.-- |
2045
|
(a) The fact that an employee has suffered previous |
2046
|
disability, impairment, anomaly, or disease, or received |
2047
|
compensation therefor, shall not preclude her or him from |
2048
|
benefits for a subsequent aggravation or acceleration of the |
2049
|
preexisting condition nor preclude benefits for death resulting |
2050
|
therefrom, except that no benefits shall be payable if the |
2051
|
employee, at the time of entering into the employment of the |
2052
|
employer by whom the benefits would otherwise be payable, |
2053
|
falsely represents herself or himself in writing as not having |
2054
|
previously been disabled or compensated because of such previous |
2055
|
disability, impairment, anomaly, or disease and the employer |
2056
|
detrimentally relies on the misrepresentation. Compensation for |
2057
|
temporary disability, medical benefits, and wage-loss benefits |
2058
|
shall not be subject to apportionment. |
2059
|
(b) If a compensable permanent impairment, or any portion |
2060
|
thereof, is a result of aggravation or acceleration of a |
2061
|
preexisting condition, or is the result of merger with a |
2062
|
preexisting impairment, an employee eligible to receive |
2063
|
impairment benefits under s. 440.1503(1)paragraph (3)(a)shall |
2064
|
receive such benefits for the total impairment found to result, |
2065
|
excluding the degree of impairment existing at the time of the |
2066
|
subject accident or injury or which would have existed by the |
2067
|
time of the impairment rating without the intervention of the |
2068
|
compensable accident or injury. The degree of permanent |
2069
|
impairment attributable to the accident or injury shall be |
2070
|
compensated in accordance with s. 440.1503(1)paragraph (3)(a). |
2071
|
As used in this paragraph, "merger" means the combining of a |
2072
|
preexisting permanent impairment with a subsequent compensable |
2073
|
permanent impairment which, when the effects of both are |
2074
|
considered together, result in a permanent impairment rating |
2075
|
which is greater than the sum of the two permanent impairment |
2076
|
ratings when each impairment is considered individually. |
2077
|
(2)(6)OBLIGATION TO REHIRE.--If the employer has not in |
2078
|
good faith made available to the employee, within a 100-mile |
2079
|
radius of the employee's residence, work appropriate to the |
2080
|
employee's physical limitations within 30 days after the carrier |
2081
|
notifies the employer of maximum medical improvement and the |
2082
|
employee's physical limitations, the employer shall pay to the |
2083
|
department for deposit into the Workers' Compensation |
2084
|
Administration Trust Fund a fine of $250 for every $5,000 of the |
2085
|
employer's workers' compensation premium or payroll, not to |
2086
|
exceed $2,000 per violation, as the department requires by rule. |
2087
|
The employer is not subject to this subsection if the employee |
2088
|
is receiving permanent total disability benefits or if the |
2089
|
employer has 50 or fewer employees. |
2090
|
(3)(7)EMPLOYEE REFUSES EMPLOYMENT.--If an injured |
2091
|
employee refuses employment suitable to the capacity thereof, |
2092
|
offered to or procured therefor, such employee shall not be |
2093
|
entitled to any compensation at any time during the continuance |
2094
|
of such refusal unless at any time in the opinion of the judge |
2095
|
of compensation claims such refusal is justifiable. |
2096
|
(4)(8)EMPLOYEE LEAVES EMPLOYMENT.--If an injured |
2097
|
employee, when receiving compensation for temporary partial |
2098
|
disability, leaves the employment of the employer by whom she or |
2099
|
he was employed at the time of the accident for which such |
2100
|
compensation is being paid, the employee shall, upon securing |
2101
|
employment elsewhere, give to such former employer an affidavit |
2102
|
in writing containing the name of her or his new employer, the |
2103
|
place of employment, and the amount of wages being received at |
2104
|
such new employment; and, until she or he gives such affidavit, |
2105
|
the compensation for temporary partial disability will cease. |
2106
|
The employer by whom such employee was employed at the time of |
2107
|
the accident for which such compensation is being paid may also |
2108
|
at any time demand of such employee an additional affidavit in |
2109
|
writing containing the name of her or his employer, the place of |
2110
|
her or his employment, and the amount of wages she or he is |
2111
|
receiving; and if the employee, upon such demand, fails or |
2112
|
refuses to make and furnish such affidavit, her or his right to |
2113
|
compensation for temporary partial disability shall cease until |
2114
|
such affidavit is made and furnished. |
2115
|
(5)(9)EMPLOYEE BECOMES INMATE OF INSTITUTION.--In case an |
2116
|
employee becomes an inmate of a public institution, then no |
2117
|
compensation shall be payable unless she or he has dependent |
2118
|
upon her or him for support a person or persons defined as |
2119
|
dependents elsewhere in this chapter, whose dependency shall be |
2120
|
determined as if the employee were deceased and to whom |
2121
|
compensation would be paid in case of death; and such |
2122
|
compensation as is due such employee shall be paid such |
2123
|
dependents during the time she or he remains such inmate. |
2124
|
(6)(12)FULL-PAY STATUS FOR CERTAIN LAW ENFORCEMENT |
2125
|
OFFICERS.--Any law enforcement officer as defined in s. |
2126
|
943.10(1), (2), or (3) who, while acting within the course of |
2127
|
employment as provided by s. 440.091, is maliciously or |
2128
|
intentionally injured and who thereby sustains a job-connected |
2129
|
disability compensable under this chapter shall be carried in |
2130
|
full-pay status rather than being required to use sick, annual, |
2131
|
or other leave. Full-pay status shall be granted only after |
2132
|
submission to the employing agency's head of a medical report |
2133
|
which gives a current diagnosis of the employee's recovery and |
2134
|
ability to return to work. In no case shall the employee's |
2135
|
salary and workers' compensation benefits exceed the amount of |
2136
|
the employee's regular salary requirements. |
2137
|
Section 20. Subsections (10) and (11) of section 440.15, |
2138
|
Florida Statutes, are renumbered as section 440.1507, Florida |
2139
|
Statutes, and amended to read: |
2140
|
440.1507 Eligibility for benefits.--
|
2141
|
(1)(10)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER |
2142
|
AND FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE ACT.-- |
2143
|
(a) Weekly compensation benefits payable under this |
2144
|
chapter for disability resulting from injuries to an employee |
2145
|
who becomes eligible for benefits under 42 U.S.C. s. 423 shall |
2146
|
be reduced to an amount whereby the sum of such compensation |
2147
|
benefits payable under this chapter and such total benefits |
2148
|
otherwise payable for such period to the employee and her or his |
2149
|
dependents, had such employee not been entitled to benefits |
2150
|
under this chapter, under 42 U.S.C. ss. 402 and 423, does not |
2151
|
exceed 80 percent of the employee's average weekly wage. |
2152
|
However, this provision shall not operate to reduce an injured |
2153
|
worker's benefits under this chapter to a greater extent than |
2154
|
such benefits would have otherwise been reduced under 42 U.S.C. |
2155
|
s. 424(a). This reduction of compensation benefits is not |
2156
|
applicable to any compensation benefits payable for any week |
2157
|
subsequent to the week in which the injured worker reaches the |
2158
|
age of 62 years. |
2159
|
(b) If the provisions of 42 U.S.C. s. 424(a) are amended |
2160
|
to provide for a reduction or increase of the percentage of |
2161
|
average current earnings that the sum of compensation benefits |
2162
|
payable under this chapter and the benefits payable under 42 |
2163
|
U.S.C. ss. 402 and 423 can equal, the amount of the reduction of |
2164
|
benefits provided in this subsection shall be reduced or |
2165
|
increased accordingly. The department may by rule specify forms |
2166
|
and procedures governing the method for calculating and |
2167
|
administering the offset of benefits payable under this chapter |
2168
|
and benefits payable under 42 U.S.C. ss. 402 and 423. The |
2169
|
department shall have first priority in taking any available |
2170
|
social security offsets on dates of accidents occurring before |
2171
|
July 1, 1984. |
2172
|
(c) No disability compensation benefits payable for any |
2173
|
week, including those benefits provided by s. 440.1505(1)(f) |
2174
|
paragraph (1)(f), shall be reduced pursuant to this subsection |
2175
|
until the Social Security Administration determines the amount |
2176
|
otherwise payable to the employee under 42 U.S.C. ss. 402 and |
2177
|
423 and the employee has begun receiving such social security |
2178
|
benefit payments. The employee shall, upon demand by the |
2179
|
department, the employer, or the carrier, authorize the Social |
2180
|
Security Administration to release disability information |
2181
|
relating to her or him and authorize the Division of |
2182
|
Unemployment Compensation to release unemployment compensation |
2183
|
information relating to her or him, in accordance with rules to |
2184
|
be adopted by the department prescribing the procedure and |
2185
|
manner for requesting the authorization and for compliance by |
2186
|
the employee. Neither the department nor the employer or carrier |
2187
|
shall make any payment of benefits for total disability or those |
2188
|
additional benefits provided by s. 440.1505(1)(f)paragraph |
2189
|
(1)(f)for any period during which the employee willfully fails |
2190
|
or refuses to authorize the release of information in the manner |
2191
|
and within the time prescribed by such rules. The authority for |
2192
|
release of disability information granted by an employee under |
2193
|
this paragraph shall be effective for a period not to exceed 12 |
2194
|
months, such authority to be renewable as the department may |
2195
|
prescribe by rule. |
2196
|
(d) If compensation benefits are reduced pursuant to this |
2197
|
subsection, the minimum compensation provisions of s. 440.12(2) |
2198
|
do not apply. |
2199
|
(e)1. Within 30 days after any application for social |
2200
|
security benefits, an employee who has filed a petition for |
2201
|
benefits for workers’ compensation indemnity or medical benefits |
2202
|
or who is receiving workers’ compensation indemnity or medical |
2203
|
benefits shall notify the employer and carrier of the |
2204
|
application and shall:
|
2205
|
a. Provide the employer and carrier by certificate of |
2206
|
mailing with a copy or proof of such application.
|
2207
|
b. Provide the employer and carrier with a release of |
2208
|
information within 14 days after written request by certificate |
2209
|
of mailing by the employer or carrier which may be utilized by |
2210
|
the employer or carrier to obtain the employee's social security |
2211
|
file, including, but not limited to, average current earnings, |
2212
|
primary insurance amount, and offset taken by the Social |
2213
|
Security Administration.
|
2214
|
2. Within 30 days after an award or adjudication of any |
2215
|
social security benefits, the employee shall provide a copy of |
2216
|
said award or adjudication by certificate of mailing to the |
2217
|
employer and carrier by certificate of mailing and provide the |
2218
|
employer and carrier with a release as outlined in sub- |
2219
|
subparagraph 1.b. by certificate of mailing. If the employee |
2220
|
fails to provide the information required by this subparagraph, |
2221
|
the employer and carrier shall nevertheless be entitled to any |
2222
|
applicable social security disability offset retroactive to the |
2223
|
date of the social security disability award or adjudication. If |
2224
|
the employer or carrier fails to take the social security |
2225
|
disability offset within 120 days after receipt of all |
2226
|
information required in sub-subparagraph 1.b., the employer or |
2227
|
carrier shall not be entitled to any retroactive social security |
2228
|
disability offset.
|
2229
|
3. If the employee refuses or fails to provide the |
2230
|
employer or carrier with a copy or proof of application for |
2231
|
social security benefits, a release of information, and a copy |
2232
|
of any social security award or adjudication, the employer or |
2233
|
carrier shall not make any payment of compensation benefits for |
2234
|
any period during which the employee continues such failure or |
2235
|
refusal. No hearing on compensation benefits shall be scheduled |
2236
|
at the request of the employee until the documents required by |
2237
|
this paragraph are provided by certificate of mailing. The |
2238
|
employer or carrier shall provide a copy of any and all |
2239
|
information received by either the employer or carrier pursuant |
2240
|
to sub-subparagraph 1.b. to the employee within 14 days after |
2241
|
receipt of the information by certificate of mailing. No social |
2242
|
security disability offset may be taken until the employer or |
2243
|
carrier has provided a copy by certificate of mailing of all |
2244
|
information received by it pursuant to sub-subparagraph 1.b. to |
2245
|
the employee.
|
2246
|
4. Compensation or medical benefits withheld shall be |
2247
|
reinstated without penalty, interest, costs, or attorney’s fees |
2248
|
when the documents required by sub-subparagraph 1.b. and |
2249
|
subparagraph 2., have been provided.
|
2250
|
(2)(11)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER |
2251
|
WHO HAS RECEIVED OR IS ENTITLED TO RECEIVE UNEMPLOYMENT |
2252
|
COMPENSATION.-- |
2253
|
(a) No compensation benefits shall be payable for |
2254
|
temporary total disability or permanent total disability under |
2255
|
this chapter for any week in which the injured employee has |
2256
|
received, or is receiving, unemployment compensation benefits. |
2257
|
(b) If an employee is entitled to temporary partial |
2258
|
benefits pursuant to s. 440.1502(1)subsection (4)and |
2259
|
unemployment compensation benefits, such unemployment |
2260
|
compensation benefits shall be primary and the temporary partial |
2261
|
benefits shall be supplemental only, the sum of the two benefits |
2262
|
not to exceed the amount of temporary partial benefits which |
2263
|
would otherwise be payable. |
2264
|
Section 21. Subsection (13) of section 440.15, Florida |
2265
|
Statutes, is renumbered as section 440.1508, Florida Statutes, |
2266
|
and amended to read: |
2267
|
440.1508 Repayment; miscalculation of benefits.--
|
2268
|
(1)(13)REPAYMENT.--If an employee has received a sum as |
2269
|
an indemnity benefit under any classification or category of |
2270
|
benefit under this chapter to which she or he is not entitled, |
2271
|
the employee is liable to repay that sum to the employer or the |
2272
|
carrier or to have that sum deducted from future benefits, |
2273
|
regardless of the classification of benefits, payable to the |
2274
|
employee under this chapter; however, a partial payment of the |
2275
|
total repayment may not exceed 20 percent of the amount of the |
2276
|
biweekly payment. |
2277
|
(2) MISCALCULATION OF BENEFITS.--
|
2278
|
(a) When an employer or carrier alleges there has been an |
2279
|
overpayment for which it is entitled to credit, the employer or |
2280
|
carrier shall give 7 days' written notice by certificate of |
2281
|
mailing of an overpayment; provide the employee with a copy of |
2282
|
any supporting documentation, including, but not limited to, the |
2283
|
payout sheet, overpayment calculations, social security |
2284
|
disability offset calculations and material, Average Current |
2285
|
Earnings (ACE)/ Primary Insurance Amount (PIA) information |
2286
|
contained within a dated DWC-14 form completed by the Social |
2287
|
Security Administration; and advise the employee of his or her |
2288
|
right to request a hearing by filing a petition for benefits on |
2289
|
said issues.
|
2290
|
(b) If the employee objects, the employee shall file a |
2291
|
petition for benefits which shall include a statement outlining |
2292
|
the employee’s objection to the credit or miscalculation of |
2293
|
benefits, set forth the employee’s calculations with a |
2294
|
reasonable explanation, and provide any additional documentation |
2295
|
in support of the employee’s objection. A copy of any supporting |
2296
|
documentation shall be sent by certificate of mailing to the |
2297
|
employer and carrier and its representative no later than 10 |
2298
|
days after the filing of the petition for benefits.
|
2299
|
Section 22. Subsection (8) is added to section 440.16, |
2300
|
Florida Statutes, and subsection (6) of section 440.25, Florida |
2301
|
Statutes, is renumbered as subsection (9) of section 440.16, |
2302
|
Florida Statutes, and amended, to read: |
2303
|
440.16 Compensation for death.-- |
2304
|
(8)(a) A petition for benefits filed by or on behalf of a |
2305
|
dependent or person entitled to compensation under this section |
2306
|
shall be accompanied by a certified copy of the following:
|
2307
|
1. Death certificate of the deceased employee.
|
2308
|
2. The autopsy report, if an autopsy was performed, for |
2309
|
the deceased employee.
|
2310
|
3. The certificate of birth of the claimant, if the |
2311
|
claimant is a surviving child of the deceased employee.
|
2312
|
4. Adoption papers or other decrees and court records |
2313
|
establishing legal responsibility for support of dependant |
2314
|
children.
|
2315
|
5. If either the deceased employee or the surviving spouse |
2316
|
have been involved in prior divorce proceedings, copies of |
2317
|
decrees and orders of the courts.
|
2318
|
6. If the claimant is an illegitimate child, evidence of |
2319
|
the claimant's acknowledgment by the deceased employee prior to |
2320
|
death and evidence of dependency.
|
2321
|
|
2322
|
If the documentation required in subparagraphs 1.-6. is not |
2323
|
readily available, the judge of compensation claims shall |
2324
|
determine the adequacy of substitute documentation.
|
2325
|
(b) If death results from the accident within 1 year |
2326
|
thereafter or follows continuous disability and results from the |
2327
|
accident within 5 years thereafter, in addition to providing all |
2328
|
the documentation required by paragraph (a), the petition for |
2329
|
benefits filed by the claimant shall include any and all medical |
2330
|
records and reports based on medical opinions pursuant to s. |
2331
|
440.13(9)(b) establishing a causal relationship between the |
2332
|
employee’s death and the industrial accident.
|
2333
|
(c) In addition to establishing compensability of death, |
2334
|
the claimant seeking payment of actual funeral expenses shall |
2335
|
furnish the documentation required by paragraphs (a) and (b) and |
2336
|
copies of any and all funeral expense bills.
|
2337
|
(d) When the employer or carrier denies the payment of |
2338
|
death benefits or funeral expenses, the employer or carrier |
2339
|
shall give the claimant 7 days' written notice of denial by |
2340
|
certificate of mailing that the employee’s death benefits are |
2341
|
being denied; provide the employee with a copy of any |
2342
|
documentation supporting said denial, including any medical, |
2343
|
employment, wages, or unemployment records; and advise the party |
2344
|
seeking payment of such benefits of his or her right to request |
2345
|
a hearing on the payment of death benefits or funeral expenses |
2346
|
by filing a petition for benefits. The employer's or carrier’s |
2347
|
failure to comply with this time provision shall result in a |
2348
|
waiver of any time period within which the claimant must file a |
2349
|
petition for benefits on this issue. The evidence of any |
2350
|
investigator, adjuster, or other witness in the nature of |
2351
|
surveillance shall be subject to discovery when such evidence |
2352
|
will be used at trial, provided the party intending to use such |
2353
|
evidence is first given a reasonable opportunity to depose the |
2354
|
party or witness who is the subject of the surveillance.
|
2355
|
(9)(6)An award of compensation for disability may be made |
2356
|
after the death of an injured employee. |
2357
|
Section 23. Section 440.1855, Florida Statutes, is created |
2358
|
to read: |
2359
|
440.1855 Statute of limitations.-- |
2360
|
(1) When the employer or carrier denies the provision of |
2361
|
benefits on the basis that the statute of limitations has run, |
2362
|
the employer or carrier shall give the employee 7 days' written |
2363
|
notice of denial by certificate of mailing that the benefits are |
2364
|
being denied based on the statute of limitations; provide the |
2365
|
employee with copies of any supporting documentation for said |
2366
|
denial, including any medical records and reports and carrier |
2367
|
payout sheets; and advise the employee of his or her right to |
2368
|
file a petition for benefits on the issue.
|
2369
|
(2) If the employee objects to the employer's or carrier’s |
2370
|
denial on the basis of the statute of limitations, the employee |
2371
|
shall have 21 days after the date the notice of denial was |
2372
|
mailed to object to the denial of benefits by filing a petition |
2373
|
for benefits seeking the provision of workers' compensation |
2374
|
benefits. The employee’s petition for benefits shall include a |
2375
|
statement outlining why the statute of limitations has not |
2376
|
expired, set forth the nature of the benefits being sought, and |
2377
|
provide all documentation in support of the claim. A copy of |
2378
|
said documentation shall be mailed to the employer and carrier |
2379
|
and its representative no later than 10 days after the date of |
2380
|
the filing of the petition for benefits.
|
2381
|
(3) Failure of the employer or carrier or the employee to |
2382
|
provide the documentation required by this section shall result |
2383
|
in the same being excluded from evidence at any trial of this |
2384
|
issue.
|
2385
|
Section 24. Section 440.191, Florida Statutes, is |
2386
|
repealed. |
2387
|
Section 25. Section 440.1915, Florida Statutes, is created |
2388
|
to read: |
2389
|
440.1915 Stay pending criminal investigation and |
2390
|
prosecution.--An employer or carrier may apply to the department |
2391
|
for certification of a pending criminal investigation of |
2392
|
workers’ compensation fraud involving an employee who has filed |
2393
|
a petition for benefits. Once the department certifies the |
2394
|
existence of such investigation, said certification shall act as |
2395
|
an immediate and automatic stay of further workers' compensation |
2396
|
judicial proceedings, subject to the following provisions and |
2397
|
limitations:
|
2398
|
(1) During the pendency of the stay, no trial shall be |
2399
|
held.
|
2400
|
(2) The stay shall expire upon the occurrence of the |
2401
|
earliest of the following:
|
2402
|
(a) A notice of determination that no criminal prosecution |
2403
|
shall be instituted against the employee by the department or |
2404
|
the applicable state attorney.
|
2405
|
(b) A certified copy of the final disposition of the |
2406
|
criminal prosecution from the applicable clerk of court.
|
2407
|
Section 26. Subsections (1) and (6) of section 440.192, |
2408
|
Florida Statutes, are amended, present subsection (7) is |
2409
|
renumbered as subsection (6), present subsection (8) is |
2410
|
renumbered as subsection (7) and amended, and new subsections |
2411
|
(8) and (9) are added to said section, to read: |
2412
|
440.192 Procedure for resolving benefit disputes.-- |
2413
|
(1) Subject to s. 440.191,Any employee who has not |
2414
|
received a benefit to which the employee believes she or he is |
2415
|
entitled under this chapter shall file by certified mail, or by |
2416
|
electronic means approved by the DeputyChief Judge, with the |
2417
|
Office of the Judges of Compensation Claims a petition for |
2418
|
benefits which meets the requirements of this section. The |
2419
|
department shall inform employees of the location of the Office |
2420
|
of the Judges of Compensation Claims for purposes of filing a |
2421
|
petition for benefits. The employee shall also serve copies of |
2422
|
the petition for benefits by certified mail, or by electronic |
2423
|
means approved by the DeputyChief Judge, upon the employer and |
2424
|
the employer's carrier. The DeputyChief Judge shall refer the |
2425
|
petitions to the judges of compensation claims. |
2426
|
(6) If the claimant is not represented by counsel, the |
2427
|
Office of the Judges of Compensation Claims may request the |
2428
|
Employee Assistance and Ombudsman Office to assist the claimant |
2429
|
in filing a petition that meets the requirements of this |
2430
|
section.
|
2431
|
(7)(8) Within 3014days after receipt of a petition for |
2432
|
benefits by certified mail, the carrier must either pay the |
2433
|
requested benefits without prejudice to its right to deny within |
2434
|
120 days from receipt of the petition or file a response to |
2435
|
petition with the Office of the Judges of Compensation Claims. |
2436
|
The carrier must list all benefits requested but not paid and |
2437
|
explain its justification for nonpayment in the response to |
2438
|
petition. A carrier that does not deny compensability in |
2439
|
accordance with s. 440.20(4) is deemed to have accepted the |
2440
|
employee's injuries as compensable, unless it can establish |
2441
|
material facts relevant to the issue of compensability that |
2442
|
could not have been discovered through reasonable investigation |
2443
|
within the 120-day period. The carrier shall provide copies of |
2444
|
the response to the filing party, employer, and claimant by |
2445
|
certified mail. |
2446
|
(8)(a) The employer or carrier, by and through counsel, |
2447
|
shall file an answer to the petition for benefits within 30 days |
2448
|
after the receipt of the same and provide copies to the Office |
2449
|
of the Judge of Compensation Claims, the employee, and |
2450
|
employee’s counsel, if any. The answer to the petition for |
2451
|
benefits shall, if known, contain the following:
|
2452
|
1. The name and address of the attorney representing the |
2453
|
employer or carrier.
|
2454
|
2. The name and address of the carrier.
|
2455
|
3. The carrier's claim number.
|
2456
|
4. The admission or denial of the employment relationship.
|
2457
|
5. The admission or denial that the accident or illness |
2458
|
arose out of and in the course of employment.
|
2459
|
6. Average weekly wage and corresponding weekly |
2460
|
compensation rate used by the employer or carrier.
|
2461
|
7. Period and classification of benefits paid.
|
2462
|
8. Name of authorized medical providers, if any.
|
2463
|
9. The admission or denial of jurisdiction of the judge of |
2464
|
compensation claims.
|
2465
|
10. The admission or denial of coverage by the carrier for |
2466
|
the date of the accident claimed.
|
2467
|
(b) The answer shall individually admit or deny each of |
2468
|
the benefits alleged to be due and owing in the petition for |
2469
|
benefits and shall state the contention of the employer or |
2470
|
carrier with reference to notice and statute of limitations |
2471
|
defenses.
|
2472
|
(c) Each fact alleged by the petition and not specifically |
2473
|
denied by the answer is deemed admitted, but the failure to deny |
2474
|
such a fact does not preclude the requirement that the fact be |
2475
|
proven at trial.
|
2476
|
(d) A copy of the answer shall be served on the employee |
2477
|
and his or her legal counsel, if any, and the answer may be |
2478
|
prepared by the attorney for the employer and carrier based upon |
2479
|
knowledge, information, or belief.
|
2480
|
(9)(a) Upon the written request of counsel for the |
2481
|
employer or carrier, the judge of compensation claims shall |
2482
|
extend the time in which to file an answer for 7 additional |
2483
|
days. The time to file an answer may also be extended upon |
2484
|
agreement of the claimant or his or her attorney of record.
|
2485
|
(b) The judge of compensation claims shall be notified in |
2486
|
writing by the employer or carrier or its counsel, no later than |
2487
|
5 days after the time for the filing of the answer, of the fact |
2488
|
that an agreement has been reached, including the length of the |
2489
|
extension. When a petition for benefits received by the judge of |
2490
|
compensation claims does not include an answer, written |
2491
|
extension order, or written notification of the extension |
2492
|
agreement, such petition for benefits shall be set for hearing |
2493
|
on the judge of compensation claims' first available date.
|
2494
|
(c) A written request for extension to answer a claim |
2495
|
shall be made to the judge of compensation claims who has venue |
2496
|
of the case.
|
2497
|
Section 27. Section 440.1927, Florida Statutes, is created |
2498
|
to read: |
2499
|
440.1927 Procedures for expedited hearings.--
|
2500
|
(1) A request for an expedited hearing when compensability |
2501
|
has been accepted by the employer and carrier may be granted |
2502
|
upon showing of a significant financial hardship or medical |
2503
|
emergency directly attributable to the cessation of benefits |
2504
|
under this chapter. In determining whether such significant |
2505
|
financial hardship exists, the claimant shall complete and the |
2506
|
court shall consider a motion for indigency as provided by Rule |
2507
|
9.180(g), Florida Rules of Appellate Procedure, and |
2508
|
consideration shall also be given to whether an employee is |
2509
|
presently employed, the employee’s preinjury and postinjury |
2510
|
income and medical status, other financial sources available to |
2511
|
the employee, the nature and extent of the employee's expenses |
2512
|
and debts, whether the employee is the sole provider for |
2513
|
dependants, whether a foreclosure or repossession of a residence |
2514
|
or sole mode of personal transportation is imminent, and any |
2515
|
other relevant financial documents as determined by the court. |
2516
|
In determining whether a medical emergency exists, consideration |
2517
|
shall be given to the nature of the medical services recommended |
2518
|
based on medical opinions pursuant to s. 440.13(9)(b), whether |
2519
|
the issue of causation is being contested, and any impact the |
2520
|
medical condition has on the employee’s employability.
|
2521
|
(2) Absent a stipulation by the parties, or waiver by the |
2522
|
employer and carrier, that a significant financial hardship or |
2523
|
medical emergency exists, if a request for an expedited hearing |
2524
|
has been served and filed, the judge of compensation claims |
2525
|
shall hold an evidentiary hearing. If such request is denied, |
2526
|
the matter shall be returned to the regular calendar of cases. |
2527
|
If the request is granted, the judge of compensation claims |
2528
|
shall schedule the matter for expedited hearing.
|
2529
|
(3) Upon entry of an order granting the request for an |
2530
|
expedited hearing, the judge of compensation claims shall, |
2531
|
within 10 days after entry of the order, issue a mediation and |
2532
|
live pretrial hearing notice scheduling a state mediation |
2533
|
conference on the expedited issues within 60 days after the |
2534
|
mediation and scheduling a live pretrial hearing within 5 days |
2535
|
after the state mediation conference date. Following the live |
2536
|
pretrial hearing and absent an agreement or stipulation by the |
2537
|
parties, the judge of compensation claims shall issue an order |
2538
|
establishing deadlines for the parties to complete any necessary |
2539
|
additional discovery and establishing a date and time for the |
2540
|
final hearing which shall be held within 90 days after the live |
2541
|
pretrial hearing.
|
2542
|
Section 28. Present subsections (1) and (2) of section |
2543
|
440.25, Florida Statutes, are amended, present subsection (3) is |
2544
|
renumbered as subsection (6) and amended, present subsection (4) |
2545
|
is renumbered as subsection (9) and amended, present subsection |
2546
|
(7) is renumbered as subsection (10), and new subsections (2), |
2547
|
(3), (4), (5), (7), and (8) are added to said section, to read: |
2548
|
440.25 Procedures for mediation and hearings.-- |
2549
|
(1) Within 15090days after a petition for benefits is |
2550
|
filed under s. 440.192, a mediation conference concerning such |
2551
|
petition shall be held. Within 40 days after such petition is |
2552
|
filed,The judge of compensation claims shall notify the |
2553
|
interested parties by order that a mediation conference |
2554
|
concerning such petition will be held unless the parties have |
2555
|
notified the Office of the Judges of Compensation Claims that a |
2556
|
mediation has been held. Such order must give the date onby |
2557
|
which the mediation conference must be held. Such order may be |
2558
|
served personally upon the interested parties or may be sent to |
2559
|
the interested parties by mail. The claimant or the adjuster of |
2560
|
the employer or carrier may, at the mediator's discretion, |
2561
|
attend the mediation conference by telephone or, if agreed to by |
2562
|
the parties, other electronic means. The judge of compensation |
2563
|
claims may excuse the appearance of a party or attorney or |
2564
|
permit the appearance of a party or attorney by telephone upon |
2565
|
written request with timely notice of the request to the |
2566
|
opposing counsel. It is the duty of the party or attorney |
2567
|
appearing by telephone to ensure that facilities are arranged at |
2568
|
the expense of the party appearing by telephone and that the |
2569
|
means are readily available to exchange documents and sign |
2570
|
stipulations, agreements, pretrial questionnaires, and other |
2571
|
pleadings without unreasonable delay. If there is a conflict |
2572
|
with the date for which the state mediation is set, counsel or |
2573
|
the party, if unrepresented, shall within 21 days after the date |
2574
|
of the notice contact the mediator’s office to reset the |
2575
|
mediation. |
2576
|
(2)(a) The parties, upon request, shall exchange the |
2577
|
following documents within their actual or constructive control |
2578
|
within 30 days before the date of any scheduled mediation unless |
2579
|
previously produced:
|
2580
|
1. The employee’s 13-week wage statement together with |
2581
|
information regarding the receipt and value of fringe benefits |
2582
|
and the date of any suspension of same.
|
2583
|
2. Payroll records since the date of the accident.
|
2584
|
3. All medical records and reports related to the work |
2585
|
injury or disability claimed which relate to the claim or |
2586
|
defenses.
|
2587
|
4 A payout sheet or ledger.
|
2588
|
5. Statements, written or otherwise recorded, and not |
2589
|
privileged.
|
2590
|
6. All offers of employment and corresponding job |
2591
|
descriptions.
|
2592
|
7. Any and all documentation concerning the employer’s |
2593
|
communication with the employee about returning to work.
|
2594
|
8. Any and all documents relating to recommended future |
2595
|
medical treatment based on medical opinions pursuant to s. |
2596
|
440.13(9)(b).
|
2597
|
(b) Failure to comply with the requirements of paragraph |
2598
|
(a) or the requirement for continuing discovery pursuant to s. |
2599
|
440.115(2)(d) shall result in the exclusion at the hearing of |
2600
|
the documents not timely provided and other sanctions deemed |
2601
|
appropriate by the judge. Mandatory exchange of documents is |
2602
|
required unless a stipulation is entered into at the time of the |
2603
|
pretrial that such documents are immaterial to the disputed |
2604
|
issue.
|
2605
|
(c) No less than 30 days prior to any mediation, the |
2606
|
employee shall make a specific written demand for settlement of |
2607
|
the case and the issues that contains sufficient explanation and |
2608
|
supporting documentation to enable the employer and carrier and |
2609
|
its representative to evaluate the demand for settlement.
|
2610
|
(d) The employer and carrier and its representative |
2611
|
receiving the demand shall respond in writing within 15 working |
2612
|
days after receipt of the demand.
|
2613
|
(3) State mediations may be continued or rescheduled only |
2614
|
by order of the judge of compensation claims. To obtain an |
2615
|
order, a motion for continuance must be filed and state the |
2616
|
reason for the continuance and the date that the notice |
2617
|
scheduling the state mediation was mailed. The proposed order on |
2618
|
the motion must contain a blank space so that a new state |
2619
|
mediation conference date may be assigned.A continuance may be |
2620
|
granted if the requesting party demonstrates to the judge of |
2621
|
compensation claims that the reason for requesting the |
2622
|
continuance arises from circumstances beyond the party's |
2623
|
control. Any order granting a continuance must set forth the |
2624
|
date of the rescheduled mediation conference.A mediation |
2625
|
conference may not be used solely for the purpose of mediating |
2626
|
attorney's fees. |
2627
|
(4) State mediations may be cancelled if all issues other |
2628
|
than attorney’s fees have been settled or resolved, the |
2629
|
petitions for benefits have been dismissed, the parties have |
2630
|
obtained an order substituting private mediation for the |
2631
|
mandatory state mediation, or the state mediation conference has |
2632
|
been waived by order of the chief judge.
|
2633
|
(5)(a) Motions to substitute private mediation for state |
2634
|
mediation shall be filed with the presiding judge no later than |
2635
|
7 days prior to the scheduled state mediation conference. Such |
2636
|
motions shall include the date and time of the state and private |
2637
|
mediations.
|
2638
|
(b) The proposed order substituting private mediation for state |
2639
|
mediation shall include language that the parties and the |
2640
|
private mediator shall be bound by the applicable rules and |
2641
|
statutes pertaining to state mediations, including the filing by |
2642
|
the private mediator of a mediator’s report pursuant to rule |
2643
|
4.310(e), Florida Rules of Workers' Compensation Procedure. The |
2644
|
order shall state that the private mediation may only be |
2645
|
continued or rescheduled by order of the judge and that the |
2646
|
claimant's counsel is responsible for ensuring that a mediator’s |
2647
|
report is filed within 10 days after the conclusion of the |
2648
|
private mediation conference.
|
2649
|
(c) If an order is entered allowing the substitution of private |
2650
|
mediation for mandatory state mediation, or the parties agree to |
2651
|
hold a private mediation conference, such private mediation |
2652
|
conference shall be at the carrier's expense. The mediation |
2653
|
conference shall be conducted by a mediator certified under s. |
2654
|
44.106. If the parties do not agree upon a mediator within 20 |
2655
|
days after the date of the order substituting private mediation |
2656
|
for mandatory state mediation and so notify the judge of |
2657
|
compensation claims, the employee shall notify the judge in |
2658
|
writing and the judge shall appoint a mediator under this |
2659
|
paragraph within 7 days after the judge is notified. In the |
2660
|
event of a private mediation, the terms and requirements of the |
2661
|
original notice and order governing the state mediation shall |
2662
|
remain in full force and effect and the parties shall comply |
2663
|
with the terms thereof.
|
2664
|
(d) The private mediation shall be scheduled to occur no |
2665
|
later than 30 days after the deadline set forth in subsection |
2666
|
(1).
|
2667
|
(2) Any party who participates in a mediation conference |
2668
|
shall not be precluded from requesting a hearing following the |
2669
|
mediation conference should both parties not agree to be bound |
2670
|
by the results of the mediation conference. A mediation |
2671
|
conference is required to be held unless this requirement is |
2672
|
waived by the Deputy Chief Judge. No later than 3 days prior to |
2673
|
the mediation conference, all parties must submit any applicable |
2674
|
motions, including, but not limited to, a motion to waive the |
2675
|
mediation conference, to the judge of compensation claims.
|
2676
|
(6)(3)(a)Such mediation conference shall be conducted |
2677
|
informally and does not require the use of formal rules of |
2678
|
evidence or procedure. Any information from the files, reports, |
2679
|
case summaries, mediator's notes, or other communications or |
2680
|
materials, oral or written, relating to a mediation conference |
2681
|
under this section obtained by any person performing mediation |
2682
|
duties is privileged and confidential and may not be disclosed |
2683
|
without the written consent of all parties to the conference. |
2684
|
Any research or evaluation effort directed at assessing the |
2685
|
mediation program activities or performance must protect the |
2686
|
confidentiality of such information. Each party to a mediation |
2687
|
conference has a privilege during and after the conference to |
2688
|
refuse to disclose and to prevent another from disclosing |
2689
|
communications made during the conference whether or not the |
2690
|
contested issues are successfully resolved. This subsection and |
2691
|
paragraphs (9)(4)(a) and (b) shall not be construed to prevent |
2692
|
or inhibit the discovery or admissibility of any information |
2693
|
that is otherwise subject to discovery or that is admissible |
2694
|
under applicable law or rule of procedure, except that any |
2695
|
conduct or statements made during a mediation conference or in |
2696
|
negotiations concerning the conference are inadmissible in any |
2697
|
proceeding under this chapter. |
2698
|
(a)1. Unless the parties conduct a private mediation under |
2699
|
paragraph (b)subparagraph 2., mediation shall be conducted by a |
2700
|
mediator selected by the Chief Judge of Compensation Claims |
2701
|
Director of the Division of Administrative Hearingsfrom among |
2702
|
mediators employed on a full-time basis by the Office of the |
2703
|
Judges of Compensation Claims. A mediator must be a member of |
2704
|
The Florida Bar for at least 5 years,andmust complete a |
2705
|
mediation training program approved by the Chief Judge of |
2706
|
Compensation Claims, and must possess a minimum of 5 years' |
2707
|
experience in the full-time practice of workers' compensation |
2708
|
lawDirector of the Division of Administrative Hearings. Adjunct |
2709
|
mediators may be employed by the Office of the Judges of |
2710
|
Compensation Claims on an as-needed basis and shall be selected |
2711
|
from a list prepared by the Chief Judge of Compensation Claims |
2712
|
Director of the Division of Administrative Hearings. An adjunct |
2713
|
mediator must be independent of all parties participating in the |
2714
|
mediation conference. An adjunct mediator must be a member of |
2715
|
The Florida Bar for at least 5 years,and must possess a minimum |
2716
|
of 5 years' experience in the full-time practice of Florida |
2717
|
workers' compensation law, and mustcomplete a mediation |
2718
|
training program approved by the Chief Judge of Compensation |
2719
|
ClaimsDirector of the Division of Administrative Hearings. An |
2720
|
adjunct mediator shall have access to the office, equipment, and |
2721
|
supplies of the judge of compensation claims in each district. |
2722
|
(b)2. With respect to any mediation occurring on or after January |
2723
|
1, 2003, if the parties agree or if mediators are not available |
2724
|
under subparagraph 1. to conduct the required mediation within the |
2725
|
period specified in this section, the parties shall hold a |
2726
|
mediation conference at the carrier's expense within the 90-day |
2727
|
period set for mediation. The mediation conference shall be |
2728
|
conducted by a mediator certified under s. 44.106. If the parties |
2729
|
do not agree upon a mediator within 10 days after the date of the |
2730
|
order, the claimant shall notify the judge in writing and the judge |
2731
|
shall appoint a mediator under this subparagraph within 7 days.In |
2732
|
the event both parties agree, the results of the mediation |
2733
|
conference shall be binding and neither party shall have a right to |
2734
|
appeal the results. In the event either party refuses to agree to |
2735
|
the results of the mediation conference, the results of the |
2736
|
mediation conference as well as the testimony, witnesses, and |
2737
|
evidence presented at the conference shall not be admissible at any |
2738
|
subsequent proceeding on the claim. The mediator shall not be |
2739
|
called in to testify or give deposition to resolve any claim for |
2740
|
any hearing before the judge of compensation claims. The employer |
2741
|
may be represented by an attorney at the mediation conference if |
2742
|
the employee is also represented by an attorney at the mediation |
2743
|
conference. |
2744
|
(7)(a) After receiving notice of impasse from the mediator, the |
2745
|
judge of compensation claims shall hold a live pretrial hearing. |
2746
|
The judge of compensation claims shall give the parties at least |
2747
|
7 days' notice of the pretrial hearing and, unless the judge of |
2748
|
compensation claims indicates otherwise, the pretrial hearing |
2749
|
shall be held in the county where the office of the judge of |
2750
|
compensation claims is located. A pretrial hearing may be |
2751
|
continued with prior approval of the judge of compensation |
2752
|
claims.
|
2753
|
(b) The parties may submit their pretrial stipulations by mail |
2754
|
when represented by counsel and with leave of the judge of |
2755
|
compensation claims; however, the parties or their legal counsel |
2756
|
shall appear at any live pretrial hearing.
|
2757
|
(c) If a party or a party’s attorney fails to attend the |
2758
|
pretrial hearing without good cause, the judge may dismiss the |
2759
|
petition or claim, strike defenses, or take such other action as |
2760
|
may be authorized by law or rule 4.150, Florida Rules of |
2761
|
Workers' Compensation Procedure.
|
2762
|
(d) At the pretrial hearing the parties shall:
|
2763
|
1. State and simplify the claims, defense, and issues.
|
2764
|
2. Stipulate and admit to such facts and documents as will |
2765
|
avoid unnecessary proof.
|
2766
|
3. Present, examine, and mark all exhibits for identification, |
2767
|
including all impeachment and rebuttal exhibits.
|
2768
|
4. Furnish the opposing party with the names and addresses of |
2769
|
all witnesses, including impeachment and rebuttal witnesses. A |
2770
|
party may be required by the judge of compensation claims to |
2771
|
provide a statement of subject matter of the expected testimony |
2772
|
of one or more witnesses.
|
2773
|
5. Exchange all available written reports of experts when |
2774
|
expert opinion is offered at trial. The reports shall clearly |
2775
|
disclose the expert opinion and its basis on all subjects on |
2776
|
which the expert will testify. If stipulated into evidence, the |
2777
|
reports shall be presented to the judge to be so marked. The |
2778
|
parties shall consider and determine a limitation of the number |
2779
|
of expert witnesses.
|
2780
|
6. Estimate time of trial and schedule the final hearing.
|
2781
|
7. Consider and determine, as appropriate, such other matters |
2782
|
as may aid in the disposition of the case, including, but not |
2783
|
limited to, referral to additional mediation or appointment of |
2784
|
an expert medical advisor pursuant to s. 440.13(10)(c).
|
2785
|
(e) Final witness lists, final exhibit lists, supplements, and |
2786
|
amendments to the pretrial stipulation shall be served no later |
2787
|
than 30 days before the final hearing. Witness lists, exhibit |
2788
|
lists, supplements, and amendments to be filed less than 30 days |
2789
|
before the final hearing must be approved by the judge or |
2790
|
stipulated to by the parties. A motion seeking such approval is |
2791
|
a procedural motion.
|
2792
|
(f) At the discretion of the judge and on filing and service of |
2793
|
motion and notice of hearing not less than 5 days before the |
2794
|
date of the pretrial hearing, procedural motions may also be |
2795
|
heard at the pretrial hearing.
|
2796
|
(g) The judge shall record the pretrial hearing by stenographer |
2797
|
or electronic means at the request of any party or by a written |
2798
|
stipulation signed by the parties.
|
2799
|
(h)1. At the request of any party, or by his or her own motion, |
2800
|
the judge promptly shall enter an order reciting the actions |
2801
|
taken at the pretrial hearing and the agreements made by the |
2802
|
parties about any of the matters considered and limiting the |
2803
|
issues for trial to those not disposed of by admissions or |
2804
|
stipulations of the parties.
|
2805
|
2. The order shall control the subsequent course of action |
2806
|
unless the judge modifies it to prevent injustice.
|
2807
|
3. The judge shall serve the order on the attorneys for the |
2808
|
parties and on any party not represented by counsel.
|
2809
|
4. Unless otherwise specified in the notice of hearing, the |
2810
|
judge may consider and determine all issues pending as of the |
2811
|
date of the pretrial hearing.
|
2812
|
(i) If the date is not already set, the judge shall set the |
2813
|
date of the final hearing at the pretrial hearing. The notice of |
2814
|
the final hearing may be set forth in the pretrial order |
2815
|
accompanying the pretrial stipulation or may be mailed |
2816
|
separately by the judge to all interested parties.
|
2817
|
(8) Upon the motion of the judge of compensation claims or on |
2818
|
the motion of any party, the judge of compensation claims may |
2819
|
consolidate any petitions for benefits filed 30 days before the |
2820
|
scheduled mediation with any pending petitions for benefits for |
2821
|
purposes of a hearing or for any other purpose. Any hearing on a |
2822
|
consolidation must be held no later than 10 days before the |
2823
|
mediation. Only petitions for benefits filed 30 days before the |
2824
|
mediation date are ripe, due, and owing for the final hearing.
|
2825
|
(b) The parties shall complete the pretrial stipulations |
2826
|
before the conclusion of the mediation conference if the claims, |
2827
|
except for attorney's fees and costs, have not been settled and |
2828
|
if any claims in any filed petition remain unresolved. The judge |
2829
|
of compensation claims may impose sanctions against a party or |
2830
|
both parties for failing to complete the pretrial stipulations |
2831
|
before the conclusion of the mediation conference.
|
2832
|
(9)(4)(a) If the parties fail to agree upon written |
2833
|
submission of pretrial stipulations at the mediation conference, |
2834
|
the judge of compensation claims shall order a pretrial hearing |
2835
|
to occur within 14 days after the date of mediation ordered by |
2836
|
the judge of compensation claims. The judge of compensation |
2837
|
claims shall give the interested parties at least 7 days' |
2838
|
advance notice of the pretrial hearing by mail.At the pretrial |
2839
|
hearing, the judge of compensation claims shall, subject to |
2840
|
paragraph (b), set a date for the final hearing that allows the |
2841
|
parties at least 60 days to conduct discovery unless the parties |
2842
|
consent to an earlier hearing date. |
2843
|
(b) A continuance of the final hearingThe final hearing |
2844
|
must be held and concluded within 90 days after the mediation |
2845
|
conference is held. Continuances may be granted when the reason |
2846
|
for requesting the continuance arises from circumstances beyond |
2847
|
the party's control, when appropriate in the discretion of only |
2848
|
if the requesting party demonstrates tothe judge of |
2849
|
compensation claims, or by agreement of the parties; however, |
2850
|
any continuance to a date greater than 150 days after the date |
2851
|
of initial mediation shall require the written consent of the |
2852
|
claimantthat the reason for requesting the continuance arises |
2853
|
from circumstances beyond the party's control. The written |
2854
|
consent of the claimant must be obtained before any request from |
2855
|
a claimant's attorney is granted for an additional continuance |
2856
|
after the initial continuance has been granted. Any order |
2857
|
granting a continuance must set forth the date and time of the |
2858
|
rescheduled hearing. A continuance may be granted only if the |
2859
|
requesting party demonstrates to the judge of compensation |
2860
|
claims that the reason for requesting the continuance arises |
2861
|
from circumstances beyond the control of the parties. The judge |
2862
|
of compensation claims shall report any grant of two or more |
2863
|
continuances to the Deputy Chief Judge. |
2864
|
(c) The judge of compensation claims shall give the |
2865
|
interested parties at least 7 days' advance notice of the final |
2866
|
hearing, served upon the interested parties by mail. |
2867
|
(d) The final hearing shall be held within 210 days after |
2868
|
receipt of the petition for benefitsin the county where the |
2869
|
injury occurred, if the injury occurred in this state, unless |
2870
|
otherwise agreed to between the parties and authorized by the |
2871
|
judge of compensation claims in the county where the injury |
2872
|
occurred. If the injury occurred outside the state and is one |
2873
|
for which compensation is payable under this chapter, then the |
2874
|
final hearing may be held in the county of the employer's |
2875
|
residence or place of business, or in any other county of the |
2876
|
state that will, in the discretion of the DeputyChief Judge, be |
2877
|
the most convenient for a hearing. The final hearing shall be |
2878
|
conducted by a judge of compensation claims, who shall, within |
2879
|
30 days after final hearing or closure of the hearing record, |
2880
|
unless otherwise agreed by the parties, enter a final order on |
2881
|
the merits of the disputed issues. The judge of compensation |
2882
|
claims may enter an abbreviated final order in cases in which |
2883
|
compensability is not disputed. Either party may request |
2884
|
separate findings of fact and conclusions of law. At the final |
2885
|
hearing, the claimant and employer may each present evidence |
2886
|
with respect to the claims presented by the petition for |
2887
|
benefits and may be represented by any attorney authorized in |
2888
|
writing for such purpose. When there is a conflict in the |
2889
|
medical evidence submitted at the hearing, the provisions of s. |
2890
|
440.13 shall apply. The report or testimony of the expert |
2891
|
medical advisor shall be made a part of the record of the |
2892
|
proceeding and shall be given the same consideration by the |
2893
|
judge of compensation claims as is accorded other medical |
2894
|
evidence submitted in the proceeding; and all costs incurred in |
2895
|
connection with such examination and testimony may be assessed |
2896
|
as costs in the proceeding, subject to the provisions of s. |
2897
|
440.13. No judge of compensation claims may make a finding of a |
2898
|
degree of permanent impairment that is greater than the greatest |
2899
|
permanent impairment rating given the claimant by any examining |
2900
|
or treating physician, except upon stipulation of the parties. |
2901
|
Any benefit due but not raised at the final hearing which was |
2902
|
ripe, due, or owing at the time of the final hearing is waived. |
2903
|
(e) Co-counsel or any successor attorney shall file a |
2904
|
notice of appearance in accordance with the Florida Rules of |
2905
|
Workers' Compensation Procedure. Substitution of counsel may be |
2906
|
made:
|
2907
|
1. By the filing and service of a stipulation, which does |
2908
|
not require the approval of the judge; or
|
2909
|
2. By motion, which requires approval of the judge.
|
2910
|
(f) An attorney of record shall remain the attorney of |
2911
|
record and not be permitted to withdraw unless:
|
2912
|
1. The attorney files a written motion for withdrawal |
2913
|
setting forth the reasons for the motion.
|
2914
|
2. The motion is served on the client and counsel for all |
2915
|
parties. |
2916
|
3. An order is entered granting the motion of withdrawal.
|
2917
|
4. The attorney who is claiming attorney's fees and |
2918
|
taxable costs files a motion for withdrawal or substitution of |
2919
|
counsel within 60 days after the filing of said motion or |
2920
|
substitution of counsel. The failure to file the petition for |
2921
|
attorney's fees and taxable costs within 60 days is a waiver of |
2922
|
any claim for the same period.
|
2923
|
(g)(e)The order making an award or rejecting the claim, |
2924
|
referred to in this chapter as a "compensation order," shall set |
2925
|
forth the findings of ultimate facts and the mandate; and the |
2926
|
order need not include any other reason or justification for |
2927
|
such mandate. The compensation order shall be filed in the |
2928
|
Office of the Judges of Compensation Claims at Tallahassee. A |
2929
|
copy of such compensation order shall be sent by mail to the |
2930
|
parties and attorneys of record at the last known address of |
2931
|
each, with the date of mailing noted thereon. |
2932
|
(h)(f)Each judge of compensation claims is required to |
2933
|
submit a special report to the DeputyChief Judge in each |
2934
|
contested workers' compensation case in which the case is not |
2935
|
determined within 30 days of final hearing or closure of the |
2936
|
hearing record. Said form shall be provided by the secretary |
2937
|
director of the Department of Management ServicesDivision of |
2938
|
Administrative Hearingsand shall contain the names of the judge |
2939
|
of compensation claims and of the attorneys involved and a brief |
2940
|
explanation by the judge of compensation claims as to the reason |
2941
|
for such a delay in issuing a final order. |
2942
|
(g) Notwithstanding any other provision of this section, |
2943
|
the judge of compensation claims may require the appearance of |
2944
|
the parties and counsel before her or him without written notice |
2945
|
for an emergency conference where there is a bona fide emergency |
2946
|
involving the health, safety, or welfare of an employee. An |
2947
|
emergency conference under this section may result in the entry |
2948
|
of an order or the rendering of an adjudication by the judge of |
2949
|
compensation claims.
|
2950
|
(h) To expedite dispute resolution and to enhance the |
2951
|
self-executing features of the Workers' Compensation Law, the |
2952
|
Deputy Chief Judge shall make provision by rule or order for the |
2953
|
resolution of appropriate motions by judges of compensation |
2954
|
claims without oral hearing upon submission of brief written |
2955
|
statements in support and opposition, and for expedited |
2956
|
discovery and docketing. Unless the judge of compensation |
2957
|
claims, for good cause, orders a hearing under paragraph (i), |
2958
|
each claim in a petition relating to the determination of pay |
2959
|
under s. 440.14 shall be resolved under this paragraph without |
2960
|
oral hearing.
|
2961
|
(i) To further expedite dispute resolution and to enhance |
2962
|
the self-executing features of the system, those petitions filed |
2963
|
in accordance with s. 440.192 that involve a claim for benefits |
2964
|
of $5,000 or less shall, in the absence of compelling evidence |
2965
|
to the contrary, be presumed to be appropriate for expedited |
2966
|
resolution under this paragraph; and any other claim filed in |
2967
|
accordance with s. 440.192, upon the written agreement of both |
2968
|
parties and application by either party, may similarly be |
2969
|
resolved under this paragraph. A claim in a petition or $5,000 |
2970
|
or less for medical benefits only or a petition for |
2971
|
reimbursement for mileage for medical purposes shall, in the |
2972
|
absence of compelling evidence to the contrary, be resolved |
2973
|
through the expedited dispute resolution process provided in |
2974
|
this paragraph. For purposes of expedited resolution pursuant to |
2975
|
this paragraph, the Deputy Chief Judge shall make provision by |
2976
|
rule or order for expedited and limited discovery and expedited |
2977
|
docketing in such cases. At least 15 days prior to hearing, the |
2978
|
parties shall exchange and file with the judge of compensation |
2979
|
claims a pretrial outline of all issues, defenses, and witnesses |
2980
|
on a form adopted by the Deputy Chief Judge; provided, in no |
2981
|
event shall such hearing be held without 15 days' written notice |
2982
|
to all parties. No pretrial hearing shall be held. The judge of |
2983
|
compensation claims shall limit all argument and presentation of |
2984
|
evidence at the hearing to a maximum of 30 minutes, and such |
2985
|
hearings shall not exceed 30 minutes in length. Neither party |
2986
|
shall be required to be represented by counsel. The employer or |
2987
|
carrier may be represented by an adjuster or other qualified |
2988
|
representative. The employer or carrier and any witness may |
2989
|
appear at such hearing by telephone. The rules of evidence shall |
2990
|
be liberally construed in favor of allowing introduction of |
2991
|
evidence.
|
2992
|
(i)(j)A judge of compensation claims may, upon the motion |
2993
|
of a party or the judge's own motion, dismiss a petition for |
2994
|
lack of prosecution if a petition, response, motion, order, |
2995
|
request for hearing, or notice of deposition has not been filed |
2996
|
during the previous 12 months unless good cause is shown. A |
2997
|
dismissal for lack of prosecution is without prejudice and does |
2998
|
not require a hearing. |
2999
|
(j)(k)A judge of compensation claims may not award |
3000
|
interest on unpaid medical bills and the amount of such bills |
3001
|
may not be used to calculate the amount of interest awarded. |
3002
|
Regardless of the date benefits were initially requested, |
3003
|
attorney's fees do not attach under this subsection until 30 |
3004
|
days after the date the carrier or self-insured employer |
3005
|
receives the petition. |
3006
|
(10)(7)An injured employee claiming or entitled to |
3007
|
compensation shall submit to such physical examination by a |
3008
|
certified expert medical advisor approved by the agency or the |
3009
|
judge of compensation claims as the agency or the judge of |
3010
|
compensation claims may require. The place or places shall be |
3011
|
reasonably convenient for the employee. Such physician or |
3012
|
physicians as the employee, employer, or carrier may select and |
3013
|
pay for may participate in an examination if the employee, |
3014
|
employer, or carrier so requests. Proceedings shall be suspended |
3015
|
and no compensation shall be payable for any period during which |
3016
|
the employee may refuse to submit to examination. Any interested |
3017
|
party shall have the right in any case of death to require an |
3018
|
autopsy, the cost thereof to be borne by the party requesting |
3019
|
it; and the judge of compensation claims shall have authority to |
3020
|
order and require an autopsy and may, in her or his discretion, |
3021
|
withhold her or his findings and award until an autopsy is held. |
3022
|
Section 29. Subsection (5) of section 440.25, Florida |
3023
|
Statutes, is renumbered as section 440.255, Florida Statutes, |
3024
|
and amended to read: |
3025
|
440.255 Procedures for appeals.-- |
3026
|
(1)(5)(a)Procedures with respect to appeals from orders |
3027
|
of judges of compensation claims shall be governed by rules |
3028
|
adopted by the Supreme Court. Such an order shall become final |
3029
|
30 days after mailing of copies of such order to the parties, |
3030
|
unless appealed pursuant to such rules. |
3031
|
(2)(b)An appellant may be relieved of any necessary |
3032
|
filing fee by filing a verified petition of indigency for |
3033
|
approval as provided in s. 57.081(1) and may be relieved in |
3034
|
whole or in part from the costs for preparation of the record on |
3035
|
appeal if, within 15 days after the date notice of the estimated |
3036
|
costs for the preparation is served, the appellant files with |
3037
|
the judge of compensation claims a copy of the designation of |
3038
|
the record on appeal, and a verified petition to be relieved of |
3039
|
costs. A verified petition filed prior to the date of service of |
3040
|
the notice of the estimated costs shall be deemed not timely |
3041
|
filed. The verified petition relating to record costs shall |
3042
|
contain a sworn statement that the appellant is insolvent and a |
3043
|
complete, detailed, and sworn financial affidavit showing all |
3044
|
the appellant's assets, liabilities, and income. Failure to |
3045
|
state in the affidavit all assets and income, including marital |
3046
|
assets and income, shall be grounds for denying the petition |
3047
|
with prejudice. The Office of the Judges of Compensation Claims |
3048
|
shall adopt rules as may be required pursuant to this section |
3049
|
subsection, including forms for use in all petitions brought |
3050
|
under this sectionsubsection. The appellant's attorney, or the |
3051
|
appellant if she or he is not represented by an attorney, shall |
3052
|
include as a part of the verified petition relating to record |
3053
|
costs an affidavit or affirmation that, in her or his opinion, |
3054
|
the notice of appeal was filed in good faith and that there is a |
3055
|
probable basis for the District Court of Appeal, First District, |
3056
|
to find reversible error, and shall state with particularity the |
3057
|
specific legal and factual grounds for the opinion. Failure to |
3058
|
so affirm shall be grounds for denying the petition. A copy of |
3059
|
the verified petition relating to record costs shall be served |
3060
|
upon all interested parties. The judge of compensation claims |
3061
|
shall promptly conduct a hearing on the verified petition |
3062
|
relating to record costs, giving at least 15 days' notice to the |
3063
|
appellant, the department, and all other interested parties, all |
3064
|
of whom shall be parties to the proceedings. The judge of |
3065
|
compensation claims may enter an order without such hearing if |
3066
|
no objection is filed by an interested party within 20 days from |
3067
|
the service date of the verified petition relating to record |
3068
|
costs. Such proceedings shall be conducted in accordance with |
3069
|
the provisions of this section and with the workers' |
3070
|
compensation rules of procedure, to the extent applicable. In |
3071
|
the event an insolvency petition is granted, the judge of |
3072
|
compensation claims shall direct the department to pay record |
3073
|
costs and filing fees from the Workers' Compensation |
3074
|
Administration Trust Fund pending final disposition of the costs |
3075
|
of appeal. The department may transcribe or arrange for the |
3076
|
transcription of the record in any proceeding for which it is |
3077
|
ordered to pay the cost of the record. |
3078
|
(3)(c)As a condition of filing a notice of appeal to the |
3079
|
District Court of Appeal, First District, an employer who has |
3080
|
not secured the payment of compensation under this chapter in |
3081
|
compliance with s. 440.38 shall file with the notice of appeal a |
3082
|
good and sufficient bond, as provided in s. 59.13, conditioned |
3083
|
to pay the amount of the demand and any interest and costs |
3084
|
payable under the terms of the order if the appeal is dismissed, |
3085
|
or if the District Court of Appeal, First District, affirms the |
3086
|
award in any amount. Upon the failure of such employer to file |
3087
|
such bond with the judge of compensation claims or the District |
3088
|
Court of Appeal, First District, along with the notice of |
3089
|
appeal, the District Court of Appeal, First District, shall |
3090
|
dismiss the notice of appeal. |
3091
|
Section 30. Section 440.28, Florida Statutes, is amended |
3092
|
to read: |
3093
|
440.28 Modification of orders.-- |
3094
|
(1)Upon a judge of compensation claims' own initiative, |
3095
|
or upon the application of any party in interest, on the ground |
3096
|
of a change in condition or because of a mistake in a |
3097
|
determination of fact, the judge of compensation claims may, at |
3098
|
any time prior to 2 years after the date of the last payment of |
3099
|
compensation pursuant to the compensation order the party seeks |
3100
|
to modify, or at any time prior to 2 years after the date copies |
3101
|
of an order rejecting a claim are mailed to the parties at the |
3102
|
last known address of each, review a compensation case in |
3103
|
accordance with the procedure prescribed in respect of claims in |
3104
|
s. 440.25 and, in accordance with such section, issue a new |
3105
|
compensation order which may terminate, continue, reinstate, |
3106
|
increase, or decrease such compensation or award compensation. |
3107
|
Such new order shall not affect any compensation previously |
3108
|
paid, except that an award increasing the compensation rate may |
3109
|
be made effective from the date of the injury, and, if any part |
3110
|
of the compensation due or to become due is unpaid, an award |
3111
|
decreasing the compensation rate may be made effective from the |
3112
|
date of the injury, and any payment made prior thereto in excess |
3113
|
of such decreased rate shall be deducted from any unpaid |
3114
|
compensation, in such manner and by such method as may be |
3115
|
determined by the judge of compensation claims. |
3116
|
(2) Application for modification of an order under |
3117
|
subsection (1) shall be substantially in the form of a petition |
3118
|
for benefits under s. 440.192(2) and shall include a request for |
3119
|
a hearing.
|
3120
|
Section 31. Subsection (5) is added to section 440.29, |
3121
|
Florida Statutes, to read: |
3122
|
440.29 Procedure before the judge of compensation |
3123
|
claims.-- |
3124
|
(5)(a) Failure to comply with the provisions of this |
3125
|
section or any order of the judges of compensation claims may |
3126
|
subject a party to reprimand, striking of claims, defenses, |
3127
|
pleadings, imposition of costs or attorney's fees, and such |
3128
|
other sanctions as the judge may deem appropriate. These |
3129
|
sanctions are in addition to any sanctions available to the |
3130
|
judge pursuant to s. 440.33.
|
3131
|
(b) Every pleading, written motion, and other paper shall |
3132
|
be signed by the attorney of record or, if the party is not |
3133
|
represented, by the party. Each paper shall state the signer’s |
3134
|
address and telephone number, if any. Except when otherwise |
3135
|
specifically provided by rule or statute, pleadings need not be |
3136
|
verified. An unsigned paper shall be stricken unless omission of |
3137
|
the signature is corrected promptly after being called to the |
3138
|
attention of the attorney or party.
|
3139
|
(c) By presenting to the judge, whether by signing, |
3140
|
filing, submitting, or later advocating a pleading, written |
3141
|
motion, or other paper, an attorney or unrepresented party is |
3142
|
certifying to the best of the person’s knowledge, information, |
3143
|
and belief, formed after inquiry reasonable under the |
3144
|
circumstances, that:
|
3145
|
1. It is not being presented for any improper purpose, |
3146
|
such as to harass or to cause unnecessary delay or needless |
3147
|
increase in the costs of litigation.
|
3148
|
2. The claims defenses and other legal contentions therein |
3149
|
are warranted by existing law or by a nonfrivolous argument for |
3150
|
the extension, modification, or reversal of existing law or the |
3151
|
establishment of a new law.
|
3152
|
3. The allegations and other factual contentions have |
3153
|
evidentiary support or, if specifically so identified, are |
3154
|
likely to have evidentiary support after a reasonable |
3155
|
opportunity for further investigation or discovery.
|
3156
|
4. The denials of factual contentions are warranted on the |
3157
|
evidence or, if specifically so identified, are reasonably based |
3158
|
on a lack of information or belief.
|
3159
|
(d) If, after notice and a reasonable opportunity to |
3160
|
respond, the judge determines that paragraph (c) has been |
3161
|
violated, the judge may, subject to the conditions stated in |
3162
|
this section, impose an appropriate sanction on the attorneys or |
3163
|
parties who have violated paragraph (c) or who are responsible |
3164
|
for the violation.
|
3165
|
(e)1. A motion for sanctions under this section shall be |
3166
|
made separately from other motions or requests and shall |
3167
|
describe the specific conduct alleged, including, but not |
3168
|
limited to, a violation of paragraph (c). The motion shall be |
3169
|
served as provided in rule 4.030, Florida Rules of Workers' |
3170
|
Compensation Procedure, but shall not be filed with or presented |
3171
|
to the judge unless the challenged paper, claim, defense, |
3172
|
allegation, or denial is not withdrawn or appropriately |
3173
|
corrected within 21 days after service of the motion or such |
3174
|
other period as the judge may prescribe. If warranted, the judge |
3175
|
may award to the party prevailing on the motion the cost of the |
3176
|
proceeding and attorney’s fees incurred in presenting the |
3177
|
motion.
|
3178
|
2. On his or her own initiative, the judge may enter an |
3179
|
order describing the specific conduct that appears to warrant |
3180
|
sanctions and direct an attorney or party to show cause why it |
3181
|
should not be sanctioned.
|
3182
|
(f)1. A sanction imposed for the violation of this section |
3183
|
shall be limited to what is sufficient to deter repetition of |
3184
|
such conduct or comparable conduct by others similarly situated. |
3185
|
Subject to the limitations in this paragraph and in paragraph |
3186
|
(d), the sanction may consist of or include directives of a |
3187
|
nonmonetary nature, a penalty pursuant to s. 440.20 or s. |
3188
|
440.24, or, if imposed on motion and warranted for effective |
3189
|
deterrence, an order directing payment to the movant of some or |
3190
|
all of the reasonable attorney’s fees and other costs incurred |
3191
|
as a direct result of the violation. If the judge determines |
3192
|
that any proceeding was maintained or continued frivolously, the |
3193
|
costs of the proceeding, including attorney’s fees, shall be |
3194
|
assessed against the offending party or attorney. Penalties, |
3195
|
fees, and costs awarded under this section may not be recouped |
3196
|
from the party.
|
3197
|
2. Monetary sanctions may not be awarded against a |
3198
|
represented party for a violation of subparagraph (c)2.
|
3199
|
3. Monetary sanctions may not be awarded on the judge’s |
3200
|
initiative unless the judge issues an order to show cause before |
3201
|
a voluntary dismissal or settlement of the claim.
|
3202
|
(g) When imposing sanctions, the judge shall describe the |
3203
|
conduct determined to warrant such impositions of sanctions and |
3204
|
explain the basis for the sanctions imposed. If a penalty is |
3205
|
assessed against an attorney pursuant to s. 440.24 or this |
3206
|
section, the judge may forward a copy of the order assessing the |
3207
|
penalty to the appropriate grievance committee acting under the |
3208
|
jurisdiction of the Supreme Court.
|
3209
|
Section 32. Section 440.291, Florida Statutes, is created |
3210
|
to read: |
3211
|
440.291 Discovery.--
|
3212
|
(1) The judge shall have jurisdiction to take appropriate |
3213
|
action to compel discovery, including the imposition of |
3214
|
sanctions and, as circumstances warrant, may enlarge or shorten |
3215
|
the applicable time for complying with discovery.
|
3216
|
(2) Discovery may be had before or after the filing of a |
3217
|
claim or petition, in the same manner and for the same purpose |
3218
|
as provided in the Florida Rules of Civil Procedure or s. |
3219
|
440.30. At the pretrial hearing, the judge shall set a date for |
3220
|
the final hearing that allows the parties at least 30 days to |
3221
|
conduct discovery, unless the parties consent to an earlier |
3222
|
hearing date.
|
3223
|
(3) Interrogatories, requests for admission, and other |
3224
|
forms of discovery not authorized by the Florida Rules of |
3225
|
Workers' Compensation Procedure shall not be permitted or used |
3226
|
in workers' compensation proceedings.
|
3227
|
(4) Depositions of witnesses or parties may be taken and |
3228
|
used in proceedings under this chapter in the same manner and |
3229
|
for the same purposes as provided in the Florida Rules of Civil |
3230
|
Procedure or as otherwise provided by law.
|
3231
|
(a) For good cause shown, the judge may require taking a |
3232
|
deposition by telephone.
|
3233
|
(b) If a deposition is taken by telephone, the oath shall |
3234
|
be administered in the physical presence of the witness by a |
3235
|
notary public or officer authorized to administer oaths. A |
3236
|
certificate of the notary public or officer, substantially the |
3237
|
same as form 4.9105, Florida Rules of Workers' Compensation |
3238
|
Procedure, shall be filed by the party offering the witness's |
3239
|
deposition within 15 days after the date on which the deposition |
3240
|
was taken.
|
3241
|
(5)(a) The parties shall be subject to discovery |
3242
|
procedures seeking the production of records or other tangible |
3243
|
things, including, but not limited to, all hospital and medical |
3244
|
records pertaining to the industrial accident, all |
3245
|
rehabilitation reports, all records pertaining to the claimant's |
3246
|
average weekly wage at the time of the accident or earnings made |
3247
|
subsequent to the industrial accident, and a transcript of any |
3248
|
recorded statements of a party.
|
3249
|
(b) The parties shall be subject to discovery procedures |
3250
|
seeking entry on land or other property for inspection or other |
3251
|
purposes within the scope of discovery.
|
3252
|
(c) The parties shall have 30 days to serve a written |
3253
|
response after service of any request under this section.
|
3254
|
(6) The parties may seek the production of documents and |
3255
|
other tangible things within the scope of discovery for |
3256
|
inspection and copying from a person who is not a party pursuant |
3257
|
to applicable Florida Rules of Civil Procedure, except that the |
3258
|
time for objection to production of documents under this section |
3259
|
is reduced to 5 days.
|
3260
|
(7) The evidence of any investigator, adjuster, or other |
3261
|
witness in the nature of surveillance shall be subject to |
3262
|
discovery when such evidence will be used at trial, provided the |
3263
|
party intending to use such evidence is first given a reasonable |
3264
|
opportunity to depose the party or witness who is the subject of |
3265
|
the surveillance.
|
3266
|
Section 33. Section 440.292, Florida Statutes, is created |
3267
|
to read: |
3268
|
440.292 Motion practice.-- |
3269
|
(1) A motion relating to the adjudication of entitlement |
3270
|
to benefits, including, but not limited to, motions to vacate |
3271
|
orders for lump-sum advances, motions for advances under s. |
3272
|
440.20(12)(c)2. and (d), appeals of administrative fines or |
3273
|
penalties under s. 440.106, motions for appointment of |
3274
|
guardians, motions to appoint expert medical advisors under s. |
3275
|
440.13(9)(b), requests for imposition of sanctions under the |
3276
|
Florida Rules of Workers' Compensation Procedure, motions to |
3277
|
disqualify a judge or a mediator, motions to recuse counsel, |
3278
|
motions to correct the appellate record, and motions to appoint |
3279
|
independent medical examiners under s. 440.13(9)(b) shall be |
3280
|
filed and handled in the manner as provided for a claim in rule |
3281
|
4.025, Florida Rules of Workers' Compensation Procedure, except |
3282
|
the motion shall be filed with the presiding judge in cases |
3283
|
where a petition is pending.
|
3284
|
(2)(a) Procedural motions include, but are not limited to, |
3285
|
motions to consolidate, motions related to discovery, motions to |
3286
|
dismiss for lack of jurisdiction and prosecution, motions to |
3287
|
dismiss for lack of specificity, motions to amend and supplement |
3288
|
pretrial stipulations, motions for a continuance, motions to |
3289
|
compel, motions for protective orders, motions to bifurcate the |
3290
|
issues, and motions in limine. Procedural motions shall be heard |
3291
|
on not less than 5 days' written notice. The judge may require |
3292
|
the moving party to serve written notice of the hearing on |
3293
|
opposing counsel. No pretrial hearing shall be required.
|
3294
|
(b) A procedural motion shall set forth in detail the |
3295
|
facts giving rise to the motion, its legal basis, and the |
3296
|
specific relief sought. Any documents relied on should be |
3297
|
specifically referenced and attached.
|
3298
|
(3)(a) All motions shall contain a certificate of counsel |
3299
|
that the motion is made in good faith and not for the purpose of |
3300
|
delay.
|
3301
|
(b) All motions, other than motions to dismiss for lack of |
3302
|
prosecution under rule 4.075(e), Florida Rules of Workers' |
3303
|
Compensation Procedure, shall contain a certificate of counsel |
3304
|
that opposing counsel has been contacted in an effort to resolve |
3305
|
the matter without a hearing, and despite those efforts, the |
3306
|
opposing counsel objects to the motion.
|
3307
|
(4) All emergency procedural motions shall be identified |
3308
|
as such and shall identify the nature of the emergency, |
3309
|
including time constraints. Emergency procedural motions shall |
3310
|
be heard promptly.
|
3311
|
(5) A written response to a contested motion is not |
3312
|
required. If a written response is made, it shall specifically |
3313
|
state the basis for the objection.
|
3314
|
(6) Unless the moving party obtains prior approval of the |
3315
|
judge, all procedural motions shall be heard at the office of |
3316
|
the judge. If the judge allows telephone appearances, the party |
3317
|
wishing to appear by telephone shall be responsible to |
3318
|
coordinate the appearance of counsel and other necessary |
3319
|
participants and to notify the judge.
|
3320
|
(7) Notices of hearing shall be prepared and served on the |
3321
|
parties under rule 4.030, Florida Rules of Workers' Compensation |
3322
|
Procedure.
|
3323
|
(8) Motions may be heard at pretrial hearing in accordance |
3324
|
with rule 4.045, Florida Rules of Workers' Compensation |
3325
|
Procedure.
|
3326
|
(9) Judges, at their own discretion, may treat any motion |
3327
|
seeking affirmative relief or the adjudication of entitlement to |
3328
|
any benefits in the manner provided for a claim or petition |
3329
|
under these rules.
|
3330
|
(10)(a) In addition to meeting the requirements of |
3331
|
subsection (1), all motions to dismiss must state with |
3332
|
particularity the basis for the motion. The judge shall enter an |
3333
|
order on such motions without a hearing, unless good cause for |
3334
|
the hearing is shown.
|
3335
|
(b) Notwithstanding the entry of a docketing order under |
3336
|
rule 4.029, Florida Rules of Workers' Compensation Procedure, |
3337
|
any motion to dismiss for lack of specificity must be filed |
3338
|
pursuant to s. 440.192(5) and comply with the requirements of |
3339
|
subsections (1) and (2).
|
3340
|
(11) All medical records and reports of authorized |
3341
|
treating health care providers relating to the claimant and |
3342
|
subject accident shall be received into evidence upon proper |
3343
|
motion served on the opposing party at the time of the pretrial |
3344
|
hearing or no later than 30 days before the final hearing. Such |
3345
|
records shall be served with the motion.
|
3346
|
Section 34. Section 440.293, Florida Statutes, is created |
3347
|
to read: |
3348
|
440.293 Agreements or stipulations.-- |
3349
|
(1) Agreements or stipulations not involving settlements |
3350
|
under s. 440.20(11) shall comply with this section.
|
3351
|
(2) An agreement or stipulation shall not be enforceable |
3352
|
unless it is in writing and signed by the parties or their |
3353
|
attorneys or dictated on the record. |
3354
|
(3) All agreements or stipulations submitted to a judge |
3355
|
for approval and entry of an order shall include a detailed |
3356
|
statement of the issues in dispute and how the issues were |
3357
|
resolved, including a description of the benefits provided.
|
3358
|
(4) Any agreement or stipulation under this section may be |
3359
|
expressly relied on by the judge in any proceeding, unless a |
3360
|
party seeks to be relieved of the agreement or stipulation for |
3361
|
good cause shown.
|
3362
|
(5) The judge may abrogate any stipulation that appears to |
3363
|
be manifestly contrary to the evidence on due notice to the |
3364
|
parties; however, the judge need not inquire beyond the |
3365
|
stipulation or agreement.
|
3366
|
Section 35. Section 440.295, Florida Statutes, is created |
3367
|
to read: |
3368
|
440.295 Summary judgment.--
|
3369
|
(1) Any party may, at any time, move for a summary |
3370
|
judgment in the party’s favor on all or any part of the claim or |
3371
|
defense. A motion for summary judgment may not delay final |
3372
|
hearing.
|
3373
|
(2) If, upon the filing of a motion for summary judgment, |
3374
|
the party against whom the motion is directed believes the |
3375
|
summary judgment will delay final hearing, the party shall |
3376
|
immediately notify the court and arrange for a telephone |
3377
|
conference between counsel for the respective parties. The court |
3378
|
shall determine after the conference whether further briefing |
3379
|
and proceedings are appropriate.
|
3380
|
(3) Subject to other provisions, summary judgments shall |
3381
|
be rendered if the pleading, depositions, and responses to all |
3382
|
requests for production, together with affidavits, if any, show |
3383
|
there is no genuine issue as to any material fact and the moving |
3384
|
party is entitled to a judgment as a matter of law.
|
3385
|
(4) Any party filing a motion under this section shall |
3386
|
include in the motion a statement of uncontroverted facts which |
3387
|
shall set forth in full the specific facts on which the party |
3388
|
relies in support of the motion. The specific facts shall be set |
3389
|
forth in serial fashion and not in narrative form. As to each |
3390
|
fact, the statement shall refer to a specific pleading, |
3391
|
affidavit, or other document where the fact may be found. Any |
3392
|
party opposing a motion filed under this section shall include |
3393
|
in his or her opposition a brief statement of genuine issues, |
3394
|
setting forth specific facts which the opposing party asserts |
3395
|
establish a genuine issue of material fact precluding summary |
3396
|
judgment in favor of the moving party which shall refer to a |
3397
|
specific pleading, affidavit, or other document where the fact |
3398
|
may be found.
|
3399
|
(5) If the movant and the party opposing the motion agree |
3400
|
that there is no genuine issue of any material fact, they shall |
3401
|
jointly file a stipulation with the court setting forth a |
3402
|
statement of stipulated facts.
|
3403
|
(6) If either party desires a hearing on the motion, a |
3404
|
request shall be made in writing to the court which shall set a |
3405
|
time and place for hearing. If no request for hearing is made |
3406
|
within 10 days after the filing of the motion, any right to a |
3407
|
hearing afforded by this section shall be deemed waived. The |
3408
|
court may order a hearing on its own motion.
|
3409
|
(7) Supporting and opposing affidavits shall be made on |
3410
|
personal knowledge, set forth such facts as would be admissible |
3411
|
in evidence, and show affirmatively that the affiant is |
3412
|
competent to testify to the matters stated therein. Copies of |
3413
|
all papers or parts thereof referred to in an affidavit shall be |
3414
|
attached thereto or served therewith. The court may permit |
3415
|
affidavits to be supplemented or opposed by depositions, answers |
3416
|
to discovery, or further affidavits. When a motion for summary |
3417
|
judgment is made and supported as provided in this section, an |
3418
|
adverse party may not rest upon the mere allegations or denials |
3419
|
of his or her pleading, and his or her response, by affidavits |
3420
|
or as otherwise provided in this section, must set forth |
3421
|
specific facts showing that there is a genuine issue for trial. |
3422
|
If the adverse party does not so respond, summary judgment, if |
3423
|
appropriate, may be entered against the adverse party.
|
3424
|
(8) Should it appear from the affidavits of the adverse |
3425
|
party that the party filing the motion for summary judgment |
3426
|
cannot present by affidavit facts essential to justify the party |
3427
|
filing the motion for summary judgment's opposition, the court |
3428
|
may delay judgment or may order a continuance to permit |
3429
|
additional discovery or additional affidavits to be obtained.
|
3430
|
(9) Should it appear to the satisfaction of the court at |
3431
|
any time that any of the affidavits presented pursuant to this |
3432
|
rule are presented in bad faith or solely for the purpose of |
3433
|
delay, the court may punish the offending party or parties as |
3434
|
provided by law.
|
3435
|
Section 36. Subsections (5) and (6) are added to section |
3436
|
440.42, Florida Statutes, to read: |
3437
|
440.42 Insurance policies; liability.-- |
3438
|
(4) When there is any controversy as to which of two or |
3439
|
more carriers is liable for the discharge of the obligations and |
3440
|
duties of one or more employers with respect to a claim for |
3441
|
compensation, remedial treatment, or other benefits under this |
3442
|
chapter, the judge of compensation claims shall have |
3443
|
jurisdiction to adjudicate such controversy; and if one of the |
3444
|
carriers voluntarily or in compliance with a compensation order |
3445
|
makes payments in discharge of such liability and it is finally |
3446
|
determined that another carrier is liable for all or any part of |
3447
|
such obligations and duties with respect to such claim, the |
3448
|
carrier which has made payments either voluntarily or in |
3449
|
compliance with a compensation order shall be entitled to |
3450
|
reimbursement from the carrier finally determined liable, and |
3451
|
the judge of compensation claims shall have jurisdiction to |
3452
|
order such reimbursement; however, if the carrier finally |
3453
|
determined liable can demonstrate that it has been prejudiced by |
3454
|
lack of knowledge or notice of its potential liability, such |
3455
|
reimbursement shall be only with respect to payments made after |
3456
|
it had knowledge or notice of its potential liability. |
3457
|
(5) If there is a dispute between two or more carriers |
3458
|
pursuant to subsection (4) regarding liability for workers' |
3459
|
compensation benefits, the following procedures shall be |
3460
|
followed:
|
3461
|
(a) When the carriers in dispute agree that benefits are |
3462
|
payable under this chapter and a dispute exists between two or |
3463
|
more carriers as to their respective responsibilities for |
3464
|
payment to or on behalf of the injured employee, upon the motion |
3465
|
of any carrier or upon the motion of the judge of compensation |
3466
|
claims, the judge of compensation claims shall enter a temporary |
3467
|
order requiring equal payment of all compensable benefits by and |
3468
|
between the carriers in dispute.
|
3469
|
(b) At any time after the temporary order is issued, any |
3470
|
party may petition for a formal hearing pursuant to subsection |
3471
|
(4) before the judge of compensation claims for a determination |
3472
|
of liability between the carriers. When liability has been |
3473
|
determined by a final order of the judge of compensation claims, |
3474
|
the party held liable for benefits shall be ordered to reimburse |
3475
|
any moneys the other party has paid and shall provide for |
3476
|
payment of interest at 12 percent per annum on any compensation |
3477
|
benefits reimbursed.
|
3478
|
(c) Nothing in this section shall prevent the parties from |
3479
|
entering into a stipulation regarding their respective |
3480
|
liabilities which shall be approved by the judge of compensation |
3481
|
claims.
|
3482
|
(6) If the employer or carrier stipulates to the claimant |
3483
|
entitlement to attorney's fees and taxable costs and the nature |
3484
|
and amount of benefits secured, the claimant's counsel shall |
3485
|
file a petition for benefits for attorney's fees and taxable |
3486
|
costs within 60 days after said stipulation or the claim for |
3487
|
attorney's fees and taxable costs shall be barred.
|
3488
|
Section 37. Section 440.442, Florida Statutes, is amended |
3489
|
to read: |
3490
|
440.442 Code of Judicial Conduct.--The DeputyChief Judge |
3491
|
and judges of compensation claims shall observe and abide by the |
3492
|
Code of Judicial Conduct as adopted by the Florida Supreme |
3493
|
Court. Any material violation of a provision of the Code of |
3494
|
Judicial Conduct shall constitute either malfeasance or |
3495
|
misfeasance in office and shall be grounds for suspension and |
3496
|
removal of the DeputyChief Judge or judge of compensation |
3497
|
claims by the Governor. |
3498
|
Section 38. Section 440.45, Florida Statutes, is amended |
3499
|
to read: |
3500
|
440.45 Office of the Judges of Compensation Claims.-- |
3501
|
(1)(a) There is created the Office of the Judges of |
3502
|
Compensation Claims within the Department of Management |
3503
|
Services. The Office of the Judges of Compensation Claims shall |
3504
|
be headed by the Deputy Chief Judge of Compensation Claims. The |
3505
|
Deputy Chief Judge of Compensation Claims shall report to the |
3506
|
Secretarydirector of Management Servicesthe Division of |
3507
|
Administrative Hearings. The DeputyChief Judge shall be |
3508
|
appointed by the Governor for a term of 4 years from only onea |
3509
|
list of three names submitted by the statewide nominating |
3510
|
commission created under subsection (2). The Deputy Chief Judge |
3511
|
of Compensation Claimsmust demonstrate prior administrative |
3512
|
experience and possess the same qualifications for appointment |
3513
|
as a judge of compensation claims, and the procedure for |
3514
|
reappointment of the Deputy Chief Judge of Compensation Claims |
3515
|
will be the same as for reappointment of a judge of compensation |
3516
|
claims. The office shall be a separate budget entity and the |
3517
|
Chief Judge of Compensation Claimsdirector of the Division of |
3518
|
Administrative Hearings shall be its officeagencyhead for all |
3519
|
purposes, including, but not limited to, rulemaking pursuant to |
3520
|
subsection (4) and establishing agency policies and procedures. |
3521
|
The Department of Management Services shall provide |
3522
|
administrative support and service to the office to the extent |
3523
|
requested by the director of the Division of Administrative |
3524
|
Hearingsbut shall not direct, supervise, or control the Office |
3525
|
of the Judges of Compensation Claims in any manner, including, |
3526
|
but not limited to, personnel, purchasing, budgetary matters, or |
3527
|
property transactions. The operating budget of the Office of the |
3528
|
Judges of Compensation Claims shall be paid out of the Workers' |
3529
|
Compensation Administration Trust Fund established in s. 440.50. |
3530
|
(b) The current term of the DeputyChief Judge of |
3531
|
Compensation Claims shall expire October 1, 20032001. Effective |
3532
|
October 1, 20032001, the position of DeputyChief Judge of |
3533
|
Compensation Claims is created. |
3534
|
(2)(a) The Governor shall appoint full-time judges of |
3535
|
compensation claims to conduct proceedings as required by this |
3536
|
chapter or other law. No person may be nominated to serve as a |
3537
|
judge of compensation claims unless he or she has been a member |
3538
|
of The Florida Bar in good standing for the previous 5 years and |
3539
|
must possess a minimum of 5 years' experienceis experiencedin |
3540
|
the full-time practice of Floridalaw of workers' compensation |
3541
|
law. No judge of compensation claims shall engage in the private |
3542
|
practice of law during a term of office. |
3543
|
(b) Except as provided in paragraph (c), the Governor |
3544
|
shall appoint a judge of compensation claims from only onea |
3545
|
list of three persons nominated by a statewide nominating |
3546
|
commission. The statewide nominating commission shall be |
3547
|
composed of the following: |
3548
|
1. Five members, at least one of whom must be a member of |
3549
|
a minority group as defined in s. 288.703(3), one of each who |
3550
|
resides in each of the territorial jurisdictions of the district |
3551
|
courts of appeal, appointed by the Board of Governors of The |
3552
|
Florida Bar from among The Florida Bar members who are engaged |
3553
|
in the practice of law. On July 1, 1999, the term of office of |
3554
|
each person appointed by the Board of Governors of The Florida |
3555
|
Bar to the commission expires. The Board of Governors shall |
3556
|
appoint members who reside in the odd-numbered district court of |
3557
|
appeal jurisdictions to 4-year terms each, beginning July 1, |
3558
|
1999, and members who reside in the even-numbered district court |
3559
|
of appeal jurisdictions to 2-year terms each, beginning July 1, |
3560
|
1999. Thereafter, each member shall be appointed for a 4-year |
3561
|
term; |
3562
|
2. Five electors, at least one of whom must be a member of |
3563
|
a minority group as defined in s. 288.703(3), one of each who |
3564
|
resides in each of the territorial jurisdictions of the district |
3565
|
courts of appeal, appointed by the Governor. On July 1, 1999, |
3566
|
the term of office of each person appointed by the Governor to |
3567
|
the commission expires. The Governor shall appoint members who |
3568
|
reside in the odd-numbered district court of appeal |
3569
|
jurisdictions to 2-year terms each, beginning July 1, 1999, and |
3570
|
members who reside in the even-numbered district court of appeal |
3571
|
jurisdictions to 4-year terms each, beginning July 1, 1999. |
3572
|
Thereafter, each member shall be appointed for a 4-year term; |
3573
|
and |
3574
|
3. Five electors, at least one of whom must be a member of |
3575
|
a minority group as defined in s. 288.703(3), one of each who |
3576
|
resides in the territorial jurisdictions of the district courts |
3577
|
of appeal, selected and appointed by a majority vote of the |
3578
|
other 10 members of the commission. On October 1, 1999, the term |
3579
|
of office of each person appointed to the commission by its |
3580
|
other members expires. A majority of the other members of the |
3581
|
commission shall appoint members who reside in the odd-numbered |
3582
|
district court of appeal jurisdictions to 2-year terms each, |
3583
|
beginning October 1, 1999, and members who reside in the even- |
3584
|
numbered district court of appeal jurisdictions to 4-year terms |
3585
|
each, beginning October 1, 1999. Thereafter, each member shall |
3586
|
be appointed for a 4-year term. |
3587
|
|
3588
|
A vacancy occurring on the commission shall be filled by the |
3589
|
original appointing authority for the unexpired balance of the |
3590
|
term. No attorney who appears before any judge of compensation |
3591
|
claims more than four times a year is eligible to serve on the |
3592
|
statewide nominating commission.The meetings and determinations |
3593
|
of the nominating commission as to the judges of compensation |
3594
|
claims shall be open to the public. |
3595
|
(c) Each judge of compensation claims shall be appointed |
3596
|
for a term of 4 years, but during the term of office may be |
3597
|
removed by the Governor for cause. Prior to the expiration of a |
3598
|
judge's term of office, the statewide nominating commission |
3599
|
shall review the judge's conduct and determine whether the |
3600
|
judge's performance is satisfactory. Effective July 1, 2002, in |
3601
|
determining whether a judge's performance is satisfactory, the |
3602
|
commission shall consider the extent to which the judge has met |
3603
|
the requirements of this chapter, including, but not limited to, |
3604
|
the requirements of ss. 440.25(1) and (9)(a)-(h)(4)(a)-(f), |
3605
|
440.34(2), and 440.442. If the judge's performance is deemed |
3606
|
unsatisfactorysatisfactory, the commission shall report its |
3607
|
finding to the Governor no later than 6 months prior to the |
3608
|
expiration of the judge's term of office. The Governor shall |
3609
|
review the commission's report and may reappoint the judge for |
3610
|
an additional 4-year term. If the Governor does not reappoint |
3611
|
the judge, the Governor shall inform the commission. The judge |
3612
|
shall remain in office until the Governor has appointed a |
3613
|
successor judge in accordance with paragraphs (a) and (b). If a |
3614
|
vacancy occurs during a judge's unexpired term, the statewide |
3615
|
nominating commission does not find the judge's performance is |
3616
|
satisfactory, or the Governor does not reappoint the judge, the |
3617
|
Governor shall appoint a successor judge for a term of 4 years |
3618
|
in accordance with paragraph (b). |
3619
|
(d) The Governor may appoint any attorney who has been a |
3620
|
member of The Florida Bar in good standing for the previous 5 |
3621
|
years and who possesses a minimum of at least 5 years'years of |
3622
|
experience in the full-time practice of Florida workers' |
3623
|
compensation law in this stateto serve as a judge of |
3624
|
compensation claims pro hac vice in the absence or |
3625
|
disqualification of any full-time judge of compensation claims |
3626
|
or to serve temporarily as an additional judge of compensation |
3627
|
claims in any area of the state in which the Governor determines |
3628
|
that a need exists for such an additional judge. However, an |
3629
|
attorney who is so appointed by the Governor may not serve for a |
3630
|
period of more than 120 successive days. |
3631
|
(e) The Florida Bardirector of the Division of |
3632
|
Administrative Hearingsmay receive or initiate complaints, |
3633
|
conduct investigations, and dismiss complaints against the |
3634
|
DeputyChief Judge and the judges of compensation claims on the |
3635
|
basis of the Code of Judicial Conduct. The Florida Bardirector |
3636
|
may recommend to the Governor the removal or discipline of the |
3637
|
Deputy Chief Judge or a judge of compensation claims or |
3638
|
recommend the discipline of a judgewhose conduct during his or |
3639
|
her term of office warrants such discipline. For purposes of |
3640
|
this section, the term "discipline" includes reprimand, fine, |
3641
|
and suspension with or without pay. At the conclusion of each |
3642
|
investigation, The Florida Bardirectorshall submit preliminary |
3643
|
findings of fact and recommendations to the judge of |
3644
|
compensation claims who is the subject of the complaint. The |
3645
|
Chief Judge and judge of compensation claims shall each havehas |
3646
|
20 days within which to respond to the preliminary findings. The |
3647
|
response and The Florida Bar'sdirector'srebuttal to the |
3648
|
response must be included in the final report submitted to the |
3649
|
Governor. |
3650
|
(3) The DeputyChief Judge shall establish training and |
3651
|
continuing education for new and sitting judges. |
3652
|
(4) The Office of the Judges of Compensation Claims shall |
3653
|
adopt rules to effect the purposes of this section. Such rules |
3654
|
shall include procedural rules applicable to workers' |
3655
|
compensation claim resolution anduniform criteria for measuring |
3656
|
the performance of the office, including, but not limited to, |
3657
|
the number of cases assigned and disposed, the age of pending |
3658
|
and disposed cases, timeliness of decisionmaking, attorney's |
3659
|
fees paid in excess of the fee schedule and the basis therefor |
3660
|
extraordinary fee awards, and other data necessary for the |
3661
|
judicial nominating commission to review the performance of |
3662
|
judges as required in paragraph (2)(c). The Workers' |
3663
|
Compensation Rules of Procedure, rules 4.010 through 4.918, in |
3664
|
effect as of February 22, 2003, shall apply in all workers’ |
3665
|
compensation proceedings before the judges of compensation |
3666
|
claims and replace Chapter 60Q-6 Rules of Procedure for Workers' |
3667
|
Compensation Adjudication and all forms referenced therein. |
3668
|
Thereafter, Workers' Compensation Rules of Procedure shall be |
3669
|
promulgated by The Florida Bar Rules Committee and adopted |
3670
|
approved by the Supreme Court apply until the rules adopted by |
3671
|
the Office of the Judges of Compensation Claims pursuant to s. |
3672
|
440.29(3)this section become effective. All forms referenced in |
3673
|
this chapter shall be promulgated by The Florida Bar Rules |
3674
|
Committee. |
3675
|
(5) Not later than December 1 of each year, commencing |
3676
|
December 1, 2004,the Office of the Judges of Compensation |
3677
|
Claims shall issue a written report to the Governor, the House |
3678
|
of Representatives, the Senate, The Florida Bar, the Workers' |
3679
|
Compensation Section of The Florida Bar,and the statewide |
3680
|
nominating commission summarizing the amount, cost, and outcome |
3681
|
of all litigation resolved in the previous fiscal year; |
3682
|
summarizing the disposition of mediation conferences, the number |
3683
|
of mediation conferences held, the number of continuances |
3684
|
granted for mediations and final hearings,the number and |
3685
|
outcome of litigated cases, the amount of attorney's fees paid |
3686
|
in excess of the fee schedule and the basis thereforin each |
3687
|
case according to order year and accident year, and the number |
3688
|
of final orders not issued within 6030days after the final |
3689
|
hearing or closure of the hearing record; and recommending |
3690
|
changes or improvements to the dispute resolution elements of |
3691
|
the Workers' Compensation Law and regulations. If the Deputy |
3692
|
Chief Judge finds that judges generally are unable to meet a |
3693
|
particular statutory requirement for reasons beyond their |
3694
|
control, the DeputyChief Judge shall submit such findings and |
3695
|
any recommendations to the Legislature. |
3696
|
Section 39. Subsections (6) through (9) of section |
3697
|
440.491, Florida Statutes, are renumbered as subsections (7) |
3698
|
through (10), respectively, and a new subsection (6) is added to |
3699
|
said section, to read: |
3700
|
440.491 Reemployment of injured workers; rehabilitation.-- |
3701
|
(6) ADDITIONAL REHABILITATION TEMPORARY TOTAL DISABILITY |
3702
|
BENEFITS.--
|
3703
|
(a) When the employer or carrier denies the payment of |
3704
|
additional rehabilitation temporary total disability benefits, |
3705
|
an employer or carrier shall give the employee 7 days' written |
3706
|
notice of denial by certificate of mailing that the employee’s |
3707
|
additional rehabilitation temporary total disability benefits |
3708
|
are being denied; provide the employee with a copy of any |
3709
|
documentation for the denial, including any medical, employment, |
3710
|
wages, vocational reports, and unemployment records; and advise |
3711
|
the employee of his or her right to request a hearing on the |
3712
|
payment of additional rehabilitation temporary total disability |
3713
|
benefits by filing a petition for benefits. The employer's or |
3714
|
carrier’s failure to comply with this time provision shall |
3715
|
result in a waiver of any time period in which to file a |
3716
|
petition for benefits on the issue. The evidence of any |
3717
|
investigator, adjuster, or other witness in the nature of |
3718
|
surveillance shall be subject to discovery when such evidence |
3719
|
will be used at trial, provided the party intending to use such |
3720
|
evidence is first given a reasonable opportunity to depose the |
3721
|
party or witness who is the subject of the surveillance.
|
3722
|
(b) When the Division of Workers’ Compensation has |
3723
|
determined an injured employee is entitled to retraining and |
3724
|
education to obtain suitable gainful employment and the employee |
3725
|
claims and the employer or carrier contests the employee’s |
3726
|
entitlement to an additional 26 weeks of rehabilitation |
3727
|
temporary total disability benefits, or an extended period to be |
3728
|
determined necessary and proper by the judge of compensation |
3729
|
claims, the employee shall file a petition for benefits for |
3730
|
rehabilitation temporary total disability benefits which |
3731
|
includes a statement of the period in dispute, copies of all |
3732
|
vocational reports from the division establishing the employee's |
3733
|
entitlement to retraining, copies of the employee’s transcripts |
3734
|
and attendance records coinciding with the first 26 weeks of |
3735
|
benefits, medical reports establishing that the employee has |
3736
|
limitations and restrictions which preclude his or her obtaining |
3737
|
suitable gainful employment as provided in this section, and a |
3738
|
proposed course of study for the period claimed. A copy of said |
3739
|
documentation shall be sent to the employer and carrier and its |
3740
|
representative no later than 10 days after the filing of the |
3741
|
petition for benefits.
|
3742
|
(c) The failure of the employee to provide the |
3743
|
documentation required by paragraph (a) shall result in |
3744
|
dismissal of the employee's petition for benefits. The failure |
3745
|
of the employer or carrier to provide the documentation required |
3746
|
by paragraph (b) shall result in the same being excluded from |
3747
|
evidence at any trial of this issue.
|
3748
|
Section 40. Paragraph (b) of subsection (1) and subsection |
3749
|
(4) of section 112.3145, Florida Statutes, are amended to read: |
3750
|
112.3145 Disclosure of financial interests and clients |
3751
|
represented before agencies.-- |
3752
|
(1) For purposes of this section, unless the context |
3753
|
otherwise requires, the term: |
3754
|
(b) "Specified state employee" means: |
3755
|
1. Public counsel created by chapter 350, an assistant |
3756
|
state attorney, an assistant public defender, a full-time state |
3757
|
employee who serves as counsel or assistant counsel to any state |
3758
|
agency, the DeputyChief Judge of Compensation Claims, a judge |
3759
|
of compensation claims, an administrative law judge, or a |
3760
|
hearing officer. |
3761
|
2. Any person employed in the office of the Governor or in |
3762
|
the office of any member of the Cabinet if that person is exempt |
3763
|
from the Career Service System, except persons employed in |
3764
|
clerical, secretarial, or similar positions. |
3765
|
3. Each appointed secretary, assistant secretary, deputy |
3766
|
secretary, executive director, assistant executive director, or |
3767
|
deputy executive director of each state department, commission, |
3768
|
board, or council; unless otherwise provided, the division |
3769
|
director, assistant division director, deputy director, bureau |
3770
|
chief, and assistant bureau chief of any state department or |
3771
|
division; or any person having the power normally conferred upon |
3772
|
such persons, by whatever title. |
3773
|
4. The superintendent or institute director of a state |
3774
|
mental health institute established for training and research in |
3775
|
the mental health field or the warden or director of any major |
3776
|
state institution or facility established for corrections, |
3777
|
training, treatment, or rehabilitation. |
3778
|
5. Business managers, purchasing agents having the power |
3779
|
to make any purchase exceeding the threshold amount provided for |
3780
|
in s. 287.017 for CATEGORY ONE, finance and accounting |
3781
|
directors, personnel officers, or grants coordinators for any |
3782
|
state agency. |
3783
|
6. Any person, other than a legislative assistant exempted |
3784
|
by the presiding officer of the house by which the legislative |
3785
|
assistant is employed, who is employed in the legislative branch |
3786
|
of government, except persons employed in maintenance, clerical, |
3787
|
secretarial, or similar positions. |
3788
|
7. Each employee of the Commission on Ethics. |
3789
|
(4) Each elected constitutional officer, state officer, |
3790
|
local officer, and specified state employee shall file a |
3791
|
quarterly report of the names of clients represented for a fee |
3792
|
or commission, except for appearances in ministerial matters, |
3793
|
before agencies at his or her level of government. For the |
3794
|
purposes of this part, agencies of government shall be |
3795
|
classified as state-level agencies or agencies below state |
3796
|
level. Each local officer shall file such report with the |
3797
|
supervisor of elections of the county in which the officer is |
3798
|
principally employed or is a resident. Each state officer, |
3799
|
elected constitutional officer, and specified state employee |
3800
|
shall file such report with the commission. The report shall be |
3801
|
filed only when a reportable representation is made during the |
3802
|
calendar quarter and shall be filed no later than the last day |
3803
|
of each calendar quarter, for the previous calendar quarter. |
3804
|
Representation before any agency shall be deemed to include |
3805
|
representation by such officer or specified state employee or by |
3806
|
any partner or associate of the professional firm of which he or |
3807
|
she is a member and of which he or she has actual knowledge. For |
3808
|
the purposes of this subsection, the term "representation before |
3809
|
any agency" does not include appearances before any court or the |
3810
|
DeputyChief Judge of Compensation Claims or judges of |
3811
|
compensation claims or representations on behalf of one's agency |
3812
|
in one's official capacity. Such term does not include the |
3813
|
preparation and filing of forms and applications merely for the |
3814
|
purpose of obtaining or transferring a license based on a quota |
3815
|
or a franchise of such agency or a license or operation permit |
3816
|
to engage in a profession, business, or occupation, so long as |
3817
|
the issuance or granting of such license, permit, or transfer |
3818
|
does not require substantial discretion, a variance, a special |
3819
|
consideration, or a certificate of public convenience and |
3820
|
necessity. |
3821
|
Section 41. Subsection (1) of section 120.65, Florida |
3822
|
Statutes, is amended to read: |
3823
|
120.65 Administrative law judges.-- |
3824
|
(1) The Division of Administrative Hearings within the |
3825
|
Department of Management Services shall be headed by a director |
3826
|
who shall be appointed by the Administration Commission and |
3827
|
confirmed by the Senate. The director, who shall also serve as |
3828
|
the chief administrative law judge, and any deputy chief |
3829
|
administrative law judge must possess the same minimum |
3830
|
qualifications as the administrative law judges employed by the |
3831
|
division. The DeputyChief Judge of Compensation Claims must |
3832
|
possess the minimum qualifications established in s. 440.45(2) |
3833
|
and shall report to the director. The division shall be a |
3834
|
separate budget entity, and the director shall be its agency |
3835
|
head for all purposes. The Department of Management Services |
3836
|
shall provide administrative support and service to the division |
3837
|
to the extent requested by the director. The division shall not |
3838
|
be subject to control, supervision, or direction by the |
3839
|
Department of Management Services in any manner, including, but |
3840
|
not limited to, personnel, purchasing, transactions involving |
3841
|
real or personal property, and budgetary matters. |
3842
|
Section 42. Paragraph (i) of subsection (1) of section |
3843
|
121.055, Florida Statutes, is amended to read: |
3844
|
121.055 Senior Management Service Class.--There is hereby |
3845
|
established a separate class of membership within the Florida |
3846
|
Retirement System to be known as the "Senior Management Service |
3847
|
Class," which shall become effective February 1, 1987. |
3848
|
(1) |
3849
|
(i)1. Except as provided in subparagraph 2., effective |
3850
|
July 1, 1999, participation in the Senior Management Service |
3851
|
Class is compulsory for any member of the Florida Retirement |
3852
|
System who is employed as the DeputyChief Judge of Compensation |
3853
|
Claims or as a judge of compensation claims with the Office of |
3854
|
the Judges of Compensation Claims within the Division of |
3855
|
Administrative Hearings. |
3856
|
2. In lieu of participating in the Senior Management |
3857
|
Service Class, the DeputyChief Judge of Compensation Claims or |
3858
|
a judge of compensation claims may participate in the Senior |
3859
|
Management Service Optional Annuity Program established under |
3860
|
subsection (6). |
3861
|
Section 43. Paragraph (b) of subsection (2) of section |
3862
|
216.251, Florida Statutes, is amended to read: |
3863
|
216.251 Salary appropriations; limitations.-- |
3864
|
(2) |
3865
|
(b) Salary payments shall be made only to employees |
3866
|
filling established positions included in the agency's or in the |
3867
|
judicial branch's approved budgets and amendments thereto as may |
3868
|
be provided by law; provided, however: |
3869
|
1. Reclassification of established positions may be |
3870
|
accomplished when justified in accordance with the established |
3871
|
procedures for reclassifying positions; or |
3872
|
2. When the Division of Risk Management of the Department |
3873
|
of Insurance has determined that an employee is entitled to |
3874
|
receive a temporary partial disability benefit pursuant to the |
3875
|
provisions of s. 440.1502or a temporary total disability |
3876
|
benefit pursuant to the provisions of s. 440.15 and there is |
3877
|
medical certification that the employee cannot perform the |
3878
|
duties of the employee's regular position, but the employee can |
3879
|
perform some type of work beneficial to the agency, the agency |
3880
|
may return the employee to the payroll, at his or her regular |
3881
|
rate of pay, to perform such duties as the employee is capable |
3882
|
of performing, even if there is not an established position in |
3883
|
which the employee can be placed. Nothing in this subparagraph |
3884
|
shall abrogate an employee's rights under chapter 440 or chapter |
3885
|
447, nor shall it adversely affect the retirement credit of a |
3886
|
member of the Florida Retirement System in the membership class |
3887
|
he or she was in at the time of, and during, the member's |
3888
|
disability. |
3889
|
Section 44. Paragraph (b) of subsection (3) of section |
3890
|
440.105, Florida Statutes, is amended to read: |
3891
|
440.105 Prohibited activities; reports; penalties; |
3892
|
limitations.-- |
3893
|
(3) Whoever violates any provision of this subsection |
3894
|
commits a misdemeanor of the first degree, punishable as |
3895
|
provided in s. 775.082 or s. 775.083. |
3896
|
(b) It is unlawful for any attorney or other person, in |
3897
|
his or her individual capacity or in his or her capacity as a |
3898
|
public or private employee, or for any firm, corporation, |
3899
|
partnership, or association to receive any fee or other |
3900
|
consideration or any gratuity from a person on account of |
3901
|
services rendered for a person in connection with any |
3902
|
proceedings arising under this chapter, unless such fee, |
3903
|
consideration, or gratuity is approved by a judge of |
3904
|
compensation claims or by the DeputyChief Judge of Compensation |
3905
|
Claims. |
3906
|
Section 45. Subsection (16) of section 440.134, Florida |
3907
|
Statutes, is amended to read: |
3908
|
440.134 Workers' compensation managed care arrangement.-- |
3909
|
(16) When a carrier enters into a managed care arrangement |
3910
|
pursuant to this section the employees who are covered by the |
3911
|
provisions of such arrangement shall be deemed to have received |
3912
|
all the benefits to which they are entitled pursuant to ss.s. |
3913
|
440.13(2)(a) and 440.1509(1)(b). In addition, the employer shall |
3914
|
be deemed to have complied completely with the requirements of |
3915
|
such provisions. The provisions governing managed care |
3916
|
arrangements shall govern exclusively unless specifically stated |
3917
|
otherwise in this section. |
3918
|
Section 46. Subsection (4) of section 440.14, Florida |
3919
|
Statutes, is amended to read: |
3920
|
440.14 Determination of pay.-- |
3921
|
(4) Upon termination of the employee or upon termination |
3922
|
of the payment of fringe benefits of any employee who is |
3923
|
collecting indemnity benefits pursuant to ss.s. 440.15-440.1507 |
3924
|
(2) or (3)(b), the employer shall within 7 days of such |
3925
|
termination file a corrected 13-week wage statement reflecting |
3926
|
the wages paid and the fringe benefits that had been paid to the |
3927
|
injured employee, as provided in s. 440.02(28)(27). |
3928
|
Section 47. Paragraph (a) of subsection (1), subsection |
3929
|
(2), paragraph (c) of subsection (8), and paragraph (c) of |
3930
|
subsection (11) of section 440.20, Florida Statutes, are amended |
3931
|
to read: |
3932
|
440.20 Time for payment of compensation; penalties for |
3933
|
late payment.-- |
3934
|
(1)(a) Unless it denies compensability or entitlement to |
3935
|
benefits, the carrier shall pay compensation directly to the |
3936
|
employee as required by ss. 440.14, 440.15-440.1507, and 440.16, |
3937
|
in accordance with the obligations set forth in such sections. |
3938
|
If authorized by the employee, the carrier's obligation to pay |
3939
|
compensation directly to the employee is satisfied when the |
3940
|
carrier directly deposits, by electronic transfer or other |
3941
|
means, compensation into the employee's account at a financial |
3942
|
institution. As used in this paragraph, the term "financial |
3943
|
institution" means a financial institution as defined in s. |
3944
|
655.005(1)(h). Compensation by direct deposit is considered paid |
3945
|
on the date the funds become available for withdrawal by the |
3946
|
employee. |
3947
|
(2) The carrier must pay the first installment of |
3948
|
compensation or deny compensability no later than the 14th day |
3949
|
after the employer receives notice of the injury or death. The |
3950
|
carrier shall thereafter pay compensation in biweekly |
3951
|
installments or as otherwise provided in ss.s. 440.15-440.1507, |
3952
|
unless the judge of compensation claims determines or the |
3953
|
parties agree that an alternate installment schedule is in the |
3954
|
best interests of the employee. |
3955
|
(8) In addition to any other penalties provided by this |
3956
|
chapter for late payment, if any installment of compensation is |
3957
|
not paid when it becomes due, the employer, carrier, or |
3958
|
servicing agent shall pay interest thereon at the rate of 12 |
3959
|
percent per year from the date the installment becomes due until |
3960
|
it is paid, whether such installment is payable without an order |
3961
|
or under the terms of an order. The interest payment shall be |
3962
|
the greater of the amount of interest due or $5. |
3963
|
(c) In order to ensure carrier compliance under this |
3964
|
chapter and provisions of the Florida Insurance Code, the |
3965
|
department shall monitor the performance of carriers by |
3966
|
conducting market conduct examinations, as provided in s. |
3967
|
624.3161, and conducting investigations, as provided in s. |
3968
|
624.317. The department shall establish by rule minimum |
3969
|
performance standards for carriers to ensure that a minimum of |
3970
|
90 percent of all compensation benefits are timely paid. The |
3971
|
department shall fine a carrier as provided in s. 440.1312(2) |
3972
|
440.13(11)(b)up to $50 for each late payment of compensation |
3973
|
that is below the minimum 90 percent performance standard. This |
3974
|
paragraph does not affect the imposition of any penalties or |
3975
|
interest due to the claimant. If a carrier contracts with a |
3976
|
servicing agent to fulfill its administrative responsibilities |
3977
|
under this chapter, the payment practices of the servicing agent |
3978
|
are deemed the payment practices of the carrier for the purpose |
3979
|
of assessing penalties against the carrier. |
3980
|
(11) |
3981
|
(c) Notwithstanding s. 440.21(2), when a claimant is |
3982
|
represented by counsel, the claimant may waive all rights to any |
3983
|
and all benefits under this chapter by entering into a |
3984
|
settlement agreement releasing the employer and the carrier from |
3985
|
liability for workers' compensation benefits in exchange for a |
3986
|
lump-sum payment to the claimant. The settlement agreement |
3987
|
requires approval by the judge of compensation claims only as to |
3988
|
the attorney's fees paid to the claimant's attorney by the |
3989
|
claimant. The parties need not submit any information or |
3990
|
documentation in support of the settlement, except as needed to |
3991
|
justify the amount of the attorney's fees. Neither the employer |
3992
|
nor the carrier is responsible for any attorney's fees relating |
3993
|
to the settlement and release of claims under this section. |
3994
|
Payment of the lump-sum settlement amount must be made within 14 |
3995
|
days after the date the judge of compensation claims mails the |
3996
|
order approving the attorney's fees. Any order entered by a |
3997
|
judge of compensation claims approving the attorney's fees as |
3998
|
set out in the settlement under this subsection is not |
3999
|
considered to be an award and is not subject to modification or |
4000
|
review. The judge of compensation claims shall report these |
4001
|
settlements to the DeputyChief Judge in accordance with the |
4002
|
requirements set forth in paragraphs (a) and (b). Settlements |
4003
|
entered into under this subsection are valid and apply to all |
4004
|
dates of accident. |
4005
|
Section 48. Subsection (2) of section 440.207, Florida |
4006
|
Statutes, is amended to read: |
4007
|
440.207 Workers' compensation system guide.-- |
4008
|
(2) The department shall publish an understandable guide |
4009
|
to the workers' compensation system which shall contain an |
4010
|
explanation of benefits provided; services provided by the |
4011
|
Employee Assistance and Ombudsman Office;procedures regarding |
4012
|
mediation, the hearing process, and civil and criminal |
4013
|
penalties; relevant rules of the department; and such other |
4014
|
information as the department believes will inform employees, |
4015
|
employers, carriers, and those providing services pursuant to |
4016
|
this chapter of their rights and responsibilities under this |
4017
|
chapter and the rules of the department. For the purposes of |
4018
|
this subsection, a guide is understandable if the text of the |
4019
|
guide is written at a level of readability not exceeding the |
4020
|
eighth grade level, as determined by a recognized readability |
4021
|
test. |
4022
|
Section 49. Subsection (2) of section 440.29, Florida |
4023
|
Statutes, is amended to read: |
4024
|
440.29 Procedure before the judge of compensation |
4025
|
claims.-- |
4026
|
(2) Hearings before the judge of compensation claims shall |
4027
|
be open to the public, and the DeputyChief Judge is authorized |
4028
|
to designate the manner in which particular types of hearings |
4029
|
are recorded and reported and, when necessary, to contract for |
4030
|
the reporting of such hearings. The DeputyChief Judge shall |
4031
|
arrange for the preparation of a record of the hearings and |
4032
|
other proceedings before judges of compensation claims, as |
4033
|
necessary, and is authorized to allow for the attendance of |
4034
|
court reporters at hearings, for preparation of transcripts of |
4035
|
testimony, for copies of any instrument, and for other reporting |
4036
|
or recording services. The DeputyChief Judge may charge the |
4037
|
same fees allowed by law or court rule to reporters, persons |
4038
|
preparing transcripts, or clerks of courts of this state for |
4039
|
like services. |
4040
|
Section 50. Subsection (5) of section 440.44, Florida |
4041
|
Statutes, is amended to read: |
4042
|
440.44 Workers' compensation; staff organization.-- |
4043
|
(5) OFFICE.--The department, the agency, the Department of |
4044
|
Education, and the DeputyChief Judge shall maintain and keep |
4045
|
open during reasonable business hours an office, which shall be |
4046
|
provided in the Capitol or some other suitable building in the |
4047
|
City of Tallahassee, for the transaction of business under this |
4048
|
chapter, at which office the official records and papers shall |
4049
|
be kept. The office shall be furnished and equipped. The |
4050
|
department, the agency, any judge of compensation claims, or the |
4051
|
DeputyChief Judge may hold sessions and conduct hearings at any |
4052
|
place within the state. The Office of the Judges of Compensation |
4053
|
Claims shall maintain the 17 district offices, 31 judges of |
4054
|
compensation claims, and 31 mediators as they exist on June 30, |
4055
|
2001. |
4056
|
Section 51. Section 440.47, Florida Statutes, is amended |
4057
|
to read: |
4058
|
440.47 Travel expenses.--The DeputyChief Judge, judges of |
4059
|
compensation claims, and employees of the department shall be |
4060
|
reimbursed for travel expenses as provided in s. 112.061. Such |
4061
|
expenses shall be sworn to by the person who incurred the same |
4062
|
and shall be allowed and paid as provided in s. 440.50 upon the |
4063
|
presentation of vouchers therefor approved by the director of |
4064
|
the Division of Administrative Hearings or the department, |
4065
|
whichever is applicable. |
4066
|
Section 52. Paragraph (a) of subsection (4) and paragraphs |
4067
|
(a) and (c) of subsection (6) of section 440.49, Florida |
4068
|
Statutes, are amended to read: |
4069
|
440.49 Limitation of liability for subsequent injury |
4070
|
through Special Disability Trust Fund.-- |
4071
|
(4) PERMANENT IMPAIRMENT OR PERMANENT TOTAL DISABILITY, |
4072
|
TEMPORARY BENEFITS, MEDICAL BENEFITS, OR ATTENDANT CARE AFTER |
4073
|
OTHER PHYSICAL IMPAIRMENT.-- |
4074
|
(a) Permanent impairment.--If an employee who has a |
4075
|
preexisting permanent physical impairment incurs a subsequent |
4076
|
permanent impairment from injury or occupational disease arising |
4077
|
out of, and in the course of, her or his employment which merges |
4078
|
with the preexisting permanent physical impairment to cause a |
4079
|
permanent impairment, the employer shall, in the first instance, |
4080
|
pay all benefits provided by this chapter; but, subject to the |
4081
|
limitations specified in subsection (6), such employer shall be |
4082
|
reimbursed from the Special Disability Trust Fund created by |
4083
|
subsection (9) for 50 percent of all impairment benefits which |
4084
|
the employer has been required to provide pursuant to s. |
4085
|
440.1503(1)440.15(3)(a)as a result of the subsequent accident |
4086
|
or occupational disease. |
4087
|
(6) EMPLOYER KNOWLEDGE, EFFECT ON REIMBURSEMENT.-- |
4088
|
(a) Reimbursement is not allowed under this section unless |
4089
|
it is established that the employer knew of the preexisting |
4090
|
permanent physical impairment prior to the occurrence of the |
4091
|
subsequent injury or occupational disease, and that the |
4092
|
permanent physical impairment is one of the following: |
4093
|
1. Epilepsy. |
4094
|
2. Diabetes. |
4095
|
3. Cardiac disease. |
4096
|
4. Amputation of foot, leg, arm, or hand. |
4097
|
5. Total loss of sight of one or both eyes or a partial |
4098
|
loss of corrected vision of more than 75 percent bilaterally. |
4099
|
6. Residual disability from poliomyelitis. |
4100
|
7. Cerebral palsy. |
4101
|
8. Multiple sclerosis. |
4102
|
9. Parkinson's disease. |
4103
|
10. Meniscectomy. |
4104
|
11. Patellectomy. |
4105
|
12. Ruptured cruciate ligament. |
4106
|
13. Hemophilia. |
4107
|
14. Chronic osteomyelitis. |
4108
|
15. Surgical or spontaneous fusion of a major weight- |
4109
|
bearing joint. |
4110
|
16. Hyperinsulinism. |
4111
|
17. Muscular dystrophy. |
4112
|
18. Thrombophlebitis. |
4113
|
19. Herniated intervertebral disk. |
4114
|
20. Surgical removal of an intervertebral disk or spinal |
4115
|
fusion. |
4116
|
21. One or more back injuries or a disease process of the |
4117
|
back resulting in disability over a total of 120 or more days, |
4118
|
if substantiated by a doctor's opinion that there was a |
4119
|
preexisting impairment to the claimant's back. |
4120
|
22. Total deafness. |
4121
|
23. Mental retardation, provided the employee's |
4122
|
intelligence quotient is such that she or he falls within the |
4123
|
lowest 2 percentile of the general population. However, it shall |
4124
|
not be necessary for the employer to know the employee's actual |
4125
|
intelligence quotient or actual relative ranking in relation to |
4126
|
the intelligence quotient of the general population. |
4127
|
24. Any permanent physical condition which, prior to the |
4128
|
industrial accident or occupational disease, constitutes a 20- |
4129
|
percent impairment of a member or of the body as a whole. |
4130
|
25. Obesity, provided the employee is 30 percent or more |
4131
|
over the average weight designated for her or his height and age |
4132
|
in the Table of Average Weight of Americans by Height and Age |
4133
|
prepared by the Society of Actuaries using data from the 1979 |
4134
|
Build and Blood Pressure Study. |
4135
|
26. Any permanent physical impairment as defined in s. |
4136
|
440.1503440.15(3)which is a result of a prior industrial |
4137
|
accident with the same employer or the employer's parent |
4138
|
company, subsidiary, sister company, or affiliate located within |
4139
|
the geographical boundaries of this state. |
4140
|
(c) An employer's or carrier's right to apportionment or |
4141
|
deduction pursuant to ss. 440.02(1), 440.1506(1)(b) |
4142
|
440.15(5)(b), and 440.151(1)(c) does not preclude reimbursement |
4143
|
from such fund, except when the merger comes within the |
4144
|
definition of paragraph (2)(c) and such apportionment or |
4145
|
deduction relieves the employer or carrier from providing the |
4146
|
materially and substantially greater permanent disability |
4147
|
benefits otherwise contemplated in those paragraphs. |
4148
|
Section 53. Paragraph (a) of subsection (1) of section |
4149
|
440.50, Florida Statutes, is amended to read: |
4150
|
440.50 Workers' Compensation Administration Trust Fund.-- |
4151
|
(1)(a) There is established in the State Treasury a |
4152
|
special fund to be known as the "Workers' Compensation |
4153
|
Administration Trust Fund" for the purpose of providing for the |
4154
|
payment of all expenses in respect to the administration of this |
4155
|
chapter, including the vocational rehabilitation of injured |
4156
|
employees as provided in s. 440.49 and the payments due under s. |
4157
|
440.1505(1)(f)440.15(1)(f), the funding of the fixed |
4158
|
administrative expenses of the plan, and the funding of the |
4159
|
Bureau of Workers' Compensation Fraud within the Department of |
4160
|
Insurance. Such fund shall be administered by the department. |
4161
|
Section 54. Paragraph (b) of subsection (1) of section |
4162
|
440.51, Florida Statutes, is amended to read: |
4163
|
440.51 Expenses of administration.-- |
4164
|
(1) The department shall estimate annually in advance the |
4165
|
amounts necessary for the administration of this chapter, in the |
4166
|
following manner. |
4167
|
(b) The total expenses of administration shall be prorated |
4168
|
among the carriers writing compensation insurance in the state |
4169
|
and self-insurers. The net premiums collected by carriers and |
4170
|
the amount of premiums calculated by the department for self- |
4171
|
insured employers are the basis for computing the amount to be |
4172
|
assessed. When reporting deductible policy premium for purposes |
4173
|
of computing assessments levied after July 1, 2001, full policy |
4174
|
premium value must be reported prior to application of |
4175
|
deductible discounts or credits. This amount may be assessed as |
4176
|
a specific amount or as a percentage of net premiums payable as |
4177
|
the department may direct, provided such amount so assessed |
4178
|
shall not exceed 2.75 percent, beginning January 1, 2001, except |
4179
|
during the interim period from July 1, 2000, through December |
4180
|
31, 2000, such assessments shall not exceed 4 percent of such |
4181
|
net premiums. The carriers may elect to make the payments |
4182
|
required under s. 440.1505(1)(f)440.15(1)(f)rather than having |
4183
|
these payments made by the department. In that event, such |
4184
|
payments will be credited to the carriers, and the amount due by |
4185
|
the carrier under this section will be reduced accordingly. |
4186
|
Section 55. Section 631.929, Florida Statutes, is amended |
4187
|
to read: |
4188
|
631.929 Election of remedies.--An injured worker who has a |
4189
|
date of accident which occurred before January 1, 1994, and is |
4190
|
not receiving benefits due under chapter 440 due to the |
4191
|
insolvency of a self-insurance fund or its successors, |
4192
|
regardless of the date declared insolvent by the court, may |
4193
|
elect to seek medical care, treatment, and attendance, and |
4194
|
compensation required under ss. 440.15-440.1507and 440.16 from |
4195
|
the corporation and forego the remedy to seek benefits from his |
4196
|
or her employer or the insolvent self-insurance fund. An |
4197
|
employee who so elects may be required to obtain medical care, |
4198
|
treatment, and attendance through a managed care plan comporting |
4199
|
with the requirement of s. 440.134 if the plan of operation so |
4200
|
provides. An injured worker has 60 days to seek benefits from |
4201
|
the corporation upon ratification by the corporation of his or |
4202
|
her right to elect a remedy under this part. If the injured |
4203
|
worker elects to pursue his or her remedy under the provisions |
4204
|
of this part, the corporation may, with the agreement of the |
4205
|
injured employee, pay a lump-sum payment in exchange for the |
4206
|
corporation's and employer's release from liability for future |
4207
|
medical and compensation expenses, as well as any other benefit |
4208
|
provided under chapter 440. However, there shall be no |
4209
|
entitlement to attorney's fees, penalties, interest, or costs to |
4210
|
be paid on any claim presented to the corporation under this |
4211
|
part. This section shall not create any cause of action against |
4212
|
any employer who purchased workers' compensation insurance |
4213
|
coverage pursuant to s. 440.38. |
4214
|
Section 56. Subsection (2) of section 946.523, Florida |
4215
|
Statutes, is amended to read: |
4216
|
946.523 Prison industry enhancement (PIE) programs.-- |
4217
|
(2) Notwithstanding any other law to the contrary, |
4218
|
including s. 440.1506(5)440.15(9), private sector employers |
4219
|
shall provide workers' compensation coverage to inmates who |
4220
|
participate in prison industry enhancement (PIE) programs under |
4221
|
subsection (1). However, inmates are not entitled to |
4222
|
unemployment compensation. |
4223
|
Section 57. Paragraph (b) of subsection (8) of section |
4224
|
948.03, Florida Statutes, is amended to read: |
4225
|
948.03 Terms and conditions of probation or community |
4226
|
control.-- |
4227
|
(8) |
4228
|
(b) In determining the average weekly wage, unless |
4229
|
otherwise determined by a specific funding program, all |
4230
|
remuneration received from the employer shall be considered a |
4231
|
gratuity, and the offender shall not be entitled to any benefits |
4232
|
otherwise payable under ss.s. 440.15-440.1507, regardless of |
4233
|
whether the offender may be receiving wages and remuneration |
4234
|
from other employment with another employer and regardless of |
4235
|
his or her future wage-earning capacity. The provisions of this |
4236
|
subsection do not apply to any person performing labor under a |
4237
|
sentence of a court to perform community services as provided in |
4238
|
s. 316.193. |
4239
|
Section 58. Subsection (4) of section 960.13, Florida |
4240
|
Statutes, is amended to read: |
4241
|
960.13 Awards.-- |
4242
|
(4) Any award made pursuant to this chapter shall be made |
4243
|
in accordance with the schedule of benefits, degrees of |
4244
|
disability, and wage-loss formulas specified in ss. 440.12,and |
4245
|
440.15-440.1505, and 440.1507excluding subsection (5) of that |
4246
|
section. |
4247
|
Section 59. Paragraph (a) of subsection (4) of section |
4248
|
985.21, Florida Statutes, is amended to read: |
4249
|
985.21 Intake and case management.-- |
4250
|
(4) The juvenile probation officer shall make a |
4251
|
preliminary determination as to whether the report, affidavit, |
4252
|
or complaint is complete, consulting with the state attorney as |
4253
|
may be necessary. In any case where the juvenile probation |
4254
|
officer or the state attorney finds that the report, affidavit, |
4255
|
or complaint is insufficient by the standards for a probable |
4256
|
cause affidavit, the juvenile probation officer or state |
4257
|
attorney shall return the report, affidavit, or complaint, |
4258
|
without delay, to the person or agency originating the report, |
4259
|
affidavit, or complaint or having knowledge of the facts or to |
4260
|
the appropriate law enforcement agency having investigative |
4261
|
jurisdiction of the offense, and shall request, and the person |
4262
|
or agency shall promptly furnish, additional information in |
4263
|
order to comply with the standards for a probable cause |
4264
|
affidavit. |
4265
|
(a) The juvenile probation officer, upon determining that |
4266
|
the report, affidavit, or complaint is complete, pursuant to |
4267
|
uniform procedures established by the department, shall: |
4268
|
1. When indicated by the preliminary screening, provide |
4269
|
for a comprehensive assessment of the child and family for |
4270
|
substance abuse problems, using community-based licensed |
4271
|
programs with clinical expertise and experience in the |
4272
|
assessment of substance abuse problems. |
4273
|
2. When indicated by the preliminary screening, provide |
4274
|
for a comprehensive assessment of the child and family for |
4275
|
mental health problems, using community-based psychologists, |
4276
|
psychiatrists, or other licensed mental health professionals |
4277
|
with clinical expertise and experience in the assessment of |
4278
|
mental health problems. |
4279
|
|
4280
|
When indicated by the comprehensive assessment, the department |
4281
|
is authorized to contract within appropriated funds for services |
4282
|
with a local nonprofit community mental health or substance |
4283
|
abuse agency licensed or authorized under chapter 394, or |
4284
|
chapter 397, or other authorized nonprofit social service agency |
4285
|
providing related services. The determination of mental health |
4286
|
or substance abuse services shall be conducted in coordination |
4287
|
with existing programs providing mental health or substance |
4288
|
abuse services in conjunction with the intake office. Client |
4289
|
information resulting from the screening and evaluation shall be |
4290
|
documented pursuant to rules established by the department and |
4291
|
shall serve to assist the juvenile probation officer in |
4292
|
providing the most appropriate services and recommendations in |
4293
|
the least intrusive manner. Such client information shall be |
4294
|
used in the multidisciplinary assessment and classification of |
4295
|
the child, but such information, and any information obtained |
4296
|
directly or indirectly through the assessment process, is |
4297
|
inadmissible in court prior to the disposition hearing, unless |
4298
|
the child's written consent is obtained. At the disposition |
4299
|
hearing, documented client information shall serve to assist the |
4300
|
court in making the most appropriate custody, adjudicatory, and |
4301
|
dispositional decision. If the screening and assessment indicate |
4302
|
that the interest of the child and the public will be best |
4303
|
served thereby, the juvenile probation officer, with the |
4304
|
approval of the state attorney, may refer the child for care, |
4305
|
diagnostic and evaluation services, substance abuse treatment |
4306
|
services, mental health services, retardation services, a |
4307
|
diversionary or arbitration or mediation program, community |
4308
|
service work, or other programs or treatment services |
4309
|
voluntarily accepted by the child and the child's parents or |
4310
|
legal guardians. The victim, if any, and the law enforcement |
4311
|
agency which investigated the offense shall be notified |
4312
|
immediately by the state attorney of the action taken under this |
4313
|
paragraph. Whenever a child volunteers to participate in any |
4314
|
work program under this chapter or volunteers to work in a |
4315
|
specified state, county, municipal, or community service |
4316
|
organization supervised work program or to work for the victim, |
4317
|
the child shall be considered an employee of the state for the |
4318
|
purposes of liability. In determining the child's average weekly |
4319
|
wage, unless otherwise determined by a specific funding program, |
4320
|
all remuneration received from the employer is considered a |
4321
|
gratuity, and the child is not entitled to any benefits |
4322
|
otherwise payable under ss.s. 440.15-440.1507, regardless of |
4323
|
whether the child may be receiving wages and remuneration from |
4324
|
other employment with another employer and regardless of the |
4325
|
child's future wage-earning capacity. |
4326
|
Section 60. Paragraph (g) of subsection (1) of section |
4327
|
985.231, Florida Statutes, is amended to read: |
4328
|
985.231 Powers of disposition in delinquency cases.-- |
4329
|
(1) |
4330
|
(g) Whenever a child is required by the court to |
4331
|
participate in any work program under this part or whenever a |
4332
|
child volunteers to work in a specified state, county, |
4333
|
municipal, or community service organization supervised work |
4334
|
program or to work for the victim, either as an alternative to |
4335
|
monetary restitution or as a part of the rehabilitative or |
4336
|
probation program, the child is an employee of the state for the |
4337
|
purposes of liability. In determining the child's average weekly |
4338
|
wage unless otherwise determined by a specific funding program, |
4339
|
all remuneration received from the employer is a gratuity, and |
4340
|
the child is not entitled to any benefits otherwise payable |
4341
|
under ss.s. 440.15-440.1507, regardless of whether the child |
4342
|
may be receiving wages and remuneration from other employment |
4343
|
with another employer and regardless of the child's future wage- |
4344
|
earning capacity. |
4345
|
Section 61. Paragraph (c) of subsection (5) of section |
4346
|
985.315, Florida Statutes, is amended to read: |
4347
|
985.315 Educational/technical and vocational work-related |
4348
|
programs.-- |
4349
|
(5) |
4350
|
(c) Notwithstanding any other law to the contrary, |
4351
|
including s. 440.1506(5)440.15(9), private sector employers |
4352
|
shall provide juveniles participating in juvenile work programs |
4353
|
under paragraph (b) with workers' compensation coverage, and |
4354
|
juveniles shall be entitled to the benefits of such coverage. |
4355
|
Nothing in this subsection shall be construed to allow juveniles |
4356
|
to participate in unemployment compensation benefits. |
4357
|
Section 62. This act shall take effect upon becoming a |
4358
|
law. |