HB 1837, Engrossed 1 2003
1	A bill to be entitled
2	An act relating to workers' compensation; amending s.
3	440.02, F.S.; providing, revising, and deleting
4	definitions; amending s. 440.05, F.S.; revising
5	authorization to claim exemptions and requirements
6	relating to submitting notice of election of exemption;
7	specifying effect of exemption; amending s. 440.06, F.S.;
8	revising provisions relating to failure to secure
9	compensation; amending s. 440.077, F.S.; providing that a
10	corporate officer electing to be exempt may not receive
11	benefits; amending s. 440.09, F.S.; revising provisions
12	relating to compensation for subsequent injuries;
13	providing definitions; revising provisions relating to
14	drug testing; specifying effect of criminal acts; creating
15	s. 440.093, F.S.; providing for compensability of mental
16	and nervous injuries; amending s. 440.10, F.S.; revising
17	provisions relating to contractors and subcontractors with
18	regard to liability for compensation; requiring
19	subcontractors to provide evidence of workers'
20	compensation coverage or proof of exemption to a
21	contractor; deleting provisions relating to independent
22	contractors; amending s. 440.1025, F.S.; revising
23	requirements relating to workplace safety programs;
24	amending s. 440.103, F.S.; providing conditions for
25	applying for building permits; amending s. 440.105, F.S.;
26	increasing criminal penalties for certain violations;
27	providing sanctions for violation of stop-work orders and
28	presentation of certain false or misleading statements as
29	evidence; amending s. 440.1051, F.S.; increasing criminal
30	penalty for false reports; amending s. 440.107, F.S.;
31	providing additional powers to the Department of Financial
32	Services relating to compliance and enforcement; providing
33	a definition; providing penalties; amending s. 440.11,
34	F.S.; providing exclusiveness of liability; revising
35	provisions relating to employer and safety consultant
36	immunity from liability; amending s. 440.13, F.S.;
37	providing for practice parameters and treatment protocols;
38	revising provisions relating to provider reimbursement;
39	requiring revision of specified reimbursement schedules;
40	providing for release of information; providing additional
41	criteria for independent medical examinations; providing a
42	definition; providing standards for medical care under ch.
43	440, F.S.; providing penalties; amending s. 440.134, F.S.;
44	revising provisions relating to managed care arrangements;
45	revising definitions; providing for assignment of a
46	medical care coordinator; amending s. 440.14, F.S.;
47	revising provisions relating to calculation of average
48	weekly wage for injured employees; conforming cross
49	references; amending s. 440.15, F.S.; providing additional
50	limitations on compensation for permanent total
51	disability; providing a definition; specifying impairment
52	benefits and providing for partial reduction under certain
53	circumstances; deleting provisions relating to
54	supplemental benefits; amending s. 440.151, F.S.;
55	specifying compensability of occupational disease;
56	providing a definition; amending s. 440.16, F.S.;
57	increasing the limits on the amount of certain benefits
58	paid as compensation for death; amending s. 440.185, F.S.;
59	specifying duty of employer upon receipt of notice of
60	injury or death; increasing penalties for noncompliance;
61	amending s. 440.192, F.S.; revising procedure for
62	resolving benefit disputes; requiring a petition for
63	benefits to include all claims which are ripe, due, and
64	owing; providing that the Chief Judge, rather than the
65	Deputy Chief Judge, shall refer petitions for benefits;
66	creating s. 440.1926, F.S.; providing for alternative
67	dispute resolution and arbitration of claims; amending s.
68	440.20, F.S.; revising provisions relating to timely
69	payment of compensation and medical bills and penalties
70	for late payment; amending s. 440.25, F.S.; revising
71	procedures for mediation and hearings; amending s. 440.34,
72	F.S.; revising provisions relating to the award of
73	attorney's fees; amending s. 440.38, F.S.; providing
74	requirement for employers with coverage provided by
75	insurers from outside the state; amending s. 440.381,
76	F.S.; providing criminal penalty for unlawful
77	applications; requiring on-site audits of employers under
78	certain circumstances; amending s. 440.42, F.S.; revising
79	provision relating to notice of cancellation of coverage;
80	amending ss. 440.49 and 440.491, F.S., to conform cross
81	references; amending s. 440.525, F.S.; providing for
82	audits, examinations, and investigations of claims-handing
83	entities; providing penalties; providing for rules;
84	amending s. 627.162, F.S.; revising delinquency and
85	collection fee for late payment of premium installments;
86	amending s. 627.311, F.S.; requiring participation in
87	safety programs; providing for an additional subplan
88	within the joint underwriting plan for workers’
89	compensation insurance; providing for rates, surcharges,
90	and assessments; limiting assessment powers; amending s.
91	921.0022, F.S.; revising the offense severity ranking
92	chart to reflect changes in penalties under the act;
93	requiring a report to the Legislature from the Department
94	of Financial Services regarding provisions of law relating
95	to enforcement; amending ss. 946.523 and 985.315, F.S.,
96	to conform cross references; repealing s. 440.1925, F.S.,
97	relating to procedure for resolving maximum medical
98	improvement or permanent impairment disputes; providing
99	effective dates.
100
101	Be It Enacted by the Legislature of the State of Florida:
102
103	Section 1. Effective upon this act becoming a law,
104	Subsections (1), (15), (29), (38), (40), (41), and (42) of
105	section 440.02, Florida Statutes, are amended to read:
106	440.02 Definitions.-- When used in this chapter, unless
107	the context clearly requires otherwise, the following terms
108	shall have the following meanings:
109	(1) "Accident" means only an unexpected or unusual event
110	or result that happens suddenly. A mental or nervous injury due
111	to stress, fright, or excitement only, orDisability or death
112	due to the accidental acceleration or aggravation of a venereal
113	disease or of a disease due to the habitual use of alcohol or
114	controlled substances or narcotic drugs, or a disease that
115	manifests itself in the fear of or dislike for an individual
116	because of the individual's race, color, religion, sex, national
117	origin, age, or handicap is not an injury by accident arising
118	out of the employment. Subject to s. 440.15(5),if a preexisting
119	disease or anomaly is accelerated or aggravated by an accident
120	arising out of and in the course of employment, only
121	acceleration of death or acceleration or aggravation of the
122	preexisting condition reasonably attributable to the accident is
123	compensable, with respect to any compensation otherwise payable
124	under this chapterdeath or permanent impairment. An injury or
125	disease caused by exposure to a toxic substance, including, but
126	not limited to, fungus or mold, is not an injury by accident
127	arising out of the employment unless there is clear and
128	convincing evidence establishing that exposure to the specific
129	substance involved, at the levels to which the employee was
130	exposed, can cause the injury or disease sustained by the
131	employee.
132	(15)(a) "Employee" means any person engaged in any
133	employment under any appointment or contract of hire or
134	apprenticeship, express or implied, oral or written, whether
135	lawfully or unlawfully employed, and includes, but is not
136	limited to, aliens and minors.
137	(b) "Employee" includes any person who is an officer of a
138	corporation and who performs services for remuneration for such
139	corporation within this state, whether or not such services are
140	continuous.
141	1. Any officer of a corporation may elect to be exempt
142	from this chapter by filing written notice of the election with
143	the department as provided in s. 440.05.
144	2. As to officers of a corporation who are actively
145	engaged in the construction industry, no more than three
146	officers may elect to be exempt from this chapter by filing
147	written notice of the election with the department as provided
148	in s. 440.05. However, any exemption obtained by a corporate
149	officer of a corporation actively engaged in the construction
150	industry is not applicable with respect to any commercial
151	building project estimated to be valued at $250,000 or greater.
152	3. An officer of a corporation who elects to be exempt
153	from this chapter by filing a written notice of the election
154	with the department as provided in s. 440.05 is not an employee.
155
156	Services are presumed to have been rendered to the corporation
157	if the officer is compensated by other than dividends upon
158	shares of stock of the corporation which the officer owns.
159	(c)1."Employee" includes a sole proprietor or a partner
160	who devotes full time to the proprietorship or partnership and,
161	except as provided in this paragraph, elects to be included in
162	the definition of employee by filing notice thereof as provided
163	in s. 440.05. Partners or sole proprietors actively engaged in
164	the construction industry are considered employees unless they
165	elect to be excluded from the definition of employee by filing
166	written notice of the election with the department as provided
167	in s. 440.05. However, no more than three partners in a
168	partnership that is actively engaged in the construction
169	industry may elect to be excluded. A sole proprietor or partner
170	who is actively engaged in the construction industry and who
171	elects to be exempt from this chapter by filing a written notice
172	of the election with the department as provided in s. 440.05 is
173	not an employee. For purposes of this chapter, an independent
174	contractor is an employee unless he or she meets all of the
175	conditions set forth in subparagraph (d)1.
176	2. Notwithstanding the provisions of subparagraph 1., the
177	term "employee" includes a sole proprietor or partner actively
178	engaged in the construction industry with respect to any
179	commercial building project estimated to be valued at $250,000
180	or greater. Any exemption obtained is not applicable, with
181	respect to work performed at such a commercial building project.
182	(d) "Employee" does not include:
183	1. An independent contractor, if:
184	a. The independent contractor maintains a separate
185	business with his or her own work facility, truck, equipment,
186	materials, or similar accommodations;
187	b. The independent contractor holds or has applied for a
188	federal employer identification number, unless the independent
189	contractor is a sole proprietor who is not required to obtain a
190	federal employer identification number under state or federal
191	requirements;
192	c. The independent contractor performs or agrees to
193	perform specific services or work for specific amounts of money
194	and controls the means of performing the services or work;
195	d. The independent contractor incurs the principal
196	expenses related to the service or work that he or she performs
197	or agrees to perform;
198	e. The independent contractor is responsible for the
199	satisfactory completion of work or services that he or she
200	performs or agrees to perform and is or could be held liable for
201	a failure to complete the work or services;
202	f. The independent contractor receives compensation for
203	work or services performed for a commission or on a per-job or
204	competitive-bid basis and not on any other basis;
205	g. The independent contractor may realize a profit or
206	suffer a loss in connection with performing work or services;
207	h. The independent contractor has continuing or recurring
208	business liabilities or obligations; and
209	i. The success or failure of the independent contractor's
210	business depends on the relationship of business receipts to
211	expenditures.
212
213	However, the determination as to whether an individual included
214	in the Standard Industrial Classification Manual of 1987,
215	Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762, 0781, 0782,
216	0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436, 2448, or 2449,
217	or a newspaper delivery person, is an independent contractor is
218	governed not by the criteria in this paragraph but by common-law
219	principles, giving due consideration to the business activity of
220	the individual. Notwithstanding the provisions of this paragraph
221	or any other provision of this chapter, with respect to any
222	commercial building project estimated to be valued at $250,000
223	or greater, a person who is actively engaged in the construction
224	industry is not an independent contractor and is either an
225	employer or an employee who may not be exempt from the coverage
226	requirements of this chapter.
227	2. A real estate salesperson or agent, if that person
228	agrees, in writing, to perform for remuneration solely by way of
229	commission.
230	3. Bands, orchestras, and musical and theatrical
231	performers, including disk jockeys, performing in licensed
232	premises as defined in chapter 562, if a written contract
233	evidencing an independent contractor relationship is entered
234	into before the commencement of such entertainment.
235	4. An owner-operator of a motor vehicle who transports
236	property under a written contract with a motor carrier which
237	evidences a relationship by which the owner-operator assumes the
238	responsibility of an employer for the performance of the
239	contract, if the owner-operator is required to furnish the
240	necessary motor vehicle equipment and all costs incidental to
241	the performance of the contract, including, but not limited to,
242	fuel, taxes, licenses, repairs, and hired help; and the owner-
243	operator is paid a commission for transportation service and is
244	not paid by the hour or on some other time-measured basis.
245	5. A person whose employment is both casual and not in the
246	course of the trade, business, profession, or occupation of the
247	employer.
248	6. A volunteer, except a volunteer worker for the state or
249	a county, municipality, or other governmental entity. A person
250	who does not receive monetary remuneration for services is
251	presumed to be a volunteer unless there is substantial evidence
252	that a valuable consideration was intended by both employer and
253	employee. For purposes of this chapter, the term "volunteer"
254	includes, but is not limited to:
255	a. Persons who serve in private nonprofit agencies and who
256	receive no compensation other than expenses in an amount less
257	than or equivalent to the standard mileage and per-diem expenses
258	provided to salaried employees in the same agency or, if such
259	agency does not have salaried employees who receive mileage and
260	per diem, then such volunteers who receive no compensation other
261	than expenses in an amount less than or equivalent to the
262	customary mileage and per diem paid to salaried workers in the
263	community as determined by the department; and
264	b. Volunteers participating in federal programs
265	established under Pub. L. No. 93-113.
266	7. Any officer of a corporation who elects to be exempt
267	from this chapter.
268	8. A sole proprietor or officer of a corporation who
269	actively engages in the construction industry, and a partner in
270	a partnership that is actively engaged in the construction
271	industry, who elects to be exempt from the provisions of this
272	chapter. Such sole proprietor, officer, or partner is not an
273	employee for any reason until the notice of revocation of
274	election filed pursuant to s. 440.05 is effective.
275	9. An exercise rider who does not work for a single horse
276	farm or breeder, and who is compensated for riding on a case-by-
277	case basis, provided a written contract is entered into prior to
278	the commencement of such activity which evidences that an
279	employee/employer relationship does not exist.
280	10. A taxicab, limousine, or other passenger vehicle-for-
281	hire driver who operates said vehicles pursuant to a written
282	agreement with a company which provides any dispatch, marketing,
283	insurance, communications, or other services under which the
284	driver and any fees or charges paid by the driver to the company
285	for such services are not conditioned upon, or expressed as a
286	proportion of, fare revenues.
287	11. A person who performs services as a sports official
288	for an entity sponsoring an interscholastic sports event or for
289	a public entity or private, nonprofit organization that sponsors
290	an amateur sports event. For purposes of this subparagraph, such
291	a person is an independent contractor. For purposes of this
292	subparagraph, the term "sports official" means any person who is
293	a neutral participant in a sports event, including, but not
294	limited to, umpires, referees, judges, linespersons,
295	scorekeepers, or timekeepers. This subparagraph does not apply
296	to any person employed by a district school board who serves as
297	a sports official as required by the employing school board or
298	who serves as a sports official as part of his or her
299	responsibilities during normal school hours.
300	(29) "Weekly compensation rate" means and refers to the
301	amount of compensation payable for a period of 7 consecutive
302	calendardays, including any Saturdays, Sundays, holidays, and
303	other nonworking days which fall within such period of 7
304	consecutive calendardays. When Saturdays, Sundays, holidays, or
305	other nonworking days follow the first 7 calendardays of
306	disability or occur at the end of a period of disability as the
307	last day or days of such period, such nonworking days constitute
308	a part of the period of disability with respect to which
309	compensation is payable.
310	(38) "Catastrophic injury" means a permanent impairment
311	constituted by the loss of both hands, both arms, both feet,
312	both legs, or both eyes, or any two thereof, or paraplegia or
313	quadriplegia.:
314	(a) Spinal cord injury involving severe paralysis of an
315	arm, a leg, or the trunk;
316	(b) Amputation of an arm, a hand, a foot, or a leg
317	involving the effective loss of use of that appendage;
318	(c) Severe brain or closed-head injury as evidenced by:
319	1. Severe sensory or motor disturbances;
320	2. Severe communication disturbances;
321	3. Severe complex integrated disturbances of cerebral
322	function;
323	4. Severe episodic neurological disorders; or
324	5. Other severe brain and closed-head injury conditions at
325	least as severe in nature as any condition provided in
326	subparagraphs 1.-4.;
327	(d) Second-degree or third-degree burns of 25 percent or
328	more of the total body surface or third-degree burns of 5
329	percent or more to the face and hands;
330	(e) Total or industrial blindness; or
331	(f) Any other injury that would otherwise qualify under
332	this chapter of a nature and severity that would qualify an
333	employee to receive disability income benefits under Title II or
334	supplemental security income benefits under Title XVI of the
335	federal Social Security Act as the Social Security Act existed
336	on July 1, 1992, without regard to any time limitations provided
337	under that act.
338	(40) "Statement," for the purposes of ss. 440.105 and
339	440.106, shall include the exact fraud statement language in s.
340	440.105(7). This requirementincludes, but is not limited to,
341	any notice, representation, statement, proof of injury, bill for
342	services, diagnosis, prescription, hospital or doctor record, X
343	ray, test result, or other evidence of loss, injury, or expense.
344	(41) “Specificity” means information on the petition for
345	benefits sufficient to put the employer or carrier on notice of
346	the exact statutory classification and outstanding time period
347	of benefits being requested and includes a detailed explanation
348	of any benefits received that should be increased, decreased,
349	changed, or otherwise modified. If the petition is for medical
350	benefits, the information shall include specific details as to
351	why such benefits are being requested, why such benefits are
352	medically necessary, and why current treatment, if any, is not
353	sufficient. Any petition requesting alternate or other medical
354	care, including, but not limited to, petitions requesting
355	psychiatric or psychological treatment, must specifically
356	identify the physician, as defined in s. 440.13(1), that is
357	recommending such treatment. A copy of a report from such
358	physician making the recommendation for alternate or other
359	medical care shall also be attached to the petition. A judge of
360	compensation claims shall not order such treatment if a
361	physician is not recommending such treatment."Commercial
362	building" means any building or structure intended for
363	commercial or industrial use, or any building or structure
364	intended for multifamily use of more than four dwelling units,
365	as well as any accessory use structures constructed in
366	conjunction with the principal structure. The term, "commercial
367	building," does not include the conversion of any existing
368	residential building to a commercial building.
369	(42) "Residential building" means any building or
370	structure intended for residential use containing four or fewer
371	dwelling units and any structures intended as an accessory use
372	to the residential structure.
373	Section 2. Effective January 1, 2004, subsections (8),
374	(15), and (16) of section 440.02, Florida Statutes, as amended
375	by this act, are amended to read:
376	440.02 Definitions.--When used in this chapter, unless the
377	context clearly requires otherwise, the following terms shall
378	have the following meanings:
379	(8) "Construction industry" means for-profit activities
380	involving the carrying out ofany building, clearing, filling,
381	excavation, or substantial improvement in the size or use of any
382	structure or the appearance of any land. When appropriate to the
383	context, "construction" refers to the act of construction or the
384	result of construction. However, "construction" doesshallnot
385	mean a homeowner'slandowner'sact of construction or the result
386	of a construction upon his or her own premises, provided such
387	premises are not intended to be sold,or resold, or leased by
388	the owner within 1 year after the commencement of construction.
389	The division may, by rule, establish standard industrial
390	classification codes and definitions thereof which meet the
391	criteria of the term “construction industry” as set forth in
392	this section.
393	(15)(a) "Employee" means any person who receives
394	remuneration from an employer for the performance of any work or
395	service whileengaged in any employment under any appointment or
396	contract forofhire or apprenticeship, express or implied, oral
397	or written, whether lawfully or unlawfully employed, and
398	includes, but is not limited to, aliens and minors.
399	(b) "Employee" includes any person who is an officer of a
400	corporation and who performs services for remuneration for such
401	corporation within this state, whether or not such services are
402	continuous.
403	1. Any officer of a corporation may elect to be exempt
404	from this chapter by filing written notice of the election with
405	the department as provided in s. 440.05.
406	2. As to officers of a corporation who are actively
407	engaged in the construction industry, no more than three
408	officers of a corporation or of any group of affiliated
409	corporationsmay elect to be exempt from this chapter by filing
410	written notice of the election with the department as provided
411	in s. 440.05. Officers must be shareholders, each owning at
412	least 10 percent of the stock of such corporation and listed as
413	an officer of such corporation with the Division of Corporations
414	of the Department of State, in order to elect exemptions under
415	this chapter. For purposes of this subparagraph, the term
416	“affiliated” means and includes one or more corporations or
417	entities, any one of which is a corporation engaged in the
418	construction industry, under the same or substantially the same
419	control of a group of business entities which are connected or
420	associated so that one entity controls or has the power to
421	control each of the other business entities. The term
422	“affiliated” includes, but is not limited to, the officers,
423	directors, executives, shareholders active in management,
424	employees, and agents of the affiliated corporation. The
425	ownership by one business entity of a controlling interest in
426	another business entity or a pooling of equipment or income
427	among business entities shall be prima facie evidence that one
428	business is affiliated with the other.
429	3. An officer of a corporation who elects to be exempt
430	from this chapter by filing a written notice of the election
431	with the department as provided in s. 440.05 is not an employee.
432
433	Services are presumed to have been rendered to the corporation
434	if the officer is compensated by other than dividends upon
435	shares of stock of the corporation which the officer owns.
436	(c) "Employee" includes:
437	1. A sole proprietor or a partner who is not engaged in
438	the construction industry,devotes full time to the
439	proprietorship or partnership, and, except as provided in this
440	paragraph,elects to be included in the definition of employee
441	by filing notice thereof as provided in s. 440.05. Partners or
442	sole proprietors actively engaged in the construction industry
443	are considered employees unless they elect to be excluded from
444	the definition of employee by filing written notice of the
445	election with the department as provided in s. 440.05. However,
446	no more than three partners in a partnership that is actively
447	engaged in the construction industry may elect to be excluded. A
448	sole proprietor or partner who is actively engaged in the
449	construction industry and who elects to be exempt from this
450	chapter by filing a written notice of the election with the
451	department as provided in s. 440.05 is not an employee. For
452	purposes of this chapter, an independent contractor is an
453	employee unless he or she meets all of the conditions set forth
454	in subparagraph (d)1.
455	2. All persons who are being paid by a construction
456	contractor as a subcontractor, unless the subcontractor has
457	validly elected an exemption as permitted by this chapter, or
458	has otherwise secured the payment of compensation coverage as a
459	subcontractor, consistent with s. 440.10, for work performed by
460	or as a subcontractor.
461	3. An independent contractor working or performing
462	services in the construction industry.
463	4. A sole proprietor who engages in the construction
464	industry and a partner or partnership that is engaged in the
465	construction industry.
466	(d) "Employee" does not include:
467	1. An independent contractor who is not engaged in the
468	construction industry., if:
469	a. In order to meet the definition of independent
470	contractor, at least four of the following criteria must be met:
471	(I) The independent contractor maintains a separate
472	business with his or her own work facility, truck, equipment,
473	materials, or similar accommodations;
474	(II) The independent contractor holds or has applied for a
475	federal employer identification number, unless the independent
476	contractor is a sole proprietor who is not required to obtain a
477	federal employer identification number under state or federal
478	regulations;
479	(III) The independent contractor receives compensation for
480	services rendered or work performed and such compensation is
481	paid to a business rather than to an individual;
482	(IV) The independent contractor holds one or more bank
483	accounts in the name of the business entity for purposes of
484	paying business expenses or other expenses related to services
485	rendered or work performed for compensation;
486	(V) The independent contractor performs work or is able to
487	perform work for any entity in addition to or besides the
488	employer at his or her own election without the necessity of
489	completing an employment application or process; or
490	(VI) The independent contractor receives compensation for
491	work or services rendered on a competitive-bid basis or
492	completion of a task or a set of tasks as defined by a
493	contractual agreement, unless such contractual agreement
494	expressly states that an employment relationship exists.The
495	independent contractor maintains a separate business with his or
496	her own work facility, truck, equipment, materials, or similar
497	accommodations;
498	b. If four of the criteria listed in sub-subparagraph a.
499	do not exist, an individual may still be presumed to be an
500	independent contractor and not an employee based on full
501	consideration of the nature of the individual situation with
502	regard to satisfying any of the following conditions:
503	(I) The independent contractor performs or agrees to
504	perform specific services or work for a specific amount of money
505	and controls the means of performing the services or work.
506	(II) The independent contractor incurs the principal
507	expenses related to the service or work that he or she performs
508	or agrees to perform.
509	(III) The independent contractor is responsible for the
510	satisfactory completion of the work or services that he or she
511	performs or agrees to perform.
512	(IV) The independent contractor receives compensation for
513	work or services performed for a commission or on a per-job
514	basis and not on any other basis.
515	(V) The independent contractor may realize a profit or
516	suffer a loss in connection with performing work or services.
517	(VI) The independent contractor has continuing or
518	recurring business liabilities or obligations.
519	(VII) The success or failure of the independent
520	contractor’s business depends on the relationship of business
521	receipts to expenditures.The independent contractor holds or
522	has applied for a federal employer identification number, unless
523	the independent contractor is a sole proprietor who is not
524	required to obtain a federal employer identification number
525	under state or federal requirements;
526	c. Notwithstanding anything to the contrary in this
527	subparagraph, an individual claiming to be an independent
528	contractor has the burden of proving that he or she is an
529	independent contractor for purposes of this chapter.The
530	independent contractor performs or agrees to perform specific
531	services or work for specific amounts of money and controls the
532	means of performing the services or work;
533	d. The independent contractor incurs the principal
534	expenses related to the service or work that he or she performs
535	or agrees to perform;
536	e. The independent contractor is responsible for the
537	satisfactory completion of work or services that he or she
538	performs or agrees to perform and is or could be held liable for
539	a failure to complete the work or services;
540	f. The independent contractor receives compensation for
541	work or services performed for a commission or on a per-job or
542	competitive-bid basis and not on any other basis;
543	g. The independent contractor may realize a profit or
544	suffer a loss in connection with performing work or services;
545	h. The independent contractor has continuing or recurring
546	business liabilities or obligations; and
547	i. The success or failure of the independent contractor's
548	business depends on the relationship of business receipts to
549	expenditures.
550
551	However, the determination as to whether an individual included
552	in the Standard Industrial Classification Manual of 1987,
553	Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762, 0781, 0782,
554	0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436, 2448, or 2449,
555	or a newspaper delivery person, is an independent contractor is
556	governed not by the criteria in this paragraph but by common-law
557	principles, giving due consideration to the business activity of
558	the individual.
559	2. A real estate salesperson or agent, if that person
560	agrees, in writing, to perform for remuneration solely by way of
561	commission.
562	3. Bands, orchestras, and musical and theatrical
563	performers, including disk jockeys, performing in licensed
564	premises as defined in chapter 562, if a written contract
565	evidencing an independent contractor relationship is entered
566	into before the commencement of such entertainment.
567	4. An owner-operator of a motor vehicle who transports
568	property under a written contract with a motor carrier which
569	evidences a relationship by which the owner-operator assumes the
570	responsibility of an employer for the performance of the
571	contract, if the owner-operator is required to furnish the
572	necessary motor vehicle equipment and all costs incidental to
573	the performance of the contract, including, but not limited to,
574	fuel, taxes, licenses, repairs, and hired help; and the owner-
575	operator is paid a commission for transportation service and is
576	not paid by the hour or on some other time-measured basis.
577	5. A person whose employment is both casual and not in the
578	course of the trade, business, profession, or occupation of the
579	employer.
580	6. A volunteer, except a volunteer worker for the state or
581	a county, municipality, or other governmental entity. A person
582	who does not receive monetary remuneration for services is
583	presumed to be a volunteer unless there is substantial evidence
584	that a valuable consideration was intended by both employer and
585	employee. For purposes of this chapter, the term "volunteer"
586	includes, but is not limited to:
587	a. Persons who serve in private nonprofit agencies and who
588	receive no compensation other than expenses in an amount less
589	than or equivalent to the standard mileage and per diem expenses
590	provided to salaried employees in the same agency or, if such
591	agency does not have salaried employees who receive mileage and
592	per diem, then such volunteers who receive no compensation other
593	than expenses in an amount less than or equivalent to the
594	customary mileage and per diem paid to salaried workers in the
595	community as determined by the department; and
596	b. Volunteers participating in federal programs
597	established under Pub. L. No. 93-113.
598	7. Unless otherwise prohibited by this chapter,any
599	officer of a corporation who elects to be exempt from this
600	chapter. Such officer is not an employee for any reason under
601	this chapter until the notice of revocation of election filed
602	pursuant to s. 440.05 is effective.
603	8. Ana sole proprietor or officer of a corporation who
604	actively engages in the construction industry, and a partner in
605	a partnership that is activelyengaged in the construction
606	industry,who elects to be exempt from the provisions of this
607	chapter, as otherwise permitted by this chapter. Such sole
608	proprietor, officer, or partneris not an employee for any
609	reason until the notice of revocation of election filed pursuant
610	to s. 440.05 is effective.
611	9. An exercise rider who does not work for a single horse
612	farm or breeder, and who is compensated for riding on a case-by-
613	case basis, provided a written contract is entered into prior to
614	the commencement of such activity which evidences that an
615	employee/employer relationship does not exist.
616	10. A taxicab, limousine, or other passenger vehicle-for-
617	hire driver who operates said vehicles pursuant to a written
618	agreement with a company which provides any dispatch, marketing,
619	insurance, communications, or other services under which the
620	driver and any fees or charges paid by the driver to the company
621	for such services are not conditioned upon, or expressed as a
622	proportion of, fare revenues.
623	11. A person who performs services as a sports official
624	for an entity sponsoring an interscholastic sports event or for
625	a public entity or private, nonprofit organization that sponsors
626	an amateur sports event. For purposes of this subparagraph, such
627	a person is an independent contractor. For purposes of this
628	subparagraph, the term "sports official" means any person who is
629	a neutral participant in a sports event, including, but not
630	limited to, umpires, referees, judges, linespersons,
631	scorekeepers, or timekeepers. This subparagraph does not apply
632	to any person employed by a district school board who serves as
633	a sports official as required by the employing school board or
634	who serves as a sports official as part of his or her
635	responsibilities during normal school hours.
636	12. Medicaid-enrolled clients under chapter 393 who are
637	excluded from the definition of employment under s.
638	443.036(21)(d)5. and served by Adult Day Training Services under
639	the Home and Community-Based Medicaid Waiver program in a
640	sheltered workshop setting licensed by the United States
641	Department of Labor for the purpose of training and earning less
642	than the federal hourly minimum wage.
643	(16)(a)"Employer" means the state and all political
644	subdivisions thereof, all public and quasi-public corporations
645	therein, every person carrying on any employment, and the legal
646	representative of a deceased person or the receiver or trustees
647	of any person. "Employer" also includes employment agencies,
648	employee leasing companies, and similar agents who provide
649	employees to other persons.If the employer is a corporation,
650	parties in actual control of the corporation, including, but not
651	limited to, the president, officers who exercise broad corporate
652	powers, directors, and all shareholders who directly or
653	indirectly own a controlling interest in the corporation, are
654	considered the employer for the purposes of ss. 440.105,and
655	440.106, and 440.107.
656	(b) A homeowner shall not be considered the employer of
657	persons hired by the homeowner to carry out construction on the
658	homeowner’s own premises if those premises are not intended for
659	immediate lease, sale, or resale.
660	(c) Facilities serving individuals under subparagraph
661	(15)(d)12. shall be considered agents of the Agency for Health
662	Care Administration as it relates to providing Adult Day
663	Training Services under the Home and Community-Based Medicaid
664	Waiver program and not employers or third parties for the
665	purpose of limiting or denying Medicaid benefits.
666	Section 3. Effective January 1, 2004, subsections (3),
667	(4), (6), (10), (11), and (12) of section 440.05, Florida
668	Statutes, are amended, present subsection (13) is renumbered as
669	subsection (11) and amended, and new subsections (12), (13), and
670	(14) are added to said section, to read:
671	440.05 Election of exemption; revocation of election;
672	notice; certification.--
673	(3) Each sole proprietor, partner, orofficer of a
674	corporation who is activelyengaged in the construction industry
675	and who elects an exemption from this chapter or who, after
676	electing such exemption, revokes that exemption, must mail a
677	written notice to such effect to the department on a form
678	prescribed by the department. The notice of election to be
679	exempt from the provisions of this chapter must be notarized and
680	under oath. The notice of election to be exempt which is
681	submitted to the department by the sole proprietor, partner, or
682	officer of a corporation who is allowed to claim an exemption as
683	provided by this chaptermust list the name, federal tax
684	identification number, social security number, all certified or
685	registered licenses issued pursuant to chapter 489 held by the
686	person seeking the exemption, a copy of relevant documentation
687	as to employment status filed with the Internal Revenue Service
688	as specified by the department, a copy of the relevant
689	occupational license in the primary jurisdiction of the
690	business, and, for corporate officers and partners,the
691	registration number of the corporation or partnershipfiled with
692	the Division of Corporations of the Department of State along
693	with a copy of the stock certificate evidencing the required
694	ownership under this chapter. The notice of election to be
695	exempt must identify each sole proprietorship, partnership, or
696	corporation that employs the person electing the exemption and
697	must list the social security number or federal tax
698	identification number of each such employer and the additional
699	documentation required by this section. In addition, the notice
700	of election to be exempt must provide that the sole proprietor,
701	partner, orofficer electing an exemption is not entitled to
702	benefits under this chapter, must provide that the election does
703	not exceed exemption limits for officers and partnerships
704	provided in s. 440.02, and must certify that any employees of
705	the corporation whosesole proprietor, partner, or officer
706	electselectingan exemption are covered by workers'
707	compensation insurance. Upon receipt of the notice of the
708	election to be exempt, receipt of all application fees, and a
709	determination by the department that the notice meets the
710	requirements of this subsection, the department shall issue a
711	certification of the election to the sole proprietor, partner,
712	orofficer, unless the department determines that the
713	information contained in the notice is invalid. The department
714	shall revoke a certificate of election to be exempt from
715	coverage upon a determination by the department that the person
716	does not meet the requirements for exemption or that the
717	information contained in the notice of election to be exempt is
718	invalid. The certificate of election must list the namenamesof
719	the sole proprietorship, partnership, orcorporation listed in
720	the request for exemption. A new certificate of election must be
721	obtained each time the person is employed by a new sole
722	proprietorship, partnership, or differentcorporation that is
723	not listed on the certificate of election. A copy of the
724	certificate of election must be sent to each workers'
725	compensation carrier identified in the request for exemption.
726	Upon filing a notice of revocation of election, ana sole
727	proprietor, partner, or officer who is a subcontractor or an
728	officer of a corporate subcontractormust notify her or his
729	contractor. Upon revocation of a certificate of election of
730	exemption by the department, the department shall notify the
731	workers' compensation carriers identified in the request for
732	exemption.
733	(4) The notice of election to be exempt from the
734	provisions of this chapter must contain a notice that clearly
735	states in substance the following: "Any person who, knowingly
736	and with intent to injure, defraud, or deceive the department or
737	any employer or employee, insurance company, or any other person
738	purposes program, files a notice of election to be exempt
739	containing any false or misleading information is guilty of a
740	felony of the third degree." Each person filing a notice of
741	election to be exempt shall personally sign the notice and
742	attest that he or she has reviewed, understands, and
743	acknowledges the foregoing notice.
744	(6) A construction industry certificate of election to be
745	exempt which is issued in accordance with this section shall be
746	valid for 2 years after the effective date stated thereon. Both
747	the effective date and the expiration date must be listed on the
748	face of the certificate by the department. The construction
749	industry certificate must expire at midnight, 2 years from its
750	issue date, as noted on the face of the exemption certificate.
751	Any person who has received from the division a construction
752	industry certificate of election to be exempt which is in effect
753	on December 31, 1998, shall file a new notice of election to be
754	exempt by the last day in his or her birth month following
755	December 1, 1998. A construction industry certificate of
756	election to be exempt may be revoked before its expiration by
757	the sole proprietor, partner, orofficer for whom it was issued
758	or by the department for the reasons stated in this section. At
759	least 60 days prior to the expiration date of a construction
760	industry certificate of exemption issued after December 1, 1998,
761	the department shall send notice of the expiration date and an
762	application for renewal to the certificateholder at the address
763	on the certificate.
764	(10) Each sole proprietor, partner, orofficer of a
765	corporation who is actively engaged in the construction industry
766	and who elects an exemption from this chapter shall maintain
767	business records as specified by the division by rule, which
768	rules must include the provision that any corporation with
769	exempt officers and any partnership activelyengaged in the
770	construction industry with exempt partnersmust maintain written
771	statements of those exempted persons affirmatively acknowledging
772	each such individual's exempt status.
773	(11) Any sole proprietor or partner actively engaged in
774	the construction industry claiming an exemption under this
775	section shall maintain a copy of his or her federal income tax
776	records for each of the immediately previous 3 years in which he
777	or she claims an exemption. Such federal income tax records must
778	include a complete copy of the following for each year in which
779	an exemption is claimed:
780	(a) For sole proprietors, a copy of Federal Income Tax
781	Form 1040 and its accompanying Schedule C;
782	(b) For partners, a copy of the partner's Federal Income
783	Tax Schedule K-1 (Form 1065) and Federal Income Tax Form 1040
784	and its accompanying Schedule E.
785
786	A sole proprietor or partner shall produce, upon request by the
787	division, a copy of those documents together with a statement by
788	the sole proprietor or partner that the tax records provided are
789	true and accurate copies of what the sole proprietor or partner
790	has filed with the federal Internal Revenue Service. The
791	statement must be signed under oath by the sole proprietor or
792	partner and must be notarized. The division shall issue a stop-
793	work order under s. 440.107(5) to any sole proprietor or partner
794	who fails or refuses to produce a copy of the tax records and
795	affidavit required under this paragraph to the division within 3
796	business days after the request is made.
797	(12) For those sole proprietors or partners that have not
798	been in business long enough to provide the information required
799	of an established business, the division shall require such sole
800	proprietor or partner to provide copies of the most recently
801	filed Federal Income Tax Form 1040. The division shall establish
802	by rule such other criteria to show that the sole proprietor or
803	partner intends to engage in a legitimate enterprise within the
804	construction industry and is not otherwiseattempting to evade
805	the requirements of this section. The division shall establish
806	by rule the form and format of financial information required to
807	be submitted by such employers.
808	(11)(13) Any corporate officer permitted by this chapter
809	to claimclaiming an exemption under this sectionmust be listed
810	on the records of this state's Secretary of State, Division of
811	Corporations, as a corporate officer. If the person who claims
812	an exemption as a corporate officer is not so listed on the
813	records of the Secretary of State, the individual must provide
814	to the division, upon request by the division, a notarized
815	affidavit stating that the individual is a bona fide officer of
816	the corporation and stating the date his or her appointment or
817	election as a corporate officer became or will become effective.
818	The statement must be signed under oath by both the officer and
819	the president or chief operating officer of the corporation and
820	must be notarized.The division shall issue a stop-work order
821	under s. 440.107(1) to any corporation who employs a person who
822	claims to be exempt as a corporate officer but who fails or
823	refuses to produce the documents required under this subsection
824	to the division within 3 business days after the request is
825	made.
826	(12) Certificates of election to be exempt issued under
827	subsection (3) shall apply only to the corporate officer named
828	on the notice of election to be exempt and apply only within the
829	scope of the business or trade listed on the notice of election
830	to be exempt.
831	(13) Notices of election to be exempt and certificates of
832	election to be exempt shall be subject to revocation if, at any
833	time after the filing of the notice or the issuance of the
834	certificate, the person named on the notice or certificate no
835	longer meets the requirements of this section for issuance of a
836	certificate. The department shall revoke a certificate at any
837	time for failure of the person named on the certificate to meet
838	the requirements of this section.
839	(14) An officer of a corporation who elects exemption from
840	this chapter by filing a certificate of election under this
841	section may not recover benefits or compensation under this
842	chapter. For purposes of determining the appropriate premium for
843	workers' compensation coverage, carriers may not consider any
844	officer of a corporation who validly meets the requirements of
845	this section to be an employee.
846	Section 4. Section 440.06, Florida Statutes, is amended to
847	read:
848	440.06 Failure to secure compensation; effect.--Every
849	employer who fails to secure the payment of compensation, as
850	provided in s. 440.10, by failing to meet the requirements of
851	under this chapter as provided ins. 440.38 may not, in any suit
852	brought against him or her by an employee subject to this
853	chapter to recover damages for injury or death, defend such a
854	suit on the grounds that the injury was caused by the negligence
855	of a fellow servant, that the employee assumed the risk of his
856	or her employment, or that the injury was due to the comparative
857	negligence of the employee.
858	Section 5. Effective January 1, 2004, section 440.077,
859	Florida Statutes, is amended to read:
860	440.077 When a corporatesole proprietor, partner, or
861	officer rejects chapter, effect.--AnA sole proprietor, partner,
862	or officer of a corporation who is permitted to elect an
863	exemption under this chapteractively engaged in the
864	construction industryand who elects to be exempt from the
865	provisions of this chapter may not recover benefits under this
866	chapter.
867	Section 6. Subsections (1) and (4) of section 440.09,
868	Florida Statutes, are amended and paragraph (e) is added to
869	subsection (7) of said section, to read:
870	440.09 Coverage.--
871	(1) The employer mustshallpay compensation or furnish
872	benefits required by this chapter if the employee suffers an
873	accidental compensableinjury or death arising out of work
874	performed in the course and the scope of employment. The injury,
875	its occupational cause, and any resulting manifestations or
876	disability mustshallbe established to a reasonable degree of
877	medical certainty, based onand by objective relevantmedical
878	findings, and the accidental compensable injury must be the
879	major contributing cause of any resulting injuries. For purposes
880	of this section, “major contributing cause” means the cause
881	which is more than 50 percent responsible for the injury as
882	compared to all other causes combined for which treatment or
883	benefits are sought. In cases involving occupational disease or
884	repetitive exposure, both causation and sufficient exposure to
885	support causation must be proven by clear and convincing
886	evidence. Pain or other subjective complaints alone, in the
887	absence of objective relevant medical findings, are not
888	compensable. For purposes of this section, “objective relevant
889	medical findings” are those objective findings that correlate to
890	the subjective complaints of the injured employee and are
891	confirmed by physical examination findings or diagnostic
892	testing. Establishment of the causal relationship between a
893	compensable accident and injuries for conditions that are not
894	readily observable must be by medical evidence only, as
895	demonstrated by physical examination findings or diagnostic
896	testing. Major contributing cause must be demonstrated by
897	medical evidence only. Mental or nervous injuries occurring as a
898	manifestation of an injury compensable under this section shall
899	be demonstrated by clear and convincing evidence.
900	(a) This chapter does not require any compensation or
901	benefits for any subsequent injury the employee suffers as a
902	result of an original injury arising out of and in the course of
903	employment unless the original injury is the major contributing
904	cause of the subsequent injury. Major contributing cause must be
905	demonstrated by medical evidence only.
906	(b) If an injury arising out of and in the course of
907	employment combines with a preexisting disease or condition to
908	cause or prolong disability or need for treatment, the employer
909	must pay compensation or benefits required by this chapter only
910	to the extent that the injury arising out of and in the course
911	of employment is and remains more than 50 percent responsible
912	for the injury as compared to all other causes combined and
913	thereafter remainsthe major contributing cause of the
914	disability or need for treatment. Major contributing cause must
915	be demonstrated by medical evidence only.
916	(c) Death resulting from an operation by a surgeon
917	furnished by the employer for the cure of hernia as required in
918	s. %_%0%_%[F.S. 1981]shall for the purpose of this chapter be
919	considered to be a death resulting from the accident causing the
920	hernia.
921	(d) If an accident happens while the employee is employed
922	elsewhere than in this state, which would entitle the employee
923	or his or her dependents to compensation if it had happened in
924	this state, the employee or his or her dependents are entitled
925	to compensation if the contract of employment was made in this
926	state, or the employment was principally localized in this
927	state. However, if an employee receives compensation or damages
928	under the laws of any other state, the total compensation for
929	the injury may not be greater than is provided in this chapter.
930	(4)(a)An employee shall not be entitled to compensation or
931	benefits under this chapter if any judge of compensation claims,
932	administrative law judge, court, or jury convened in this state
933	determines that the employee has knowingly or intentionally
934	engaged in any of the acts described in s. 440.105 or any
935	criminal actfor the purpose of securing workers' compensation
936	benefits. For purposes of this section, the term “intentional”
937	shall include, but is not limited to, pleas of guilty or nolo
938	contendere in criminal matters. This section shall apply to
939	accidents, regardless of the date of the accident. For injuries
940	occurring prior to January 1, 1994, this section shall pertain
941	to the acts of the employee described in s. 440.105 or criminal
942	activities occurring subsequent to January 1, 1994.
943	(b) A judge of compensation claims, administrative law
944	judge, or court of this state shall take judicial notice of a
945	finding of insurance fraud by a court of competent jurisdiction
946	and terminate or otherwise disallow benefits.
947	(c) Upon the denial of benefits in accordance with this
948	section, a judge of compensation claims shall have the
949	jurisdiction to order any benefits payable to the employee to be
950	paid into the court registry or an escrow account during the
951	pendency of an appeal or until such time as the time in which to
952	file an appeal has expired.
953	(7)
954	(e) As a part of rebutting any presumptions under
955	paragraph (b), the injured worker must prove the actual
956	quantitative amounts of the drug or its metabolites as measured
957	on the initial and confirmation post-accident drug tests of the
958	injured worker’s urine sample and provide additional evidence
959	regarding the absence of drug influence other than the worker’s
960	denial of being under the influence of a drug. No drug test
961	conducted on a urine sample shall be rejected as to its results
962	or the presumption imposed under paragraph (b) on the basis of
963	the urine being bodily fluid tested.
964	Section 7. Section 440.093, Florida Statutes, is created
965	to read:
966	440.093 Mental and nervous injuries.--
967	(1) A mental or nervous injury due to stress, fright, or
968	excitement only is not an injury by accident arising out of the
969	employment. Nothing in this section shall be construed to allow
970	for the payment of benefits under this chapter for mental or
971	nervous injuries without an accompanying physical injury
972	requiring medical treatment. A physical injury resulting from
973	mental or nervous injuries unaccompanied by physical trauma
974	requiring medical treatment shall not be compensable under this
975	chapter.
976	(2) Mental or nervous injuries occurring as a
977	manifestation of an injury compensable under this chapter shall
978	be demonstrated by clear and convincing medical evidence by a
979	licensed psychiatrist meeting criteria established in the most
980	recent edition of the diagnostic and statistical manual of
981	mental disorders published by the American Psychiatric
982	Association. The compensable physical injury must be and remain
983	the major contributing cause of the mental or nervous condition
984	and the compensable physical injury as determined by reasonable
985	medical certainty must be at least 50 percent responsible for
986	the mental or nervous condition as compared to all other
987	contributing causes combined. Compensation is not payable for
988	the mental, psychological, or emotional injury arising out of
989	depression from being out of work or losing employment
990	opportunities, resulting from a preexisting mental,
991	psychological, or emotional condition or due to pain or other
992	subjective complaints that cannot be substantiated by objective,
993	relevant medical findings.
994	(3) Subject to the payment of permanent benefits under s.
995	440.15, in no event shall benefits for a compensable mental or
996	nervous injury be paid for more than 3 months after the date of
997	maximum medical improvement for the injured employee’s physical
998	injury or injuries, which shall be included in the period of 104
999	weeks as provided in s. 440.15(2) and (4). Mental or nervous
1000	injuries are compensable only in accordance with the terms of
1001	this section.
1002	Section 8. Effective January 1, 2004, subsection (1) of
1003	section 440.10, Florida Statutes, is amended to read:
1004	440.10 Liability for compensation.--
1005	(1)(a) Every employer coming within the provisions of this
1006	chapter, including any brought within the chapter by waiver of
1007	exclusion or of exemption,shall be liable for, and shall
1008	secure, the payment to his or her employees, or any physician,
1009	surgeon, or pharmacist providing services under the provisions
1010	of s. 440.13, of the compensation payable under ss. 440.13,
1011	440.15, and 440.16. Any contractor or subcontractor who engages
1012	in any public or private construction in the state shall secure
1013	and maintain compensation for his or her employees under this
1014	chapter as provided in s. 440.38.
1015	(b) In case a contractor sublets any part or parts of his
1016	or her contract work to a subcontractor or subcontractors, all
1017	of the employees of such contractor and subcontractor or
1018	subcontractors engaged on such contract work shall be deemed to
1019	be employed in one and the same business or establishment,;and
1020	the contractor shall be liable for, and shall secure, the
1021	payment of compensation to all such employees, except to
1022	employees of a subcontractor who has secured such payment.
1023	(c) A contractor shallmayrequire a subcontractor to
1024	provide evidence of workers' compensation insurance or a copy of
1025	his or her certificate of election. A subcontractor who is a
1026	corporation and has an officer who electselectingto be exempt
1027	as permitted under this chaptera sole proprietor, partner, or
1028	officer of a corporationshall provide a copy of his or her
1029	certificate of exemptionelectionto the contractor.
1030	(d)1. If a contractor becomes liable for the payment of
1031	compensation to the employees of a subcontractor who has failed
1032	to secure such payment in violation of s. 440.38, the contractor
1033	or other third-party payor shall be entitled to recover from the
1034	subcontractor all benefits paid or payable plus interest unless
1035	the contractor and subcontractor have agreed in writing that the
1036	contractor will provide coverage.
1037	2. If a contractor or third-party payor becomes liable for
1038	the payment of compensation to the corporate officeremployeeof
1039	a subcontractor who is activelyengaged in the construction
1040	industry and has elected to be exempt from the provisions of
1041	this chapter, but whose election is invalid, the contractor or
1042	third-party payor may recover from the claimant, partnership,or
1043	corporation all benefits paid or payable plus interest, unless
1044	the contractor and the subcontractor have agreed in writing that
1045	the contractor will provide coverage.
1046	(e) A subcontractor providing services in conjunction with
1047	a contractor on the same project or contract workis not liable
1048	for the payment of compensation to the employees of another
1049	subcontractor or the contractor on such contract work and is not
1050	protected by the exclusiveness-of-liability provisions of s.
1051	440.11 from anyaction at law or in admiralty on account of
1052	injury to anof such employee of another subcontractor, or of
1053	the contractor, provided that:
1054	1. The subcontractor has secured workers’ compensation
1055	insurance for its employees or the contractor has secured such
1056	insurance on behalf of the subcontractor and its employees in
1057	accordance with paragraph (b); and
1058	2. The subcontractor’s own gross negligence was not the
1059	major contributing cause of the injury.
1060	(f) If an employer fails to secure compensation as
1061	required by this chapter, the department shallmayassess
1062	against the employer a penalty not to exceed $5,000 for each
1063	employee of that employer who is classified by the employer as
1064	an independent contractor but who is found by the department to
1065	not meet the criteria for an independent contractor that are set
1066	forth in s. 440.02. The division shall adopt rules to administer
1067	the provisions of this paragraph.
1068	(g) Subject to s. 440.38, any employer who has employees
1069	engaged in work in this state shall obtain a Florida policy or
1070	endorsement for such employees which utilizes Florida class
1071	codes, rates, rules, and manuals that are in compliance with and
1072	approved under the provisions of this chapter and the Florida
1073	Insurance Code. Failure to comply with this paragraph is a
1074	felony of the second degree, punishable as provided in s.
1075	775.082, s. 775.083, or s. 775.084. The department shall adopt
1076	rules for construction industry and nonconstruction-industry
1077	employers with regard to the activities that define what
1078	constitutes being “engaged in work” in this state, using the
1079	following standards:
1080	1. For employees of nonconstruction-industry employers who
1081	have their headquarters outside of Florida and also operate in
1082	Florida and who are routinely crossing state lines, but usually
1083	return to their homes each night, the employee shall be assigned
1084	to the headquarters’ state. However, the construction industry
1085	employees performing new construction or alterations in Florida
1086	shall be assigned to Florida even if the employees return to
1087	their home state each night.
1088	2. The payroll of executive supervisors who may visit a
1089	Florida location but who are not in direct charge of a Florida
1090	location shall be assigned to the state in which the
1091	headquarters is located.
1092	3. For construction contractors who maintain a permanent
1093	staff of employees and superintendents, if any of these
1094	employees or superintendents are assigned to a job that is
1095	located in Florida, either for the duration of the job or any
1096	portion thereof, their payroll shall be assigned to Florida
1097	rather than headquarters’ state.
1098	4. Employees who are hired for a specific project in
1099	Florida shall be assigned to Florida.For purposes of this
1100	section, a person is conclusively presumed to be an independent
1101	contractor if:
1102	1. The independent contractor provides the general
1103	contractor with an affidavit stating that he or she meets all
1104	the requirements of s. 440.02; and
1105	2. The independent contractor provides the general
1106	contractor with a valid certificate of workers' compensation
1107	insurance or a valid certificate of exemption issued by the
1108	department.
1109
1110	A sole proprietor, partner, or officer of a corporation who
1111	elects exemption from this chapter by filing a certificate of
1112	election under s. 440.05 may not recover benefits or
1113	compensation under this chapter. An independent contractor who
1114	provides the general contractor with both an affidavit stating
1115	that he or she meets the requirements of s. 440.02 and a
1116	certificate of exemption is not an employee under s. 440.02 and
1117	may not recover benefits under this chapter. For purposes of
1118	determining the appropriate premium for workers' compensation
1119	coverage, carriers may not consider any person who meets the
1120	requirements of this paragraph to be an employee.
1121	Section 9. Section 440.1025, Florida Statutes, is amended
1122	to read:
1123	440.1025 Consideration of publicEmployer workplace safety
1124	program in rate-setting; program requirements; rulemaking.—
1125	(1) For a public or privateemployer to be eligible for
1126	receipt of specific identifiable consideration under s. 627.0915
1127	for a workplace safety program in the setting of rates, the
1128	publicemployer must have a workplace safety program. At a
1129	minimum, the program must include a written safety policy and
1130	safety rules, and make provision for safety inspections,
1131	preventative maintenance, safety training, first-aid, accident
1132	investigation, and necessary recordkeeping. For purposes of this
1133	section, "public employer" means any agency within state,
1134	county, or municipal government employing individuals for
1135	salary, wages, or other remuneration. The division may adopt
1136	promulgate rules for insurers to utilize in determining public
1137	employer compliance with the requirements of this section.
1138	(2) The division shall publicize on the Internet, and
1139	shall encourage insurers to publicize, the availability of free
1140	safety consultation services and safety program resources.
1141	Section 10. Section 440.103, Florida Statutes, is amended
1142	to read:
1143	440.103 Building permits; identification of minimum
1144	premium policy.--Except as otherwise provided in this chapter,
1145	Every employer shall, as a condition to applying for and
1146	receiving a building permit, show proof and certify to the
1147	permit issuerthat it has secured compensation for its employees
1148	under this chapter as provided in ss. 440.10 and 440.38. Such
1149	proof of compensation must be evidenced by a certificate of
1150	coverage issued by the carrier, a valid exemption certificate
1151	approved by the department or the former Division of Workers'
1152	Compensation of the Department of Labor and Employment Security,
1153	or a copy of the employer's authority to self-insure and shall
1154	be presented each time the employer applies for a building
1155	permit. As provided in s. 627.413(5), each certificate of
1156	coverage must show, on its face, whether or not coverage is
1157	secured under the minimum premium provisions of rules adopted by
1158	rating organizations licensed by the department. The words
1159	"minimum premium policy" or equivalent language shall be typed,
1160	printed, stamped, or legibly handwritten.
1161	Section 11. Section 440.105, Florida Statutes, is amended
1162	to read:
1163	440.105 Prohibited activities; reports; penalties;
1164	limitations.--
1165	(1)(a) Any insurance carrier, any individual self-insured,
1166	any commercial or group self-insurance fund, any professional
1167	practitioner licensed or regulated by the Department of Health
1168	Business and Professional Regulation, except as otherwise
1169	provided by law, any medical review committee as defined in s.
1170	766.101, any private medical review committee, and any insurer,
1171	agent, or other person licensed under the insurance code, or any
1172	employee thereof, having knowledge or who believes that a
1173	fraudulent act or any other act or practice which, upon
1174	conviction, constitutes a felony or misdemeanor under this
1175	chapter is being or has been committed shall send to the
1176	Division of Insurance Fraud, Bureau of Workers' Compensation
1177	Fraud, a report or information pertinent to such knowledge or
1178	belief and such additional information relative thereto as the
1179	bureau may require. The bureau shall review such information or
1180	reports and select such information or reports as, in its
1181	judgment, may require further investigation. It shall then cause
1182	an independent examination of the facts surrounding such
1183	information or report to be made to determine the extent, if
1184	any, to which a fraudulent act or any other act or practice
1185	which, upon conviction, constitutes a felony or a misdemeanor
1186	under this chapter is being committed. The bureau shall report
1187	any alleged violations of law which its investigations disclose
1188	to the appropriate licensing agency and state attorney or other
1189	prosecuting agency having jurisdiction with respect to any such
1190	violations of this chapter. If prosecution by the state attorney
1191	or other prosecuting agency having jurisdiction with respect to
1192	such violation is not begun within 60 days of the bureau's
1193	report, the state attorney or other prosecuting agency having
1194	jurisdiction with respect to such violation shall inform the
1195	bureau of the reasons for the lack of prosecution.
1196	(b) In the absence of fraud or bad faith, a person is not
1197	subject to civil liability for libel, slander, or any other
1198	relevant tort by virtue of filing reports, without malice, or
1199	furnishing other information, without malice, required by this
1200	section or required by the bureau, and no civil cause of action
1201	of any nature shall arise against such person:
1202	1. For any information relating to suspected fraudulent
1203	acts furnished to or received from law enforcement officials,
1204	their agents, or employees;
1205	2. For any information relating to suspected fraudulent
1206	acts furnished to or received from other persons subject to the
1207	provisions of this chapter; or
1208	3. For any such information relating to suspected
1209	fraudulent acts furnished in reports to the bureau, or the
1210	National Association of Insurance Commissioners.
1211	(2) Whoever violates any provision of this subsection
1212	commits a misdemeanor of the firstseconddegree, punishable as
1213	provided in s. 775.082 or s. 775.083.
1214	(a) It shall be unlawful for any employer to knowingly:
1215	1. Coerce or attempt to coerce, as a precondition to
1216	employment or otherwise, an employee to obtain a certificate of
1217	election of exemption pursuant to s. 440.05.
1218	2. Discharge or refuse to hire an employee or job
1219	applicant because the employee or applicant has filed a claim
1220	for benefits under this chapter.
1221	3. Discharge, discipline, or take any other adverse
1222	personnel action against any employee for disclosing information
1223	to the department or any law enforcement agency relating to any
1224	violation or suspected violation of any of the provisions of
1225	this chapter or rules promulgated hereunder.
1226	4. Violate a stop-work order issued by the department
1227	pursuant to s. 440.107.
1228	(b) It shall be unlawful for any insurance entity to
1229	revoke or cancel a workers' compensation insurance policy or
1230	membership because an employer has returned an employee to work
1231	or hired an employee who has filed a workers' compensation
1232	claim.
1233	(3) Whoever violates any provision of this subsection
1234	commits a misdemeanor of the first degree, punishable as
1235	provided in s. 775.082 or s. 775.083.
1236	(a) It shall be unlawful for any employer to knowingly
1237	fail to update applications for coverage as required by s.
1238	440.381(1) and department of Insurance rules within 7 days after
1239	the reporting date for any change in the required information,
1240	or to post notice of coverage pursuant to s. 440.40.
1241	(b) It is unlawful for any attorney or other person, in
1242	his or her individual capacity or in his or her capacity as a
1243	public or private employee, or for any firm, corporation,
1244	partnership, or association to receive any fee or other
1245	consideration or any gratuity from a person on account of
1246	services rendered for a person in connection with any
1247	proceedings arising under this chapter, unless such fee,
1248	consideration, or gratuity is approved by a judge of
1249	compensation claims or by the Deputy Chief Judge of Compensation
1250	Claims.
1251	(4) Whoever violates any provision of this subsection
1252	commits insurance fraud, punishable as provided in paragraph
1253	(f).
1254	(a) It shall be unlawful for any employer to knowingly:
1255	1. Present or cause to be presented any false, fraudulent,
1256	or misleading oral or written statement to any person as
1257	evidence of compliance with s. 440.38.
1258	2. Make a deduction from the pay of any employee entitled
1259	to the benefits of this chapter for the purpose of requiring the
1260	employee to pay any portion of premium paid by the employer to a
1261	carrier or to contribute to a benefit fund or department
1262	maintained by such employer for the purpose of providing
1263	compensation or medical services and supplies as required by
1264	this chapter.
1265	3. Fail to secure payment of compensation if required to
1266	do so by this chapter.
1267	(b) It shall be unlawful for any person:
1268	1. To knowingly make, or cause to be made, any false,
1269	fraudulent, or misleading oral or written statement for the
1270	purpose of obtaining or denying any benefit or payment under
1271	this chapter.
1272	2. To present or cause to be presented any written or oral
1273	statement as part of, or in support of, a claim for payment or
1274	other benefit pursuant to any provision of this chapter, knowing
1275	that such statement contains any false, incomplete, or
1276	misleading information concerning any fact or thing material to
1277	such claim.
1278	3. To prepare or cause to be prepared any written or oral
1279	statement that is intended to be presented to any employer,
1280	insurance company, or self-insured program in connection with,
1281	or in support of, any claim for payment or other benefit
1282	pursuant to any provision of this chapter, knowing that such
1283	statement contains any false, incomplete, or misleading
1284	information concerning any fact or thing material to such claim.
1285	4. To knowingly assist, conspire with, or urge any person
1286	to engage in activity prohibited by this section.
1287	5. To knowingly make any false, fraudulent, or misleading
1288	oral or written statement, or to knowingly omit or conceal
1289	material information, required by s. 440.185 or s. 440.381, for
1290	the purpose of obtaining workers' compensation coverage or for
1291	the purpose of avoiding, delaying, or diminishing the amount of
1292	payment of any workers' compensation premiums.
1293	6. To knowingly misrepresent or conceal payroll,
1294	classification of workers, or information regarding an
1295	employer's loss history which would be material to the
1296	computation and application of an experience rating modification
1297	factor for the purpose of avoiding or diminishing the amount of
1298	payment of any workers' compensation premiums.
1299	7. To knowingly present or cause to be presented any
1300	false, fraudulent, or misleading oral or written statement to
1301	any person as evidence of compliance with s. 440.38, as evidence
1302	of eligibility for a certificate of exemption under s. 440.05.
1303	8. To knowingly violate a stop-work order issued by the
1304	department pursuant to s. 440.107.
1305	9. To knowingly present or cause to be presented any
1306	false, fraudulent, or misleading oral or written statement to
1307	any person as evidence of identity for the purpose of obtaining
1308	employment or filing or supporting a claim for workers’
1309	compensation benefits.
1310	(c) It shall be unlawful for any physician licensed under
1311	chapter 458, osteopathic physician licensed under chapter 459,
1312	chiropractic physician licensed under chapter 460, podiatric
1313	physician licensed under chapter 461, optometric physician
1314	licensed under chapter 463, or any other practitioner licensed
1315	under the laws of this state to knowingly and willfully assist,
1316	conspire with, or urge any person to fraudulently violate any of
1317	the provisions of this chapter.
1318	(d) It shall be unlawful for any person or governmental
1319	entity licensed under chapter 395 to maintain or operate a
1320	hospital in such a manner so that such person or governmental
1321	entity knowingly and willfully allows the use of the facilities
1322	of such hospital by any person, in a scheme or conspiracy to
1323	fraudulently violate any of the provisions of this chapter.
1324	(e) It shall be unlawful for any attorney or other person,
1325	in his or her individual capacity or in his or her capacity as a
1326	public or private employee, or any firm, corporation,
1327	partnership, or association, to knowingly assist, conspire with,
1328	or urge any person to fraudulently violate any of the provisions
1329	of this chapter.
1330	(f) If the monetary value amount of any claim or workers'
1331	compensation insurance premium involved in anyviolation of this
1332	subsection:
1333	1. Is less than $20,000, the offender commits a felony of
1334	the third degree, punishable as provided in s. 775.082, s.
1335	775.083, or s. 775.084.
1336	2. Is $20,000 or more, but less than $100,000, the
1337	offender commits a felony of the second degree, punishable as
1338	provided in s. 775.082,. 775.083, or s. 775.084.
1339	3. Is $100,000 or more, the offender commits a felony of
1340	the first degree, punishable as provided in s. 775.082, s.
1341	775.083, or s. 775.084.
1342	(5) It shall be unlawful for any attorney or other person,
1343	in his or her individual capacity or in his or her capacity as a
1344	public or private employee or for any firm, corporation,
1345	partnership, or association, to unlawfully solicit any business
1346	in and about city or county hospitals, courts, or any public
1347	institution or public place; in and about private hospitals or
1348	sanitariums; in and about any private institution; or upon
1349	private property of any character whatsoever for the purpose of
1350	making workers' compensation claims. Whoever violates any
1351	provision of this subsection commits a felony of the second
1352	thirddegree, punishable as provided in s. 775.082, s. 775.083,
1353	or s. 775.085.
1354	(6) This section shall not be construed to preclude the
1355	applicability of any other provision of criminal law that
1356	applies or may apply to any transaction.
1357	(7) For the purpose of the section, the term "statement"
1358	includes, but is not limited to, any notice, representation,
1359	statement, proof of injury, bill for services, diagnosis,
1360	prescription, hospital or doctor records, X ray, test result, or
1361	other evidence of loss, injury, or expense.
1362	(7)(8)An injured employee or any other party making a
1363	claim under this chapter shall provide his or her personal
1364	signature attesting that he or she has reviewed, understands,
1365	and acknowledgesAll claim forms as provided for in this chapter
1366	shall contain a notice that clearly states in substancethe
1367	following statement: "Any person who, knowingly and with intent
1368	to injure, defraud, or deceive any employer or employee,
1369	insurance company, or self-insured program, files a statement of
1370	claim containing any false or misleading information commits
1371	insurance fraud, punishable as provided in s. 817.234." If the
1372	injured employee or other party refuses to sign the document
1373	attestingEach claimant shall personally sign the claim form and
1374	attestthat he or she has reviewed, understands, and
1375	acknowledges the statement, benefits or payments under this
1376	chapter shall be suspended until such signature is obtained
1377	foregoing notice.
1378	Section 12. Subsection (3) of section 440.1051, Florida
1379	Statutes, is amended to read:
1380	440.1051 Fraud reports; civil immunity; criminal
1381	penalties.--
1382	(2) Any person who reports workers' compensation fraud to
1383	the division under subsection (1) is immune from civil liability
1384	for doing so, and the person or entity alleged to have committed
1385	the fraud may not retaliate against him or her for providing
1386	such report, unless the person making the report knows it to be
1387	false.
1388	(3) A person who calls and, knowingly and falsely, reports
1389	workers' compensation fraud or who, in violation of subsection
1390	(2) retaliates against a person for making such report, commits
1391	is guilty of a felonymisdemeanor of the thirdfirstdegree,
1392	punishable as provided in s. 775.082,or s. 775.083, or s.
1393	775.084both.
1394	Section 13. Section 440.107, Florida Statutes, is amended
1395	to read:
1396	440.107 Department powers to enforce employer compliance
1397	with coverage requirements.--
1398	(1) The Legislature finds that the failure of an employer
1399	to comply with the workers' compensation coverage requirements
1400	under this chapter poses an immediate danger to public health,
1401	safety, and welfare. The Legislature authorizes the department
1402	to secure employer compliance with the workers' compensation
1403	coverage requirements and authorizes the department to conduct
1404	investigations for the purpose of ensuring employer compliance.
1405	(2) For the purposes of this section, “securing the
1406	payment of workers’ compensation” means obtaining coverage that
1407	meets the requirements of this chapter and the Florida Insurance
1408	Code. However, if at any time an employer materially understates
1409	or conceals payroll, materially misrepresents or conceals
1410	employee duties so as to avoid proper classification for premium
1411	calculations, or materially misrepresents or conceals
1412	information pertinent to the computation and application of an
1413	experience rating modification factor, such employer shall be
1414	deemed to have failed to secure payment of workers’ compensation
1415	and shall be subject to the sanctions set forth in this section.
1416	A stop-work order issued because an employer is deemed to have
1417	failed to secure the payment of workers’ compensation required
1418	under this chapter because the employer has materially
1419	understated or concealed payroll, materially misrepresented or
1420	concealed employee duties so as to avoid proper classification
1421	for premium calculations, or materially misrepresented or
1422	concealed information pertinent to the computation and
1423	application of an experience rating modification factor shall
1424	have no effect upon an employer’s or carrier’s duty to provide
1425	benefits under this chapter or upon any of the employer’s or
1426	carrier’s rights and defenses under this chapter, including
1427	exclusive remedy.The department and its authorized
1428	representatives may enter and inspect any place of business at
1429	any reasonable time for the limited purpose of investigating
1430	compliance with workers' compensation coverage requirements
1431	under this chapter. Each employer shall keep true and accurate
1432	business records that contain such information as the department
1433	prescribes by rule. The business records must contain
1434	information necessary for the department to determine compliance
1435	with workers' compensation coverage requirements and must be
1436	maintained within this state by the business, in such a manner
1437	as to be accessible within a reasonable time upon request by the
1438	department. The business records must be open to inspection and
1439	be available for copying by the department at any reasonable
1440	time and place and as often as necessary. The department may
1441	require from any employer any sworn or unsworn reports,
1442	pertaining to persons employed by that employer, deemed
1443	necessary for the effective administration of the workers'
1444	compensation coverage requirements.
1445	(3) The department shall enforce workers’ compensation
1446	coverage requirements, including the requirement that the
1447	employer secure the payment of workers’ compensation, and the
1448	requirement that the employer provide the carrier with
1449	information to accurately determine payroll and correctly assign
1450	classification codes. In addition to any other powers under this
1451	chapter, the department shall have the power to:
1452	(a) Conduct investigations for the purpose of ensuring
1453	employer compliance.
1454	(b) Enter and inspect any place of business at any
1455	reasonable time for the purpose of investigating employer
1456	compliance.
1457	(c) Examine and copy business records.
1458	(d) Administer oaths and affirmations.
1459	(e) Certify to official acts.
1460	(f) Issue and serve subpoenas for attendance of witnesses
1461	or production of business records, books, papers,
1462	correspondence, memoranda, and other records.
1463	(g) Issue stop-work orders, penalty assessment orders, and
1464	any other orders necessary for the administration of this
1465	section.
1466	(h) Enforce the terms of a stop-work order.
1467	(i) Levy and pursue actions to recover penalties.
1468	(j) Seek injunctions and other appropriate relief.In
1469	discharging its duties, the department may administer oaths and
1470	affirmations, certify to official acts, issue subpoenas to
1471	compel the attendance of witnesses and the production of books,
1472	papers, correspondence, memoranda, and other records deemed
1473	necessary by the department as evidence in order to ensure
1474	proper with the coverage provisions of this chapter.
1475	(4) The department shall designate representatives who may
1476	serve subpoenas and other process of the department issued under
1477	this section.
1478	(5) The department shall specify by rule the business
1479	records that employers must maintain and produce to comply with
1480	this section.
1481	(6)(4)If a person has refused to obey a subpoena to
1482	appear before the department or its authorized representative or
1483	andproduce evidence requested by the department or to give
1484	testimony about the matter that is under investigation, a court
1485	has jurisdiction to issue an order requiring compliance with the
1486	subpoena if the court has jurisdiction in the geographical area
1487	where the inquiry is being carried on or in the area where the
1488	person who has refused the subpoena is found, resides, or
1489	transacts business. Failure to obey such a court order may be
1490	punished by the court as contempt, either civilly or criminally.
1491	Costs, including reasonable attorney's fees, incurred by the
1492	department to obtain an order granting, in whole or in part, a
1493	petition to enforce a subpoena or a subpoena duces tecum shall
1494	be taxed against the subpoenaed party.
1495	(7)(a)(5)Whenever the department determines that an
1496	employer who is required to secure the payment to his or her
1497	employees of the compensation provided for by this chapter has
1498	failed to secure the payment of workers’ compensation required
1499	by this chapter or produce the required business records under
1500	subsection (5) within 5 business days after receipt of the
1501	written request of the departmentdo so, such failure shall be
1502	deemed an immediate serious danger to public health, safety, or
1503	welfare sufficient to justify service by the department of a
1504	stop-work order on the employer, requiring the cessation of all
1505	business operations at the place of employment or job site. If
1506	the departmentdivision makes such a determination, the
1507	departmentdivisionshall issue a stop-work order within 72
1508	hours. The order shall take effect when served upon the date of
1509	service upon the employer or, for a particular employer
1510	worksite, when served at that worksite. In addition to serving a
1511	stop-work order, which shall be effective immediately, at a
1512	particular worksite, the department shall immediately proceed
1513	with service upon the employer which shall be effective upon all
1514	employer worksites in the state. A stop-work order may be served
1515	with regard to an employer’s worksite by posting a copy of the
1516	stop-work order in a conspicuous location at such site. The
1517	order shall remain in effect until the department issues an
1518	order releasing the stop-work order upon a finding that the
1519	employer has come into compliance with the coverage requirements
1520	of this chapter and has paid any penalty assessed under this
1521	section. The department may require an employer who is found to
1522	have failed to comply with the coverage requirements of s.
1523	440.38 to file with the department, as a condition of release
1524	from a stop-work order, periodic reports that demonstrate the
1525	employer's continued compliance with this chapter for a
1526	probationary period that shall not exceed 2 years. The
1527	department shall by rule specify the reports required and the
1528	time for filing under this subsectionunless the employer
1529	provides evidence satisfactory to the department of having
1530	secured any necessary insurance or self-insurance and pays a
1531	civil penalty to the department, to be deposited by the
1532	department into the Workers' Compensation Administration Trust
1533	Fund, in the amount of $100 per day for each day the employer
1534	was not in compliance with this chapter.
1535	(b) Stop-work orders and penalty assessment orders issued
1536	under this section against a corporation, partnership, or sole
1537	proprietorship shall be in effect against any successor
1538	corporation or business entity that has one or more of the same
1539	principals or officers as the corporation or partnership against
1540	which the stop-work order was issued and is engaged in the same
1541	or related enterprise.
1542	(c) The department shall assess a penalty of $1,000 per
1543	day against an employer for each day that the employer conducts
1544	business operations that are in violation of a stop-work order.
1545	(d)1. In addition to any penalty, stop-work order, or
1546	injunction, the department shall assess against any employer who
1547	has failed to secure the payment of compensation as required by
1548	this chapter a penalty equal to 1.5 times the amount the
1549	employer would have paid in premium when applying approved
1550	manual rates to the employer’s payroll during periods for which
1551	it failed to secure the payment of workers’ compensation
1552	required by this chapter within the preceding 3-year period or
1553	$1,000, whichever is greater.
1554	2. Any subsequent violation within 5 years after the most
1555	recent violation shall, in addition to the penalties set forth
1556	in this subsection, be deemed a knowing act within the meaning
1557	of s. 440.105.
1558	(e) When an employer fails to provide business records
1559	sufficient to enable the department to determine the employer’s
1560	payroll for the period requested for the calculation of the
1561	penalty provided in paragraph (d), for penalty calculation
1562	purposes, the imputed weekly payroll for each employee,
1563	corporate officer, sole proprietor, or partner shall be the
1564	statewide average weekly wage as defined in s. 440.12(2)
1565	multiplied by 1.5.
1566	(f) In addition to any other penalties provided for in
1567	this chapter, the department may assess against the employer a
1568	penalty of $5,000 for each employee of that employer who the
1569	employer represents to the department or carrier as an
1570	independent contractor but who is determined by the department
1571	not to be an independent contractor as defined in s. 440.02.
1572	(8)(6)In addition to the issuance of a stop-work order
1573	under subsection (7),the department may file a complaint in the
1574	circuit court in and for Leon County to enjoin any employer,who
1575	has failed to secure the payment of workers’ compensation as
1576	required by this chapter,from employing individuals and from
1577	conducting business until the employer presents evidence
1578	satisfactory to the department of having secured the payment of
1579	workers’for compensation required by this chapterand pays a
1580	civil penalty assessed byto the department under this section,
1581	to be deposited by the department into the Workers' Compensation
1582	Administration Trust Fund, in the amount of $100 per day for
1583	each day the employer was not in compliance with this chapter.
1584	(9)(7) In addition to any penalty, stop-work order, or
1585	injunction, the department shall assess against any employer,
1586	who has failed to secure the payment of compensation as required
1587	by this chapter, a penalty in the following amount:
1588	(a) An amount equal to at least the amount that the
1589	employer would have paid or up to twice the amount the employer
1590	would have paid during periods it illegally failed to secure
1591	payment of compensation in the preceding 3-year period based on
1592	the employer's payroll during the preceding 3-year period; or
1593	(b) One thousand dollars, whichever is greater. Any
1594	penalty assessed under this subsection is due within 30 days
1595	after the date on which the employer is notified, except that,
1596	if the department has posted a stop-work order or obtained
1597	injunctive relief against the employer, payment is due, in
1598	addition to those conditions set forth in this section, as a
1599	condition to relief from a stop-work order or an injunction.
1600	Interest shall accrue on amounts not paidwhen due at the rate
1601	of 1 percent per month. The departmentdivisionshall adopt
1602	rules to administer this section.
1603	(10)(8)The department may bring an action in circuit
1604	court to recover penalties assessed under this section,
1605	including any interest owed to the department pursuant to this
1606	section. In any action brought by the department pursuant to
1607	this section in which it prevails, the circuit court shall award
1608	costs, including the reasonable costs of investigation and a
1609	reasonable attorney's fee.
1610	(11)(9)Any judgment obtained by the department and any
1611	penalty due pursuant to the service of a stop-work order or
1612	otherwise due under this section shall, until collected,
1613	constitute a lien upon the entire interest of the employer,
1614	legal or equitable, in any property, real or personal, tangible
1615	or intangible; however, such lien is subordinate to claims for
1616	unpaid wages and any prior recorded liens, and a lien created by
1617	this section is not valid against any person who, subsequent to
1618	such lien and in good faith and for value, purchases real or
1619	personal property from such employer or becomes the mortgagee on
1620	real or personal property of such employer, or against a
1621	subsequent attaching creditor, unless, with respect to real
1622	estate of the employer, a notice of the lien is recorded in the
1623	public records of the county where the real estate is located,
1624	and with respect to personal property of the employer, notice is
1625	recorded with the Secretary of State.
1626	(12)(10)Any law enforcement agency in the state may, at
1627	the request of the department, render any assistance necessary
1628	to carry out the provisions of this section, including, but not
1629	limited to, preventing any employee or other person from
1630	remaining at a place of employment or job site after a stop-work
1631	order or injunction has taken effect.
1632	(13)(11)Agency actionActionsby the department under
1633	this section, if contested,must be contested as provided in
1634	chapter 120. All civilpenalties assessed by the department must
1635	be paid into the Workers' Compensation Administration Trust
1636	Fund. The department shall return any sums previously paid, upon
1637	conclusion of an action, if the department fails to prevail and
1638	if so directed by an order of court or an administrative hearing
1639	officer. The requirements of this subsection may be met by
1640	posting a bond in an amount equal to twice the penalty and in a
1641	form approved by the department.
1642	(14)(12) If the departmentdivisionfinds that an employer
1643	who is certified or registered under part I or part II of
1644	chapter 489 and who is required to secure the payment of
1645	workers’the compensation underprovided for bythis chapter to
1646	his or her employees has failed to do so, the department
1647	divisionshall immediately notify the Department of Business and
1648	Professional Regulation.
1649	Section 14. Subsections (1) and (3) of section 440.11,
1650	Florida Statutes, are amended to read:
1651	440.11 Exclusiveness of liability.--
1652	(1) The liability of an employer prescribed in s. 440.10
1653	shall be exclusive and in place of all other liability,
1654	including vicarious liability,of such employer to any third-
1655	party tortfeasor and to the employee, the legal representative
1656	thereof, husband or wife, parents, dependents, next of kin, and
1657	anyone otherwise entitled to recover damages from such employer
1658	at law or in admiralty on account of such injury or death,
1659	except as follows:that
1660	(a)If an employer fails to secure payment of compensation
1661	as required by this chapter, an injured employee, or the legal
1662	representative thereof in case death results from the injury,
1663	may elect to claim compensation under this chapter or to
1664	maintain an action at law or in admiralty for damages on account
1665	of such injury or death. In such action the defendant may not
1666	plead as a defense that the injury was caused by negligence of a
1667	fellow employee, that the employee assumed the risk of the
1668	employment, or that the injury was due to the comparative
1669	negligence of the employee.
1670	(b) When an employer commits an intentional tort that
1671	causes the injury or death of the employee. For purposes of this
1672	paragraph, an employer’s actions shall be deemed to constitute
1673	an intentional tort and not an accident only when the employee
1674	proves, by clear and convincing evidence, that:
1675	1. The employer deliberately intended to injure the
1676	employee; or
1677	2. The employer engaged in conduct that the employer knew,
1678	based on prior similar accidents or on explicit warnings
1679	specifically identifying a known danger, was certain to result
1680	in injury or death to the employee, and the employee was not
1681	aware of the risk because the danger was not apparent and the
1682	employer deliberately concealed or misrepresented the danger so
1683	as to prevent the employee from exercising informed judgment
1684	about whether to perform the work.
1685
1686	The same immunities from liability enjoyed by an employer shall
1687	extend as well to each employee of the employer when such
1688	employee is acting in furtherance of the employer's business and
1689	the injured employee is entitled to receive benefits under this
1690	chapter. Such fellow-employee immunities shall not be applicable
1691	to an employee who acts, with respect to a fellow employee, with
1692	willful and wanton disregard or unprovoked physical aggression
1693	or with gross negligence when such acts result in injury or
1694	death or such acts proximately cause such injury or death, nor
1695	shall such immunities be applicable to employees of the same
1696	employer when each is operating in the furtherance of the
1697	employer's business but they are assigned primarily to unrelated
1698	works within private or public employment. The same immunity
1699	provisions enjoyed by an employer shall also apply to any sole
1700	proprietor, partner, corporate officer or director, supervisor,
1701	or other person who in the course and scope of his or her duties
1702	acts in a managerial or policymaking capacity and the conduct
1703	which caused the alleged injury arose within the course and
1704	scope of said managerial or policymaking duties and was not a
1705	violation of a law, whether or not a violation was charged, for
1706	which the maximum penalty which may be imposed does not exceed
1707	60 days' imprisonment as set forth in s. 775.082. The immunity
1708	from liability provided in this subsection extends to county
1709	governments with respect to employees of county constitutional
1710	officers whose offices are funded by the board of county
1711	commissioners.
1712	(3) An employer's workers' compensation carrier, service
1713	agent, or safety consultant shall not be liable as a third-party
1714	tortfeasor to employees of the employer or employees of its
1715	subcontractors for assisting the employer and its
1716	subcontractors, if any,in carrying out the employer's rights
1717	and responsibilities under this chapter by furnishing any safety
1718	inspection, safety consultative service, or other safety service
1719	incidental to the workers' compensation or employers' liability
1720	coverage or to the workers' compensation or employer's liability
1721	servicing contract. Without limitation, a safety consultant may
1722	include an owner, as defined in chapter 713, or an owner’s
1723	related, affiliated, or subsidiary companies and the employees
1724	of each.The exclusion from liability under this subsection
1725	shall not apply in any case in which injury or death is
1726	proximately caused by the willful and unprovoked physical
1727	aggression, or by the negligent operation of a motor vehicle, by
1728	employees, officers, or directors of the employer's workers'
1729	compensation carrier, service agent, or safety consultant.
1730	Section 15. Section 440.13, Florida Statutes, is amended
1731	to read:
1732	440.13 Medical services and supplies; penalty for
1733	violations; limitations.--
1734	(1) DEFINITIONS.-- As used in this section, the term:
1735	(a) "Alternate medical care" means a change in treatment
1736	or health care provider.
1737	(b) "Attendant care" means care rendered by trained
1738	professional attendants which is beyond the scope of household
1739	duties. Family members may provide nonprofessional attendant
1740	care, but may not be compensated under this chapter for care
1741	that falls within the scope of household duties and other
1742	services normally and gratuitously provided by family members.
1743	"Family member" means a spouse, father, mother, brother, sister,
1744	child, grandchild, father-in-law, mother-in-law, aunt, or uncle.
1745	(c) "Carrier" means, for purposes of this section,
1746	insurance carrier, self-insurance fund or individually self-
1747	insured employer, assessable mutual insurer.
1748	(d) "Catastrophic injury" means an injury as defined in s.
1749	440.02.
1750	(e) "Certified health care provider" means a health care
1751	provider who has been certified by the agency or who has entered
1752	an agreement with a licensed managed care organization to
1753	provide treatment to injured workers under this section.
1754	Certification of such health care provider must include
1755	documentation that the health care provider has read and is
1756	familiar with the portions of the statute, impairment guides,
1757	practice parameters, protocols of treatment,and rules which
1758	govern the provision of remedial treatment, care, and
1759	attendance.
1760	(f) "Compensable" means a determination by a carrier or
1761	judge of compensation claims that a condition suffered by an
1762	employee results from an injury arising out of and in the course
1763	of employment.
1764	(g) "Emergency services and care" means emergency services
1765	and care as defined in s. 395.002.
1766	(h) "Health care facility" means any hospital licensed
1767	under chapter 395 and any health care institution licensed under
1768	chapter 400.
1769	(i) "Health care provider" means a physician or any
1770	recognized practitioner who provides skilled services pursuant
1771	to a prescription or under the supervision or direction of a
1772	physician and who has been certified by the agency as a health
1773	care provider. The term "health care provider" includes a health
1774	care facility.
1775	(j) "Independent medical examiner" means a physician
1776	selected by either an employee or a carrier to render one or
1777	more independent medical examinations in connection with a
1778	dispute arising under this chapter.
1779	(k) "Independent medical examination" means an objective
1780	evaluation of the injured employee's medical condition,
1781	including, but not limited to, impairment or work status,
1782	performed by a physician or an expert medical advisor at the
1783	request of a party, a judge of compensation claims, or the
1784	agency to assist in the resolution of a dispute arising under
1785	this chapter.
1786	(l) “Instance of overutilization" means a specific
1787	inappropriate service or level of service provided to an injured
1788	employee that includes the provision of treatment in excess of
1789	established practice parameters and protocols of treatment
1790	established in accordance with this chapter.
1791	(m) "Medically necessary" or “medical necessity”means any
1792	medical service or medical supply which is used to identify or
1793	treat an illness or injury, is appropriate to the patient's
1794	diagnosis and status of recovery, and is consistent with the
1795	location of service, the level of care provided, and applicable
1796	practice parameters. The service should be widely accepted among
1797	practicing health care providers, based on scientific criteria,
1798	and determined to be reasonably safe. The service must not be of
1799	an experimental, investigative, or research nature, except in
1800	those instances in which prior approval of the Agency for Health
1801	Care Administration has been obtained. The Agency for Health
1802	Care Administration shall adopt rules providing for such
1803	approval on a case-by-case basis when the service or supply is
1804	shown to have significant benefits to the recovery and well-
1805	being of the patient.
1806	(n) "Medicine" means a drug prescribed by an authorized
1807	health care provider and includes only generic drugs or single-
1808	source patented drugs for which there is no generic equivalent,
1809	unless the authorized health care provider writes or states that
1810	the brand-name drug as defined in s. 465.025 is medically
1811	necessary, or is a drug appearing on the schedule of drugs
1812	created pursuant to s. 465.025(6), or is available at a cost
1813	lower than its generic equivalent.
1814	(o) "Palliative care" means noncurative medical services
1815	that mitigate the conditions, effects, or pain of an injury.
1816	(p) "Pattern or practice of overutilization" means
1817	repetition of instances of overutilization within a specific
1818	medical case or multiple cases by a single health care provider.
1819	(q) "Peer review" means an evaluation by two or more
1820	physicians licensed under the same authority and with the same
1821	or similar specialty as the physician under review, of the
1822	appropriateness, quality, and cost of health care and health
1823	services provided to a patient, based on medically accepted
1824	standards.
1825	(r) "Physician" or "doctor" means a physician licensed
1826	under chapter 458, an osteopathic physician licensed under
1827	chapter 459, a chiropractic physician licensed under chapter
1828	460, a podiatric physician licensed under chapter 461, an
1829	optometrist licensed under chapter 463, or a dentist licensed
1830	under chapter 466, each of whom must be certified by the agency
1831	as a health care provider.
1832	(s) "Reimbursement dispute" means any disagreement between
1833	a health care provider or health care facility and carrier
1834	concerning payment for medical treatment.
1835	(t) “Utilization control" means a systematic process of
1836	implementing measures that assure overall management and cost
1837	containment of services delivered, including compliance with
1838	practice parameters and protocols of treatment as provided for
1839	in this chapter.
1840	(u) "Utilization review" means the evaluation of the
1841	appropriateness of both the level and the quality of health care
1842	and health services provided to a patient, including, but not
1843	limited to, evaluation of the appropriateness of treatment,
1844	hospitalization, or office visits based on medically accepted
1845	standards. Such evaluation must be accomplished by means of a
1846	system that identifies the utilization of medical services based
1847	on practice parameters and protocols of treatment as provided
1848	for in this chaptermedically accepted standards as established
1849	by medical consultants with qualifications similar to those
1850	providing the care under review, and that refers patterns and
1851	practices of overutilization to the agency.
1852	(2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.--
1853	(a) Subject to the limitations specified elsewhere in this
1854	chapter, the employer shall furnish to the employee such
1855	medically necessary remedial treatment, care, and attendance for
1856	such period as the nature of the injury or the process of
1857	recovery may require, which is in accordance with established
1858	practice parameters and protocols of treatment as provided for
1859	in this chapter, including medicines, medical supplies, durable
1860	medical equipment, orthoses, prostheses, and other medically
1861	necessary apparatus. Remedial treatment, care, and attendance,
1862	including work-hardening programs or pain-management programs
1863	accredited by the Commission on Accreditation of Rehabilitation
1864	Facilities or Joint Commission on the Accreditation of Health
1865	Organizations or pain-management programs affiliated with
1866	medical schools, shall be considered as covered treatment only
1867	when such care is given based on a referral by a physician as
1868	defined in this chapter. Each facility shall maintain outcome
1869	data, including work status at discharges, total program
1870	charges, total number of visits, and length of stay. The
1871	department shall utilize such data and report to the President
1872	of the Senate and the Speaker of the House of Representatives
1873	regarding the efficacy and cost-effectiveness of such program,
1874	no later than October 1, 1994.Medically necessary treatment,
1875	care, and attendance does not include chiropractic services in
1876	excess of 2418 treatments or rendered 128weeks beyond the
1877	date of the initial chiropractic treatment, whichever comes
1878	first, unless the carrier authorizes additional treatment or the
1879	employee is catastrophically injured.
1880	(b) The employer shall provide appropriate professional or
1881	nonprofessional attendant care performed only at the direction
1882	and control of a physician when such care is medically
1883	necessary. The physician shall prescribe such care in writing.
1884	The employer or carrier shall not be responsible for such care
1885	until the prescription for attendant care is received by the
1886	employer and carrier, which shall specify the time periods for
1887	such care, the level of care required, and the type of
1888	assistance required. A prescription for attendant care shall not
1889	prescribe such care retroactively.The value of nonprofessional
1890	attendant care provided by a family member must be determined as
1891	follows:
1892	1. If the family member is not employed or if the family
1893	member is employed and is providing attendant care services
1894	during hours that he or she is not engaged in employment, the
1895	per-hour value equals the federal minimum hourly wage.
1896	2. If the family member is employed and elects to leave
1897	that employment to provide attendant or custodial care, the per-
1898	hour value of that care equals the per-hour value of the family
1899	member's former employment, not to exceed the per-hour value of
1900	such care available in the community at large. A family member
1901	or a combination of family members providing nonprofessional
1902	attendant care under this paragraph may not be compensated for
1903	more than a total of 12 hours per day.
1904	3. If the family member remains employed while providing
1905	attendant or custodial care, the per-hour value of that care
1906	equals the per-hour value of the family member’s employment, not
1907	to exceed the per-hour value of such care available in the
1908	community at large.
1909	(c) If the employer fails to provide initialtreatment or
1910	care required by this section after request by the injured
1911	employee, the employee may obtain such initialtreatment at the
1912	expense of the employer, if the initial treatment or careis
1913	compensable and medically necessary and is in accordance with
1914	established practice parameters and protocols of treatment as
1915	provided for in this chapter. There must be a specific request
1916	for the initial treatment or care, and the employer or carrier
1917	must be given a reasonable time period within which to provide
1918	the initialtreatment or care. However, the employee is not
1919	entitled to recover any amount personally expended for the
1920	initial treatment or careserviceunless he or she has requested
1921	the employer to furnish that initialtreatment or service and
1922	the employer has failed, refused, or neglected to do so within a
1923	reasonable time or unless the nature of the injury requires such
1924	initialtreatment, nursing, and services and the employer or his
1925	or her superintendent or foreman, having knowledge of the
1926	injury, has neglected to provide the initial treatment or care
1927	service.
1928	(d) The carrier has the right to transfer the care of an
1929	injured employee from the attending health care provider if an
1930	independent medical examination determines that the employee is
1931	not making appropriate progress in recuperation.
1932	(e) Except in emergency situations and for treatment
1933	rendered by a managed care arrangement, after any initial
1934	examination and diagnosis by a physician providing remedial
1935	treatment, care, and attendance, and before a proposed course of
1936	medical treatment begins, each insurer shall review, in
1937	accordance with the requirements of this chapter, the proposed
1938	course of treatment, to determine whether such treatment would
1939	be recognized as reasonably prudent. The review must be in
1940	accordance with all applicable workers' compensation practice
1941	parameters and protocols of treatment established in accordance
1942	with this chapter. The insurer must accept any such proposed
1943	course of treatment unless the insurer notifies the physician of
1944	its specific objections to the proposed course of treatment by
1945	the close of the tenth business day after notification by the
1946	physician, or a supervised designee of the physician, of the
1947	proposed course of treatment.
1948	(f) Upon the written request of the employee, the carrier
1949	shall give the employee the opportunity for one change of
1950	physician during the course of treatment for any one accident.
1951	Upon the granting of a change of physician, the originally
1952	authorized physician in the same specialty as the changed
1953	physician shall become deauthorized upon written notification by
1954	the employer or carrier. The carrier shall authorize an
1955	alternative physician who shall not be professionally affiliated
1956	with the previous physician within 5 days after receipt of the
1957	request. If the carrier fails to provide a change of physician
1958	as requested by the employee, the employee may select the
1959	physician and such physician shall be considered authorized if
1960	the treatment being provided is compensable and medically
1961	necessary.
1962
1963	Failure of the carrier to timely comply with this subsection
1964	shall be a violation of this chapter and the carrier shall be
1965	subject to penalties as provided for in s. 440.525.The employee
1966	shall be entitled to select another physician from among not
1967	fewer than three carrier-authorized physicians who are not
1968	professionally affiliated.
1969	(3) PROVIDER ELIGIBILITY; AUTHORIZATION.--
1970	(a) As a condition to eligibility for payment under this
1971	chapter, a health care provider who renders services must be a
1972	certified health care provider and must receive authorization
1973	from the carrier before providing treatment. This paragraph does
1974	not apply to emergency care. The agency shall adopt rules to
1975	implement the certification of health care providers.
1976	(b) A health care provider who renders emergency care must
1977	notify the carrier by the close of the third business day after
1978	it has rendered such care. If the emergency care results in
1979	admission of the employee to a health care facility, the health
1980	care provider must notify the carrier by telephone within 24
1981	hours after initial treatment. Emergency care is not compensable
1982	under this chapter unless the injury requiring emergency care
1983	arose as a result of a work-related accident. Pursuant to
1984	chapter 395, all licensed physicians and health care providers
1985	in this state shall be required to make their services available
1986	for emergency treatment of any employee eligible for workers'
1987	compensation benefits. To refuse to make such treatment
1988	available is cause for revocation of a license.
1989	(c) A health care provider may not refer the employee to
1990	another health care provider, diagnostic facility, therapy
1991	center, or other facility without prior authorization from the
1992	carrier, except when emergency care is rendered. Any referral
1993	must be to a health care provider that has been certified by the
1994	agency, unless the referral is for emergency treatment, and the
1995	referral must be made in accordance with practice parameters and
1996	protocols of treatment as provided for in this chapter.
1997	(d) A carrier must respond, by telephone or in writing, to
1998	a request for authorization from an authorized health care
1999	providerby the close of the third business day after receipt of
2000	the request. A carrier who fails to respond to a written request
2001	for authorization for referral for medical treatment by the
2002	close of the third business day after receipt of the request
2003	consents to the medical necessity for such treatment. All such
2004	requests must be made to the carrier. Notice to the carrier does
2005	not include notice to the employer.
2006	(e) Carriers shall adopt procedures for receiving,
2007	reviewing, documenting, and responding to requests for
2008	authorization. Such procedures shall be for a health care
2009	provider certified under this section.
2010	(f) By accepting payment under this chapter for treatment
2011	rendered to an injured employee, a health care provider consents
2012	to the jurisdiction of the agency as set forth in subsection
2013	(11) and to the submission of all records and other information
2014	concerning such treatment to the agency in connection with a
2015	reimbursement dispute, audit, or review as provided by this
2016	section. The health care provider must further agree to comply
2017	with any decision of the agency rendered under this section.
2018	(g) The employee is not liable for payment for medical
2019	treatment or services provided pursuant to this section except
2020	as otherwise provided in this section.
2021	(h) The provisions of s. 456.053 are applicable to
2022	referrals among health care providers, as defined in subsection
2023	(1), treating injured workers.
2024	(i) Notwithstanding paragraph (d), a claim for specialist
2025	consultations, surgical operations, physiotherapeutic or
2026	occupational therapy procedures, X-ray examinations, or special
2027	diagnostic laboratory tests that cost more than $1,000 and other
2028	specialty services that the agency identifies by rule is not
2029	valid and reimbursable unless the services have been expressly
2030	authorized by the carrier, or unless the carrier has failed to
2031	respond within 10 days to a written request for authorization,
2032	or unless emergency care is required. The insurer shall not
2033	refuse toauthorize such consultation or procedure unless the
2034	health care provider or facility is not authorized or certified,
2035	unless such treatment is not in accordance with practice
2036	parameters and protocols of treatment established in this
2037	chapter, or unless a judge of compensation claimsan expert
2038	medical advisorhas determined that the consultation or
2039	procedure is not medically necessary, not in accordance with the
2040	practice parameters and protocols of treatment established in
2041	this chapter, or otherwise notcompensable under this chapter.
2042	Authorization of a treatment plan does not constitute express
2043	authorization for purposes of this section, except to the extent
2044	the carrier provides otherwise in its authorization procedures.
2045	This paragraph does not limit the carrier's obligation to
2046	identify and disallow overutilization or billing errors.
2047	(j) Notwithstanding anything in this chapter to the
2048	contrary, a sick or injured employee shall be entitled, at all
2049	times, to free, full, and absolute choice in the selection of
2050	the pharmacy or pharmacist dispensing and filling prescriptions
2051	for medicines required under this chapter. It is expressly
2052	forbidden for the agency, an employer, or a carrier, or any
2053	agent or representative of the agency, an employer, or a
2054	carrier to select the pharmacy or pharmacist which the sick or
2055	injured employee must use; condition coverage or payment on the
2056	basis of the pharmacy or pharmacist utilized; or to otherwise
2057	interfere in the selection by the sick or injured employee of a
2058	pharmacy or pharmacist.
2059	(4) NOTICE OF TREATMENT TO CARRIER; FILING WITH
2060	DEPARTMENT.--
2061	(a) Any health care provider providing necessary remedial
2062	treatment, care, or attendance to any injured worker shall
2063	submit treatment reports to the carrier in a format prescribed
2064	by the department in consultation with the agency. A claim for
2065	medical or surgical treatment is not valid or enforceable
2066	against such employer or employee, unless, by the close of the
2067	third business day following the first treatment, the physician
2068	providing the treatment furnishes to the employer or carrier a
2069	preliminary notice of the injury and treatment in a formaton
2070	forms prescribed by the department in consultation with the
2071	agencyand, within 15 days thereafter, furnishes to the employer
2072	or carrier a complete report, and subsequent thereto furnishes
2073	progress reports, if requested by the employer or insurance
2074	carrier, at intervals of not less than 3 weeks apart or at less
2075	frequent intervals if requested in a formaton formsprescribed
2076	by the department in consultation with the agency.
2077	(b) Upon the request of the department or agency, each
2078	medical report or bill obtained or received by the employer, the
2079	carrier, or the injured employee, or the attorney for the
2080	employer, carrier, or injured employee, with respect to the
2081	remedial treatment, care, and attendance of the injured
2082	employee, including any report of an examination, diagnosis, or
2083	disability evaluation, must be produced by the health care
2084	provider tofiled with the department or agencypursuant to
2085	rules adopted by the department in consultation with the agency.
2086	The health care provider shall also furnish to the injured
2087	employee or to his or her attorney and the employer or carrier
2088	or its attorney, on demand, a copy of his or her office chart,
2089	records, and reports, and may charge the injured employee no
2090	more than 50 cents per page for copying the records and the
2091	actual direct cost to the health care provider or health care
2092	facility for X rays, microfilm, or other nonpaper recordsan
2093	amount authorized by the department for the copies. Each such
2094	health care provider shall provide to the agency ordepartment
2095	information about the remedial treatment, care, and attendance
2096	which the agency ordepartment reasonably requests.
2097	(c) It is the policy for the administration of the
2098	workers' compensation system that there shallbe reasonable
2099	access to medical information by all parties to facilitate the
2100	self-executing features of the law. An employee who reports an
2101	injury or illness alleged to be work-related waives any
2102	physician-patient privilege with respect to any condition or
2103	complaint reasonably related to the condition for which the
2104	employee claims compensation.Notwithstanding the limitations in
2105	s. 456.057 and subject to the limitations in s. 381.004, upon
2106	the request of the employer, the carrier, an authorized
2107	qualified rehabilitation provider, or the attorney for the
2108	employer or carrier, the medical records, reports, and
2109	information of an injured employee relevant to the particular
2110	injury or illness for which compensation is soughtmust be
2111	furnished to those persons and the medical condition of the
2112	injured employee must be discussed with those persons, if the
2113	records and the discussions are restricted to conditions
2114	relating to the workplace injury. Release of medical information
2115	by the health care provider or other physician does not require
2116	the authorization of the injured employee. If medical records,
2117	reports, and information of an injured employee are sought from
2118	health care providers who are not subject to the jurisdiction of
2119	the state, the injured employee shall sign an authorization
2120	allowing for the employer or carrier to obtain the medical
2121	records, reports, or information. Any such discussions or
2122	release of informationmay be held before or after the filing of
2123	a claim or petition for benefitswithout the knowledge, consent,
2124	or presence of any other party or his or her agent or
2125	representative. A health care provider who willfully refuses to
2126	provide medical records or to discuss the medical condition of
2127	the injured employee, after a reasonable request is made for
2128	such information pursuant to this subsection, shall be subject
2129	by the departmentagencyto one or more of the penalties set
2130	forth in paragraph (8)(b). The department may adopt rules to
2131	carry out this subsection.
2132	(5) INDEPENDENT MEDICAL EXAMINATIONS.--
2133	(a) In any dispute concerning overutilization, medical
2134	benefits, compensability, or disability under this chapter, the
2135	carrier or the employee may select an independent medical
2136	examiner. If the parties agree,the examiner may be a health
2137	care provider treating or providing other care to the employee.
2138	An independent medical examiner may not render an opinion
2139	outside his or her area of expertise, as demonstrated by
2140	licensure and applicable practice parameters. The employer and
2141	employee shall be entitled to only one independent medical
2142	examination per accident and not one independent medical
2143	examination per medical specialty. The party requesting and
2144	selecting the independent medical examination shall be
2145	responsible for all expenses associated with said examination,
2146	including, but not limited to, medically necessary diagnostic
2147	testing performed and physician or medical care provider fees
2148	for the evaluation. The party selecting the independent medical
2149	examination shall identify the choice of the independent medical
2150	examiner to all other parties within 15 days after the date the
2151	independent medical examination is to take place. Failure to
2152	timely provide such notification shall preclude the requesting
2153	party from submitting the findings of such independent medical
2154	examiner in a proceeding before a judge of compensation claims.
2155	The independent medical examiner may not provide followup care
2156	if such recommendation for care is found to be medically
2157	necessary. If the employee prevails in a medical dispute as
2158	determined in an order by a judge of compensation claims or if
2159	benefits are paid or treatment provided after the employee has
2160	obtained an independent medical examination based upon the
2161	examiner’s findings, the costs of such examination shall be paid
2162	by the employer or carrier.
2163	(b) Each party is bound by his or her selection of an
2164	independent medical examiner, including the selection of the
2165	independent medical examiner in accordance with s. 440.134 and
2166	the opinions of such independent medical examiner. Each party
2167	andis entitled to an alternate examiner only if:
2168	1. The examiner is not qualified to render an opinion upon
2169	an aspect of the employee's illness or injury which is material
2170	to the claim or petition for benefits;
2171	2. The examiner ceases to practice in the specialty
2172	relevant to the employee's condition;
2173	3. The examiner is unavailable due to injury, death, or
2174	relocation outside a reasonably accessible geographic area; or
2175	4. The parties agree to an alternate examiner.
2176
2177	Any party may request, or a judge of compensation claims may
2178	require, designation of an agency medical advisor as an
2179	independent medical examiner. The opinion of the advisors acting
2180	as examiners shall not be afforded the presumption set forth in
2181	paragraph (9)(c).
2182	(c) The carrier may, at its election, contact the claimant
2183	directly to schedule a reasonable time for an independent
2184	medical examination. The carrier must confirm the scheduling
2185	agreement in writing with the claimant and thewithin 5 days and
2186	notifyclaimant's counsel, if any, at least 7 days before the
2187	date upon which the independent medical examination is scheduled
2188	to occur. An attorney representing a claimant is not authorized
2189	to schedule the self-insured employer’s or carrier’sindependent
2190	medical evaluations under this subsection. Neither the self-
2191	insured employer nor the carrier shall be responsible for
2192	scheduling any independent medical examination other than an
2193	employer or carrier independent medical examination.
2194	(d) If the employee fails to appear for the independent
2195	medical examination scheduled by the employer or carrierwithout
2196	good cause and fails to advise the physician at least 24 hours
2197	before the scheduled date for the examination that he or she
2198	cannot appear, the employee is barred from recovering
2199	compensation for any period during which he or she has refused
2200	to submit to such examination. Further, the employee shall
2201	reimburse the employer orcarrier 50 percent of the physician's
2202	cancellation or no-show fee unless the employer orcarrier that
2203	schedules the examination fails to timely provide to the
2204	employee a written confirmation of the date of the examination
2205	pursuant to paragraph (c) which includes an explanation of why
2206	he or she failed to appear. The employee may appeal to a judge
2207	of compensation claims for reimbursement when the employer or
2208	carrier withholds payment in excess of the authority granted by
2209	this section.
2210	(e) No medical opinion other than the opinion of a medical
2211	advisor appointed by the judge of compensation claims or the
2212	departmentagency, an independent medical examiner, or an
2213	authorized treating provider is admissible in proceedings before
2214	the judges of compensation claims.
2215	(f) Attorney’s fees incurred by an injured employee in
2216	connection with delay of or opposition to an independent medical
2217	examination, including, but not limited to, motions for
2218	protective orders, are not recoverable under this chapter.
2219	(g) When a medical dispute arises, the parties may
2220	mutually agree to refer the employee to a licensed physician
2221	specializing in the diagnosis and treatment of the medical
2222	condition at issue for an independent medical examination and
2223	report. Such medical examination shall be referred to as a
2224	“consensus independent medical examination.” The findings and
2225	conclusions of such mutually agreed upon consensus independent
2226	medical examination shall be binding on the parties and shall
2227	constitute resolution of the medical dispute addressed in the
2228	independent consensus medical examination and in any proceeding.
2229	Agreement by the parties to a consensus independent medical
2230	examination shall not affect the employer's, carrier's, or
2231	employee's entitlement to one independent medical examination
2232	per accident as provided for in this subsection.
2233	(6) UTILIZATION REVIEW.--Carriers shall review all bills,
2234	invoices, and other claims for payment submitted by health care
2235	providers in order to identify overutilization and billing
2236	errors, including compliance with practice parameters and
2237	protocols of treatment established in accordance with this
2238	chapter, and may hire peer review consultants or conduct
2239	independent medical evaluations. Such consultants, including
2240	peer review organizations, are immune from liability in the
2241	execution of their functions under this subsection to the extent
2242	provided in s. 766.101. If a carrier finds that overutilization
2243	of medical services or a billing error has occurred, or there is
2244	a violation of the practice parameters and protocols of
2245	treatment established in accordance with this chapter, it must
2246	disallow or adjust payment for such services or error without
2247	order of a judge of compensation claims or the agency, if the
2248	carrier, in making its determination, has complied with this
2249	section and rules adopted by the agency.
2250	(7) UTILIZATION AND REIMBURSEMENT DISPUTES.--
2251	(a) Any health care provider, carrier, or employer who
2252	elects to contest the disallowance or adjustment of payment by a
2253	carrier under subsection (6) must, within 30 days after receipt
2254	of notice of disallowance or adjustment of payment, petition the
2255	agency to resolve the dispute. The petitioner must serve a copy
2256	of the petition on the carrier and on all affected parties by
2257	certified mail. The petition must be accompanied by all
2258	documents and records that support the allegations contained in
2259	the petition. Failure of a petitioner to submit such
2260	documentation to the agency results in dismissal of the
2261	petition.
2262	(b) The carrier must submit to the agency within 10 days
2263	after receipt of the petition all documentation substantiating
2264	the carrier's disallowance or adjustment. Failure of the carrier
2265	to timelysubmit the requested documentation to the agency
2266	within 10 days constitutes a waiver of all objections to the
2267	petition.
2268	(c) Within 60 days after receipt of all documentation, the
2269	agency must provide to the petitioner, the carrier, and the
2270	affected parties a written determination of whether the carrier
2271	properly adjusted or disallowed payment. The agency must be
2272	guided by standards and policies set forth in this chapter,
2273	including all applicable reimbursement schedules, practice
2274	parameters, and protocols of treatment,in rendering its
2275	determination.
2276	(d) If the agency finds an improper disallowance or
2277	improper adjustment of payment by an insurer, the insurer shall
2278	reimburse the health care provider, facility, insurer, or
2279	employer within 30 days, subject to the penalties provided in
2280	this subsection.
2281	(e) The agency shall adopt rules to carry out this
2282	subsection. The rules may include provisions for consolidating
2283	petitions filed by a petitioner and expanding the timetable for
2284	rendering a determination upon a consolidated petition.
2285	(f) Any carrier that engages in a pattern or practice of
2286	arbitrarily or unreasonably disallowing or reducing payments to
2287	health care providers may be subject to one or more of the
2288	following penalties imposed by the agency:
2289	1. Repayment of the appropriate amount to the health care
2290	provider.
2291	2. An administrative fine assessed by the agency in an
2292	amount not to exceed $5,000 per instance of improperly
2293	disallowing or reducing payments.
2294	3. Award of the health care provider's costs, including a
2295	reasonable attorney's fee, for prosecuting the petition.
2296	(8) PATTERN OR PRACTICE OF OVERUTILIZATION.--
2297	(a) Carriers must report to the agency all instances of
2298	overutilization including, but not limited to, all instances in
2299	which the carrier disallows or adjusts payment or a
2300	determination has been made that the provided or recommended
2301	treatment is in excess of the practice parameters and protocols
2302	of treatment established in this chapter. The agency shall
2303	determine whether a pattern or practice of overutilization
2304	exists.
2305	(b) If the agency determines that a health care provider
2306	has engaged in a pattern or practice of overutilization or a
2307	violation of this chapter or rules adopted by the agency,
2308	including a pattern or practice of providing treatment in excess
2309	of the practice parameters or protocols of treatment, it may
2310	impose one or more of the following penalties:
2311	1. An order of the agency barring the provider from
2312	payment under this chapter;
2313	2. Deauthorization of care under review;
2314	3. Denial of payment for care rendered in the future;
2315	4. Decertification of a health care provider certified as
2316	an expert medical advisor under subsection (9) or of a
2317	rehabilitation provider certified under s. 440.49;
2318	5. An administrative fine assessed by the agency in an
2319	amount not to exceed $5,000 per instance of overutilization or
2320	violation; and
2321	6. Notification of and review by the appropriate licensing
2322	authority pursuant to s. 440.106(3).
2323	(9) EXPERT MEDICAL ADVISORS.--
2324	(a) The agency shall certify expert medical advisors in
2325	each specialty to assist the agency and the judges of
2326	compensation claims within the advisor's area of expertise as
2327	provided in this section. The agency shall, in a manner
2328	prescribed by rule, in certifying, recertifying, or decertifying
2329	an expert medical advisor, consider the qualifications,
2330	training, impartiality, and commitment of the health care
2331	provider to the provision of quality medical care at a
2332	reasonable cost. As a prerequisite for certification or
2333	recertification, the agency shall require, at a minimum, that
2334	an expert medical advisor have specialized workers' compensation
2335	training or experience under the workers' compensation system of
2336	this state and board certification or board eligibility.
2337	(b) The agency shall contract with one or more entities
2338	that employ, contract with, or otherwise secureor employexpert
2339	medical advisors to provide peer review or expertmedical
2340	consultation, opinions, and testimonyto the agency or to a
2341	judge of compensation claims in connection with resolving
2342	disputes relating to reimbursement, differing opinions of health
2343	care providers, and health care and physician services rendered
2344	under this chapter, including utilization issues. The agency
2345	shall by rule establish the qualifications of expert medical
2346	advisors, including training and experience in the workers’
2347	compensation system in the state and the expert medical
2348	advisor’s knowledge of and commitment to the standards of care,
2349	practice parameters, and protocols established pursuant to this
2350	chapter.Expert medical advisors contracting with the agency
2351	shall, as a term of such contract, agree to provide consultation
2352	or services in accordance with the timetables set forth in this
2353	chapter and to abide by rules adopted by the agency, including,
2354	but not limited to, rules pertaining to procedures for review of
2355	the services rendered by health care providers and preparation
2356	of reports and testimony orrecommendations for submission to
2357	the agency or the judge of compensation claims.
2358	(c) If there is disagreement in the opinions of the health
2359	care providers, if two health care providers disagree on medical
2360	evidence supporting the employee's complaints or the need for
2361	additional medical treatment, or if two health care providers
2362	disagree that the employee is able to return to work, the agency
2363	may, and the judge of compensation claims shall, upon his or her
2364	own motion or within 15 days after receipt of a written request
2365	by either the injured employee, the employer, or the carrier,
2366	order the injured employee to be evaluated by an expert medical
2367	advisor. The opinion of the expert medical advisor is presumed
2368	to be correct unless there is clear and convincing evidence to
2369	the contrary as determined by the judge of compensation claims.
2370	The expert medical advisor appointed to conduct the evaluation
2371	shall have free and complete access to the medical records of
2372	the employee. An employee who fails to report to and cooperate
2373	with such evaluation forfeits entitlement to compensation during
2374	the period of failure to report or cooperate.
2375	(d) The expert medical advisor must complete his or her
2376	evaluation and issue his or her report to the agency or to the
2377	judge of compensation claims within 1545days after receipt of
2378	all medical records. The expert medical advisor must furnish a
2379	copy of the report to the carrier and to the employee.
2380	(e) An expert medical advisor is not liable under any
2381	theory of recovery for evaluations performed under this section
2382	without a showing of fraud or malice. The protections of s.
2383	766.101 apply to any officer, employee, or agent of the agency
2384	and to any officer, employee, or agent of any entity with which
2385	the agency has contracted under this subsection.
2386	(f) If the agency or a judge of compensation claims orders
2387	determines thatthe services of a certified expert medical
2388	advisor are requiredto resolve a dispute under this section,
2389	the party requesting such examinationcarriermust compensate
2390	the advisor for his or her time in accordance with a schedule
2391	adopted by the agency. If the employee prevails in a dispute as
2392	determined in an order by a judge of compensation claims based
2393	upon the expert medical advisor’s findings, the employer or
2394	carrier shall pay for the costs of such expert medical advisor.
2395	If a judge of compensation claims, upon his or her motion, finds
2396	that an expert medical advisor is needed to resolve the dispute,
2397	the carrier must compensate the advisor for his or her time in
2398	accordance with a schedule adopted by the agency.The agency may
2399	assess a penalty not to exceed $500 against any carrier that
2400	fails to timely compensate an advisor in accordance with this
2401	section.
2402	(10) WITNESS FEES.-- Any health care provider who gives a
2403	deposition shall be allowed a witness fee. The amount charged by
2404	the witness may not exceed $200 per hour. An expert witness who
2405	has never provided direct professional services to a party but
2406	has merely reviewed medical records and provided an expert
2407	opinion or has provided only direct professional services that
2408	were unrelated to the workers' compensation case may not be
2409	allowed a witness fee in excess of $200 per day.
2410	(11) AUDITS BY AGENCY FOR HEALTH CARE ADMINISTRATION AND
2411	THE DEPARTMENT OF INSURANCE; JURISDICTION.--
2412	(a) The Agency for Health Care Administration may
2413	investigate health care providers to determine whether providers
2414	are complying with this chapter and with rules adopted by the
2415	agency, whether the providers are engaging in overutilization,
2416	andwhether providers are engaging in improper billing
2417	practices, and whether providers are adhering to practice
2418	parameters and protocols established in accordance with this
2419	chapter. If the agency finds that a health care provider has
2420	improperly billed, overutilized, or failed to comply with agency
2421	rules or the requirements of this chapter, including, but not
2422	limited to, practice parameters and protocols established in
2423	accordance with this chapter,it must notify the provider of its
2424	findings and may determine that the health care provider may not
2425	receive payment from the carrier or may impose penalties as set
2426	forth in subsection (8) or other sections of this chapter. If
2427	the health care provider has received payment from a carrier for
2428	services that were improperly billed, that constitute
2429	overutilization, or that were outside practice parameters or
2430	protocols established in accordance with this chapteror for
2431	overutilization, it must return those payments to the carrier.
2432	The agency may assess a penalty not to exceed $500 for each
2433	overpayment that is not refunded within 30 days after
2434	notification of overpayment by the agency or carrier.
2435	(b) The department shall fine or otherwise discipline an
2436	employer or carrier, pursuant to this chapter, the insurance
2437	code, or rules adopted by the department, for each late payment
2438	of compensation that is below the minimum 95-percent90-percent
2439	performance standard. Any carrier that is found to be not in
2440	compliance in subsequent consecutive quarters must implement a
2441	medical-bill review program approved by the division, and the
2442	carrier is subject to disciplinary action by the Department of
2443	Insurance.
2444	(c) The agency has exclusive jurisdiction to decide any
2445	matters concerning reimbursement, to resolve any overutilization
2446	dispute under subsection (7), and to decide any question
2447	concerning overutilization under subsection (8), which question
2448	or dispute arises after January 1, 1994.
2449	(d) The following agency actions do not constitute agency
2450	action subject to review under ss. 120.569 and 120.57 and do not
2451	constitute actions subject to s. 120.56: referral by the entity
2452	responsible for utilization review; a decision by the agency to
2453	refer a matter to a peer review committee; establishment by a
2454	health care provider or entity of procedures by which a peer
2455	review committee reviews the rendering of health care services;
2456	and the review proceedings, report, and recommendation of the
2457	peer review committee.
2458	(12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
2459	REIMBURSEMENT ALLOWANCES.--
2460	(a) A three-member panel is created, consisting of the
2461	Insurance Commissioner, or the Insurance Commissioner's
2462	designee, and two members to be appointed by the Governor,
2463	subject to confirmation by the Senate, one member who, on
2464	account of present or previous vocation, employment, or
2465	affiliation, shall be classified as a representative of
2466	employers, the other member who, on account of previous
2467	vocation, employment, or affiliation, shall be classified as a
2468	representative of employees. The panel shall determine statewide
2469	schedules of maximum reimbursement allowances for medically
2470	necessary treatment, care, and attendance provided by
2471	physicians, hospitals, ambulatory surgical centers, work-
2472	hardening programs, pain programs, and durable medical
2473	equipment. The maximum reimbursement allowances for inpatient
2474	hospital care shall be based on a schedule of per diem rates, to
2475	be approved by the three-member panel no later than March 1,
2476	1994, to be used in conjunction with a precertification manual
2477	as determined by the department, including maximum hours in
2478	which an outpatient may remain in observation status, which
2479	shall not exceed 23 hoursagency. All compensable charges for
2480	hospital outpatient care shall be reimbursed at 75 percent of
2481	usual and customary charges, except as otherwise provided by
2482	this subsection. Until the three-member panel approves a
2483	schedule of per diem rates for inpatient hospital care and it
2484	becomes effective, all compensable charges for hospital
2485	inpatient care must be reimbursed at 75 percent of their usual
2486	and customary charges.Annually, the three-member panel shall
2487	adopt schedules of maximum reimbursement allowances for
2488	physicians, hospital inpatient care, hospital outpatient care,
2489	ambulatory surgical centers, work-hardening programs, and pain
2490	programs. However, the maximum percentage of increase in the
2491	individual reimbursement allowance may not exceed the percentage
2492	of increase in the Consumer Price Index for the previous year.
2493	An individual physician, hospital, ambulatory surgical center,
2494	pain program, or work-hardening program shall be reimbursed
2495	either the usual and customary charge for treatment, care, and
2496	attendance, the agreed-upon contract price,or the maximum
2497	reimbursement allowance in the appropriate schedule, whichever
2498	is less.
2499	(b) It is the intent of the Legislature to increase the
2500	schedule of maximum reimbursement allowances for selected
2501	physicians effective January 1, 2004, and to pay for the
2502	increases through reductions in payments to hospitals. Revisions
2503	developed pursuant to this subsection are limited to the
2504	following:
2505	1. Payments for outpatient physical, occupational, and
2506	speech therapy provided by hospitals shall be reduced to the
2507	schedule of maximum reimbursement allowances for these services
2508	which applies to nonhospital providers.
2509	2. Payments for scheduled outpatient nonemergency
2510	radiological and clinical laboratory services that are not
2511	provided in conjunction with a surgical procedure shall be
2512	reduced to the schedule of maximum reimbursement allowances for
2513	these services which applies to nonhospital providers.
2514	3. Outpatient reimbursement for scheduled surgeries shall
2515	be reduced from 75 percent of charges to 60 percent of charges.
2516	4. Maximum reimbursement for a physician licensed under
2517	chapter 458 or chapter 459 shall be increased to 110 percent of
2518	the reimbursement allowed by Medicare, using appropriate codes
2519	and modifiers or the medical reimbursement level adopted by the
2520	three-member panel as of January 1, 2003, whichever is greater.
2521	5. Maximum reimbursement for surgical procedures shall be
2522	increased to 140 percent of the reimbursement allowed by
2523	Medicare or the medical reimbursement level adopted by the
2524	three-member panel as of January 1, 2003, whichever is greater.
2525	(c)(b)As to reimbursement for a prescription medication,
2526	the reimbursement amount for a prescription shall be the average
2527	wholesale price times 0.861.2 plus $4.26$4.18for the
2528	dispensing fee, except where the carrier has contracted for a
2529	lower amount. Fees for pharmaceuticals and pharmaceutical
2530	services shall be reimbursable at the applicable fee schedule
2531	amount. Where the employer or carrier has contracted for such
2532	services and the employee elects to obtain them through a
2533	provider not a party to the contract, the carrier shall
2534	reimburse at the schedule, negotiated, or contract price,
2535	whichever is lower. No such contract shall rely on a provider
2536	that is not reasonably accessible to the employee.
2537	(d)(c)Reimbursement for all fees and other charges for
2538	such treatment, care, and attendance, including treatment, care,
2539	and attendance provided by any hospital or other health care
2540	provider, ambulatory surgical center, work-hardening program, or
2541	pain program, must not exceed the amounts provided by the
2542	uniform schedule of maximum reimbursement allowances as
2543	determined by the panel or as otherwise provided in this
2544	section. This subsection also applies to independent medical
2545	examinations performed by health care providers under this
2546	chapter. In determining the uniform schedule, the panel shall
2547	first approve the data which it finds representative of
2548	prevailing charges in the state for similar treatment, care, and
2549	attendance of injured persons. Each health care provider, health
2550	care facility, ambulatory surgical center, work-hardening
2551	program, or pain program receiving workers' compensation
2552	payments shall maintain records verifying their usual charges.
2553	In establishing the uniform schedule of maximum reimbursement
2554	allowances, the panel must consider:
2555	1. The levels of reimbursement for similar treatment,
2556	care, and attendance made by other health care programs or
2557	third-party providers;
2558	2. The impact upon cost to employers for providing a level
2559	of reimbursement for treatment, care, and attendance which will
2560	ensure the availability of treatment, care, and attendance
2561	required by injured workers;
2562	3. The financial impact of the reimbursement allowances
2563	upon health care providers and health care facilities, including
2564	trauma centers as defined in s. 395.4001, and its effect upon
2565	their ability to make available to injured workers such
2566	medically necessary remedial treatment, care, and attendance.
2567	The uniform schedule of maximum reimbursement allowances must be
2568	reasonable, must promote health care cost containment and
2569	efficiency with respect to the workers' compensation health care
2570	delivery system, and must be sufficient to ensure availability
2571	of such medically necessary remedial treatment, care, and
2572	attendance to injured workers; and
2573	4. The most recent average maximum allowable rate of
2574	increase for hospitals determined by the Health Care Board under
2575	chapter 408.
2576	(e)(d)In addition to establishing the uniform schedule of
2577	maximum reimbursement allowances, the panel shall:
2578	1. Take testimony, receive records, and collect data to
2579	evaluate the adequacy of the workers' compensation fee schedule,
2580	nationally recognized fee schedules and alternative methods of
2581	reimbursement to certified health care providers and health care
2582	facilities for inpatient and outpatient treatment and care.
2583	2. Survey certified health care providers and health care
2584	facilities to determine the availability and accessibility of
2585	workers' compensation health care delivery systems for injured
2586	workers.
2587	3. Survey carriers to determine the estimated impact on
2588	carrier costs and workers' compensation premium rates by
2589	implementing changes to the carrier reimbursement schedule or
2590	implementing alternative reimbursement methods.
2591	4. Submit recommendations on or before January 1, 2003,
2592	and biennially thereafter, to the President of the Senate and
2593	the Speaker of the House of Representatives on methods to
2594	improve the workers' compensation health care delivery system.
2595
2596	The division shall provide data to the panel, including but not
2597	limited to, utilization trends in the workers' compensation
2598	health care delivery system. The division shall provide the
2599	panel with an annual report regarding the resolution of medical
2600	reimbursement disputes and any actions pursuant to s. 440.13(8).
2601	The division shall provide administrative support and service to
2602	the panel to the extent requested by the panel.
2603	(13) REMOVAL OF PHYSICIANS FROM LISTS OF THOSE AUTHORIZED
2604	TO RENDER MEDICAL CARE.-- The agency shall remove from the list
2605	of physicians or facilities authorized to provide remedial
2606	treatment, care, and attendance under this chapter the name of
2607	any physician or facility found after reasonable investigation
2608	to have:
2609	(a) Engaged in professional or other misconduct or
2610	incompetency in connection with medical services rendered under
2611	this chapter;
2612	(b) Exceeded the limits of his or her or its professional
2613	competence in rendering medical care under this chapter, or to
2614	have made materially false statements regarding his or her or
2615	its qualifications in his or her application;
2616	(c) Failed to transmit copies of medical reports to the
2617	employer or carrier, or failed to submit full and truthful
2618	medical reports of all his or her or its findings to the
2619	employer or carrier as required under this chapter;
2620	(d) Solicited, or employed another to solicit for himself
2621	or herself or itself or for another, professional treatment,
2622	examination, or care of an injured employee in connection with
2623	any claim under this chapter;
2624	(e) Refused to appear before, or to answer upon request
2625	of, the agency or any duly authorized officer of the state, any
2626	legal question, or to produce any relevant book or paper
2627	concerning his or her conduct under any authorization granted to
2628	him or her under this chapter;
2629	(f) Self-referred in violation of this chapter or other
2630	laws of this state; or
2631	(g) Engaged in a pattern of practice of overutilization or
2632	a violation of this chapter or rules adopted by the agency,
2633	including failure to adhere to practice parameters and protocols
2634	established in accordance with this chapter.
2635	(14) PAYMENT OF MEDICAL FEES.--
2636	(a) Except for emergency care treatment, fees for medical
2637	services are payable only to a health care provider certified
2638	and authorized to render remedial treatment, care, or attendance
2639	under this chapter. Carriers shall pay, disallow, or deny
2640	payment to health care providers in the manner and at times set
2641	forth in this chapter.A health care provider may not collect or
2642	receive a fee from an injured employee within this state, except
2643	as otherwise provided by this chapter. Such providers have
2644	recourse against the employer or carrier for payment for
2645	services rendered in accordance with this chapter. Payment to
2646	health care providers or physicians shall be subject to the
2647	medical fee schedule and applicable practice parameters and
2648	protocols, regardless of whether the health care provider or
2649	claimant is asserting that the payment should be made.
2650	(b) Fees charged for remedial treatment, care, and
2651	attendance, except for independent medical examinations and
2652	consensus independent medical examinations, may not exceed the
2653	applicable fee schedules adopted under this chapter and
2654	department rule. Notwithstanding any other provision in this
2655	chapter, if a physician or health care provider specifically
2656	agrees in writing to follow identified procedures aimed at
2657	providing quality medical care to injured workers at reasonable
2658	costs, deviations from established fee schedules shall be
2659	permitted. Written agreements warranting deviations may include,
2660	but are not limited to, the timely scheduling of appointments
2661	for injured workers, participating in return-to-work programs
2662	with injured workers’ employers, expediting the reporting of
2663	treatments provided to injured workers, and agreeing to
2664	continuing education, utilization review, quality assurance,
2665	precertification, and case management systems that are designed
2666	to provide needed treatment for injured workers.
2667	(c) Notwithstanding any other provision of this chapter,
2668	following overall maximum medical improvement from an injury
2669	compensable under this chapter, the employee is obligated to pay
2670	a copayment of $10 per visit for medical services. The copayment
2671	shall not apply to emergency care provided to the employee.
2672	(15) PRACTICE PARAMETERS.—The practice parameters and
2673	protocols mandated under this chapter shall be the Workers’
2674	Compensation Utilization Management Standards adopted by the
2675	American Accreditation Health Care Commission in effect on
2676	January 1, 2003.
2677	(a) The Agency for Health Care Administration, in
2678	conjunction with the department and appropriate health
2679	professional associations and health-related organizations shall
2680	develop and may adopt by rule scientifically sound practice
2681	parameters for medical procedures relevant to workers'
2682	compensation claimants. Practice parameters developed under this
2683	section must focus on identifying effective remedial treatments
2684	and promoting the appropriate utilization of health care
2685	resources. Priority must be given to those procedures that
2686	involve the greatest utilization of resources either because
2687	they are the most costly or because they are the most frequently
2688	performed. Practice parameters for treatment of the 10 top
2689	procedures associated with workers' compensation injuries
2690	including the remedial treatment of lower-back injuries must be
2691	developed by December 31, 1994.
2692	(b) The guidelines may be initially based on guidelines
2693	prepared by nationally recognized health care institutions and
2694	professional organizations but should be tailored to meet the
2695	workers' compensation goal of returning employees to full
2696	employment as quickly as medically possible, taking into
2697	consideration outcomes data collected from managed care
2698	providers and any other inpatient and outpatient facilities
2699	serving workers' compensation claimants.
2700	(c) Procedures must be instituted which provide for the
2701	periodic review and revision of practice parameters based on the
2702	latest outcomes data, research findings, technological
2703	advancements, and clinical experiences, at least once every 3
2704	years.
2705	(d) Practice parameters developed under this section must
2706	be used by carriers and the agency in evaluating the
2707	appropriateness and overutilization of medical services provided
2708	to injured employees.
2709	(16) STANDARDS OF CARE.--The following standards of care
2710	shall be followed in providing medical care under this chapter:
2711	(a) Abnormal anatomical findings alone, in the absence of
2712	objective relevant medical findings, shall not be an indicator
2713	of injury or illness, a justification for the provision of
2714	remedial medical care or the assignment of restrictions, or a
2715	foundation for limitations.
2716	(b) At all times during evaluation and treatment, the
2717	provider shall act on the premise that returning to work is an
2718	integral part of the treatment plan. The goal of removing all
2719	restrictions and limitations as early as appropriate shall be
2720	part of the treatment plan on a continuous basis. The assignment
2721	of restrictions and limitations shall be reviewed with each
2722	patient exam and upon receipt of new information, such as
2723	progress reports from physical therapists and other providers.
2724	Consideration shall be given to upgrading or removing the
2725	restrictions and limitations with each patient exam, based upon
2726	the presence or absence of objective relevant medical findings.
2727	(c) Reasonable necessary medical care of injured employees
2728	shall in all situations:
2729	1. Utilize a high intensity, short duration treatment
2730	approach that focuses on early activation and restoration of
2731	function whenever possible.
2732	2. Include reassessment of the treatment plans, regimes,
2733	therapies, prescriptions, and functional limitations or
2734	restrictions prescribed by the provider every 30 days.
2735	3. Be focused on treatment of the individual employee's
2736	specific clinical dysfunction or status and shall not be based
2737	upon nondescript diagnostic labels.
2738
2739	All treatment shall be inherently scientifically logical and the
2740	evaluation or treatment procedure must match the documented
2741	physiologic and clinical problem. Treatment shall match the
2742	type, intensity, and duration of service required by the problem
2743	identified.
2744	(17) Failure to comply with this section shall be
2745	considered a violation of this chapter and is subject to
2746	penalties as provided for in s. 440.525.
2747	Section 16. Paragraphs (d) and (i) of subsection (1) and
2748	subsections (2), (6), (7), (8), (9), (10), (11), (17), and (25)
2749	of section 440.134, Florida Statutes, are amended to read:
2750	440.134 Workers' compensation managed care arrangement.--
2751	(1) As used in this section, the term:
2752	(d) “Grievance" means a written complaint, other than a
2753	petition for benefits, filed by the injured worker pursuant to
2754	the requirements of the managed care arrangement, expressing
2755	dissatisfaction with the medical care provided by aninsurer's
2756	workers' compensation managed care arrangement’s refusal to
2757	provide medical care or the medical care providedarrangement
2758	health care providers, expressed in writing by an injured
2759	worker.
2760	(i) "Medical care coordinator" means a primary care
2761	provider within a provider network who is responsible for
2762	managing the medical care of an injured worker including
2763	determining other health care providers and health care
2764	facilities to which the injured employee will be referred for
2765	evaluation or treatment. A medical care coordinator shall be a
2766	physician licensed under chapter 458,oran osteopathic
2767	physician licensed under chapter 459, a chiropractic physician
2768	licensed under chapter 460, or a podiatric physician licensed
2769	under chapter 461.
2770	(2)(a) The self-insured employer or carrier may, subject
2771	to the terms and limitations specified elsewhere in this section
2772	and chapter, furnish to the employee solely through managed care
2773	arrangements such medically necessary remedial treatment, care,
2774	and attendance for such period as the nature of the injury or
2775	the process of recovery requires and which shall be in
2776	accordance with practice parameters and protocols established
2777	pursuant to this chapter. For any self-insured employer or
2778	carrier who elects to deliver the medical benefits required by
2779	this chapter through a method other than a workers' compensation
2780	managed care arrangement, the discontinuance of the use of the
2781	workers' compensation managed care arrangement shall be without
2782	regard to the date of the accident, notwithstanding any other
2783	provision of law or rule.
2784	(b) The agency shall authorize an insurer to offer or
2785	utilize a workers' compensation managed care arrangement after
2786	the insurer files a completed application along with the payment
2787	of a $1,000 application fee, and upon the agency's being
2788	satisfied that the applicant has the ability to provide quality
2789	of care consistent with the prevailing professional standards of
2790	care and the insurer and its workers' compensation managed care
2791	arrangement otherwise meets the requirements of this section. No
2792	insurer may offer or utilize a managed care arrangement without
2793	such authorization. The authorization, unless sooner suspended
2794	or revoked, shall automatically expire 2 years after the date of
2795	issuance unless renewed by the insurer. The authorization shall
2796	be renewed upon application for renewal and payment of a renewal
2797	fee of $1,000, provided that the insurer is in compliance with
2798	the requirements of this section and any rules adopted
2799	hereunder. An application for renewal of the authorization shall
2800	be made 90 days prior to expiration of the authorization, on
2801	forms provided by the agency. Renewal application shall not
2802	require the resubmission of any documents previously filed with
2803	the agency if such documents have remained valid and unchanged
2804	since their original filing.
2805	(6) The proposed managed care plan of operation must
2806	include:
2807	(a) A statement or map providing a clear description of
2808	the service area.
2809	(b) A description of the grievance procedure to be used.
2810	(c) A description of the quality assurance program which
2811	assures that the health care services provided to workers shall
2812	be rendered under reasonable standards of quality of care
2813	consistent with the prevailing standards of medical practice in
2814	the medical community. The program shall include, but not be
2815	limited to:
2816	1. A written statement of goals and objectives that
2817	stresses health and return-to-work outcomes as the principal
2818	criteria for the evaluation of the quality of care rendered to
2819	injured workers.
2820	2. A written statement describing how methodology has been
2821	incorporated into an ongoing system for monitoring of care that
2822	is individual case oriented and, when implemented, can provide
2823	interpretation and analysis of patterns of care rendered to
2824	individual patients by individual providers.
2825	3. Written procedures for taking appropriate remedial
2826	action whenever, as determined under the quality assurance
2827	program, inappropriate or substandard services have been
2828	provided or services that should have been furnished have not
2829	been provided.
2830	4. A written plan, which includes ongoing review, for
2831	providing review of physicians and other licensed medical
2832	providers.
2833	5. Appropriate financial incentives to reduce service
2834	costs and utilization without sacrificing the quality of
2835	service.
2836	6. Adequate methods of peer review and utilization review.
2837	The utilization review process shall include a health care
2838	facility'sfacilitiesprecertification mechanism, including, but
2839	not limited to, all elective admissions and nonemergency
2840	surgeries and adherence to practice parameters and protocols
2841	established in accordance with this chapter.
2842	7. Provisions for resolution of disputes arising between a
2843	health care provider and an insurer regarding reimbursements and
2844	utilization review.
2845	8. Availability of a process for aggressive medical care
2846	coordination, as well as a program involving cooperative efforts
2847	by the workers, the employer, and the workers' compensation
2848	managed care arrangement to promote early return to work for
2849	injured workers.
2850	9. A written plan allowing for the independent medical
2851	examination provided for in s. 440.13(5). Notwithstanding any
2852	provision to the contrary, the costs for the independent medical
2853	examination shall be paid by the carrier if such examination is
2854	performed by a physician in the provider network. Otherwise,
2855	such costs shall be paid in accordance with s. 440.13(5). An
2856	independent medical examination requested by a claimant and paid
2857	for by the carrier shall constitute the claimant’s one
2858	independent medical examination per accident under s. 440.13(5).
2859	A process allowing employees to obtain one second medical
2860	opinion in the same specialty and within the provider network
2861	during the course of treatment for a work-related injury.
2862	10. A provision for the selection of a primary care
2863	provider by the employee from among primary providers in the
2864	provider network.
2865	11. The written information proposed to be used by the
2866	insurer to comply with subparagraph 8.
2867	(7) Written procedures to provide the insurer with timely
2868	medical records and information including, but not limited to,
2869	work status, work restrictions, date of maximum medical
2870	improvement, permanent impairment ratings, and other information
2871	as required, including information demonstrating compliance with
2872	the practice parameters and protocols of treatment established
2873	pursuant to this chapter.
2874	(8) Evidence that appropriate health care providers and
2875	administrative staff of the insurer's workers' compensation
2876	managed care arrangement have received training and education on
2877	the provisions of this chapter;andthe administrative rules
2878	that govern the provision of remedial treatment, care, and
2879	attendance of injured workers; and the practice parameters and
2880	protocols of treatment established pursuant to this chapter.
2881	(9) Written procedures and methods to prevent
2882	inappropriate or excessive treatment that are in accordance with
2883	the practice parameters and protocols of treatment established
2884	pursuant to this chapter.
2885	(10) Written procedures and methods for the management of
2886	an injured worker's medical care by a medical care coordinator
2887	including:
2888	(a) The mechanism for assuring that covered employees
2889	receive all initial covered services from a primary care
2890	provider participating in the provider network, except for
2891	emergency care.
2892	(b) The mechanism for assuring that all continuing covered
2893	services be received from the same primary care provider
2894	participating in the provider network that provided the initial
2895	covered services, except when services from another provider are
2896	authorized by the medical care coordinator pursuant to paragraph
2897	(d).
2898	(c) The policies and procedures for allowing an employee
2899	one change to another provider within the same specialty and
2900	provider network as the authorized treating physician during the
2901	course of treatment for a work-related injury, in accordance
2902	with the procedures provided in s. 440.13(2)(f), if a request is
2903	made to the medical care coordinator by the employee; and
2904	requiring that special provision be made for more than one such
2905	referral through the arrangement's grievance procedures.
2906	(d) The process for assuring that all referrals authorized
2907	by a medical care coordinator, in accordance with the practice
2908	parameters and protocols of treatment established pursuant to
2909	this chapter,are made to the participating network providers,
2910	unless medically necessary treatment, care, and attendance are
2911	not available and accessible to the injured worker in the
2912	provider network.
2913	(e) Assignment of a medical care coordinator licensed
2914	under chapter 458 or chapter 459 to manage care by physicians
2915	licensed under chapter 458 or chapter 459, a medical care
2916	coordinator licensed under chapter 460 to manage care by
2917	physicians licensed under chapter 460, and a medical care
2918	coordinator licensed under chapter 461 to manage care by
2919	physicians licensed under chapter 461 upon request by an injured
2920	employee for care by a physician licensed under chapter 458,
2921	chapter 459, chapter 460, or chapter 461.
2922	(11) A description of the use of workers' compensation
2923	practice parameters and protocols of treatmentfor health care
2924	services when adopted by the agency.
2925	(17) Notwithstanding any other provisions of this chapter,
2926	when a carrier provides medical care through a workers'
2927	compensation managed care arrangement, pursuant to this section,
2928	those workers who are subject to the arrangement must receive
2929	medical services for work-related injuries and diseases as
2930	prescribed in the contract, provided the employer and carrier
2931	have provided notice to the employees of the arrangement in a
2932	manner approved by the agency and the medical services are in
2933	accordance with the practice parameters and protocols
2934	established pursuant to this chapter. Treatment received outside
2935	the workers' compensation managed care arrangement is not
2936	compensable, regardless of the purpose of the treatment,
2937	including, but not limited to, evaluations, examinations, or
2938	diagnostic studies to determine causation between medical
2939	findings and a compensable accident, the existence or extent of
2940	impairments or disabilities, and whether the injured employee
2941	has reached maximum medical improvement,unless authorized by
2942	the carrier prior to the treatment date.
2943	(25) The agency shall adopt rules that specify:
2944	(a) Procedures for authorization and examination of
2945	workers' compensation managed care arrangements by the agency.
2946	(b) Requirements and procedures for authorization of
2947	workers' compensation arrangement provider networks and
2948	procedures for the agency to grant exceptions from accessibility
2949	of services.
2950	(c) Requirements and procedures for case management,
2951	utilization management, and peer review.
2952	(d) Requirements and procedures for quality assurance and
2953	medical records.
2954	(e) Requirements and procedures for dispute resolution in
2955	conformance with this chapter.
2956	(f) Requirements and procedures for employee and provider
2957	education.
2958	(g) Requirements and procedures for reporting data
2959	regarding grievances, return-to-work outcomes, and provider
2960	networks.
2961	Section 17. Subsections (1) and (4)and paragraph (b) of
2962	subsection (5) of section 440.14, Florida Statutes, are amended
2963	to read:
2964	440.14 Determination of pay.--
2965	(1) Except as otherwise provided in this chapter, the
2966	average weekly wages of the injured employee on the date of the
2967	accidentat the time of the injuryshall be taken as the basis
2968	upon which to compute compensation and shall be determined,
2969	subject to the limitations of s. 440.12(2), as follows:
2970	(a) If the injured employee has worked in the employment
2971	in which she or he was working on the date of the accidentat
2972	the time of the injury, whether for the same or another
2973	employer, during substantially the whole of 13 weeks immediately
2974	preceding the accidentinjury, her or his average weekly wage
2975	shall be one-thirteenth of the total amount of wages earned in
2976	such employment during the 13 weeks. As used in this paragraph,
2977	the term "substantially the whole of 13 weeks" means the
2978	calendarshall be deemed to mean and refer to a constructive
2979	period of 13 weeks as a whole, which shall be defined as the 13
2980	calendar weeks before the date of the accident, excluding the
2981	week during which the accident occurred.a consecutive period of
2982	91 days, andThe term "during substantially the whole of 13
2983	weeks" shall be deemed to mean during not less than 7590
2984	percent of the total customary full-timehours of employment
2985	within such period considered as a whole.
2986	(b) If the injured employee has not worked in such
2987	employment during substantially the whole of 13 weeks
2988	immediately preceding the accidentinjury, the wages of a
2989	similar employee in the same employment who has worked
2990	substantially the whole of such 13 weeks shall be used in making
2991	the determination under the preceding paragraph.
2992	(c) If an employee is a seasonal worker and the foregoing
2993	method cannot be fairly applied in determining the average
2994	weekly wage, then the employee may use, instead of the 13 weeks
2995	immediately preceding the accidentinjury, the calendar year or
2996	the 52 weeks immediately preceding the accidentinjury. The
2997	employee will have the burden of proving that this method will
2998	be more reasonable and fairer than the method set forth in
2999	paragraphs (a) and (b) and, further, must document prior
3000	earnings with W-2 forms, written wage statements, or income tax
3001	returns. The employer shall have 30 days following the receipt
3002	of this written proof to adjust the compensation rate, including
3003	the making of any additional payment due for prior weekly
3004	payments, based on the lower rate compensation.
3005	(d) If any of the foregoing methods cannot reasonably and
3006	fairly be applied, the full-time weekly wages of the injured
3007	employee shall be used, except as otherwise provided in
3008	paragraph (e) or paragraph (f).
3009	(e) If it is established that the injured employee was
3010	under 22 years of age when the accident occurredinjuredand
3011	that under normal conditions her or his wages should be expected
3012	to increase during the period of disability, the fact may be
3013	considered in arriving at her or his average weekly wages.
3014	(f) If it is established that the injured employee was a
3015	part-time worker on the date of the accidentat the time of the
3016	injury, that she or he had adopted part-time employment as a
3017	customary practice, and that under normal working conditions she
3018	or he probably would have remained a part-time worker during the
3019	period of disability, these factors shall be considered in
3020	arriving at her or his average weekly wages. For the purpose of
3021	this paragraph, the term "part-time worker" means an individual
3022	who customarily works less than the full-time hours or full-time
3023	workweek of a similar employee in the same employment.
3024	(g) If compensation is due for a fractional part of the
3025	week, the compensation for such fractional part shall be
3026	determined by dividing the weekly compensation rate by the
3027	number of days employed per week to compute the amount due for
3028	each day.
3029	(4) Upon termination of the employee or upon termination
3030	of the payment of fringe benefits of any employee who is
3031	collecting indemnity benefits pursuant to s. 440.15(2) or
3032	(3)(b), the employer shall within 7 days of such termination
3033	file a corrected 13-week wage statement reflecting the wages
3034	paid and the fringe benefits that had been paid to the injured
3035	employee, as provided in s. 440.02(27).
3036	(5)
3037	(b) The employee waives any entitlement to interest,
3038	penalties, and attorney's fees during the period in which the
3039	employee has not provided information concerning the loss of
3040	earnings from concurrent employment. Carriers are not subject to
3041	penalties by the division under s. 440.20(8)(b) and (c)for
3042	unpaid compensation related to concurrent employment during the
3043	period in which the employee has not provided information
3044	concerning the loss of earnings from concurrent employment.
3045	Section 18. Section 440.15, Florida Statutes, is amended
3046	to read:
3047	440.15 Compensation for disability.-- Compensation for
3048	disability shall be paid to the employee, subject to the limits
3049	provided in s. 440.12(2), as follows:
3050	(1) PERMANENT TOTAL DISABILITY.--
3051	(a) In case of total disability adjudged to be permanent,
3052	662/3 percent of the average weekly wages shall be paid to the
3053	employee during the continuance of such total disability.
3054	(b) Only A catastrophic injury as defined in s. 440.02(38)
3055	shall, in the absence of conclusive proof of a substantial
3056	earning capacity, constitute permanent total disability. In all
3057	other cases, no compensation shall be payable under paragraph
3058	(a) if the employee is engaged in, or is physically capable of
3059	engaging in, employment, including sheltered employment. In
3060	order to obtain permanent total disability benefits, the
3061	employee must establish that he or she is not able
3062	uninterruptedly to engage in any employment, including part-time
3063	sedentary employment or available sheltered employment within a
3064	50-mile radius of the employee’s residence, due to his or her
3065	physical limitation. “Sheltered employment” means work
3066	unavailable in the open labor market that is offered to the
3067	employee or that is actually performed by the employee as
3068	offered by the employer in whose employment the injured worker
3069	was engaged at the time of the accident. Such benefits shall be
3070	payable until the employee reaches age 70, notwithstanding any
3071	age limits. If the accident occurred on or after the employee
3072	reaches age 65, benefits shall be payable during the continuance
3073	of permanent total disability, not to exceed 5 years following
3074	the determination of permanent total disability.Only claimants
3075	with catastrophic injuries or claimants who are incapable of
3076	engaging in employment, including sheltered employment as
3077	described in this paragraph,are eligible for permanent total
3078	benefits. In no other case may permanent total disability be
3079	awarded.
3080	(c) In cases of permanent total disability resulting from
3081	injuries that occurred prior to July 1, 1955, such payments
3082	shall not be made in excess of 700 weeks.
3083	(d) If an employee who is being paid compensation for
3084	permanent total disability becomes rehabilitated to the extent
3085	that she or he establishes an earning capacity, the employee
3086	shall be paid, instead of the compensation provided in paragraph
3087	(a), benefits pursuant to subsection (3). The department shall
3088	adopt rules to enable a permanently and totally disabled
3089	employee who may have reestablished an earning capacity to
3090	undertake a trial period of reemployment without prejudicing her
3091	or his return to permanent total status in the case that such
3092	employee is unable to sustain an earning capacity.
3093	(e)1. The employer's or carrier's right to conduct
3094	vocational evaluations or testing by the employer's or carrier's
3095	chosen rehabilitation advisor or providerpursuant to s. 440.491
3096	continues even after the employee has been accepted or
3097	adjudicated as entitled to compensation under this chapter and
3098	costs for such evaluations and testing shall be borne by the
3099	employer or carrier, respectively. This right includes, but is
3100	not limited to, instances in which such evaluations or tests are
3101	recommended by a treating physician or independent medical-
3102	examination physician, instances warranted by a change in the
3103	employee's medical condition, or instances in which the employee
3104	appears to be making appropriate progress in recuperation. This
3105	right may not be exercised more than once every calendar year.
3106	2. The carrier must confirm the scheduling of the
3107	vocational evaluation or testing in writing, and must notify the
3108	employee and theemployee's counsel, if any, at least 7 days
3109	before the date on which vocational evaluation or testing is
3110	scheduled to occur.
3111	3. Pursuant to an order of the judge of compensation
3112	claims,The employer or carrier may withhold payment of benefits
3113	for permanent total disability or supplements for any period
3114	during which the employee willfully fails or refuses to appear
3115	without good cause for the scheduled vocational evaluation or
3116	testing.
3117	(f)1. If permanent total disability results from injuries
3118	that occurred subsequent to June 30, 1955, and for which the
3119	liability of the employer for compensation has not been
3120	discharged under s. 440.20(11), the injured employee shall
3121	receive additional weekly compensation benefits equal to 5
3122	percent of her or his weekly compensation rate, as established
3123	pursuant to the law in effect on the date of her or his injury,
3124	multiplied by the number of calendar years since the date of
3125	injury. The weekly compensation payable and the additional
3126	benefits payable under this paragraph, when combined, may not
3127	exceed the maximum weekly compensation rate in effect at the
3128	time of payment as determined pursuant to s. 440.12(2).
3129	Entitlement to These supplemental payments shall not be paid or
3130	payable after the employee attainscease at age 62, regardless
3131	of whetherif the employee has applied for or is eligible to
3132	applyis eligiblefor social security benefits under 42 U.S.C.
3133	ss. 402 and 423, whether or not the employee has applied for
3134	such benefits. These supplemental benefits shall be paid by the
3135	department out of the Workers' Compensation Administration Trust
3136	Fund when the injury occurred subsequent to June 30, 1955, and
3137	before July 1, 1984. These supplemental benefits shall be paid
3138	by the employer when the injury occurred on or after July 1,
3139	1984. Supplemental benefits are not payable for any period prior
3140	to October 1, 1974.
3141	2.a. The department shall provide by rule for the periodic
3142	reporting to the department of all earnings of any nature and
3143	social security income by the injured employee entitled to or
3144	claiming additional compensation under subparagraph 1. Neither
3145	the department nor the employer or carrier shall make any
3146	payment of those additional benefits provided by subparagraph 1.
3147	for any period during which the employee willfully fails or
3148	refuses to report upon request by the department in the manner
3149	prescribed by such rules.
3150	b. The department shall provide by rule for the periodic
3151	reporting to the employer or carrier of all earnings of any
3152	nature and social security income by the injured employee
3153	entitled to or claiming benefits for permanent total disability.
3154	The employer or carrier is not required to make any payment of
3155	benefits for permanent total disability for any period during
3156	which the employee willfully fails or refuses to report upon
3157	request by the employer or carrier in the manner prescribed by
3158	such rules or if any employee who is receiving permanent total
3159	disability benefits refuses to apply for or cooperate with the
3160	employer or carrier in applying for social security benefits.
3161	3. When an injured employee receives a full or partial
3162	lump-sum advance of the employee's permanent total disability
3163	compensation benefits, the employee's benefits under this
3164	paragraph shall be computed on the employee's weekly
3165	compensation rate as reduced by the lump-sum advance.
3166	(2) TEMPORARY TOTAL DISABILITY.--
3167	(a) Subject to subsection (7),in case of disability total
3168	in character but temporary in quality, 662/3 percent of the
3169	average weekly wages shall be paid to the employee during the
3170	continuance thereof, not to exceed 104 weeks except as provided
3171	in this subsection, s. 440.12(1), and s. 440.14(3). Once the
3172	employee reaches the maximum number of weeks allowed, or the
3173	employee reaches the date of maximum medical improvement,
3174	whichever occurs earlier, temporary disability benefits shall
3175	cease and the injured worker's permanent impairment shall be
3176	determined.
3177	(b) Notwithstanding the provisions of paragraph (a), an
3178	employee who has sustained the loss of an arm, leg, hand, or
3179	foot, has been rendered a paraplegic, paraparetic, quadriplegic,
3180	or quadriparetic, or has lost the sight of both eyes shall be
3181	paid temporary total disability of 80 percent of her or his
3182	average weekly wage. The increased temporary total disability
3183	compensation provided for in this paragraph must not extend
3184	beyond 6 months from the date of the accident; however, such
3185	benefits shall not be due or payable if the employee is eligible
3186	for, entitled to, or collecting permanent total disability
3187	benefits. The compensation provided by this paragraph is not
3188	subject to the limits provided in s. 440.12(2), but instead is
3189	subject to a maximum weekly compensation rate of $700. If, at
3190	the conclusion of this period of increased temporary total
3191	disability compensation, the employee is still temporarily
3192	totally disabled, the employee shall continue to receive
3193	temporary total disability compensation as set forth in
3194	paragraphs (a) and (c). The period of time the employee has
3195	received this increased compensation will be counted as part of,
3196	and not in addition to, the maximum periods of time for which
3197	the employee is entitled to compensation under paragraph (a) but
3198	not paragraph (c).
3199	(c) Temporary total disability benefits paid pursuant to
3200	this subsection shall include such period as may be reasonably
3201	necessary for training in the use of artificial members and
3202	appliances, and shall include such period as the employee may be
3203	receiving training and education under a program pursuant to s.
3204	440.491. Notwithstanding s. 440.02, the date of maximum medical
3205	improvement for purposes of paragraph (3)(b) shall be no earlier
3206	than the last day for which such temporary disability benefits
3207	are paid.
3208	(d) The department shall, by rule, provide for the
3209	periodic reporting to the department, employer, or carrier of
3210	all earned income, including income from social security, by the
3211	injured employee who is entitled to or claiming benefits for
3212	temporary total disability. The employer or carrier is not
3213	required to make any payment of benefits for temporary total
3214	disability for any period during which the employee willfully
3215	fails or refuses to report upon request by the employer or
3216	carrier in the manner prescribed by the rules. The rule must
3217	require the claimant to personally sign the claim form and
3218	attest that she or he has reviewed, understands, and
3219	acknowledges the foregoing.
3220	(3) PERMANENT IMPAIRMENT AND WAGE-LOSSBENEFITS.--
3221	(a) Impairment benefits.--
3222	1.Once the employee has reached the date of maximum
3223	medical improvement, impairment benefits are due and payable
3224	within 1420days after the carrier has knowledge of the
3225	impairment.
3226	(b)2.The three-member panel, in cooperation with the
3227	department, shall establish and use a uniform permanent
3228	impairment rating schedule. This schedule must be based on
3229	medically or scientifically demonstrable findings as well as the
3230	systems and criteria set forth in the American Medical
3231	Association's Guides to the Evaluation of Permanent Impairment;
3232	the Snellen Charts, published by American Medical Association
3233	Committee for Eye Injuries; and the Minnesota Department of
3234	Labor and Industry Disability Schedules. The schedule must
3235	shouldbe based upon objective findings. The schedule shall be
3236	more comprehensive than the AMA Guides to the Evaluation of
3237	Permanent Impairment and shall expand the areas already
3238	addressed and address additional areas not currently contained
3239	in the guides. On August 1, 1979, and pending the adoption, by
3240	rule, of a permanent schedule, Guides to the Evaluation of
3241	Permanent Impairment, copyright 1977, 1971, 1988, by the
3242	American Medical Association, shall be the temporary schedule
3243	and shall be used for the purposes hereof. For injuries after
3244	July 1, 1990, pending the adoption by rule of a uniform
3245	disability rating agency schedule, the Minnesota Department of
3246	Labor and Industry Disability Schedule shall be used unless that
3247	schedule does not address an injury. In such case, the Guides to
3248	the Evaluation of Permanent Impairment by the American Medical
3249	Association shall be used. Determination of permanent impairment
3250	under this schedule must be made by a physician licensed under
3251	chapter 458, a doctor of osteopathic medicine licensed under
3252	chapters 458 and 459, a chiropractic physician licensed under
3253	chapter 460, a podiatric physician licensed under chapter 461,
3254	an optometrist licensed under chapter 463, or a dentist licensed
3255	under chapter 466, as appropriate considering the nature of the
3256	injury. No other persons are authorized to render opinions
3257	regarding the existence of or the extent of permanent
3258	impairment.
3259	(c)3.All impairment income benefits shall be based on an
3260	impairment rating using the impairment schedule referred to in
3261	paragraph (b)subparagraph 2. Impairment income benefits are
3262	paid biweeklyweekly at the rate of 7550percent of the
3263	employee's average weekly temporary total disability benefit not
3264	to exceed the maximum weekly benefit under s. 440.12; provided,
3265	however, that such benefits shall be reduced by 50 percent for
3266	each week in which the employee has earned income equal to or in
3267	excess of the employee’s average weekly wage. An employee's
3268	entitlement to impairment income benefits begins the day after
3269	the employee reaches maximum medical improvement or the
3270	expiration of temporary benefits, whichever occurs earlier, and
3271	continues until the earlier of:
3272	1.a.The expiration of a period computed at the rate of 3
3273	weeks for each percentage point of impairment; or
3274	2.b.The death of the employee.
3275
3276	Impairment income benefits as defined by this subsection are
3277	payable only for impairment ratings for physical impairments. If
3278	objective medical findings can substantiate a permanent
3279	psychiatric impairment resulting from the accident, permanent
3280	impairment benefits are limited for the permanent psychiatric
3281	impairment to 1-percent permanent impairment.
3282	(d)4.After the employee has been certified by a doctor as
3283	having reached maximum medical improvement or 6 weeks before the
3284	expiration of temporary benefits, whichever occurs earlier, the
3285	certifying doctor shall evaluate the condition of the employee
3286	and assign an impairment rating, using the impairment schedule
3287	referred to in paragraph (b)subparagraph 2. Compensation is not
3288	payable for the mental, psychological, or emotional injury
3289	arising out of depression from being out of work.If the
3290	certification and evaluation are performed by a doctor other
3291	than the employee's treating doctor, the certification and
3292	evaluation must be submitted to the treating doctor, the
3293	employee, and the carrier within 10 days after the evaluation.
3294	and The treating doctor must indicate to the carrieragreement
3295	or disagreement with the other doctor’scertification and
3296	evaluation.
3297	1.The certifying doctor shall issue a written report to
3298	the department, the employee,and the carrier certifying that
3299	maximum medical improvement has been reached, stating the
3300	impairment rating to the body as a whole, and providing any
3301	other information required by the department by rule. The
3302	carrier shall establish an overall maximum medical improvement
3303	date and permanent impairment rating, based upon all such
3304	reports.
3305	2. Within 14 days after the carrier’s knowledge of each
3306	maximum medical improvement date and impairment rating to the
3307	body as a whole upon which the carrier is paying benefits, the
3308	carrier shall report such maximum medical improvement date and,
3309	when determined, the overall maximum medical improvement date
3310	and associated impairment rating to the department in a format
3311	as set forth in department rule.If the employee has not been
3312	certified as having reached maximum medical improvement before
3313	the expiration of 98102 weeks after the date temporary total
3314	disability benefits begin to accrue, the carrier shall notify
3315	the treating doctor of the requirements of this section.
3316	(e)5. The carrier shall pay the employee impairment income
3317	benefits for a period based on the impairment rating.
3318	(f)6. The department may by rule specify forms and
3319	procedures governing the method of payment of wage loss and
3320	impairment benefits under this sectionfor dates of accidents
3321	before January 1, 1994, and for dates of accidents on or after
3322	January 1, 1994.
3323	(b) Supplemental benefits.--
3324	1. All supplemental benefits must be paid in accordance
3325	with this subsection. An employee is entitled to supplemental
3326	benefits as provided in this paragraph as of the expiration of
3327	the impairment period, if:
3328	a. The employee has an impairment rating from the
3329	compensable injury of 20 percent or more as determined pursuant
3330	to this chapter;
3331	b. The employee has not returned to work or has returned
3332	to work earning less than 80 percent of the employee's average
3333	weekly wage as a direct result of the employee's impairment; and
3334	c. The employee has in good faith attempted to obtain
3335	employment commensurate with the employee's ability to work.
3336	2. If an employee is not entitled to supplemental benefits
3337	at the time of payment of the final weekly impairment income
3338	benefit because the employee is earning at least 80 percent of
3339	the employee's average weekly wage, the employee may become
3340	entitled to supplemental benefits at any time within 1 year
3341	after the impairment income benefit period ends if:
3342	a. The employee earns wages that are less than 80 percent
3343	of the employee's average weekly wage for a period of at least
3344	90 days;
3345	b. The employee meets the other requirements of
3346	subparagraph 1.; and
3347	c. The employee's decrease in earnings is a direct result
3348	of the employee's impairment from the compensable injury.
3349	3. If an employee earns wages that are at least 80 percent
3350	of the employee's average weekly wage for a period of at least
3351	90 days during which the employee is receiving supplemental
3352	benefits, the employee ceases to be entitled to supplemental
3353	benefits for the filing period. Supplemental benefits that have
3354	been terminated shall be reinstated when the employee satisfies
3355	the conditions enumerated in subparagraph 2. and files the
3356	statement required under subparagraph 4. Notwithstanding any
3357	other provision, if an employee is not entitled to supplemental
3358	benefits for 12 consecutive months, employee ceases to be
3359	entitled to any additional income benefits for the compensable
3360	injury. If the employee is discharged within 12 months after
3361	losing entitlement under this subsection, benefits may be
3362	reinstated if the employee was discharged at that time with the
3363	intent to deprive the employee of supplemental benefits.
3364	4. After the initial determination of supplemental
3365	benefits, the employee must file a statement with the carrier
3366	stating that the employee has earned less than 80 percent of the
3367	employee's average weekly wage as a direct result of the
3368	employee's impairment, stating the amount of wages the employee
3369	earned in the filing period, and stating that the employee has
3370	in good faith sought employment commensurate with the employee's
3371	ability to work. The statement must be filed quarterly on a form
3372	and in the manner prescribed by the department. The department
3373	may modify the filing period as appropriate to an individual
3374	case. Failure to file a statement relieves the carrier of
3375	liability for supplemental benefits for the period during which
3376	a statement is not filed.
3377	5. The carrier shall begin payment of supplemental
3378	benefits not later than the seventh day after the expiration
3379	date of the impairment income benefit period and shall continue
3380	to timely pay those benefits. The carrier may request a
3381	mediation conference for the purpose of contesting the
3382	employee's entitlement to or the amount of supplemental income
3383	benefits.
3384	6. Supplemental benefits are calculated quarterly and paid
3385	monthly. For purposes of calculating supplemental benefits, 80
3386	percent of the employee's average weekly wage and the average
3387	wages the employee has earned per week are compared quarterly.
3388	For purposes of this paragraph, if the employee is offered a
3389	bona fide position of employment that the employee is capable of
3390	performing, given the physical condition of the employee and the
3391	geographic accessibility of the position, the employee's weekly
3392	wages are considered equivalent to the weekly wages for the
3393	position offered to the employee.
3394	7. Supplemental benefits are payable at the rate of 80
3395	percent of the difference between 80 percent of the employee's
3396	average weekly wage determined pursuant to s. 440.14 and the
3397	weekly wages the employee has earned during the reporting
3398	period, not to exceed the maximum weekly income benefit under s.
3399	440.12.
3400	8. The department may by rule define terms that are
3401	necessary for the administration of this section and forms and
3402	procedures governing the method of payment of supplemental
3403	benefits for dates of accidents before January 1, 1994, and for
3404	dates of accidents on or after January 1, 1994.
3405	(c) Duration of temporary impairment and supplemental
3406	income benefits.-- The employee's eligibility for temporary
3407	benefits, impairment income benefits, and supplemental benefits
3408	terminates on the expiration of 401 weeks after the date of
3409	injury.
3410	(g) Notwithstanding paragraph (c), for accidents occurring
3411	on or after October 1, 2003, an employee's entitlement to
3412	impairment income benefits begins the day after the employee
3413	reaches maximum medical improvement or the expiration of
3414	temporary benefits, whichever occurs earlier, and continues for
3415	the following periods:
3416	1. Two weeks of benefits are to be paid to the employee
3417	for each percentage point of impairment from 1 percent up to and
3418	including 10 percent.
3419	2. For each percentage point of impairment from 11 percent
3420	up to and including 15 percent, 3 weeks of benefits are to be
3421	paid.
3422	3. For each percentage point of impairment from 16 percent
3423	up to and including 20 percent, 4 weeks of benefits are to be
3424	paid.
3425	4. For each percentage point of impairment from 21 percent
3426	and higher, 6 weeks of benefits are to be paid.
3427	(4) TEMPORARY PARTIAL DISABILITY.--
3428	(a) Subject to subsection (7),in case of temporary
3429	partial disability, compensation shall be equal to 80 percent of
3430	the difference between 80 percent of the employee's average
3431	weekly wage and the salary, wages, and other remuneration the
3432	employee is able to earn post injury, as compared weekly;
3433	however, the weekly temporary partial disabilitybenefits may
3434	not exceed an amount equal to 66 2/3 percent of the employee's
3435	average weekly wage at the time of accidentinjury. In order to
3436	simplify the comparison of the preinjury average weekly wage
3437	with the salary, wages, and other remuneration the employee is
3438	able to earn post injury, the department may by rule provide for
3439	payment of the initial installment of temporary partial
3440	disability benefits to be paid as a partial week so that payment
3441	for remaining weeks of temporary partial disability canthe
3442	modification of the weekly comparison so as tocoincide as
3443	closely as possible with the post injury employer’s work week
3444	injured worker's pay periods. The amount determined to be the
3445	salary, wages, and other remuneration the employee is able to
3446	earn shall in no case be less than the sum actually being earned
3447	by the employee, including earnings from sheltered employment.
3448	Benefits shall be payable under this subsection only if overall
3449	maximum medical improvement has not been reached and the medical
3450	conditions resulting from the accident create restrictions on
3451	the injured employee’s ability to return to work.
3452	(b) Within 5 business days after the carrier’s knowledge
3453	of the employee’s release to restricted work, the carrier shall
3454	mail to the employee and employer an informational letter,
3455	adopted by department rule, explaining the employee’s possible
3456	eligibility and responsibilities for temporary partial
3457	disability benefits.
3458	(c) When an employee returns to work with the restrictions
3459	resulting from the accident and is earning wages less than 80
3460	percent of the preinjury average weekly wage, the first
3461	installment of temporary partial disability benefits is due 7
3462	days after the last date of the post injury employer’s first
3463	biweekly work week. Thereafter, payment for temporary partial
3464	benefits shall be paid biweekly no later than the 7th day
3465	following the last day of each biweekly work week.
3466	(d) If the employee is unable to return to work with the
3467	restrictions resulting from the accident and is not earning
3468	wages, salary, or other remuneration, temporary partial
3469	disability benefits shall be paid no later than the last day of
3470	each biweekly period. The employee shall notify the carrier
3471	within 5 business days after returning to work. Failure to
3472	notify the carrier of the establishment of an earning capacity
3473	in the required time shall result in a suspension or nonpayment
3474	of temporary partial disability benefits until the proper
3475	notification is provided.
3476	(e)(b)Such benefits shall be paid during the continuance
3477	of such disability, not to exceed a period of 104 weeks, as
3478	provided by this subsection and subsection (2). Once the injured
3479	employee reaches the maximum number of weeks, temporary
3480	disability benefits cease and the injured worker's permanent
3481	impairment must be determined. If the employee is terminated
3482	from post injury employment based on the employee’s misconduct,
3483	temporary partial disability benefits are not payable as
3484	provided for in this section. The department shallmayby rule
3485	specify forms and procedures governing the method and time for
3486	ofpayment of temporary disability benefits for dates of
3487	accidents before January 1, 1994, and for dates of accidents on
3488	or after January 1, 1994.
3489	(5) SUBSEQUENT INJURY.--
3490	(a) The fact that an employee has suffered previous
3491	disability, impairment, anomaly, or disease, or received
3492	compensation therefor, shall not preclude her or him from
3493	benefits, as specified in paragraph (b),for a subsequent
3494	aggravation or acceleration of the preexisting condition ornor
3495	preclude benefits for death resulting therefrom, except that no
3496	benefits shall be payable if the employee, at the time of
3497	entering into the employment of the employer by whom the
3498	benefits would otherwise be payable, falsely represents herself
3499	or himself in writing as not having previously been disabled or
3500	compensated because of such previous disability, impairment,
3501	anomaly, or disease and the employer detrimentally relies on the
3502	misrepresentation. Compensation for temporary disability,
3503	medical benefits, and wage-loss benefitsshall not be subject to
3504	apportionment.
3505	(b) If a compensable injury, disability, or need for
3506	medical carepermanent impairment, or any portion thereof, is a
3507	result of aggravation or acceleration of a preexisting
3508	condition, or is the result of merger with a preexisting
3509	condition, only the disabilities and medical treatment
3510	associated with such compensable injury shall be payable under
3511	this chapter, excluding the degree of disability or medical
3512	conditions existing at the time of the impairment rating or at
3513	the time of the accident, regardless of whether the preexisting
3514	condition was disabling at the time of the accident or at the
3515	time of the impairment rating and without considering whether
3516	the preexisting condition would be disabling without the
3517	compensable accidentimpairment, an employee eligible to receive
3518	impairment benefits under paragraph (3)(a) shall receive such
3519	benefits for the total impairment found to result, excluding the
3520	degree of impairment existing at the time of the subject
3521	accident or injury or which would have existed by the time of
3522	the impairment rating without the intervention of the
3523	compensable accident or injury. The degree of permanent
3524	impairment or disabilityattributable to the accident or injury
3525	shall be compensated in accordance with this section,
3526	apportioning out the preexisting condition based on the
3527	anatomical impairment rating attributable to the preexisting
3528	condition. Medical benefits shall be paid apportioning out the
3529	percentage of the need for such care attributable to the
3530	preexisting conditionparagraph (3)(a). As used in this
3531	paragraph, "merger" means the combining of a preexisting
3532	permanent impairment or disabilitywith a subsequent compensable
3533	permanent impairment or disabilitywhich, when the effects of
3534	both are considered together, result in a permanent impairment
3535	or disabilityrating which is greater than the sum of the two
3536	permanent impairment or disability ratings when each impairment
3537	or disability is considered individually.
3538	(6) OBLIGATION TO REHIRE.-- If the employer has not in
3539	good faith made available to the employee, within a 100-mile
3540	radius of the employee's residence, work appropriate to the
3541	employee's physical limitations within 30 days after the carrier
3542	notifies the employer of maximum medical improvement and the
3543	employee's physical limitations, the employer shall pay to the
3544	department for deposit into the Workers' Compensation
3545	Administration Trust Fund a fine of $250 for every $5,000 of the
3546	employer's workers' compensation premium or payroll, not to
3547	exceed $2,000 per violation, as the department requires by rule.
3548	The employer is not subject to this subsection if the employee
3549	is receiving permanent total disability benefits or if the
3550	employer has 50 or fewer employees.
3551	(6)(7)EMPLOYEE REFUSES EMPLOYMENT.--If an injured
3552	employee refuses employment suitable to the capacity thereof,
3553	offered to or procured therefor, such employee shall not be
3554	entitled to any compensation at any time during the continuance
3555	of such refusal unless at any time in the opinion of the judge
3556	of compensation claims such refusal is justifiable. Time periods
3557	for the payment of benefits in accordance with this section
3558	shall be counted in determining the limitation of benefits as
3559	provided for in paragraphs (2)(a), (3)(c), and (4)(b).
3560	(7)(8)EMPLOYEE LEAVES EMPLOYMENT.-- If an injured
3561	employee, when receiving compensation for temporary partial
3562	disability, leaves the employment of the employer by whom she or
3563	he was employed at the time of the accident for which such
3564	compensation is being paid, the employee shall, upon securing
3565	employment elsewhere, give to such former employer an affidavit
3566	in writing containing the name of her or his new employer, the
3567	place of employment, and the amount of wages being received at
3568	such new employment; and, until she or he gives such affidavit,
3569	the compensation for temporary partial disability will cease.
3570	The employer by whom such employee was employed at the time of
3571	the accident for which such compensation is being paid may also
3572	at any time demand of such employee an additional affidavit in
3573	writing containing the name of her or his employer, the place of
3574	her or his employment, and the amount of wages she or he is
3575	receiving; and if the employee, upon such demand, fails or
3576	refuses to make and furnish such affidavit, her or his right to
3577	compensation for temporary partial disability shall cease until
3578	such affidavit is made and furnished. If the employee leaves her
3579	or his employment while receiving temporary partial benefits
3580	without just cause as determined by the judge of compensation
3581	claims, temporary partial benefits shall be payable based on the
3582	deemed earnings of the employee as if she or he had remained
3583	employed.
3584	(8)(9)EMPLOYEE BECOMES INMATE OF INSTITUTION.--In case an
3585	employee becomes an inmate of a public institution, then no
3586	compensation shall be payable unless she or he has dependent
3587	upon her or him for support a person or persons defined as
3588	dependents elsewhere in this chapter, whose dependency shall be
3589	determined as if the employee were deceased and to whom
3590	compensation would be paid in case of death; and such
3591	compensation as is due such employee shall be paid such
3592	dependents during the time she or he remains such inmate.
3593	(9)(10)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER
3594	AND FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE ACT.--
3595	(a) Weekly compensation benefits payable under this
3596	chapter for disability resulting from injuries to an employee
3597	who becomes eligible for benefits under 42 U.S.C. s. 423 shall
3598	be reduced to an amount whereby the sum of such compensation
3599	benefits payable under this chapter and such total benefits
3600	otherwise payable for such period to the employee and her or his
3601	dependents, had such employee not been entitled to benefits
3602	under this chapter, under 42 U.S.C. ss. 402 and 423, does not
3603	exceed 80 percent of the employee's average weekly wage.
3604	However, this provision shall not operate to reduce an injured
3605	worker's benefits under this chapter to a greater extent than
3606	such benefits would have otherwise been reduced under 42 U.S.C.
3607	s. 424(a). This reduction of compensation benefits is not
3608	applicable to any compensation benefits payable for any week
3609	subsequent to the week in which the injured worker reaches the
3610	age of 62 years.
3611	(b) If the provisions of 42 U.S.C. s. 424(a) are amended
3612	to provide for a reduction or increase of the percentage of
3613	average current earnings that the sum of compensation benefits
3614	payable under this chapter and the benefits payable under 42
3615	U.S.C. ss. 402 and 423 can equal, the amount of the reduction of
3616	benefits provided in this subsection shall be reduced or
3617	increased accordingly. The department may by rule specify forms
3618	and procedures governing the method for calculating and
3619	administering the offset of benefits payable under this chapter
3620	and benefits payable under 42 U.S.C. ss. 402 and 423. The
3621	department shall have first priority in taking any available
3622	social security offsets on dates of accidents occurring before
3623	July 1, 1984.
3624	(c) No disability compensation benefits payable for any
3625	week, including those benefits provided by paragraph (1)(f),
3626	shall be reduced pursuant to this subsection until the Social
3627	Security Administration determines the amount otherwise payable
3628	to the employee under 42 U.S.C. ss. 402 and 423 and the employee
3629	has begun receiving such social security benefit payments. The
3630	employee shall, upon demand by the department, the employer, or
3631	the carrier, authorize the Social Security Administration to
3632	release disability information relating to her or him and
3633	authorize the Division of Unemployment Compensation to release
3634	unemployment compensation information relating to her or him, in
3635	accordance with rules to be adopted by the department
3636	prescribing the procedure and manner for requesting the
3637	authorization and for compliance by the employee. Neither the
3638	department nor the employer or carrier shall make any payment of
3639	benefits for total disability or those additional benefits
3640	provided by paragraph (1)(f) for any period during which the
3641	employee willfully fails or refuses to authorize the release of
3642	information in the manner and within the time prescribed by such
3643	rules. The authority for release of disability information
3644	granted by an employee under this paragraph shall be effective
3645	for a period not to exceed 12 months, such authority to be
3646	renewable as the department may prescribe by rule.
3647	(d) If compensation benefits are reduced pursuant to this
3648	subsection, the minimum compensation provisions of s. 440.12(2)
3649	do not apply.
3650	(10)(11)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER
3651	WHO HAS RECEIVED OR IS ENTITLED TO RECEIVE UNEMPLOYMENT
3652	COMPENSATION.--
3653	(a) No compensation benefits shall be payable for
3654	temporary total disability or permanent total disability under
3655	this chapter for any week in which the injured employee has
3656	received, or is receiving, unemployment compensation benefits.
3657	(b) If an employee is entitled to temporary partial
3658	benefits pursuant to subsection (4) and unemployment
3659	compensation benefits, such unemployment compensation benefits
3660	shall be primary and the temporary partial benefits shall be
3661	supplemental only, the sum of the two benefits not to exceed the
3662	amount of temporary partial benefits which would otherwise be
3663	payable.
3664	(11)(12)FULL-PAY STATUS FOR CERTAIN LAW ENFORCEMENT
3665	OFFICERS.--Any law enforcement officer as defined in s.
3666	943.10(1), (2), or (3) who, while acting within the course of
3667	employment as provided by s. 440.091, is maliciously or
3668	intentionally injured and who thereby sustains a job-connected
3669	disability compensable under this chapter shall be carried in
3670	full-pay status rather than being required to use sick, annual,
3671	or other leave. Full-pay status shall be granted only after
3672	submission to the employing agency's head of a medical report
3673	which gives a current diagnosis of the employee's recovery and
3674	ability to return to work. In no case shall the employee's
3675	salary and workers' compensation benefits exceed the amount of
3676	the employee's regular salary requirements.
3677	(12)(13)REPAYMENT.--If an employee has received a sum as
3678	an indemnity benefit under any classification or category of
3679	benefit under this chapter to which she or he is not entitled,
3680	the employee is liable to repay that sum to the employer or the
3681	carrier or to have that sum deducted from future benefits,
3682	regardless of the classification of benefits, payable to the
3683	employee under this chapter; however, a partial payment of the
3684	total repayment may not exceed 20 percent of the amount of the
3685	biweekly payment.
3686	Section 19. Subsections (1), (2), and (3) of section
3687	440.151, Florida Statutes, are amended to read:
3688	440.151 Occupational diseases.--
3689	(1)(a) Where the employer and employee are subject to the
3690	provisions of the Workers' Compensation Law, the disablement or
3691	death of an employee resulting from an occupational disease as
3692	hereinafter defined shall be treated as the happening of an
3693	injury by accident, notwithstanding any other provisions of this
3694	chapter, and the employee or, in case of death, the employee's
3695	dependents shall be entitled to compensation as provided by this
3696	chapter, except as hereinafter otherwise provided; and the
3697	practice and procedure prescribed by this chapter shall apply to
3698	all proceedings under this section, except as hereinafter
3699	otherwise provided. Provided, however, that in no case shall an
3700	employer be liable for compensation under the provisions of this
3701	section unless such disease has resulted from the nature of the
3702	employment in which the employee was engaged under such
3703	employer,and was actually contracted while so engaged, and the
3704	nature of the employment was the major contributing cause of the
3705	disease. Major contributing cause must be shown by medical
3706	evidence only, as demonstrated by physical examination findings
3707	and diagnostic testing.meaning by "Nature of the employment"
3708	means that intothe occupation in which the employee was so
3709	engaged there is attached a particular hazard of such disease
3710	that distinguishes it from the usual run of occupations, or the
3711	incidence of such disease is substantially higher in the
3712	occupation in which the employee was so engaged than in the
3713	usual run of occupations. In claims for death under s. 440.16,
3714	death must occuror, in case of death, unless death follows
3715	continuous disability from such disease, commencing within the
3716	period above limited, for which compensation has been paid or
3717	awarded, or timely claim made as provided in this section, and
3718	results within 350 weeks after such last exposure. Both
3719	causation and sufficient exposure to a specific harmful
3720	substance shown to be present in the workplace to support
3721	causation shall be proven by clear and convincing evidence.
3722	(b) No compensation shall be payable for an occupational
3723	disease if the employee, at the time of entering into the
3724	employment of the employer by whom the compensation would
3725	otherwise be payable, falsely represents herself or himself in
3726	writing as not having previously been disabled, laid off or
3727	compensated in damages or otherwise, because of such disease.
3728	(c) Where an occupational disease is aggravated by any
3729	other disease or infirmity, not itself compensable, or where
3730	disability or death from any other cause, not itself
3731	compensable, is aggravated, prolonged, accelerated or in anywise
3732	contributed to by an occupational disease, the compensation
3733	shall be payable only if the occupational disease is the major
3734	contributing cause of the injury. Any compensationshall be
3735	reduced and limited to such proportion only of the compensation
3736	that would be payable if the occupational disease were the sole
3737	cause of the disability or death as such occupational disease,
3738	as a causative factor, bears to all the causes of such
3739	disability or death, such reduction in compensation to be
3740	effected by reducing the number of weekly or monthly payments or
3741	the amounts of such payments, as under the circumstances of the
3742	particular case may be for the best interest of the claimant or
3743	claimants. Major contributing cause must be demonstrated by
3744	medical evidence based on physical examination findings and
3745	diagnostic testing.
3746	(d) No compensation for death from an occupational disease
3747	shall be payable to any person whose relationship to the
3748	deceased, which under the provisions of this Workers'
3749	Compensation Law would give right to compensation, arose
3750	subsequent to the beginning of the first compensable disability,
3751	save only to afterborn children of a marriage existing at the
3752	beginning of such disability.
3753	(e) No compensation shall be payable for disability or
3754	death resulting from tuberculosis arising out of and in the
3755	course of employment by the Department of Health at a state
3756	tuberculosis hospital, or aggravated by such employment, when
3757	the employee had suffered from said disease at any time prior to
3758	the commencement of such employment.
3759	(2) Whenever used in this section the term "occupational
3760	disease" shall be construed to mean only a disease which is due
3761	to causes and conditions which are characteristic of and
3762	peculiar to a particular trade, occupation, process, or
3763	employment, and to exclude all ordinary diseases of life to
3764	which the general public is exposed, unless the incidence of the
3765	disease is substantially higher in the particular trade,
3766	occupation, process, or employment than for the general public.
3767	“Occupational disease” means only a disease for which there are
3768	epidemiological studies showing that exposure to the specific
3769	substance involved, at the levels to which the employee was
3770	exposed, may cause the precise disease sustained by the
3771	employee.
3772	(3) Except as hereinafterotherwise provided in this
3773	section, "disablement" means disability as described in s.
3774	440.02(13)the event of an employee's becoming actually
3775	incapacitated, partially or totally, because of an occupational
3776	disease, from performing her or his work in the last occupation
3777	in which injuriously exposed to the hazards of such disease; and
3778	"disability" means the state of being so incapacitated.
3779	Section 20. Subsections (1) and (7) of section 440.16,
3780	Florida Statutes, are amended to read:
3781	440.16 Compensation for death.--
3782	(1) If death results from the accident within 1 year
3783	thereafter or follows continuous disability and results from the
3784	accident within 5 years thereafter, the employer shall pay:
3785	(a) Within 14 days after receiving the bill, actual
3786	funeral expenses not to exceed $7,500$5,000.
3787	(b) Compensation, in addition to the above, in the
3788	following percentages of the average weekly wages to the
3789	following persons entitled thereto on account of dependency upon
3790	the deceased, and in the following order of preference, subject
3791	to the limitation provided in subparagraph 2., but such
3792	compensation shall be subject to the limits provided in s.
3793	440.12(2), shall not exceed $150,000$100,000, and may be less
3794	than, but shall not exceed, for all dependents or persons
3795	entitled to compensation, 662/3 percent of the average wage:
3796	1. To the spouse, if there is no child, 50 percent of the
3797	average weekly wage, such compensation to cease upon the
3798	spouse's death.
3799	2. To the spouse, if there is a child or children, the
3800	compensation payable under subparagraph 1. and, in addition,
3801	162/3 percent on account of the child or children. However, when
3802	the deceased is survived by a spouse and also a child or
3803	children, whether such child or children are the product of the
3804	union existing at the time of death or of a former marriage or
3805	marriages, the judge of compensation claims may provide for the
3806	payment of compensation in such manner as may appear to the
3807	judge of compensation claims just and proper and for the best
3808	interests of the respective parties and, in so doing, may
3809	provide for the entire compensation to be paid exclusively to
3810	the child or children; and, in the case of death of such spouse,
3811	331/3 percent for each child. However, upon the surviving
3812	spouse's remarriage, the spouse shall be entitled to a lump-sum
3813	payment equal to 26 weeks of compensation at the rate of 50
3814	percent of the average weekly wage as provided in s. 440.12(2),
3815	unless the $150,000$100,000limit provided in this paragraph is
3816	exceeded, in which case the surviving spouse shall receive a
3817	lump-sum payment equal to the remaining available benefits in
3818	lieu of any further indemnity benefits. In no case shall a
3819	surviving spouse's acceptance of a lump-sum payment affect
3820	payment of death benefits to other dependents.
3821	3. To the child or children, if there is no spouse, 331/3
3822	percent for each child.
3823	4. To the parents, 25 percent to each, such compensation
3824	to be paid during the continuance of dependency.
3825	5. To the brothers, sisters, and grandchildren, 15 percent
3826	for each brother, sister, or grandchild.
3827	(c) To the surviving spouse, payment of postsecondary
3828	student fees for instruction at any area technical center
3829	established under s. 1001.44 for up to 1,800 classroom hours or
3830	payment of student fees at any community college established
3831	under part III of chapter 1004 for up to 80 semester hours. The
3832	spouse of a deceased state employee shall be entitled to a full
3833	waiver of such fees as provided in ss. 1009.22 and 1009.23 in
3834	lieu of the payment of such fees. The benefits provided for in
3835	this paragraph shall be in addition to other benefits provided
3836	for in this section and shall terminate 7 years after the death
3837	of the deceased employee, or when the total payment in eligible
3838	compensation under paragraph (b) has been received. To qualify
3839	for the educational benefit under this paragraph, the spouse
3840	shall be required to meet and maintain the regular admission
3841	requirements of, and be registered at, such area technical
3842	center or community college, and make satisfactory academic
3843	progress as defined by the educational institution in which the
3844	student is enrolled.
3845	(7) Compensation under this chapter to aliens not
3846	residents (or about to become nonresidents) of the United States
3847	or Canada shall be the same in amount as provided for residents,
3848	except that dependents in any foreign country shall be limited
3849	to surviving spouse and child or children, or if there be no
3850	surviving spouse or child or children, to surviving father or
3851	mother whom the employee has supported, either wholly or in
3852	part, for the period of 1 year prior to the date of the injury,
3853	and except that the judge of compensation claims may, at the
3854	option of the judge of compensation claims, or upon the
3855	application of the insurance carrier, commute all future
3856	installments of compensation to be paid to such aliens by paying
3857	or causing to be paid to them one-half of the commuted amount of
3858	such future installments of compensation as determined by the
3859	judge of compensation claims, and provided further that
3860	compensation to dependents referred to in this subsection shall
3861	in no case exceed $75,000$50,000.
3862	Section 21. Subsection (9) of section 440.185, Florida
3863	Statutes, is amended, and subsection (12) is added to said
3864	section, to read:
3865	440.185 Notice of injury or death; reports; penalties for
3866	violations.--
3867	(9) Any employer or carrier who fails or refuses to timely
3868	send any form, report, or notice required by this section shall
3869	be subject to an administrative fine by the departmenta civil
3870	penalty not to exceed $1,000$500for each such failure or
3871	refusal. If, within 1 calendar year, an employer fails to timely
3872	submit to the carrier more than 10 percent of its notices of
3873	injury or death, the employer shall be subject to an
3874	administrative fine by the department not to exceed $2,000 for
3875	each such failure or refusal.However, any employer who fails to
3876	notify the carrier of the injury on the prescribed form or by
3877	letter within the 7 days required in subsection (2) shall be
3878	liable for the administrative finecivil penalty, which shall be
3879	paid by the employer and not the carrier. Failure by the
3880	employer to meet its obligations under subsection (2) shall not
3881	relieve the carrier from liability for the administrative fine
3882	civil penaltyif it fails to comply with subsections (4) and
3883	(5).
3884	(12) Upon receiving notice of an injury from an employee
3885	under subsection (1), the employer or carrier shall provide the
3886	employee with a written notice, in the form and manner
3887	determined by the department by rule, of the availability of
3888	services from the Employee Assistance and Ombudsman Office. The
3889	substance of the notice to the employee shall include:
3890	(a) A description of the scope of services provided by the
3891	office.
3892	(b) A listing of the toll-free telephone number of, the
3893	email address, and the postal address of the office.
3894	(c) A statement that the informational brochure referred
3895	to in subsection (4) will be mailed to the employee within 3
3896	days after the carrier receives notice of the injury.
3897	(d) Any other information regarding access to assistance
3898	that the department finds is immediately necessary for an
3899	injured employee.
3900	Section 22. Subsections (1) and (2) of section 440.192,
3901	Florida Statutes, are amended, and subsection (9) is added to
3902	said section, to read:
3903	440.192 Procedure for resolving benefit disputes.—
3904	(1) Subject to s. 440.191, Any employee may, for any
3905	benefit that is ripe, due, and owing,who has not received a
3906	benefit to which the employee believes she or he is entitled
3907	under this chapter shallfile by certified mail, or by
3908	electronic means approved by the Deputy Chief Judge, with the
3909	Office of the Judges of Compensation Claims a petition for
3910	benefits which meets the requirements of this section and the
3911	definition of specificity in s. 440.02. The department shall
3912	inform employees of the location of the Office of the Judges of
3913	Compensation Claims for purposes of filing a petition for
3914	benefits. The employee shall also serve copies of the petition
3915	for benefits by certified mail, or by electronic means approved
3916	by the Deputy Chief Judge, upon the employer and the employer's
3917	carrier. The DeputyChief Judge shall refer the petitions to the
3918	judges of compensation claims.
3919	(2) Upon receipt, the Office of the Judges of Compensation
3920	Claims shall review each petition and shall dismiss each
3921	petition or any portion of such a petition, upon the judge's own
3922	motion or upon the motion of any party,that does not on its
3923	face specifically identify or itemize the following:
3924	(a) Name, address, telephone number, and social security
3925	number of the employee.
3926	(b) Name, address, and telephone number of the employer.
3927	(c) A detailed description of the injury and cause of the
3928	injury, including the location of the occurrence and the date or
3929	dates of the accident.
3930	(d) A detailed description of the employee's job, work
3931	responsibilities, and work the employee was performing when the
3932	injury occurred.
3933	(e) The time period for which compensation and the
3934	specific classification of compensation were not timely
3935	provided.
3936	(f) Date of maximum medical improvement, character of
3937	disability, specific statement of all benefits or compensation
3938	that the employee is seeking.
3939	(g) All specific travel costs to which the employee
3940	believes she or he is entitled, including dates of travel and
3941	purpose of travel, means of transportation, and mileage and
3942	including the date the request for mileage was filed with the
3943	carrier and a copy of the request filed with the carrier.
3944	(h) Specific listing of all medical charges alleged
3945	unpaid, including the name and address of the medical provider,
3946	the amounts due, and the specific dates of treatment.
3947	(i) The type or nature of treatment care or attendance
3948	sought and the justification for such treatment. If the employee
3949	is under the care of a physician for an injury identified under
3950	paragraph (c), a copy of the physician’s request, authorization,
3951	or recommendation for treatment, care, or attendance must
3952	accompany the petition.
3953	(j) Specific explanation of any other disputed issue that
3954	a judge of compensation claims will be called to rule upon.
3955
3956	The dismissal of any petition or portion of such a petition
3957	under this section is without prejudice and does not require a
3958	hearing.
3959	(9) A petition for benefits must contain claims for all
3960	benefits that are ripe, due, and owing on the date the petition
3961	is filed. Unless stipulated in writing by the parties, only
3962	claims which have been properly raised in a petition for
3963	benefits and have undergone mediation may be considered for
3964	adjudication by a judge of compensation claims.
3965	Section 23. Section 440.1926, Florida Statutes, is created
3966	to read:
3967	440.1926 Alternate dispute resolution; claim
3968	arbitration.--Notwithstanding any other provision of this
3969	chapter, the employer, carrier, and employee may mutually agree
3970	to seek consent from a judge of compensation claims to enter
3971	into binding claim arbitration in lieu of any other remedy
3972	provided for in this chapter to resolve all issues in dispute
3973	regarding an injury. Arbitrations agreed to pursuant to this
3974	section shall be governed by chapter 682, the Florida
3975	Arbitration Code, except that, notwithstanding any provision in
3976	chapter 682, the term “court” shall mean a judge of compensation
3977	claims. An arbitration award in accordance with this section
3978	shall be enforceable in the same manner and with the same powers
3979	as any final compensation order.
3980	Section 24. Subsections (2), (3), (4), (6), and (8) and
3981	paragraph (d) of subsection (11) of section 440.20, Florida
3982	Statutes, are amended to read:
3983	440.20 Time for payment of compensation and medical bills;
3984	penalties for late payment.--
3985	(2)(a)The carrier must pay the first installment of
3986	compensation for total disability or death benefitsor deny
3987	compensability no later than the 14th calendarday after the
3988	employer receives notificationnotice of the injury or death,
3989	when disability is immediate and continuous for 8 calendar days
3990	or more after the injury. If the first 7 days after disability
3991	are nonconsecutive or delayed, the first installment of
3992	compensation is due on the 6th day after the first 8 calendar
3993	days of disability.The carrier shall thereafter pay
3994	compensation in biweekly installments or as otherwise provided
3995	in s. 440.15, unless the judge of compensation claims determines
3996	or the parties agree that an alternate installment schedule is
3997	in the best interests of the employee.
3998	(b) The carrier must pay, disallow, or deny all medical,
3999	dental, pharmacy, and hospital bills submitted to the carrier in
4000	accordance with department rule no later than 45 calendar days
4001	after the carrier’s receipt of the bill.
4002	(3) Upon making initial payment of indemnity benefits, or
4003	upon suspension or cessation of payment for any reason, the
4004	carrier shall immediately notify the injured employee, the
4005	employer, and thedepartment that it has commenced, suspended,
4006	or ceased payment of compensation. The department may require
4007	such notification to the injured employee, employer, and the
4008	department in aanyformat and manner it deems necessary to
4009	obtain accurate and timely notificationreporting.
4010	(4) If the carrier is uncertain of its obligation to
4011	provide all benefits or compensation, it may initiate payment
4012	without prejudice and without admitting liability. the carrier
4013	shall immediately and in good faith commence investigation of
4014	the employee's entitlement to benefits under this chapter and
4015	shall admit or deny compensability within 120 days after the
4016	initial provision of compensation or benefits as required under
4017	subsection (2) or s. 440.192(8). Additionally, the carrier shall
4018	initiate payment and continue the provision of all benefits and
4019	compensation as if the claim had been accepted as compensable,
4020	without prejudice and without admitting liability.Upon
4021	commencement of payment as required under subsection (2) or s.
4022	440.192 (8), the carrier shall provide written notice to the
4023	employee that itis has elected to pay all or part ofthe claim
4024	pending further investigation, and that it will advise the
4025	employee of claim acceptance or denial within 120 days. A
4026	carrier that fails to deny compensability within 120 days after
4027	the initial provision of benefits or payment of compensation as
4028	required under subsection (2) or s. 440.192(8) waives the right
4029	to deny compensability, unless the carrier can establish
4030	material facts relevant to the issue of compensability that it
4031	could not have discovered through reasonable investigation
4032	within the 120-day period. The initial provision of compensation
4033	or benefits, for purposes of this subsection, means the first
4034	installment of compensation or benefits to be paid by the
4035	carrier under subsection (2) or pursuant to a petition for
4036	benefits under s. 440.192(8).
4037	(6)(a)If any installment of compensation for death or
4038	dependency benefits, or compensation for disability benefits,
4039	permanent impairment, or wage losspayable without an award is
4040	not paid within 7 days after it becomes due, as provided in
4041	subsection (2), subsection (3), or subsection (4), there shall
4042	be added to such unpaid installment a punitivepenalty of an
4043	amount equal to 20 percent of the unpaid installment or $5,
4044	which shall be paid at the same time as, but in addition to,
4045	such installment of compensation. This penalty shall not apply
4046	for late payments resulting, unless notice is filed under
4047	subsection (4) or unless such nonpayment resultsfrom conditions
4048	over which the employer or carrier had no control. When any
4049	installment of compensation payable without an award has not
4050	been paid within 7 days after it became due and the claimant
4051	concludes the prosecution of the claim before a judge of
4052	compensation claims without having specifically claimed
4053	additional compensation in the nature of a penalty under this
4054	section, the claimant will be deemed to have acknowledged that,
4055	owing to conditions over which the employer or carrier had no
4056	control, such installment could not be paid within the period
4057	prescribed for payment and to have waived the right to claim
4058	such penalty. However, during the course of a hearing, the judge
4059	of compensation claims shall on her or his own motion raise the
4060	question of whether such penalty should be awarded or excused.
4061	The department may assess without a hearing the punitivepenalty
4062	against either the employer or the insurancecarrier, depending
4063	upon who was at fault in causing the delay. The insurance policy
4064	cannot provide that this sum will be paid by the carrier if the
4065	department or the judge of compensation claims determines that
4066	the punitive penalty should be paidmadeby the employer rather
4067	than the carrier. Any additional installment of compensation
4068	paid by the carrier pursuant to this section shall be paid
4069	directly to the employee by check or, if authorized by the
4070	employee, by direct deposit into the employee's account at a
4071	financial institution. As used in this subsection, the term
4072	"financial institution" means a financial institution as defined
4073	in s. 655.005(1)(h).
4074	(b) For medical services provided on or after January 1,
4075	2004, the department shall require that all medical, hospital,
4076	pharmacy, or dental bills properly submitted by the provider,
4077	except for bills that are disallowed or denied by the carrier or
4078	its authorized vendor in accordance with department rule, are
4079	timely paid within 45 calendar days after the carrier’s receipt
4080	of the bill. The department shall impose penalties for late
4081	payments or disallowances or denials of medical, hospital,
4082	pharmacy, or dental bills that are below a minimum 95 percent
4083	timely performance standard. The carrier shall pay to the
4084	Workers’ Compensation Administration Trust Fund a penalty of:
4085	1. Twenty-five dollars for each bill below the 95 percent
4086	timely performance standard, but meeting a 90 percent timely
4087	standard.
4088	2. Fifty dollars for each bill below a 90 percent timely
4089	performance standard.
4090	(8)(a)In addition to any other penalties provided by this
4091	chapter for late payment, if any installment of compensation is
4092	not paid when it becomes due, the employer, carrier, or
4093	servicing agent shall pay interest thereon at the rate of 12
4094	percent per year from the date the installment becomes due until
4095	it is paid, whether such installment is payable without an order
4096	or terms of an order. The interest payment shall be the greater
4097	of the amount due or $5.
4098	(a) Within 30 days after final payment of compensation has
4099	been made, the employer, carrier, or servicing agent shall send
4100	to the department a notice, in accordance with a format and
4101	manner prescribed by the department, stating that such final
4102	payment has been made and stating the total amount of
4103	compensation paid, the name of the employee and of any other
4104	person to whom compensation has been paid, the date of the
4105	injury or death, and the date to which compensation has been
4106	paid.
4107	(b) If the employer, carrier, or servicing agent fails to
4108	so notify the department within such time, the department shall
4109	assess against such employer, carrier, or servicing agent a
4110	civil penalty in an amount not over $100.
4111	(b)(c)In order to ensure carrier compliance under this
4112	chapter and provisions of the Insurance Code, the department
4113	shall monitor, audit, and investigatethe performance of
4114	carriers by conducting market conduct examinations, as provided
4115	in s. 624.3161, and conducting investigations, as provided in s.
4116	624.317. The department shall requireestablish by rule a
4117	minimum performance standards for carriers to ensure that a
4118	minimum of 90 percent ofall compensation benefits are timely
4119	paid in accordance with this section. The department shall
4120	impose penaltiesfine a carrier as provided in s. 440.13(11)(b)
4121	up to $50 for each late paymentspayment of compensation that
4122	areis below athe minimum 9590 percent timely payment
4123	performance standard. The carrier shall pay to the Workers’
4124	Compensation Administration Trust Fund a penalty of:
4125	1. Fifty dollars per number of installments of
4126	compensation below the 95 percent timely payment performance
4127	standard and equal to or greater than a 90 percent timely
4128	payment performance standard.
4129	2. One hundred dollars per number of installments of
4130	compensation below a 90 percent timely payment performance
4131	standard.
4132
4133	This section does not affect the imposition of any penalties or
4134	interest due to the claimant. If a carrier contracts with a
4135	servicing agent to fulfill its administrative responsibilities
4136	under this chapter, the payment practices of the servicing agent
4137	are deemed the payment practices of the carrier for the purpose
4138	of assessing penalties against the carrier.
4139	(11)
4140	(d)1. With respect to any lump-sum settlement under this
4141	subsection, a judge of compensation claims must consider at the
4142	time of the settlement, whether the settlement allocation
4143	provides for the appropriate recovery of child support
4144	arrearages. An employer or carrier does not have a duty to
4145	investigate or collect information regarding child support
4146	arrearages.
4147	2. When reviewing any settlement of lump-sum payment
4148	pursuant to this subsection, judges of compensation claims shall
4149	consider the interests of the worker and the worker's family
4150	when approving the settlement, which must consider and provide
4151	for appropriate recovery of past due support.
4152	Section 25. Section 440.25, Florida Statutes, is amended
4153	to read:
4154	440.25 Procedures for mediation and hearings.--
4155	(1) Forty daysWithin 90 daysafter a petition for
4156	benefits is filed under s. 440.192, a mediation conference
4157	concerning such petition shall be held. Within 40 days after
4158	such petition is filed,the judge of compensation claims shall
4159	notify the interested parties by order that a mediation
4160	conference concerning such petition has been scheduledwill be
4161	held unless the parties have notified the judgeOffice of the
4162	Judges of compensation claims that a privatemediation has been
4163	held or is scheduled to be held. A mediation, whether private
4164	or public, shall be held within 130 days after the filing of the
4165	petition. Such order must give the date by whichthe mediation
4166	conference is tomustbe held. Such order may be served
4167	personally upon the interested parties or may be sent to the
4168	interested parties by mail. If multiple petitions are pending,
4169	or if additional petitions are filed after the scheduling of a
4170	mediation, the judge of compensation claims shall consolidate
4171	all petitions into one mediation.The claimant or the adjuster
4172	of the employer or carrier may, at the mediator's discretion,
4173	attend the mediation conference by telephone or, if agreed to by
4174	the parties, other electronic means. A continuance may be
4175	granted upon the agreement of the parties orif the requesting
4176	party demonstrates to the judge of compensation claims that the
4177	reason for requesting the continuance arises from circumstances
4178	beyond the party's control. Any order granting a continuance
4179	must set forth the date of the rescheduled mediation conference.
4180	A mediation conference may not be used solely for the purpose of
4181	mediating attorney's fees.
4182	(2) Any party who participates in a mediation conference
4183	shall not be precluded from requesting a hearing following the
4184	mediation conference should both parties not agree to be bound
4185	by the results of the mediation conference. A mediation
4186	conference is required to be held unless this requirement is
4187	waived by the Deputy Chief Judge. No later than 3 days prior to
4188	the mediation conference, all parties must submit any applicable
4189	motions, including, but not limited to, a motion to waive the
4190	mediation conference, to the judge of compensation claims.
4191	(3)(a)Such mediation conference shall be conducted
4192	informally and does not require the use of formal rules of
4193	evidence or procedure. Any information from the files, reports,
4194	case summaries, mediator's notes, or other communications or
4195	materials, oral or written, relating to a mediation conference
4196	under this section obtained by any person performing mediation
4197	duties is privileged and confidential and may not be disclosed
4198	without the written consent of all parties to the conference.
4199	Any research or evaluation effort directed at assessing the
4200	mediation program activities or performance must protect the
4201	confidentiality of such information. Each party to a mediation
4202	conference has a privilege during and after the conference to
4203	refuse to disclose and to prevent another from disclosing
4204	communications made during the conference whether or not the
4205	contested issues are successfully resolved. This subsection and
4206	paragraphs (4)(a) and (b) shall not be construed to prevent or
4207	inhibit the discovery or admissibility of any information that
4208	is otherwise subject to discovery or that is admissible under
4209	applicable law or rule of procedure, except that any conduct or
4210	statements made during a mediation conference or in negotiations
4211	concerning the conference are inadmissible in any proceeding
4212	under this chapter.
4213	(a)1. Unless the parties conduct a private mediation under
4214	paragraph (b)subparagraph 2., mediation shall be conducted by a
4215	mediator selected by the Director of the Division of
4216	Administrative Hearings from among mediators employed on a full-
4217	time basis by the Office of the Judges of Compensation Claims. A
4218	mediator must be a member of The Florida Bar for at least 5
4219	years and must complete a mediation training program approved by
4220	the Deputy Chief JudgeDirector of the Division of
4221	Administrative Hearings. Adjunct mediators may be employed by
4222	the Office of the Judges of Compensation Claims on an as-needed
4223	basis and shall be selected from a list prepared by the Director
4224	of the Division of Administrative Hearings. An adjunct mediator
4225	must be independent of all parties participating in the
4226	mediation conference. An adjunct mediator must be a member of
4227	The Florida Bar for at least 5 years and must complete a
4228	mediation training program approved by the Office of the Judges
4229	of Compensation ClaimsDirector of the Division of
4230	Administrative Hearings. An adjunct mediator shall have access
4231	to the office, equipment, and supplies of the judge of
4232	compensation claims in each district.
4233	(b)2. With respect to any private mediation occurring on
4234	or after January 1, 2003, if the parties agree or if mediators
4235	are not available under paragraph (a), pursuant to notice from
4236	the judge of compensation claimssubparagraph 1., to conduct the
4237	required mediation within the period specified in this section,
4238	the parties shall hold a mediation conference at the carrier's
4239	expense within the 130-day90-dayperiod set for mediation. The
4240	mediation conference shall be conducted by a mediator certified
4241	under s. 44.106. If the parties do not agree upon a mediator
4242	within 10 days after the date of the order, the claimant shall
4243	notify the judge in writing and the judge shall appoint a
4244	mediator under this subparagraph within 7 days. In the event
4245	both parties agree, the results of the mediation conference
4246	shall be binding and neither party shall have a right to appeal
4247	the results. In the event either party refuses to agree to the
4248	results of the mediation conference, the results of the
4249	mediation conference as well as the testimony, witnesses, and
4250	evidence presented at the conference shall not be admissible at
4251	any subsequent proceeding on the claim. The mediator shall not
4252	be called in to testify or give deposition to resolve any claim
4253	for any hearing before the judge of compensation claims. The
4254	employer may be represented by an attorney at the mediation
4255	conference if the employee is also represented by an attorney at
4256	the mediation conference.
4257	(b) The parties shall complete the pretrial stipulations
4258	before the conclusion of the mediation conference if the claims,
4259	except for attorney's fees and costs, have not been settled and
4260	if any claims in any filed petition remain unresolved. The judge
4261	of compensation claims may impose sanctions against a party or
4262	both parties for failing to complete the pretrial stipulations
4263	before the conclusion of the mediation conference.
4264	(4)(a) If the parties fail to agree touponwritten
4265	submission of pretrial stipulations at the mediation conference,
4266	the judge of compensation claims shall conduct a liveorder a
4267	pretrial hearing to occur within 14 days after the date of
4268	mediation ordered by the judge of compensation claims. The judge
4269	of compensation claims shall give the interested parties at
4270	least 147 days' advance notice of the pretrial hearing by mail.
4271	At the pretrial hearing, the judge of compensation claims shall,
4272	subject to paragraph (b), set a date for the final hearing that
4273	allows the parties at least 60 days to conduct discovery unless
4274	the parties consent to an earlier hearing date.
4275	(b) The final hearing must be held and concluded within 90
4276	days after the mediation conference is held, allowing the
4277	parties sufficient time to complete discovery. Except as set
4278	forth in this section,continuances may be granted only if the
4279	requesting party demonstrates to the judge of compensation
4280	claims that the reason for requesting the continuance arises
4281	from circumstances beyond the party's control. The written
4282	consent of the claimant must be obtained before any request from
4283	a claimant's attorney is granted for an additional continuance
4284	after the initial continuance has been granted. Any order
4285	granting a continuance must set forth the date and time of the
4286	rescheduled hearing. A continuance may be granted only if the
4287	requesting party demonstrates to the judge of compensation
4288	claims that the reason for requesting the continuance arises
4289	from circumstances beyond the control of the parties. The judge
4290	of compensation claims shall report any grant of two or more
4291	continuances to the Deputy Chief Judge.
4292	(c) The judge of compensation claims shall give the
4293	interested parties at least 147days' advance notice of the
4294	final hearing, served upon the interested parties by mail.
4295	(d) The final hearing shall be held within 210 days after
4296	receipt of the petition for benefits in the county where the
4297	injury occurred, if the injury occurred in this state, unless
4298	otherwise agreed to between the parties and authorized by the
4299	judge of compensation claims in the county where the injury
4300	occurred; However, the claimant may waive the timeframes within
4301	this section for good cause shown. If the injury occurred
4302	outside the state and is one for which compensation is payable
4303	under this chapter, then the final hearing may be held in the
4304	county of the employer's residence or place of business, or in
4305	any other county of the state that will, in the discretion of
4306	the Deputy Chief Judge, be the most convenient for a hearing.
4307	The final hearing shall be conducted by a judge of compensation
4308	claims, who shall, within 30 days after final hearing or closure
4309	of the hearing record, unless otherwise agreed by the parties,
4310	enter a final order on the merits of the disputed issues. The
4311	judge of compensation claims may enter an abbreviated final
4312	order in cases in which compensability is not disputed. Either
4313	party may request separate findings of fact and conclusions of
4314	law. At the final hearing, the claimant and employer may each
4315	present evidence with respect to the claims presented by the
4316	petition for benefits and may be represented by any attorney
4317	authorized in writing for such purpose. When there is a conflict
4318	in the medical evidence submitted at the hearing, the provisions
4319	of s. 440.13 shall apply. The report or testimony of the expert
4320	medical advisor shall be admitted into evidence in amade a part
4321	of the record of the proceeding and shall be given the same
4322	consideration by the judge of compensation claims as is accorded
4323	other medical evidence submitted in the proceeding;and all
4324	costs incurred in connection with such examination and testimony
4325	may be assessed as costs in the proceeding, subject to the
4326	provisions of s. 440.13. No judge of compensation claims may
4327	make a finding of a degree of permanent impairment that is
4328	greater than the greatest permanent impairment rating given the
4329	claimant by any examining or treating physician,except upon
4330	stipulation of the parties. Any benefit due but not raised at
4331	the final hearing which was ripe, due, or owing at the time of
4332	the final hearing is waived.
4333	(e) The order making an award or rejecting the claim,
4334	referred to in this chapter as a "compensation order," shall set
4335	forth the findings of ultimate facts and the mandate; and the
4336	order need not include any other reason or justification for
4337	such mandate. The compensation order shall be filed in the
4338	Office of the Judges of Compensation Claims at Tallahassee. A
4339	copy of such compensation order shall be sent by mail to the
4340	parties and attorneys of record at the last known address of
4341	each, with the date of mailing noted thereon.
4342	(f) Each judge of compensation claims is required to
4343	submit a special report to the Deputy Chief Judge in each
4344	contested workers' compensation case in which the case is not
4345	determined within 30 days of final hearing or closure of the
4346	hearing record. Said form shall be provided by the director of
4347	the Division of Administrative Hearings and shall contain the
4348	names of the judge of compensation claims and of the attorneys
4349	involved and a brief explanation by the judge of compensation
4350	claims as to the reason for such a delay in issuing a final
4351	order.
4352	(f)(g)Notwithstanding any other provision of this
4353	section, the judge of compensation claims may require the
4354	appearance of the parties and counsel before her or him without
4355	written notice for an emergency conference where there is a bona
4356	fide emergency involving the health, safety, or welfare of an
4357	employee. An emergency conference under this section may result
4358	in the entry of an order or the rendering of an adjudication by
4359	the judge of compensation claims.
4360	(g)(h)To expedite dispute resolution and to enhance the
4361	self-executing features of the Workers' Compensation Law, the
4362	Deputy Chief Judge shall make provision by rule or order for the
4363	resolution of appropriate motions by judges of compensation
4364	claims without oral hearing upon submission of brief written
4365	statements in support and opposition, and for expedited
4366	discovery and docketing. Unless the judge of compensation
4367	claims, for good cause, orders a hearing under paragraph (h)(i),
4368	each claim in a petition relating to the determination of the
4369	average weekly wagepayunder s. 440.14 shall be resolved under
4370	this paragraph without oral hearing.
4371	(h)(i)To further expedite dispute resolution and to
4372	enhance the self-executing features of the system, those
4373	petitions filed in accordance with s. 440.192 that involve a
4374	claim for benefits of $5,000 or less shall, in the absence of
4375	compelling evidence to the contrary, be presumed to be
4376	appropriate for expedited resolution under this paragraph; and
4377	any other claim filed in accordance with s. 440.192, upon the
4378	written agreement of both parties and application by either
4379	party, may similarly be resolved under this paragraph. A claim
4380	in a petition or $5,000 or less for medical benefits only or a
4381	petition for reimbursement for mileage for medical purposes
4382	shall, in the absence of compelling evidence to the contrary, be
4383	resolved through the expedited dispute resolution process
4384	provided in this paragraph. For purposes of expedited resolution
4385	pursuant to this paragraph, the Deputy Chief Judge shall make
4386	provision by rule or order for expedited and limited discovery
4387	and expedited docketing in such cases. At least 15 days prior to
4388	hearing, the parties shall exchange and file with the judge of
4389	compensation claims a pretrial outline of all issues, defenses,
4390	and witnesses on a form adopted by the Deputy Chief Judge;
4391	provided, in no event shall such hearing be held without 15
4392	days' written notice to all parties. No pretrial hearing shall
4393	be held and no mediation scheduled unless requested by a party.
4394	The judge of compensation claims shall limit all argument and
4395	presentation of evidence at the hearing to a maximum of 30
4396	minutes, and such hearings shall not exceed 30 minutes in
4397	length. Neither party shall be required to be represented by
4398	counsel. The employer or carrier may be represented by an
4399	adjuster or other qualified representative. The employer or
4400	carrier and any witness may appear at such hearing by telephone.
4401	The rules of evidence shall be liberally construed in favor of
4402	allowing introduction of evidence.
4403	(i)(j)A judge of compensation claims may, upon the motion
4404	of a party or the judge's own motion, dismiss a petition for
4405	lack of prosecution if a petition, response, motion, order,
4406	request for hearing, or notice of deposition has not been filed
4407	during the previous 12 months unless good cause is shown. A
4408	dismissal for lack of prosecution is without prejudice and does
4409	not require a hearing.
4410	(j)(k)A judge of compensation claims may not award
4411	interest on unpaid medical bills and the amount of such bills
4412	may not be used to calculate the amount of interest awarded.
4413	Regardless of the date benefits were initially requested,
4414	attorney's fees do not attach under this subsection until 30
4415	days after the date the carrier or self-insured employer
4416	receives the petition.
4417	(5)(a) Procedures with respect to appeals from orders of
4418	judges of compensation claims shall be governed by rules adopted
4419	by the Supreme Court. Such an order shall become final 30 days
4420	after mailing of copies of such order to the parties, unless
4421	appealed pursuant to such rules.
4422	(b) An appellant may be relieved of any necessary filing
4423	fee by filing a verified petition of indigency for approval as
4424	provided in s. 57.081(1) and may be relieved in whole or in part
4425	from the costs for preparation of the record on appeal if,
4426	within 15 days after the date notice of the estimated costs for
4427	the preparation is served, the appellant files with the judge of
4428	compensation claims a copy of the designation of the record on
4429	appeal, and a verified petition to be relieved of costs. A
4430	verified petition filed prior to the date of service of the
4431	notice of the estimated costs shall be deemed not timely filed.
4432	The verified petition relating to record costs shall contain a
4433	sworn statement that the appellant is insolvent and a complete,
4434	detailed, and sworn financial affidavit showing all the
4435	appellant's assets, liabilities, and income. Failure to state in
4436	the affidavit all assets and income, including marital assets
4437	and income, shall be grounds for denying the petition with
4438	prejudice. The Office of the Judges of Compensation Claims shall
4439	adopt rules as may be required pursuant to this subsection,
4440	including forms for use in all petitions brought under this
4441	subsection. The appellant's attorney, or the appellant if she or
4442	he is not represented by an attorney, shall include as a part of
4443	the verified petition relating to record costs an affidavit or
4444	affirmation that, in her or his opinion, the notice of appeal
4445	was filed in good faith and that there is a probable basis for
4446	the District Court of Appeal, First District, to find reversible
4447	error, and shall state with particularity the specific legal and
4448	factual grounds for the opinion. Failure to so affirm shall be
4449	grounds for denying the petition. A copy of the verified
4450	petition relating to record costs shall be served upon all
4451	interested parties. The judge of compensation claims shall
4452	promptly conduct a hearing on the verified petition relating to
4453	record costs, giving at least 15 days' notice to the appellant,
4454	the department, and all other interested parties, all of whom
4455	shall be parties to the proceedings. The judge of compensation
4456	claims may enter an order without such hearing if no objection
4457	is filed by an interested party within 20 days from the service
4458	date of the verified petition relating to record costs. Such
4459	proceedings shall be conducted in accordance with the provisions
4460	of this section and with the workers' compensation rules of
4461	procedure, to the extent applicable. In the event an insolvency
4462	petition is granted, the judge of compensation claims shall
4463	direct the department to pay record costs and filing fees from
4464	the Workers' Compensation Administration Trust Fund pending
4465	final disposition of the costs of appeal. The department may
4466	transcribe or arrange for the transcription of the record in any
4467	proceeding for which it is ordered to pay the cost of the
4468	record.
4469	(c) As a condition of filing a notice of appeal to the
4470	District Court of Appeal, First District, an employer who has
4471	not secured the payment of compensation under this chapter in
4472	compliance with s. 440.38 shall file with the notice of appeal a
4473	good and sufficient bond, as provided in s. 59.13, conditioned
4474	to pay the amount of the demand and any interest and costs
4475	payable under the terms of the order if the appeal is dismissed,
4476	or if the District Court of Appeal, First District, affirms the
4477	award in any amount. Upon the failure of such employer to file
4478	such bond with the judge of compensation claims orthe District
4479	Court of Appeal, First District, along with the notice of
4480	appeal, the District Court of Appeal, First District, shall
4481	dismiss the notice of appeal.
4482	(6) An award of compensation for disability may be made
4483	after the death of an injured employee.
4484	(7) An injured employee claiming or entitled to
4485	compensation shall submit to such physical examination by a
4486	certified expert medical advisor approved by the agency or the
4487	judge of compensation claims as the agency or the judge of
4488	compensation claims may require. The place or places shall be
4489	reasonably convenient for the employee. Such physician or
4490	physicians as the employee, employer, or carrier may select and
4491	pay for may participate in an examination if the employee,
4492	employer, or carrier so requests. Proceedings shall be suspended
4493	and no compensation shall be payable for any period during which
4494	the employee may refuse to submit to examination.Any interested
4495	party shall have the right in any case of death to require an
4496	autopsy, the cost thereof to be borne by the party requesting
4497	it; and the judge of compensation claims shall have authority to
4498	order and require an autopsy and may, in her or his discretion,
4499	withhold her or his findings and award until an autopsy is held.
4500	Section 26. Section 440.34, Florida Statutes, is amended
4501	to read:
4502	440.34 Attorney's fees; costs.--
4503	(1) A fee, gratuity, or other consideration may not be
4504	paid for services rendered fora claimant in connection with any
4505	proceedings arising under this chapter, unless approved as
4506	reasonable by the judge of compensation claims or court having
4507	jurisdiction over such proceedings. Except as provided by this
4508	subsection,Any attorney's fee approved by a judge of
4509	compensation claims for benefits secured on behalf ofservices
4510	rendered to a claimant may not exceed 18must equal to 20
4511	percent of the first $5,000 of the amount of the benefits
4512	secured, 1315percent of the next $5,000 of the amount of the
4513	benefits secured, 810percent of the remaining amount of the
4514	benefits secured to be provided during the first 10 years after
4515	the date the claim is filed, and 5 percent of the benefits
4516	secured after 10 years. The judge of compensation claims shall
4517	not approve a compensation order, a joint stipulation for lump-
4518	sum settlement, a stipulation or agreement between a claimant
4519	and his or her attorney, or any other agreement related to
4520	benefits under this chapter that provides for an attorney’s fee
4521	in excess of the amount permitted by this section. The judge of
4522	compensation claims is not required to approve any retainer
4523	agreement between the claimant and his or her attorney. The
4524	retainer agreement as to fees and costs may not be for
4525	compensation in excess of the amount allowed under this section.
4526	However, The judge of compensation claims shall consider the
4527	following factors in each case and may increase or decrease the
4528	attorney's fee if, in her or his judgment, the circumstances of
4529	the particular case warrant such action:
4530	(a) The time and labor required, the novelty and
4531	difficulty of the questions involved, and the skill requisite to
4532	perform the legal service properly.
4533	(b) The fee customarily charged in the locality for
4534	similar legal services.
4535	(c) The amount involved in the controversy and the
4536	benefits resulting to the claimant.
4537	(d) The time limitation imposed by the claimant or the
4538	circumstances.
4539	(e) The experience, reputation, and ability of the lawyer
4540	or lawyers performing services.
4541	(f) The contingency or certainty of a fee.
4542	(2) In awarding a reasonable claimant's attorney's fee,
4543	the judge of compensation claims shall consider only those
4544	benefits secured byto the claimant that the attorney is
4545	responsible for securing. The amount, statutory basis, and type
4546	of benefits obtained through legal representation shall be
4547	listed on all attorney's fees awarded by the judge of
4548	compensation claims. For purposes of this section, the term
4549	"benefits secured" means benefits obtained as a result of the
4550	claimant's attorney's legal services rendered in connection with
4551	the claim for benefits. However, such termdoes not include
4552	future medical benefits to be provided on any date more than 5
4553	years after the date the claim is filed. In the event an offer
4554	to settle an issue pending before a judge of compensation claims
4555	is communicated in writing to the claimant or the claimant’s
4556	attorney at least 30 days prior to the trial date on such issue,
4557	benefits secured shall be only that amount awarded above that
4558	specified in the offer to settle. If multiple issues are pending
4559	before the judge of compensation claims, said offer of
4560	settlement shall address each issue pending and shall state
4561	explicitly whether or not the offer on each issue is severable.
4562	The written offer shall also unequivocally state whether or not
4563	it includes medical witness fees and expenses, and all other
4564	costs associated with the claim.
4565	(3) If any partythe claimantshould prevail in any
4566	proceedings before a judge of compensation claims or court,
4567	there shall be taxed against the nonprevailing party employer
4568	the reasonable costs of such proceedings, not to include the
4569	attorney's fees of the claimant. A claimant shall be responsible
4570	for the payment of her or his own attorney's fees, except that a
4571	claimant shall be entitled to recover a reasonable attorney's
4572	fee from a carrier or employer:
4573	(a) Against whom she or he successfully asserts a petition
4574	for medical benefits only, if the claimant has not filed or is
4575	not entitled to file at such time a claim for disability,
4576	permanent impairment, wage-loss, or death benefits, arising out
4577	of the same accident;
4578	(b) In any case in which the employer or carrier files a
4579	response to petition denying benefits with the Office of the
4580	Judges of Compensation Claims and the injured person has
4581	employed an attorney in the successful prosecution of the
4582	petition;
4583	(c) In a proceeding in which a carrier or employer denies
4584	that an accident occurred for which compensation benefits are
4585	payable, and the claimant prevails on the issue of
4586	compensability; or
4587	(d) In cases where the claimant successfully prevails in
4588	proceedings filed under s. 440.24 or s. 440.28.
4589
4590	Regardless of the date benefits were initially requested,
4591	attorney's fees shall not attach under this subsection until 30
4592	days after the date the carrier or employer, if self-insured,
4593	receives the petition. In applying the factors set forth in
4594	subsection (1) to cases arising under paragraphs (a), (b), (c),
4595	and (d), the judge of compensation claims must only consider
4596	only such benefits and the time reasonably spent in obtaining
4597	them as were secured for the claimant within the scope of
4598	paragraphs (a), (b), (c), and (d).
4599	(4) In such cases in which the claimant is responsible for
4600	the payment of her or his own attorney's fees, such fees are a
4601	lien upon compensation payable to the claimant, notwithstanding
4602	s. 440.22.
4603	(5) If any proceedings are had for review of any claim,
4604	award, or compensation order before any court, the court may
4605	award the injured employee or dependent an attorney's fee to be
4606	paid by the employer or carrier, in its discretion, which shall
4607	be paid as the court may direct.
4608	(6) A judge of compensation claims may not enter an order
4609	approving the contents of a retainer agreement that permits the
4610	escrowing of any portion of the employee's compensation until
4611	benefits have been secured.
4612	(7) If an employer or carrier incurs defense fees that
4613	exceed the fee payable to an injured worker's attorney that
4614	would be calculated by the formulas set forth in this section,
4615	the fee limitations set forth in paragraphs (3)(a) and (b) shall
4616	not apply and the fee shall be calculated based on factors in
4617	this section.
4618	Section 27. Subsection (7) is added to section 440.38,
4619	Florida Statutes, to read:
4620	440.38 Security for compensation; insurance carriers and
4621	self-insurers.—
4622	(7) Any employer who meets the requirements of subsection
4623	(1) through a policy of insurance issued outside of this state
4624	must at all times, with respect to all employees working in this
4625	state, maintain the required coverage under a Florida
4626	endorsement using Florida rates and rules pursuant to payroll
4627	reporting that accurately reflects the work performed in this
4628	state by such employees.
4629	Section 28. Subsections (2) and (6) of section 440.381,
4630	Florida Statutes, are amended to read:
4631	440.381 Application for coverage; reporting payroll;
4632	payroll audit procedures; penalties.--
4633	(2) Submission of an application that contains false,
4634	misleading, or incomplete information provided with the purpose
4635	of avoiding or reducing the amount of premiums for workers’
4636	compensation coverage is a felony of the second degree,
4637	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
4638	The application must contain a statement that the filing of an
4639	application containing false, misleading, or incomplete
4640	information providedwith the purpose of avoiding or reducing
4641	the amount of premiums for workers' compensation coverage is a
4642	felony of the third degree, punishable as provided in s.
4643	775.082, s. 775.083, or s. 775.084. The application must contain
4644	a sworn statement by the employer attesting to the accuracy of
4645	the information submitted and acknowledging the provisions of
4646	former s. 440.37(4). The application must contain a sworn
4647	statement by the agent attesting that the agent explained to the
4648	employer or officer the classification codes that are used for
4649	premium calculations.
4650	(6)(a) If an employer understates or conceals payroll, or
4651	misrepresents or conceals employee duties so as to avoid proper
4652	classification for premium calculations, or misrepresents or
4653	conceals information pertinent to the computation and
4654	application of an experience rating modification factor, the
4655	employer, or the employer's agent or attorney, shall pay to the
4656	insurance carrier a penalty of 10 times the amount of the
4657	difference in premium paid and the amount the employer should
4658	have paid and reasonable attorney's fees. The penalty may be
4659	enforced in the circuit courts of this state.
4660	(b) If the department determines that an employer has
4661	materially understated or concealed payroll, has materially
4662	misrepresented or concealed employee duties so as to avoid
4663	proper classification for premium calculations, or has
4664	materially misrepresented or concealed information pertinent to
4665	the computation and application of an experience rating
4666	modification factor, the department shall immediately notify the
4667	employer’s carrier of such determination. The carrier shall
4668	commence a physical onsite audit of the employer within 30 days
4669	after receiving notification from the department. If the carrier
4670	fails to commence the audit as required by this section, the
4671	department shall contract with auditing professionals to conduct
4672	the audit at the carrier’s expense. A copy of the carrier’s
4673	audit of the employer shall be provided to the department upon
4674	completion. The carrier is not required to conduct the physical
4675	onsite audit of the employer as set forth in this paragraph if
4676	the carrier gives written notice of cancellation to the employer
4677	within 30 days after receiving notification from the department
4678	of the material misrepresentation, understatement, or
4679	concealment and an audit is conducted in conjunction with the
4680	cancellation.
4681	Section 29. Subsection (3) of section 440.42, Florida
4682	Statutes, is amended to read:
4683	440.42 Insurance policies; liability.--
4684	(3) No contract or policy of insurance issued by a carrier
4685	under this chapter shall expire or be canceled until at least 30
4686	days have elapsed after a notice of cancellation has been sent
4687	to the department and to the employer in accordance with the
4688	provisions of s. 440.185(7). For cancellation due to nonpayment
4689	of premium, the insurer shall mail notification to the employer
4690	at least 10 days prior to the effective date of the
4691	cancellation.However, when duplicate or dual coverage exists by
4692	reason of two different carriers having issued policies of
4693	insurance to the same employer securing the same liability, it
4694	shall be presumed that only that policy with the later effective
4695	date shall be in force and that the earlier policy terminated
4696	upon the effective date of the latter. In the event that both
4697	policies carry the same effective date, one of the policies may
4698	be canceled instanter upon filing a notice of cancellation with
4699	the department and serving a copy thereof upon the employer in
4700	such manner as the department prescribes by rule. The department
4701	may by rule prescribe the content of the notice of retroactive
4702	cancellation and specify the time, place, and manner in which
4703	the notice of cancellation is to be served.
4704	Section 30. Paragraph (a) of subsection (4) of section
4705	440.49, Florida Statutes, is amended to read:
4706	440.49 Limitation of liability for subsequent injury
4707	through Special Disability Trust Fund.--
4708	(4) PERMANENT IMPAIRMENT OR PERMANENT TOTAL DISABILITY,
4709	TEMPORARY BENEFITS, MEDICAL BENEFITS, OR ATTENDANT CARE AFTER
4710	OTHER PHYSICAL IMPAIRMENT.--
4711	(a) Permanent impairment.--If an employee who has a
4712	preexisting permanent physical impairment incurs a subsequent
4713	permanent impairment from injury or occupational disease arising
4714	out of, and in the course of, her or his employment which merges
4715	with the preexisting permanent physical impairment to cause a
4716	permanent impairment, the employer shall, in the first instance,
4717	pay all benefits provided by this chapter; but, subject to the
4718	limitations specified in subsection (6), such employer shall be
4719	reimbursed from the Special Disability Trust Fund created by
4720	subsection (9) for 50 percent of all impairment benefits which
4721	the employer has been required to provide pursuant to s.
4722	440.15(3)(a)as a result of the subsequent accident or
4723	occupational disease.
4724	Section 31. Paragraph (b) of subsection (6) of section
4725	440.491, Florida Statutes, is amended to read:
4726	440.491 Reemployment of injured workers; rehabilitation.--
4727	(6) TRAINING AND EDUCATION.--
4728	(b) When it appears that an employee who has attained
4729	maximum medical improvement requires training and education to
4730	obtain suitable gainful employment, the employer shall pay the
4731	employee additional temporary total compensation while the
4732	employee receives such training and education for a period not
4733	to exceed 26 weeks, which period may be extended for an
4734	additional 26 weeks or less, if such extended period is
4735	determined to be necessary and proper by a judge of compensation
4736	claims. However, a carrier or employer is not precluded from
4737	voluntarily paying additional temporary total disability
4738	compensation beyond that period. If an employee requires
4739	temporary residence at or near a facility or an institution
4740	providing training and education which is located more than 50
4741	miles away from the employee's customary residence, the
4742	reasonable cost of board, lodging, or travel must be borne by
4743	the department from the Workers' Compensation Administration
4744	Trust Fund established by s. 440.50. An employee who refuses to
4745	accept training and education that is recommended by the
4746	vocational evaluator and considered necessary by the department
4747	is subject to a 50-percent reduction in weekly compensation
4748	benefits, including wage-loss benefits, as determined under s.
4749	440.15(3)(b).
4750	Section 32. Section 440.525, Florida Statutes, is amended
4751	to read:
4752	440.525 Audit, examination, and examination of carriers
4753	and claims-handling entities.--
4754	(1) The department may audit, examine, or investigate any
4755	each carrier, third-party administrator, servicing agent, or
4756	other claims-handling entityas often as is warranted to ensure
4757	that it iscarriers are fulfilling itstheir obligations under
4758	this chapterthe law. The examination may cover any period of
4759	the carrier's operations since the last previous examination.
4760	(2) An audit or examination may cover any period of the
4761	carrier’s, third-party administrator’s, servicing agent’s, or
4762	other claims-handling entity’s operations since the last
4763	previous audit or examination. An investigation based upon a
4764	reasonable belief by the department that a material violation of
4765	this chapter has occurred may cover any time period, but may not
4766	predate the last audit by more than 5 years. The department may
4767	by rule establish procedures, standards, and protocols for
4768	audits, examinations, and investigations. If the department
4769	finds any violation of this chapter, it may impose
4770	administrative penalties pursuant to this chapter. If the
4771	department finds any self-insurer in violation of this chapter,
4772	it may take action pursuant s. 440.38(3). Audits, examinations,
4773	or investigations by the department may address, but are not
4774	limited to addressing: unfair or unreasonable claims-handling
4775	techniques; patterns or practices of unreasonable denial of
4776	claims or unreasonable delay in claims handling; timeliness and
4777	accuracy of payments and reports under ss. 440.13, 440.16, and
4778	440.185; proper application of practice parameters and protocols
4779	in paying medical benefits; or patterns or practices of
4780	harassment, coercion, or intimidation of claimants. The
4781	department may also specify by rule the documentation to be
4782	maintained for each claim file.
4783	(3) As to any audit, examination, or investigation
4784	conducted under this chapter, the department shall have the
4785	power to conduct onsite inspections of claims records and
4786	documentation of a carrier, third-party administrator, servicing
4787	agent, or other claims-handling entity, and conduct interviews,
4788	both sworn and unsworn, of claims-handling personnel. Carriers,
4789	third-party administrators, servicing agents, and other claims-
4790	handling entities shall make all claims records, documentation,
4791	communication, and correspondence available to department
4792	personnel during regular business hours. If any person fails to
4793	comply with a department request for production of records or
4794	documents or fails to produce an employee for interview, the
4795	department may compel production or attendance by subpoena. The
4796	results of an audit, examination, or investigation shall be
4797	provided to the carrier, third-party administrator, servicing
4798	agent, or other claims-handling entity in a written report
4799	setting forth the basis for any violations that are asserted.
4800	Such report is agency action for purposes of chapter 120, and
4801	the aggrieved party may request a proceeding under s. 120.57
4802	with regard to the findings and conclusion of the report.
4803	(4) If the department finds that violations of this
4804	chapter have occurred, the department may impose an
4805	administrative penalty upon the offending entity or entities.
4806	For each offending entity, such penalties shall not exceed
4807	$2,500 for each pattern or practice constituting nonwillful
4808	violation and shall not exceed an aggregate amount of $10,000
4809	for all nonwillful violations arising out of the same action. If
4810	the department finds a pattern of practice that constitutes a
4811	willful violation, the department may impose an administrative
4812	penalty upon each offending entity not to exceed $20,000 for
4813	each willful pattern or practice. Such fines shall not exceed
4814	$100,000 for all willful violations arising out of the same
4815	action. No penalty assessed under this section may be recouped
4816	by any carrier in the rate base, the premium, or any rate
4817	filing. Any administrative penalty imposed under this section
4818	for a nonwillful violation shall not duplicate an administrative
4819	penalty imposed under another provision of this chapter. The
4820	department may adopt rules to implement this section. The
4821	department shall adopt penalty guidelines by rule to set
4822	penalties under this chapter.
4823	Section 33. Subsection (2) of section 627.162, Florida
4824	Statutes, is amended to read:
4825	627.162 Requirements for premium installments;
4826	delinquency, collection, and check return charges; attorney's
4827	fees.--
4828	(2) Insurers providing workers' compensation coverage
4829	under chapter 440 may charge the insured a delinquency and
4830	collection fee on each installment in default for a period of
4831	not less than 5 days in an amount not to exceed $25$10or 5
4832	percent of the delinquent installment, whichever is greater.
4833	Only one such delinquency and collection fee may be collected on
4834	any such installment regardless of the period during which it
4835	remains in default.
4836	Section 34. Paragraphs (c) and (d) of subsection (4) of
4837	section 627.311, Florida Statutes, are amended to read
4838	627.311 Joint underwriters and joint reinsurers.--
4839	(4)
4840	(c) The operation of the plan shall be governed by a plan
4841	of operation that is prepared at the direction of the board of
4842	governors. The plan of operation may be changed at any time by
4843	the board of governors or upon request of the department. The
4844	plan of operation and all changes thereto are subject to the
4845	approval of the department. The plan of operation shall:
4846	1. Authorize the board to engage in the activities
4847	necessary to implement this subsection, including, but not
4848	limited to, borrowing money.
4849	2. Develop criteria for eligibility for coverage by the
4850	plan, including, but not limited to, documented rejection by at
4851	least two insurers which reasonably assures that insureds
4852	covered under the plan are unable to acquire coverage in the
4853	voluntary market. Any insured may voluntarily elect to accept
4854	coverage from an insurer for a premium equal to or greater than
4855	the plan premium if the insurer writing the coverage adheres to
4856	the provisions of s. 627.171.
4857	3. Require notice from the agent to the insured at the
4858	time of the application for coverage that the application is for
4859	coverage with the plan and that coverage may be available
4860	through an insurer, group self-insurers' fund, commercial self-
4861	insurance fund, or assessable mutual insurer through another
4862	agent at a lower cost.
4863	4. Establish programs to encourage insurers to provide
4864	coverage to applicants of the plan in the voluntary market and
4865	to insureds of the plan, including, but not limited to:
4866	a. Establishing procedures for an insurer to use in
4867	notifying the plan of the insurer's desire to provide coverage
4868	to applicants to the plan or existing insureds of the plan and
4869	in describing the types of risks in which the insurer is
4870	interested. The description of the desired risks must be on a
4871	form developed by the plan.
4872	b. Developing forms and procedures that provide an insurer
4873	with the information necessary to determine whether the insurer
4874	wants to write particular applicants to the plan or insureds of
4875	the plan.
4876	c. Developing procedures for notice to the plan and the
4877	applicant to the plan or insured of the plan that an insurer
4878	will insure the applicant or the insured of the plan, and notice
4879	of the cost of the coverage offered; and developing procedures
4880	for the selection of an insuring entity by the applicant or
4881	insured of the plan.
4882	d. Provide for a market-assistance plan to assist in the
4883	placement of employers. All applications for coverage in the
4884	plan received 45 days before the effective date for coverage
4885	shall be processed through the market-assistance plan. A market-
4886	assistance plan specifically designed to serve the needs of
4887	small good policyholders as defined by the board must be
4888	finalized by January 1, 1994.
4889	5. Provide for policy and claims services to the insureds
4890	of the plan of the nature and quality provided for insureds in
4891	the voluntary market.
4892	6. Provide for the review of applications for coverage
4893	with the plan for reasonableness and accuracy, using any
4894	available historic information regarding the insured.
4895	7. Provide for procedures for auditing insureds of the
4896	plan which are based on reasonable business judgment and are
4897	designed to maximize the likelihood that the plan will collect
4898	the appropriate premiums.
4899	8. Authorize the plan to terminate the coverage of and
4900	refuse future coverage for any insured that submits a fraudulent
4901	application to the plan or provides fraudulent or grossly
4902	erroneous records to the plan or to any service provider of the
4903	plan in conjunction with the activities of the plan.
4904	9. Establish service standards for agents who submit
4905	business to the plan.
4906	10. Establish criteria and procedures to prohibit any
4907	agent who does not adhere to the established service standards
4908	from placing business with the plan or receiving, directly or
4909	indirectly, any commissions for business placed with the plan.
4910	11. Provide for the establishment of reasonable safety
4911	programs for all insureds in the plan. All insureds of the plan
4912	must participate in the safety program.
4913	12. Authorize the plan to terminate the coverage of and
4914	refuse future coverage to any insured who fails to pay premiums
4915	or surcharges when due; who, at the time of application, is
4916	delinquent in payments of workers' compensation or employer's
4917	liability insurance premiums or surcharges owed to an insurer,
4918	group self-insurers' fund, commercial self-insurance fund, or
4919	assessable mutual insurer licensed to write such coverage in
4920	this state; or who refuses to substantially comply with any
4921	safety programs recommended by the plan.
4922	13. Authorize the board of governors to provide the
4923	services required by the plan through staff employed by the
4924	plan, through reasonably compensated service providers who
4925	contract with the plan to provide services as specified by the
4926	board of governors, or through a combination of employees and
4927	service providers.
4928	14. Provide for service standards for service providers,
4929	methods of determining adherence to those service standards,
4930	incentives and disincentives for service, and procedures for
4931	terminating contracts for service providers that fail to adhere
4932	to service standards.
4933	15. Provide procedures for selecting service providers and
4934	standards for qualification as a service provider that
4935	reasonably assure that any service provider selected will
4936	continue to operate as an ongoing concern and is capable of
4937	providing the specified services in the manner required.
4938	16. Provide for reasonable accounting and data-reporting
4939	practices.
4940	17. Provide for annual review of costs associated with the
4941	administration and servicing of the policies issued by the plan
4942	to determine alternatives by which costs can be reduced.
4943	18. Authorize the acquisition of such excess insurance or
4944	reinsurance as is consistent with the purposes of the plan.
4945	19. Provide for an annual report to the department on a
4946	date specified by the department and containing such information
4947	as the department reasonably requires.
4948	20. Establish multiple rating plans for various
4949	classifications of risk which reflect risk of loss, hazard
4950	grade, actual losses, size of premium, and compliance with loss
4951	control. At least one of such plans must be a preferred-rating
4952	plan to accommodate small-premium policyholders with good
4953	experience as defined in sub-subparagraph 22.a.
4954	21. Establish agent commission schedules.
4955	22. Establish fourthreesubplans as follows:
4956	a. Subplan “A” must include those insureds whose annual
4957	premium does not exceed $2,500 and who have neither incurred any
4958	lost-time claims nor incurred medical-only claims exceeding 50
4959	percent of their premium for the immediate 2 years.
4960	b. Subplan “B” must include insureds that are employers
4961	identified by the board of governors as high-risk employers due
4962	solely to the nature of the operations being performed by those
4963	insureds and for whom no market exists in the voluntary market,
4964	and whose experience modifications are less than 1.00.
4965	c. Subplan “C” must include all otherinsureds within the
4966	plan that are not eligible for subplan “A,” subplan “B,” or
4967	subplan “D.”
4968	d. Subplan “D” must include any employer with 50 or fewer
4969	employees, except that an employer who is eligible for subplan
4970	“D” and another subplan may elect the subplan in which it will
4971	participate. The rate plan for subplan “D” shall be the same
4972	rate plan as the plan approved under ss. 627.091-627.151 and
4973	each participant in subplan “D” shall pay the premium determined
4974	under such rate plan, plus a surcharge determined by the board
4975	to be sufficient to ensure that the plan does not compete with
4976	the voluntary market rate for any participant, but not to exceed
4977	25 percent.
4978	23. Provide for a depopulation program to reduce the
4979	number of insureds in subplan “D.” If an employer insured
4980	through subplan “D” is offered coverage from a voluntary market
4981	carrier:
4982	a. During the first 30 days of coverage under the subplan;
4983	b. Before a policy is issued under the subplan;
4984	c. By issuance of a policy upon expiration or cancellation
4985	of the policy under the subplan; or
4986	d. By assumption of the subplan’s obligation with respect
4987	to an in-force policy,
4988
4989	that employer is no longer eligible for coverage through the
4990	plan. The premium for risks assumed by the voluntary market
4991	carrier must be the same premium plus, for the first 2 years,
4992	the surcharge as determined in sub-subparagraph 22.d. A premium
4993	under this subparagraph, including surcharge, is deemed approved
4994	and is not an excess premium for purposes of s. 627.171.
4995	24. Require that policies issued under subplan “D” and
4996	applications for such policies must include a notice that the
4997	policy issued under subplan “D” could be replaced by a policy
4998	issued from a voluntary market carrier and that if an offer of
4999	coverage is obtained from a voluntary market carrier, the
5000	policyholder is no longer eligible for coverage through subplan
5001	“D.” The notice must also specify that acceptance of coverage
5002	under subplan “D” creates a conclusive presumption that the
5003	applicant or policyholder is aware of this potential. With
5004	respect to any employer organized as a not-for-profit
5005	corporation and tax-exempt under s. 501(c)(3) of the Internal
5006	Revenue Code, the surcharge shall be sufficient to ensure that
5007	the subplan does not compete with the voluntary market but does
5008	not exceed 10 percent.
5009	(d)1.The plan must be funded through actuarially sound
5010	premiums charged to insureds of the plan.
5011	2.The plan may issue assessable policies only to those
5012	insureds in subplan “C.” and subplan “D.” Assessments levied
5013	against subplan “C” participants shall cover only the excess
5014	losses attributable to subplan “C,” and assessments levied
5015	against subplan “D” participants shall cover only the excess
5016	losses attributable to subplan “D.” In no event may the plan
5017	levy assessments against any person or entity except as
5018	authorized by this paragraph.Those assessable policies must be
5019	clearly identified as assessable by containing, in contrasting
5020	color and in not less than 10-point type, the following
5021	statements: “This is an assessable policy. If the plan is unable
5022	to pay its obligations, policyholders will be required to
5023	contribute on a pro rata earned premium basis the money
5024	necessary to meet any assessment levied.”
5025	3.The plan may issue assessable policies with differing
5026	terms and conditions to different groups within subplan “C” and
5027	subplan “D”the planwhen a reasonable basis exists for the
5028	differentiation.
5029	4.The plan may offer rating, dividend plans, and other
5030	plans to encourage loss prevention programs.
5031	Section 35. Paragraphs (c) and (e) of subsection (3) of
5032	section 921.0022, Florida Statutes, are amended to read:
5033	921.0022 Criminal Punishment Code; offense severity
5034	ranking chart.--
5035	(3) OFFENSE SEVERITY RANKING CHART
5036	FloridaStatute FelonyDegree Description
5037	(c) LEVEL 3
5038	316.193(2)(b) 3rd Felony DUI, 3rd conviction.
5039	316.1935(2) 3rd Fleeing or attempting to elude law enforcement officer in marked patrol vehicle with siren and lights activated.
5040	319.30(4) 3rd Possession by junkyard of motor vehicle with identification number plate removed.
5041	319.33(1)(a) 3rd Alter or forge any certificate of title to a motor vehicle or mobile home.
5042	319.33(1)(c) 3rd Procure or pass title on stolen vehicle.
5043	319.33(4) 3rd With intent to defraud, possess, sell, etc., a blank, forged, or unlawfully obtained title or registration.
5044	327.35(2)(b) 3rd Felony BUI.
5045	328.05(2) 3rd Possess, sell, or counterfeit fictitious, stolen, or fraudulent titles or bills of sale of vessels.
5046	328.07(4) 3rd Manufacture, exchange, or possess vessel with counterfeit or wrong ID number.
5047	376.302(5) 3rd Fraud related to reimbursement for cleanup expenses under the Inland Protection Trust Fund.
5048	440.105(3)(a) 3rd Failure to update workers’ compensation insurance coverage application or to post notice of coverage.
5049	440.105(3)(b) 3rd Receipt of fee or consideration without approval by judge of compensation claims.
5050	440.1051(3) 3rd False report of workers’ compensation fraud or retaliation for making such a report.
5051	501.001(2)(b) 2nd Tampers with a consumer product or the container using materially false/misleading information.
5052	697.08 3rd Equity skimming.
5053	790.15(3) 3rd Person directs another to discharge firearm from a vehicle.
5054	796.05(1) 3rd Live on earnings of a prostitute.
5055	806.10(1) 3rd Maliciously injure, destroy, or interfere with vehicles or equipment used in firefighting.
5056	806.10(2) 3rd Interferes with or assaults firefighter in performance of duty.
5057	810.09(2)(c) 3rd Trespass on property other than structure or conveyance armed with firearm or dangerous weapon.
5058	812.014(2)(c)2. 3rd Grand theft; $5,000 or more but less than $10,000.
5059	812.0145(2)(c) 3rd Theft from person 65 years of age or older; $300 or more but less than $10,000.
5060	815.04(4)(b) 2nd Computer offense devised to defraud or obtain property.
5061	817.034(4)(a)3. 3rd Engages in scheme to defraud (Florida Communications Fraud Act), property valued at less than $20,000.
5062	817.233 3rd Burning to defraud insurer.
5063	817.234(8)&(9) 3rd Unlawful solicitation of persons involved in motor vehicle accidents.
5064	817.234(11)(a) 3rd Insurance fraud; property value less than $20,000.
5065	817.505(4) 3rd Patient brokering.
5066	828.12(2) 3rd Tortures any animal with intent to inflict intense pain, serious physical injury, or death.
5067	831.28(2)(a) 3rd Counterfeiting a payment instrument with intent to defraud or possessing a counterfeit payment instrument.
5068	831.29 2nd Possession of instruments for counterfeiting drivers' licenses or identification cards.
5069	838.021(3)(b) 3rd Threatens unlawful harm to public servant.
5070	843.19 3rd Injure, disable, or kill police dog or horse.
5071	870.01(2) 3rd Riot; inciting or encouraging.
5072	893.13(1)(a)2. 3rd Sell, manufacture, or deliver cannabis (or other s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs).
5073	893.13(1)(d)2. 2nd Sell, manufacture, or deliver s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs within 200 feet of university or public park.
5074	893.13(1)(f)2. 3rd Sell, manufacture, or deliver s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs within 200 feet of public housing facility.
5075	893.13(6)(a) 3rd Possession of any controlled substance other than felony possession of cannabis.
5076	893.13(7)(a)8. 3rd Withhold information from practitioner regarding previous receipt of or prescription for a controlled substance.
5077	893.13(7)(a)9. 3rd Obtain or attempt to obtain controlled substance by fraud, forgery, misrepresentation, etc.
5078	893.13(7)(a)10. 3rd Affix false or forged label to package of controlled substance.
5079	893.13(7)(a)11. 3rd Furnish false or fraudulent material information on any document or record required by chapter 893.
5080	893.13(8)(a)1. 3rd Knowingly assist a patient, other person, or owner of an animal in obtaining a controlled substance through deceptive, untrue, or fraudulent representations in or related to the practitioner's practice.
5081	893.13(8)(a)2. 3rd Employ a trick or scheme in the practitioner's practice to assist a patient, other person, or owner of an animal in obtaining a controlled substance.
5082	893.13(8)(a)3. 3rd Knowingly write a prescription for a controlled substance for a fictitious person.
5083	893.13(8)(a)4. 3rd Write a prescription for a controlled substance for a patient, other person, or an animal if the sole purpose of writing the prescription is a monetary benefit for the practitioner.
5084	918.13(1)(a) 3rd Alter, destroy, or conceal investigation evidence.
5085	944.47(1)(a)1.-2. 3rd Introduce contraband to correctional facility.
5086	944.47(1)(c) 2nd Possess contraband while upon the grounds of a correctional institution.
5087	985.3141 3rd Escapes from a juvenile facility (secure detention or residential commitment facility).
5088	(e) LEVEL 5
5089	316.027(1)(a) 3rd Accidents involving personal injuries, failure to stop; leaving scene.
5090	316.1935(4) 2nd Aggravated fleeing or eluding.
5091	322.34(6) 3rd Careless operation of motor vehicle with suspended license, resulting in death or serious bodily injury.
5092	327.30(5) 3rd Vessel accidents involving personal injury; leaving scene.
5093	381.0041(11)(b) 3rd Donate blood, plasma, or organs knowing HIV positive.
5094
5095	440.10(1)(g) 2nd Failure to obtain workers’ compensation coverage.
5096	440.105(5) 2nd Unlawful solicitation for the purpose of making workers' compensation claims.
5097	440.381(2) 2nd Submission of false, misleading, or incomplete information with the purpose of avoiding or reducing workers’ compensation premiums.
5098	790.01(2) 3rd Carrying a concealed firearm.
5099	790.162 2nd Threat to throw or discharge destructive device.
5100	790.163(1) 2nd False report of deadly explosive or weapon of mass destruction.
5101	790.221(1) 2nd Possession of short-barreled shotgun or machine gun.
5102	790.23 2nd Felons in possession of firearms or electronic weapons or devices.
5103	800.04(6)(c) 3rd Lewd or lascivious conduct; offender less than 18 years.
5104	800.04(7)(c) 2nd Lewd or lascivious exhibition; offender 18 years or older.
5105	806.111(1) 3rd Possess, manufacture, or dispense fire bomb with intent to damage any structure or property.
5106	812.0145(2)(b) 2nd Theft from person 65 years of age or older; $10,000 or more but less than $50,000.
5107	812.015(8) 3rd Retail theft; property stolen is valued at $300 or more and one or more specified acts.
5108	812.019(1) 2nd Stolen property; dealing in or trafficking in.
5109	812.131(2)(b) 3rd Robbery by sudden snatching.
5110	812.16(2) 3rd Owning, operating, or conducting a chop shop.
5111	817.034(4)(a)2. 2nd Communications fraud, value $20,000 to $50,000.
5112	817.234(11)(b) 2nd Insurance fraud; property value $20,000 or more but less than $100,000.
5113	817.568(2)(b) 2nd Fraudulent use of personal identification information; value of benefit, services received, payment avoided, or amount of injury or fraud, $75,000 or more.
5114	817.625(2)(b) 2nd Second or subsequent fraudulent use of scanning device or reencoder.
5115	825.1025(4) 3rd Lewd or lascivious exhibition in the presence of an elderly person or disabled adult.
5116	827.071(4) 2nd Possess with intent to promote any photographic material, motion picture, etc., which includes sexual conduct by a child.
5117	839.13(2)(b) 2nd Falsifying records of an individual in the care and custody of a state agency involving great bodily harm or death.
5118	843.01 3rd Resist officer with violence to person; resist arrest with violence.
5119	874.05(2) 2nd Encouraging or recruiting another to join a criminal street gang; second or subsequent offense.
5120	893.13(1)(a)1. 2nd Sell, manufacture, or deliver cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4. drugs).
5121	893.13(1)(c)2. 2nd Sell, manufacture, or deliver cannabis (or other s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs) within 1,000 feet of a child care facility or school.
5122	893.13(1)(d)1. 1st Sell, manufacture, or deliver cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4. drugs) within 200 feet of university or public park.
5123	893.13(1)(e)2. 2nd Sell, manufacture, or deliver cannabis or other drug prohibited under s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) within 1,000 feet of property used for religious services or a specified business site.
5124	893.13(1)(f)1. 1st Sell, manufacture, or deliver cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), or (2)(a), (2)(b), or (2)(c)4. drugs) within 200 feet of public housing facility.
5125	893.13(4)(b) 2nd Deliver to minor cannabis (or other s. 893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6., (2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) drugs).
5126	Section 36. Report to the Legislature regarding
5127	outstanding enforcement issues.--The Department of Financial
5128	Services shall, no later than January 1, 2004, provide a report
5129	to the President of the Senate, the Speaker of the House of
5130	Representatives, the minority leaders of the Senate and the
5131	House of Representatives, and the chairs of the standing
5132	committees of the Senate and the House of Representatives having
5133	jurisdiction over insurance issues, containing the following
5134	information:
5135	(1) Any provision of chapter 440, Florida Statutes,
5136	relating to workers’ compensation carrier compliance and
5137	enforcement, that the department finds it is unable to enforce.
5138	(2) Any administrative rule relating to workers’
5139	compensation carrier compliance and enforcement that the
5140	department finds it is unable to enforce.
5141	(3) Any other impediment to enforcement of chapter 440,
5142	Florida Statutes, resulting from the transfer of activities from
5143	the former Department of Labor and Employment Security to the
5144	department or the reorganization of the former Department of
5145	Insurance into the department.
5146	Section 37. Subsection (2) of section 946.523, Florida
5147	Statutes, is amended to read:
5148	946.523 Prison industry enhancement (PIE) programs.--
5149	(2) Notwithstanding any other law to the contrary,
5150	including s. 440.15(8)(9), private sector employers shall
5151	provide workers' compensation coverage to inmates who
5152	participate in prison industry enhancement (PIE) programs under
5153	subsection (1). However, inmates are not entitled to
5154	unemployment compensation.
5155	Section 38. Paragraph (c) of subsection (5) of section
5156	985.315, Florida Statutes, is amended to read:
5157	985.315 Educational/technical and vocational work-related
5158	programs.--
5159	(5)
5160	(c) Notwithstanding any other law to the contrary,
5161	including s. 440.15(8)(9), private sector employers shall
5162	provide juveniles participating in juvenile work programs under
5163	paragraph (b) with workers' compensation coverage, and juveniles
5164	shall be entitled to the benefits of such coverage. Nothing in
5165	this subsection shall be construed to allow juveniles to
5166	participate in unemployment compensation benefits.
5167	Section 39. Section 440.1925, Florida Statutes, is
5168	repealed.
5169	Section 40. Except as otherwise provided herein, this act
5170	shall take effect October 1, 2003.