HB 0025A, 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; providing a definition;
8	amending s. 440.06, F.S.; revising provisions relating to
9	failure to secure compensation; amending s. 440.077, F.S.;
10	providing that a corporate officer electing to be exempt
11	may not receive benefits; amending s. 440.09, F.S.;
12	revising provisions relating to compensation for
13	subsequent injuries; providing definitions; revising
14	provisions relating to drug testing; specifying effect of
15	criminal acts; creating s. 440.093, F.S.; providing for
16	compensability of mental and nervous injuries; amending s.
17	440.10, F.S.; revising provisions relating to contractors
18	and subcontractors with regard to liability for
19	compensation; requiring subcontractors to provide evidence
20	of workers' compensation coverage or proof of exemption to
21	a 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; prohibiting the clerk of the circuit
71	court from assessing certain fees or costs; amending s.
72	440.25, F.S.; revising procedures for mediation and
73	hearings; amending s. 440.34, F.S.; revising provisions
74	relating to the award of attorney's fees; amending s.
75	440.38, F.S.; providing requirement for employers with
76	coverage provided by insurers from outside the state;
77	amending s. 440.381, F.S.; providing criminal penalty for
78	unlawful applications; requiring on-site audits of
79	employers under certain circumstances; amending s. 440.42,
80	F.S.; revising provision relating to notice of
81	cancellation of coverage; amending s. 440.49, F.S., to
82	conform cross references; amending s. 440.491, F.S.;
83	providing training and education requirements and benefits
84	relating to reemployment of injured workers; providing for
85	rules; amending s. 440.525, F.S.; providing for the Office
86	of Insurance Regulation of the Financial Services
87	Commission to conduct examinations and investigations of
88	claims-handing entities; providing penalties; providing
89	for rules; amending s. 627.162, F.S.; revising delinquency
90	and collection fee for late payment of premium
91	installments; creating s. 627.285, F.S.; providing for
92	annual actuarial peer review of rating organization
93	processes; requiring a report; amending s. 627.311, F.S.;
94	revising membership of the board of governors of the
95	workers’ compensation joint underwriting plan; requiring
96	participation in safety programs; providing for an
97	additional subplan within the joint underwriting plan for
98	workers' compensation insurance; providing for rates,
99	surcharges, and assessments; limiting assessment powers;
100	amending s. 921.0022, F.S.; revising the offense severity
101	ranking chart to reflect changes in penalties under the
102	act; requiring a report to the Legislature from the
103	Department of Financial Services regarding provisions of
104	law relating to enforcement; amending ss. 946.523 and
105	985.315, F.S., to conform cross references; establishing a
106	Joint Select Committee on Workers’ Compensation Rating
107	Reform and specifying duties thereof; providing for
108	termination of the committee; requiring the board of
109	governors of the workers’ compensation joint underwriting
110	plan to submit a report to the Legislature; amending s.
111	443.1715, F.S.; revising provisions relating to records
112	and reports; providing for disclosure of specified
113	information; amending s. 625.989, F.S.; providing that the
114	Department of Financial Services shall prepare an annual
115	report relating to workers’ compensation fraud and
116	compliance; amending s. 626.9891, F.S.; amending reporting
117	requirements for insurers; providing penalties for
118	noncompliance; providing for rules; repealing s. 440.1925,
119	F.S., relating to procedure for resolving maximum medical
120	improvement or permanent impairment disputes; providing
121	that amendments to ss. 440.02 and 440.15, F.S., do not
122	affect certain disability, determination, and benefits;
123	providing for construction of the act in pari materia with
124	laws enacted during the Regular Session of the
125	Legislature; providing effective dates.
126
127	Be It Enacted by the Legislature of the State of Florida:
128
129	Section 1. Effective upon this act becoming a law,
130	subsections (1), (15), (29), (38), (40), (41), and (42) of
131	section 440.02, Florida Statutes, are amended to read:
132	440.02 Definitions.--When used in this chapter, unless the
133	context clearly requires otherwise, the following terms shall
134	have the following meanings:
135	(1) "Accident" means only an unexpected or unusual event
136	or result that happens suddenly. A mental or nervous injury due
137	to stress, fright, or excitement only, orDisability or death
138	due to the accidental acceleration or aggravation of a venereal
139	disease or of a disease due to the habitual use of alcohol or
140	controlled substances or narcotic drugs, or a disease that
141	manifests itself in the fear of or dislike for an individual
142	because of the individual's race, color, religion, sex, national
143	origin, age, or handicap is not an injury by accident arising
144	out of the employment. Subject to s. 440.15(5),if a preexisting
145	disease or anomaly is accelerated or aggravated by an accident
146	arising out of and in the course of employment, only
147	acceleration of death or acceleration or aggravation of the
148	preexisting condition reasonably attributable to the accident is
149	compensable, with respect to any compensation otherwise payable
150	under this chapterdeath or permanent impairment. An injury or
151	disease caused by exposure to a toxic substance, including, but
152	not limited to, fungus or mold, is not an injury by accident
153	arising out of the employment unless there is clear and
154	convincing evidence establishing that exposure to the specific
155	substance involved, at the levels to which the employee was
156	exposed, can cause the injury or disease sustained by the
157	employee.
158	(15)(a) "Employee" means any person engaged in any
159	employment under any appointment or contract of hire or
160	apprenticeship, express or implied, oral or written, whether
161	lawfully or unlawfully employed, and includes, but is not
162	limited to, aliens and minors.
163	(b) "Employee" includes any person who is an officer of a
164	corporation and who performs services for remuneration for such
165	corporation within this state, whether or not such services are
166	continuous.
167	1. Any officer of a corporation may elect to be exempt
168	from this chapter by filing written notice of the election with
169	the department as provided in s. 440.05.
170	2. As to officers of a corporation who are actively
171	engaged in the construction industry, no more than three
172	officers may elect to be exempt from this chapter by filing
173	written notice of the election with the department as provided
174	in s. 440.05. However, any exemption obtained by a corporate
175	officer of a corporation actively engaged in the construction
176	industry is not applicable with respect to any commercial
177	building project estimated to be valued at $250,000 or greater.
178	3. An officer of a corporation who elects to be exempt
179	from this chapter by filing a written notice of the election
180	with the department as provided in s. 440.05 is not an employee.
181
182	Services are presumed to have been rendered to the corporation
183	if the officer is compensated by other than dividends upon
184	shares of stock of the corporation which the officer owns.
185	(c)1."Employee" includes a sole proprietor or a partner
186	who devotes full time to the proprietorship or partnership and,
187	except as provided in this paragraph, elects to be included in
188	the definition of employee by filing notice thereof as provided
189	in s. 440.05. Partners or sole proprietors actively engaged in
190	the construction industry are considered employees unless they
191	elect to be excluded from the definition of employee by filing
192	written notice of the election with the department as provided
193	in s. 440.05. However, no more than three partners in a
194	partnership that is actively engaged in the construction
195	industry may elect to be excluded. A sole proprietor or partner
196	who is actively engaged in the construction industry and who
197	elects to be exempt from this chapter by filing a written notice
198	of the election with the department as provided in s. 440.05 is
199	not an employee. For purposes of this chapter, an independent
200	contractor is an employee unless he or she meets all of the
201	conditions set forth in subparagraph (d)1.
202	2. Notwithstanding the provisions of subparagraph 1., the
203	term "employee" includes a sole proprietor or partner actively
204	engaged in the construction industry with respect to any
205	commercial building project estimated to be valued at $250,000
206	or greater. Any exemption obtained is not applicable, with
207	respect to work performed at such a commercial building project.
208	(d) "Employee" does not include:
209	1. An independent contractor, if:
210	a. The independent contractor maintains a separate
211	business with his or her own work facility, truck, equipment,
212	materials, or similar accommodations;
213	b. The independent contractor holds or has applied for a
214	federal employer identification number, unless the independent
215	contractor is a sole proprietor who is not required to obtain a
216	federal employer identification number under state or federal
217	requirements;
218	c. The independent contractor performs or agrees to
219	perform specific services or work for specific amounts of money
220	and controls the means of performing the services or work;
221	d. The independent contractor incurs the principal
222	expenses related to the service or work that he or she performs
223	or agrees to perform;
224	e. The independent contractor is responsible for the
225	satisfactory completion of work or services that he or she
226	performs or agrees to perform and is or could be held liable for
227	a failure to complete the work or services;
228	f. The independent contractor receives compensation for
229	work or services performed for a commission or on a per-job or
230	competitive-bid basis and not on any other basis;
231	g. The independent contractor may realize a profit or
232	suffer a loss in connection with performing work or services;
233	h. The independent contractor has continuing or recurring
234	business liabilities or obligations; and
235	i. The success or failure of the independent contractor's
236	business depends on the relationship of business receipts to
237	expenditures.
238
239	However, the determination as to whether an individual included
240	in the Standard Industrial Classification Manual of 1987,
241	Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762, 0781, 0782,
242	0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436, 2448, or 2449,
243	or a newspaper delivery person, is an independent contractor is
244	governed not by the criteria in this paragraph but by common-law
245	principles, giving due consideration to the business activity of
246	the individual. Notwithstanding the provisions of this paragraph
247	or any other provision of this chapter, with respect to any
248	commercial building project estimated to be valued at $250,000
249	or greater, a person who is actively engaged in the construction
250	industry is not an independent contractor and is either an
251	employer or an employee who may not be exempt from the coverage
252	requirements of this chapter.
253	2. A real estate salesperson or agent, if that person
254	agrees, in writing, to perform for remuneration solely by way of
255	commission.
256	3. Bands, orchestras, and musical and theatrical
257	performers, including disk jockeys, performing in licensed
258	premises as defined in chapter 562, if a written contract
259	evidencing an independent contractor relationship is entered
260	into before the commencement of such entertainment.
261	4. An owner-operator of a motor vehicle who transports
262	property under a written contract with a motor carrier which
263	evidences a relationship by which the owner-operator assumes the
264	responsibility of an employer for the performance of the
265	contract, if the owner-operator is required to furnish the
266	necessary motor vehicle equipment and all costs incidental to
267	the performance of the contract, including, but not limited to,
268	fuel, taxes, licenses, repairs, and hired help; and the owner-
269	operator is paid a commission for transportation service and is
270	not paid by the hour or on some other time-measured basis.
271	5. A person whose employment is both casual and not in the
272	course of the trade, business, profession, or occupation of the
273	employer.
274	6. A volunteer, except a volunteer worker for the state or
275	a county, municipality, or other governmental entity. A person
276	who does not receive monetary remuneration for services is
277	presumed to be a volunteer unless there is substantial evidence
278	that a valuable consideration was intended by both employer and
279	employee. For purposes of this chapter, the term "volunteer"
280	includes, but is not limited to:
281	a. Persons who serve in private nonprofit agencies and who
282	receive no compensation other than expenses in an amount less
283	than or equivalent to the standard mileage and per-diem expenses
284	provided to salaried employees in the same agency or, if such
285	agency does not have salaried employees who receive mileage and
286	per diem, then such volunteers who receive no compensation other
287	than expenses in an amount less than or equivalent to the
288	customary mileage and per diem paid to salaried workers in the
289	community as determined by the department; and
290	b. Volunteers participating in federal programs
291	established under Pub. L. No. 93-113.
292	7. Any officer of a corporation who elects to be exempt
293	from this chapter.
294	8. A sole proprietor or officer of a corporation who
295	actively engages in the construction industry, and a partner in
296	a partnership that is actively engaged in the construction
297	industry, who elects to be exempt from the provisions of this
298	chapter. Such sole proprietor, officer, or partner is not an
299	employee for any reason until the notice of revocation of
300	election filed pursuant to s. 440.05 is effective.
301	9. An exercise rider who does not work for a single horse
302	farm or breeder, and who is compensated for riding on a case-by-
303	case basis, provided a written contract is entered into prior to
304	the commencement of such activity which evidences that an
305	employee/employer relationship does not exist.
306	10. A taxicab, limousine, or other passenger vehicle-for-
307	hire driver who operates said vehicles pursuant to a written
308	agreement with a company which provides any dispatch, marketing,
309	insurance, communications, or other services under which the
310	driver and any fees or charges paid by the driver to the company
311	for such services are not conditioned upon, or expressed as a
312	proportion of, fare revenues.
313	11. A person who performs services as a sports official
314	for an entity sponsoring an interscholastic sports event or for
315	a public entity or private, nonprofit organization that sponsors
316	an amateur sports event. For purposes of this subparagraph, such
317	a person is an independent contractor. For purposes of this
318	subparagraph, the term "sports official" means any person who is
319	a neutral participant in a sports event, including, but not
320	limited to, umpires, referees, judges, linespersons,
321	scorekeepers, or timekeepers. This subparagraph does not apply
322	to any person employed by a district school board who serves as
323	a sports official as required by the employing school board or
324	who serves as a sports official as part of his or her
325	responsibilities during normal school hours.
326	(29) "Weekly compensation rate" means and refers to the
327	amount of compensation payable for a period of 7 consecutive
328	calendardays, including any Saturdays, Sundays, holidays, and
329	other nonworking days which fall within such period of 7
330	consecutive calendardays. When Saturdays, Sundays, holidays, or
331	other nonworking days immediately follow the first 7 calendar
332	days of disability or occur at the end of a period of disability
333	as the last day or days of such period, such nonworking days
334	constitute a part of the period of disability with respect to
335	which compensation is payable.
336	(38) "Catastrophic injury" means a permanent impairment
337	constituted by the loss of both hands, both arms, both feet,
338	both legs, or both eyes, or any two thereof, or paraplegia or
339	quadriplegia.:
340	(a) Spinal cord injury involving severe paralysis of an
341	arm, a leg, or the trunk;
342	(b) Amputation of an arm, a hand, a foot, or a leg
343	involving the effective loss of use of that appendage;
344	(c) Severe brain or closed-head injury as evidenced by:
345	1. Severe sensory or motor disturbances;
346	2. Severe communication disturbances;
347	3. Severe complex integrated disturbances of cerebral
348	function;
349	4. Severe episodic neurological disorders; or
350	5. Other severe brain and closed-head injury conditions at
351	least as severe in nature as any condition provided in
352	subparagraphs 1.-4.;
353	(d) Second-degree or third-degree burns of 25 percent or
354	more of the total body surface or third-degree burns of 5
355	percent or more to the face and hands;
356	(e) Total or industrial blindness; or
357	(f) Any other injury that would otherwise qualify under
358	this chapter of a nature and severity that would qualify an
359	employee to receive disability income benefits under Title II or
360	supplemental security income benefits under Title XVI of the
361	federal Social Security Act as the Social Security Act existed
362	on July 1, 1992, without regard to any time limitations provided
363	under that act.
364	(40) "Statement," for the purposes of ss. 440.105 and
365	440.106, shall include the exact fraud statement language in s.
366	440.105(7). This requirementincludes, but is not limited to,
367	any notice, representation, statement, proof of injury, bill for
368	services, diagnosis, prescription, hospital or doctor record, X
369	ray, test result, or other evidence of loss, injury, or expense.
370	(41) "Specificity" means information on the petition for
371	benefits sufficient to put the employer or carrier on notice of
372	the exact statutory classification and outstanding time period
373	of benefits being requested and includes a detailed explanation
374	of any benefits received that should be increased, decreased,
375	changed, or otherwise modified. If the petition is for medical
376	benefits, the information shall include specific details as to
377	why such benefits are being requested, why such benefits are
378	medically necessary, and why current treatment, if any, is not
379	sufficient. Any petition requesting alternate or other medical
380	care, including, but not limited to, petitions requesting
381	psychiatric or psychological treatment, must specifically
382	identify the physician, as defined in s. 440.13(1), that is
383	recommending such treatment. A copy of a report from such
384	physician making the recommendation for alternate or other
385	medical care shall also be attached to the petition. A judge of
386	compensation claims shall not order such treatment if a
387	physician is not recommending such treatment."Commercial
388	building" means any building or structure intended for
389	commercial or industrial use, or any building or structure
390	intended for multifamily use of more than four dwelling units,
391	as well as any accessory use structures constructed in
392	conjunction with the principal structure. The term, "commercial
393	building," does not include the conversion of any existing
394	residential building to a commercial building.
395	(42) "Residential building" means any building or
396	structure intended for residential use containing four or fewer
397	dwelling units and any structures intended as an accessory use
398	to the residential structure.
399	Section 2. Effective January 1, 2004, subsections (8),
400	(15), and (16) of section 440.02, Florida Statutes, as amended
401	by this act, are amended to read:
402	440.02 Definitions.--When used in this chapter, unless the
403	context clearly requires otherwise, the following terms shall
404	have the following meanings:
405	(8) "Construction industry" means for-profit activities
406	involving the carrying out ofany building, clearing, filling,
407	excavation, or substantial improvement in the size or use of any
408	structure or the appearance of any land. When appropriate to the
409	context, "construction" refers to the act of construction or the
410	result of construction. However, "construction" doesshallnot
411	mean a homeowner'slandowner'sact of construction or the result
412	of a construction upon his or her own premises, provided such
413	premises are not intended to be sold,or resold, or leased by
414	the owner within 1 year after the commencement of construction.
415	The division may, by rule, establish standard industrial
416	classification codes and definitions thereof which meet the
417	criteria of the term "construction industry" as set forth in
418	this section.
419	(15)(a) "Employee" means any person who receives
420	remuneration from an employer for the performance of any work or
421	service whileengaged in any employment under any appointment or
422	contract forofhire or apprenticeship, express or implied, oral
423	or written, whether lawfully or unlawfully employed, and
424	includes, but is not limited to, aliens and minors.
425	(b) "Employee" includes any person who is an officer of a
426	corporation and who performs services for remuneration for such
427	corporation within this state, whether or not such services are
428	continuous.
429	1. Any officer of a corporation may elect to be exempt
430	from this chapter by filing written notice of the election with
431	the department as provided in s. 440.05.
432	2. As to officers of a corporation who are actively
433	engaged in the construction industry, no more than three
434	officers of a corporation or of any group of affiliated
435	corporationsmay elect to be exempt from this chapter by filing
436	written notice of the election with the department as provided
437	in s. 440.05. Officers must be shareholders, each owning at
438	least 10 percent of the stock of such corporation and listed as
439	an officer of such corporation with the Division of Corporations
440	of the Department of State, in order to elect exemptions under
441	this chapter. For purposes of this subparagraph, the term
442	"affiliated" means and includes one or more corporations or
443	entities, any one of which is a corporation engaged in the
444	construction industry, under the same or substantially the same
445	control of a group of business entities which are connected or
446	associated so that one entity controls or has the power to
447	control each of the other business entities. The term
448	"affiliated" includes, but is not limited to, the officers,
449	directors, executives, shareholders active in management,
450	employees, and agents of the affiliated corporation. The
451	ownership by one business entity of a controlling interest in
452	another business entity or a pooling of equipment or income
453	among business entities shall be prima facie evidence that one
454	business is affiliated with the other.
455	3. An officer of a corporation who elects to be exempt
456	from this chapter by filing a written notice of the election
457	with the department as provided in s. 440.05 is not an employee.
458
459	Services are presumed to have been rendered to the corporation
460	if the officer is compensated by other than dividends upon
461	shares of stock of the corporation which the officer owns.
462	(c) "Employee" includes:
463	1. A sole proprietor or a partner who is not engaged in
464	the construction industry,devotes full time to the
465	proprietorship or partnership, and, except as provided in this
466	paragraph,elects to be included in the definition of employee
467	by filing notice thereof as provided in s. 440.05. Partners or
468	sole proprietors actively engaged in the construction industry
469	are considered employees unless they elect to be excluded from
470	the definition of employee by filing written notice of the
471	election with the department as provided in s. 440.05. However,
472	no more than three partners in a partnership that is actively
473	engaged in the construction industry may elect to be excluded. A
474	sole proprietor or partner who is actively engaged in the
475	construction industry and who elects to be exempt from this
476	chapter by filing a written notice of the election with the
477	department as provided in s. 440.05 is not an employee. For
478	purposes of this chapter, an independent contractor is an
479	employee unless he or she meets all of the conditions set forth
480	in subparagraph (d)1.
481	2. All persons who are being paid by a construction
482	contractor as a subcontractor, unless the subcontractor has
483	validly elected an exemption as permitted by this chapter, or
484	has otherwise secured the payment of compensation coverage as a
485	subcontractor, consistent with s. 440.10, for work performed by
486	or as a subcontractor.
487	3. An independent contractor working or performing
488	services in the construction industry.
489	4. A sole proprietor who engages in the construction
490	industry and a partner or partnership that is engaged in the
491	construction industry.
492	(d) "Employee" does not include:
493	1. An independent contractor who is not engaged in the
494	construction industry., if:
495	a. In order to meet the definition of independent
496	contractor, at least four of the following criteria must be met:
497	(I) The independent contractor maintains a separate
498	business with his or her own work facility, truck, equipment,
499	materials, or similar accommodations;
500	(II) The independent contractor holds or has applied for a
501	federal employer identification number, unless the independent
502	contractor is a sole proprietor who is not required to obtain a
503	federal employer identification number under state or federal
504	regulations;
505	(III) The independent contractor receives compensation for
506	services rendered or work performed and such compensation is
507	paid to a business rather than to an individual;
508	(IV) The independent contractor holds one or more bank
509	accounts in the name of the business entity for purposes of
510	paying business expenses or other expenses related to services
511	rendered or work performed for compensation;
512	(V) The independent contractor performs work or is able to
513	perform work for any entity in addition to or besides the
514	employer at his or her own election without the necessity of
515	completing an employment application or process; or
516	(VI) The independent contractor receives compensation for
517	work or services rendered on a competitive-bid basis or
518	completion of a task or a set of tasks as defined by a
519	contractual agreement, unless such contractual agreement
520	expressly states that an employment relationship exists.The
521	independent contractor maintains a separate business with his or
522	her own work facility, truck, equipment, materials, or similar
523	accommodations;
524	b. If four of the criteria listed in sub-subparagraph a.
525	do not exist, an individual may still be presumed to be an
526	independent contractor and not an employee based on full
527	consideration of the nature of the individual situation with
528	regard to satisfying any of the following conditions:
529	(I) The independent contractor performs or agrees to
530	perform specific services or work for a specific amount of money
531	and controls the means of performing the services or work.
532	(II) The independent contractor incurs the principal
533	expenses related to the service or work that he or she performs
534	or agrees to perform.
535	(III) The independent contractor is responsible for the
536	satisfactory completion of the work or services that he or she
537	performs or agrees to perform.
538	(IV) The independent contractor receives compensation for
539	work or services performed for a commission or on a per-job
540	basis and not on any other basis.
541	(V) The independent contractor may realize a profit or
542	suffer a loss in connection with performing work or services.
543	(VI) The independent contractor has continuing or
544	recurring business liabilities or obligations.
545	(VII) The success or failure of the independent
546	contractor's business depends on the relationship of business
547	receipts to expenditures.The independent contractor holds or
548	has applied for a federal employer identification number, unless
549	the independent contractor is a sole proprietor who is not
550	required to obtain a federal employer identification number
551	under state or federal requirements;
552	c. Notwithstanding anything to the contrary in this
553	subparagraph, an individual claiming to be an independent
554	contractor has the burden of proving that he or she is an
555	independent contractor for purposes of this chapter.The
556	independent contractor performs or agrees to perform specific
557	services or work for specific amounts of money and controls the
558	means of performing the services or work;
559	d. The independent contractor incurs the principal
560	expenses related to the service or work that he or she performs
561	or agrees to perform;
562	e. The independent contractor is responsible for the
563	satisfactory completion of work or services that he or she
564	performs or agrees to perform and is or could be held liable for
565	a failure to complete the work or services;
566	f. The independent contractor receives compensation for
567	work or services performed for a commission or on a per-job or
568	competitive-bid basis and not on any other basis;
569	g. The independent contractor may realize a profit or
570	suffer a loss in connection with performing work or services;
571	h. The independent contractor has continuing or recurring
572	business liabilities or obligations; and
573	i. The success or failure of the independent contractor's
574	business depends on the relationship of business receipts to
575	expenditures.
576
577	However, the determination as to whether an individual included
578	in the Standard Industrial Classification Manual of 1987,
579	Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762, 0781, 0782,
580	0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436, 2448, or 2449,
581	or a newspaper delivery person, is an independent contractor is
582	governed not by the criteria in this paragraph but by common-law
583	principles, giving due consideration to the business activity of
584	the individual.
585	2. A real estate salesperson or agent, if that person
586	agrees, in writing, to perform for remuneration solely by way of
587	commission.
588	3. Bands, orchestras, and musical and theatrical
589	performers, including disk jockeys, performing in licensed
590	premises as defined in chapter 562, if a written contract
591	evidencing an independent contractor relationship is entered
592	into before the commencement of such entertainment.
593	4. An owner-operator of a motor vehicle who transports
594	property under a written contract with a motor carrier which
595	evidences a relationship by which the owner-operator assumes the
596	responsibility of an employer for the performance of the
597	contract, if the owner-operator is required to furnish the
598	necessary motor vehicle equipment and all costs incidental to
599	the performance of the contract, including, but not limited to,
600	fuel, taxes, licenses, repairs, and hired help; and the owner-
601	operator is paid a commission for transportation service and is
602	not paid by the hour or on some other time-measured basis.
603	5. A person whose employment is both casual and not in the
604	course of the trade, business, profession, or occupation of the
605	employer.
606	6. A volunteer, except a volunteer worker for the state or
607	a county, municipality, or other governmental entity. A person
608	who does not receive monetary remuneration for services is
609	presumed to be a volunteer unless there is substantial evidence
610	that a valuable consideration was intended by both employer and
611	employee. For purposes of this chapter, the term "volunteer"
612	includes, but is not limited to:
613	a. Persons who serve in private nonprofit agencies and who
614	receive no compensation other than expenses in an amount less
615	than or equivalent to the standard mileage and per diem expenses
616	provided to salaried employees in the same agency or, if such
617	agency does not have salaried employees who receive mileage and
618	per diem, then such volunteers who receive no compensation other
619	than expenses in an amount less than or equivalent to the
620	customary mileage and per diem paid to salaried workers in the
621	community as determined by the department; and
622	b. Volunteers participating in federal programs
623	established under Pub. L. No. 93-113.
624	7. Unless otherwise prohibited by this chapter,any
625	officer of a corporation who elects to be exempt from this
626	chapter. Such officer is not an employee for any reason under
627	this chapter until the notice of revocation of election filed
628	pursuant to s. 440.05 is effective.
629	8. Ana sole proprietor or officer of a corporation who
630	actively engages in the construction industry, and a partner in
631	a partnership that is activelyengaged in the construction
632	industry,who elects to be exempt from the provisions of this
633	chapter, as otherwise permitted by this chapter. Such sole
634	proprietor, officer, or partneris not an employee for any
635	reason until the notice of revocation of election filed pursuant
636	to s. 440.05 is effective.
637	9. An exercise rider who does not work for a single horse
638	farm or breeder, and who is compensated for riding on a case-by-
639	case basis, provided a written contract is entered into prior to
640	the commencement of such activity which evidences that an
641	employee/employer relationship does not exist.
642	10. A taxicab, limousine, or other passenger vehicle-for-
643	hire driver who operates said vehicles pursuant to a written
644	agreement with a company which provides any dispatch, marketing,
645	insurance, communications, or other services under which the
646	driver and any fees or charges paid by the driver to the company
647	for such services are not conditioned upon, or expressed as a
648	proportion of, fare revenues.
649	11. A person who performs services as a sports official
650	for an entity sponsoring an interscholastic sports event or for
651	a public entity or private, nonprofit organization that sponsors
652	an amateur sports event. For purposes of this subparagraph, such
653	a person is an independent contractor. For purposes of this
654	subparagraph, the term "sports official" means any person who is
655	a neutral participant in a sports event, including, but not
656	limited to, umpires, referees, judges, linespersons,
657	scorekeepers, or timekeepers. This subparagraph does not apply
658	to any person employed by a district school board who serves as
659	a sports official as required by the employing school board or
660	who serves as a sports official as part of his or her
661	responsibilities during normal school hours.
662	12. Medicaid-enrolled clients under chapter 393 who are
663	excluded from the definition of employment under s.
664	443.036(21)(d)5. and served by Adult Day Training Services under
665	the Home and Community-Based Medicaid Waiver program in a
666	sheltered workshop setting licensed by the United States
667	Department of Labor for the purpose of training and earning less
668	than the federal hourly minimum wage.
669	(16)(a)"Employer" means the state and all political
670	subdivisions thereof, all public and quasi-public corporations
671	therein, every person carrying on any employment, and the legal
672	representative of a deceased person or the receiver or trustees
673	of any person. "Employer" also includes employment agencies,
674	employee leasing companies, and similar agents who provide
675	employees to other persons.If the employer is a corporation,
676	parties in actual control of the corporation, including, but not
677	limited to, the president, officers who exercise broad corporate
678	powers, directors, and all shareholders who directly or
679	indirectly own a controlling interest in the corporation, are
680	considered the employer for the purposes of ss. 440.105,and
681	440.106, and 440.107.
682	(b) A homeowner shall not be considered the employer of
683	persons hired by the homeowner to carry out construction on the
684	homeowner's own premises if those premises are not intended for
685	immediate lease, sale, or resale.
686	(c) Facilities serving individuals under subparagraph
687	(15)(d)12. shall be considered agents of the Agency for Health
688	Care Administration as it relates to providing Adult Day
689	Training Services under the Home and Community-Based Medicaid
690	Waiver program and not employers or third parties for the
691	purpose of limiting or denying Medicaid benefits.
692	Section 3. Effective January 1, 2004, subsections (3),
693	(4), (6), (10), (11), and (12) of section 440.05, Florida
694	Statutes, are amended, present subsection (13) is renumbered as
695	subsection (11) and amended, and new subsections (12), (13),
696	(14), and (15) are added to said section, to read:
697	440.05 Election of exemption; revocation of election;
698	notice; certification.--
699	(3) Each sole proprietor, partner, orofficer of a
700	corporation who is activelyengaged in the construction industry
701	and who elects an exemption from this chapter or who, after
702	electing such exemption, revokes that exemption, must mail a
703	written notice to such effect to the department on a form
704	prescribed by the department. The notice of election to be
705	exempt from the provisions of this chapter must be notarized and
706	under oath. The notice of election to be exempt which is
707	submitted to the department by the sole proprietor, partner, or
708	officer of a corporation who is allowed to claim an exemption as
709	provided by this chaptermust list the name, federal tax
710	identification number, social security number, all certified or
711	registered licenses issued pursuant to chapter 489 held by the
712	person seeking the exemption, a copy of relevant documentation
713	as to employment status filed with the Internal Revenue Service
714	as specified by the department, a copy of the relevant
715	occupational license in the primary jurisdiction of the
716	business, and, for corporate officers and partners,the
717	registration number of the corporation or partnershipfiled with
718	the Division of Corporations of the Department of State along
719	with a copy of the stock certificate evidencing the required
720	ownership under this chapter. The notice of election to be
721	exempt must identify each sole proprietorship, partnership, or
722	corporation that employs the person electing the exemption and
723	must list the social security number or federal tax
724	identification number of each such employer and the additional
725	documentation required by this section. In addition, the notice
726	of election to be exempt must provide that the sole proprietor,
727	partner, orofficer electing an exemption is not entitled to
728	benefits under this chapter, must provide that the election does
729	not exceed exemption limits for officers and partnerships
730	provided in s. 440.02, and must certify that any employees of
731	the corporation whosesole proprietor, partner, or officer
732	electselectingan exemption are covered by workers'
733	compensation insurance. Upon receipt of the notice of the
734	election to be exempt, receipt of all application fees, and a
735	determination by the department that the notice meets the
736	requirements of this subsection, the department shall issue a
737	certification of the election to the sole proprietor, partner,
738	orofficer, unless the department determines that the
739	information contained in the notice is invalid. The department
740	shall revoke a certificate of election to be exempt from
741	coverage upon a determination by the department that the person
742	does not meet the requirements for exemption or that the
743	information contained in the notice of election to be exempt is
744	invalid. The certificate of election must list the namenamesof
745	the sole proprietorship, partnership, orcorporation listed in
746	the request for exemption. A new certificate of election must be
747	obtained each time the person is employed by a new sole
748	proprietorship, partnership, or differentcorporation that is
749	not listed on the certificate of election. A copy of the
750	certificate of election must be sent to each workers'
751	compensation carrier identified in the request for exemption.
752	Upon filing a notice of revocation of election, ana sole
753	proprietor, partner, or officer who is a subcontractor or an
754	officer of a corporate subcontractormust notify her or his
755	contractor. Upon revocation of a certificate of election of
756	exemption by the department, the department shall notify the
757	workers' compensation carriers identified in the request for
758	exemption.
759	(4) The notice of election to be exempt from the
760	provisions of this chapter must contain a notice that clearly
761	states in substance the following: "Any person who, knowingly
762	and with intent to injure, defraud, or deceive the department or
763	any employer or employee, insurance company, or any other person
764	purposes program, files a notice of election to be exempt
765	containing any false or misleading information is guilty of a
766	felony of the third degree." Each person filing a notice of
767	election to be exempt shall personally sign the notice and
768	attest that he or she has reviewed, understands, and
769	acknowledges the foregoing notice.
770	(6) A construction industry certificate of election to be
771	exempt which is issued in accordance with this section shall be
772	valid for 2 years after the effective date stated thereon. Both
773	the effective date and the expiration date must be listed on the
774	face of the certificate by the department. The construction
775	industry certificate must expire at midnight, 2 years from its
776	issue date, as noted on the face of the exemption certificate.
777	Any person who has received from the division a construction
778	industry certificate of election to be exempt which is in effect
779	on December 31, 1998, shall file a new notice of election to be
780	exempt by the last day in his or her birth month following
781	December 1, 1998. A construction industry certificate of
782	election to be exempt may be revoked before its expiration by
783	the sole proprietor, partner, orofficer for whom it was issued
784	or by the department for the reasons stated in this section. At
785	least 60 days prior to the expiration date of a construction
786	industry certificate of exemption issued after December 1, 1998,
787	the department shall send notice of the expiration date and an
788	application for renewal to the certificateholder at the address
789	on the certificate.
790	(10) Each sole proprietor, partner, orofficer of a
791	corporation who is actively engaged in the construction industry
792	and who elects an exemption from this chapter shall maintain
793	business records as specified by the division by rule, which
794	rules must include the provision that any corporation with
795	exempt officers and any partnership activelyengaged in the
796	construction industry with exempt partnersmust maintain written
797	statements of those exempted persons affirmatively acknowledging
798	each such individual's exempt status.
799	(11) Any sole proprietor or partner actively engaged in
800	the construction industry claiming an exemption under this
801	section shall maintain a copy of his or her federal income tax
802	records for each of the immediately previous 3 years in which he
803	or she claims an exemption. Such federal income tax records must
804	include a complete copy of the following for each year in which
805	an exemption is claimed:
806	(a) For sole proprietors, a copy of Federal Income Tax
807	Form 1040 and its accompanying Schedule C;
808	(b) For partners, a copy of the partner's Federal Income
809	Tax Schedule K-1 (Form 1065) and Federal Income Tax Form 1040
810	and its accompanying Schedule E.
811
812	A sole proprietor or partner shall produce, upon request by the
813	division, a copy of those documents together with a statement by
814	the sole proprietor or partner that the tax records provided are
815	true and accurate copies of what the sole proprietor or partner
816	has filed with the federal Internal Revenue Service. The
817	statement must be signed under oath by the sole proprietor or
818	partner and must be notarized. The division shall issue a stop-
819	work order under s. 440.107(5) to any sole proprietor or partner
820	who fails or refuses to produce a copy of the tax records and
821	affidavit required under this paragraph to the division within 3
822	business days after the request is made.
823	(12) For those sole proprietors or partners that have not
824	been in business long enough to provide the information required
825	of an established business, the division shall require such sole
826	proprietor or partner to provide copies of the most recently
827	filed Federal Income Tax Form 1040. The division shall establish
828	by rule such other criteria to show that the sole proprietor or
829	partner intends to engage in a legitimate enterprise within the
830	construction industry and is not otherwiseattempting to evade
831	the requirements of this section. The division shall establish
832	by rule the form and format of financial information required to
833	be submitted by such employers.
834	(11)(13) Any corporate officer permitted by this chapter
835	to claimclaiming an exemption under this sectionmust be listed
836	on the records of this state's Secretary of State, Division of
837	Corporations, as a corporate officer. If the person who claims
838	an exemption as a corporate officer is not so listed on the
839	records of the Secretary of State, the individual must provide
840	to the division, upon request by the division, a notarized
841	affidavit stating that the individual is a bona fide officer of
842	the corporation and stating the date his or her appointment or
843	election as a corporate officer became or will become effective.
844	The statement must be signed under oath by both the officer and
845	the president or chief operating officer of the corporation and
846	must be notarized.The division shall issue a stop-work order
847	under s. 440.107(1) to any corporation who employs a person who
848	claims to be exempt as a corporate officer but who fails or
849	refuses to produce the documents required under this subsection
850	to the division within 3 business days after the request is
851	made.
852	(12) Certificates of election to be exempt issued under
853	subsection (3) shall apply only to the corporate officer named
854	on the notice of election to be exempt and apply only within the
855	scope of the business or trade listed on the notice of election
856	to be exempt.
857	(13) Notices of election to be exempt and certificates of
858	election to be exempt shall be subject to revocation if, at any
859	time after the filing of the notice or the issuance of the
860	certificate, the person named on the notice or certificate no
861	longer meets the requirements of this section for issuance of a
862	certificate. The department shall revoke a certificate at any
863	time for failure of the person named on the certificate to meet
864	the requirements of this section.
865	(14) An officer of a corporation who elects exemption from
866	this chapter by filing a certificate of election under this
867	section may not recover benefits or compensation under this
868	chapter. For purposes of determining the appropriate premium for
869	workers' compensation coverage, carriers may not consider any
870	officer of a corporation who validly meets the requirements of
871	this section to be an employee.
872	(15) Any corporate officer who is an affiliated person
873	of a person who is delinquent in paying a stop-work order and
874	penalty assessment order issued pursuant to s. 440.107, or owed
875	pursuant to a court order, is ineligible for an election of
876	exemption. The stop-work order and penalty assessment shall be
877	in effect against any such affiliated person. As used in this
878	subsection, the term "affiliated person" means:
879	(a) The spouse of such other person;
880	(b) Any person who directly or indirectly owns or
881	controls, or holds with the power to vote, 10 percent or more of
882	the outstanding voting securities of such other person;
883	(c) Any person who directly or indirectly owns 10 percent
884	or more of the outstanding voting securities that are directly
885	or indirectly owned, controlled, or held with the power to vote
886	by such other person;
887	(d) Any person or group of persons who directly or
888	indirectly control, are controlled by, or are under common
889	control with such other person;
890	(e) Any person who directly or indirectly acquires all or
891	substantially all of the other assets of such other person;
892	(f) Any officer, director, trustee, partner, owner,
893	manager, joint venturer, or employee of such other person or a
894	person performing duties similar to persons in such positions;
895	or
896	(g) Any person who has an officer, director, trustee,
897	partner, or joint venturer in common with such person.
898	Section 4. Section 440.06, Florida Statutes, is amended to
899	read:
900	440.06 Failure to secure compensation; effect.--Every
901	employer who fails to secure the payment of compensation, as
902	provided in s. 440.10, by failing to meet the requirements of
903	under this chapter as provided ins. 440.38 may not, in any suit
904	brought against him or her by an employee subject to this
905	chapter to recover damages for injury or death, defend such a
906	suit on the grounds that the injury was caused by the negligence
907	of a fellow servant, that the employee assumed the risk of his
908	or her employment, or that the injury was due to the comparative
909	negligence of the employee.
910	Section 5. Effective January 1, 2004, section 440.077,
911	Florida Statutes, is amended to read:
912	440.077 When a corporatesole proprietor, partner, or
913	officer rejects chapter, effect.--AnA sole proprietor, partner,
914	or officer of a corporation who is permitted to elect an
915	exemption under this chapteractively engaged in the
916	construction industryand who elects to be exempt from the
917	provisions of this chapter may not recover benefits under this
918	chapter.
919	Section 6. Subsections (1) and (4) of section 440.09,
920	Florida Statutes, are amended and paragraph (e) is added to
921	subsection (7) of said section, to read:
922	440.09 Coverage.--
923	(1) The employer mustshallpay compensation or furnish
924	benefits required by this chapter if the employee suffers an
925	accidental compensableinjury or death arising out of work
926	performed in the course and the scope of employment. The injury,
927	its occupational cause, and any resulting manifestations or
928	disability mustshallbe established to a reasonable degree of
929	medical certainty, based onand by objective relevantmedical
930	findings, and the accidental compensable injury must be the
931	major contributing cause of any resulting injuries. For purposes
932	of this section, "major contributing cause" means the cause
933	which is more than 50 percent responsible for the injury as
934	compared to all other causes combined for which treatment or
935	benefits are sought. In cases involving occupational disease or
936	repetitive exposure, both causation and sufficient exposure to
937	support causation must be proven by clear and convincing
938	evidence. Pain or other subjective complaints alone, in the
939	absence of objective relevant medical findings, are not
940	compensable. For purposes of this section, "objective relevant
941	medical findings" are those objective findings that correlate to
942	the subjective complaints of the injured employee and are
943	confirmed by physical examination findings or diagnostic
944	testing. Establishment of the causal relationship between a
945	compensable accident and injuries for conditions that are not
946	readily observable must be by medical evidence only, as
947	demonstrated by physical examination findings or diagnostic
948	testing. Major contributing cause must be demonstrated by
949	medical evidence only. Mental or nervous injuries occurring as a
950	manifestation of an injury compensable under this section shall
951	be demonstrated by clear and convincing evidence.
952	(a) This chapter does not require any compensation or
953	benefits for any subsequent injury the employee suffers as a
954	result of an original injury arising out of and in the course of
955	employment unless the original injury is the major contributing
956	cause of the subsequent injury. Major contributing cause must be
957	demonstrated by medical evidence only.
958	(b) If an injury arising out of and in the course of
959	employment combines with a preexisting disease or condition to
960	cause or prolong disability or need for treatment, the employer
961	must pay compensation or benefits required by this chapter only
962	to the extent that the injury arising out of and in the course
963	of employment is and remains more than 50 percent responsible
964	for the injury as compared to all other causes combined and
965	thereafter remainsthe major contributing cause of the
966	disability or need for treatment. Major contributing cause must
967	be demonstrated by medical evidence only.
968	(c) Death resulting from an operation by a surgeon
969	furnished by the employer for the cure of hernia as required in
970	s. %_%0%_%[F.S. 1981]shall for the purpose of this chapter be
971	considered to be a death resulting from the accident causing the
972	hernia.
973	(d) If an accident happens while the employee is employed
974	elsewhere than in this state, which would entitle the employee
975	or his or her dependents to compensation if it had happened in
976	this state, the employee or his or her dependents are entitled
977	to compensation if the contract of employment was made in this
978	state, or the employment was principally localized in this
979	state. However, if an employee receives compensation or damages
980	under the laws of any other state, the total compensation for
981	the injury may not be greater than is provided in this chapter.
982	(4)(a)An employee shall not be entitled to compensation
983	or benefits under this chapter if any judge of compensation
984	claims, administrative law judge, court, or jury convened in
985	this state determines that the employee has knowingly or
986	intentionally engaged in any of the acts described in s. 440.105
987	or any criminal actfor the purpose of securing workers'
988	compensation benefits. For purposes of this section, the term
989	"intentional" shall include, but is not limited to, pleas of
990	guilty or nolo contendere in criminal matters. This section
991	shall apply to accidents, regardless of the date of the
992	accident. For injuries occurring prior to January 1, 1994, this
993	section shall pertain to the acts of the employee described in
994	s. 440.105 or criminal activities occurring subsequent to
995	January 1, 1994.
996	(b) A judge of compensation claims, administrative law
997	judge, or court of this state shall take judicial notice of a
998	finding of insurance fraud by a court of competent jurisdiction
999	and terminate or otherwise disallow benefits.
1000	(c) Upon the denial of benefits in accordance with this
1001	section, a judge of compensation claims shall have the
1002	jurisdiction to order any benefits payable to the employee to be
1003	paid into the court registry or an escrow account during the
1004	pendency of an appeal or until such time as the time in which to
1005	file an appeal has expired.
1006	(7)
1007	(e) As a part of rebutting any presumptions under
1008	paragraph (b), the injured worker must prove the actual
1009	quantitative amounts of the drug or its metabolites as measured
1010	on the initial and confirmation post-accident drug tests of the
1011	injured worker's urine sample and provide additional evidence
1012	regarding the absence of drug influence other than the worker's
1013	denial of being under the influence of a drug. No drug test
1014	conducted on a urine sample shall be rejected as to its results
1015	or the presumption imposed under paragraph (b) on the basis of
1016	the urine being bodily fluid tested.
1017	Section 7. Section 440.093, Florida Statutes, is created
1018	to read:
1019	440.093 Mental and nervous injuries.--
1020	(1) A mental or nervous injury due to stress, fright, or
1021	excitement only is not an injury by accident arising out of the
1022	employment. Nothing in this section shall be construed to allow
1023	for the payment of benefits under this chapter for mental or
1024	nervous injuries without an accompanying physical injury
1025	requiring medical treatment. A physical injury resulting from
1026	mental or nervous injuries unaccompanied by physical trauma
1027	requiring medical treatment shall not be compensable under this
1028	chapter.
1029	(2) Mental or nervous injuries occurring as a
1030	manifestation of an injury compensable under this chapter shall
1031	be demonstrated by clear and convincing medical evidence by a
1032	licensed psychiatrist meeting criteria established in the most
1033	recent edition of the diagnostic and statistical manual of
1034	mental disorders published by the American Psychiatric
1035	Association. The compensable physical injury must be and remain
1036	the major contributing cause of the mental or nervous condition
1037	and the compensable physical injury as determined by reasonable
1038	medical certainty must be at least 50 percent responsible for
1039	the mental or nervous condition as compared to all other
1040	contributing causes combined. Compensation is not payable for
1041	the mental, psychological, or emotional injury arising out of
1042	depression from being out of work or losing employment
1043	opportunities, resulting from a preexisting mental,
1044	psychological, or emotional condition or due to pain or other
1045	subjective complaints that cannot be substantiated by objective,
1046	relevant medical findings.
1047	(3) Subject to the payment of permanent benefits under s.
1048	440.15, in no event shall benefits for a compensable mental or
1049	nervous injury be paid for more than 3 months after the date of
1050	maximum medical improvement for the injured employee's physical
1051	injury or injuries, which shall be included in the period of 104
1052	weeks as provided in s. 440.15(2) and (4). Mental or nervous
1053	injuries are compensable only in accordance with the terms of
1054	this section.
1055	Section 8. Effective January 1, 2004, subsection (1) of
1056	section 440.10, Florida Statutes, is amended to read:
1057	440.10 Liability for compensation.--
1058	(1)(a) Every employer coming within the provisions of this
1059	chapter, including any brought within the chapter by waiver of
1060	exclusion or of exemption,shall be liable for, and shall
1061	secure, the payment to his or her employees, or any physician,
1062	surgeon, or pharmacist providing services under the provisions
1063	of s. 440.13, of the compensation payable under ss. 440.13,
1064	440.15, and 440.16. Any contractor or subcontractor who engages
1065	in any public or private construction in the state shall secure
1066	and maintain compensation for his or her employees under this
1067	chapter as provided in s. 440.38.
1068	(b) In case a contractor sublets any part or parts of his
1069	or her contract work to a subcontractor or subcontractors, all
1070	of the employees of such contractor and subcontractor or
1071	subcontractors engaged on such contract work shall be deemed to
1072	be employed in one and the same business or establishment,;and
1073	the contractor shall be liable for, and shall secure, the
1074	payment of compensation to all such employees, except to
1075	employees of a subcontractor who has secured such payment.
1076	(c) A contractor shallmayrequire a subcontractor to
1077	provide evidence of workers' compensation insurance or a copy of
1078	his or her certificate of election. A subcontractor who is a
1079	corporation and has an officer who electselectingto be exempt
1080	as permitted under this chaptera sole proprietor, partner, or
1081	officer of a corporationshall provide a copy of his or her
1082	certificate of exemptionelectionto the contractor.
1083	(d)1. If a contractor becomes liable for the payment of
1084	compensation to the employees of a subcontractor who has failed
1085	to secure such payment in violation of s. 440.38, the contractor
1086	or other third-party payor shall be entitled to recover from the
1087	subcontractor all benefits paid or payable plus interest unless
1088	the contractor and subcontractor have agreed in writing that the
1089	contractor will provide coverage.
1090	2. If a contractor or third-party payor becomes liable for
1091	the payment of compensation to the corporate officeremployeeof
1092	a subcontractor who is activelyengaged in the construction
1093	industry and has elected to be exempt from the provisions of
1094	this chapter, but whose election is invalid, the contractor or
1095	third-party payor may recover from the claimant, partnership,or
1096	corporation all benefits paid or payable plus interest, unless
1097	the contractor and the subcontractor have agreed in writing that
1098	the contractor will provide coverage.
1099	(e) A subcontractor providing services in conjunction with
1100	a contractor on the same project or contract workis not liable
1101	for the payment of compensation to the employees of another
1102	subcontractor or the contractor on such contract work and is not
1103	protected by the exclusiveness-of-liability provisions of s.
1104	440.11 from anyaction at law or in admiralty on account of
1105	injury to anof such employee of another subcontractor, or of
1106	the contractor, provided that:
1107	1. The subcontractor has secured workers' compensation
1108	insurance for its employees or the contractor has secured such
1109	insurance on behalf of the subcontractor and its employees in
1110	accordance with paragraph (b); and
1111	2. The subcontractor's own gross negligence was not the
1112	major contributing cause of the injury.
1113	(f) If an employer fails to secure compensation as
1114	required by this chapter, the department shallmayassess
1115	against the employer a penalty not to exceed $5,000 for each
1116	employee of that employer who is classified by the employer as
1117	an independent contractor but who is found by the department to
1118	not meet the criteria for an independent contractor that are set
1119	forth in s. 440.02. The division shall adopt rules to administer
1120	the provisions of this paragraph.
1121	(g) Subject to s. 440.38, any employer who has employees
1122	engaged in work in this state shall obtain a Florida policy or
1123	endorsement for such employees which utilizes Florida class
1124	codes, rates, rules, and manuals that are in compliance with and
1125	approved under the provisions of this chapter and the Florida
1126	Insurance Code. Failure to comply with this paragraph is a
1127	felony of the second degree, punishable as provided in s.
1128	775.082, s. 775.083, or s. 775.084. The department shall adopt
1129	rules for construction industry and nonconstruction-industry
1130	employers with regard to the activities that define what
1131	constitutes being "engaged in work" in this state, using the
1132	following standards:
1133	1. For employees of nonconstruction-industry employers who
1134	have their headquarters outside of Florida and also operate in
1135	Florida and who are routinely crossing state lines, but usually
1136	return to their homes each night, the employee shall be assigned
1137	to the headquarters' state. However, the construction industry
1138	employees performing new construction or alterations in Florida
1139	shall be assigned to Florida even if the employees return to
1140	their home state each night.
1141	2. The payroll of executive supervisors who may visit a
1142	Florida location but who are not in direct charge of a Florida
1143	location shall be assigned to the state in which the
1144	headquarters is located.
1145	3. For construction contractors who maintain a permanent
1146	staff of employees and superintendents, if any of these
1147	employees or superintendents are assigned to a job that is
1148	located in Florida, either for the duration of the job or any
1149	portion thereof, their payroll shall be assigned to Florida
1150	rather than headquarters' state.
1151	4. Employees who are hired for a specific project in
1152	Florida shall be assigned to Florida.For purposes of this
1153	section, a person is conclusively presumed to be an independent
1154	contractor if:
1155	1. The independent contractor provides the general
1156	contractor with an affidavit stating that he or she meets all
1157	the requirements of s. 440.02; and
1158	2. The independent contractor provides the general
1159	contractor with a valid certificate of workers' compensation
1160	insurance or a valid certificate of exemption issued by the
1161	department.
1162
1163	A sole proprietor, partner, or officer of a corporation who
1164	elects exemption from this chapter by filing a certificate of
1165	election under s. 440.05 may not recover benefits or
1166	compensation under this chapter. An independent contractor who
1167	provides the general contractor with both an affidavit stating
1168	that he or she meets the requirements of s. 440.02 and a
1169	certificate of exemption is not an employee under s. 440.02 and
1170	may not recover benefits under this chapter. For purposes of
1171	determining the appropriate premium for workers' compensation
1172	coverage, carriers may not consider any person who meets the
1173	requirements of this paragraph to be an employee.
1174	Section 9. Section 440.1025, Florida Statutes, is amended
1175	to read:
1176	440.1025 Consideration of publicEmployer workplace safety
1177	program in rate-setting; program requirements; rulemaking.—
1178	(1) For a public or privateemployer to be eligible for
1179	receipt of specific identifiable consideration under s. 627.0915
1180	for a workplace safety program in the setting of rates, the
1181	publicemployer must have a workplace safety program. At a
1182	minimum, the program must include a written safety policy and
1183	safety rules, and make provision for safety inspections,
1184	preventative maintenance, safety training, first-aid, accident
1185	investigation, and necessary recordkeeping. For purposes of this
1186	section, "public employer" means any agency within state,
1187	county, or municipal government employing individuals for
1188	salary, wages, or other remuneration. The division may adopt
1189	promulgate rules for insurers to utilize in determining public
1190	employer compliance with the requirements of this section.
1191	(2) The division shall publicize on the Internet, and
1192	shall encourage insurers to publicize, the availability of free
1193	safety consultation services and safety program resources.
1194	Section 10. Section 440.103, Florida Statutes, is amended
1195	to read:
1196	440.103 Building permits; identification of minimum
1197	premium policy.--Except as otherwise provided in this chapter,
1198	Every employer shall, as a condition to applying for and
1199	receiving a building permit, show proof and certify to the
1200	permit issuerthat it has secured compensation for its employees
1201	under this chapter as provided in ss. 440.10 and 440.38. Such
1202	proof of compensation must be evidenced by a certificate of
1203	coverage issued by the carrier, a valid exemption certificate
1204	approved by the department or the former Division of Workers'
1205	Compensation of the Department of Labor and Employment Security,
1206	or a copy of the employer's authority to self-insure and shall
1207	be presented each time the employer applies for a building
1208	permit. As provided in s. 627.413(5), each certificate of
1209	coverage must show, on its face, whether or not coverage is
1210	secured under the minimum premium provisions of rules adopted by
1211	rating organizations licensed by the department. The words
1212	"minimum premium policy" or equivalent language shall be typed,
1213	printed, stamped, or legibly handwritten.
1214	Section 11. Section 440.105, Florida Statutes, is amended
1215	to read:
1216	440.105 Prohibited activities; reports; penalties;
1217	limitations.--
1218	(1)(a) Any insurance carrier, any individual self-insured,
1219	any commercial or group self-insurance fund, any professional
1220	practitioner licensed or regulated by the Department of Health
1221	Business and Professional Regulation, except as otherwise
1222	provided by law, any medical review committee as defined in s.
1223	766.101, any private medical review committee, and any insurer,
1224	agent, or other person licensed under the insurance code, or any
1225	employee thereof, having knowledge or who believes that a
1226	fraudulent act or any other act or practice which, upon
1227	conviction, constitutes a felony or misdemeanor under this
1228	chapter is being or has been committed shall send to the
1229	Division of Insurance Fraud, Bureau of Workers' Compensation
1230	Fraud, a report or information pertinent to such knowledge or
1231	belief and such additional information relative thereto as the
1232	bureau may require. The bureau shall review such information or
1233	reports and select such information or reports as, in its
1234	judgment, may require further investigation. It shall then cause
1235	an independent examination of the facts surrounding such
1236	information or report to be made to determine the extent, if
1237	any, to which a fraudulent act or any other act or practice
1238	which, upon conviction, constitutes a felony or a misdemeanor
1239	under this chapter is being committed. The bureau shall report
1240	any alleged violations of law which its investigations disclose
1241	to the appropriate licensing agency and state attorney or other
1242	prosecuting agency having jurisdiction with respect to any such
1243	violations of this chapter. If prosecution by the state attorney
1244	or other prosecuting agency having jurisdiction with respect to
1245	such violation is not begun within 60 days of the bureau's
1246	report, the state attorney or other prosecuting agency having
1247	jurisdiction with respect to such violation shall inform the
1248	bureau of the reasons for the lack of prosecution.
1249	(b) In the absence of fraud or bad faith, a person is not
1250	subject to civil liability for libel, slander, or any other
1251	relevant tort by virtue of filing reports, without malice, or
1252	furnishing other information, without malice, required by this
1253	section or required by the bureau, and no civil cause of action
1254	of any nature shall arise against such person:
1255	1. For any information relating to suspected fraudulent
1256	acts furnished to or received from law enforcement officials,
1257	their agents, or employees;
1258	2. For any information relating to suspected fraudulent
1259	acts furnished to or received from other persons subject to the
1260	provisions of this chapter; or
1261	3. For any such information relating to suspected
1262	fraudulent acts furnished in reports to the bureau, or the
1263	National Association of Insurance Commissioners.
1264	(2) Whoever violates any provision of this subsection
1265	commits a misdemeanor of the firstseconddegree, punishable as
1266	provided in s. 775.082 or s. 775.083.
1267	(a) It shall be unlawful for any employer to knowingly:
1268	1. Coerce or attempt to coerce, as a precondition to
1269	employment or otherwise, an employee to obtain a certificate of
1270	election of exemption pursuant to s. 440.05.
1271	2. Discharge or refuse to hire an employee or job
1272	applicant because the employee or applicant has filed a claim
1273	for benefits under this chapter.
1274	3. Discharge, discipline, or take any other adverse
1275	personnel action against any employee for disclosing information
1276	to the department or any law enforcement agency relating to any
1277	violation or suspected violation of any of the provisions of
1278	this chapter or rules promulgated hereunder.
1279	4. Violate a stop-work order issued by the department
1280	pursuant to s. 440.107.
1281	(b) It shall be unlawful for any insurance entity to
1282	revoke or cancel a workers' compensation insurance policy or
1283	membership because an employer has returned an employee to work
1284	or hired an employee who has filed a workers' compensation
1285	claim.
1286	(3) Whoever violates any provision of this subsection
1287	commits a misdemeanor of the first degree, punishable as
1288	provided in s. 775.082 or s. 775.083.
1289	(a) It shall be unlawful for any employer to knowingly
1290	fail to update applications for coverage as required by s.
1291	440.381(1) and department of Insurance rules within 7 days after
1292	the reporting date for any change in the required information,
1293	or to post notice of coverage pursuant to s. 440.40.
1294	(b) It is unlawful for any attorney or other person, in
1295	his or her individual capacity or in his or her capacity as a
1296	public or private employee, or for any firm, corporation,
1297	partnership, or association to receive any fee or other
1298	consideration or any gratuity from a person on account of
1299	services rendered for a person in connection with any
1300	proceedings arising under this chapter, unless such fee,
1301	consideration, or gratuity is approved by a judge of
1302	compensation claims or by the Deputy Chief Judge of Compensation
1303	Claims.
1304	(4) Whoever violates any provision of this subsection
1305	commits insurance fraud, punishable as provided in paragraph
1306	(f).
1307	(a) It shall be unlawful for any employer to knowingly:
1308	1. Present or cause to be presented any false, fraudulent,
1309	or misleading oral or written statement to any person as
1310	evidence of compliance with s. 440.38.
1311	2. Make a deduction from the pay of any employee entitled
1312	to the benefits of this chapter for the purpose of requiring the
1313	employee to pay any portion of premium paid by the employer to a
1314	carrier or to contribute to a benefit fund or department
1315	maintained by such employer for the purpose of providing
1316	compensation or medical services and supplies as required by
1317	this chapter.
1318	3. Fail to secure payment of compensation if required to
1319	do so by this chapter.
1320	(b) It shall be unlawful for any person:
1321	1. To knowingly make, or cause to be made, any false,
1322	fraudulent, or misleading oral or written statement for the
1323	purpose of obtaining or denying any benefit or payment under
1324	this chapter.
1325	2. To present or cause to be presented any written or oral
1326	statement as part of, or in support of, a claim for payment or
1327	other benefit pursuant to any provision of this chapter, knowing
1328	that such statement contains any false, incomplete, or
1329	misleading information concerning any fact or thing material to
1330	such claim.
1331	3. To prepare or cause to be prepared any written or oral
1332	statement that is intended to be presented to any employer,
1333	insurance company, or self-insured program in connection with,
1334	or in support of, any claim for payment or other benefit
1335	pursuant to any provision of this chapter, knowing that such
1336	statement contains any false, incomplete, or misleading
1337	information concerning any fact or thing material to such claim.
1338	4. To knowingly assist, conspire with, or urge any person
1339	to engage in activity prohibited by this section.
1340	5. To knowingly make any false, fraudulent, or misleading
1341	oral or written statement, or to knowingly omit or conceal
1342	material information, required by s. 440.185 or s. 440.381, for
1343	the purpose of obtaining workers' compensation coverage or for
1344	the purpose of avoiding, delaying, or diminishing the amount of
1345	payment of any workers' compensation premiums.
1346	6. To knowingly misrepresent or conceal payroll,
1347	classification of workers, or information regarding an
1348	employer's loss history which would be material to the
1349	computation and application of an experience rating modification
1350	factor for the purpose of avoiding or diminishing the amount of
1351	payment of any workers' compensation premiums.
1352	7. To knowingly present or cause to be presented any
1353	false, fraudulent, or misleading oral or written statement to
1354	any person as evidence of compliance with s. 440.38, as evidence
1355	of eligibility for a certificate of exemption under s. 440.05.
1356	8. To knowingly violate a stop-work order issued by the
1357	department pursuant to s. 440.107.
1358	9. To knowingly present or cause to be presented any
1359	false, fraudulent, or misleading oral or written statement to
1360	any person as evidence of identity for the purpose of obtaining
1361	employment or filing or supporting a claim for workers'
1362	compensation benefits.
1363	(c) It shall be unlawful for any physician licensed under
1364	chapter 458, osteopathic physician licensed under chapter 459,
1365	chiropractic physician licensed under chapter 460, podiatric
1366	physician licensed under chapter 461, optometric physician
1367	licensed under chapter 463, or any other practitioner licensed
1368	under the laws of this state to knowingly and willfully assist,
1369	conspire with, or urge any person to fraudulently violate any of
1370	the provisions of this chapter.
1371	(d) It shall be unlawful for any person or governmental
1372	entity licensed under chapter 395 to maintain or operate a
1373	hospital in such a manner so that such person or governmental
1374	entity knowingly and willfully allows the use of the facilities
1375	of such hospital by any person, in a scheme or conspiracy to
1376	fraudulently violate any of the provisions of this chapter.
1377	(e) It shall be unlawful for any attorney or other person,
1378	in his or her individual capacity or in his or her capacity as a
1379	public or private employee, or any firm, corporation,
1380	partnership, or association, to knowingly assist, conspire with,
1381	or urge any person to fraudulently violate any of the provisions
1382	of this chapter.
1383	(f) If the monetary valueamount of any claim or workers'
1384	compensation insurance premium involved in anyviolation of this
1385	subsection:
1386	1. Is less than $20,000, the offender commits a felony of
1387	the third degree, punishable as provided in s. 775.082, s.
1388	775.083, or s. 775.084.
1389	2. Is $20,000 or more, but less than $100,000, the
1390	offender commits a felony of the second degree, punishable as
1391	provided in s. 775.082,. 775.083, or s. 775.084.
1392	3. Is $100,000 or more, the offender commits a felony of
1393	the first degree, punishable as provided in s. 775.082, s.
1394	775.083, or s. 775.084.
1395	(5) It shall be unlawful for any attorney or other person,
1396	in his or her individual capacity or in his or her capacity as a
1397	public or private employee or for any firm, corporation,
1398	partnership, or association, to unlawfully solicit any business
1399	in and about city or county hospitals, courts, or any public
1400	institution or public place; in and about private hospitals or
1401	sanitariums; in and about any private institution; or upon
1402	private property of any character whatsoever for the purpose of
1403	making workers' compensation claims. Whoever violates any
1404	provision of this subsection commits a felony of the second
1405	thirddegree, punishable as provided in s. 775.082, s. 775.083,
1406	or s. 775.085.
1407	(6) This section shall not be construed to preclude the
1408	applicability of any other provision of criminal law that
1409	applies or may apply to any transaction.
1410	(7) For the purpose of the section, the term "statement"
1411	includes, but is not limited to, any notice, representation,
1412	statement, proof of injury, bill for services, diagnosis,
1413	prescription, hospital or doctor records, X ray, test result, or
1414	other evidence of loss, injury, or expense.
1415	(7)(8)An injured employee or any other party making a
1416	claim under this chapter shall provide his or her personal
1417	signature attesting that he or she has reviewed, understands,
1418	and acknowledgesAll claim forms as provided for in this chapter
1419	shall contain a notice that clearly states in substancethe
1420	following statement: "Any person who, knowingly and with intent
1421	to injure, defraud, or deceive any employer or employee,
1422	insurance company, or self-insured program, files a statement of
1423	claim containing any false or misleading information commits
1424	insurance fraud, punishable as provided in s. 817.234." If the
1425	injured employee or other party refuses to sign the document
1426	attestingEach claimant shall personally sign the claim form and
1427	attestthat he or she has reviewed, understands, and
1428	acknowledges the statement, benefits or payments under this
1429	chapter shall be suspended until such signature is obtained
1430	foregoing notice.
1431	Section 12. Subsection (3) of section 440.1051, Florida
1432	Statutes, is amended to read:
1433	440.1051 Fraud reports; civil immunity; criminal
1434	penalties.--
1435	(2) Any person who reports workers' compensation fraud to
1436	the division under subsection (1) is immune from civil liability
1437	for doing so, and the person or entity alleged to have committed
1438	the fraud may not retaliate against him or her for providing
1439	such report, unless the person making the report knows it to be
1440	false.
1441	(3) A person who calls and, knowingly and falsely, reports
1442	workers' compensation fraud or who, in violation of subsection
1443	(2) retaliates against a person for making such report, commits
1444	is guilty of a felonymisdemeanor of the thirdfirstdegree,
1445	punishable as provided in s. 775.082,or s. 775.083, or s.
1446	775.084both.
1447	Section 13. Section 440.107, Florida Statutes, is amended
1448	to read:
1449	440.107 Department powers to enforce employer compliance
1450	with coverage requirements.--
1451	(1) The Legislature finds that the failure of an employer
1452	to comply with the workers' compensation coverage requirements
1453	under this chapter poses an immediate danger to public health,
1454	safety, and welfare. The Legislature authorizes the department
1455	to secure employer compliance with the workers' compensation
1456	coverage requirements and authorizes the department to conduct
1457	investigations for the purpose of ensuring employer compliance.
1458	(2) For the purposes of this section, "securing the
1459	payment of workers' compensation" means obtaining coverage that
1460	meets the requirements of this chapter and the Florida Insurance
1461	Code. However, if at any time an employer materially understates
1462	or conceals payroll, materially misrepresents or conceals
1463	employee duties so as to avoid proper classification for premium
1464	calculations, or materially misrepresents or conceals
1465	information pertinent to the computation and application of an
1466	experience rating modification factor, such employer shall be
1467	deemed to have failed to secure payment of workers' compensation
1468	and shall be subject to the sanctions set forth in this section.
1469	A stop-work order issued because an employer is deemed to have
1470	failed to secure the payment of workers' compensation required
1471	under this chapter because the employer has materially
1472	understated or concealed payroll, materially misrepresented or
1473	concealed employee duties so as to avoid proper classification
1474	for premium calculations, or materially misrepresented or
1475	concealed information pertinent to the computation and
1476	application of an experience rating modification factor shall
1477	have no effect upon an employer's or carrier's duty to provide
1478	benefits under this chapter or upon any of the employer's or
1479	carrier's rights and defenses under this chapter, including
1480	exclusive remedy.The department and its authorized
1481	representatives may enter and inspect any place of business at
1482	any reasonable time for the limited purpose of investigating
1483	compliance with workers' compensation coverage requirements
1484	under this chapter. Each employer shall keep true and accurate
1485	business records that contain such information as the department
1486	prescribes by rule. The business records must contain
1487	information necessary for the department to determine compliance
1488	with workers' compensation coverage requirements and must be
1489	maintained within this state by the business, in such a manner
1490	as to be accessible within a reasonable time upon request by the
1491	department. The business records must be open to inspection and
1492	be available for copying by the department at any reasonable
1493	time and place and as often as necessary. The department may
1494	require from any employer any sworn or unsworn reports,
1495	pertaining to persons employed by that employer, deemed
1496	necessary for the effective administration of the workers'
1497	compensation coverage requirements.
1498	(3) The department shall enforce workers' compensation
1499	coverage requirements, including the requirement that the
1500	employer secure the payment of workers' compensation, and the
1501	requirement that the employer provide the carrier with
1502	information to accurately determine payroll and correctly assign
1503	classification codes. In addition to any other powers under this
1504	chapter, the department shall have the power to:
1505	(a) Conduct investigations for the purpose of ensuring
1506	employer compliance.
1507	(b) Enter and inspect any place of business at any
1508	reasonable time for the purpose of investigating employer
1509	compliance.
1510	(c) Examine and copy business records.
1511	(d) Administer oaths and affirmations.
1512	(e) Certify to official acts.
1513	(f) Issue and serve subpoenas for attendance of witnesses
1514	or production of business records, books, papers,
1515	correspondence, memoranda, and other records.
1516	(g) Issue stop-work orders, penalty assessment orders, and
1517	any other orders necessary for the administration of this
1518	section.
1519	(h) Enforce the terms of a stop-work order.
1520	(i) Levy and pursue actions to recover penalties.
1521	(j) Seek injunctions and other appropriate relief.In
1522	discharging its duties, the department may administer oaths and
1523	affirmations, certify to official acts, issue subpoenas to
1524	compel the attendance of witnesses and the production of books,
1525	papers, correspondence, memoranda, and other records deemed
1526	necessary by the department as evidence in order to ensure
1527	proper compliance with the coverage provisions of this chapter.
1528	(4) The department shall designate representatives who may
1529	serve subpoenas and other process of the department issued under
1530	this section.
1531	(5) The department shall specify by rule the business
1532	records that employers must maintain and produce to comply with
1533	this section.
1534	(6)(4)If a person has refused to obey a subpoena to
1535	appear before the department or its authorized representative or
1536	andproduce evidence requested by the department or to give
1537	testimony about the matter that is under investigation, a court
1538	has jurisdiction to issue an order requiring compliance with the
1539	subpoena if the court has jurisdiction in the geographical area
1540	where the inquiry is being carried on or in the area where the
1541	person who has refused the subpoena is found, resides, or
1542	transacts business. Failure to obey such a court order may be
1543	punished by the court as contempt, either civilly or criminally.
1544	Costs, including reasonable attorney's fees, incurred by the
1545	department to obtain an order granting, in whole or in part, a
1546	petition to enforce a subpoena or a subpoena duces tecum shall
1547	be taxed against the subpoenaed party.
1548	(7)(a)(5)Whenever the department determines that an
1549	employer who is required to secure the payment to his or her
1550	employees of the compensation provided for by this chapter has
1551	failed to secure the payment of workers' compensation required
1552	by this chapter or to produce the required business records
1553	under subsection (5) within 5 business days after receipt of the
1554	written request of the departmentdo so, such failure shall be
1555	deemed an immediate serious danger to public health, safety, or
1556	welfare sufficient to justify service by the department of a
1557	stop-work order on the employer, requiring the cessation of all
1558	business operations at the place of employment or job site. If
1559	the departmentdivision makes such a determination, the
1560	departmentdivisionshall issue a stop-work order within 72
1561	hours. The order shall take effect when served upon the date of
1562	service upon the employer or, for a particular employer work
1563	site, when served at that work site, unless the employer
1564	provides evidence satisfactory to the department of having
1565	secured any necessary insurance or self-insurance and pays a
1566	civil penalty to the department, to be deposited by the
1567	department into the Workers' Compensation Administration Trust
1568	Fund, in the amount of $100 per day for each day the employer
1569	was not in compliance with this chapter. In addition to serving
1570	a stop-work order at a particular work site which shall be
1571	effective immediately, the department shall immediately proceed
1572	with service upon the employer which shall be effective upon all
1573	employer work sites in the state for which the employer is not
1574	in compliance. A stop-work order may be served with regard to an
1575	employer’s work site by posting a copy of the stop-work order in
1576	a conspicuous location at the work site. The order shall remain
1577	in effect until the department issues an order releasing the
1578	stop-work order upon a finding that the employer has come into
1579	compliance with the coverage requirements of this chapter and
1580	has paid any penalty assessed under this section. The department
1581	may require an employer who is found to have failed to comply
1582	with the coverage requirements of s. 440.38 to file with the
1583	department, as a condition of release from a stop-work order,
1584	periodic reports for a probationary period that shall not exceed
1585	2 years that demonstrate the employer’s continued compliance
1586	with this chapter. The department shall by rule specify the
1587	reports required and the time for filing under this subsection.
1588	(b) Stop-work orders and penalty assessment orders issued
1589	under this section against a corporation, partnership, or sole
1590	proprietorship shall be in effect against any successor
1591	corporation or business entity that has one or more of the same
1592	principals or officers as the corporation or partnership against
1593	which the stop-work order was issued and are engaged in the same
1594	or equivalent trade or activity.
1595	(c) The department shall assess a penalty of $1,000 per
1596	day against an employer for each day that the employer conducts
1597	business operations that are in violation of a stop-work order.
1598	(d)1. In addition to any penalty, stop-work order, or
1599	injunction, the department shall assess against any employer who
1600	has failed to secure the payment of compensation as required by
1601	this chapter a penalty equal to 1.5 times the amount the
1602	employer would have paid in premium when applying approved
1603	manual rates to the employer's payroll during periods for which
1604	it failed to secure the payment of workers' compensation
1605	required by this chapter within the preceding 3-year period or
1606	$1,000, whichever is greater.
1607	2. Any subsequent violation within 5 years after the most
1608	recent violation shall, in addition to the penalties set forth
1609	in this subsection, be deemed a knowing act within the meaning
1610	of s. 440.105.
1611	(e) When an employer fails to provide business records
1612	sufficient to enable the department to determine the employer's
1613	payroll for the period requested for the calculation of the
1614	penalty provided in paragraph (d), for penalty calculation
1615	purposes, the imputed weekly payroll for each employee,
1616	corporate officer, sole proprietor, or partner shall be the
1617	statewide average weekly wage as defined in s. 440.12(2)
1618	multiplied by 1.5.
1619	(f) In addition to any other penalties provided for in
1620	this chapter, the department may assess against the employer a
1621	penalty of $5,000 for each employee of that employer who the
1622	employer represents to the department or carrier as an
1623	independent contractor but who is determined by the department
1624	not to be an independent contractor as defined in s. 440.02.
1625	(8)(6)In addition to the issuance of a stop-work order
1626	under subsection (7),the department may file a complaint in the
1627	circuit court in and for Leon County to enjoin any employer,who
1628	has failed to secure the payment of workers' compensation as
1629	required by this chapter,from employing individuals and from
1630	conducting business until the employer presents evidence
1631	satisfactory to the department of having secured the payment of
1632	workers'for compensation required by this chapterand pays a
1633	civil penalty assessed byto the department under this section,
1634	to be deposited by the department into the Workers' Compensation
1635	Administration Trust Fund, in the amount of $100 per day for
1636	each day the employer was not in compliance with this chapter.
1637	(9)(7) In addition to any penalty, stop-work order, or
1638	injunction, the department shall assess against any employer,
1639	who has failed to secure the payment of compensation as required
1640	by this chapter, a penalty in the following amount:
1641	(a) An amount equal to at least the amount that the
1642	employer would have paid or up to twice the amount the employer
1643	would have paid during periods it illegally failed to secure
1644	payment of compensation in the preceding 3-year period based on
1645	the employer's payroll during the preceding 3-year period; or
1646	(b) One thousand dollars, whichever is greater. Any
1647	penalty assessed under this subsection is due within 30 days
1648	after the date on which the employer is notified, except that,
1649	if the department has posted a stop-work order or obtained
1650	injunctive relief against the employer, payment is due, in
1651	addition to those conditions set forth in this section, as a
1652	condition to relief from a stop-work order or an injunction.
1653	Interest shall accrue on amounts not paid when due at the rate
1654	of 1 percent per month. The departmentdivisionshall adopt
1655	rules to administer this section.
1656	(10)(8)The department may bring an action in circuit
1657	court to recover penalties assessed under this section,
1658	including any interest owed to the department pursuant to this
1659	section. In any action brought by the department pursuant to
1660	this section in which it prevails, the circuit court shall award
1661	costs, including the reasonable costs of investigation and a
1662	reasonable attorney's fee.
1663	(11)(9)Any judgment obtained by the department and any
1664	penalty due pursuant to the service of a stop-work order or
1665	otherwise due under this section shall, until collected,
1666	constitute a lien upon the entire interest of the employer,
1667	legal or equitable, in any property, real or personal, tangible
1668	or intangible; however, such lien is subordinate to claims for
1669	unpaid wages and any prior recorded liens, and a lien created by
1670	this section is not valid against any person who, subsequent to
1671	such lien and in good faith and for value, purchases real or
1672	personal property from such employer or becomes the mortgagee on
1673	real or personal property of such employer, or against a
1674	subsequent attaching creditor, unless, with respect to real
1675	estate of the employer, a notice of the lien is recorded in the
1676	public records of the county where the real estate is located,
1677	and with respect to personal property of the employer, the
1678	notice is recorded with the Secretary of State.
1679	(12)(10)Any law enforcement agency in the state may, at
1680	the request of the department, render any assistance necessary
1681	to carry out the provisions of this section, including, but not
1682	limited to, preventing any employee or other person from
1683	remaining at a place of employment or job site after a stop-work
1684	order or injunction has taken effect.
1685	(13)(11)Agency actionActionsby the department under
1686	this section, if contested,must be contested as provided in
1687	chapter 120. All civilpenalties assessed by the department must
1688	be paid into the Workers' Compensation Administration Trust
1689	Fund. The department shall return any sums previously paid, upon
1690	conclusion of an action, if the department fails to prevail and
1691	if so directed by an order of court or an administrative hearing
1692	officer. The requirements of this subsection may be met by
1693	posting a bond in an amount equal to twice the penalty and in a
1694	form approved by the department.
1695	(14)(12) If the departmentdivisionfinds that an employer
1696	who is certified or registered under part I or part II of
1697	chapter 489 and who is required to secure the payment of
1698	workers'the compensation underprovided for bythis chapter to
1699	his or her employees has failed to do so, the department
1700	divisionshall immediately notify the Department of Business and
1701	Professional Regulation.
1702	Section 14. Subsections (1) and (3) of section 440.11,
1703	Florida Statutes, are amended to read:
1704	440.11 Exclusiveness of liability.--
1705	(1) The liability of an employer prescribed in s. 440.10
1706	shall be exclusive and in place of all other liability,
1707	including vicarious liability,of such employer to any third-
1708	party tortfeasor and to the employee, the legal representative
1709	thereof, husband or wife, parents, dependents, next of kin, and
1710	anyone otherwise entitled to recover damages from such employer
1711	at law or in admiralty on account of such injury or death,
1712	except as follows:that
1713	(a)If an employer fails to secure payment of compensation
1714	as required by this chapter, an injured employee, or the legal
1715	representative thereof in case death results from the injury,
1716	may elect to claim compensation under this chapter or to
1717	maintain an action at law or in admiralty for damages on account
1718	of such injury or death. In such action the defendant may not
1719	plead as a defense that the injury was caused by negligence of a
1720	fellow employee, that the employee assumed the risk of the
1721	employment, or that the injury was due to the comparative
1722	negligence of the employee.
1723	(b) When an employer commits an intentional tort that
1724	causes the injury or death of the employee. For purposes of this
1725	paragraph, an employer's actions shall be deemed to constitute
1726	an intentional tort and not an accident only when the employee
1727	proves, by clear and convincing evidence, that:
1728	1. The employer deliberately intended to injure the
1729	employee; or
1730	2. The employer engaged in conduct that the employer knew,
1731	based on prior similar accidents or on explicit warnings
1732	specifically identifying a known danger, was certain to result
1733	in injury or death to the employee, and the employee was not
1734	aware of the risk because the danger was not apparent and the
1735	employer deliberately concealed or misrepresented the danger so
1736	as to prevent the employee from exercising informed judgment
1737	about whether to perform the work.
1738
1739	The same immunities from liability enjoyed by an employer shall
1740	extend as well to each employee of the employer when such
1741	employee is acting in furtherance of the employer's business and
1742	the injured employee is entitled to receive benefits under this
1743	chapter. Such fellow-employee immunities shall not be applicable
1744	to an employee who acts, with respect to a fellow employee, with
1745	willful and wanton disregard or unprovoked physical aggression
1746	or with gross negligence when such acts result in injury or
1747	death or such acts proximately cause such injury or death, nor
1748	shall such immunities be applicable to employees of the same
1749	employer when each is operating in the furtherance of the
1750	employer's business but they are assigned primarily to unrelated
1751	works within private or public employment. The same immunity
1752	provisions enjoyed by an employer shall also apply to any sole
1753	proprietor, partner, corporate officer or director, supervisor,
1754	or other person who in the course and scope of his or her duties
1755	acts in a managerial or policymaking capacity and the conduct
1756	which caused the alleged injury arose within the course and
1757	scope of said managerial or policymaking duties and was not a
1758	violation of a law, whether or not a violation was charged, for
1759	which the maximum penalty which may be imposed does not exceed
1760	60 days' imprisonment as set forth in s. 775.082. The immunity
1761	from liability provided in this subsection extends to county
1762	governments with respect to employees of county constitutional
1763	officers whose offices are funded by the board of county
1764	commissioners.
1765	(3) An employer's workers' compensation carrier, service
1766	agent, or safety consultant shall not be liable as a third-party
1767	tortfeasor to employees of the employer or employees of its
1768	subcontractors for assisting the employer and its
1769	subcontractors, if any,in carrying out the employer's rights
1770	and responsibilities under this chapter by furnishing any safety
1771	inspection, safety consultative service, or other safety service
1772	incidental to the workers' compensation or employers' liability
1773	coverage or to the workers' compensation or employer's liability
1774	servicing contract. Without limitation, a safety consultant may
1775	include an owner, as defined in chapter 713, or an owner's
1776	related, affiliated, or subsidiary companies and the employees
1777	of each.The exclusion from liability under this subsection
1778	shall not apply in any case in which injury or death is
1779	proximately caused by the willful and unprovoked physical
1780	aggression, or by the negligent operation of a motor vehicle, by
1781	employees, officers, or directors of the employer's workers'
1782	compensation carrier, service agent, or safety consultant.
1783	Section 15. Section 440.13, Florida Statutes, is amended
1784	to read:
1785	440.13 Medical services and supplies; penalty for
1786	violations; limitations.--
1787	(1) DEFINITIONS.--As used in this section, the term:
1788	(a) "Alternate medical care" means a change in treatment
1789	or health care provider.
1790	(b) "Attendant care" means care rendered by trained
1791	professional attendants which is beyond the scope of household
1792	duties. Family members may provide nonprofessional attendant
1793	care, but may not be compensated under this chapter for care
1794	that falls within the scope of household duties and other
1795	services normally and gratuitously provided by family members.
1796	"Family member" means a spouse, father, mother, brother, sister,
1797	child, grandchild, father-in-law, mother-in-law, aunt, or uncle.
1798	(c) "Carrier" means, for purposes of this section,
1799	insurance carrier, self-insurance fund or individually self-
1800	insured employer, or assessable mutual insurer.
1801	(d) "Catastrophic injury" means an injury as defined in s.
1802	440.02.
1803	(e) "Certified health care provider" means a health care
1804	provider who has been certified by the agency or who has entered
1805	an agreement with a licensed managed care organization to
1806	provide treatment to injured workers under this section.
1807	Certification of such health care provider must include
1808	documentation that the health care provider has read and is
1809	familiar with the portions of the statute, impairment guides,
1810	practice parameters, protocols of treatment,and rules which
1811	govern the provision of remedial treatment, care, and
1812	attendance.
1813	(f) "Compensable" means a determination by a carrier or
1814	judge of compensation claims that a condition suffered by an
1815	employee results from an injury arising out of and in the course
1816	of employment.
1817	(g) "Emergency services and care" means emergency services
1818	and care as defined in s. 395.002.
1819	(h) "Health care facility" means any hospital licensed
1820	under chapter 395 and any health care institution licensed under
1821	chapter 400.
1822	(i) "Health care provider" means a physician or any
1823	recognized practitioner who provides skilled services pursuant
1824	to a prescription or under the supervision or direction of a
1825	physician and who has been certified by the agency as a health
1826	care provider. The term "health care provider" includes a health
1827	care facility.
1828	(j) "Independent medical examiner" means a physician
1829	selected by either an employee or a carrier to render one or
1830	more independent medical examinations in connection with a
1831	dispute arising under this chapter.
1832	(k) "Independent medical examination" means an objective
1833	evaluation of the injured employee's medical condition,
1834	including, but not limited to, impairment or work status,
1835	performed by a physician or an expert medical advisor at the
1836	request of a party, a judge of compensation claims, or the
1837	agency to assist in the resolution of a dispute arising under
1838	this chapter.
1839	(l) "Instance of overutilization" means a specific
1840	inappropriate service or level of service provided to an injured
1841	employee that includes the provision of treatment in excess of
1842	established practice parameters and protocols of treatment
1843	established in accordance with this chapter.
1844	(m) "Medically necessary" or "medical necessity"means any
1845	medical service or medical supply which is used to identify or
1846	treat an illness or injury, is appropriate to the patient's
1847	diagnosis and status of recovery, and is consistent with the
1848	location of service, the level of care provided, and applicable
1849	practice parameters. The service should be widely accepted among
1850	practicing health care providers, based on scientific criteria,
1851	and determined to be reasonably safe. The service must not be of
1852	an experimental, investigative, or research nature, except in
1853	those instances in which prior approval of the Agency for Health
1854	Care Administration has been obtained. The Agency for Health
1855	Care Administration shall adopt rules providing for such
1856	approval on a case-by-case basis when the service or supply is
1857	shown to have significant benefits to the recovery and well-
1858	being of the patient.
1859	(n) "Medicine" means a drug prescribed by an authorized
1860	health care provider and includes only generic drugs or single-
1861	source patented drugs for which there is no generic equivalent,
1862	unless the authorized health care provider writes or states that
1863	the brand-name drug as defined in s. 465.025 is medically
1864	necessary, or is a drug appearing on the schedule of drugs
1865	created pursuant to s. 465.025(6), or is available at a cost
1866	lower than its generic equivalent.
1867	(o) "Palliative care" means noncurative medical services
1868	that mitigate the conditions, effects, or pain of an injury.
1869	(p) "Pattern or practice of overutilization" means
1870	repetition of instances of overutilization within a specific
1871	medical case or multiple cases by a single health care provider.
1872	(q) "Peer review" means an evaluation by two or more
1873	physicians licensed under the same authority and with the same
1874	or similar specialty as the physician under review, of the
1875	appropriateness, quality, and cost of health care and health
1876	services provided to a patient, based on medically accepted
1877	standards.
1878	(r) "Physician" or "doctor" means a physician licensed
1879	under chapter 458, an osteopathic physician licensed under
1880	chapter 459, a chiropractic physician licensed under chapter
1881	460, a podiatric physician licensed under chapter 461, an
1882	optometrist licensed under chapter 463, or a dentist licensed
1883	under chapter 466, each of whom must be certified by the agency
1884	as a health care provider.
1885	(s) "Reimbursement dispute" means any disagreement between
1886	a health care provider or health care facility and carrier
1887	concerning payment for medical treatment.
1888	(t) "Utilization control" means a systematic process of
1889	implementing measures that assure overall management and cost
1890	containment of services delivered, including compliance with
1891	practice parameters and protocols of treatment as provided for
1892	in this chapter.
1893	(u) "Utilization review" means the evaluation of the
1894	appropriateness of both the level and the quality of health care
1895	and health services provided to a patient, including, but not
1896	limited to, evaluation of the appropriateness of treatment,
1897	hospitalization, or office visits based on medically accepted
1898	standards. Such evaluation must be accomplished by means of a
1899	system that identifies the utilization of medical services based
1900	on practice parameters and protocols of treatment as provided
1901	for in this chaptermedically accepted standards as established
1902	by medical consultants with qualifications similar to those
1903	providing the care under review, and that refers patterns and
1904	practices of overutilization to the agency.
1905	(2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.--
1906	(a) Subject to the limitations specified elsewhere in this
1907	chapter, the employer shall furnish to the employee such
1908	medically necessary remedial treatment, care, and attendance for
1909	such period as the nature of the injury or the process of
1910	recovery may require, which is in accordance with established
1911	practice parameters and protocols of treatment as provided for
1912	in this chapter, including medicines, medical supplies, durable
1913	medical equipment, orthoses, prostheses, and other medically
1914	necessary apparatus. Remedial treatment, care, and attendance,
1915	including work-hardening programs or pain-management programs
1916	accredited by the Commission on Accreditation of Rehabilitation
1917	Facilities or Joint Commission on the Accreditation of Health
1918	Organizations or pain-management programs affiliated with
1919	medical schools, shall be considered as covered treatment only
1920	when such care is given based on a referral by a physician as
1921	defined in this chapter. Each facility shall maintain outcome
1922	data, including work status at discharges, total program
1923	charges, total number of visits, and length of stay. The
1924	department shall utilize such data and report to the President
1925	of the Senate and the Speaker of the House of Representatives
1926	regarding the efficacy and cost-effectiveness of such program,
1927	no later than October 1, 1994.Medically necessary treatment,
1928	care, and attendance does not include chiropractic services in
1929	excess of 2418 treatments or rendered 128weeks beyond the
1930	date of the initial chiropractic treatment, whichever comes
1931	first, unless the carrier authorizes additional treatment or the
1932	employee is catastrophically injured.
1933	(b) The employer shall provide appropriate professional or
1934	nonprofessional attendant care performed only at the direction
1935	and control of a physician when such care is medically
1936	necessary. The physician shall prescribe such care in writing.
1937	The employer or carrier shall not be responsible for such care
1938	until the prescription for attendant care is received by the
1939	employer and carrier, which shall specify the time periods for
1940	such care, the level of care required, and the type of
1941	assistance required. A prescription for attendant care shall not
1942	prescribe such care retroactively.The value of nonprofessional
1943	attendant care provided by a family member must be determined as
1944	follows:
1945	1. If the family member is not employed or if the family
1946	member is employed and is providing attendant care services
1947	during hours that he or she is not engaged in employment, the
1948	per-hour value equals the federal minimum hourly wage.
1949	2. If the family member is employed and elects to leave
1950	that employment to provide attendant or custodial care, the per-
1951	hour value of that care equals the per-hour value of the family
1952	member's former employment, not to exceed the per-hour value of
1953	such care available in the community at large. A family member
1954	or a combination of family members providing nonprofessional
1955	attendant care under this paragraph may not be compensated for
1956	more than a total of 12 hours per day.
1957	3. If the family member remains employed while providing
1958	attendant or custodial care, the per-hour value of that care
1959	equals the per-hour value of the family member's employment, not
1960	to exceed the per-hour value of such care available in the
1961	community at large.
1962	(c) If the employer fails to provide initialtreatment or
1963	care required by this section after request by the injured
1964	employee, the employee may obtain such initialtreatment at the
1965	expense of the employer, if the initial treatment or careis
1966	compensable and medically necessary and is in accordance with
1967	established practice parameters and protocols of treatment as
1968	provided for in this chapter. There must be a specific request
1969	for the initial treatment or care, and the employer or carrier
1970	must be given a reasonable time period within which to provide
1971	the initialtreatment or care. However, the employee is not
1972	entitled to recover any amount personally expended for the
1973	initial treatment or careserviceunless he or she has requested
1974	the employer to furnish that initialtreatment or service and
1975	the employer has failed, refused, or neglected to do so within a
1976	reasonable time or unless the nature of the injury requires such
1977	initialtreatment, nursing, and services and the employer or his
1978	or her superintendent or foreman, having knowledge of the
1979	injury, has neglected to provide the initial treatment or care
1980	service.
1981	(d) The carrier has the right to transfer the care of an
1982	injured employee from the attending health care provider if an
1983	independent medical examination determines that the employee is
1984	not making appropriate progress in recuperation.
1985	(e) Except in emergency situations and for treatment
1986	rendered by a managed care arrangement, after any initial
1987	examination and diagnosis by a physician providing remedial
1988	treatment, care, and attendance, and before a proposed course of
1989	medical treatment begins, each insurer shall review, in
1990	accordance with the requirements of this chapter, the proposed
1991	course of treatment, to determine whether such treatment would
1992	be recognized as reasonably prudent. The review must be in
1993	accordance with all applicable workers' compensation practice
1994	parameters and protocols of treatment established in accordance
1995	with this chapter. The insurer must accept any such proposed
1996	course of treatment unless the insurer notifies the physician of
1997	its specific objections to the proposed course of treatment by
1998	the close of the tenth business day after notification by the
1999	physician, or a supervised designee of the physician, of the
2000	proposed course of treatment.
2001	(f) Upon the written request of the employee, the carrier
2002	shall give the employee the opportunity for one change of
2003	physician during the course of treatment for any one accident.
2004	Upon the granting of a change of physician, the originally
2005	authorized physician in the same specialty as the changed
2006	physician shall become deauthorized upon written notification by
2007	the employer or carrier. The carrier shall authorize an
2008	alternative physician who shall not be professionally affiliated
2009	with the previous physician within 5 days after receipt of the
2010	request. If the carrier fails to provide a change of physician
2011	as requested by the employee, the employee may select the
2012	physician and such physician shall be considered authorized if
2013	the treatment being provided is compensable and medically
2014	necessary.
2015
2016	Failure of the carrier to timely comply with this subsection
2017	shall be a violation of this chapter and the carrier shall be
2018	subject to penalties as provided for in s. 440.525.The employee
2019	shall be entitled to select another physician from among not
2020	fewer than three carrier-authorized physicians who are not
2021	professionally affiliated.
2022	(3) PROVIDER ELIGIBILITY; AUTHORIZATION.--
2023	(a) As a condition to eligibility for payment under this
2024	chapter, a health care provider who renders services must be a
2025	certified health care provider and must receive authorization
2026	from the carrier before providing treatment. This paragraph does
2027	not apply to emergency care. The agency shall adopt rules to
2028	implement the certification of health care providers.
2029	(b) A health care provider who renders emergency care must
2030	notify the carrier by the close of the third business day after
2031	it has rendered such care. If the emergency care results in
2032	admission of the employee to a health care facility, the health
2033	care provider must notify the carrier by telephone within 24
2034	hours after initial treatment. Emergency care is not compensable
2035	under this chapter unless the injury requiring emergency care
2036	arose as a result of a work-related accident. Pursuant to
2037	chapter 395, all licensed physicians and health care providers
2038	in this state shall be required to make their services available
2039	for emergency treatment of any employee eligible for workers'
2040	compensation benefits. To refuse to make such treatment
2041	available is cause for revocation of a license.
2042	(c) A health care provider may not refer the employee to
2043	another health care provider, diagnostic facility, therapy
2044	center, or other facility without prior authorization from the
2045	carrier, except when emergency care is rendered. Any referral
2046	must be to a health care provider that has been certified by the
2047	agency, unless the referral is for emergency treatment, and the
2048	referral must be made in accordance with practice parameters and
2049	protocols of treatment as provided for in this chapter.
2050	(d) A carrier must respond, by telephone or in writing, to
2051	a request for authorization from an authorized health care
2052	providerby the close of the third business day after receipt of
2053	the request. A carrier who fails to respond to a written request
2054	for authorization for referral for medical treatment by the
2055	close of the third business day after receipt of the request
2056	consents to the medical necessity for such treatment. All such
2057	requests must be made to the carrier. Notice to the carrier does
2058	not include notice to the employer.
2059	(e) Carriers shall adopt procedures for receiving,
2060	reviewing, documenting, and responding to requests for
2061	authorization. Such procedures shall be for a health care
2062	provider certified under this section.
2063	(f) By accepting payment under this chapter for treatment
2064	rendered to an injured employee, a health care provider consents
2065	to the jurisdiction of the agency as set forth in subsection
2066	(11) and to the submission of all records and other information
2067	concerning such treatment to the agency in connection with a
2068	reimbursement dispute, audit, or review as provided by this
2069	section. The health care provider must further agree to comply
2070	with any decision of the agency rendered under this section.
2071	(g) The employee is not liable for payment for medical
2072	treatment or services provided pursuant to this section except
2073	as otherwise provided in this section.
2074	(h) The provisions of s. 456.053 are applicable to
2075	referrals among health care providers, as defined in subsection
2076	(1), treating injured workers.
2077	(i) Notwithstanding paragraph (d), a claim for specialist
2078	consultations, surgical operations, physiotherapeutic or
2079	occupational therapy procedures, X-ray examinations, or special
2080	diagnostic laboratory tests that cost more than $1,000 and other
2081	specialty services that the agency identifies by rule is not
2082	valid and reimbursable unless the services have been expressly
2083	authorized by the carrier, or unless the carrier has failed to
2084	respond within 10 days to a written request for authorization,
2085	or unless emergency care is required. The insurer shall not
2086	refuse toauthorize such consultation or procedure unless the
2087	health care provider or facility is not authorized or certified,
2088	unless such treatment is not in accordance with practice
2089	parameters and protocols of treatment established in this
2090	chapter, or unless a judge of compensation claimsan expert
2091	medical advisorhas determined that the consultation or
2092	procedure is not medically necessary, not in accordance with the
2093	practice parameters and protocols of treatment established in
2094	this chapter, or otherwise notcompensable under this chapter.
2095	Authorization of a treatment plan does not constitute express
2096	authorization for purposes of this section, except to the extent
2097	the carrier provides otherwise in its authorization procedures.
2098	This paragraph does not limit the carrier's obligation to
2099	identify and disallow overutilization or billing errors.
2100	(j) Notwithstanding anything in this chapter to the
2101	contrary, a sick or injured employee shall be entitled, at all
2102	times, to free, full, and absolute choice in the selection of
2103	the pharmacy or pharmacist dispensing and filling prescriptions
2104	for medicines required under this chapter. It is expressly
2105	forbidden for the agency, an employer, or a carrier, or any
2106	agent or representative of the agency, an employer, or a carrier
2107	to select the pharmacy or pharmacist which the sick or injured
2108	employee must use; condition coverage or payment on the basis of
2109	the pharmacy or pharmacist utilized; or to otherwise interfere
2110	in the selection by the sick or injured employee of a pharmacy
2111	or pharmacist.
2112	(4) NOTICE OF TREATMENT TO CARRIER; FILING WITH
2113	DEPARTMENT.--
2114	(a) Any health care provider providing necessary remedial
2115	treatment, care, or attendance to any injured worker shall
2116	submit treatment reports to the carrier in a format prescribed
2117	by the department in consultation with the agency. A claim for
2118	medical or surgical treatment is not valid or enforceable
2119	against such employer or employee, unless, by the close of the
2120	third business day following the first treatment, the physician
2121	providing the treatment furnishes to the employer or carrier a
2122	preliminary notice of the injury and treatment in a formaton
2123	forms prescribed by the department in consultation with the
2124	agencyand, within 15 days thereafter, furnishes to the employer
2125	or carrier a complete report, and subsequent thereto furnishes
2126	progress reports, if requested by the employer or insurance
2127	carrier, at intervals of not less than 3 weeks apart or at less
2128	frequent intervals if requested in a formaton formsprescribed
2129	by the department in consultation with the agency.
2130	(b) Upon the request of the department or agency, each
2131	medical report or bill obtained or received by the employer, the
2132	carrier, or the injured employee, or the attorney for the
2133	employer, carrier, or injured employee, with respect to the
2134	remedial treatment, care, and attendance of the injured
2135	employee, including any report of an examination, diagnosis, or
2136	disability evaluation, must be produced by the health care
2137	provider tofiled with the department or agencypursuant to
2138	rules adopted by the department in consultation with the agency.
2139	The health care provider shall also furnish to the injured
2140	employee or to his or her attorney and the employer or carrier
2141	or its attorney, on demand, a copy of his or her office chart,
2142	records, and reports, and may charge the injured employee no
2143	more than 50 cents per page for copying the records and the
2144	actual direct cost to the health care provider or health care
2145	facility for X rays, microfilm, or other nonpaper recordsan
2146	amount authorized by the department for the copies. Each such
2147	health care provider shall provide to the agency ordepartment
2148	information about the remedial treatment, care, and attendance
2149	which the agency ordepartment reasonably requests.
2150	(c) It is the policy for the administration of the
2151	workers' compensation system that there shallbe reasonable
2152	access to medical information by all parties to facilitate the
2153	self-executing features of the law. An employee who reports an
2154	injury or illness alleged to be work-related waives any
2155	physician-patient privilege with respect to any condition or
2156	complaint reasonably related to the condition for which the
2157	employee claims compensation.Notwithstanding the limitations in
2158	s. 456.057 and subject to the limitations in s. 381.004, upon
2159	the request of the employer, the carrier, an authorized
2160	qualified rehabilitation provider, or the attorney for the
2161	employer or carrier, the medical records, reports, and
2162	information of an injured employee relevant to the particular
2163	injury or illness for which compensation is soughtmust be
2164	furnished to those persons and the medical condition of the
2165	injured employee must be discussed with those persons, if the
2166	records and the discussions are restricted to conditions
2167	relating to the workplace injury. Release of medical information
2168	by the health care provider or other physician does not require
2169	the authorization of the injured employee. If medical records,
2170	reports, and information of an injured employee are sought from
2171	health care providers who are not subject to the jurisdiction of
2172	the state, the injured employee shall sign an authorization
2173	allowing for the employer or carrier to obtain the medical
2174	records, reports, or information. Any such discussions or
2175	release of informationmay be held before or after the filing of
2176	a claim or petition for benefitswithout the knowledge, consent,
2177	or presence of any other party or his or her agent or
2178	representative. A health care provider who willfully refuses to
2179	provide medical records or to discuss the medical condition of
2180	the injured employee, after a reasonable request is made for
2181	such information pursuant to this subsection, shall be subject
2182	by the departmentagencyto one or more of the penalties set
2183	forth in paragraph (8)(b). The department may adopt rules to
2184	carry out this subsection.
2185	(5) INDEPENDENT MEDICAL EXAMINATIONS.--
2186	(a) In any dispute concerning overutilization, medical
2187	benefits, compensability, or disability under this chapter, the
2188	carrier or the employee may select an independent medical
2189	examiner. If the parties agree,the examiner may be a health
2190	care provider treating or providing other care to the employee.
2191	An independent medical examiner may not render an opinion
2192	outside his or her area of expertise, as demonstrated by
2193	licensure and applicable practice parameters. The employer and
2194	employee shall be entitled to only one independent medical
2195	examination per accident and not one independent medical
2196	examination per medical specialty. The party requesting and
2197	selecting the independent medical examination shall be
2198	responsible for all expenses associated with said examination,
2199	including, but not limited to, medically necessary diagnostic
2200	testing performed and physician or medical care provider fees
2201	for the evaluation. The party selecting the independent medical
2202	examination shall identify the choice of the independent medical
2203	examiner to all other parties within 15 days after the date the
2204	independent medical examination is to take place. Failure to
2205	timely provide such notification shall preclude the requesting
2206	party from submitting the findings of such independent medical
2207	examiner in a proceeding before a judge of compensation claims.
2208	The independent medical examiner may not provide followup care
2209	if such recommendation for care is found to be medically
2210	necessary. If the employee prevails in a medical dispute as
2211	determined in an order by a judge of compensation claims or if
2212	benefits are paid or treatment provided after the employee has
2213	obtained an independent medical examination based upon the
2214	examiner's findings, the costs of such examination shall be paid
2215	by the employer or carrier.
2216	(b) Each party is bound by his or her selection of an
2217	independent medical examiner, including the selection of the
2218	independent medical examiner in accordance with s. 440.134 and
2219	the opinions of such independent medical examiner. Each party
2220	andis entitled to an alternate examiner only if:
2221	1. The examiner is not qualified to render an opinion upon
2222	an aspect of the employee's illness or injury which is material
2223	to the claim or petition for benefits;
2224	2. The examiner ceases to practice in the specialty
2225	relevant to the employee's condition;
2226	3. The examiner is unavailable due to injury, death, or
2227	relocation outside a reasonably accessible geographic area; or
2228	4. The parties agree to an alternate examiner.
2229
2230	Any party may request, or a judge of compensation claims may
2231	require, designation of an agency medical advisor as an
2232	independent medical examiner. The opinion of the advisors acting
2233	as examiners shall not be afforded the presumption set forth in
2234	paragraph (9)(c).
2235	(c) The carrier may, at its election, contact the claimant
2236	directly to schedule a reasonable time for an independent
2237	medical examination. The carrier must confirm the scheduling
2238	agreement in writing with the claimant and thewithin 5 days and
2239	notifyclaimant's counsel, if any, at least 7 days before the
2240	date upon which the independent medical examination is scheduled
2241	to occur. An attorney representing a claimant is not authorized
2242	to schedule the self-insured employer's or carrier'sindependent
2243	medical evaluations under this subsection. Neither the self-
2244	insured employer nor the carrier shall be responsible for
2245	scheduling any independent medical examination other than an
2246	employer or carrier independent medical examination.
2247	(d) If the employee fails to appear for the independent
2248	medical examination scheduled by the employer or carrierwithout
2249	good cause and fails to advise the physician at least 24 hours
2250	before the scheduled date for the examination that he or she
2251	cannot appear, the employee is barred from recovering
2252	compensation for any period during which he or she has refused
2253	to submit to such examination. Further, the employee shall
2254	reimburse the employer orcarrier 50 percent of the physician's
2255	cancellation or no-show fee unless the employer orcarrier that
2256	schedules the examination fails to timely provide to the
2257	employee a written confirmation of the date of the examination
2258	pursuant to paragraph (c) which includes an explanation of why
2259	he or she failed to appear. The employee may appeal to a judge
2260	of compensation claims for reimbursement when the employer or
2261	carrier withholds payment in excess of the authority granted by
2262	this section.
2263	(e) No medical opinion other than the opinion of a medical
2264	advisor appointed by the judge of compensation claims or the
2265	departmentagency, an independent medical examiner, or an
2266	authorized treating provider is admissible in proceedings before
2267	the judges of compensation claims.
2268	(f) Attorney's fees incurred by an injured employee in
2269	connection with delay of or opposition to an independent medical
2270	examination, including, but not limited to, motions for
2271	protective orders, are not recoverable under this chapter.
2272	(g) When a medical dispute arises, the parties may
2273	mutually agree to refer the employee to a licensed physician
2274	specializing in the diagnosis and treatment of the medical
2275	condition at issue for an independent medical examination and
2276	report. Such medical examination shall be referred to as a
2277	"consensus independent medical examination." The findings and
2278	conclusions of such mutually agreed upon consensus independent
2279	medical examination shall be binding on the parties and shall
2280	constitute resolution of the medical dispute addressed in the
2281	independent consensus medical examination and in any proceeding.
2282	Agreement by the parties to a consensus independent medical
2283	examination shall not affect the employer's, carrier's, or
2284	employee's entitlement to one independent medical examination
2285	per accident as provided for in this subsection.
2286	(6) UTILIZATION REVIEW.--Carriers shall review all bills,
2287	invoices, and other claims for payment submitted by health care
2288	providers in order to identify overutilization and billing
2289	errors, including compliance with practice parameters and
2290	protocols of treatment established in accordance with this
2291	chapter, and may hire peer review consultants or conduct
2292	independent medical evaluations. Such consultants, including
2293	peer review organizations, are immune from liability in the
2294	execution of their functions under this subsection to the extent
2295	provided in s. 766.101. If a carrier finds that overutilization
2296	of medical services or a billing error has occurred, or there is
2297	a violation of the practice parameters and protocols of
2298	treatment established in accordance with this chapter, it must
2299	disallow or adjust payment for such services or error without
2300	order of a judge of compensation claims or the agency, if the
2301	carrier, in making its determination, has complied with this
2302	section and rules adopted by the agency.
2303	(7) UTILIZATION AND REIMBURSEMENT DISPUTES.--
2304	(a) Any health care provider, carrier, or employer who
2305	elects to contest the disallowance or adjustment of payment by a
2306	carrier under subsection (6) must, within 30 days after receipt
2307	of notice of disallowance or adjustment of payment, petition the
2308	agency to resolve the dispute. The petitioner must serve a copy
2309	of the petition on the carrier and on all affected parties by
2310	certified mail. The petition must be accompanied by all
2311	documents and records that support the allegations contained in
2312	the petition. Failure of a petitioner to submit such
2313	documentation to the agency results in dismissal of the
2314	petition.
2315	(b) The carrier must submit to the agency within 10 days
2316	after receipt of the petition all documentation substantiating
2317	the carrier's disallowance or adjustment. Failure of the carrier
2318	to timelysubmit the requested documentation to the agency
2319	within 10 days constitutes a waiver of all objections to the
2320	petition.
2321	(c) Within 60 days after receipt of all documentation, the
2322	agency must provide to the petitioner, the carrier, and the
2323	affected parties a written determination of whether the carrier
2324	properly adjusted or disallowed payment. The agency must be
2325	guided by standards and policies set forth in this chapter,
2326	including all applicable reimbursement schedules, practice
2327	parameters, and protocols of treatment,in rendering its
2328	determination.
2329	(d) If the agency finds an improper disallowance or
2330	improper adjustment of payment by an insurer, the insurer shall
2331	reimburse the health care provider, facility, insurer, or
2332	employer within 30 days, subject to the penalties provided in
2333	this subsection.
2334	(e) The agency shall adopt rules to carry out this
2335	subsection. The rules may include provisions for consolidating
2336	petitions filed by a petitioner and expanding the timetable for
2337	rendering a determination upon a consolidated petition.
2338	(f) Any carrier that engages in a pattern or practice of
2339	arbitrarily or unreasonably disallowing or reducing payments to
2340	health care providers may be subject to one or more of the
2341	following penalties imposed by the agency:
2342	1. Repayment of the appropriate amount to the health care
2343	provider.
2344	2. An administrative fine assessed by the agency in an
2345	amount not to exceed $5,000 per instance of improperly
2346	disallowing or reducing payments.
2347	3. Award of the health care provider's costs, including a
2348	reasonable attorney's fee, for prosecuting the petition.
2349	(8) PATTERN OR PRACTICE OF OVERUTILIZATION.--
2350	(a) Carriers must report to the agency all instances of
2351	overutilization including, but not limited to, all instances in
2352	which the carrier disallows or adjusts payment or a
2353	determination has been made that the provided or recommended
2354	treatment is in excess of the practice parameters and protocols
2355	of treatment established in this chapter. The agency shall
2356	determine whether a pattern or practice of overutilization
2357	exists.
2358	(b) If the agency determines that a health care provider
2359	has engaged in a pattern or practice of overutilization or a
2360	violation of this chapter or rules adopted by the agency,
2361	including a pattern or practice of providing treatment in excess
2362	of the practice parameters or protocols of treatment, it may
2363	impose one or more of the following penalties:
2364	1. An order of the agency barring the provider from
2365	payment under this chapter;
2366	2. Deauthorization of care under review;
2367	3. Denial of payment for care rendered in the future;
2368	4. Decertification of a health care provider certified as
2369	an expert medical advisor under subsection (9) or of a
2370	rehabilitation provider certified under s. 440.49;
2371	5. An administrative fine assessed by the agency in an
2372	amount not to exceed $5,000 per instance of overutilization or
2373	violation; and
2374	6. Notification of and review by the appropriate licensing
2375	authority pursuant to s. 440.106(3).
2376	(9) EXPERT MEDICAL ADVISORS.--
2377	(a) The agency shall certify expert medical advisors in
2378	each specialty to assist the agency and the judges of
2379	compensation claims within the advisor's area of expertise as
2380	provided in this section. The agency shall, in a manner
2381	prescribed by rule, in certifying, recertifying, or decertifying
2382	an expert medical advisor, consider the qualifications,
2383	training, impartiality, and commitment of the health care
2384	provider to the provision of quality medical care at a
2385	reasonable cost. As a prerequisite for certification or
2386	recertification, the agency shall require, at a minimum, that
2387	an expert medical advisor have specialized workers' compensation
2388	training or experience under the workers' compensation system of
2389	this state and board certification or board eligibility.
2390	(b) The agency shall contract with one or more entities
2391	that employ, contract with, or otherwise secureor employexpert
2392	medical advisors to provide peer review or expertmedical
2393	consultation, opinions, and testimonyto the agency or to a
2394	judge of compensation claims in connection with resolving
2395	disputes relating to reimbursement, differing opinions of health
2396	care providers, and health care and physician services rendered
2397	under this chapter, including utilization issues. The agency
2398	shall by rule establish the qualifications of expert medical
2399	advisors, including training and experience in the workers'
2400	compensation system in the state and the expert medical
2401	advisor's knowledge of and commitment to the standards of care,
2402	practice parameters, and protocols established pursuant to this
2403	chapter. Expert medical advisors contracting with the agency
2404	shall, as a term of such contract, agree to provide consultation
2405	or services in accordance with the timetables set forth in this
2406	chapter and to abide by rules adopted by the agency, including,
2407	but not limited to, rules pertaining to procedures for review of
2408	the services rendered by health care providers and preparation
2409	of reports and testimony orrecommendations for submission to
2410	the agency or the judge of compensation claims.
2411	(c) If there is disagreement in the opinions of the health
2412	care providers, if two health care providers disagree on medical
2413	evidence supporting the employee's complaints or the need for
2414	additional medical treatment, or if two health care providers
2415	disagree that the employee is able to return to work, the agency
2416	may, and the judge of compensation claims shall, upon his or her
2417	own motion or within 15 days after receipt of a written request
2418	by either the injured employee, the employer, or the carrier,
2419	order the injured employee to be evaluated by an expert medical
2420	advisor. The opinion of the expert medical advisor is presumed
2421	to be correct unless there is clear and convincing evidence to
2422	the contrary as determined by the judge of compensation claims.
2423	The expert medical advisor appointed to conduct the evaluation
2424	shall have free and complete access to the medical records of
2425	the employee. An employee who fails to report to and cooperate
2426	with such evaluation forfeits entitlement to compensation during
2427	the period of failure to report or cooperate.
2428	(d) The expert medical advisor must complete his or her
2429	evaluation and issue his or her report to the agency or to the
2430	judge of compensation claims within 1545days after receipt of
2431	all medical records. The expert medical advisor must furnish a
2432	copy of the report to the carrier and to the employee.
2433	(e) An expert medical advisor is not liable under any
2434	theory of recovery for evaluations performed under this section
2435	without a showing of fraud or malice. The protections of s.
2436	766.101 apply to any officer, employee, or agent of the agency
2437	and to any officer, employee, or agent of any entity with which
2438	the agency has contracted under this subsection.
2439	(f) If the agency or a judge of compensation claims orders
2440	determines thatthe services of a certified expert medical
2441	advisor are requiredto resolve a dispute under this section,
2442	the party requesting such examinationcarriermust compensate
2443	the advisor for his or her time in accordance with a schedule
2444	adopted by the agency. If the employee prevails in a dispute as
2445	determined in an order by a judge of compensation claims based
2446	upon the expert medical advisor's findings, the employer or
2447	carrier shall pay for the costs of such expert medical advisor.
2448	If a judge of compensation claims, upon his or her motion, finds
2449	that an expert medical advisor is needed to resolve the dispute,
2450	the carrier must compensate the advisor for his or her time in
2451	accordance with a schedule adopted by the agency.The agency may
2452	assess a penalty not to exceed $500 against any carrier that
2453	fails to timely compensate an advisor in accordance with this
2454	section.
2455	(10) WITNESS FEES.--Any health care provider who gives a
2456	deposition shall be allowed a witness fee. The amount charged by
2457	the witness may not exceed $200 per hour. An expert witness who
2458	has never provided direct professional services to a party but
2459	has merely reviewed medical records and provided an expert
2460	opinion or has provided only direct professional services that
2461	were unrelated to the workers' compensation case may not be
2462	allowed a witness fee in excess of $200 per day.
2463	(11) AUDITS BY AGENCY FOR HEALTH CARE ADMINISTRATION AND
2464	THE DEPARTMENT OF INSURANCE; JURISDICTION.--
2465	(a) The Agency for Health Care Administration may
2466	investigate health care providers to determine whether providers
2467	are complying with this chapter and with rules adopted by the
2468	agency, whether the providers are engaging in overutilization,
2469	andwhether providers are engaging in improper billing
2470	practices, and whether providers are adhering to practice
2471	parameters and protocols established in accordance with this
2472	chapter. If the agency finds that a health care provider has
2473	improperly billed, overutilized, or failed to comply with agency
2474	rules or the requirements of this chapter, including, but not
2475	limited to, practice parameters and protocols established in
2476	accordance with this chapter,it must notify the provider of its
2477	findings and may determine that the health care provider may not
2478	receive payment from the carrier or may impose penalties as set
2479	forth in subsection (8) or other sections of this chapter. If
2480	the health care provider has received payment from a carrier for
2481	services that were improperly billed, that constitute
2482	overutilization, or that were outside practice parameters or
2483	protocols established in accordance with this chapteror for
2484	overutilization, it must return those payments to the carrier.
2485	The agency may assess a penalty not to exceed $500 for each
2486	overpayment that is not refunded within 30 days after
2487	notification of overpayment by the agency or carrier.
2488	(b) The department shall monitor and audit carriers as
2489	provided in s. 624.3161, to determine if medical bills are paid
2490	in accordance with this section and department rules. Any
2491	employer, if self-insured, or carrier found by the division not
2492	to be within 90 percent compliance as to the payment of medical
2493	bills after July 1, 1994, must be assessed a fine not to exceed
2494	1 percent of the prior year's assessment levied against such
2495	entity under s. 440.51 for every quarter in which the entity
2496	fails to attain 90-percent compliance. The department shall fine
2497	or otherwise discipline an employer or carrier, pursuant to this
2498	chapter, the insurance code, or rules adopted by the department,
2499	for each late payment of compensation that is below the minimum
2500	95-percent90-percentperformance standard. Any carrier that is
2501	found to be not in compliance in subsequent consecutive quarters
2502	must implement a medical-bill review program approved by the
2503	division, and the carrier is subject to disciplinary action by
2504	the Department of Insurance.
2505	(c) The agency has exclusive jurisdiction to decide any
2506	matters concerning reimbursement, to resolve any overutilization
2507	dispute under subsection (7), and to decide any question
2508	concerning overutilization under subsection (8), which question
2509	or dispute arises after January 1, 1994.
2510	(d) The following agency actions do not constitute agency
2511	action subject to review under ss. 120.569 and 120.57 and do not
2512	constitute actions subject to s. 120.56: referral by the entity
2513	responsible for utilization review; a decision by the agency to
2514	refer a matter to a peer review committee; establishment by a
2515	health care provider or entity of procedures by which a peer
2516	review committee reviews the rendering of health care services;
2517	and the review proceedings, report, and recommendation of the
2518	peer review committee.
2519	(12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
2520	REIMBURSEMENT ALLOWANCES.--
2521	(a) A three-member panel is created, consisting of the
2522	Insurance Commissioner, or the Insurance Commissioner's
2523	designee, and two members to be appointed by the Governor,
2524	subject to confirmation by the Senate, one member who, on
2525	account of present or previous vocation, employment, or
2526	affiliation, shall be classified as a representative of
2527	employers, the other member who, on account of previous
2528	vocation, employment, or affiliation, shall be classified as a
2529	representative of employees. The panel shall determine statewide
2530	schedules of maximum reimbursement allowances for medically
2531	necessary treatment, care, and attendance provided by
2532	physicians, hospitals, ambulatory surgical centers, work-
2533	hardening programs, pain programs, and durable medical
2534	equipment. The maximum reimbursement allowances for inpatient
2535	hospital care shall be based on a schedule of per diem rates, to
2536	be approved by the three-member panel no later than March 1,
2537	1994, to be used in conjunction with a precertification manual
2538	as determined by the department, including maximum hours in
2539	which an outpatient may remain in observation status, which
2540	shall not exceed 23 hoursagency. All compensable charges for
2541	hospital outpatient care shall be reimbursed at 75 percent of
2542	usual and customary charges, except as otherwise provided by
2543	this subsection. Until the three-member panel approves a
2544	schedule of per diem rates for inpatient hospital care and it
2545	becomes effective, all compensable charges for hospital
2546	inpatient care must be reimbursed at 75 percent of their usual
2547	and customary charges.Annually, the three-member panel shall
2548	adopt schedules of maximum reimbursement allowances for
2549	physicians, hospital inpatient care, hospital outpatient care,
2550	ambulatory surgical centers, work-hardening programs, and pain
2551	programs. However, the maximum percentage of increase in the
2552	individual reimbursement allowance may not exceed the percentage
2553	of increase in the Consumer Price Index for the previous year.
2554	An individual physician, hospital, ambulatory surgical center,
2555	pain program, or work-hardening program shall be reimbursed
2556	either the usual and customary charge for treatment, care, and
2557	attendance, the agreed-upon contract price,or the maximum
2558	reimbursement allowance in the appropriate schedule, whichever
2559	is less.
2560	(b) It is the intent of the Legislature to increase the
2561	schedule of maximum reimbursement allowances for selected
2562	physicians effective January 1, 2004, and to pay for the
2563	increases through reductions in payments to hospitals. Revisions
2564	developed pursuant to this subsection are limited to the
2565	following:
2566	1. Payments for outpatient physical, occupational, and
2567	speech therapy provided by hospitals shall be reduced to the
2568	schedule of maximum reimbursement allowances for these services
2569	which applies to nonhospital providers.
2570	2. Payments for scheduled outpatient nonemergency
2571	radiological and clinical laboratory services that are not
2572	provided in conjunction with a surgical procedure shall be
2573	reduced to the schedule of maximum reimbursement allowances for
2574	these services which applies to nonhospital providers.
2575	3. Outpatient reimbursement for scheduled surgeries shall
2576	be reduced from 75 percent of charges to 60 percent of charges.
2577	4. Maximum reimbursement for a physician licensed under
2578	chapter 458 or chapter 459 shall be increased to 110 percent of
2579	the reimbursement allowed by Medicare, using appropriate codes
2580	and modifiers or the medical reimbursement level adopted by the
2581	three-member panel as of January 1, 2003, whichever is greater.
2582	5. Maximum reimbursement for surgical procedures shall be
2583	increased to 140 percent of the reimbursement allowed by
2584	Medicare or the medical reimbursement level adopted by the
2585	three-member panel as of January 1, 2003, whichever is greater.
2586	(c)(b)As to reimbursement for a prescription medication,
2587	the reimbursement amount for a prescription shall be the average
2588	wholesale price times 1.2plus $4.18 for the dispensing fee,
2589	except where the carrier has contracted for a lower amount. Fees
2590	for pharmaceuticals and pharmaceutical services shall be
2591	reimbursable at the applicable fee schedule amount. Where the
2592	employer or carrier has contracted for such services and the
2593	employee elects to obtain them through a provider not a party to
2594	the contract, the carrier shall reimburse at the schedule,
2595	negotiated, or contract price, whichever is lower. No such
2596	contract shall rely on a provider that is not reasonably
2597	accessible to the employee.
2598	(d)(c)Reimbursement for all fees and other charges for
2599	such treatment, care, and attendance, including treatment, care,
2600	and attendance provided by any hospital or other health care
2601	provider, ambulatory surgical center, work-hardening program, or
2602	pain program, must not exceed the amounts provided by the
2603	uniform schedule of maximum reimbursement allowances as
2604	determined by the panel or as otherwise provided in this
2605	section. This subsection also applies to independent medical
2606	examinations performed by health care providers under this
2607	chapter. Until the three-member panel approves a uniform
2608	schedule of maximum reimbursement allowances and it becomes
2609	effective, all compensable charges for treatment, care, and
2610	attendance provided by physicians, ambulatory surgical centers,
2611	work-hardening programs, or pain programs shall be reimbursed at
2612	the lowest maximum reimbursement allowance across all 1992
2613	schedules of maximum reimbursement allowances for the services
2614	provided regardless of the place of service.In determining the
2615	uniform schedule, the panel shall first approve the data which
2616	it finds representative of prevailing charges in the state for
2617	similar treatment, care, and attendance of injured persons. Each
2618	health care provider, health care facility, ambulatory surgical
2619	center, work-hardening program, or pain program receiving
2620	workers' compensation payments shall maintain records verifying
2621	their usual charges. In establishing the uniform schedule of
2622	maximum reimbursement allowances, the panel must consider:
2623	1. The levels of reimbursement for similar treatment,
2624	care, and attendance made by other health care programs or
2625	third-party providers;
2626	2. The impact upon cost to employers for providing a level
2627	of reimbursement for treatment, care, and attendance which will
2628	ensure the availability of treatment, care, and attendance
2629	required by injured workers;
2630	3. The financial impact of the reimbursement allowances
2631	upon health care providers and health care facilities, including
2632	trauma centers as defined in s. 395.4001, and its effect upon
2633	their ability to make available to injured workers such
2634	medically necessary remedial treatment, care, and attendance.
2635	The uniform schedule of maximum reimbursement allowances must be
2636	reasonable, must promote health care cost containment and
2637	efficiency with respect to the workers' compensation health care
2638	delivery system, and must be sufficient to ensure availability
2639	of such medically necessary remedial treatment, care, and
2640	attendance to injured workers; and
2641	4. The most recent average maximum allowable rate of
2642	increase for hospitals determined by the Health Care Board under
2643	chapter 408.
2644	(e)(d)In addition to establishing the uniform schedule of
2645	maximum reimbursement allowances, the panel shall:
2646	1. Take testimony, receive records, and collect data to
2647	evaluate the adequacy of the workers' compensation fee schedule,
2648	nationally recognized fee schedules and alternative methods of
2649	reimbursement to certified health care providers and health care
2650	facilities for inpatient and outpatient treatment and care.
2651	2. Survey certified health care providers and health care
2652	facilities to determine the availability and accessibility of
2653	workers' compensation health care delivery systems for injured
2654	workers.
2655	3. Survey carriers to determine the estimated impact on
2656	carrier costs and workers' compensation premium rates by
2657	implementing changes to the carrier reimbursement schedule or
2658	implementing alternative reimbursement methods.
2659	4. Submit recommendations on or before January 1, 2003,
2660	and biennially thereafter, to the President of the Senate and
2661	the Speaker of the House of Representatives on methods to
2662	improve the workers' compensation health care delivery system.
2663
2664	The division shall provide data to the panel, including but not
2665	limited to, utilization trends in the workers' compensation
2666	health care delivery system. The division shall provide the
2667	panel with an annual report regarding the resolution of medical
2668	reimbursement disputes and any actions pursuant to s. 440.13(8).
2669	The division shall provide administrative support and service to
2670	the panel to the extent requested by the panel.
2671	(13) REMOVAL OF PHYSICIANS FROM LISTS OF THOSE AUTHORIZED
2672	TO RENDER MEDICAL CARE.--The agency shall remove from the list
2673	of physicians or facilities authorized to provide remedial
2674	treatment, care, and attendance under this chapter the name of
2675	any physician or facility found after reasonable investigation
2676	to have:
2677	(a) Engaged in professional or other misconduct or
2678	incompetency in connection with medical services rendered under
2679	this chapter;
2680	(b) Exceeded the limits of his or her or its professional
2681	competence in rendering medical care under this chapter, or to
2682	have made materially false statements regarding his or her or
2683	its qualifications in his or her application;
2684	(c) Failed to transmit copies of medical reports to the
2685	employer or carrier, or failed to submit full and truthful
2686	medical reports of all his or her or its findings to the
2687	employer or carrier as required under this chapter;
2688	(d) Solicited, or employed another to solicit for himself
2689	or herself or itself or for another, professional treatment,
2690	examination, or care of an injured employee in connection with
2691	any claim under this chapter;
2692	(e) Refused to appear before, or to answer upon request
2693	of, the agency or any duly authorized officer of the state, any
2694	legal question, or to produce any relevant book or paper
2695	concerning his or her conduct under any authorization granted to
2696	him or her under this chapter;
2697	(f) Self-referred in violation of this chapter or other
2698	laws of this state; or
2699	(g) Engaged in a pattern of practice of overutilization or
2700	a violation of this chapter or rules adopted by the agency,
2701	including failure to adhere to practice parameters and protocols
2702	established in accordance with this chapter.
2703	(14) PAYMENT OF MEDICAL FEES.--
2704	(a) Except for emergency care treatment, fees for medical
2705	services are payable only to a health care provider certified
2706	and authorized to render remedial treatment, care, or attendance
2707	under this chapter. Carriers shall pay, disallow, or deny
2708	payment to health care providers in the manner and at times set
2709	forth in this chapter.A health care provider may not collect or
2710	receive a fee from an injured employee within this state, except
2711	as otherwise provided by this chapter. Such providers have
2712	recourse against the employer or carrier for payment for
2713	services rendered in accordance with this chapter. Payment to
2714	health care providers or physicians shall be subject to the
2715	medical fee schedule and applicable practice parameters and
2716	protocols, regardless of whether the health care provider or
2717	claimant is asserting that the payment should be made.
2718	(b) Fees charged for remedial treatment, care, and
2719	attendance, except for independent medical examinations and
2720	consensus independent medical examinations, may not exceed the
2721	applicable fee schedules adopted under this chapter and
2722	department rule. Notwithstanding any other provision in this
2723	chapter, if a physician or health care provider specifically
2724	agrees in writing to follow identified procedures aimed at
2725	providing quality medical care to injured workers at reasonable
2726	costs, deviations from established fee schedules shall be
2727	permitted. Written agreements warranting deviations may include,
2728	but are not limited to, the timely scheduling of appointments
2729	for injured workers, participating in return-to-work programs
2730	with injured workers' employers, expediting the reporting of
2731	treatments provided to injured workers, and agreeing to
2732	continuing education, utilization review, quality assurance,
2733	precertification, and case management systems that are designed
2734	to provide needed treatment for injured workers.
2735	(c) Notwithstanding any other provision of this chapter,
2736	following overall maximum medical improvement from an injury
2737	compensable under this chapter, the employee is obligated to pay
2738	a copayment of $10 per visit for medical services. The copayment
2739	shall not apply to emergency care provided to the employee.
2740	(15) PRACTICE PARAMETERS.--The practice parameters and
2741	protocols mandated under this chapter shall be the practice
2742	parameters and protocols adopted by the United States Agency for
2743	Healthcare Research and Quality in effect on January 1, 2003.
2744	(a) The Agency for Health Care Administration, in
2745	conjunction with the department and appropriate health
2746	professional associations and health-related organizations shall
2747	develop and may adopt by rule scientifically sound practice
2748	parameters for medical procedures relevant to workers'
2749	compensation claimants. Practice parameters developed under this
2750	section must focus on identifying effective remedial treatments
2751	and promoting the appropriate utilization of health care
2752	resources. Priority must be given to those procedures that
2753	involve the greatest utilization of resources either because
2754	they are the most costly or because they are the most frequently
2755	performed. Practice parameters for treatment of the 10 top
2756	procedures associated with workers' compensation injuries
2757	including the remedial treatment of lower-back injuries must be
2758	developed by December 31, 1994.
2759	(b) The guidelines may be initially based on guidelines
2760	prepared by nationally recognized health care institutions and
2761	professional organizations but should be tailored to meet the
2762	workers' compensation goal of returning employees to full
2763	employment as quickly as medically possible, taking into
2764	consideration outcomes data collected from managed care
2765	providers and any other inpatient and outpatient facilities
2766	serving workers' compensation claimants.
2767	(c) Procedures must be instituted which provide for the
2768	periodic review and revision of practice parameters based on the
2769	latest outcomes data, research findings, technological
2770	advancements, and clinical experiences, at least once every 3
2771	years.
2772	(d) Practice parameters developed under this section must
2773	be used by carriers and the agency in evaluating the
2774	appropriateness and overutilization of medical services provided
2775	to injured employees.
2776	(16) STANDARDS OF CARE.--The following standards of care
2777	shall be followed in providing medical care under this chapter:
2778	(a) Abnormal anatomical findings alone, in the absence of
2779	objective relevant medical findings, shall not be an indicator
2780	of injury or illness, a justification for the provision of
2781	remedial medical care or the assignment of restrictions, or a
2782	foundation for limitations.
2783	(b) At all times during evaluation and treatment, the
2784	provider shall act on the premise that returning to work is an
2785	integral part of the treatment plan. The goal of removing all
2786	restrictions and limitations as early as appropriate shall be
2787	part of the treatment plan on a continuous basis. The assignment
2788	of restrictions and limitations shall be reviewed with each
2789	patient exam and upon receipt of new information, such as
2790	progress reports from physical therapists and other providers.
2791	Consideration shall be given to upgrading or removing the
2792	restrictions and limitations with each patient exam, based upon
2793	the presence or absence of objective relevant medical findings.
2794	(c) Reasonable necessary medical care of injured employees
2795	shall in all situations:
2796	1. Utilize a high intensity, short duration treatment
2797	approach that focuses on early activation and restoration of
2798	function whenever possible.
2799	2. Include reassessment of the treatment plans, regimes,
2800	therapies, prescriptions, and functional limitations or
2801	restrictions prescribed by the provider every 30 days.
2802	3. Be focused on treatment of the individual employee's
2803	specific clinical dysfunction or status and shall not be based
2804	upon nondescript diagnostic labels.
2805
2806	All treatment shall be inherently scientifically logical and the
2807	evaluation or treatment procedure must match the documented
2808	physiologic and clinical problem. Treatment shall match the
2809	type, intensity, and duration of service required by the problem
2810	identified.
2811	(17) Failure to comply with this section shall be
2812	considered a violation of this chapter and is subject to
2813	penalties as provided for in s. 440.525.
2814	Section 16. Paragraphs (d) and (i) of subsection (1) and
2815	subsections (2), (6), (7), (8), (9), (10), (11), (17), and (25)
2816	of section 440.134, Florida Statutes, are amended to read:
2817	440.134 Workers' compensation managed care arrangement.--
2818	(1) As used in this section, the term:
2819	(d) "Grievance" means a written complaint, other than a
2820	petition for benefits, filed by the injured worker pursuant to
2821	the requirements of the managed care arrangement, expressing
2822	dissatisfaction with the medical care provided by aninsurer's
2823	workers' compensation managed care arrangement's refusal to
2824	provide medical care or the medical care providedarrangement
2825	health care providers, expressed in writing by an injured
2826	worker.
2827	(i) "Medical care coordinator" means a primary care
2828	provider within a provider network who is responsible for
2829	managing the medical care of an injured worker including
2830	determining other health care providers and health care
2831	facilities to which the injured employee will be referred for
2832	evaluation or treatment. A medical care coordinator shall be a
2833	physician licensed under chapter 458,oran osteopathic
2834	physician licensed under chapter 459, a chiropractic physician
2835	licensed under chapter 460, or a podiatric physician licensed
2836	under chapter 461.
2837	(2)(a) The self-insured employer or carrier may, subject
2838	to the terms and limitations specified elsewhere in this section
2839	and chapter, furnish to the employee solely through managed care
2840	arrangements such medically necessary remedial treatment, care,
2841	and attendance for such period as the nature of the injury or
2842	the process of recovery requires and which shall be in
2843	accordance with practice parameters and protocols established
2844	pursuant to this chapter. For any self-insured employer or
2845	carrier who elects to deliver the medical benefits required by
2846	this chapter through a method other than a workers' compensation
2847	managed care arrangement, the discontinuance of the use of the
2848	workers' compensation managed care arrangement shall be without
2849	regard to the date of the accident, notwithstanding any other
2850	provision of law or rule.
2851	(b) The agency shall authorize an insurer to offer or
2852	utilize a workers' compensation managed care arrangement after
2853	the insurer files a completed application along with the payment
2854	of a $1,000 application fee, and upon the agency's being
2855	satisfied that the applicant has the ability to provide quality
2856	of care consistent with the prevailing professional standards of
2857	care and the insurer and its workers' compensation managed care
2858	arrangement otherwise meets the requirements of this section. No
2859	insurer may offer or utilize a managed care arrangement without
2860	such authorization. The authorization, unless sooner suspended
2861	or revoked, shall automatically expire 2 years after the date of
2862	issuance unless renewed by the insurer. The authorization shall
2863	be renewed upon application for renewal and payment of a renewal
2864	fee of $1,000, provided that the insurer is in compliance with
2865	the requirements of this section and any rules adopted
2866	hereunder. An application for renewal of the authorization shall
2867	be made 90 days prior to expiration of the authorization, on
2868	forms provided by the agency. The renewal application shall not
2869	require the resubmission of any documents previously filed with
2870	the agency if such documents have remained valid and unchanged
2871	since their original filing.
2872	(6) The proposed managed care plan of operation must
2873	include:
2874	(a) A statement or map providing a clear description of
2875	the service area.
2876	(b) A description of the grievance procedure to be used.
2877	(c) A description of the quality assurance program which
2878	assures that the health care services provided to workers shall
2879	be rendered under reasonable standards of quality of care
2880	consistent with the prevailing standards of medical practice in
2881	the medical community. The program shall include, but not be
2882	limited to:
2883	1. A written statement of goals and objectives that
2884	stresses health and return-to-work outcomes as the principal
2885	criteria for the evaluation of the quality of care rendered to
2886	injured workers.
2887	2. A written statement describing how methodology has been
2888	incorporated into an ongoing system for monitoring of care that
2889	is individual case oriented and, when implemented, can provide
2890	interpretation and analysis of patterns of care rendered to
2891	individual patients by individual providers.
2892	3. Written procedures for taking appropriate remedial
2893	action whenever, as determined under the quality assurance
2894	program, inappropriate or substandard services have been
2895	provided or services that should have been furnished have not
2896	been provided.
2897	4. A written plan, which includes ongoing review, for
2898	providing review of physicians and other licensed medical
2899	providers.
2900	5. Appropriate financial incentives to reduce service
2901	costs and utilization without sacrificing the quality of
2902	service.
2903	6. Adequate methods of peer review and utilization review.
2904	The utilization review process shall include a health care
2905	facility'sfacilitiesprecertification mechanism, including, but
2906	not limited to, all elective admissions and nonemergency
2907	surgeries and adherence to practice parameters and protocols
2908	established in accordance with this chapter.
2909	7. Provisions for resolution of disputes arising between a
2910	health care provider and an insurer regarding reimbursements and
2911	utilization review.
2912	8. Availability of a process for aggressive medical care
2913	coordination, as well as a program involving cooperative efforts
2914	by the workers, the employer, and the workers' compensation
2915	managed care arrangement to promote early return to work for
2916	injured workers.
2917	9. A written plan allowing for the independent medical
2918	examination provided for in s. 440.13(5). Notwithstanding any
2919	provision to the contrary, the costs for the independent medical
2920	examination shall be paid by the carrier if such examination is
2921	performed by a physician in the provider network. Otherwise,
2922	such costs shall be paid in accordance with s. 440.13(5). An
2923	independent medical examination requested by a claimant and paid
2924	for by the carrier shall constitute the claimant's one
2925	independent medical examination per accident under s. 440.13(5).
2926	A process allowing employees to obtain one second medical
2927	opinion in the same specialty and within the provider network
2928	during the course of treatment for a work-related injury.
2929	10. A provision for the selection of a primary care
2930	provider by the employee from among primary providers in the
2931	provider network.
2932	11. The written information proposed to be used by the
2933	insurer to comply with subparagraph 8.
2934	(7) Written procedures to provide the insurer with timely
2935	medical records and information including, but not limited to,
2936	work status, work restrictions, date of maximum medical
2937	improvement, permanent impairment ratings, and other information
2938	as required, including information demonstrating compliance with
2939	the practice parameters and protocols of treatment established
2940	pursuant to this chapter.
2941	(8) Evidence that appropriate health care providers and
2942	administrative staff of the insurer's workers' compensation
2943	managed care arrangement have received training and education on
2944	the provisions of this chapter;andthe administrative rules
2945	that govern the provision of remedial treatment, care, and
2946	attendance of injured workers; and the practice parameters and
2947	protocols of treatment established pursuant to this chapter.
2948	(9) Written procedures and methods to prevent
2949	inappropriate or excessive treatment that are in accordance with
2950	the practice parameters and protocols of treatment established
2951	pursuant to this chapter.
2952	(10) Written procedures and methods for the management of
2953	an injured worker's medical care by a medical care coordinator
2954	including:
2955	(a) The mechanism for assuring that covered employees
2956	receive all initial covered services from a primary care
2957	provider participating in the provider network, except for
2958	emergency care.
2959	(b) The mechanism for assuring that all continuing covered
2960	services be received from the same primary care provider
2961	participating in the provider network that provided the initial
2962	covered services, except when services from another provider are
2963	authorized by the medical care coordinator pursuant to paragraph
2964	(d).
2965	(c) The policies and procedures for allowing an employee
2966	one change to another provider within the same specialty and
2967	provider network as the authorized treating physician during the
2968	course of treatment for a work-related injury, in accordance
2969	with the procedures provided in s. 440.13(2)(f), if a request is
2970	made to the medical care coordinator by the employee; and
2971	requiring that special provision be made for more than one such
2972	referral through the arrangement's grievance procedures.
2973	(d) The process for assuring that all referrals authorized
2974	by a medical care coordinator, in accordance with the practice
2975	parameters and protocols of treatment established pursuant to
2976	this chapter,are made to the participating network providers,
2977	unless medically necessary treatment, care, and attendance are
2978	not available and accessible to the injured worker in the
2979	provider network.
2980	(e) Assignment of a medical care coordinator licensed
2981	under chapter 458 or chapter 459 to manage care by physicians
2982	licensed under chapter 458 or chapter 459, a medical care
2983	coordinator licensed under chapter 460 to manage care by
2984	physicians licensed under chapter 460, and a medical care
2985	coordinator licensed under chapter 461 to manage care by
2986	physicians licensed under chapter 461 upon request by an injured
2987	employee for care by a physician licensed under chapter 458,
2988	chapter 459, chapter 460, or chapter 461.
2989	(11) A description of the use of workers' compensation
2990	practice parameters and protocols of treatmentfor health care
2991	services when adopted by the agency.
2992	(17) Notwithstanding any other provisions of this chapter,
2993	when a carrier provides medical care through a workers'
2994	compensation managed care arrangement, pursuant to this section,
2995	those workers who are subject to the arrangement must receive
2996	medical services for work-related injuries and diseases as
2997	prescribed in the contract, provided the employer and carrier
2998	have provided notice to the employees of the arrangement in a
2999	manner approved by the agency and the medical services are in
3000	accordance with the practice parameters and protocols
3001	established pursuant to this chapter. Treatment received outside
3002	the workers' compensation managed care arrangement is not
3003	compensable, regardless of the purpose of the treatment,
3004	including, but not limited to, evaluations, examinations, or
3005	diagnostic studies to determine causation between medical
3006	findings and a compensable accident, the existence or extent of
3007	impairments or disabilities, and whether the injured employee
3008	has reached maximum medical improvement,unless authorized by
3009	the carrier prior to the treatment date.
3010	(25) The agency shall adopt rules that specify:
3011	(a) Procedures for authorization and examination of
3012	workers' compensation managed care arrangements by the agency.
3013	(b) Requirements and procedures for authorization of
3014	workers' compensation arrangement provider networks and
3015	procedures for the agency to grant exceptions from accessibility
3016	of services.
3017	(c) Requirements and procedures for case management,
3018	utilization management, and peer review.
3019	(d) Requirements and procedures for quality assurance and
3020	medical records.
3021	(e) Requirements and procedures for dispute resolution in
3022	conformance with this chapter.
3023	(f) Requirements and procedures for employee and provider
3024	education.
3025	(g) Requirements and procedures for reporting data
3026	regarding grievances, return-to-work outcomes, and provider
3027	networks.
3028	Section 17. Subsections (1) and (4)and paragraph (b) of
3029	subsection (5) of section 440.14, Florida Statutes, are amended
3030	to read:
3031	440.14 Determination of pay.--
3032	(1) Except as otherwise provided in this chapter, the
3033	average weekly wages of the injured employee on the date of the
3034	accidentat the time of the injuryshall be taken as the basis
3035	upon which to compute compensation and shall be determined,
3036	subject to the limitations of s. 440.12(2), as follows:
3037	(a) If the injured employee has worked in the employment
3038	in which she or he was working on the date of the accidentat
3039	the time of the injury, whether for the same or another
3040	employer, during substantially the whole of 13 weeks immediately
3041	preceding the accidentinjury, her or his average weekly wage
3042	shall be one-thirteenth of the total amount of wages earned in
3043	such employment during the 13 weeks. As used in this paragraph,
3044	the term "substantially the whole of 13 weeks" means the
3045	calendarshall be deemed to mean and refer to a constructive
3046	period of 13 weeks as a whole, which shall be defined as the 13
3047	calendar weeks before the date of the accident, excluding the
3048	week during which the accident occurred.a consecutive period of
3049	91 days, andThe term "during substantially the whole of 13
3050	weeks" shall be deemed to mean during not less than 7590
3051	percent of the total customary full-timehours of employment
3052	within such period considered as a whole.
3053	(b) If the injured employee has not worked in such
3054	employment during substantially the whole of 13 weeks
3055	immediately preceding the accidentinjury, the wages of a
3056	similar employee in the same employment who has worked
3057	substantially the whole of such 13 weeks shall be used in making
3058	the determination under the preceding paragraph.
3059	(c) If an employee is a seasonal worker and the foregoing
3060	method cannot be fairly applied in determining the average
3061	weekly wage, then the employee may use, instead of the 13 weeks
3062	immediately preceding the accidentinjury, the calendar year or
3063	the 52 weeks immediately preceding the accidentinjury. The
3064	employee will have the burden of proving that this method will
3065	be more reasonable and fairer than the method set forth in
3066	paragraphs (a) and (b) and, further, must document prior
3067	earnings with W-2 forms, written wage statements, or income tax
3068	returns. The employer shall have 30 days following the receipt
3069	of this written proof to adjust the compensation rate, including
3070	the making of any additional payment due for prior weekly
3071	payments, based on the lower rate compensation.
3072	(d) If any of the foregoing methods cannot reasonably and
3073	fairly be applied, the full-time weekly wages of the injured
3074	employee shall be used, except as otherwise provided in
3075	paragraph (e) or paragraph (f).
3076	(e) If it is established that the injured employee was
3077	under 22 years of age when the accident occurredinjuredand
3078	that under normal conditions her or his wages should be expected
3079	to increase during the period of disability, the fact may be
3080	considered in arriving at her or his average weekly wages.
3081	(f) If it is established that the injured employee was a
3082	part-time worker on the date of the accidentat the time of the
3083	injury, that she or he had adopted part-time employment as a
3084	customary practice, and that under normal working conditions she
3085	or he probably would have remained a part-time worker during the
3086	period of disability, these factors shall be considered in
3087	arriving at her or his average weekly wages. For the purpose of
3088	this paragraph, the term "part-time worker" means an individual
3089	who customarily works less than the full-time hours or full-time
3090	workweek of a similar employee in the same employment.
3091	(g) If compensation is due for a fractional part of the
3092	week, the compensation for such fractional part shall be
3093	determined by dividing the weekly compensation rate by the
3094	number of days employed per week to compute the amount due for
3095	each day.
3096	(4) Upon termination of the employee or upon termination
3097	of the payment of fringe benefits of any employee who is
3098	collecting indemnity benefits pursuant to s. 440.15(2) or
3099	(3)(b), the employer shall within 7 days of such termination
3100	file a corrected 13-week wage statement reflecting the wages
3101	paid and the fringe benefits that had been paid to the injured
3102	employee, as provided in s. 440.02(27).
3103	(5)
3104	(b) The employee waives any entitlement to interest,
3105	penalties, and attorney's fees during the period in which the
3106	employee has not provided information concerning the loss of
3107	earnings from concurrent employment. Carriers are not subject to
3108	penalties by the division under s. 440.20(8)(b) and (c)for
3109	unpaid compensation related to concurrent employment during the
3110	period in which the employee has not provided information
3111	concerning the loss of earnings from concurrent employment.
3112	Section 18. Section 440.15, Florida Statutes, is amended
3113	to read:
3114	440.15 Compensation for disability.--Compensation for
3115	disability shall be paid to the employee, subject to the limits
3116	provided in s. 440.12(2), as follows:
3117	(1) PERMANENT TOTAL DISABILITY.--
3118	(a) In case of total disability adjudged to be permanent,
3119	66 2/3 percent of the average weekly wages shall be paid to the
3120	employee during the continuance of such total disability.
3121	(b) Only A catastrophic injury as defined in s. 440.02(38)
3122	shall, in the absence of conclusive proof of a substantial
3123	earning capacity, constitute permanent total disability. In all
3124	other cases, no compensation shall be payable under paragraph
3125	(a) if the employee is engaged in, or is physically capable of
3126	engaging in at least sedentary employment. In order to obtain
3127	permanent total disability benefits, the employee must establish
3128	that he or she is not able uninterruptedly to engage in at least
3129	sedentary employment, within a 50-mile radius of the employee's
3130	residence, due to his or her physical limitation. Such benefits
3131	shall be payable until the employee reaches age 75,
3132	notwithstanding any age limits. If the accident occurred on or
3133	after the employee reaches age 70, benefits shall be payable
3134	during the continuance of permanent total disability, not to
3135	exceed 5 years following the determination of permanent total
3136	disability. Only claimants with catastrophic injuries or
3137	claimants who are incapable of engaging in employment, as
3138	described in this paragraph,are eligible for permanent total
3139	benefits. In no other case may permanent total disability be
3140	awarded.
3141	(c) In cases of permanent total disability resulting from
3142	injuries that occurred prior to July 1, 1955, such payments
3143	shall not be made in excess of 700 weeks.
3144	(d) If an employee who is being paid compensation for
3145	permanent total disability becomes rehabilitated to the extent
3146	that she or he establishes an earning capacity, the employee
3147	shall be paid, instead of the compensation provided in paragraph
3148	(a), benefits pursuant to subsection (3). The department shall
3149	adopt rules to enable a permanently and totally disabled
3150	employee who may have reestablished an earning capacity to
3151	undertake a trial period of reemployment without prejudicing her
3152	or his return to permanent total status in the case that such
3153	employee is unable to sustain an earning capacity.
3154	(e)1. The employer's or carrier's right to conduct
3155	vocational evaluations or testing by the employer's or carrier's
3156	chosen rehabilitation advisor or providerpursuant to s. 440.491
3157	continues even after the employee has been accepted or
3158	adjudicated as entitled to compensation under this chapter and
3159	costs for such evaluations and testing shall be borne by the
3160	employer or carrier, respectively. This right includes, but is
3161	not limited to, instances in which such evaluations or tests are
3162	recommended by a treating physician or independent medical-
3163	examination physician, instances warranted by a change in the
3164	employee's medical condition, or instances in which the employee
3165	appears to be making appropriate progress in recuperation. This
3166	right may not be exercised more than once every calendar year.
3167	2. The carrier must confirm the scheduling of the
3168	vocational evaluation or testing in writing, and must notify the
3169	employee and theemployee's counsel, if any, at least 7 days
3170	before the date on which vocational evaluation or testing is
3171	scheduled to occur.
3172	3. Pursuant to an order of the judge of compensation
3173	claims,The employer or carrier may withhold payment of benefits
3174	for permanent total disability or supplements for any period
3175	during which the employee willfully fails or refuses to appear
3176	without good cause for the scheduled vocational evaluation or
3177	testing.
3178	(f)1. If permanent total disability results from injuries
3179	that occurred subsequent to June 30, 1955, and for which the
3180	liability of the employer for compensation has not been
3181	discharged under s. 440.20(11), the injured employee shall
3182	receive additional weekly compensation benefits equal to 35
3183	percent of her or his weekly compensation rate, as established
3184	pursuant to the law in effect on the date of her or his injury,
3185	multiplied by the number of calendar years since the date of
3186	injury. The weekly compensation payable and the additional
3187	benefits payable under this paragraph, when combined, may not
3188	exceed the maximum weekly compensation rate in effect at the
3189	time of payment as determined pursuant to s. 440.12(2).
3190	Entitlement to These supplemental payments shall not be paid or
3191	payable after the employee attainscease at age 62, regardless
3192	of whetherif the employee has applied for or is eligible to
3193	applyis eligiblefor social security benefits under 42 U.S.C.
3194	ss. 402 and 423, whether or not the employee has applied for
3195	such benefits. These supplemental benefits shall be paid by the
3196	department out of the Workers' Compensation Administration Trust
3197	Fund when the injury occurred subsequent to June 30, 1955, and
3198	before July 1, 1984. These supplemental benefits shall be paid
3199	by the employer when the injury occurred on or after July 1,
3200	1984. Supplemental benefits are not payable for any period prior
3201	to October 1, 1974.
3202	2.a. The department shall provide by rule for the periodic
3203	reporting to the department of all earnings of any nature and
3204	social security income by the injured employee entitled to or
3205	claiming additional compensation under subparagraph 1. Neither
3206	the department nor the employer or carrier shall make any
3207	payment of those additional benefits provided by subparagraph 1.
3208	for any period during which the employee willfully fails or
3209	refuses to report upon request by the department in the manner
3210	prescribed by such rules.
3211	b. The department shall provide by rule for the periodic
3212	reporting to the employer or carrier of all earnings of any
3213	nature and social security income by the injured employee
3214	entitled to or claiming benefits for permanent total disability.
3215	The employer or carrier is not required to make any payment of
3216	benefits for permanent total disability for any period during
3217	which the employee willfully fails or refuses to report upon
3218	request by the employer or carrier in the manner prescribed by
3219	such rules or if any employee who is receiving permanent total
3220	disability benefits refuses to apply for or cooperate with the
3221	employer or carrier in applying for social security benefits.
3222	3. When an injured employee receives a full or partial
3223	lump-sum advance of the employee's permanent total disability
3224	compensation benefits, the employee's benefits under this
3225	paragraph shall be computed on the employee's weekly
3226	compensation rate as reduced by the lump-sum advance.
3227	(2) TEMPORARY TOTAL DISABILITY.--
3228	(a) Subject to subsection (7),in case of disability total
3229	in character but temporary in quality, 66 2/3 percent of the
3230	average weekly wages shall be paid to the employee during the
3231	continuance thereof, not to exceed 104 weeks except as provided
3232	in this subsection, s. 440.12(1), and s. 440.14(3). Once the
3233	employee reaches the maximum number of weeks allowed, or the
3234	employee reaches the date of maximum medical improvement,
3235	whichever occurs earlier, temporary disability benefits shall
3236	cease and the injured worker's permanent impairment shall be
3237	determined.
3238	(b) Notwithstanding the provisions of paragraph (a), an
3239	employee who has sustained the loss of an arm, leg, hand, or
3240	foot, has been rendered a paraplegic, paraparetic, quadriplegic,
3241	or quadriparetic, or has lost the sight of both eyes shall be
3242	paid temporary total disability of 80 percent of her or his
3243	average weekly wage. The increased temporary total disability
3244	compensation provided for in this paragraph must not extend
3245	beyond 6 months from the date of the accident; however, such
3246	benefits shall not be due or payable if the employee is eligible
3247	for, entitled to, or collecting permanent total disability
3248	benefits. The compensation provided by this paragraph is not
3249	subject to the limits provided in s. 440.12(2), but instead is
3250	subject to a maximum weekly compensation rate of $700. If, at
3251	the conclusion of this period of increased temporary total
3252	disability compensation, the employee is still temporarily
3253	totally disabled, the employee shall continue to receive
3254	temporary total disability compensation as set forth in
3255	paragraphs (a) and (c). The period of time the employee has
3256	received this increased compensation will be counted as part of,
3257	and not in addition to, the maximum periods of time for which
3258	the employee is entitled to compensation under paragraph (a) but
3259	not paragraph (c).
3260	(c) Temporary total disability benefits paid pursuant to
3261	this subsection shall include such period as may be reasonably
3262	necessary for training in the use of artificial members and
3263	appliances, and shall include such period as the employee may be
3264	receiving training and education under a program pursuant to s.
3265	440.491. Notwithstanding s. 440.02, the date of maximum medical
3266	improvement for purposes of paragraph (3)(b) shall be no earlier
3267	than the last day for which such temporary disability benefits
3268	are paid.
3269	(d) The department shall, by rule, provide for the
3270	periodic reporting to the department, employer, or carrier of
3271	all earned income, including income from social security, by the
3272	injured employee who is entitled to or claiming benefits for
3273	temporary total disability. The employer or carrier is not
3274	required to make any payment of benefits for temporary total
3275	disability for any period during which the employee willfully
3276	fails or refuses to report upon request by the employer or
3277	carrier in the manner prescribed by the rules. The rule must
3278	require the claimant to personally sign the claim form and
3279	attest that she or he has reviewed, understands, and
3280	acknowledges the foregoing.
3281	(3) PERMANENT IMPAIRMENT AND WAGE-LOSSBENEFITS.--
3282	(a) Impairment benefits.--
3283	1.Once the employee has reached the date of maximum
3284	medical improvement, impairment benefits are due and payable
3285	within 1420days after the carrier has knowledge of the
3286	impairment.
3287	(b)2.The three-member panel, in cooperation with the
3288	department, shall establish and use a uniform permanent
3289	impairment rating schedule. This schedule must be based on
3290	medically or scientifically demonstrable findings as well as the
3291	systems and criteria set forth in the American Medical
3292	Association's Guides to the Evaluation of Permanent Impairment;
3293	the Snellen Charts, published by American Medical Association
3294	Committee for Eye Injuries; and the Minnesota Department of
3295	Labor and Industry Disability Schedules. The schedule must
3296	shouldbe based upon objective findings. The schedule shall be
3297	more comprehensive than the AMA Guides to the Evaluation of
3298	Permanent Impairment and shall expand the areas already
3299	addressed and address additional areas not currently contained
3300	in the guides. On August 1, 1979, and pending the adoption, by
3301	rule, of a permanent schedule, Guides to the Evaluation of
3302	Permanent Impairment, copyright 1977, 1971, 1988, by the
3303	American Medical Association, shall be the temporary schedule
3304	and shall be used for the purposes hereof. For injuries after
3305	July 1, 1990, pending the adoption by rule of a uniform
3306	disability rating agency schedule, the Minnesota Department of
3307	Labor and Industry Disability Schedule shall be used unless that
3308	schedule does not address an injury. In such case, the Guides to
3309	the Evaluation of Permanent Impairment by the American Medical
3310	Association shall be used. Determination of permanent impairment
3311	under this schedule must be made by a physician licensed under
3312	chapter 458, a doctor of osteopathic medicine licensed under
3313	chapters 458 and 459, a chiropractic physician licensed under
3314	chapter 460, a podiatric physician licensed under chapter 461,
3315	an optometrist licensed under chapter 463, or a dentist licensed
3316	under chapter 466, as appropriate considering the nature of the
3317	injury. No other persons are authorized to render opinions
3318	regarding the existence of or the extent of permanent
3319	impairment.
3320	(c)3.All impairment income benefits shall be based on an
3321	impairment rating using the impairment schedule referred to in
3322	paragraph (b)subparagraph 2. Impairment income benefits are
3323	paid biweeklyweekly at the rate of 7550percent of the
3324	employee's average weekly temporary total disability benefit not
3325	to exceed the maximum weekly benefit under s. 440.12; provided,
3326	however, that such benefits shall be reduced by 50 percent for
3327	each week in which the employee has earned income equal to or in
3328	excess of the employee's average weekly wage. An employee's
3329	entitlement to impairment income benefits begins the day after
3330	the employee reaches maximum medical improvement or the
3331	expiration of temporary benefits, whichever occurs earlier, and
3332	continues until the earlier of:
3333	1.a.The expiration of a period computed at the rate of 3
3334	weeks for each percentage point of impairment; or
3335	2.b.The death of the employee.
3336
3337	Impairment income benefits as defined by this subsection are
3338	payable only for impairment ratings for physical impairments. If
3339	objective medical findings can substantiate a permanent
3340	psychiatric impairment resulting from the accident, permanent
3341	impairment benefits are limited for the permanent psychiatric
3342	impairment to 1-percent permanent impairment.
3343	(d)4.After the employee has been certified by a doctor as
3344	having reached maximum medical improvement or 6 weeks before the
3345	expiration of temporary benefits, whichever occurs earlier, the
3346	certifying doctor shall evaluate the condition of the employee
3347	and assign an impairment rating, using the impairment schedule
3348	referred to in paragraph (b)subparagraph 2. Compensation is not
3349	payable for the mental, psychological, or emotional injury
3350	arising out of depression from being out of work.If the
3351	certification and evaluation are performed by a doctor other
3352	than the employee's treating doctor, the certification and
3353	evaluation must be submitted to the treating doctor, the
3354	employee, and the carrier within 10 days after the evaluation.
3355	and The treating doctor must indicate to the carrieragreement
3356	or disagreement with the other doctor'scertification and
3357	evaluation.
3358	1.The certifying doctor shall issue a written report to
3359	the department, the employee,and the carrier certifying that
3360	maximum medical improvement has been reached, stating the
3361	impairment rating to the body as a whole, and providing any
3362	other information required by the department by rule. The
3363	carrier shall establish an overall maximum medical improvement
3364	date and permanent impairment rating, based upon all such
3365	reports.
3366	2. Within 14 days after the carrier's knowledge of each
3367	maximum medical improvement date and impairment rating to the
3368	body as a whole upon which the carrier is paying benefits, the
3369	carrier shall report such maximum medical improvement date and,
3370	when determined, the overall maximum medical improvement date
3371	and associated impairment rating to the department in a format
3372	as set forth in department rule.If the employee has not been
3373	certified as having reached maximum medical improvement before
3374	the expiration of 98102 weeks after the date temporary total
3375	disability benefits begin to accrue, the carrier shall notify
3376	the treating doctor of the requirements of this section.
3377	(e)5. The carrier shall pay the employee impairment income
3378	benefits for a period based on the impairment rating.
3379	(f)6. The department may by rule specify forms and
3380	procedures governing the method of payment of wage loss and
3381	impairment benefits under this sectionfor dates of accidents
3382	before January 1, 1994, and for dates of accidents on or after
3383	January 1, 1994.
3384	(b) Supplemental benefits.--
3385	1. All supplemental benefits must be paid in accordance
3386	with this subsection. An employee is entitled to supplemental
3387	benefits as provided in this paragraph as of the expiration of
3388	the impairment period, if:
3389	a. The employee has an impairment rating from the
3390	compensable injury of 20 percent or more as determined pursuant
3391	to this chapter;
3392	b. The employee has not returned to work or has returned
3393	to work earning less than 80 percent of the employee's average
3394	weekly wage as a direct result of the employee's impairment; and
3395	c. The employee has in good faith attempted to obtain
3396	employment commensurate with the employee's ability to work.
3397	2. If an employee is not entitled to supplemental benefits
3398	at the time of payment of the final weekly impairment income
3399	benefit because the employee is earning at least 80 percent of
3400	the employee's average weekly wage, the employee may become
3401	entitled to supplemental benefits at any time within 1 year
3402	after the impairment income benefit period ends if:
3403	a. The employee earns wages that are less than 80 percent
3404	of the employee's average weekly wage for a period of at least
3405	90 days;
3406	b. The employee meets the other requirements of
3407	subparagraph 1.; and
3408	c. The employee's decrease in earnings is a direct result
3409	of the employee's impairment from the compensable injury.
3410	3. If an employee earns wages that are at least 80 percent
3411	of the employee's average weekly wage for a period of at least
3412	90 days during which the employee is receiving supplemental
3413	benefits, the employee ceases to be entitled to supplemental
3414	benefits for the filing period. Supplemental benefits that have
3415	been terminated shall be reinstated when the employee satisfies
3416	the conditions enumerated in subparagraph 2. and files the
3417	statement required under subparagraph 4. Notwithstanding any
3418	other provision, if an employee is not entitled to supplemental
3419	benefits for 12 consecutive months, the employee ceases to be
3420	entitled to any additional income benefits for the compensable
3421	injury. If the employee is discharged within 12 months after
3422	losing entitlement under this subsection, benefits may be
3423	reinstated if the employee was discharged at that time with the
3424	intent to deprive the employee of supplemental benefits.
3425	4. After the initial determination of supplemental
3426	benefits, the employee must file a statement with the carrier
3427	stating that the employee has earned less than 80 percent of the
3428	employee's average weekly wage as a direct result of the
3429	employee's impairment, stating the amount of wages the employee
3430	earned in the filing period, and stating that the employee has
3431	in good faith sought employment commensurate with the employee's
3432	ability to work. The statement must be filed quarterly on a form
3433	and in the manner prescribed by the department. The department
3434	may modify the filing period as appropriate to an individual
3435	case. Failure to file a statement relieves the carrier of
3436	liability for supplemental benefits for the period during which
3437	a statement is not filed.
3438	5. The carrier shall begin payment of supplemental
3439	benefits not later than the seventh day after the expiration
3440	date of the impairment income benefit period and shall continue
3441	to timely pay those benefits. The carrier may request a
3442	mediation conference for the purpose of contesting the
3443	employee's entitlement to or the amount of supplemental income
3444	benefits.
3445	6. Supplemental benefits are calculated quarterly and paid
3446	monthly. For purposes of calculating supplemental benefits, 80
3447	percent of the employee's average weekly wage and the average
3448	wages the employee has earned per week are compared quarterly.
3449	For purposes of this paragraph, if the employee is offered a
3450	bona fide position of employment that the employee is capable of
3451	performing, given the physical condition of the employee and the
3452	geographic accessibility of the position, the employee's weekly
3453	wages are considered equivalent to the weekly wages for the
3454	position offered to the employee.
3455	7. Supplemental benefits are payable at the rate of 80
3456	percent of the difference between 80 percent of the employee's
3457	average weekly wage determined pursuant to s. 440.14 and the
3458	weekly wages the employee has earned during the reporting
3459	period, not to exceed the maximum weekly income benefit under s.
3460	440.12.
3461	8. The department may by rule define terms that are
3462	necessary for the administration of this section and forms and
3463	procedures governing the method of payment of supplemental
3464	benefits for dates of accidents before January 1, 1994, and for
3465	dates of accidents on or after January 1, 1994.
3466	(c) Duration of temporary impairment and supplemental
3467	income benefits.--The employee's eligibility for temporary
3468	benefits, impairment income benefits, and supplemental benefits
3469	terminates on the expiration of 401 weeks after the date of
3470	injury.
3471	(g) Notwithstanding paragraph (c), for accidents occurring
3472	on or after October 1, 2003, an employee's entitlement to
3473	impairment income benefits begins the day after the employee
3474	reaches maximum medical improvement or the expiration of
3475	temporary benefits, whichever occurs earlier, and continues for
3476	the following periods:
3477	1. Two weeks of benefits are to be paid to the employee
3478	for each percentage point of impairment from 1 percent up to and
3479	including 10 percent.
3480	2. For each percentage point of impairment from 11 percent
3481	up to and including 15 percent, 3 weeks of benefits are to be
3482	paid.
3483	3. For each percentage point of impairment from 16 percent
3484	up to and including 20 percent, 4 weeks of benefits are to be
3485	paid.
3486	4. For each percentage point of impairment from 21 percent
3487	and higher, 6 weeks of benefits are to be paid.
3488	(4) TEMPORARY PARTIAL DISABILITY.--
3489	(a) Subject to subsection (7),in case of temporary
3490	partial disability, compensation shall be equal to 80 percent of
3491	the difference between 80 percent of the employee's average
3492	weekly wage and the salary, wages, and other remuneration the
3493	employee is able to earn post injury, as compared weekly;
3494	however, the weekly temporary partial disabilitybenefits may
3495	not exceed an amount equal to 66 2/3 percent of the employee's
3496	average weekly wage at the time of accidentinjury. In order to
3497	simplify the comparison of the preinjury average weekly wage
3498	with the salary, wages, and other remuneration the employee is
3499	able to earn post injury, the department may by rule provide for
3500	payment of the initial installment of temporary partial
3501	disability benefits to be paid as a partial week so that payment
3502	for remaining weeks of temporary partial disability canthe
3503	modification of the weekly comparison so as tocoincide as
3504	closely as possible with the post injury employer's work week
3505	injured worker's pay periods. The amount determined to be the
3506	salary, wages, and other remuneration the employee is able to
3507	earn shall in no case be less than the sum actually being earned
3508	by the employee, including earnings from sheltered employment.
3509	Benefits shall be payable under this subsection only if overall
3510	maximum medical improvement has not been reached and the medical
3511	conditions resulting from the accident create restrictions on
3512	the injured employee's ability to return to work.
3513	(b) Within 5 business days after the carrier's knowledge
3514	of the employee's release to restricted work, the carrier shall
3515	mail to the employee and employer an informational letter,
3516	adopted by department rule, explaining the employee's possible
3517	eligibility and responsibilities for temporary partial
3518	disability benefits.
3519	(c) When an employee returns to work with the restrictions
3520	resulting from the accident and is earning wages less than 80
3521	percent of the preinjury average weekly wage, the first
3522	installment of temporary partial disability benefits is due 7
3523	days after the last date of the post injury employer's first
3524	biweekly work week. Thereafter, payment for temporary partial
3525	benefits shall be paid biweekly no later than the 7th day
3526	following the last day of each biweekly work week.
3527	(d) If the employee is unable to return to work with the
3528	restrictions resulting from the accident and is not earning
3529	wages, salary, or other remuneration, temporary partial
3530	disability benefits shall be paid no later than the last day of
3531	each biweekly period. The employee shall notify the carrier
3532	within 5 business days after returning to work. Failure to
3533	notify the carrier of the establishment of an earning capacity
3534	in the required time shall result in a suspension or nonpayment
3535	of temporary partial disability benefits until the proper
3536	notification is provided.
3537	(e)(b)Such benefits shall be paid during the continuance
3538	of such disability, not to exceed a period of 104 weeks, as
3539	provided by this subsection and subsection (2). Once the injured
3540	employee reaches the maximum number of weeks, temporary
3541	disability benefits cease and the injured worker's permanent
3542	impairment must be determined. If the employee is terminated
3543	from post injury employment based on the employee's misconduct,
3544	temporary partial disability benefits are not payable as
3545	provided for in this section. The department shallmayby rule
3546	specify forms and procedures governing the method and time for
3547	ofpayment of temporary disability benefits for dates of
3548	accidents before January 1, 1994, and for dates of accidents on
3549	or after January 1, 1994.
3550	(5) SUBSEQUENT INJURY.--
3551	(a) The fact that an employee has suffered previous
3552	disability, impairment, anomaly, or disease, or received
3553	compensation therefor, shall not preclude her or him from
3554	benefits, as specified in paragraph (b),for a subsequent
3555	aggravation or acceleration of the preexisting condition ornor
3556	preclude benefits for death resulting therefrom, except that no
3557	benefits shall be payable if the employee, at the time of
3558	entering into the employment of the employer by whom the
3559	benefits would otherwise be payable, falsely represents herself
3560	or himself in writing as not having previously been disabled or
3561	compensated because of such previous disability, impairment,
3562	anomaly, or disease and the employer detrimentally relies on the
3563	misrepresentation. Compensation for temporary disability,
3564	medical benefits, and wage-loss benefitsshall not be subject to
3565	apportionment.
3566	(b) If a compensable injury, disability, or need for
3567	medical carepermanent impairment, or any portion thereof, is a
3568	result of aggravation or acceleration of a preexisting
3569	condition, or is the result of merger with a preexisting
3570	condition, only the disabilities and medical treatment
3571	associated with such compensable injury shall be payable under
3572	this chapter, excluding the degree of disability or medical
3573	conditions existing at the time of the impairment rating or at
3574	the time of the accident, regardless of whether the preexisting
3575	condition was disabling at the time of the accident or at the
3576	time of the impairment rating and without considering whether
3577	the preexisting condition would be disabling without the
3578	compensable accidentimpairment, an employee eligible to receive
3579	impairment benefits under paragraph (3)(a) shall receive such
3580	benefits for the total impairment found to result, excluding the
3581	degree of impairment existing at the time of the subject
3582	accident or injury or which would have existed by the time of
3583	the impairment rating without the intervention of the
3584	compensable accident or injury. The degree of permanent
3585	impairment or disabilityattributable to the accident or injury
3586	shall be compensated in accordance with this section,
3587	apportioning out the preexisting condition based on the
3588	anatomical impairment rating attributable to the preexisting
3589	condition. Medical benefits shall be paid apportioning out the
3590	percentage of the need for such care attributable to the
3591	preexisting conditionparagraph (3)(a). As used in this
3592	paragraph, "merger" means the combining of a preexisting
3593	permanent impairment or disabilitywith a subsequent compensable
3594	permanent impairment or disabilitywhich, when the effects of
3595	both are considered together, result in a permanent impairment
3596	or disabilityrating which is greater than the sum of the two
3597	permanent impairment or disability ratings when each impairment
3598	or disability is considered individually.
3599	(6) OBLIGATION TO REHIRE.--If the employer has not in good
3600	faith made available to the employee, within a 100-mile radius
3601	of the employee's residence, work appropriate to the employee's
3602	physical limitations within 30 days after the carrier notifies
3603	the employer of maximum medical improvement and the employee's
3604	physical limitations, the employer shall pay to the department
3605	for deposit into the Workers' Compensation Administration Trust
3606	Fund a fine of $250 for every $5,000 of the employer's workers'
3607	compensation premium or payroll, not to exceed $2,000 per
3608	violation, as the department requires by rule. The employer is
3609	not subject to this subsection if the employee is receiving
3610	permanent total disability benefits or if the employer has 50 or
3611	fewer employees.
3612	(6)(7)EMPLOYEE REFUSES EMPLOYMENT.--If an injured
3613	employee refuses employment suitable to the capacity thereof,
3614	offered to or procured therefor, such employee shall not be
3615	entitled to any compensation at any time during the continuance
3616	of such refusal unless at any time in the opinion of the judge
3617	of compensation claims such refusal is justifiable. Time periods
3618	for the payment of benefits in accordance with this section
3619	shall be counted in determining the limitation of benefits as
3620	provided for in paragraphs (2)(a), (3)(c), and (4)(b).
3621	(7)(8)EMPLOYEE LEAVES EMPLOYMENT.--If an injured
3622	employee, when receiving compensation for temporary partial
3623	disability, leaves the employment of the employer by whom she or
3624	he was employed at the time of the accident for which such
3625	compensation is being paid, the employee shall, upon securing
3626	employment elsewhere, give to such former employer an affidavit
3627	in writing containing the name of her or his new employer, the
3628	place of employment, and the amount of wages being received at
3629	such new employment; and, until she or he gives such affidavit,
3630	the compensation for temporary partial disability will cease.
3631	The employer by whom such employee was employed at the time of
3632	the accident for which such compensation is being paid may also
3633	at any time demand of such employee an additional affidavit in
3634	writing containing the name of her or his employer, the place of
3635	her or his employment, and the amount of wages she or he is
3636	receiving; and if the employee, upon such demand, fails or
3637	refuses to make and furnish such affidavit, her or his right to
3638	compensation for temporary partial disability shall cease until
3639	such affidavit is made and furnished. If the employee leaves her
3640	or his employment while receiving temporary partial benefits
3641	without just cause as determined by the judge of compensation
3642	claims, temporary partial benefits shall be payable based on the
3643	deemed earnings of the employee as if she or he had remained
3644	employed.
3645	(8)(9)EMPLOYEE BECOMES INMATE OF INSTITUTION.--In case an
3646	employee becomes an inmate of a public institution, then no
3647	compensation shall be payable unless she or he has dependent
3648	upon her or him for support a person or persons defined as
3649	dependents elsewhere in this chapter, whose dependency shall be
3650	determined as if the employee were deceased and to whom
3651	compensation would be paid in case of death; and such
3652	compensation as is due such employee shall be paid such
3653	dependents during the time she or he remains such inmate.
3654	(9)(10)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER
3655	AND FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE ACT.--
3656	(a) Weekly compensation benefits payable under this
3657	chapter for disability resulting from injuries to an employee
3658	who becomes eligible for benefits under 42 U.S.C. s. 423 shall
3659	be reduced to an amount whereby the sum of such compensation
3660	benefits payable under this chapter and such total benefits
3661	otherwise payable for such period to the employee and her or his
3662	dependents, had such employee not been entitled to benefits
3663	under this chapter, under 42 U.S.C. ss. 402 and 423, does not
3664	exceed 80 percent of the employee's average weekly wage.
3665	However, this provision shall not operate to reduce an injured
3666	worker's benefits under this chapter to a greater extent than
3667	such benefits would have otherwise been reduced under 42 U.S.C.
3668	s. 424(a). This reduction of compensation benefits is not
3669	applicable to any compensation benefits payable for any week
3670	subsequent to the week in which the injured worker reaches the
3671	age of 62 years.
3672	(b) If the provisions of 42 U.S.C. s. 424(a) are amended
3673	to provide for a reduction or increase of the percentage of
3674	average current earnings that the sum of compensation benefits
3675	payable under this chapter and the benefits payable under 42
3676	U.S.C. ss. 402 and 423 can equal, the amount of the reduction of
3677	benefits provided in this subsection shall be reduced or
3678	increased accordingly. The department may by rule specify forms
3679	and procedures governing the method for calculating and
3680	administering the offset of benefits payable under this chapter
3681	and benefits payable under 42 U.S.C. ss. 402 and 423. The
3682	department shall have first priority in taking any available
3683	social security offsets on dates of accidents occurring before
3684	July 1, 1984.
3685	(c) No disability compensation benefits payable for any
3686	week, including those benefits provided by paragraph (1)(f),
3687	shall be reduced pursuant to this subsection until the Social
3688	Security Administration determines the amount otherwise payable
3689	to the employee under 42 U.S.C. ss. 402 and 423 and the employee
3690	has begun receiving such social security benefit payments. The
3691	employee shall, upon demand by the department, the employer, or
3692	the carrier, authorize the Social Security Administration to
3693	release disability information relating to her or him and
3694	authorize the Division of Unemployment Compensation to release
3695	unemployment compensation information relating to her or him, in
3696	accordance with rules to be adopted by the department
3697	prescribing the procedure and manner for requesting the
3698	authorization and for compliance by the employee. Neither the
3699	department nor the employer or carrier shall make any payment of
3700	benefits for total disability or those additional benefits
3701	provided by paragraph (1)(f) for any period during which the
3702	employee willfully fails or refuses to authorize the release of
3703	information in the manner and within the time prescribed by such
3704	rules. The authority for release of disability information
3705	granted by an employee under this paragraph shall be effective
3706	for a period not to exceed 12 months, such authority to be
3707	renewable as the department may prescribe by rule.
3708	(d) If compensation benefits are reduced pursuant to this
3709	subsection, the minimum compensation provisions of s. 440.12(2)
3710	do not apply.
3711	(10)(11)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER
3712	WHO HAS RECEIVED OR IS ENTITLED TO RECEIVE UNEMPLOYMENT
3713	COMPENSATION.--
3714	(a) No compensation benefits shall be payable for
3715	temporary total disability or permanent total disability under
3716	this chapter for any week in which the injured employee has
3717	received, or is receiving, unemployment compensation benefits.
3718	(b) If an employee is entitled to temporary partial
3719	benefits pursuant to subsection (4) and unemployment
3720	compensation benefits, such unemployment compensation benefits
3721	shall be primary and the temporary partial benefits shall be
3722	supplemental only, the sum of the two benefits not to exceed the
3723	amount of temporary partial benefits which would otherwise be
3724	payable.
3725	(11)(12)FULL-PAY STATUS FOR CERTAIN LAW ENFORCEMENT
3726	OFFICERS.--Any law enforcement officer as defined in s.
3727	943.10(1), (2), or (3) who, while acting within the course of
3728	employment as provided by s. 440.091, is maliciously or
3729	intentionally injured and who thereby sustains a job-connected
3730	disability compensable under this chapter shall be carried in
3731	full-pay status rather than being required to use sick, annual,
3732	or other leave. Full-pay status shall be granted only after
3733	submission to the employing agency's head of a medical report
3734	which gives a current diagnosis of the employee's recovery and
3735	ability to return to work. In no case shall the employee's
3736	salary and workers' compensation benefits exceed the amount of
3737	the employee's regular salary requirements.
3738	(12)(13)REPAYMENT.--If an employee has received a sum as
3739	an indemnity benefit under any classification or category of
3740	benefit under this chapter to which she or he is not entitled,
3741	the employee is liable to repay that sum to the employer or the
3742	carrier or to have that sum deducted from future benefits,
3743	regardless of the classification of benefits, payable to the
3744	employee under this chapter; however, a partial payment of the
3745	total repayment may not exceed 20 percent of the amount of the
3746	biweekly payment.
3747	Section 19. Subsections (1), (2), and (3) of section
3748	440.151, Florida Statutes, are amended to read:
3749	440.151 Occupational diseases.--
3750	(1)(a) Where the employer and employee are subject to the
3751	provisions of the Workers' Compensation Law, the disablement or
3752	death of an employee resulting from an occupational disease as
3753	hereinafter defined shall be treated as the happening of an
3754	injury by accident, notwithstanding any other provisions of this
3755	chapter, and the employee or, in case of death, the employee's
3756	dependents shall be entitled to compensation as provided by this
3757	chapter, except as hereinafter otherwise provided; and the
3758	practice and procedure prescribed by this chapter shall apply to
3759	all proceedings under this section, except as hereinafter
3760	otherwise provided. Provided, however, that in no case shall an
3761	employer be liable for compensation under the provisions of this
3762	section unless such disease has resulted from the nature of the
3763	employment in which the employee was engaged under such
3764	employer,and was actually contracted while so engaged, and the
3765	nature of the employment was the major contributing cause of the
3766	disease. Major contributing cause must be shown by medical
3767	evidence only, as demonstrated by physical examination findings
3768	and diagnostic testing.meaning by "Nature of the employment"
3769	means that intothe occupation in which the employee was so
3770	engaged there is attached a particular hazard of such disease
3771	that distinguishes it from the usual run of occupations, or the
3772	incidence of such disease is substantially higher in the
3773	occupation in which the employee was so engaged than in the
3774	usual run of occupations. In claims for death under s. 440.16,
3775	death must occuror, in case of death, unless death follows
3776	continuous disability from such disease, commencing within the
3777	period above limited, for which compensation has been paid or
3778	awarded, or timely claim made as provided in this section, and
3779	results within 350 weeks after such last exposure. Both
3780	causation and sufficient exposure to a specific harmful
3781	substance shown to be present in the workplace to support
3782	causation shall be proven by clear and convincing evidence.
3783	(b) No compensation shall be payable for an occupational
3784	disease if the employee, at the time of entering into the
3785	employment of the employer by whom the compensation would
3786	otherwise be payable, falsely represents herself or himself in
3787	writing as not having previously been disabled, laid off or
3788	compensated in damages or otherwise, because of such disease.
3789	(c) Where an occupational disease is aggravated by any
3790	other disease or infirmity, not itself compensable, or where
3791	disability or death from any other cause, not itself
3792	compensable, is aggravated, prolonged, accelerated or in anywise
3793	contributed to by an occupational disease, the compensation
3794	shall be payable only if the occupational disease is the major
3795	contributing cause of the injury. Any compensationshall be
3796	reduced and limited to such proportion only of the compensation
3797	that would be payable if the occupational disease were the sole
3798	cause of the disability or death as such occupational disease,
3799	as a causative factor, bears to all the causes of such
3800	disability or death, such reduction in compensation to be
3801	effected by reducing the number of weekly or monthly payments or
3802	the amounts of such payments, as under the circumstances of the
3803	particular case may be for the best interest of the claimant or
3804	claimants. Major contributing cause must be demonstrated by
3805	medical evidence based on physical examination findings and
3806	diagnostic testing.
3807	(d) No compensation for death from an occupational disease
3808	shall be payable to any person whose relationship to the
3809	deceased, which under the provisions of this Workers'
3810	Compensation Law would give right to compensation, arose
3811	subsequent to the beginning of the first compensable disability,
3812	save only to afterborn children of a marriage existing at the
3813	beginning of such disability.
3814	(e) No compensation shall be payable for disability or
3815	death resulting from tuberculosis arising out of and in the
3816	course of employment by the Department of Health at a state
3817	tuberculosis hospital, or aggravated by such employment, when
3818	the employee had suffered from said disease at any time prior to
3819	the commencement of such employment.
3820	(2) Whenever used in this section the term "occupational
3821	disease" shall be construed to mean only a disease which is due
3822	to causes and conditions which are characteristic of and
3823	peculiar to a particular trade, occupation, process, or
3824	employment, and to exclude all ordinary diseases of life to
3825	which the general public is exposed, unless the incidence of the
3826	disease is substantially higher in the particular trade,
3827	occupation, process, or employment than for the general public.
3828	"Occupational disease" means only a disease for which there are
3829	epidemiological studies showing that exposure to the specific
3830	substance involved, at the levels to which the employee was
3831	exposed, may cause the precise disease sustained by the
3832	employee.
3833	(3) Except as hereinafterotherwise provided in this
3834	section, "disablement" means disability as described in s.
3835	440.02(13)the event of an employee's becoming actually
3836	incapacitated, partially or totally, because of an occupational
3837	disease, from performing her or his work in the last occupation
3838	in which injuriously exposed to the hazards of such disease; and
3839	"disability" means the state of being so incapacitated.
3840	Section 20. Subsections (1) and (7) of section 440.16,
3841	Florida Statutes, are amended to read:
3842	440.16 Compensation for death.--
3843	(1) If death results from the accident within 1 year
3844	thereafter or follows continuous disability and results from the
3845	accident within 5 years thereafter, the employer shall pay:
3846	(a) Within 14 days after receiving the bill, actual
3847	funeral expenses not to exceed $7,500$5,000.
3848	(b) Compensation, in addition to the above, in the
3849	following percentages of the average weekly wages to the
3850	following persons entitled thereto on account of dependency upon
3851	the deceased, and in the following order of preference, subject
3852	to the limitation provided in subparagraph 2., but such
3853	compensation shall be subject to the limits provided in s.
3854	440.12(2), shall not exceed $150,000$100,000, and may be less
3855	than, but shall not exceed, for all dependents or persons
3856	entitled to compensation, 66 2/3 percent of the average wage:
3857	1. To the spouse, if there is no child, 50 percent of the
3858	average weekly wage, such compensation to cease upon the
3859	spouse's death.
3860	2. To the spouse, if there is a child or children, the
3861	compensation payable under subparagraph 1. and, in addition, 16
3862	2/3 percent on account of the child or children. However, when
3863	the deceased is survived by a spouse and also a child or
3864	children, whether such child or children are the product of the
3865	union existing at the time of death or of a former marriage or
3866	marriages, the judge of compensation claims may provide for the
3867	payment of compensation in such manner as may appear to the
3868	judge of compensation claims just and proper and for the best
3869	interests of the respective parties and, in so doing, may
3870	provide for the entire compensation to be paid exclusively to
3871	the child or children; and, in the case of death of such spouse,
3872	33 1/3 percent for each child. However, upon the surviving
3873	spouse's remarriage, the spouse shall be entitled to a lump-sum
3874	payment equal to 26 weeks of compensation at the rate of 50
3875	percent of the average weekly wage as provided in s. 440.12(2),
3876	unless the $150,000$100,000limit provided in this paragraph is
3877	exceeded, in which case the surviving spouse shall receive a
3878	lump-sum payment equal to the remaining available benefits in
3879	lieu of any further indemnity benefits. In no case shall a
3880	surviving spouse's acceptance of a lump-sum payment affect
3881	payment of death benefits to other dependents.
3882	3. To the child or children, if there is no spouse, 33 1/3
3883	percent for each child.
3884	4. To the parents, 25 percent to each, such compensation
3885	to be paid during the continuance of dependency.
3886	5. To the brothers, sisters, and grandchildren, 15 percent
3887	for each brother, sister, or grandchild.
3888	(c) To the surviving spouse, payment of postsecondary
3889	student fees for instruction at any area technical center
3890	established under s. 1001.44 for up to 1,800 classroom hours or
3891	payment of student fees at any community college established
3892	under part III of chapter 1004 for up to 80 semester hours. The
3893	spouse of a deceased state employee shall be entitled to a full
3894	waiver of such fees as provided in ss. 1009.22 and 1009.23 in
3895	lieu of the payment of such fees. The benefits provided for in
3896	this paragraph shall be in addition to other benefits provided
3897	for in this section and shall terminate 7 years after the death
3898	of the deceased employee, or when the total payment in eligible
3899	compensation under paragraph (b) has been received. To qualify
3900	for the educational benefit under this paragraph, the spouse
3901	shall be required to meet and maintain the regular admission
3902	requirements of, and be registered at, such area technical
3903	center or community college, and make satisfactory academic
3904	progress as defined by the educational institution in which the
3905	student is enrolled.
3906	(7) Compensation under this chapter to aliens not
3907	residents (or about to become nonresidents) of the United States
3908	or Canada shall be the same in amount as provided for residents,
3909	except that dependents in any foreign country shall be limited
3910	to surviving spouse and child or children, or if there be no
3911	surviving spouse or child or children, to surviving father or
3912	mother whom the employee has supported, either wholly or in
3913	part, for the period of 1 year prior to the date of the injury,
3914	and except that the judge of compensation claims may, at the
3915	option of the judge of compensation claims, or upon the
3916	application of the insurance carrier, commute all future
3917	installments of compensation to be paid to such aliens by paying
3918	or causing to be paid to them one-half of the commuted amount of
3919	such future installments of compensation as determined by the
3920	judge of compensation claims, and provided further that
3921	compensation to dependents referred to in this subsection shall
3922	in no case exceed $75,000$50,000.
3923	Section 21. Subsection (9) of section 440.185, Florida
3924	Statutes, is amended, and subsection (12) is added to said
3925	section, to read:
3926	440.185 Notice of injury or death; reports; penalties for
3927	violations.--
3928	(9) Any employer or carrier who fails or refuses to timely
3929	send any form, report, or notice required by this section shall
3930	be subject to an administrative fine by the departmenta civil
3931	penalty not to exceed $1,000$500for each such failure or
3932	refusal. If, within 1 calendar year, an employer fails to timely
3933	submit to the carrier more than 10 percent of its notices of
3934	injury or death, the employer shall be subject to an
3935	administrative fine by the department not to exceed $2,000 for
3936	each such failure or refusal.However, any employer who fails to
3937	notify the carrier of the injury on the prescribed form or by
3938	letter within the 7 days required in subsection (2) shall be
3939	liable for the administrative finecivil penalty, which shall be
3940	paid by the employer and not the carrier. Failure by the
3941	employer to meet its obligations under subsection (2) shall not
3942	relieve the carrier from liability for the administrative fine
3943	civil penaltyif it fails to comply with subsections (4) and
3944	(5).
3945	(12) Upon receiving notice of an injury from an employee
3946	under subsection (1), the employer or carrier shall provide the
3947	employee with a written notice, in the form and manner
3948	determined by the department by rule, of the availability of
3949	services from the Employee Assistance and Ombudsman Office. The
3950	substance of the notice to the employee shall include:
3951	(a) A description of the scope of services provided by the
3952	office.
3953	(b) A listing of the toll-free telephone number of, the
3954	email address, and the postal address of the office.
3955	(c) A statement that the informational brochure referred
3956	to in subsection (4) will be mailed to the employee within 3
3957	days after the carrier receives notice of the injury.
3958	(d) Any other information regarding access to assistance
3959	that the department finds is immediately necessary for an
3960	injured employee.
3961	Section 22. Subsections (1) and (2) of section 440.192,
3962	Florida Statutes, are amended, and subsection (9) is added to
3963	said section, to read:
3964	440.192 Procedure for resolving benefit disputes.—
3965	(1) Subject to s. 440.191, Any employee may, for any
3966	benefit that is ripe, due, and owing,who has not received a
3967	benefit to which the employee believes she or he is entitled
3968	under this chapter shallfile by certified mail, or by
3969	electronic means approved by the Deputy Chief Judge, with the
3970	Office of the Judges of Compensation Claims a petition for
3971	benefits which meets the requirements of this section and the
3972	definition of specificity in s. 440.02. The department shall
3973	inform employees of the location of the Office of the Judges of
3974	Compensation Claims for purposes of filing a petition for
3975	benefits. The employee shall also serve copies of the petition
3976	for benefits by certified mail, or by electronic means approved
3977	by the Deputy Chief Judge, upon the employer and the employer's
3978	carrier. The DeputyChief Judge shall refer the petitions to the
3979	judges of compensation claims.
3980	(2) Upon receipt, the Office of the Judges of Compensation
3981	Claims shall review each petition and shall dismiss each
3982	petition or any portion of such a petition, upon the judge's own
3983	motion or upon the motion of any party,that does not on its
3984	face specifically identify or itemize the following:
3985	(a) Name, address, telephone number, and social security
3986	number of the employee.
3987	(b) Name, address, and telephone number of the employer.
3988	(c) A detailed description of the injury and cause of the
3989	injury, including the location of the occurrence and the date or
3990	dates of the accident.
3991	(d) A detailed description of the employee's job, work
3992	responsibilities, and work the employee was performing when the
3993	injury occurred.
3994	(e) The time period for which compensation and the
3995	specific classification of compensation were not timely
3996	provided.
3997	(f) Date of maximum medical improvement, character of
3998	disability, and specific statement of all benefits or
3999	compensation that the employee is seeking.
4000	(g) All specific travel costs to which the employee
4001	believes she or he is entitled, including dates of travel and
4002	purpose of travel, means of transportation, and mileage and
4003	including the date the request for mileage was filed with the
4004	carrier and a copy of the request filed with the carrier.
4005	(h) Specific listing of all medical charges alleged
4006	unpaid, including the name and address of the medical provider,
4007	the amounts due, and the specific dates of treatment.
4008	(i) The type or nature of treatment care or attendance
4009	sought and the justification for such treatment. If the employee
4010	is under the care of a physician for an injury identified under
4011	paragraph (c), a copy of the physician's request, authorization,
4012	or recommendation for treatment, care, or attendance must
4013	accompany the petition.
4014	(j) Specific explanation of any other disputed issue that
4015	a judge of compensation claims will be called to rule upon.
4016
4017	The dismissal of any petition or portion of such a petition
4018	under this section is without prejudice and does not require a
4019	hearing.
4020	(9) A petition for benefits must contain claims for all
4021	benefits that are ripe, due, and owing on the date the petition
4022	is filed. Unless stipulated in writing by the parties, only
4023	claims which have been properly raised in a petition for
4024	benefits and have undergone mediation may be considered for
4025	adjudication by a judge of compensation claims.
4026	Section 23. Section 440.1926, Florida Statutes, is created
4027	to read:
4028	440.1926 Alternate dispute resolution; claim
4029	arbitration.--Notwithstanding any other provision of this
4030	chapter, the employer, carrier, and employee may mutually agree
4031	to seek consent from a judge of compensation claims to enter
4032	into binding claim arbitration in lieu of any other remedy
4033	provided for in this chapter to resolve all issues in dispute
4034	regarding an injury. Arbitrations agreed to pursuant to this
4035	section shall be governed by chapter 682, the Florida
4036	Arbitration Code, except that, notwithstanding any provision in
4037	chapter 682, the term "court" shall mean a judge of compensation
4038	claims. An arbitration award in accordance with this section
4039	shall be enforceable in the same manner and with the same powers
4040	as any final compensation order.
4041	Section 24. Subsections (2), (3), (4), (6), and (8) and
4042	paragraph (d) of subsection (11) of section 440.20, Florida
4043	Statutes, are amended to read:
4044	440.20 Time for payment of compensation and medical bills;
4045	penalties for late payment.--
4046	(2)(a)The carrier must pay the first installment of
4047	compensation for total disability or death benefitsor deny
4048	compensability no later than the 14th calendarday after the
4049	employer receives notificationnotice of the injury or death,
4050	when disability is immediate and continuous for 8 calendar days
4051	or more after the injury. If the first 7 days after disability
4052	are nonconsecutive or delayed, the first installment of
4053	compensation is due on the 6th day after the first 8 calendar
4054	days of disability. The carrier shall thereafter pay
4055	compensation in biweekly installments or as otherwise provided
4056	in s. 440.15, unless the judge of compensation claims determines
4057	or the parties agree that an alternate installment schedule is
4058	in the best interests of the employee.
4059	(b) The carrier must pay, disallow, or deny all medical,
4060	dental, pharmacy, and hospital bills submitted to the carrier in
4061	accordance with department rule no later than 45 calendar days
4062	after the carrier's receipt of the bill.
4063	(3) Upon making initial payment of indemnity benefits, or
4064	upon suspension or cessation of payment for any reason, the
4065	carrier shall immediately notify the injured employee, the
4066	employer, and thedepartment that it has commenced, suspended,
4067	or ceased payment of compensation. The department may require
4068	such notification to the injured employee, employer, and the
4069	department in aanyformat and manner it deems necessary to
4070	obtain accurate and timely notificationreporting.
4071	(4) If the carrier is uncertain of its obligation to
4072	provide all benefits or compensation, it may initiate payment
4073	without prejudice and without admitting liability. the carrier
4074	shall immediately and in good faith commence investigation of
4075	the employee's entitlement to benefits under this chapter and
4076	shall admit or deny compensability within 120 days after the
4077	initial provision of compensation or benefits as required under
4078	subsection (2) or s. 440.192(8). Additionally, the carrier shall
4079	initiate payment and continue the provision of all benefits and
4080	compensation as if the claim had been accepted as compensable,
4081	without prejudice and without admitting liability.Upon
4082	commencement of payment as required under subsection (2) or s.
4083	440.192 (8), the carrier shall provide written notice to the
4084	employee that it has elected to pay all or part ofthe claim
4085	pending further investigation, and that it will advise the
4086	employee of claim acceptance or denial within 120 days. A
4087	carrier that fails to deny compensability within 120 days after
4088	the initial provision of benefits or payment of compensation as
4089	required under subsection (2) or s. 440.192(8) waives the right
4090	to deny compensability, unless the carrier can establish
4091	material facts relevant to the issue of compensability that it
4092	could not have discovered through reasonable investigation
4093	within the 120-day period. The initial provision of compensation
4094	or benefits, for purposes of this subsection, means the first
4095	installment of compensation or benefits to be paid by the
4096	carrier under subsection (2) or pursuant to a petition for
4097	benefits under s. 440.192(8).
4098	(6)(a)If any installment of compensation for death or
4099	dependency benefits, or compensation for disability benefits,
4100	permanent impairment, or wage losspayable without an award is
4101	not paid within 7 days after it becomes due, as provided in
4102	subsection (2), subsection (3), or subsection (4), there shall
4103	be added to such unpaid installment a punitivepenalty of an
4104	amount equal to 20 percent of the unpaid installment or $5,
4105	which shall be paid at the same time as, but in addition to,
4106	such installment of compensation. This penalty shall not apply
4107	for late payments resulting, unless notice is filed under
4108	subsection (4) or unless such nonpayment resultsfrom conditions
4109	over which the employer or carrier had no control. When any
4110	installment of compensation payable without an award has not
4111	been paid within 7 days after it became due and the claimant
4112	concludes the prosecution of the claim before a judge of
4113	compensation claims without having specifically claimed
4114	additional compensation in the nature of a penalty under this
4115	section, the claimant will be deemed to have acknowledged that,
4116	owing to conditions over which the employer or carrier had no
4117	control, such installment could not be paid within the period
4118	prescribed for payment and to have waived the right to claim
4119	such penalty. However, during the course of a hearing, the judge
4120	of compensation claims shall on her or his own motion raise the
4121	question of whether such penalty should be awarded or excused.
4122	The department may assess without a hearing the punitivepenalty
4123	against either the employer or the insurancecarrier, depending
4124	upon who was at fault in causing the delay. The insurance policy
4125	cannot provide that this sum will be paid by the carrier if the
4126	department or the judge of compensation claims determines that
4127	the punitive penalty should be paidmadeby the employer rather
4128	than the carrier. Any additional installment of compensation
4129	paid by the carrier pursuant to this section shall be paid
4130	directly to the employee by check or, if authorized by the
4131	employee, by direct deposit into the employee's account at a
4132	financial institution. As used in this subsection, the term
4133	"financial institution" means a financial institution as defined
4134	in s. 655.005(1)(h).
4135	(b) For medical services provided on or after January 1,
4136	2004, the department shall require that all medical, hospital,
4137	pharmacy, or dental bills properly submitted by the provider,
4138	except for bills that are disallowed or denied by the carrier or
4139	its authorized vendor in accordance with department rule, are
4140	timely paid within 45 calendar days after the carrier's receipt
4141	of the bill. The department shall impose penalties for late
4142	payments or disallowances or denials of medical, hospital,
4143	pharmacy, or dental bills that are below a minimum 95 percent
4144	timely performance standard. The carrier shall pay to the
4145	Workers' Compensation Administration Trust Fund a penalty of:
4146	1. Twenty-five dollars for each bill below the 95 percent
4147	timely performance standard, but meeting a 90 percent timely
4148	standard.
4149	2. Fifty dollars for each bill below a 90 percent timely
4150	performance standard.
4151	(8)(a)In addition to any other penalties provided by this
4152	chapter for late payment, if any installment of compensation is
4153	not paid when it becomes due, the employer, carrier, or
4154	servicing agent shall pay interest thereon at the rate of 12
4155	percent per year from the date the installment becomes due until
4156	it is paid, whether such installment is payable without an order
4157	or under the terms of an order. The interest payment shall be
4158	the greater of the amount of interest due or $5.
4159	(a) Within 30 days after final payment of compensation has
4160	been made, the employer, carrier, or servicing agent shall send
4161	to the department a notice, in accordance with a format and
4162	manner prescribed by the department, stating that such final
4163	payment has been made and stating the total amount of
4164	compensation paid, the name of the employee and of any other
4165	person to whom compensation has been paid, the date of the
4166	injury or death, and the date to which compensation has been
4167	paid.
4168	(b) If the employer, carrier, or servicing agent fails to
4169	so notify the department within such time, the department shall
4170	assess against such employer, carrier, or servicing agent a
4171	civil penalty in an amount not over $100.
4172	(b)(c)In order to ensure carrier compliance under this
4173	chapter and provisions of the Florida Insurance Code, the office
4174	department shall monitor, audit, and investigatethe performance
4175	of carriers by conducting market conduct examinations, as
4176	provided in s. 624.3161, and conducting investigations, as
4177	provided in s. 624.317. The officedepartment shall require
4178	establish by rule minimum performance standards for carriers to
4179	ensure that a minimum of 90 percent ofall compensation benefits
4180	are timely paid in accordance with this section. The office
4181	department shall impose penaltiesfine a carrier as provided in
4182	s. 440.13(11)(b) up to $50 for each late paymentspaymentof
4183	compensation that areis below athe minimum 9590 percent
4184	timely payment performance standard. The carrier shall pay to
4185	the Workers' Compensation Administration Trust Fund a penalty
4186	of:
4187	1. Fifty dollars per number of installments of
4188	compensation below the 95 percent timely payment performance
4189	standard and equal to or greater than a 90 percent timely
4190	payment performance standard.
4191	2. One hundred dollars per number of installments of
4192	compensation below a 90 percent timely payment performance
4193	standard.
4194
4195	This section does not affect the imposition of any penalties or
4196	interest due to the claimant. If a carrier contracts with a
4197	servicing agent to fulfill its administrative responsibilities
4198	under this chapter, the payment practices of the servicing agent
4199	are deemed the payment practices of the carrier for the purpose
4200	of assessing penalties against the carrier.
4201	(11)
4202	(d)1. With respect to any lump-sum settlement under this
4203	subsection, a judge of compensation claims must consider at the
4204	time of the settlement, whether the settlement allocation
4205	provides for the appropriate recovery of child support
4206	arrearages. An employer or carrier does not have a duty to
4207	investigate or collect information regarding child support
4208	arrearages.
4209	2. When reviewing any settlement of lump-sum payment
4210	pursuant to this subsection, judges of compensation claims shall
4211	consider the interests of the worker and the worker's family
4212	when approving the settlement, which must consider and provide
4213	for appropriate recovery of past due support.
4214	3. With respect to any lump-sum settlement under this
4215	subsection, any correspondence to a clerk of the circuit court
4216	of this state regarding child support documentation shall be
4217	exempt from any fees or costs ordinarily assessed by the clerk’s
4218	office.
4219	Section 25. Section 440.25, Florida Statutes, is amended
4220	to read:
4221	440.25 Procedures for mediation and hearings.--
4222	(1) Forty daysWithin 90 daysafter a petition for
4223	benefits is filed under s. 440.192, a mediation conference
4224	concerning such petition shall be held. Within 40 days after
4225	such petition is filed,the judge of compensation claims shall
4226	notify the interested parties by order that a mediation
4227	conference concerning such petition has been scheduledwill be
4228	held unless the parties have notified the judgeOffice of the
4229	Judges of compensation claims that a privatemediation has been
4230	held or is scheduled to be held. A mediation, whether private or
4231	public, shall be held within 130 days after the filing of the
4232	petition. Such order must give the date by whichthe mediation
4233	conference is tomustbe held. Such order may be served
4234	personally upon the interested parties or may be sent to the
4235	interested parties by mail. If multiple petitions are pending,
4236	or if additional petitions are filed after the scheduling of a
4237	mediation, the judge of compensation claims shall consolidate
4238	all petitions into one mediation.The claimant or the adjuster
4239	of the employer or carrier may, at the mediator's discretion,
4240	attend the mediation conference by telephone or, if agreed to by
4241	the parties, other electronic means. A continuance may be
4242	granted upon the agreement of the parties orif the requesting
4243	party demonstrates to the judge of compensation claims that the
4244	reason for requesting the continuance arises from circumstances
4245	beyond the party's control. Any order granting a continuance
4246	must set forth the date of the rescheduled mediation conference.
4247	A mediation conference may not be used solely for the purpose of
4248	mediating attorney's fees.
4249	(2) Any party who participates in a mediation conference
4250	shall not be precluded from requesting a hearing following the
4251	mediation conference should both parties not agree to be bound
4252	by the results of the mediation conference. A mediation
4253	conference is required to be held unless this requirement is
4254	waived by the Deputy Chief Judge. No later than 3 days prior to
4255	the mediation conference, all parties must submit any applicable
4256	motions, including, but not limited to, a motion to waive the
4257	mediation conference, to the judge of compensation claims.
4258	(3)(a)Such mediation conference shall be conducted
4259	informally and does not require the use of formal rules of
4260	evidence or procedure. Any information from the files, reports,
4261	case summaries, mediator's notes, or other communications or
4262	materials, oral or written, relating to a mediation conference
4263	under this section obtained by any person performing mediation
4264	duties is privileged and confidential and may not be disclosed
4265	without the written consent of all parties to the conference.
4266	Any research or evaluation effort directed at assessing the
4267	mediation program activities or performance must protect the
4268	confidentiality of such information. Each party to a mediation
4269	conference has a privilege during and after the conference to
4270	refuse to disclose and to prevent another from disclosing
4271	communications made during the conference whether or not the
4272	contested issues are successfully resolved. This subsection and
4273	paragraphs (4)(a) and (b) shall not be construed to prevent or
4274	inhibit the discovery or admissibility of any information that
4275	is otherwise subject to discovery or that is admissible under
4276	applicable law or rule of procedure, except that any conduct or
4277	statements made during a mediation conference or in negotiations
4278	concerning the conference are inadmissible in any proceeding
4279	under this chapter.
4280	(a)1. Unless the parties conduct a private mediation under
4281	paragraph (b)subparagraph 2., mediation shall be conducted by a
4282	mediator selected by the Director of the Division of
4283	Administrative Hearings from among mediators employed on a full-
4284	time basis by the Office of the Judges of Compensation Claims. A
4285	mediator must be a member of The Florida Bar for at least 5
4286	years and must complete a mediation training program approved by
4287	the Deputy Chief JudgeDirector of the Division of
4288	Administrative Hearings. Adjunct mediators may be employed by
4289	the Office of the Judges of Compensation Claims on an as-needed
4290	basis and shall be selected from a list prepared by the Director
4291	of the Division of Administrative Hearings. An adjunct mediator
4292	must be independent of all parties participating in the
4293	mediation conference. An adjunct mediator must be a member of
4294	The Florida Bar for at least 5 years and must complete a
4295	mediation training program approved by the Office of the Judges
4296	of Compensation ClaimsDirector of the Division of
4297	Administrative Hearings. An adjunct mediator shall have access
4298	to the office, equipment, and supplies of the judge of
4299	compensation claims in each district.
4300	(b)2. With respect to any private mediation occurring on
4301	or after January 1, 2003, if the parties agree or if mediators
4302	are not available under paragraph (a), pursuant to notice from
4303	the judge of compensation claims,subparagraph 1.to conduct the
4304	required mediation within the period specified in this section,
4305	the parties shall hold a mediation conference at the carrier's
4306	expense within the 130-day90-dayperiod set for mediation. The
4307	mediation conference shall be conducted by a mediator certified
4308	under s. 44.106. If the parties do not agree upon a mediator
4309	within 10 days after the date of the order, the claimant shall
4310	notify the judge in writing and the judge shall appoint a
4311	mediator under this subparagraph within 7 days. In the event
4312	both parties agree, the results of the mediation conference
4313	shall be binding and neither party shall have a right to appeal
4314	the results. In the event either party refuses to agree to the
4315	results of the mediation conference, the results of the
4316	mediation conference as well as the testimony, witnesses, and
4317	evidence presented at the conference shall not be admissible at
4318	any subsequent proceeding on the claim. The mediator shall not
4319	be called in to testify or give deposition to resolve any claim
4320	for any hearing before the judge of compensation claims. The
4321	employer may be represented by an attorney at the mediation
4322	conference if the employee is also represented by an attorney at
4323	the mediation conference.
4324	(b) The parties shall complete the pretrial stipulations
4325	before the conclusion of the mediation conference if the claims,
4326	except for attorney's fees and costs, have not been settled and
4327	if any claims in any filed petition remain unresolved. The judge
4328	of compensation claims may impose sanctions against a party or
4329	both parties for failing to complete the pretrial stipulations
4330	before the conclusion of the mediation conference.
4331	(4)(a) If the parties fail to agree touponwritten
4332	submission of pretrial stipulations at the mediation conference,
4333	the judge of compensation claims shall conduct a liveorder a
4334	pretrial hearing to occur within 14 days after the date of
4335	mediation ordered by the judge of compensation claims. The judge
4336	of compensation claims shall give the interested parties at
4337	least 147 days' advance notice of the pretrial hearing by mail.
4338	At the pretrial hearing, the judge of compensation claims shall,
4339	subject to paragraph (b), set a date for the final hearing that
4340	allows the parties at least 60 days to conduct discovery unless
4341	the parties consent to an earlier hearing date.
4342	(b) The final hearing must be held and concluded within 90
4343	days after the mediation conference is held, allowing the
4344	parties sufficient time to complete discovery. Except as set
4345	forth in this section,continuances may be granted only if the
4346	requesting party demonstrates to the judge of compensation
4347	claims that the reason for requesting the continuance arises
4348	from circumstances beyond the party's control. The written
4349	consent of the claimant must be obtained before any request from
4350	a claimant's attorney is granted for an additional continuance
4351	after the initial continuance has been granted. Any order
4352	granting a continuance must set forth the date and time of the
4353	rescheduled hearing. A continuance may be granted only if the
4354	requesting party demonstrates to the judge of compensation
4355	claims that the reason for requesting the continuance arises
4356	from circumstances beyond the control of the parties. The judge
4357	of compensation claims shall report any grant of two or more
4358	continuances to the Deputy Chief Judge.
4359	(c) The judge of compensation claims shall give the
4360	interested parties at least 147days' advance notice of the
4361	final hearing, served upon the interested parties by mail.
4362	(d) The final hearing shall be held within 210 days after
4363	receipt of the petition for benefits in the county where the
4364	injury occurred, if the injury occurred in this state, unless
4365	otherwise agreed to between the parties and authorized by the
4366	judge of compensation claims in the county where the injury
4367	occurred. However, the claimant may waive the timeframes within
4368	this section for good cause shown.If the injury occurred
4369	outside the state and is one for which compensation is payable
4370	under this chapter, then the final hearing may be held in the
4371	county of the employer's residence or place of business, or in
4372	any other county of the state that will, in the discretion of
4373	the Deputy Chief Judge, be the most convenient for a hearing.
4374	The final hearing shall be conducted by a judge of compensation
4375	claims, who shall, within 30 days after final hearing or closure
4376	of the hearing record, unless otherwise agreed by the parties,
4377	enter a final order on the merits of the disputed issues. The
4378	judge of compensation claims may enter an abbreviated final
4379	order in cases in which compensability is not disputed. Either
4380	party may request separate findings of fact and conclusions of
4381	law. At the final hearing, the claimant and employer may each
4382	present evidence with respect to the claims presented by the
4383	petition for benefits and may be represented by any attorney
4384	authorized in writing for such purpose. When there is a conflict
4385	in the medical evidence submitted at the hearing, the provisions
4386	of s. 440.13 shall apply. The report or testimony of the expert
4387	medical advisor shall be admitted into evidence in amade a part
4388	of the record of the proceeding and shall be given the same
4389	consideration by the judge of compensation claims as is accorded
4390	other medical evidence submitted in the proceeding;and all
4391	costs incurred in connection with such examination and testimony
4392	may be assessed as costs in the proceeding, subject to the
4393	provisions of s. 440.13. No judge of compensation claims may
4394	make a finding of a degree of permanent impairment that is
4395	greater than the greatest permanent impairment rating given the
4396	claimant by any examining or treating physician,except upon
4397	stipulation of the parties. Any benefit due but not raised at
4398	the final hearing which was ripe, due, or owing at the time of
4399	the final hearing is waived.
4400	(e) The order making an award or rejecting the claim,
4401	referred to in this chapter as a "compensation order," shall set
4402	forth the findings of ultimate facts and the mandate; and the
4403	order need not include any other reason or justification for
4404	such mandate. The compensation order shall be filed in the
4405	Office of the Judges of Compensation Claims at Tallahassee. A
4406	copy of such compensation order shall be sent by mail to the
4407	parties and attorneys of record at the last known address of
4408	each, with the date of mailing noted thereon.
4409	(f) Each judge of compensation claims is required to
4410	submit a special report to the Deputy Chief Judge in each
4411	contested workers' compensation case in which the case is not
4412	determined within 30 days of final hearing or closure of the
4413	hearing record. Said form shall be provided by the director of
4414	the Division of Administrative Hearings and shall contain the
4415	names of the judge of compensation claims and of the attorneys
4416	involved and a brief explanation by the judge of compensation
4417	claims as to the reason for such a delay in issuing a final
4418	order.
4419	(f)(g)Notwithstanding any other provision of this
4420	section, the judge of compensation claims may require the
4421	appearance of the parties and counsel before her or him without
4422	written notice for an emergency conference where there is a bona
4423	fide emergency involving the health, safety, or welfare of an
4424	employee. An emergency conference under this section may result
4425	in the entry of an order or the rendering of an adjudication by
4426	the judge of compensation claims.
4427	(g)(h)To expedite dispute resolution and to enhance the
4428	self-executing features of the Workers' Compensation Law, the
4429	Deputy Chief Judge shall make provision by rule or order for the
4430	resolution of appropriate motions by judges of compensation
4431	claims without oral hearing upon submission of brief written
4432	statements in support and opposition, and for expedited
4433	discovery and docketing. Unless the judge of compensation
4434	claims, for good cause, orders a hearing under paragraph (h)(i),
4435	each claim in a petition relating to the determination of the
4436	average weekly wagepayunder s. 440.14 shall be resolved under
4437	this paragraph without oral hearing.
4438	(h)(i)To further expedite dispute resolution and to
4439	enhance the self-executing features of the system, those
4440	petitions filed in accordance with s. 440.192 that involve a
4441	claim for benefits of $5,000 or less shall, in the absence of
4442	compelling evidence to the contrary, be presumed to be
4443	appropriate for expedited resolution under this paragraph; and
4444	any other claim filed in accordance with s. 440.192, upon the
4445	written agreement of both parties and application by either
4446	party, may similarly be resolved under this paragraph. A claim
4447	in a petition or $5,000 or less for medical benefits only or a
4448	petition for reimbursement for mileage for medical purposes
4449	shall, in the absence of compelling evidence to the contrary, be
4450	resolved through the expedited dispute resolution process
4451	provided in this paragraph. For purposes of expedited resolution
4452	pursuant to this paragraph, the Deputy Chief Judge shall make
4453	provision by rule or order for expedited and limited discovery
4454	and expedited docketing in such cases. At least 15 days prior to
4455	hearing, the parties shall exchange and file with the judge of
4456	compensation claims a pretrial outline of all issues, defenses,
4457	and witnesses on a form adopted by the Deputy Chief Judge;
4458	provided, in no event shall such hearing be held without 15
4459	days' written notice to all parties. No pretrial hearing shall
4460	be held and no mediation scheduled unless requested by a party.
4461	The judge of compensation claims shall limit all argument and
4462	presentation of evidence at the hearing to a maximum of 30
4463	minutes, and such hearings shall not exceed 30 minutes in
4464	length. Neither party shall be required to be represented by
4465	counsel. The employer or carrier may be represented by an
4466	adjuster or other qualified representative. The employer or
4467	carrier and any witness may appear at such hearing by telephone.
4468	The rules of evidence shall be liberally construed in favor of
4469	allowing introduction of evidence.
4470	(i)(j)A judge of compensation claims may, upon the motion
4471	of a party or the judge's own motion, dismiss a petition for
4472	lack of prosecution if a petition, response, motion, order,
4473	request for hearing, or notice of deposition has not been filed
4474	during the previous 12 months unless good cause is shown. A
4475	dismissal for lack of prosecution is without prejudice and does
4476	not require a hearing.
4477	(j)(k)A judge of compensation claims may not award
4478	interest on unpaid medical bills and the amount of such bills
4479	may not be used to calculate the amount of interest awarded.
4480	Regardless of the date benefits were initially requested,
4481	attorney's fees do not attach under this subsection until 30
4482	days after the date the carrier or self-insured employer
4483	receives the petition.
4484	(5)(a) Procedures with respect to appeals from orders of
4485	judges of compensation claims shall be governed by rules adopted
4486	by the Supreme Court. Such an order shall become final 30 days
4487	after mailing of copies of such order to the parties, unless
4488	appealed pursuant to such rules.
4489	(b) An appellant may be relieved of any necessary filing
4490	fee by filing a verified petition of indigency for approval as
4491	provided in s. 57.081(1) and may be relieved in whole or in part
4492	from the costs for preparation of the record on appeal if,
4493	within 15 days after the date notice of the estimated costs for
4494	the preparation is served, the appellant files with the judge of
4495	compensation claims a copy of the designation of the record on
4496	appeal, and a verified petition to be relieved of costs. A
4497	verified petition filed prior to the date of service of the
4498	notice of the estimated costs shall be deemed not timely filed.
4499	The verified petition relating to record costs shall contain a
4500	sworn statement that the appellant is insolvent and a complete,
4501	detailed, and sworn financial affidavit showing all the
4502	appellant's assets, liabilities, and income. Failure to state in
4503	the affidavit all assets and income, including marital assets
4504	and income, shall be grounds for denying the petition with
4505	prejudice. The Office of the Judges of Compensation Claims shall
4506	adopt rules as may be required pursuant to this subsection,
4507	including forms for use in all petitions brought under this
4508	subsection. The appellant's attorney, or the appellant if she or
4509	he is not represented by an attorney, shall include as a part of
4510	the verified petition relating to record costs an affidavit or
4511	affirmation that, in her or his opinion, the notice of appeal
4512	was filed in good faith and that there is a probable basis for
4513	the District Court of Appeal, First District, to find reversible
4514	error, and shall state with particularity the specific legal and
4515	factual grounds for the opinion. Failure to so affirm shall be
4516	grounds for denying the petition. A copy of the verified
4517	petition relating to record costs shall be served upon all
4518	interested parties. The judge of compensation claims shall
4519	promptly conduct a hearing on the verified petition relating to
4520	record costs, giving at least 15 days' notice to the appellant,
4521	the department, and all other interested parties, all of whom
4522	shall be parties to the proceedings. The judge of compensation
4523	claims may enter an order without such hearing if no objection
4524	is filed by an interested party within 20 days from the service
4525	date of the verified petition relating to record costs. Such
4526	proceedings shall be conducted in accordance with the provisions
4527	of this section and with the workers' compensation rules of
4528	procedure, to the extent applicable. In the event an insolvency
4529	petition is granted, the judge of compensation claims shall
4530	direct the department to pay record costs and filing fees from
4531	the Workers' Compensation Administration Trust Fund pending
4532	final disposition of the costs of appeal. The department may
4533	transcribe or arrange for the transcription of the record in any
4534	proceeding for which it is ordered to pay the cost of the
4535	record.
4536	(c) As a condition of filing a notice of appeal to the
4537	District Court of Appeal, First District, an employer who has
4538	not secured the payment of compensation under this chapter in
4539	compliance with s. 440.38 shall file with the notice of appeal a
4540	good and sufficient bond, as provided in s. 59.13, conditioned
4541	to pay the amount of the demand and any interest and costs
4542	payable under the terms of the order if the appeal is dismissed,
4543	or if the District Court of Appeal, First District, affirms the
4544	award in any amount. Upon the failure of such employer to file
4545	such bond with the judge of compensation claims orthe District
4546	Court of Appeal, First District, along with the notice of
4547	appeal, the District Court of Appeal, First District, shall
4548	dismiss the notice of appeal.
4549	(6) An award of compensation for disability may be made
4550	after the death of an injured employee.
4551	(7) An injured employee claiming or entitled to
4552	compensation shall submit to such physical examination by a
4553	certified expert medical advisor approved by the agency or the
4554	judge of compensation claims as the agency or the judge of
4555	compensation claims may require. The place or places shall be
4556	reasonably convenient for the employee. Such physician or
4557	physicians as the employee, employer, or carrier may select and
4558	pay for may participate in an examination if the employee,
4559	employer, or carrier so requests. Proceedings shall be suspended
4560	and no compensation shall be payable for any period during which
4561	the employee may refuse to submit to examination.Any interested
4562	party shall have the right in any case of death to require an
4563	autopsy, the cost thereof to be borne by the party requesting
4564	it; and the judge of compensation claims shall have authority to
4565	order and require an autopsy and may, in her or his discretion,
4566	withhold her or his findings and award until an autopsy is held.
4567	Section 26. Subsections (1), (2), and (3) of section
4568	440.34, Florida Statutes, are amended, and subsection (7) is
4569	added to said section, to read:
4570	440.34 Attorney's fees; costs.--
4571	(1) A fee, gratuity, or other consideration may not be
4572	paid for services rendered fora claimant in connection with any
4573	proceedings arising under this chapter, unless approved as
4574	reasonable by the judge of compensation claims or court having
4575	jurisdiction over such proceedings. Except as provided by this
4576	subsection,Any attorney's fee approved by a judge of
4577	compensation claims for benefits secured on behalf ofservices
4578	rendered toa claimant must equal to 20 percent of the first
4579	$5,000 of the amount of the benefits secured, 15 percent of the
4580	next $5,000 of the amount of the benefits secured, 10 percent of
4581	the remaining amount of the benefits secured to be provided
4582	during the first 10 years after the date the claim is filed, and
4583	5 percent of the benefits secured after 10 years. The judge of
4584	compensation claims shall not approve a compensation order, a
4585	joint stipulation for lump-sum settlement, a stipulation or
4586	agreement between a claimant and his or her attorney, or any
4587	other agreement related to benefits under this chapter that
4588	provides for an attorney's fee in excess of the amount permitted
4589	by this section. The judge of compensation claims is not
4590	required to approve any retainer agreement between the claimant
4591	and his or her attorney. The retainer agreement as to fees and
4592	costs may not be for compensation in excess of the amount
4593	allowed under this section.However, The judge of compensation
4594	claims shall consider the following factors in each case and may
4595	increase or decrease the attorney's fee if, in her or his
4596	judgment, the circumstances of the particular case warrant such
4597	action:
4598	(a) The time and labor required, the novelty and
4599	difficulty of the questions involved, and the skill requisite to
4600	perform the legal service properly.
4601	(b) The fee customarily charged in the locality for
4602	similar legal services.
4603	(c) The amount involved in the controversy and the
4604	benefits resulting to the claimant.
4605	(d) The time limitation imposed by the claimant or the
4606	circumstances.
4607	(e) The experience, reputation, and ability of the lawyer
4608	or lawyers performing services.
4609	(f) The contingency or certainty of a fee.
4610	(2) In awarding a reasonableclaimant's attorney's fee,
4611	the judge of compensation claims shall consider only those
4612	benefits secured byto the claimant that the attorney is
4613	responsible for securing. An attorney is not entitled to
4614	attorney's fees for representation in any issue that was ripe,
4615	due, and owing and that reasonably could have been addressed,
4616	but was not addressed, during the pendency of other issues for
4617	the same injury.The amount, statutory basis, and type of
4618	benefits obtained through legal representation shall be listed
4619	on all attorney's fees awarded by the judge of compensation
4620	claims. For purposes of this section, the term "benefits
4621	secured" means benefits obtained as a result of the claimant's
4622	attorney's legal services rendered in connection with the claim
4623	for benefits. However, such termdoes not include future
4624	medical benefits to be provided on any date more than 5 years
4625	after the date the claim is filed. In the event an offer to
4626	settle an issue pending before a judge of compensation claims,
4627	including attorney’s fees as provided for in this section, is
4628	communicated in writing to the claimant or the claimant's
4629	attorney at least 30 days prior to the trial date on such issue,
4630	for purposes of calculating the amount of attorney’s fees to be
4631	taxed against the employer or carrier, the term “benefits
4632	secured” shall be deemed to include only that amount awarded to
4633	the claimant above the amount specified in the offer to settle.
4634	If multiple issues are pending before the judge of compensation
4635	claims, said offer of settlement shall address each issue
4636	pending and shall state explicitly whether or not the offer on
4637	each issue is severable. The written offer shall also
4638	unequivocally state whether or not it includes medical witness
4639	fees and expenses and all other costs associated with the claim.
4640	(3) If any partythe claimantshould prevail in any
4641	proceedings before a judge of compensation claims or court,
4642	there shall be taxed against the nonprevailing partyemployer
4643	the reasonable costs of such proceedings, not to include the
4644	attorney's fees of the claimant. A claimant shall be
4645	responsible for the payment of her or his own attorney's fees,
4646	except that a claimant shall be entitled to recover a reasonable
4647	attorney's fee from a carrier or employer:
4648	(a) Against whom she or he successfully asserts a petition
4649	for medical benefits only, if the claimant has not filed or is
4650	not entitled to file at such time a claim for disability,
4651	permanent impairment, wage-loss, or death benefits, arising out
4652	of the same accident;
4653	(b) In any case in which the employer or carrier files a
4654	response to petition denying benefits with the Office of the
4655	Judges of Compensation Claims and the injured person has
4656	employed an attorney in the successful prosecution of the
4657	petition;
4658	(c) In a proceeding in which a carrier or employer denies
4659	that an accident occurred for which compensation benefits are
4660	payable, and the claimant prevails on the issue of
4661	compensability; or
4662	(d) In cases where the claimant successfully prevails in
4663	proceedings filed under s. 440.24 or s. 440.28.
4664
4665	Regardless of the date benefits were initially requested,
4666	attorney's fees shall not attach under this subsection until 30
4667	days after the date the carrier or employer, if self-insured,
4668	receives the petition. In applying the factors set forth in
4669	subsection (1) to cases arising under paragraphs (a), (b), (c),
4670	and (d), the judge of compensation claims must only consider
4671	only such benefits and the time reasonably spent in obtaining
4672	them as were secured for the claimant within the scope of
4673	paragraphs (a), (b), (c), and (d).
4674	(7) If an attorney's fee is owed under paragraph (3)(a),
4675	the judge of compensation claims may approve an alternative
4676	attorney's fee not to exceed $1,500 only once per accident,
4677	based on a maximum hourly rate of $150 per hour, if the judge of
4678	compensation claims expressly finds that the attorney's fee
4679	amount provided for in subsection (1), based on benefits
4680	secured, fails to fairly compensate the attorney for disputed
4681	medical-only claims as provided in paragraph (3)(a) and the
4682	circumstances of the particular case warrant such action.
4683	Section 27. Subsection (7) is added to section 440.38,
4684	Florida Statutes, to read:
4685	440.38 Security for compensation; insurance carriers and
4686	self-insurers.—
4687	(7) Any employer who meets the requirements of subsection
4688	(1) through a policy of insurance issued outside of this state
4689	must at all times, with respect to all employees working in this
4690	state, maintain the required coverage under a Florida
4691	endorsement using Florida rates and rules pursuant to payroll
4692	reporting that accurately reflects the work performed in this
4693	state by such employees.
4694	Section 28. Subsections (2) and (6) of section 440.381,
4695	Florida Statutes, are amended to read:
4696	440.381 Application for coverage; reporting payroll;
4697	payroll audit procedures; penalties.--
4698	(2) Submission of an application that contains false,
4699	misleading, or incomplete information provided with the purpose
4700	of avoiding or reducing the amount of premiums for workers'
4701	compensation coverage is a felony of the second degree,
4702	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
4703	The application must contain a statement that the filing of an
4704	application containing false, misleading, or incomplete
4705	information providedwith the purpose of avoiding or reducing
4706	the amount of premiums for workers' compensation coverage is a
4707	felony of the third degree, punishable as provided in s.
4708	775.082, s. 775.083, or s. 775.084. The application must contain
4709	a sworn statement by the employer attesting to the accuracy of
4710	the information submitted and acknowledging the provisions of
4711	former s. 440.37(4). The application must contain a sworn
4712	statement by the agent attesting that the agent explained to the
4713	employer or officer the classification codes that are used for
4714	premium calculations.
4715	(6)(a)If an employer understates or conceals payroll, or
4716	misrepresents or conceals employee duties so as to avoid proper
4717	classification for premium calculations, or misrepresents or
4718	conceals information pertinent to the computation and
4719	application of an experience rating modification factor, the
4720	employer, or the employer's agent or attorney, shall pay to the
4721	insurance carrier a penalty of 10 times the amount of the
4722	difference in premium paid and the amount the employer should
4723	have paid and reasonable attorney's fees. The penalty may be
4724	enforced in the circuit courts of this state.
4725	(b) If the department determines that an employer has
4726	materially understated or concealed payroll, has materially
4727	misrepresented or concealed employee duties so as to avoid
4728	proper classification for premium calculations, or has
4729	materially misrepresented or concealed information pertinent to
4730	the computation and application of an experience rating
4731	modification factor, the department shall immediately notify the
4732	employer's carrier of such determination. The carrier shall
4733	commence a physical onsite audit of the employer within 30 days
4734	after receiving notification from the department. If the carrier
4735	fails to commence the audit as required by this section, the
4736	department shall contract with auditing professionals to conduct
4737	the audit at the carrier's expense. A copy of the carrier's
4738	audit of the employer shall be provided to the department upon
4739	completion. The carrier is not required to conduct the physical
4740	onsite audit of the employer as set forth in this paragraph if
4741	the carrier gives written notice of cancellation to the employer
4742	within 30 days after receiving notification from the department
4743	of the material misrepresentation, understatement, or
4744	concealment and an audit is conducted in conjunction with the
4745	cancellation.
4746	Section 29. Subsection (3) of section 440.42, Florida
4747	Statutes, is amended to read:
4748	440.42 Insurance policies; liability.--
4749	(3) No contract or policy of insurance issued by a carrier
4750	under this chapter shall expire or be canceled until at least 30
4751	days have elapsed after a notice of cancellation has been sent
4752	to the department and to the employer in accordance with the
4753	provisions of s. 440.185(7). For cancellation due to nonpayment
4754	of premium, the insurer shall mail notification to the employer
4755	at least 10 days prior to the effective date of the
4756	cancellation.However, when duplicate or dual coverage exists by
4757	reason of two different carriers having issued policies of
4758	insurance to the same employer securing the same liability, it
4759	shall be presumed that only that policy with the later effective
4760	date shall be in force and that the earlier policy terminated
4761	upon the effective date of the latter. In the event that both
4762	policies carry the same effective date, one of the policies may
4763	be canceled instanter upon filing a notice of cancellation with
4764	the department and serving a copy thereof upon the employer in
4765	such manner as the department prescribes by rule. The department
4766	may by rule prescribe the content of the notice of retroactive
4767	cancellation and specify the time, place, and manner in which
4768	the notice of cancellation is to be served.
4769	Section 30. Paragraph (a) of subsection (4) of section
4770	440.49, Florida Statutes, is amended to read:
4771	440.49 Limitation of liability for subsequent injury
4772	through Special Disability Trust Fund.--
4773	(4) PERMANENT IMPAIRMENT OR PERMANENT TOTAL DISABILITY,
4774	TEMPORARY BENEFITS, MEDICAL BENEFITS, OR ATTENDANT CARE AFTER
4775	OTHER PHYSICAL IMPAIRMENT.--
4776	(a) Permanent impairment.--If an employee who has a
4777	preexisting permanent physical impairment incurs a subsequent
4778	permanent impairment from injury or occupational disease arising
4779	out of, and in the course of, her or his employment which merges
4780	with the preexisting permanent physical impairment to cause a
4781	permanent impairment, the employer shall, in the first instance,
4782	pay all benefits provided by this chapter; but, subject to the
4783	limitations specified in subsection (6), such employer shall be
4784	reimbursed from the Special Disability Trust Fund created by
4785	subsection (9) for 50 percent of all impairment benefits which
4786	the employer has been required to provide pursuant to s.
4787	440.15(3)(a)as a result of the subsequent accident or
4788	occupational disease.
4789	Section 31. Subsection (6) of section 440.491, Florida
4790	Statutes, is amended to read:
4791	440.491 Reemployment of injured workers; rehabilitation.--
4792	(6) TRAINING AND EDUCATION.--
4793	(a) Upon referral of an injured employee by the carrier,
4794	or upon the request of an injured employee, the department shall
4795	conduct a training and education screening to determine whether
4796	it should refer the employee for a vocational evaluation and, if
4797	appropriate, approve training and education or other vocational
4798	services for the employee. The department may not approve formal
4799	training and education programs unless it determines, after
4800	consideration of the reemployment assessment, pertinent
4801	reemployment status reviews or reports, and such other relevant
4802	factors as it prescribes by rule, that the reemployment plan is
4803	likely to result in return to suitable gainful employment. The
4804	department is authorized to expend moneys from the Workers'
4805	Compensation Administration Trust Fund, established by s.
4806	440.50, to secure appropriate training and education at a
4807	community college established under part III of chapter 240 or
4808	at a vocational-technical school established under s. 230.63, or
4809	to secureother vocational services when necessary to satisfy
4810	the recommendation of a vocational evaluator. As used in this
4811	paragraph, "appropriate training and education" includes
4812	securing a general education diploma (GED), if necessary.The
4813	department shall establish training and education standards
4814	pertaining to employee eligibility, course curricula and
4815	duration, and associated costs.
4816	(b) When it appears thatan employee who has attained
4817	maximum medical improvement is unable to earn at least 80
4818	percent of the compensation rate andrequires training and
4819	education to obtain suitable gainful employment, the employer or
4820	carrier shall pay the employee additional training and education
4821	temporary total compensation benefitswhile the employee
4822	receives such training and education for a period not to exceed
4823	26 weeks, which period may be extended for an additional 26
4824	weeks or less, if such extended period is determined to be
4825	necessary and proper by a judge of compensation claims. The
4826	benefits provided under this paragraph shall not be in addition
4827	to the 104 weeks as specified in s. 440.15(2).However, a
4828	carrier or employer is not precluded from voluntarily paying
4829	additional temporary total disability compensation beyond that
4830	period. If an employee requires temporary residence at or near a
4831	facility or an institution providing training and education
4832	which is located more than 50 miles away from the employee's
4833	customary residence, the reasonable cost of board, lodging, or
4834	travel must be borne by the department from the Workers'
4835	Compensation Administration Trust Fund established by s. 440.50.
4836	An employee who refuses to accept training and education that is
4837	recommended by the vocational evaluator and considered necessary
4838	by the department will forfeit any additional training and
4839	education benefits and any additional payment for lost wages
4840	under this chapter. The department shall adopt rules to
4841	implement this section, which shall include requirements placed
4842	upon the carrier to notify the injured employee of the
4843	availability of training and education benefits as specified in
4844	this chapter. The department shall also include information
4845	regarding the eligibility for training and education benefits in
4846	informational materials specified in ss. 440.207 and 440.40is
4847	subject to a 50-percent reduction in weekly compensation
4848	benefits, including wage-loss benefits, as determined under s.
4849	440.15(3)(b).
4850	Section 32. Section 440.525, Florida Statutes, is amended
4851	to read:
4852	440.525 Examination and investigation of carriers and
4853	claims-handling entities.--
4854	(1) The department may examine, or investigate anyeach
4855	carrier, third-party administrator, servicing agent, or other
4856	claims-handling entity as often as is warranted to ensure that
4857	it iscarriers are fulfilling itstheir obligations under this
4858	chapterthe law. The examination may cover any period of the
4859	carrier's operations since the last previous examination.
4860	(2) An examination may cover any period of the carrier's,
4861	third-party administrator's, servicing agent's, or other claims-
4862	handling entity's operations since the last previous
4863	examination. An investigation based upon a reasonable belief by
4864	the department that a material violation of this chapter has
4865	occurred may cover any time period, but may not predate the last
4866	examination by more than 5 years. The department may by rule
4867	establish procedures, standards, and protocols for examinations
4868	and investigations. If the department finds any violation of
4869	this chapter, it may impose administrative penalties pursuant to
4870	this chapter. If the department finds any self-insurer in
4871	violation of this chapter, it may take action pursuant s.
4872	440.38(3). Examinations or investigations by the department may
4873	address, but are not limited to addressing, patterns or
4874	practices of unreasonable delay in claims handling; timeliness
4875	and accuracy of payments and reports under ss. 440.13, 440.16,
4876	and 440.185; or patterns or practices of harassment, coercion,
4877	or intimidation of claimants. The department may also specify by
4878	rule the documentation to be maintained for each claim file.
4879	(3) As to any examination or investigation conducted under
4880	this chapter, the department shall have the power to conduct
4881	onsite inspections of claims records and documentation of a
4882	carrier, third-party administrator, servicing agent, or other
4883	claims-handling entity, and conduct interviews, both sworn and
4884	unsworn, of claims-handling personnel. Carriers, third-party
4885	administrators, servicing agents, and other claims-handling
4886	entities shall make all claims records, documentation,
4887	communication, and correspondence available to department
4888	personnel during regular business hours. If any person fails to
4889	comply with a request for production of records or documents or
4890	fails to produce an employee for interview, the department may
4891	compel production or attendance by subpoena. The results of an
4892	examination or investigation shall be provided to the carrier,
4893	third-party administrator, servicing agent, or other claims-
4894	handling entity in a written report setting forth the basis for
4895	any violations that are asserted. Such report is agency action
4896	for purposes of chapter 120, and the aggrieved party may request
4897	a proceeding under s. 120.57 with regard to the findings and
4898	conclusion of the report.
4899	(4) If the department finds that violations of this
4900	chapter have occurred, the department may impose an
4901	administrative penalty upon the offending entity or entities.
4902	For each offending entity, such penalties shall not exceed
4903	$2,500 for each pattern or practice constituting nonwillful
4904	violation and shall not exceed an aggregate amount of $10,000
4905	for all nonwillful violations arising out of the same action. If
4906	the department finds a pattern of practice that constitutes a
4907	willful violation, the department may impose an administrative
4908	penalty upon each offending entity not to exceed $20,000 for
4909	each willful pattern or practice. Such fines shall not exceed
4910	$100,000 for all willful violations arising out of the same
4911	action. No penalty assessed under this section may be recouped
4912	by any carrier in the rate base, the premium, or any rate
4913	filing. Any administrative penalty imposed under this section
4914	for a nonwillful violation shall not duplicate an administrative
4915	penalty imposed under another provision of this chapter or the
4916	Insurance Code. The department may adopt rules to implement this
4917	section. The department shall adopt penalty guidelines by rule
4918	to set penalties under this chapter.
4919	Section 33. Subsection (2) of section 627.162, Florida
4920	Statutes, is amended to read:
4921	627.162 Requirements for premium installments;
4922	delinquency, collection, and check return charges; attorney's
4923	fees.--
4924	(2) Insurers providing workers' compensation coverage
4925	under chapter 440 may charge the insured a delinquency and
4926	collection fee on each installment in default for a period of
4927	not less than 5 days in an amount not to exceed $25$10or 5
4928	percent of the delinquent installment, whichever is greater.
4929	Only one such delinquency and collection fee may be collected on
4930	any such installment regardless of the period during which it
4931	remains in default.
4932	Section 34. Section 627.285, Florida Statutes, is created
4933	to read:
4934	627.285 Independent actuarial peer review of workers'
4935	compensation rating organization.--The Financial Services
4936	Commission shall at least once every other year contract for an
4937	independent actuarial peer review and analysis of the ratemaking
4938	processes of any licensed rating organization that makes rate
4939	filings for workers' compensation insurance and the rating
4940	organization shall fully cooperate in the peer review. The
4941	contract shall require submission of a final report to the
4942	commission, the President of the Senate, and the Speaker of the
4943	House of Representatives by February 1. The first report shall
4944	be submitted by February 1, 2004. The costs of the independent
4945	actuarial peer review shall be paid from the Workers'
4946	Compensation Administration Trust Fund.
4947	Section 35. Effective July, 1, 2003, paragraphs (b), (c),
4948	and (d) of subsection (4) of section 627.311, Florida Statutes,
4949	are amended to read
4950	627.311 Joint underwriters and joint reinsurers.--
4951	(4)
4952	(b) The operation of the plan is subject to the
4953	supervision of a 9-member13-memberboard of governors. The
4954	board of governors shall be comprised of:
4955	1. Three members appointed by the Financial Services
4956	Commission. Each member appointed by the commission shall serve
4957	at the pleasure of the commission;
4958	2.1.TwoFiveof the 20 domestic insurers, as defined in
4959	s. 624.06(1), having the largest voluntary direct premiums
4960	written in this state for workers' compensation and employer's
4961	liability insurance, which shall be elected by those 20 domestic
4962	insurers;
4963	3.2.TwoFiveof the 20 foreign insurers as defined in s.
4964	624.06(2) having the largest voluntary direct premiums written
4965	in this state for workers' compensation and employer's liability
4966	insurance, which shall be elected by those 20 foreign insurers;
4967	3. One person, who shall serve as the chair, appointed by
4968	the Insurance Commissioner;
4969	4. One person appointed by the largest property and
4970	casualty insurance agents' association in this state; and
4971	5. The consumer advocate appointed under s. 627.0613 or
4972	the consumer advocate's designee.
4973
4974	Each board member shall serve a 4-year term and may serve
4975	consecutive terms. A vacancy on the board shall be filled in the
4976	same manner as the original appointment for the unexpired
4977	portion of the term. The Financial Services Commission shall
4978	designate a member of the board to serve as chair.No board
4979	member shall be an insurer which provides service to the plan or
4980	which has an affiliate which provides services to the plan or
4981	which is serviced by a service company or third-party
4982	administrator which provides services to the plan or which has
4983	an affiliate which provides services to the plan. The minutes,
4984	audits, and procedures of the board of governors are subject to
4985	chapter 119.
4986	(c) The operation of the plan shall be governed by a plan
4987	of operation that is prepared at the direction of the board of
4988	governors. The plan of operation may be changed at any time by
4989	the board of governors or upon request of the department. The
4990	plan of operation and all changes thereto are subject to the
4991	approval of the department. The plan of operation shall:
4992	1. Authorize the board to engage in the activities
4993	necessary to implement this subsection, including, but not
4994	limited to, borrowing money.
4995	2. Develop criteria for eligibility for coverage by the
4996	plan, including, but not limited to, documented rejection by at
4997	least two insurers which reasonably assures that insureds
4998	covered under the plan are unable to acquire coverage in the
4999	voluntary market. Any insured may voluntarily elect to accept
5000	coverage from an insurer for a premium equal to or greater than
5001	the plan premium if the insurer writing the coverage adheres to
5002	the provisions of s. 627.171.
5003	3. Require notice from the agent to the insured at the
5004	time of the application for coverage that the application is for
5005	coverage with the plan and that coverage may be available
5006	through an insurer, group self-insurers' fund, commercial self-
5007	insurance fund, or assessable mutual insurer through another
5008	agent at a lower cost.
5009	4. Establish programs to encourage insurers to provide
5010	coverage to applicants of the plan in the voluntary market and
5011	to insureds of the plan, including, but not limited to:
5012	a. Establishing procedures for an insurer to use in
5013	notifying the plan of the insurer's desire to provide coverage
5014	to applicants to the plan or existing insureds of the plan and
5015	in describing the types of risks in which the insurer is
5016	interested. The description of the desired risks must be on a
5017	form developed by the plan.
5018	b. Developing forms and procedures that provide an insurer
5019	with the information necessary to determine whether the insurer
5020	wants to write particular applicants to the plan or insureds of
5021	the plan.
5022	c. Developing procedures for notice to the plan and the
5023	applicant to the plan or insured of the plan that an insurer
5024	will insure the applicant or the insured of the plan, and notice
5025	of the cost of the coverage offered; and developing procedures
5026	for the selection of an insuring entity by the applicant or
5027	insured of the plan.
5028	d. Provide for a market-assistance plan to assist in the
5029	placement of employers. All applications for coverage in the
5030	plan received 45 days before the effective date for coverage
5031	shall be processed through the market-assistance plan. A market-
5032	assistance plan specifically designed to serve the needs of
5033	small good policyholders as defined by the board must be
5034	finalized by January 1, 1994.
5035	5. Provide for policy and claims services to the insureds
5036	of the plan of the nature and quality provided for insureds in
5037	the voluntary market.
5038	6. Provide for the review of applications for coverage
5039	with the plan for reasonableness and accuracy, using any
5040	available historic information regarding the insured.
5041	7. Provide for procedures for auditing insureds of the
5042	plan which are based on reasonable business judgment and are
5043	designed to maximize the likelihood that the plan will collect
5044	the appropriate premiums.
5045	8. Authorize the plan to terminate the coverage of and
5046	refuse future coverage for any insured that submits a fraudulent
5047	application to the plan or provides fraudulent or grossly
5048	erroneous records to the plan or to any service provider of the
5049	plan in conjunction with the activities of the plan.
5050	9. Establish service standards for agents who submit
5051	business to the plan.
5052	10. Establish criteria and procedures to prohibit any
5053	agent who does not adhere to the established service standards
5054	from placing business with the plan or receiving, directly or
5055	indirectly, any commissions for business placed with the plan.
5056	11. Provide for the establishment of reasonable safety
5057	programs for all insureds in the plan. All insureds of the plan
5058	must participate in the safety program.
5059	12. Authorize the plan to terminate the coverage of and
5060	refuse future coverage to any insured who fails to pay premiums
5061	or surcharges when due; who, at the time of application, is
5062	delinquent in payments of workers' compensation or employer's
5063	liability insurance premiums or surcharges owed to an insurer,
5064	group self-insurers' fund, commercial self-insurance fund, or
5065	assessable mutual insurer licensed to write such coverage in
5066	this state; or who refuses to substantially comply with any
5067	safety programs recommended by the plan.
5068	13. Authorize the board of governors to provide the
5069	services required by the plan through staff employed by the
5070	plan, through reasonably compensated service providers who
5071	contract with the plan to provide services as specified by the
5072	board of governors, or through a combination of employees and
5073	service providers.
5074	14. Provide for service standards for service providers,
5075	methods of determining adherence to those service standards,
5076	incentives and disincentives for service, and procedures for
5077	terminating contracts for service providers that fail to adhere
5078	to service standards.
5079	15. Provide procedures for selecting service providers and
5080	standards for qualification as a service provider that
5081	reasonably assure that any service provider selected will
5082	continue to operate as an ongoing concern and is capable of
5083	providing the specified services in the manner required.
5084	16. Provide for reasonable accounting and data-reporting
5085	practices.
5086	17. Provide for annual review of costs associated with the
5087	administration and servicing of the policies issued by the plan
5088	to determine alternatives by which costs can be reduced.
5089	18. Authorize the acquisition of such excess insurance or
5090	reinsurance as is consistent with the purposes of the plan.
5091	19. Provide for an annual report to the department on a
5092	date specified by the department and containing such information
5093	as the department reasonably requires.
5094	20. Establish multiple rating plans for various
5095	classifications of risk which reflect risk of loss, hazard
5096	grade, actual losses, size of premium, and compliance with loss
5097	control. At least one of such plans must be a preferred-rating
5098	plan to accommodate small-premium policyholders with good
5099	experience as defined in sub-subparagraph 22.a.
5100	21. Establish agent commission schedules.
5101	22. Establish fourthreesubplans as follows:
5102	a. Subplan "A" must include those insureds whose annual
5103	premium does not exceed $2,500 and who have neither incurred any
5104	lost-time claims nor incurred medical-only claims exceeding 50
5105	percent of their premium for the immediate 2 years.
5106	b. Subplan "B" must include insureds that are employers
5107	identified by the board of governors as high-risk employers due
5108	solely to the nature of the operations being performed by those
5109	insureds and for whom no market exists in the voluntary market,
5110	and whose experience modifications are less than 1.00.
5111	c. Subplan "C" must include all otherinsureds within the
5112	plan that are not eligible for subplan "A," subplan "B," or
5113	subplan "D."
5114	d. Subplan "D" must include any employer, regardless of
5115	the length of time for which it has conducted business
5116	operations, which has an experience modification factor of 1.10
5117	or less and either employs 15 or fewer employees or is an
5118	organization that is exempt from federal income tax pursuant to
5119	s. 501(c)(3) of the Internal Revenue Code and receives more than
5120	50 percent of its funding from gifts, grants, endowments, or
5121	federal or state contracts. The rate plan for subplan "D" shall
5122	be the same rate plan as the plan approved under ss. 627.091-
5123	627.151 and each participant in subplan "D" shall pay the
5124	premium determined under such rate plan, plus a surcharge
5125	determined by the board to be sufficient to ensure that the plan
5126	does not compete with the voluntary market rate for any
5127	participant, but not to exceed 25 percent. However, the
5128	surcharge shall not exceed 10 percent for an organization that
5129	is exempt from federal income tax pursuant to s. 501(c)(3) of
5130	the Internal Revenue Code.
5131	23. Provide for a depopulation program to reduce the
5132	number of insureds in subplan "D." If an employer insured
5133	through subplan "D" is offered coverage from a voluntary market
5134	carrier:
5135	a. During the first 30 days of coverage under the subplan;
5136	b. Before a policy is issued under the subplan;
5137	c. By issuance of a policy upon expiration or cancellation
5138	of the policy under the subplan; or
5139	d. By assumption of the subplan's obligation with respect
5140	to an in-force policy,
5141
5142	that employer is no longer eligible for coverage through the
5143	plan. The premium for risks assumed by the voluntary market
5144	carrier must be the same premium plus, for the first 2 years,
5145	the surcharge as determined in sub-subparagraph 22.d. A premium
5146	under this subparagraph, including surcharge, is deemed approved
5147	and is not an excess premium for purposes of s. 627.171.
5148	24. Require that policies issued under subplan "D" and
5149	applications for such policies must include a notice that the
5150	policy issued under subplan "D" could be replaced by a policy
5151	issued from a voluntary market carrier and that, if an offer of
5152	coverage is obtained from a voluntary market carrier, the
5153	policyholder is no longer eligible for coverage through subplan
5154	"D." The notice must also specify that acceptance of coverage
5155	under subplan "D" creates a conclusive presumption that the
5156	applicant or policyholder is aware of this potential.
5157	(d)1.The plan must be funded through actuarially sound
5158	premiums charged to insureds of the plan.
5159	2.The plan may issue assessable policies only to those
5160	insureds in subplan "C." and subplan "D." Subject to
5161	verification by the department, the board may levy assessments
5162	against insureds in subplan "C" or subplan "D," on a pro rata
5163	earned premium basis, to fund any deficits that exist in those
5164	subplans. Assessments levied against subplan "C" participants
5165	shall cover only the deficits attributable to subplan "C," and
5166	assessments levied against subplan "D" participants shall cover
5167	only the deficits attributable to subplan "D." In no event may
5168	the plan levy assessments against any person or entity, except
5169	as authorized by this paragraph.Those assessable policies must
5170	be clearly identified as assessable by containing, in
5171	contrasting color and in not less than 10-point type, the
5172	following statements: "This is an assessable policy. If the plan
5173	is unable to pay its obligations, policyholders will be required
5174	to contribute on a pro rata earned premium basis the money
5175	necessary to meet any assessment levied."
5176	3.The plan may issue assessable policies with differing
5177	terms and conditions to different groups within subplans "C" and
5178	"D"the planwhen a reasonable basis exists for the
5179	differentiation.
5180	4.The plan may offer rating, dividend plans, and other
5181	plans to encourage loss prevention programs.
5182	Section 36. Paragraphs (c) and (e) of subsection (3) of
5183	section 921.0022, Florida Statutes, are amended to read:
5184	921.0022 Criminal Punishment Code; offense severity
5185	ranking chart.--
5186	(3) OFFENSE SEVERITY RANKING CHART
5187	FloridaStatute FelonyDegree Description
5188	(c) LEVEL 3
5189	316.193(2)(b) 3rd Felony DUI, 3rd conviction.
5190	316.1935(2) 3rd Fleeing or attempting to elude law enforcement officer in marked patrol vehicle with siren and lights activated.
5191	319.30(4) 3rd Possession by junkyard of motor vehicle with identification number plate removed.
5192	319.33(1)(a) 3rd Alter or forge any certificate of title to a motor vehicle or mobile home.
5193	319.33(1)(c) 3rd Procure or pass title on stolen vehicle.
5194	319.33(4) 3rd With intent to defraud, possess, sell, etc., a blank, forged, or unlawfully obtained title or registration.
5195	327.35(2)(b) 3rd Felony BUI.
5196	328.05(2) 3rd Possess, sell, or counterfeit fictitious, stolen, or fraudulent titles or bills of sale of vessels.
5197	328.07(4) 3rd Manufacture, exchange, or possess vessel with counterfeit or wrong ID number.
5198	376.302(5) 3rd Fraud related to reimbursement for cleanup expenses under the Inland Protection Trust Fund.
5199	440.105(3)(b) 3rd Receipt of fee or consideration without approval by judge of compensation claims.
5200	440.1051(3) 3rd False report of workers' compensation fraud or retaliation for making such a report.
5201	501.001(2)(b) 2nd Tampers with a consumer product or the container using materially false/misleading information.
5202	697.08 3rd Equity skimming.
5203	790.15(3) 3rd Person directs another to discharge firearm from a vehicle.
5204	796.05(1) 3rd Live on earnings of a prostitute.
5205	806.10(1) 3rd Maliciously injure, destroy, or interfere with vehicles or equipment used in firefighting.
5206	806.10(2) 3rd Interferes with or assaults firefighter in performance of duty.
5207	810.09(2)(c) 3rd Trespass on property other than structure or conveyance armed with firearm or dangerous weapon.
5208	812.014(2)(c)2. 3rd Grand theft; $5,000 or more but less than $10,000.
5209	812.0145(2)(c) 3rd Theft from person 65 years of age or older; $300 or more but less than $10,000.
5210	815.04(4)(b) 2nd Computer offense devised to defraud or obtain property.
5211	817.034(4)(a)3. 3rd Engages in scheme to defraud (Florida Communications Fraud Act), property valued at less than $20,000.
5212	817.233 3rd Burning to defraud insurer.
5213	817.234(8)&(9) 3rd Unlawful solicitation of persons involved in motor vehicle accidents.
5214	817.234(11)(a) 3rd Insurance fraud; property value less than $20,000.
5215	817.505(4) 3rd Patient brokering.
5216	828.12(2) 3rd Tortures any animal with intent to inflict intense pain, serious physical injury, or death.
5217	831.28(2)(a) 3rd Counterfeiting a payment instrument with intent to defraud or possessing a counterfeit payment instrument.
5218	831.29 2nd Possession of instruments for counterfeiting drivers' licenses or identification cards.
5219	838.021(3)(b) 3rd Threatens unlawful harm to public servant.
5220	843.19 3rd Injure, disable, or kill police dog or horse.
5221	870.01(2) 3rd Riot; inciting or encouraging.
5222	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).
5223	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.
5224	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.
5225	893.13(6)(a) 3rd Possession of any controlled substance other than felony possession of cannabis.
5226	893.13(7)(a)8. 3rd Withhold information from practitioner regarding previous receipt of or prescription for a controlled substance.
5227	893.13(7)(a)9. 3rd Obtain or attempt to obtain controlled substance by fraud, forgery, misrepresentation, etc.
5228	893.13(7)(a)10. 3rd Affix false or forged label to package of controlled substance.
5229	893.13(7)(a)11. 3rd Furnish false or fraudulent material information on any document or record required by chapter 893.
5230	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.
5231	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.
5232	893.13(8)(a)3. 3rd Knowingly write a prescription for a controlled substance for a fictitious person.
5233	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.
5234	918.13(1)(a) 3rd Alter, destroy, or conceal investigation evidence.
5235	944.47(1)(a)1.-2. 3rd Introduce contraband to correctional facility.
5236	944.47(1)(c) 2nd Possess contraband while upon the grounds of a correctional institution.
5237	985.3141 3rd Escapes from a juvenile facility (secure detention or residential commitment facility).
5238	(e) LEVEL 5
5239	316.027(1)(a) 3rd Accidents involving personal injuries, failure to stop; leaving scene.
5240	316.1935(4) 2nd Aggravated fleeing or eluding.
5241	322.34(6) 3rd Careless operation of motor vehicle with suspended license, resulting in death or serious bodily injury.
5242	327.30(5) 3rd Vessel accidents involving personal injury; leaving scene.
5243	381.0041(11)(b) 3rd Donate blood, plasma, or organs knowing HIV positive.
5244
5245	440.10(1)(g) 2nd Failure to obtain workers' compensation coverage.
5246	440.105(5) 2nd Unlawful solicitation for the purpose of making workers' compensation claims.
5247	440.381(2) 2nd Submission of false, misleading, or incomplete information with the purpose of avoiding or reducing workers' compensation premiums.
5248	790.01(2) 3rd Carrying a concealed firearm.
5249	790.162 2nd Threat to throw or discharge destructive device.
5250	790.163(1) 2nd False report of deadly explosive or weapon of mass destruction.
5251	790.221(1) 2nd Possession of short-barreled shotgun or machine gun.
5252	790.23 2nd Felons in possession of firearms or electronic weapons or devices.
5253	800.04(6)(c) 3rd Lewd or lascivious conduct; offender less than 18 years.
5254	800.04(7)(c) 2nd Lewd or lascivious exhibition; offender 18 years or older.
5255	806.111(1) 3rd Possess, manufacture, or dispense fire bomb with intent to damage any structure or property.
5256	812.0145(2)(b) 2nd Theft from person 65 years of age or older; $10,000 or more but less than $50,000.
5257	812.015(8) 3rd Retail theft; property stolen is valued at $300 or more and one or more specified acts.
5258	812.019(1) 2nd Stolen property; dealing in or trafficking in.
5259	812.131(2)(b) 3rd Robbery by sudden snatching.
5260	812.16(2) 3rd Owning, operating, or conducting a chop shop.
5261	817.034(4)(a)2. 2nd Communications fraud, value $20,000 to $50,000.
5262	817.234(11)(b) 2nd Insurance fraud; property value $20,000 or more but less than $100,000.
5263	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.
5264	817.625(2)(b) 2nd Second or subsequent fraudulent use of scanning device or reencoder.
5265	825.1025(4) 3rd Lewd or lascivious exhibition in the presence of an elderly person or disabled adult.
5266	827.071(4) 2nd Possess with intent to promote any photographic material, motion picture, etc., which includes sexual conduct by a child.
5267	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.
5268	843.01 3rd Resist officer with violence to person; resist arrest with violence.
5269	874.05(2) 2nd Encouraging or recruiting another to join a criminal street gang; second or subsequent offense.
5270	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).
5271	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.
5272	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.
5273	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.
5274	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.
5275	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).
5276	Section 37. Report to the Legislature regarding
5277	outstanding enforcement issues.--The Department of Financial
5278	Services shall, no later than January 1, 2004, provide a report
5279	to the President of the Senate, the Speaker of the House of
5280	Representatives, the minority leaders of the Senate and the
5281	House of Representatives, and the chairs of the standing
5282	committees of the Senate and the House of Representatives having
5283	jurisdiction over insurance issues, containing the following
5284	information:
5285	(1) Any provision of chapter 440, Florida Statutes,
5286	relating to workers' compensation carrier compliance and
5287	enforcement, that the department finds it is unable to enforce.
5288	(2) Any administrative rule relating to workers'
5289	compensation carrier compliance and enforcement that the
5290	department finds it is unable to enforce.
5291	(3) Any other impediment to enforcement of chapter 440,
5292	Florida Statutes, resulting from the transfer of activities from
5293	the former Department of Labor and Employment Security to the
5294	department or the reorganization of the former Department of
5295	Insurance into the department.
5296	Section 38. Subsection (2) of section 946.523, Florida
5297	Statutes, is amended to read:
5298	946.523 Prison industry enhancement (PIE) programs.--
5299	(2) Notwithstanding any other law to the contrary,
5300	including s. 440.15(8)(9), private sector employers shall
5301	provide workers' compensation coverage to inmates who
5302	participate in prison industry enhancement (PIE) programs under
5303	subsection (1). However, inmates are not entitled to
5304	unemployment compensation.
5305	Section 39. Paragraph (c) of subsection (5) of section
5306	985.315, Florida Statutes, is amended to read:
5307	985.315 Educational/technical and vocational work-related
5308	programs.--
5309	(5)
5310	(c) Notwithstanding any other law to the contrary,
5311	including s. 440.15(8)(9), private sector employers shall
5312	provide juveniles participating in juvenile work programs under
5313	paragraph (b) with workers' compensation coverage, and juveniles
5314	shall be entitled to the benefits of such coverage. Nothing in
5315	this subsection shall be construed to allow juveniles to
5316	participate in unemployment compensation benefits.
5317	Section 40. (1) There is established a Joint Select
5318	Committee on Workers’ Compensation Rating Reform. The committee
5319	shall study the merits of requiring each workers’ compensation
5320	insurer to individually file its expense and profit portion of a
5321	rate filing, while permitting each insurer to use a lost cost
5322	filing made by a licensed rating organization. The committee
5323	shall also study options for the current prior approval system
5324	for workers’ compensation rate filings, including, but not
5325	limited to, rate filing procedures that would promote greater
5326	competition and would encourage insurers to write workers'
5327	compensation coverage in the state while protecting employers
5328	from rates that are excessive, inadequate, or unfairly
5329	discriminatory.
5330	(2) The committee shall be composed of three Senators
5331	appointed by the President of the Senate and three
5332	Representatives appointed by the Speaker of the House of
5333	Representatives. The appointed members of the committee shall
5334	elect a chair and vice chair. The Department of Financial
5335	Services shall provide information and assistance as requested
5336	by the committee.
5337	(3) The committee shall issue its final report and
5338	recommendations to the President of the Senate and the Speaker
5339	of the House of Representatives by December 1, 2003. The
5340	committee shall terminate on December 1, 2003.
5341	Section 41. The board of governors of the joint
5342	underwriting plan for workers’ compensation insurance created by
5343	s. 627.311(4), Florida Statutes, shall, by January 1, 2005,
5344	submit a report to the President of the Senate, the Speaker of
5345	the House of Representatives, the minority party leaders of the
5346	Senate and the House of Representatives, and the chairs of the
5347	standing committees of the Senate and the House of
5348	Representatives having jurisdiction over matters relating to
5349	workers’ compensation. The report shall include the board’s
5350	findings and recommendations on the following issues:
5351	(1) The number of policies and the aggregate premium of
5352	the workers’ compensation joint underwriting plan, before and
5353	after enactment of this act, and projections for future policy
5354	and premium growth.
5355	(2) Increases or decreases in availability of workers’
5356	compensation coverage in the voluntary market and the
5357	effectiveness of this act in improving the availability of
5358	workers’ compensation coverage in the state.
5359	(3) The board’s efforts to depopulate the plan and the
5360	willingness of insurers in the voluntary market to avail
5361	themselves of depopulation incentives.
5362	(4) Further actions that could be taken by the Legislature
5363	to improve availability of workers’ compensation coverage in the
5364	voluntary and residual markets.
5365	(5) Actions that the board has taken to restructure the
5366	joint underwriting plan and recommendations for legislative
5367	action to restructure the plan.
5368	(6) Projected surpluses or deficits and possible means of
5369	providing funding to ensure the continued solvency of the plan.
5370	(7) An independent actuarial review of all rates under the
5371	plan. The costs of the independent actuarial review shall be
5372	paid from the Workers' Compensation Administration Trust Fund,
5373	pursuant to a budget amendment approved by the Legislative
5374	Budget Commission. The board shall submit a plan for such review
5375	to the Legislative Budget Commission by October 1, 2003.
5376	(8) Such other issues as the board determines are worthy
5377	of the Legislature’s consideration.
5378	Section 42. Subsections (1) and (2) of section 443.1715,
5379	Florida Statutes, are amended to read:
5380	443.1715 Disclosure of information; confidentiality.--
5381	(1) RECORDS AND REPORTS.--Information revealing the
5382	employing unit's or individual's identity obtained from the
5383	employing unit or from any individual pursuant to the
5384	administration of this chapter, and any determination revealing
5385	such information, except to the extent necessary for the proper
5386	presentation of a claim or upon written authorization of the
5387	claimant who has a workers’ compensation claim pending or is
5388	receiving compensation benefits, must be held confidential and
5389	exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I
5390	of the State Constitution. Such information may be made
5391	available only to public employees in the performance of their
5392	public duties, including employees of the Department of
5393	Education in obtaining information for the Florida Education and
5394	Training Placement Information Program and the Office of
5395	Tourism, Trade, and Economic Development in its administration
5396	of the qualified defense contractor tax refund program
5397	authorized by s. 288.1045 and the qualified target industry tax
5398	refund program authorized by s. 288.106. Except as otherwise
5399	provided by law, public employees receiving such information
5400	must retain the confidentiality of such information. Any
5401	claimant, or the claimant's legal representative, at a hearing
5402	before an appeals referee or the commission shall be supplied
5403	with information from such records to the extent necessary for
5404	the proper presentation of her or his claim. Any employee or
5405	member of the commission or any employee of the division, or any
5406	other person receiving confidential information, who violates
5407	any provision of this subsection commits a misdemeanor of the
5408	second degree, punishable as provided in s. 775.082 or s.
5409	775.083. However, the division may furnish to any employer
5410	copies of any report previously submitted by such employer, upon
5411	the request of such employer, and may furnish to any claimant
5412	copies of any report previously submitted by such claimant, upon
5413	the request of such claimant, and the division is authorized to
5414	charge therefor such reasonable fee as the division may by rule
5415	prescribe not to exceed the actual reasonable cost of the
5416	preparation of such copies. Fees received by the division for
5417	copies as provided in this subsection must be deposited to the
5418	credit of the Employment Security Administration Trust Fund.
5419	(2) DISCLOSURE OF INFORMATION.—
5420	(a)Subject to such restrictions as the division
5421	prescribes by rule, information declared confidential under this
5422	section may be made available to any agency of this or any other
5423	state, or any federal agency, charged with the administration of
5424	any unemployment compensation law or the maintenance of a system
5425	of public employment offices, or the Bureau of Internal Revenue
5426	of the United States Department of the Treasury, or the Florida
5427	Department of Revenue and information obtained in connection
5428	with the administration of the employment service may be made
5429	available to persons or agencies for purposes appropriate to the
5430	operation of a public employment service or a job-preparatory or
5431	career education or training program. The division shall on a
5432	quarterly basis, furnish the National Directory of New Hires
5433	with information concerning the wages and unemployment
5434	compensation paid to individuals, by such dates, in such format
5435	and containing such information as the Secretary of Health and
5436	Human Services shall specify in regulations. Upon request
5437	therefor, the division shall furnish any agency of the United
5438	States charged with the administration of public works or
5439	assistance through public employment, and may furnish to any
5440	state agency similarly charged, the name, address, ordinary
5441	occupation, and employment status of each recipient of benefits
5442	and such recipient's rights to further benefits under this
5443	chapter. Except as otherwise provided by law, the receiving
5444	agency must retain the confidentiality of such information as
5445	provided in this section. The division may request the
5446	Comptroller of the Currency of the United States to cause an
5447	examination of the correctness of any return or report of any
5448	national banking association rendered pursuant to the provisions
5449	of this chapter and may in connection with such request transmit
5450	any such report or return to the Comptroller of the Currency of
5451	the United States as provided in s. 3305(c) of the federal
5452	Internal Revenue Code.
5453	(b)1. The employer or the employer’s workers’ compensation
5454	carrier against whom a claim for benefits under chapter 440 has
5455	been made, or a representative of either, may request from the
5456	division records of wages of the employee reported to the
5457	division by any employer for the quarter that includes the date
5458	of the accident that is the subject of such claim and for
5459	subsequent quarters. The request must be made with the
5460	authorization or consent of the employee or any employer who
5461	paid wages to the employee subsequent to the date of the
5462	accident.
5463	2. The employer or carrier shall make the request on a
5464	form prescribed by rule for such purpose by the division. Such
5465	form shall contain a certification by the requesting party that
5466	it is a party entitled to the information requested as
5467	authorized by this paragraph.
5468	3. The division shall provide the most current information
5469	readily available within 15 days after receiving the request.
5470	Section 43. Subsection (9) of section 626.989, Florida
5471	Statutes, is amended to read:
5472	626.989 Investigation by department or Division of
5473	Insurance Fraud; compliance; immunity; confidential information;
5474	reports to division; division investigator's power of arrest.--
5475	(9) In recognition of the complementary roles of
5476	investigating instances of workers' compensation fraud and
5477	enforcing compliance with the workers' compensation coverage
5478	requirements under chapter 440, the Department of Financial
5479	Services shallInsurance is directed toprepare and submit a
5480	joint performance report to the President of the Senate and the
5481	Speaker of the House of Representatives by November 1, 2003, and
5482	then by January 1 of each yearNovember 1 every 3 years
5483	thereafter, describing the results obtained in achieving
5484	compliance with the workers' compensation coverage requirements
5485	and reducing the incidence of workers' compensation fraud. The
5486	annual report must include, but need not be limited to:
5487	(a) The total number of initial referrals received, cases
5488	opened, cases presented for prosecution, cases closed, and
5489	convictions resulting from cases presented for prosecution by
5490	the Bureau of Workers’ Compensation Insurance Fraud by type of
5491	workers’ compensation fraud and circuit.
5492	(b) The number of referrals received from insurers and the
5493	Division of Workers’ Compensation and the outcome of those
5494	referrals.
5495	(c) The number of investigations undertaken by the office
5496	which were not the result of a referral from an insurer or the
5497	Division of Workers’ Compensation.
5498	(d) The number of investigations that resulted in a
5499	referral to a regulatory agency and the disposition of those
5500	referrals.
5501	(e) The number and reasons provided by local prosecutors
5502	or the statewide prosecutor for declining prosecution of a case
5503	presented by the office by circuit.
5504	(f) The total number of employees assigned to the office
5505	and the Division of Workers’ Compliance unit delineated by
5506	location of staff assigned and the number and location of
5507	employees assigned to the office who were assigned to work other
5508	types of fraud cases.
5509	(g) The average caseload and turnaround time by type of
5510	case for each investigator and division compliance employee.
5511	(h) The training provided during the year to workers’
5512	compensation fraud investigators and the division’s compliance
5513	employees.
5514	Section 44. Section 626.9891, Florida Statutes, is amended
5515	to read:
5516	626.9891 Insurer anti-fraud investigative units; reporting
5517	requirements; penalties for noncompliance.--
5518	(1) Every insurer admitted to do business in this state
5519	who in the previous calendar year, at any time during that year,
5520	had $10 million or more in direct premiums written shall:
5521	(a) Establish and maintain a unit or division within the
5522	company to investigate possible fraudulent claims by insureds or
5523	by persons making claims for services or repairs against
5524	policies held by insureds; or
5525	(b) Contract with others to investigate possible
5526	fraudulent claims for services or repairs against policies held
5527	by insureds.
5528
5529	An insurer subject to this subsection shall file with the
5530	Division of Insurance Fraud of the department on or before July
5531	1, 1996, a detailed description of the unit or division
5532	established pursuant to paragraph (a) or a copy of the contract
5533	and related documents required by paragraph (b).
5534	(2) Every insurer admitted to do business in this state,
5535	which in the previous calendar year had less than $10 million in
5536	direct premiums written, must adopt an anti-fraud plan and file
5537	it with the Division of Insurance Fraud of the department on or
5538	before July 1, 1996. An insurer may, in lieu of adopting and
5539	filing an anti-fraud plan, comply with the provisions of
5540	subsection (1).
5541	(3) Each insurers anti-fraud plans shall include:
5542	(a) A description of the insurer's procedures for
5543	detecting and investigating possible fraudulent insurance acts;
5544	(b) A description of the insurer's procedures for the
5545	mandatory reporting of possible fraudulent insurance acts to the
5546	Division of Insurance Fraud of the department;
5547	(c) A description of the insurer's plan for anti-fraud
5548	education and training of its claims adjusters or other
5549	personnel; and
5550	(d) A written description or chart outlining the
5551	organizational arrangement of the insurer's anti-fraud personnel
5552	who are responsible for the investigation and reporting of
5553	possible fraudulent insurance acts.
5554	(4) Any insurer who obtains a certificate of authority
5555	after July 1, 1995, shall have 18 months in which to comply with
5556	the requirements of this section.
5557	(5) For purposes of this section, the term "unit or
5558	division" includes the assignment of fraud investigation to
5559	employees whose principal responsibilities are the investigation
5560	and disposition of claims. If an insurer creates a distinct unit
5561	or division, hires additional employees, or contracts with
5562	another entity to fulfill the requirements of this section, the
5563	additional cost incurred must be included as an administrative
5564	expense for ratemaking purposes.
5565	(6) Each insurer writing workers’ compensation insurance
5566	shall report to the department, on or before August 1 of each
5567	year, on its experience in implementing and maintaining an anti-
5568	fraud investigative unit or an anti-fraud plan. The report must
5569	include, at a minimum:
5570	(a) The dollar amount of recoveries and losses
5571	attributable to workers’ compensation fraud delineated by the
5572	type of fraud: claimant, employer, provider, agent, or other.
5573	(b) The number of referrals to the Bureau of Workers’
5574	Compensation Fraud for the prior year.
5575	(c) A description of the organization of the anti-fraud
5576	investigative unit, if applicable, including the position titles
5577	and descriptions of staffing.
5578	(d) The rationale for the level of staffing and resources
5579	being provided for the anti-fraud investigative unit, which may
5580	include objective criteria such as number of policies written,
5581	number of claims received on an annual basis, volume of
5582	suspected fraudulent claims currently being detected, other
5583	factors, and an assessment of optimal caseload that can be
5584	handled by an investigator on an annual basis.
5585	(e) The in-service education and training provided to
5586	underwriting and claims personnel to assist in identifying and
5587	evaluating instances of suspected fraudulent activity in
5588	underwriting or claims activities.
5589	(f) A description of a public awareness program focused on
5590	the costs and frequency of insurance fraud and methods by which
5591	the public can prevent it.
5592	(7) If an insurer fails to submit a final anti-fraud plan
5593	or otherwise fails to submit a plan, fails to implement the
5594	provisions of a plan or an anti-fraud investigative unit, or
5595	otherwise refuses to comply with the provisions of this section,
5596	the department may:
5597	(a) Impose an administrative fine of not more than $2,000
5598	per day for such failure by an insurer, until the department
5599	deems the insurer to be in compliance;
5600	(b) Impose upon the insurer a fraud detection and
5601	prevention plan that is deemed to be appropriate by the
5602	department and that must be implemented by the insurer; or
5603	(c) Impose the provisions of both paragraphs (a) and (b).
5604	(8) The department may adopt rules to administer this
5605	section.
5606	Section 45. Section 440.1925, Florida Statutes, is
5607	repealed.
5608	Section 46. The amendments to ss. 440.02 and 440.15,
5609	Florida Statutes, which are made by this act shall not be
5610	construed to affect any determination of disability under s.
5611	112.18, s. 112.181, or s. 112.19, Florida Statutes.
5612	Section 47. If any law amended by this act was also
5613	amended by a law enacted at the 2003 Regular Session of the
5614	Legislature, such laws shall be construed as if they had been
5615	enacted at the same session of the Legislature, and full effect
5616	shall be given to each if possible.
5617	Section 48. Except as otherwise provided herein, this act
5618	shall take effect October 1, 2003.