HB 0025A, Engrossed 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; amending ss.
121	112.19 and 112.191, F.S., to conform references to changes
122	made by the act; providing that amendments to ss. 440.02
123	and 440.15, F.S., do not affect certain disability,
124	determination, and benefits; providing for construction of
125	the act in pari materia with laws enacted during the
126	Regular Session of the Legislature; providing effective
127	dates.
128
129	Be It Enacted by the Legislature of the State of Florida:
130
131	Section 1. Effective upon this act becoming a law,
132	subsections (1), (15), (29), (38), (39), (40), (41), and (42) of
133	section 440.02, Florida Statutes, are amended to read:
134	440.02 Definitions.--When used in this chapter, unless the
135	context clearly requires otherwise, the following terms shall
136	have the following meanings:
137	(1) "Accident" means only an unexpected or unusual event
138	or result that happens suddenly. A mental or nervous injury due
139	to stress, fright, or excitement only, orDisability or death
140	due to the accidental acceleration or aggravation of a venereal
141	disease or of a disease due to the habitual use of alcohol or
142	controlled substances or narcotic drugs, or a disease that
143	manifests itself in the fear of or dislike for an individual
144	because of the individual's race, color, religion, sex, national
145	origin, age, or handicap is not an injury by accident arising
146	out of the employment. Subject to s. 440.15(5),if a preexisting
147	disease or anomaly is accelerated or aggravated by an accident
148	arising out of and in the course of employment, only
149	acceleration of death or acceleration or aggravation of the
150	preexisting condition reasonably attributable to the accident is
151	compensable, with respect to any compensation otherwise payable
152	under this chapterdeath or permanent impairment. An injury or
153	disease caused by exposure to a toxic substance, including, but
154	not limited to, fungus or mold, is not an injury by accident
155	arising out of the employment unless there is clear and
156	convincing evidence establishing that exposure to the specific
157	substance involved, at the levels to which the employee was
158	exposed, can cause the injury or disease sustained by the
159	employee.
160	(15)(a) "Employee" means any person engaged in any
161	employment under any appointment or contract of hire or
162	apprenticeship, express or implied, oral or written, whether
163	lawfully or unlawfully employed, and includes, but is not
164	limited to, aliens and minors.
165	(b) "Employee" includes any person who is an officer of a
166	corporation and who performs services for remuneration for such
167	corporation within this state, whether or not such services are
168	continuous.
169	1. Any officer of a corporation may elect to be exempt
170	from this chapter by filing written notice of the election with
171	the department as provided in s. 440.05.
172	2. As to officers of a corporation who are actively
173	engaged in the construction industry, no more than three
174	officers may elect to be exempt from this chapter by filing
175	written notice of the election with the department as provided
176	in s. 440.05. However, any exemption obtained by a corporate
177	officer of a corporation actively engaged in the construction
178	industry is not applicable with respect to any commercial
179	building project estimated to be valued at $250,000 or greater.
180	3. An officer of a corporation who elects to be exempt
181	from this chapter by filing a written notice of the election
182	with the department as provided in s. 440.05 is not an employee.
183
184	Services are presumed to have been rendered to the corporation
185	if the officer is compensated by other than dividends upon
186	shares of stock of the corporation which the officer owns.
187	(c)1."Employee" includes a sole proprietor or a partner
188	who devotes full time to the proprietorship or partnership and,
189	except as provided in this paragraph, elects to be included in
190	the definition of employee by filing notice thereof as provided
191	in s. 440.05. Partners or sole proprietors actively engaged in
192	the construction industry are considered employees unless they
193	elect to be excluded from the definition of employee by filing
194	written notice of the election with the department as provided
195	in s. 440.05. However, no more than three partners in a
196	partnership that is actively engaged in the construction
197	industry may elect to be excluded. A sole proprietor or partner
198	who is actively engaged in the construction industry and who
199	elects to be exempt from this chapter by filing a written notice
200	of the election with the department as provided in s. 440.05 is
201	not an employee. For purposes of this chapter, an independent
202	contractor is an employee unless he or she meets all of the
203	conditions set forth in subparagraph (d)1.
204	2. Notwithstanding the provisions of subparagraph 1., the
205	term "employee" includes a sole proprietor or partner actively
206	engaged in the construction industry with respect to any
207	commercial building project estimated to be valued at $250,000
208	or greater. Any exemption obtained is not applicable, with
209	respect to work performed at such a commercial building project.
210	(d) "Employee" does not include:
211	1. An independent contractor, if:
212	a. The independent contractor maintains a separate
213	business with his or her own work facility, truck, equipment,
214	materials, or similar accommodations;
215	b. The independent contractor holds or has applied for a
216	federal employer identification number, unless the independent
217	contractor is a sole proprietor who is not required to obtain a
218	federal employer identification number under state or federal
219	requirements;
220	c. The independent contractor performs or agrees to
221	perform specific services or work for specific amounts of money
222	and controls the means of performing the services or work;
223	d. The independent contractor incurs the principal
224	expenses related to the service or work that he or she performs
225	or agrees to perform;
226	e. The independent contractor is responsible for the
227	satisfactory completion of work or services that he or she
228	performs or agrees to perform and is or could be held liable for
229	a failure to complete the work or services;
230	f. The independent contractor receives compensation for
231	work or services performed for a commission or on a per-job or
232	competitive-bid basis and not on any other basis;
233	g. The independent contractor may realize a profit or
234	suffer a loss in connection with performing work or services;
235	h. The independent contractor has continuing or recurring
236	business liabilities or obligations; and
237	i. The success or failure of the independent contractor's
238	business depends on the relationship of business receipts to
239	expenditures.
240
241	However, the determination as to whether an individual included
242	in the Standard Industrial Classification Manual of 1987,
243	Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762, 0781, 0782,
244	0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436, 2448, or 2449,
245	or a newspaper delivery person, is an independent contractor is
246	governed not by the criteria in this paragraph but by common-law
247	principles, giving due consideration to the business activity of
248	the individual. Notwithstanding the provisions of this paragraph
249	or any other provision of this chapter, with respect to any
250	commercial building project estimated to be valued at $250,000
251	or greater, a person who is actively engaged in the construction
252	industry is not an independent contractor and is either an
253	employer or an employee who may not be exempt from the coverage
254	requirements of this chapter.
255	2. A real estate salesperson or agent, if that person
256	agrees, in writing, to perform for remuneration solely by way of
257	commission.
258	3. Bands, orchestras, and musical and theatrical
259	performers, including disk jockeys, performing in licensed
260	premises as defined in chapter 562, if a written contract
261	evidencing an independent contractor relationship is entered
262	into before the commencement of such entertainment.
263	4. An owner-operator of a motor vehicle who transports
264	property under a written contract with a motor carrier which
265	evidences a relationship by which the owner-operator assumes the
266	responsibility of an employer for the performance of the
267	contract, if the owner-operator is required to furnish the
268	necessary motor vehicle equipment and all costs incidental to
269	the performance of the contract, including, but not limited to,
270	fuel, taxes, licenses, repairs, and hired help; and the owner-
271	operator is paid a commission for transportation service and is
272	not paid by the hour or on some other time-measured basis.
273	5. A person whose employment is both casual and not in the
274	course of the trade, business, profession, or occupation of the
275	employer.
276	6. A volunteer, except a volunteer worker for the state or
277	a county, municipality, or other governmental entity. A person
278	who does not receive monetary remuneration for services is
279	presumed to be a volunteer unless there is substantial evidence
280	that a valuable consideration was intended by both employer and
281	employee. For purposes of this chapter, the term "volunteer"
282	includes, but is not limited to:
283	a. Persons who serve in private nonprofit agencies and who
284	receive no compensation other than expenses in an amount less
285	than or equivalent to the standard mileage and per-diem expenses
286	provided to salaried employees in the same agency or, if such
287	agency does not have salaried employees who receive mileage and
288	per diem, then such volunteers who receive no compensation other
289	than expenses in an amount less than or equivalent to the
290	customary mileage and per diem paid to salaried workers in the
291	community as determined by the department; and
292	b. Volunteers participating in federal programs
293	established under Pub. L. No. 93-113.
294	7. Any officer of a corporation who elects to be exempt
295	from this chapter.
296	8. A sole proprietor or officer of a corporation who
297	actively engages in the construction industry, and a partner in
298	a partnership that is actively engaged in the construction
299	industry, who elects to be exempt from the provisions of this
300	chapter. Such sole proprietor, officer, or partner is not an
301	employee for any reason until the notice of revocation of
302	election filed pursuant to s. 440.05 is effective.
303	9. An exercise rider who does not work for a single horse
304	farm or breeder, and who is compensated for riding on a case-by-
305	case basis, provided a written contract is entered into prior to
306	the commencement of such activity which evidences that an
307	employee/employer relationship does not exist.
308	10. A taxicab, limousine, or other passenger vehicle-for-
309	hire driver who operates said vehicles pursuant to a written
310	agreement with a company which provides any dispatch, marketing,
311	insurance, communications, or other services under which the
312	driver and any fees or charges paid by the driver to the company
313	for such services are not conditioned upon, or expressed as a
314	proportion of, fare revenues.
315	11. A person who performs services as a sports official
316	for an entity sponsoring an interscholastic sports event or for
317	a public entity or private, nonprofit organization that sponsors
318	an amateur sports event. For purposes of this subparagraph, such
319	a person is an independent contractor. For purposes of this
320	subparagraph, the term "sports official" means any person who is
321	a neutral participant in a sports event, including, but not
322	limited to, umpires, referees, judges, linespersons,
323	scorekeepers, or timekeepers. This subparagraph does not apply
324	to any person employed by a district school board who serves as
325	a sports official as required by the employing school board or
326	who serves as a sports official as part of his or her
327	responsibilities during normal school hours.
328	(29) "Weekly compensation rate" means and refers to the
329	amount of compensation payable for a period of 7 consecutive
330	calendardays, including any Saturdays, Sundays, holidays, and
331	other nonworking days which fall within such period of 7
332	consecutive calendardays. When Saturdays, Sundays, holidays, or
333	other nonworking days immediately follow the first 7 calendar
334	days of disability or occur at the end of a period of disability
335	as the last day or days of such period, such nonworking days
336	constitute a part of the period of disability with respect to
337	which compensation is payable.
338	(38) "Catastrophic injury" means a permanent impairment
339	constituted by:
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	(38)(39)"Insurer" means a group self-insurers' fund
365	authorized by s. 624.4621, an individual self-insurer authorized
366	by s. 440.38, a commercial self-insurance fund authorized by s.
367	624.462, an assessable mutual insurer authorized by s. 628.6011,
368	and an insurer licensed to write workers' compensation and
369	employer's liability insurance in this state. The term
370	"carrier," as used in this chapter, means an insurer as defined
371	in this subsection.
372	(39)(40)"Statement," for the purposes of ss. 440.105 and
373	440.106, shall include the exact fraud statement language in s.
374	440.105(7). This requirementincludes, but is not limited to,
375	any notice, representation, statement, proof of injury, bill for
376	services, diagnosis, prescription, hospital or doctor record, X
377	ray, test result, or other evidence of loss, injury, or expense.
378	(40)(41)"Specificity" means information on the petition
379	for benefits sufficient to put the employer or carrier on notice
380	of the exact statutory classification and outstanding time
381	period of benefits being requested and includes a detailed
382	explanation of any benefits received that should be increased,
383	decreased, changed, or otherwise modified. If the petition is
384	for medical benefits, the information shall include specific
385	details as to why such benefits are being requested, why such
386	benefits are medically necessary, and why current treatment, if
387	any, is not sufficient. Any petition requesting alternate or
388	other medical care, including, but not limited to, petitions
389	requesting psychiatric or psychological treatment, must
390	specifically identify the physician, as defined in s. 440.13(1),
391	that is recommending such treatment. A copy of a report from
392	such physician making the recommendation for alternate or other
393	medical care shall also be attached to the petition. A judge of
394	compensation claims shall not order such treatment if a
395	physician is not recommending such treatment."Commercial
396	building" means any building or structure intended for
397	commercial or industrial use, or any building or structure
398	intended for multifamily use of more than four dwelling units,
399	as well as any accessory use structures constructed in
400	conjunction with the principal structure. The term, "commercial
401	building," does not include the conversion of any existing
402	residential building to a commercial building.
403	(42) "Residential building" means any building or
404	structure intended for residential use containing four or fewer
405	dwelling units and any structures intended as an accessory use
406	to the residential structure.
407	Section 2. Effective January 1, 2004, subsections (8),
408	(15), and (16) of section 440.02, Florida Statutes, as amended
409	by this act, are amended to read:
410	440.02 Definitions.--When used in this chapter, unless the
411	context clearly requires otherwise, the following terms shall
412	have the following meanings:
413	(8) "Construction industry" means for-profit activities
414	involving the carrying out ofany building, clearing, filling,
415	excavation, or substantial improvement in the size or use of any
416	structure or the appearance of any land. When appropriate to the
417	context, "construction" refers to the act of construction or the
418	result of construction. However, "construction" doesshallnot
419	mean a homeowner'slandowner'sact of construction or the result
420	of a construction upon his or her own premises, provided such
421	premises are not intended to be sold,or resold, or leased by
422	the owner within 1 year after the commencement of construction.
423	The division may, by rule, establish standard industrial
424	classification codes and definitions thereof which meet the
425	criteria of the term "construction industry" as set forth in
426	this section.
427	(15)(a) "Employee" means any person who receives
428	remuneration from an employer for the performance of any work or
429	service whileengaged in any employment under any appointment or
430	contract forofhire or apprenticeship, express or implied, oral
431	or written, whether lawfully or unlawfully employed, and
432	includes, but is not limited to, aliens and minors.
433	(b) "Employee" includes any person who is an officer of a
434	corporation and who performs services for remuneration for such
435	corporation within this state, whether or not such services are
436	continuous.
437	1. Any officer of a corporation may elect to be exempt
438	from this chapter by filing written notice of the election with
439	the department as provided in s. 440.05.
440	2. As to officers of a corporation who are actively
441	engaged in the construction industry, no more than three
442	officers of a corporation or of any group of affiliated
443	corporationsmay elect to be exempt from this chapter by filing
444	written notice of the election with the department as provided
445	in s. 440.05. Officers must be shareholders, each owning at
446	least 10 percent of the stock of such corporation and listed as
447	an officer of such corporation with the Division of Corporations
448	of the Department of State, in order to elect exemptions under
449	this chapter. For purposes of this subparagraph, the term
450	"affiliated" means and includes one or more corporations or
451	entities, any one of which is a corporation engaged in the
452	construction industry, under the same or substantially the same
453	control of a group of business entities which are connected or
454	associated so that one entity controls or has the power to
455	control each of the other business entities. The term
456	"affiliated" includes, but is not limited to, the officers,
457	directors, executives, shareholders active in management,
458	employees, and agents of the affiliated corporation. The
459	ownership by one business entity of a controlling interest in
460	another business entity or a pooling of equipment or income
461	among business entities shall be prima facie evidence that one
462	business is affiliated with the other.
463	3. An officer of a corporation who elects to be exempt
464	from this chapter by filing a written notice of the election
465	with the department as provided in s. 440.05 is not an employee.
466
467	Services are presumed to have been rendered to the corporation
468	if the officer is compensated by other than dividends upon
469	shares of stock of the corporation which the officer owns.
470	(c) "Employee" includes:
471	1. A sole proprietor or a partner who is not engaged in
472	the construction industry,devotes full time to the
473	proprietorship or partnership, and, except as provided in this
474	paragraph,elects to be included in the definition of employee
475	by filing notice thereof as provided in s. 440.05. Partners or
476	sole proprietors actively engaged in the construction industry
477	are considered employees unless they elect to be excluded from
478	the definition of employee by filing written notice of the
479	election with the department as provided in s. 440.05. However,
480	no more than three partners in a partnership that is actively
481	engaged in the construction industry may elect to be excluded. A
482	sole proprietor or partner who is actively engaged in the
483	construction industry and who elects to be exempt from this
484	chapter by filing a written notice of the election with the
485	department as provided in s. 440.05 is not an employee. For
486	purposes of this chapter, an independent contractor is an
487	employee unless he or she meets all of the conditions set forth
488	in subparagraph (d)1.
489	2. All persons who are being paid by a construction
490	contractor as a subcontractor, unless the subcontractor has
491	validly elected an exemption as permitted by this chapter, or
492	has otherwise secured the payment of compensation coverage as a
493	subcontractor, consistent with s. 440.10, for work performed by
494	or as a subcontractor.
495	3. An independent contractor working or performing
496	services in the construction industry.
497	4. A sole proprietor who engages in the construction
498	industry and a partner or partnership that is engaged in the
499	construction industry.
500	(d) "Employee" does not include:
501	1. An independent contractor who is not engaged in the
502	construction industry., if:
503	a. In order to meet the definition of independent
504	contractor, at least four of the following criteria must be met:
505	(I) The independent contractor maintains a separate
506	business with his or her own work facility, truck, equipment,
507	materials, or similar accommodations;
508	(II) The independent contractor holds or has applied for a
509	federal employer identification number, unless the independent
510	contractor is a sole proprietor who is not required to obtain a
511	federal employer identification number under state or federal
512	regulations;
513	(III) The independent contractor receives compensation for
514	services rendered or work performed and such compensation is
515	paid to a business rather than to an individual;
516	(IV) The independent contractor holds one or more bank
517	accounts in the name of the business entity for purposes of
518	paying business expenses or other expenses related to services
519	rendered or work performed for compensation;
520	(V) The independent contractor performs work or is able to
521	perform work for any entity in addition to or besides the
522	employer at his or her own election without the necessity of
523	completing an employment application or process; or
524	(VI) The independent contractor receives compensation for
525	work or services rendered on a competitive-bid basis or
526	completion of a task or a set of tasks as defined by a
527	contractual agreement, unless such contractual agreement
528	expressly states that an employment relationship exists.The
529	independent contractor maintains a separate business with his or
530	her own work facility, truck, equipment, materials, or similar
531	accommodations;
532	b. If four of the criteria listed in sub-subparagraph a.
533	do not exist, an individual may still be presumed to be an
534	independent contractor and not an employee based on full
535	consideration of the nature of the individual situation with
536	regard to satisfying any of the following conditions:
537	(I) The independent contractor performs or agrees to
538	perform specific services or work for a specific amount of money
539	and controls the means of performing the services or work.
540	(II) The independent contractor incurs the principal
541	expenses related to the service or work that he or she performs
542	or agrees to perform.
543	(III) The independent contractor is responsible for the
544	satisfactory completion of the work or services that he or she
545	performs or agrees to perform.
546	(IV) The independent contractor receives compensation for
547	work or services performed for a commission or on a per-job
548	basis and not on any other basis.
549	(V) The independent contractor may realize a profit or
550	suffer a loss in connection with performing work or services.
551	(VI) The independent contractor has continuing or
552	recurring business liabilities or obligations.
553	(VII) The success or failure of the independent
554	contractor's business depends on the relationship of business
555	receipts to expenditures.The independent contractor holds or
556	has applied for a federal employer identification number, unless
557	the independent contractor is a sole proprietor who is not
558	required to obtain a federal employer identification number
559	under state or federal requirements;
560	c. Notwithstanding anything to the contrary in this
561	subparagraph, an individual claiming to be an independent
562	contractor has the burden of proving that he or she is an
563	independent contractor for purposes of this chapter.The
564	independent contractor performs or agrees to perform specific
565	services or work for specific amounts of money and controls the
566	means of performing the services or work;
567	d. The independent contractor incurs the principal
568	expenses related to the service or work that he or she performs
569	or agrees to perform;
570	e. The independent contractor is responsible for the
571	satisfactory completion of work or services that he or she
572	performs or agrees to perform and is or could be held liable for
573	a failure to complete the work or services;
574	f. The independent contractor receives compensation for
575	work or services performed for a commission or on a per-job or
576	competitive-bid basis and not on any other basis;
577	g. The independent contractor may realize a profit or
578	suffer a loss in connection with performing work or services;
579	h. The independent contractor has continuing or recurring
580	business liabilities or obligations; and
581	i. The success or failure of the independent contractor's
582	business depends on the relationship of business receipts to
583	expenditures.
584
585	However, the determination as to whether an individual included
586	in the Standard Industrial Classification Manual of 1987,
587	Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762, 0781, 0782,
588	0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436, 2448, or 2449,
589	or a newspaper delivery person, is an independent contractor is
590	governed not by the criteria in this paragraph but by common-law
591	principles, giving due consideration to the business activity of
592	the individual.
593	2. A real estate salesperson or agent, if that person
594	agrees, in writing, to perform for remuneration solely by way of
595	commission.
596	3. Bands, orchestras, and musical and theatrical
597	performers, including disk jockeys, performing in licensed
598	premises as defined in chapter 562, if a written contract
599	evidencing an independent contractor relationship is entered
600	into before the commencement of such entertainment.
601	4. An owner-operator of a motor vehicle who transports
602	property under a written contract with a motor carrier which
603	evidences a relationship by which the owner-operator assumes the
604	responsibility of an employer for the performance of the
605	contract, if the owner-operator is required to furnish the
606	necessary motor vehicle equipment and all costs incidental to
607	the performance of the contract, including, but not limited to,
608	fuel, taxes, licenses, repairs, and hired help; and the owner-
609	operator is paid a commission for transportation service and is
610	not paid by the hour or on some other time-measured basis.
611	5. A person whose employment is both casual and not in the
612	course of the trade, business, profession, or occupation of the
613	employer.
614	6. A volunteer, except a volunteer worker for the state or
615	a county, municipality, or other governmental entity. A person
616	who does not receive monetary remuneration for services is
617	presumed to be a volunteer unless there is substantial evidence
618	that a valuable consideration was intended by both employer and
619	employee. For purposes of this chapter, the term "volunteer"
620	includes, but is not limited to:
621	a. Persons who serve in private nonprofit agencies and who
622	receive no compensation other than expenses in an amount less
623	than or equivalent to the standard mileage and per diem expenses
624	provided to salaried employees in the same agency or, if such
625	agency does not have salaried employees who receive mileage and
626	per diem, then such volunteers who receive no compensation other
627	than expenses in an amount less than or equivalent to the
628	customary mileage and per diem paid to salaried workers in the
629	community as determined by the department; and
630	b. Volunteers participating in federal programs
631	established under Pub. L. No. 93-113.
632	7. Unless otherwise prohibited by this chapter,any
633	officer of a corporation who elects to be exempt from this
634	chapter. Such officer is not an employee for any reason under
635	this chapter until the notice of revocation of election filed
636	pursuant to s. 440.05 is effective.
637	8. Ana sole proprietor or officer of a corporation who
638	actively engages in the construction industry, and a partner in
639	a partnership that is activelyengaged in the construction
640	industry,who elects to be exempt from the provisions of this
641	chapter, as otherwise permitted by this chapter. Such sole
642	proprietor, officer, or partneris not an employee for any
643	reason until the notice of revocation of election filed pursuant
644	to s. 440.05 is effective.
645	9. An exercise rider who does not work for a single horse
646	farm or breeder, and who is compensated for riding on a case-by-
647	case basis, provided a written contract is entered into prior to
648	the commencement of such activity which evidences that an
649	employee/employer relationship does not exist.
650	10. A taxicab, limousine, or other passenger vehicle-for-
651	hire driver who operates said vehicles pursuant to a written
652	agreement with a company which provides any dispatch, marketing,
653	insurance, communications, or other services under which the
654	driver and any fees or charges paid by the driver to the company
655	for such services are not conditioned upon, or expressed as a
656	proportion of, fare revenues.
657	11. A person who performs services as a sports official
658	for an entity sponsoring an interscholastic sports event or for
659	a public entity or private, nonprofit organization that sponsors
660	an amateur sports event. For purposes of this subparagraph, such
661	a person is an independent contractor. For purposes of this
662	subparagraph, the term "sports official" means any person who is
663	a neutral participant in a sports event, including, but not
664	limited to, umpires, referees, judges, linespersons,
665	scorekeepers, or timekeepers. This subparagraph does not apply
666	to any person employed by a district school board who serves as
667	a sports official as required by the employing school board or
668	who serves as a sports official as part of his or her
669	responsibilities during normal school hours.
670	12. Medicaid-enrolled clients under chapter 393 who are
671	excluded from the definition of employment under s.
672	443.036(21)(d)5. and served by Adult Day Training Services under
673	the Home and Community-Based Medicaid Waiver program in a
674	sheltered workshop setting licensed by the United States
675	Department of Labor for the purpose of training and earning less
676	than the federal hourly minimum wage.
677	(16)(a)"Employer" means the state and all political
678	subdivisions thereof, all public and quasi-public corporations
679	therein, every person carrying on any employment, and the legal
680	representative of a deceased person or the receiver or trustees
681	of any person. "Employer" also includes employment agencies,
682	employee leasing companies, and similar agents who provide
683	employees to other persons.If the employer is a corporation,
684	parties in actual control of the corporation, including, but not
685	limited to, the president, officers who exercise broad corporate
686	powers, directors, and all shareholders who directly or
687	indirectly own a controlling interest in the corporation, are
688	considered the employer for the purposes of ss. 440.105,and
689	440.106, and 440.107.
690	(b) A homeowner shall not be considered the employer of
691	persons hired by the homeowner to carry out construction on the
692	homeowner's own premises if those premises are not intended for
693	immediate lease, sale, or resale.
694	(c) Facilities serving individuals under subparagraph
695	(15)(d)12. shall be considered agents of the Agency for Health
696	Care Administration as it relates to providing Adult Day
697	Training Services under the Home and Community-Based Medicaid
698	Waiver program and not employers or third parties for the
699	purpose of limiting or denying Medicaid benefits.
700	Section 3. Effective January 1, 2004, subsections (3),
701	(4), (6), (10), (11), and (12) of section 440.05, Florida
702	Statutes, are amended, present subsection (13) is renumbered as
703	subsection (11) and amended, and new subsections (12), (13),
704	(14), and (15) are added to said section, to read:
705	440.05 Election of exemption; revocation of election;
706	notice; certification.--
707	(3) Each sole proprietor, partner, orofficer of a
708	corporation who is activelyengaged in the construction industry
709	and who elects an exemption from this chapter or who, after
710	electing such exemption, revokes that exemption, must mail a
711	written notice to such effect to the department on a form
712	prescribed by the department. The notice of election to be
713	exempt from the provisions of this chapter must be notarized and
714	under oath. The notice of election to be exempt which is
715	submitted to the department by the sole proprietor, partner, or
716	officer of a corporation who is allowed to claim an exemption as
717	provided by this chaptermust list the name, federal tax
718	identification number, social security number, all certified or
719	registered licenses issued pursuant to chapter 489 held by the
720	person seeking the exemption, a copy of relevant documentation
721	as to employment status filed with the Internal Revenue Service
722	as specified by the department, a copy of the relevant
723	occupational license in the primary jurisdiction of the
724	business, and, for corporate officers and partners,the
725	registration number of the corporation or partnershipfiled with
726	the Division of Corporations of the Department of State along
727	with a copy of the stock certificate evidencing the required
728	ownership under this chapter. The notice of election to be
729	exempt must identify each sole proprietorship, partnership, or
730	corporation that employs the person electing the exemption and
731	must list the social security number or federal tax
732	identification number of each such employer and the additional
733	documentation required by this section. In addition, the notice
734	of election to be exempt must provide that the sole proprietor,
735	partner, orofficer electing an exemption is not entitled to
736	benefits under this chapter, must provide that the election does
737	not exceed exemption limits for officers and partnerships
738	provided in s. 440.02, and must certify that any employees of
739	the corporation whosesole proprietor, partner, or officer
740	electselectingan exemption are covered by workers'
741	compensation insurance. Upon receipt of the notice of the
742	election to be exempt, receipt of all application fees, and a
743	determination by the department that the notice meets the
744	requirements of this subsection, the department shall issue a
745	certification of the election to the sole proprietor, partner,
746	orofficer, unless the department determines that the
747	information contained in the notice is invalid. The department
748	shall revoke a certificate of election to be exempt from
749	coverage upon a determination by the department that the person
750	does not meet the requirements for exemption or that the
751	information contained in the notice of election to be exempt is
752	invalid. The certificate of election must list the namenamesof
753	the sole proprietorship, partnership, orcorporation listed in
754	the request for exemption. A new certificate of election must be
755	obtained each time the person is employed by a new sole
756	proprietorship, partnership, or differentcorporation that is
757	not listed on the certificate of election. A copy of the
758	certificate of election must be sent to each workers'
759	compensation carrier identified in the request for exemption.
760	Upon filing a notice of revocation of election, ana sole
761	proprietor, partner, or officer who is a subcontractor or an
762	officer of a corporate subcontractormust notify her or his
763	contractor. Upon revocation of a certificate of election of
764	exemption by the department, the department shall notify the
765	workers' compensation carriers identified in the request for
766	exemption.
767	(4) The notice of election to be exempt from the
768	provisions of this chapter must contain a notice that clearly
769	states in substance the following: "Any person who, knowingly
770	and with intent to injure, defraud, or deceive the department or
771	any employer or employee, insurance company, or any other person
772	purposes program, files a notice of election to be exempt
773	containing any false or misleading information is guilty of a
774	felony of the third degree." Each person filing a notice of
775	election to be exempt shall personally sign the notice and
776	attest that he or she has reviewed, understands, and
777	acknowledges the foregoing notice.
778	(6) A construction industry certificate of election to be
779	exempt which is issued in accordance with this section shall be
780	valid for 2 years after the effective date stated thereon. Both
781	the effective date and the expiration date must be listed on the
782	face of the certificate by the department. The construction
783	industry certificate must expire at midnight, 2 years from its
784	issue date, as noted on the face of the exemption certificate.
785	Any person who has received from the division a construction
786	industry certificate of election to be exempt which is in effect
787	on December 31, 1998, shall file a new notice of election to be
788	exempt by the last day in his or her birth month following
789	December 1, 1998. A construction industry certificate of
790	election to be exempt may be revoked before its expiration by
791	the sole proprietor, partner, orofficer for whom it was issued
792	or by the department for the reasons stated in this section. At
793	least 60 days prior to the expiration date of a construction
794	industry certificate of exemption issued after December 1, 1998,
795	the department shall send notice of the expiration date and an
796	application for renewal to the certificateholder at the address
797	on the certificate.
798	(10) Each sole proprietor, partner, orofficer of a
799	corporation who is actively engaged in the construction industry
800	and who elects an exemption from this chapter shall maintain
801	business records as specified by the division by rule, which
802	rules must include the provision that any corporation with
803	exempt officers and any partnership activelyengaged in the
804	construction industry with exempt partnersmust maintain written
805	statements of those exempted persons affirmatively acknowledging
806	each such individual's exempt status.
807	(11) Any sole proprietor or partner actively engaged in
808	the construction industry claiming an exemption under this
809	section shall maintain a copy of his or her federal income tax
810	records for each of the immediately previous 3 years in which he
811	or she claims an exemption. Such federal income tax records must
812	include a complete copy of the following for each year in which
813	an exemption is claimed:
814	(a) For sole proprietors, a copy of Federal Income Tax
815	Form 1040 and its accompanying Schedule C;
816	(b) For partners, a copy of the partner's Federal Income
817	Tax Schedule K-1 (Form 1065) and Federal Income Tax Form 1040
818	and its accompanying Schedule E.
819
820	A sole proprietor or partner shall produce, upon request by the
821	division, a copy of those documents together with a statement by
822	the sole proprietor or partner that the tax records provided are
823	true and accurate copies of what the sole proprietor or partner
824	has filed with the federal Internal Revenue Service. The
825	statement must be signed under oath by the sole proprietor or
826	partner and must be notarized. The division shall issue a stop-
827	work order under s. 440.107(5) to any sole proprietor or partner
828	who fails or refuses to produce a copy of the tax records and
829	affidavit required under this paragraph to the division within 3
830	business days after the request is made.
831	(12) For those sole proprietors or partners that have not
832	been in business long enough to provide the information required
833	of an established business, the division shall require such sole
834	proprietor or partner to provide copies of the most recently
835	filed Federal Income Tax Form 1040. The division shall establish
836	by rule such other criteria to show that the sole proprietor or
837	partner intends to engage in a legitimate enterprise within the
838	construction industry and is not otherwiseattempting to evade
839	the requirements of this section. The division shall establish
840	by rule the form and format of financial information required to
841	be submitted by such employers.
842	(11)(13) Any corporate officer permitted by this chapter
843	to claimclaiming an exemption under this sectionmust be listed
844	on the records of this state's Secretary of State, Division of
845	Corporations, as a corporate officer. If the person who claims
846	an exemption as a corporate officer is not so listed on the
847	records of the Secretary of State, the individual must provide
848	to the division, upon request by the division, a notarized
849	affidavit stating that the individual is a bona fide officer of
850	the corporation and stating the date his or her appointment or
851	election as a corporate officer became or will become effective.
852	The statement must be signed under oath by both the officer and
853	the president or chief operating officer of the corporation and
854	must be notarized.The division shall issue a stop-work order
855	under s. 440.107(1) to any corporation who employs a person who
856	claims to be exempt as a corporate officer but who fails or
857	refuses to produce the documents required under this subsection
858	to the division within 3 business days after the request is
859	made.
860	(12) Certificates of election to be exempt issued under
861	subsection (3) shall apply only to the corporate officer named
862	on the notice of election to be exempt and apply only within the
863	scope of the business or trade listed on the notice of election
864	to be exempt.
865	(13) Notices of election to be exempt and certificates of
866	election to be exempt shall be subject to revocation if, at any
867	time after the filing of the notice or the issuance of the
868	certificate, the person named on the notice or certificate no
869	longer meets the requirements of this section for issuance of a
870	certificate. The department shall revoke a certificate at any
871	time for failure of the person named on the certificate to meet
872	the requirements of this section.
873	(14) An officer of a corporation who elects exemption from
874	this chapter by filing a certificate of election under this
875	section may not recover benefits or compensation under this
876	chapter. For purposes of determining the appropriate premium for
877	workers' compensation coverage, carriers may not consider any
878	officer of a corporation who validly meets the requirements of
879	this section to be an employee.
880	(15) Any corporate officer who is an affiliated person
881	of a person who is delinquent in paying a stop-work order and
882	penalty assessment order issued pursuant to s. 440.107, or owed
883	pursuant to a court order, is ineligible for an election of
884	exemption. The stop-work order and penalty assessment shall be
885	in effect against any such affiliated person. As used in this
886	subsection, the term "affiliated person" means:
887	(a) The spouse of such other person;
888	(b) Any person who directly or indirectly owns or
889	controls, or holds with the power to vote, 10 percent or more of
890	the outstanding voting securities of such other person;
891	(c) Any person who directly or indirectly owns 10 percent
892	or more of the outstanding voting securities that are directly
893	or indirectly owned, controlled, or held with the power to vote
894	by such other person;
895	(d) Any person or group of persons who directly or
896	indirectly control, are controlled by, or are under common
897	control with such other person;
898	(e) Any person who directly or indirectly acquires all or
899	substantially all of the other assets of such other person;
900	(f) Any officer, director, trustee, partner, owner,
901	manager, joint venturer, or employee of such other person or a
902	person performing duties similar to persons in such positions;
903	or
904	(g) Any person who has an officer, director, trustee,
905	partner, or joint venturer in common with such person.
906	Section 4. Section 440.06, Florida Statutes, is amended to
907	read:
908	440.06 Failure to secure compensation; effect.--Every
909	employer who fails to secure the payment of compensation, as
910	provided in s. 440.10, by failing to meet the requirements of
911	under this chapter as provided ins. 440.38 may not, in any suit
912	brought against him or her by an employee subject to this
913	chapter to recover damages for injury or death, defend such a
914	suit on the grounds that the injury was caused by the negligence
915	of a fellow servant, that the employee assumed the risk of his
916	or her employment, or that the injury was due to the comparative
917	negligence of the employee.
918	Section 5. Effective January 1, 2004, section 440.077,
919	Florida Statutes, is amended to read:
920	440.077 When a corporatesole proprietor, partner, or
921	officer rejects chapter, effect.--AnA sole proprietor, partner,
922	or officer of a corporation who is permitted to elect an
923	exemption under this chapteractively engaged in the
924	construction industryand who elects to be exempt from the
925	provisions of this chapter may not recover benefits under this
926	chapter.
927	Section 6. Subsections (1) and (4) of section 440.09,
928	Florida Statutes, are amended and paragraph (e) is added to
929	subsection (7) of said section, to read:
930	440.09 Coverage.--
931	(1) The employer mustshallpay compensation or furnish
932	benefits required by this chapter if the employee suffers an
933	accidental compensableinjury or death arising out of work
934	performed in the course and the scope of employment. The injury,
935	its occupational cause, and any resulting manifestations or
936	disability mustshallbe established to a reasonable degree of
937	medical certainty, based onand by objective relevantmedical
938	findings, and the accidental compensable injury must be the
939	major contributing cause of any resulting injuries. For purposes
940	of this section, "major contributing cause" means the cause
941	which is more than 50 percent responsible for the injury as
942	compared to all other causes combined for which treatment or
943	benefits are sought. In cases involving occupational disease or
944	repetitive exposure, both causation and sufficient exposure to
945	support causation must be proven by clear and convincing
946	evidence. Pain or other subjective complaints alone, in the
947	absence of objective relevant medical findings, are not
948	compensable. For purposes of this section, "objective relevant
949	medical findings" are those objective findings that correlate to
950	the subjective complaints of the injured employee and are
951	confirmed by physical examination findings or diagnostic
952	testing. Establishment of the causal relationship between a
953	compensable accident and injuries for conditions that are not
954	readily observable must be by medical evidence only, as
955	demonstrated by physical examination findings or diagnostic
956	testing. Major contributing cause must be demonstrated by
957	medical evidence only. Mental or nervous injuries occurring as a
958	manifestation of an injury compensable under this section shall
959	be demonstrated by clear and convincing evidence.
960	(a) This chapter does not require any compensation or
961	benefits for any subsequent injury the employee suffers as a
962	result of an original injury arising out of and in the course of
963	employment unless the original injury is the major contributing
964	cause of the subsequent injury. Major contributing cause must be
965	demonstrated by medical evidence only.
966	(b) If an injury arising out of and in the course of
967	employment combines with a preexisting disease or condition to
968	cause or prolong disability or need for treatment, the employer
969	must pay compensation or benefits required by this chapter only
970	to the extent that the injury arising out of and in the course
971	of employment is and remains more than 50 percent responsible
972	for the injury as compared to all other causes combined and
973	thereafter remainsthe major contributing cause of the
974	disability or need for treatment. Major contributing cause must
975	be demonstrated by medical evidence only.
976	(c) Death resulting from an operation by a surgeon
977	furnished by the employer for the cure of hernia as required in
978	s. %_%0%_%[F.S. 1981]shall for the purpose of this chapter be
979	considered to be a death resulting from the accident causing the
980	hernia.
981	(d) If an accident happens while the employee is employed
982	elsewhere than in this state, which would entitle the employee
983	or his or her dependents to compensation if it had happened in
984	this state, the employee or his or her dependents are entitled
985	to compensation if the contract of employment was made in this
986	state, or the employment was principally localized in this
987	state. However, if an employee receives compensation or damages
988	under the laws of any other state, the total compensation for
989	the injury may not be greater than is provided in this chapter.
990	(4)(a)An employee shall not be entitled to compensation
991	or benefits under this chapter if any judge of compensation
992	claims, administrative law judge, court, or jury convened in
993	this state determines that the employee has knowingly or
994	intentionally engaged in any of the acts described in s. 440.105
995	or any criminal actfor the purpose of securing workers'
996	compensation benefits. For purposes of this section, the term
997	"intentional" shall include, but is not limited to, pleas of
998	guilty or nolo contendere in criminal matters. This section
999	shall apply to accidents, regardless of the date of the
1000	accident. For injuries occurring prior to January 1, 1994, this
1001	section shall pertain to the acts of the employee described in
1002	s. 440.105 or criminal activities occurring subsequent to
1003	January 1, 1994.
1004	(b) A judge of compensation claims, administrative law
1005	judge, or court of this state shall take judicial notice of a
1006	finding of insurance fraud by a court of competent jurisdiction
1007	and terminate or otherwise disallow benefits.
1008	(c) Upon the denial of benefits in accordance with this
1009	section, a judge of compensation claims shall have the
1010	jurisdiction to order any benefits payable to the employee to be
1011	paid into the court registry or an escrow account during the
1012	pendency of an appeal or until such time as the time in which to
1013	file an appeal has expired.
1014	(7)
1015	(e) As a part of rebutting any presumptions under
1016	paragraph (b), the injured worker must prove the actual
1017	quantitative amounts of the drug or its metabolites as measured
1018	on the initial and confirmation post-accident drug tests of the
1019	injured worker's urine sample and provide additional evidence
1020	regarding the absence of drug influence other than the worker's
1021	denial of being under the influence of a drug. No drug test
1022	conducted on a urine sample shall be rejected as to its results
1023	or the presumption imposed under paragraph (b) on the basis of
1024	the urine being bodily fluid tested.
1025	Section 7. Section 440.093, Florida Statutes, is created
1026	to read:
1027	440.093 Mental and nervous injuries.--
1028	(1) A mental or nervous injury due to stress, fright, or
1029	excitement only is not an injury by accident arising out of the
1030	employment. Nothing in this section shall be construed to allow
1031	for the payment of benefits under this chapter for mental or
1032	nervous injuries without an accompanying physical injury
1033	requiring medical treatment. A physical injury resulting from
1034	mental or nervous injuries unaccompanied by physical trauma
1035	requiring medical treatment shall not be compensable under this
1036	chapter.
1037	(2) Mental or nervous injuries occurring as a
1038	manifestation of an injury compensable under this chapter shall
1039	be demonstrated by clear and convincing medical evidence by a
1040	licensed psychiatrist meeting criteria established in the most
1041	recent edition of the diagnostic and statistical manual of
1042	mental disorders published by the American Psychiatric
1043	Association. The compensable physical injury must be and remain
1044	the major contributing cause of the mental or nervous condition
1045	and the compensable physical injury as determined by reasonable
1046	medical certainty must be at least 50 percent responsible for
1047	the mental or nervous condition as compared to all other
1048	contributing causes combined. Compensation is not payable for
1049	the mental, psychological, or emotional injury arising out of
1050	depression from being out of work or losing employment
1051	opportunities, resulting from a preexisting mental,
1052	psychological, or emotional condition or due to pain or other
1053	subjective complaints that cannot be substantiated by objective,
1054	relevant medical findings.
1055	(3) Subject to the payment of permanent benefits under s.
1056	440.15, in no event shall temporary benefits for a compensable
1057	mental or nervous injury be paid for more than 6 months after
1058	the date of maximum medical improvement for the injured
1059	employee's physical injury or injuries, which shall be included
1060	in the period of 104 weeks as provided in s. 440.15(2) and (4).
1061	Mental or nervous injuries are compensable only in accordance
1062	with the terms of this section.
1063	Section 8. Effective January 1, 2004, subsection (1) of
1064	section 440.10, Florida Statutes, is amended to read:
1065	440.10 Liability for compensation.--
1066	(1)(a) Every employer coming within the provisions of this
1067	chapter, including any brought within the chapter by waiver of
1068	exclusion or of exemption,shall be liable for, and shall
1069	secure, the payment to his or her employees, or any physician,
1070	surgeon, or pharmacist providing services under the provisions
1071	of s. 440.13, of the compensation payable under ss. 440.13,
1072	440.15, and 440.16. Any contractor or subcontractor who engages
1073	in any public or private construction in the state shall secure
1074	and maintain compensation for his or her employees under this
1075	chapter as provided in s. 440.38.
1076	(b) In case a contractor sublets any part or parts of his
1077	or her contract work to a subcontractor or subcontractors, all
1078	of the employees of such contractor and subcontractor or
1079	subcontractors engaged on such contract work shall be deemed to
1080	be employed in one and the same business or establishment,;and
1081	the contractor shall be liable for, and shall secure, the
1082	payment of compensation to all such employees, except to
1083	employees of a subcontractor who has secured such payment.
1084	(c) A contractor shallmayrequire a subcontractor to
1085	provide evidence of workers' compensation insurance or a copy of
1086	his or her certificate of election. A subcontractor who is a
1087	corporation and has an officer who electselectingto be exempt
1088	as permitted under this chaptera sole proprietor, partner, or
1089	officer of a corporationshall provide a copy of his or her
1090	certificate of exemptionelectionto the contractor.
1091	(d)1. If a contractor becomes liable for the payment of
1092	compensation to the employees of a subcontractor who has failed
1093	to secure such payment in violation of s. 440.38, the contractor
1094	or other third-party payor shall be entitled to recover from the
1095	subcontractor all benefits paid or payable plus interest unless
1096	the contractor and subcontractor have agreed in writing that the
1097	contractor will provide coverage.
1098	2. If a contractor or third-party payor becomes liable for
1099	the payment of compensation to the corporate officeremployeeof
1100	a subcontractor who is activelyengaged in the construction
1101	industry and has elected to be exempt from the provisions of
1102	this chapter, but whose election is invalid, the contractor or
1103	third-party payor may recover from the claimant, partnership,or
1104	corporation all benefits paid or payable plus interest, unless
1105	the contractor and the subcontractor have agreed in writing that
1106	the contractor will provide coverage.
1107	(e) A subcontractor providing services in conjunction with
1108	a contractor on the same project or contract workis not liable
1109	for the payment of compensation to the employees of another
1110	subcontractor or the contractor on such contract work and is not
1111	protected by the exclusiveness-of-liability provisions of s.
1112	440.11 from anyaction at law or in admiralty on account of
1113	injury to anof such employee of another subcontractor, or of
1114	the contractor, provided that:
1115	1. The subcontractor has secured workers' compensation
1116	insurance for its employees or the contractor has secured such
1117	insurance on behalf of the subcontractor and its employees in
1118	accordance with paragraph (b); and
1119	2. The subcontractor's own gross negligence was not the
1120	major contributing cause of the injury.
1121	(f) If an employer fails to secure compensation as
1122	required by this chapter, the department shallmayassess
1123	against the employer a penalty not to exceed $5,000 for each
1124	employee of that employer who is classified by the employer as
1125	an independent contractor but who is found by the department to
1126	not meet the criteria for an independent contractor that are set
1127	forth in s. 440.02. The division shall adopt rules to administer
1128	the provisions of this paragraph.
1129	(g) Subject to s. 440.38, any employer who has employees
1130	engaged in work in this state shall obtain a Florida policy or
1131	endorsement for such employees which utilizes Florida class
1132	codes, rates, rules, and manuals that are in compliance with and
1133	approved under the provisions of this chapter and the Florida
1134	Insurance Code. Failure to comply with this paragraph is a
1135	felony of the second degree, punishable as provided in s.
1136	775.082, s. 775.083, or s. 775.084. The department shall adopt
1137	rules for construction industry and nonconstruction-industry
1138	employers with regard to the activities that define what
1139	constitutes being "engaged in work" in this state, using the
1140	following standards:
1141	1. For employees of nonconstruction-industry employers who
1142	have their headquarters outside of Florida and also operate in
1143	Florida and who are routinely crossing state lines, but usually
1144	return to their homes each night, the employee shall be assigned
1145	to the headquarters' state. However, the construction industry
1146	employees performing new construction or alterations in Florida
1147	shall be assigned to Florida even if the employees return to
1148	their home state each night.
1149	2. The payroll of executive supervisors who may visit a
1150	Florida location but who are not in direct charge of a Florida
1151	location shall be assigned to the state in which the
1152	headquarters is located.
1153	3. For construction contractors who maintain a permanent
1154	staff of employees and superintendents, if any of these
1155	employees or superintendents are assigned to a job that is
1156	located in Florida, either for the duration of the job or any
1157	portion thereof, their payroll shall be assigned to Florida
1158	rather than headquarters' state.
1159	4. Employees who are hired for a specific project in
1160	Florida shall be assigned to Florida.For purposes of this
1161	section, a person is conclusively presumed to be an independent
1162	contractor if:
1163	1. The independent contractor provides the general
1164	contractor with an affidavit stating that he or she meets all
1165	the requirements of s. 440.02; and
1166	2. The independent contractor provides the general
1167	contractor with a valid certificate of workers' compensation
1168	insurance or a valid certificate of exemption issued by the
1169	department.
1170
1171	A sole proprietor, partner, or officer of a corporation who
1172	elects exemption from this chapter by filing a certificate of
1173	election under s. 440.05 may not recover benefits or
1174	compensation under this chapter. An independent contractor who
1175	provides the general contractor with both an affidavit stating
1176	that he or she meets the requirements of s. 440.02 and a
1177	certificate of exemption is not an employee under s. 440.02 and
1178	may not recover benefits under this chapter. For purposes of
1179	determining the appropriate premium for workers' compensation
1180	coverage, carriers may not consider any person who meets the
1181	requirements of this paragraph to be an employee.
1182	Section 9. Section 440.1025, Florida Statutes, is amended
1183	to read:
1184	440.1025 Consideration of publicEmployer workplace safety
1185	program in rate-setting; program requirements; rulemaking.—
1186	(1) For a public or privateemployer to be eligible for
1187	receipt of specific identifiable consideration under s. 627.0915
1188	for a workplace safety program in the setting of rates, the
1189	publicemployer must have a workplace safety program. At a
1190	minimum, the program must include a written safety policy and
1191	safety rules, and make provision for safety inspections,
1192	preventative maintenance, safety training, first-aid, accident
1193	investigation, and necessary recordkeeping. For purposes of this
1194	section, "public employer" means any agency within state,
1195	county, or municipal government employing individuals for
1196	salary, wages, or other remuneration. The division may adopt
1197	promulgate rules for insurers to utilize in determining public
1198	employer compliance with the requirements of this section.
1199	(2) The division shall publicize on the Internet, and
1200	shall encourage insurers to publicize, the availability of free
1201	safety consultation services and safety program resources.
1202	Section 10. Section 440.103, Florida Statutes, is amended
1203	to read:
1204	440.103 Building permits; identification of minimum
1205	premium policy.--Except as otherwise provided in this chapter,
1206	Every employer shall, as a condition to applying for and
1207	receiving a building permit, show proof and certify to the
1208	permit issuerthat it has secured compensation for its employees
1209	under this chapter as provided in ss. 440.10 and 440.38. Such
1210	proof of compensation must be evidenced by a certificate of
1211	coverage issued by the carrier, a valid exemption certificate
1212	approved by the department or the former Division of Workers'
1213	Compensation of the Department of Labor and Employment Security,
1214	or a copy of the employer's authority to self-insure and shall
1215	be presented each time the employer applies for a building
1216	permit. As provided in s. 627.413(5), each certificate of
1217	coverage must show, on its face, whether or not coverage is
1218	secured under the minimum premium provisions of rules adopted by
1219	rating organizations licensed by the department. The words
1220	"minimum premium policy" or equivalent language shall be typed,
1221	printed, stamped, or legibly handwritten.
1222	Section 11. Section 440.105, Florida Statutes, is amended
1223	to read:
1224	440.105 Prohibited activities; reports; penalties;
1225	limitations.--
1226	(1)(a) Any insurance carrier, any individual self-insured,
1227	any commercial or group self-insurance fund, any professional
1228	practitioner licensed or regulated by the Department of Health
1229	Business and Professional Regulation, except as otherwise
1230	provided by law, any medical review committee as defined in s.
1231	766.101, any private medical review committee, and any insurer,
1232	agent, or other person licensed under the insurance code, or any
1233	employee thereof, having knowledge or who believes that a
1234	fraudulent act or any other act or practice which, upon
1235	conviction, constitutes a felony or misdemeanor under this
1236	chapter is being or has been committed shall send to the
1237	Division of Insurance Fraud, Bureau of Workers' Compensation
1238	Fraud, a report or information pertinent to such knowledge or
1239	belief and such additional information relative thereto as the
1240	bureau may require. The bureau shall review such information or
1241	reports and select such information or reports as, in its
1242	judgment, may require further investigation. It shall then cause
1243	an independent examination of the facts surrounding such
1244	information or report to be made to determine the extent, if
1245	any, to which a fraudulent act or any other act or practice
1246	which, upon conviction, constitutes a felony or a misdemeanor
1247	under this chapter is being committed. The bureau shall report
1248	any alleged violations of law which its investigations disclose
1249	to the appropriate licensing agency and state attorney or other
1250	prosecuting agency having jurisdiction with respect to any such
1251	violations of this chapter. If prosecution by the state attorney
1252	or other prosecuting agency having jurisdiction with respect to
1253	such violation is not begun within 60 days of the bureau's
1254	report, the state attorney or other prosecuting agency having
1255	jurisdiction with respect to such violation shall inform the
1256	bureau of the reasons for the lack of prosecution.
1257	(b) In the absence of fraud or bad faith, a person is not
1258	subject to civil liability for libel, slander, or any other
1259	relevant tort by virtue of filing reports, without malice, or
1260	furnishing other information, without malice, required by this
1261	section or required by the bureau, and no civil cause of action
1262	of any nature shall arise against such person:
1263	1. For any information relating to suspected fraudulent
1264	acts furnished to or received from law enforcement officials,
1265	their agents, or employees;
1266	2. For any information relating to suspected fraudulent
1267	acts furnished to or received from other persons subject to the
1268	provisions of this chapter; or
1269	3. For any such information relating to suspected
1270	fraudulent acts furnished in reports to the bureau, or the
1271	National Association of Insurance Commissioners.
1272	(2) Whoever violates any provision of this subsection
1273	commits a misdemeanor of the firstseconddegree, punishable as
1274	provided in s. 775.082 or s. 775.083.
1275	(a) It shall be unlawful for any employer to knowingly:
1276	1. Coerce or attempt to coerce, as a precondition to
1277	employment or otherwise, an employee to obtain a certificate of
1278	election of exemption pursuant to s. 440.05.
1279	2. Discharge or refuse to hire an employee or job
1280	applicant because the employee or applicant has filed a claim
1281	for benefits under this chapter.
1282	3. Discharge, discipline, or take any other adverse
1283	personnel action against any employee for disclosing information
1284	to the department or any law enforcement agency relating to any
1285	violation or suspected violation of any of the provisions of
1286	this chapter or rules promulgated hereunder.
1287	4. Violate a stop-work order issued by the department
1288	pursuant to s. 440.107.
1289	(b) It shall be unlawful for any insurance entity to
1290	revoke or cancel a workers' compensation insurance policy or
1291	membership because an employer has returned an employee to work
1292	or hired an employee who has filed a workers' compensation
1293	claim.
1294	(3) Whoever violates any provision of this subsection
1295	commits a misdemeanor of the first degree, punishable as
1296	provided in s. 775.082 or s. 775.083.
1297	(a) It shall be unlawful for any employer to knowingly
1298	fail to update applications for coverage as required by s.
1299	440.381(1) and department of Insurance rules within 7 days after
1300	the reporting date for any change in the required information,
1301	or to post notice of coverage pursuant to s. 440.40.
1302	(b) It shall be unlawful for any employer to knowingly
1303	participate in the creation of the employment relationship in
1304	which the employee has used any false, fraudulent, or misleading
1305	oral or written statement as evidence of identity.
1306	(c)(b)It is unlawful for any attorney or other person, in
1307	his or her individual capacity or in his or her capacity as a
1308	public or private employee, or for any firm, corporation,
1309	partnership, or association to receive any fee or other
1310	consideration or any gratuity from a person on account of
1311	services rendered for a person in connection with any
1312	proceedings arising under this chapter, unless such fee,
1313	consideration, or gratuity is approved by a judge of
1314	compensation claims or by the Deputy Chief Judge of Compensation
1315	Claims.
1316	(4) Whoever violates any provision of this subsection
1317	commits insurance fraud, punishable as provided in paragraph
1318	(f).
1319	(a) It shall be unlawful for any employer to knowingly:
1320	1. Present or cause to be presented any false, fraudulent,
1321	or misleading oral or written statement to any person as
1322	evidence of compliance with s. 440.38.
1323	2. Make a deduction from the pay of any employee entitled
1324	to the benefits of this chapter for the purpose of requiring the
1325	employee to pay any portion of premium paid by the employer to a
1326	carrier or to contribute to a benefit fund or department
1327	maintained by such employer for the purpose of providing
1328	compensation or medical services and supplies as required by
1329	this chapter.
1330	3. Fail to secure payment of compensation if required to
1331	do so by this chapter.
1332	(b) It shall be unlawful for any person:
1333	1. To knowingly make, or cause to be made, any false,
1334	fraudulent, or misleading oral or written statement for the
1335	purpose of obtaining or denying any benefit or payment under
1336	this chapter.
1337	2. To present or cause to be presented any written or oral
1338	statement as part of, or in support of, a claim for payment or
1339	other benefit pursuant to any provision of this chapter, knowing
1340	that such statement contains any false, incomplete, or
1341	misleading information concerning any fact or thing material to
1342	such claim.
1343	3. To prepare or cause to be prepared any written or oral
1344	statement that is intended to be presented to any employer,
1345	insurance company, or self-insured program in connection with,
1346	or in support of, any claim for payment or other benefit
1347	pursuant to any provision of this chapter, knowing that such
1348	statement contains any false, incomplete, or misleading
1349	information concerning any fact or thing material to such claim.
1350	4. To knowingly assist, conspire with, or urge any person
1351	to engage in activity prohibited by this section.
1352	5. To knowingly make any false, fraudulent, or misleading
1353	oral or written statement, or to knowingly omit or conceal
1354	material information, required by s. 440.185 or s. 440.381, for
1355	the purpose of obtaining workers' compensation coverage or for
1356	the purpose of avoiding, delaying, or diminishing the amount of
1357	payment of any workers' compensation premiums.
1358	6. To knowingly misrepresent or conceal payroll,
1359	classification of workers, or information regarding an
1360	employer's loss history which would be material to the
1361	computation and application of an experience rating modification
1362	factor for the purpose of avoiding or diminishing the amount of
1363	payment of any workers' compensation premiums.
1364	7. To knowingly present or cause to be presented any
1365	false, fraudulent, or misleading oral or written statement to
1366	any person as evidence of compliance with s. 440.38, as evidence
1367	of eligibility for a certificate of exemption under s. 440.05.
1368	8. To knowingly violate a stop-work order issued by the
1369	department pursuant to s. 440.107.
1370	9. To knowingly present or cause to be presented any
1371	false, fraudulent, or misleading oral or written statement to
1372	any person as evidence of identity for the purpose of obtaining
1373	employment or filing or supporting a claim for workers'
1374	compensation benefits.
1375	(c) It shall be unlawful for any physician licensed under
1376	chapter 458, osteopathic physician licensed under chapter 459,
1377	chiropractic physician licensed under chapter 460, podiatric
1378	physician licensed under chapter 461, optometric physician
1379	licensed under chapter 463, or any other practitioner licensed
1380	under the laws of this state to knowingly and willfully assist,
1381	conspire with, or urge any person to fraudulently violate any of
1382	the provisions of this chapter.
1383	(d) It shall be unlawful for any person or governmental
1384	entity licensed under chapter 395 to maintain or operate a
1385	hospital in such a manner so that such person or governmental
1386	entity knowingly and willfully allows the use of the facilities
1387	of such hospital by any person, in a scheme or conspiracy to
1388	fraudulently violate any of the provisions of this chapter.
1389	(e) It shall be unlawful for any attorney or other person,
1390	in his or her individual capacity or in his or her capacity as a
1391	public or private employee, or any firm, corporation,
1392	partnership, or association, to knowingly assist, conspire with,
1393	or urge any person to fraudulently violate any of the provisions
1394	of this chapter.
1395	(f) If the monetary valueamount of any claim or workers'
1396	compensation insurance premium involved in anyviolation of this
1397	subsection:
1398	1. Is less than $20,000, the offender commits a felony of
1399	the third degree, punishable as provided in s. 775.082, s.
1400	775.083, or s. 775.084.
1401	2. Is $20,000 or more, but less than $100,000, the
1402	offender commits a felony of the second degree, punishable as
1403	provided in s. 775.082,. 775.083, or s. 775.084.
1404	3. Is $100,000 or more, the offender commits a felony of
1405	the first degree, punishable as provided in s. 775.082, s.
1406	775.083, or s. 775.084.
1407	(5) It shall be unlawful for any attorney or other person,
1408	in his or her individual capacity or in his or her capacity as a
1409	public or private employee or for any firm, corporation,
1410	partnership, or association, to unlawfully solicit any business
1411	in and about city or county hospitals, courts, or any public
1412	institution or public place; in and about private hospitals or
1413	sanitariums; in and about any private institution; or upon
1414	private property of any character whatsoever for the purpose of
1415	making workers' compensation claims. Whoever violates any
1416	provision of this subsection commits a felony of the second
1417	thirddegree, punishable as provided in s. 775.082, s. 775.083,
1418	or s. 775.085.
1419	(6) This section shall not be construed to preclude the
1420	applicability of any other provision of criminal law that
1421	applies or may apply to any transaction.
1422	(7) For the purpose of the section, the term "statement"
1423	includes, but is not limited to, any notice, representation,
1424	statement, proof of injury, bill for services, diagnosis,
1425	prescription, hospital or doctor records, X ray, test result, or
1426	other evidence of loss, injury, or expense.
1427	(7)(8)An injured employee or any other party making a
1428	claim under this chapter shall provide his or her personal
1429	signature attesting that he or she has reviewed, understands,
1430	and acknowledgesAll claim forms as provided for in this chapter
1431	shall contain a notice that clearly states in substancethe
1432	following statement: "Any person who, knowingly and with intent
1433	to injure, defraud, or deceive any employer or employee,
1434	insurance company, or self-insured program, files a statement of
1435	claim containing any false or misleading information commits
1436	insurance fraud, punishable as provided in s. 817.234." If the
1437	injured employee or other party refuses to sign the document
1438	attestingEach claimant shall personally sign the claim form and
1439	attestthat he or she has reviewed, understands, and
1440	acknowledges the statement, benefits or payments under this
1441	chapter shall be suspended until such signature is obtained
1442	foregoing notice.
1443	Section 12. Subsection (3) of section 440.1051, Florida
1444	Statutes, is amended to read:
1445	440.1051 Fraud reports; civil immunity; criminal
1446	penalties.--
1447	(2) Any person who reports workers' compensation fraud to
1448	the division under subsection (1) is immune from civil liability
1449	for doing so, and the person or entity alleged to have committed
1450	the fraud may not retaliate against him or her for providing
1451	such report, unless the person making the report knows it to be
1452	false.
1453	(3) A person who calls and, knowingly and falsely, reports
1454	workers' compensation fraud or who, in violation of subsection
1455	(2) retaliates against a person for making such report, commits
1456	is guilty of a felonymisdemeanor of the thirdfirstdegree,
1457	punishable as provided in s. 775.082,or s. 775.083, or s.
1458	775.084both.
1459	Section 13. Section 440.107, Florida Statutes, is amended
1460	to read:
1461	440.107 Department powers to enforce employer compliance
1462	with coverage requirements.--
1463	(1) The Legislature finds that the failure of an employer
1464	to comply with the workers' compensation coverage requirements
1465	under this chapter poses an immediate danger to public health,
1466	safety, and welfare. The Legislature authorizes the department
1467	to secure employer compliance with the workers' compensation
1468	coverage requirements and authorizes the department to conduct
1469	investigations for the purpose of ensuring employer compliance.
1470	(2) For the purposes of this section, "securing the
1471	payment of workers' compensation" means obtaining coverage that
1472	meets the requirements of this chapter and the Florida Insurance
1473	Code. However, if at any time an employer materially understates
1474	or conceals payroll, materially misrepresents or conceals
1475	employee duties so as to avoid proper classification for premium
1476	calculations, or materially misrepresents or conceals
1477	information pertinent to the computation and application of an
1478	experience rating modification factor, such employer shall be
1479	deemed to have failed to secure payment of workers' compensation
1480	and shall be subject to the sanctions set forth in this section.
1481	A stop-work order issued because an employer is deemed to have
1482	failed to secure the payment of workers' compensation required
1483	under this chapter because the employer has materially
1484	understated or concealed payroll, materially misrepresented or
1485	concealed employee duties so as to avoid proper classification
1486	for premium calculations, or materially misrepresented or
1487	concealed information pertinent to the computation and
1488	application of an experience rating modification factor shall
1489	have no effect upon an employer's or carrier's duty to provide
1490	benefits under this chapter or upon any of the employer's or
1491	carrier's rights and defenses under this chapter, including
1492	exclusive remedy.The department and its authorized
1493	representatives may enter and inspect any place of business at
1494	any reasonable time for the limited purpose of investigating
1495	compliance with workers' compensation coverage requirements
1496	under this chapter. Each employer shall keep true and accurate
1497	business records that contain such information as the department
1498	prescribes by rule. The business records must contain
1499	information necessary for the department to determine compliance
1500	with workers' compensation coverage requirements and must be
1501	maintained within this state by the business, in such a manner
1502	as to be accessible within a reasonable time upon request by the
1503	department. The business records must be open to inspection and
1504	be available for copying by the department at any reasonable
1505	time and place and as often as necessary. The department may
1506	require from any employer any sworn or unsworn reports,
1507	pertaining to persons employed by that employer, deemed
1508	necessary for the effective administration of the workers'
1509	compensation coverage requirements.
1510	(3) The department shall enforce workers' compensation
1511	coverage requirements, including the requirement that the
1512	employer secure the payment of workers' compensation, and the
1513	requirement that the employer provide the carrier with
1514	information to accurately determine payroll and correctly assign
1515	classification codes. In addition to any other powers under this
1516	chapter, the department shall have the power to:
1517	(a) Conduct investigations for the purpose of ensuring
1518	employer compliance.
1519	(b) Enter and inspect any place of business at any
1520	reasonable time for the purpose of investigating employer
1521	compliance.
1522	(c) Examine and copy business records.
1523	(d) Administer oaths and affirmations.
1524	(e) Certify to official acts.
1525	(f) Issue and serve subpoenas for attendance of witnesses
1526	or production of business records, books, papers,
1527	correspondence, memoranda, and other records.
1528	(g) Issue stop-work orders, penalty assessment orders, and
1529	any other orders necessary for the administration of this
1530	section.
1531	(h) Enforce the terms of a stop-work order.
1532	(i) Levy and pursue actions to recover penalties.
1533	(j) Seek injunctions and other appropriate relief.In
1534	discharging its duties, the department may administer oaths and
1535	affirmations, certify to official acts, issue subpoenas to
1536	compel the attendance of witnesses and the production of books,
1537	papers, correspondence, memoranda, and other records deemed
1538	necessary by the department as evidence in order to ensure
1539	proper compliance with the coverage provisions of this chapter.
1540	(4) The department shall designate representatives who may
1541	serve subpoenas and other process of the department issued under
1542	this section.
1543	(5) The department shall specify by rule the business
1544	records that employers must maintain and produce to comply with
1545	this section.
1546	(6)(4)If a person has refused to obey a subpoena to
1547	appear before the department or its authorized representative or
1548	andproduce evidence requested by the department or to give
1549	testimony about the matter that is under investigation, a court
1550	has jurisdiction to issue an order requiring compliance with the
1551	subpoena if the court has jurisdiction in the geographical area
1552	where the inquiry is being carried on or in the area where the
1553	person who has refused the subpoena is found, resides, or
1554	transacts business. Failure to obey such a court order may be
1555	punished by the court as contempt, either civilly or criminally.
1556	Costs, including reasonable attorney's fees, incurred by the
1557	department to obtain an order granting, in whole or in part, a
1558	petition to enforce a subpoena or a subpoena duces tecum shall
1559	be taxed against the subpoenaed party.
1560	(7)(a)(5)Whenever the department determines that an
1561	employer who is required to secure the payment to his or her
1562	employees of the compensation provided for by this chapter has
1563	failed to secure the payment of workers' compensation required
1564	by this chapter or to produce the required business records
1565	under subsection (5) within 5 business days after receipt of the
1566	written request of the departmentdo so, such failure shall be
1567	deemed an immediate serious danger to public health, safety, or
1568	welfare sufficient to justify service by the department of a
1569	stop-work order on the employer, requiring the cessation of all
1570	business operations at the place of employment or job site. If
1571	the departmentdivision makes such a determination, the
1572	departmentdivisionshall issue a stop-work order within 72
1573	hours. The order shall take effect when served upon the date of
1574	service upon the employer or, for a particular employer work
1575	site, when served at that work site, unless the employer
1576	provides evidence satisfactory to the department of having
1577	secured any necessary insurance or self-insurance and pays a
1578	civil penalty to the department, to be deposited by the
1579	department into the Workers' Compensation Administration Trust
1580	Fund, in the amount of $100 per day for each day the employer
1581	was not in compliance with this chapter. In addition to serving
1582	a stop-work order at a particular work site which shall be
1583	effective immediately, the department shall immediately proceed
1584	with service upon the employer which shall be effective upon all
1585	employer work sites in the state for which the employer is not
1586	in compliance. A stop-work order may be served with regard to an
1587	employer’s work site by posting a copy of the stop-work order in
1588	a conspicuous location at the work site. The order shall remain
1589	in effect until the department issues an order releasing the
1590	stop-work order upon a finding that the employer has come into
1591	compliance with the coverage requirements of this chapter and
1592	has paid any penalty assessed under this section. The department
1593	may require an employer who is found to have failed to comply
1594	with the coverage requirements of s. 440.38 to file with the
1595	department, as a condition of release from a stop-work order,
1596	periodic reports for a probationary period that shall not exceed
1597	2 years that demonstrate the employer’s continued compliance
1598	with this chapter. The department shall by rule specify the
1599	reports required and the time for filing under this subsection.
1600	(b) Stop-work orders and penalty assessment orders issued
1601	under this section against a corporation, partnership, or sole
1602	proprietorship shall be in effect against any successor
1603	corporation or business entity that has one or more of the same
1604	principals or officers as the corporation or partnership against
1605	which the stop-work order was issued and are engaged in the same
1606	or equivalent trade or activity.
1607	(c) The department shall assess a penalty of $1,000 per
1608	day against an employer for each day that the employer conducts
1609	business operations that are in violation of a stop-work order.
1610	(d)1. In addition to any penalty, stop-work order, or
1611	injunction, the department shall assess against any employer who
1612	has failed to secure the payment of compensation as required by
1613	this chapter a penalty equal to 1.5 times the amount the
1614	employer would have paid in premium when applying approved
1615	manual rates to the employer's payroll during periods for which
1616	it failed to secure the payment of workers' compensation
1617	required by this chapter within the preceding 3-year period or
1618	$1,000, whichever is greater.
1619	2. Any subsequent violation within 5 years after the most
1620	recent violation shall, in addition to the penalties set forth
1621	in this subsection, be deemed a knowing act within the meaning
1622	of s. 440.105.
1623	(e) When an employer fails to provide business records
1624	sufficient to enable the department to determine the employer's
1625	payroll for the period requested for the calculation of the
1626	penalty provided in paragraph (d), for penalty calculation
1627	purposes, the imputed weekly payroll for each employee,
1628	corporate officer, sole proprietor, or partner shall be the
1629	statewide average weekly wage as defined in s. 440.12(2)
1630	multiplied by 1.5.
1631	(f) In addition to any other penalties provided for in
1632	this chapter, the department may assess against the employer a
1633	penalty of $5,000 for each employee of that employer who the
1634	employer represents to the department or carrier as an
1635	independent contractor but who is determined by the department
1636	not to be an independent contractor as defined in s. 440.02.
1637	(8)(6)In addition to the issuance of a stop-work order
1638	under subsection (7),the department may file a complaint in the
1639	circuit court in and for Leon County to enjoin any employer,who
1640	has failed to secure the payment of workers' compensation as
1641	required by this chapter,from employing individuals and from
1642	conducting business until the employer presents evidence
1643	satisfactory to the department of having secured the payment of
1644	workers'for compensation required by this chapterand pays a
1645	civil penalty assessed byto the department under this section,
1646	to be deposited by the department into the Workers' Compensation
1647	Administration Trust Fund, in the amount of $100 per day for
1648	each day the employer was not in compliance with this chapter.
1649	(9)(7) In addition to any penalty, stop-work order, or
1650	injunction, the department shall assess against any employer,
1651	who has failed to secure the payment of compensation as required
1652	by this chapter, a penalty in the following amount:
1653	(a) An amount equal to at least the amount that the
1654	employer would have paid or up to twice the amount the employer
1655	would have paid during periods it illegally failed to secure
1656	payment of compensation in the preceding 3-year period based on
1657	the employer's payroll during the preceding 3-year period; or
1658	(b) One thousand dollars, whichever is greater. Any
1659	penalty assessed under this subsection is due within 30 days
1660	after the date on which the employer is notified, except that,
1661	if the department has posted a stop-work order or obtained
1662	injunctive relief against the employer, payment is due, in
1663	addition to those conditions set forth in this section, as a
1664	condition to relief from a stop-work order or an injunction.
1665	Interest shall accrue on amounts not paid when due at the rate
1666	of 1 percent per month. The departmentdivisionshall adopt
1667	rules to administer this section.
1668	(10)(8)The department may bring an action in circuit
1669	court to recover penalties assessed under this section,
1670	including any interest owed to the department pursuant to this
1671	section. In any action brought by the department pursuant to
1672	this section in which it prevails, the circuit court shall award
1673	costs, including the reasonable costs of investigation and a
1674	reasonable attorney's fee.
1675	(11)(9)Any judgment obtained by the department and any
1676	penalty due pursuant to the service of a stop-work order or
1677	otherwise due under this section shall, until collected,
1678	constitute a lien upon the entire interest of the employer,
1679	legal or equitable, in any property, real or personal, tangible
1680	or intangible; however, such lien is subordinate to claims for
1681	unpaid wages and any prior recorded liens, and a lien created by
1682	this section is not valid against any person who, subsequent to
1683	such lien and in good faith and for value, purchases real or
1684	personal property from such employer or becomes the mortgagee on
1685	real or personal property of such employer, or against a
1686	subsequent attaching creditor, unless, with respect to real
1687	estate of the employer, a notice of the lien is recorded in the
1688	public records of the county where the real estate is located,
1689	and with respect to personal property of the employer, the
1690	notice is recorded with the Secretary of State.
1691	(12)(10)Any law enforcement agency in the state may, at
1692	the request of the department, render any assistance necessary
1693	to carry out the provisions of this section, including, but not
1694	limited to, preventing any employee or other person from
1695	remaining at a place of employment or job site after a stop-work
1696	order or injunction has taken effect.
1697	(13)(11)Agency actionActionsby the department under
1698	this section, if contested,must be contested as provided in
1699	chapter 120. All civilpenalties assessed by the department must
1700	be paid into the Workers' Compensation Administration Trust
1701	Fund. The department shall return any sums previously paid, upon
1702	conclusion of an action, if the department fails to prevail and
1703	if so directed by an order of court or an administrative hearing
1704	officer. The requirements of this subsection may be met by
1705	posting a bond in an amount equal to twice the penalty and in a
1706	form approved by the department.
1707	(14)(12) If the departmentdivisionfinds that an employer
1708	who is certified or registered under part I or part II of
1709	chapter 489 and who is required to secure the payment of
1710	workers'the compensation underprovided for bythis chapter to
1711	his or her employees has failed to do so, the department
1712	divisionshall immediately notify the Department of Business and
1713	Professional Regulation.
1714	Section 14. Subsections (1) and (3) of section 440.11,
1715	Florida Statutes, are amended to read:
1716	440.11 Exclusiveness of liability.--
1717	(1) The liability of an employer prescribed in s. 440.10
1718	shall be exclusive and in place of all other liability,
1719	including vicarious liability,of such employer to any third-
1720	party tortfeasor and to the employee, the legal representative
1721	thereof, husband or wife, parents, dependents, next of kin, and
1722	anyone otherwise entitled to recover damages from such employer
1723	at law or in admiralty on account of such injury or death,
1724	except as follows:that
1725	(a)If an employer fails to secure payment of compensation
1726	as required by this chapter, an injured employee, or the legal
1727	representative thereof in case death results from the injury,
1728	may elect to claim compensation under this chapter or to
1729	maintain an action at law or in admiralty for damages on account
1730	of such injury or death. In such action the defendant may not
1731	plead as a defense that the injury was caused by negligence of a
1732	fellow employee, that the employee assumed the risk of the
1733	employment, or that the injury was due to the comparative
1734	negligence of the employee.
1735	(b) When an employer commits an intentional tort that
1736	causes the injury or death of the employee. For purposes of this
1737	paragraph, an employer's actions shall be deemed to constitute
1738	an intentional tort and not an accident only when the employee
1739	proves, by clear and convincing evidence, that:
1740	1. The employer deliberately intended to injure the
1741	employee; or
1742	2. The employer engaged in conduct that the employer knew,
1743	based on prior similar accidents or on explicit warnings
1744	specifically identifying a known danger, was virtually certain
1745	to result in injury or death to the employee, and the employee
1746	was not aware of the risk because the danger was not apparent
1747	and the employer deliberately concealed or misrepresented the
1748	danger so as to prevent the employee from exercising informed
1749	judgment about whether to perform the work.
1750
1751	The same immunities from liability enjoyed by an employer shall
1752	extend as well to each employee of the employer when such
1753	employee is acting in furtherance of the employer's business and
1754	the injured employee is entitled to receive benefits under this
1755	chapter. Such fellow-employee immunities shall not be applicable
1756	to an employee who acts, with respect to a fellow employee, with
1757	willful and wanton disregard or unprovoked physical aggression
1758	or with gross negligence when such acts result in injury or
1759	death or such acts proximately cause such injury or death, nor
1760	shall such immunities be applicable to employees of the same
1761	employer when each is operating in the furtherance of the
1762	employer's business but they are assigned primarily to unrelated
1763	works within private or public employment. The same immunity
1764	provisions enjoyed by an employer shall also apply to any sole
1765	proprietor, partner, corporate officer or director, supervisor,
1766	or other person who in the course and scope of his or her duties
1767	acts in a managerial or policymaking capacity and the conduct
1768	which caused the alleged injury arose within the course and
1769	scope of said managerial or policymaking duties and was not a
1770	violation of a law, whether or not a violation was charged, for
1771	which the maximum penalty which may be imposed does not exceed
1772	60 days' imprisonment as set forth in s. 775.082. The immunity
1773	from liability provided in this subsection extends to county
1774	governments with respect to employees of county constitutional
1775	officers whose offices are funded by the board of county
1776	commissioners.
1777	(3) An employer's workers' compensation carrier, service
1778	agent, or safety consultant shall not be liable as a third-party
1779	tortfeasor to employees of the employer or employees of its
1780	subcontractors for assisting the employer and its
1781	subcontractors, if any,in carrying out the employer's rights
1782	and responsibilities under this chapter by furnishing any safety
1783	inspection, safety consultative service, or other safety service
1784	incidental to the workers' compensation or employers' liability
1785	coverage or to the workers' compensation or employer's liability
1786	servicing contract. Without limitation, a safety consultant may
1787	include an owner, as defined in chapter 713, or an owner's
1788	related, affiliated, or subsidiary companies and the employees
1789	of each.The exclusion from liability under this subsection
1790	shall not apply in any case in which injury or death is
1791	proximately caused by the willful and unprovoked physical
1792	aggression, or by the negligent operation of a motor vehicle, by
1793	employees, officers, or directors of the employer's workers'
1794	compensation carrier, service agent, or safety consultant.
1795	Section 15. Section 440.13, Florida Statutes, is amended
1796	to read:
1797	440.13 Medical services and supplies; penalty for
1798	violations; limitations.--
1799	(1) DEFINITIONS.--As used in this section, the term:
1800	(a) "Alternate medical care" means a change in treatment
1801	or health care provider.
1802	(b) "Attendant care" means care rendered by trained
1803	professional attendants which is beyond the scope of household
1804	duties. Family members may provide nonprofessional attendant
1805	care, but may not be compensated under this chapter for care
1806	that falls within the scope of household duties and other
1807	services normally and gratuitously provided by family members.
1808	"Family member" means a spouse, father, mother, brother, sister,
1809	child, grandchild, father-in-law, mother-in-law, aunt, or uncle.
1810	(c) "Carrier" means, for purposes of this section,
1811	insurance carrier, self-insurance fund or individually self-
1812	insured employer, or assessable mutual insurer.
1813	(d) "Catastrophic injury" means an injury as defined in s.
1814	440.02.
1815	(d)(e)"Certified health care provider" means a health
1816	care provider who has been certified by the agency or who has
1817	entered an agreement with a licensed managed care organization
1818	to provide treatment to injured workers under this section.
1819	Certification of such health care provider must include
1820	documentation that the health care provider has read and is
1821	familiar with the portions of the statute, impairment guides,
1822	practice parameters, protocols of treatment,and rules which
1823	govern the provision of remedial treatment, care, and
1824	attendance.
1825	(e)(f)"Compensable" means a determination by a carrier or
1826	judge of compensation claims that a condition suffered by an
1827	employee results from an injury arising out of and in the course
1828	of employment.
1829	(f)(g)"Emergency services and care" means emergency
1830	services and care as defined in s. 395.002.
1831	(g)(h)"Health care facility" means any hospital licensed
1832	under chapter 395 and any health care institution licensed under
1833	chapter 400.
1834	(h)(i)"Health care provider" means a physician or any
1835	recognized practitioner who provides skilled services pursuant
1836	to a prescription or under the supervision or direction of a
1837	physician and who has been certified by the agency as a health
1838	care provider. The term "health care provider" includes a health
1839	care facility.
1840	(i)(j)"Independent medical examiner" means a physician
1841	selected by either an employee or a carrier to render one or
1842	more independent medical examinations in connection with a
1843	dispute arising under this chapter.
1844	(j)(k)"Independent medical examination" means an
1845	objective evaluation of the injured employee's medical
1846	condition, including, but not limited to, impairment or work
1847	status, performed by a physician or an expert medical advisor at
1848	the request of a party, a judge of compensation claims, or the
1849	agency to assist in the resolution of a dispute arising under
1850	this chapter.
1851	(k)(l)"Instance of overutilization" means a specific
1852	inappropriate service or level of service provided to an injured
1853	employee that includes the provision of treatment in excess of
1854	established practice parameters and protocols of treatment
1855	established in accordance with this chapter.
1856	(l)(m) "Medically necessary" or "medical necessity"means
1857	any medical service or medical supply which is used to identify
1858	or treat an illness or injury, is appropriate to the patient's
1859	diagnosis and status of recovery, and is consistent with the
1860	location of service, the level of care provided, and applicable
1861	practice parameters. The service should be widely accepted among
1862	practicing health care providers, based on scientific criteria,
1863	and determined to be reasonably safe. The service must not be of
1864	an experimental, investigative, or research nature, except in
1865	those instances in which prior approval of the Agency for Health
1866	Care Administration has been obtained. The Agency for Health
1867	Care Administration shall adopt rules providing for such
1868	approval on a case-by-case basis when the service or supply is
1869	shown to have significant benefits to the recovery and well-
1870	being of the patient.
1871	(m)(n)"Medicine" means a drug prescribed by an authorized
1872	health care provider and includes only generic drugs or single-
1873	source patented drugs for which there is no generic equivalent,
1874	unless the authorized health care provider writes or states that
1875	the brand-name drug as defined in s. 465.025 is medically
1876	necessary, or is a drug appearing on the schedule of drugs
1877	created pursuant to s. 465.025(6), or is available at a cost
1878	lower than its generic equivalent.
1879	(n)(o)"Palliative care" means noncurative medical
1880	services that mitigate the conditions, effects, or pain of an
1881	injury.
1882	(o)(p)"Pattern or practice of overutilization" means
1883	repetition of instances of overutilization within a specific
1884	medical case or multiple cases by a single health care provider.
1885	(p)(q)"Peer review" means an evaluation by two or more
1886	physicians licensed under the same authority and with the same
1887	or similar specialty as the physician under review, of the
1888	appropriateness, quality, and cost of health care and health
1889	services provided to a patient, based on medically accepted
1890	standards.
1891	(q)(r)"Physician" or "doctor" means a physician licensed
1892	under chapter 458, an osteopathic physician licensed under
1893	chapter 459, a chiropractic physician licensed under chapter
1894	460, a podiatric physician licensed under chapter 461, an
1895	optometrist licensed under chapter 463, or a dentist licensed
1896	under chapter 466, each of whom must be certified by the agency
1897	as a health care provider.
1898	(r)(s)"Reimbursement dispute" means any disagreement
1899	between a health care provider or health care facility and
1900	carrier concerning payment for medical treatment.
1901	(s)(t)"Utilization control" means a systematic process of
1902	implementing measures that assure overall management and cost
1903	containment of services delivered, including compliance with
1904	practice parameters and protocols of treatment as provided for
1905	in this chapter.
1906	(t)(u)"Utilization review" means the evaluation of the
1907	appropriateness of both the level and the quality of health care
1908	and health services provided to a patient, including, but not
1909	limited to, evaluation of the appropriateness of treatment,
1910	hospitalization, or office visits based on medically accepted
1911	standards. Such evaluation must be accomplished by means of a
1912	system that identifies the utilization of medical services based
1913	on practice parameters and protocols of treatment as provided
1914	for in this chaptermedically accepted standards as established
1915	by medical consultants with qualifications similar to those
1916	providing the care under review, and that refers patterns and
1917	practices of overutilization to the agency.
1918	(2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.--
1919	(a) Subject to the limitations specified elsewhere in this
1920	chapter, the employer shall furnish to the employee such
1921	medically necessary remedial treatment, care, and attendance for
1922	such period as the nature of the injury or the process of
1923	recovery may require, which is in accordance with established
1924	practice parameters and protocols of treatment as provided for
1925	in this chapter, including medicines, medical supplies, durable
1926	medical equipment, orthoses, prostheses, and other medically
1927	necessary apparatus. Remedial treatment, care, and attendance,
1928	including work-hardening programs or pain-management programs
1929	accredited by the Commission on Accreditation of Rehabilitation
1930	Facilities or Joint Commission on the Accreditation of Health
1931	Organizations or pain-management programs affiliated with
1932	medical schools, shall be considered as covered treatment only
1933	when such care is given based on a referral by a physician as
1934	defined in this chapter. Each facility shall maintain outcome
1935	data, including work status at discharges, total program
1936	charges, total number of visits, and length of stay. The
1937	department shall utilize such data and report to the President
1938	of the Senate and the Speaker of the House of Representatives
1939	regarding the efficacy and cost-effectiveness of such program,
1940	no later than October 1, 1994.Medically necessary treatment,
1941	care, and attendance does not include chiropractic services in
1942	excess of 2418 treatments or rendered 128weeks beyond the
1943	date of the initial chiropractic treatment, whichever comes
1944	first, unless the carrier authorizes additional treatment or the
1945	employee is catastrophically injured.
1946	(b) The employer shall provide appropriate professional or
1947	nonprofessional attendant care performed only at the direction
1948	and control of a physician when such care is medically
1949	necessary. The physician shall prescribe such care in writing.
1950	The employer or carrier shall not be responsible for such care
1951	until the prescription for attendant care is received by the
1952	employer and carrier, which shall specify the time periods for
1953	such care, the level of care required, and the type of
1954	assistance required. A prescription for attendant care shall not
1955	prescribe such care retroactively.The value of nonprofessional
1956	attendant care provided by a family member must be determined as
1957	follows:
1958	1. If the family member is not employed or if the family
1959	member is employed and is providing attendant care services
1960	during hours that he or she is not engaged in employment, the
1961	per-hour value equals the federal minimum hourly wage.
1962	2. If the family member is employed and elects to leave
1963	that employment to provide attendant or custodial care, the per-
1964	hour value of that care equals the per-hour value of the family
1965	member's former employment, not to exceed the per-hour value of
1966	such care available in the community at large. A family member
1967	or a combination of family members providing nonprofessional
1968	attendant care under this paragraph may not be compensated for
1969	more than a total of 12 hours per day.
1970	3. If the family member remains employed while providing
1971	attendant or custodial care, the per-hour value of that care
1972	equals the per-hour value of the family member's employment, not
1973	to exceed the per-hour value of such care available in the
1974	community at large.
1975	(c) If the employer fails to provide initialtreatment or
1976	care required by this section after request by the injured
1977	employee, the employee may obtain such initialtreatment at the
1978	expense of the employer, if the initial treatment or careis
1979	compensable and medically necessary and is in accordance with
1980	established practice parameters and protocols of treatment as
1981	provided for in this chapter. There must be a specific request
1982	for the initial treatment or care, and the employer or carrier
1983	must be given a reasonable time period within which to provide
1984	the initialtreatment or care. However, the employee is not
1985	entitled to recover any amount personally expended for the
1986	initial treatment or careserviceunless he or she has requested
1987	the employer to furnish that initialtreatment or service and
1988	the employer has failed, refused, or neglected to do so within a
1989	reasonable time or unless the nature of the injury requires such
1990	initialtreatment, nursing, and services and the employer or his
1991	or her superintendent or foreman, having knowledge of the
1992	injury, has neglected to provide the initial treatment or care
1993	service.
1994	(d) The carrier has the right to transfer the care of an
1995	injured employee from the attending health care provider if an
1996	independent medical examination determines that the employee is
1997	not making appropriate progress in recuperation.
1998	(e) Except in emergency situations and for treatment
1999	rendered by a managed care arrangement, after any initial
2000	examination and diagnosis by a physician providing remedial
2001	treatment, care, and attendance, and before a proposed course of
2002	medical treatment begins, each insurer shall review, in
2003	accordance with the requirements of this chapter, the proposed
2004	course of treatment, to determine whether such treatment would
2005	be recognized as reasonably prudent. The review must be in
2006	accordance with all applicable workers' compensation practice
2007	parameters and protocols of treatment established in accordance
2008	with this chapter. The insurer must accept any such proposed
2009	course of treatment unless the insurer notifies the physician of
2010	its specific objections to the proposed course of treatment by
2011	the close of the tenth business day after notification by the
2012	physician, or a supervised designee of the physician, of the
2013	proposed course of treatment.
2014	(f) Upon the written request of the employee, the carrier
2015	shall give the employee the opportunity for one change of
2016	physician during the course of treatment for any one accident.
2017	Upon the granting of a change of physician, the originally
2018	authorized physician in the same specialty as the changed
2019	physician shall become deauthorized upon written notification by
2020	the employer or carrier. The carrier shall authorize an
2021	alternative physician who shall not be professionally affiliated
2022	with the previous physician within 5 days after receipt of the
2023	request. If the carrier fails to provide a change of physician
2024	as requested by the employee, the employee may select the
2025	physician and such physician shall be considered authorized if
2026	the treatment being provided is compensable and medically
2027	necessary.
2028
2029	Failure of the carrier to timely comply with this subsection
2030	shall be a violation of this chapter and the carrier shall be
2031	subject to penalties as provided for in s. 440.525.The employee
2032	shall be entitled to select another physician from among not
2033	fewer than three carrier-authorized physicians who are not
2034	professionally affiliated.
2035	(3) PROVIDER ELIGIBILITY; AUTHORIZATION.--
2036	(a) As a condition to eligibility for payment under this
2037	chapter, a health care provider who renders services must be a
2038	certified health care provider and must receive authorization
2039	from the carrier before providing treatment. This paragraph does
2040	not apply to emergency care. The agency shall adopt rules to
2041	implement the certification of health care providers.
2042	(b) A health care provider who renders emergency care must
2043	notify the carrier by the close of the third business day after
2044	it has rendered such care. If the emergency care results in
2045	admission of the employee to a health care facility, the health
2046	care provider must notify the carrier by telephone within 24
2047	hours after initial treatment. Emergency care is not compensable
2048	under this chapter unless the injury requiring emergency care
2049	arose as a result of a work-related accident. Pursuant to
2050	chapter 395, all licensed physicians and health care providers
2051	in this state shall be required to make their services available
2052	for emergency treatment of any employee eligible for workers'
2053	compensation benefits. To refuse to make such treatment
2054	available is cause for revocation of a license.
2055	(c) A health care provider may not refer the employee to
2056	another health care provider, diagnostic facility, therapy
2057	center, or other facility without prior authorization from the
2058	carrier, except when emergency care is rendered. Any referral
2059	must be to a health care provider that has been certified by the
2060	agency, unless the referral is for emergency treatment, and the
2061	referral must be made in accordance with practice parameters and
2062	protocols of treatment as provided for in this chapter.
2063	(d) A carrier must respond, by telephone or in writing, to
2064	a request for authorization from an authorized health care
2065	providerby the close of the third business day after receipt of
2066	the request. A carrier who fails to respond to a written request
2067	for authorization for referral for medical treatment by the
2068	close of the third business day after receipt of the request
2069	consents to the medical necessity for such treatment. All such
2070	requests must be made to the carrier. Notice to the carrier does
2071	not include notice to the employer.
2072	(e) Carriers shall adopt procedures for receiving,
2073	reviewing, documenting, and responding to requests for
2074	authorization. Such procedures shall be for a health care
2075	provider certified under this section.
2076	(f) By accepting payment under this chapter for treatment
2077	rendered to an injured employee, a health care provider consents
2078	to the jurisdiction of the agency as set forth in subsection
2079	(11) and to the submission of all records and other information
2080	concerning such treatment to the agency in connection with a
2081	reimbursement dispute, audit, or review as provided by this
2082	section. The health care provider must further agree to comply
2083	with any decision of the agency rendered under this section.
2084	(g) The employee is not liable for payment for medical
2085	treatment or services provided pursuant to this section except
2086	as otherwise provided in this section.
2087	(h) The provisions of s. 456.053 are applicable to
2088	referrals among health care providers, as defined in subsection
2089	(1), treating injured workers.
2090	(i) Notwithstanding paragraph (d), a claim for specialist
2091	consultations, surgical operations, physiotherapeutic or
2092	occupational therapy procedures, X-ray examinations, or special
2093	diagnostic laboratory tests that cost more than $1,000 and other
2094	specialty services that the agency identifies by rule is not
2095	valid and reimbursable unless the services have been expressly
2096	authorized by the carrier, or unless the carrier has failed to
2097	respond within 10 days to a written request for authorization,
2098	or unless emergency care is required. The insurer shall not
2099	refuse toauthorize such consultation or procedure unless the
2100	health care provider or facility is not authorized or certified,
2101	unless such treatment is not in accordance with practice
2102	parameters and protocols of treatment established in this
2103	chapter, or unless a judge of compensation claimsan expert
2104	medical advisorhas determined that the consultation or
2105	procedure is not medically necessary, not in accordance with the
2106	practice parameters and protocols of treatment established in
2107	this chapter, or otherwise notcompensable under this chapter.
2108	Authorization of a treatment plan does not constitute express
2109	authorization for purposes of this section, except to the extent
2110	the carrier provides otherwise in its authorization procedures.
2111	This paragraph does not limit the carrier's obligation to
2112	identify and disallow overutilization or billing errors.
2113	(j) Notwithstanding anything in this chapter to the
2114	contrary, a sick or injured employee shall be entitled, at all
2115	times, to free, full, and absolute choice in the selection of
2116	the pharmacy or pharmacist dispensing and filling prescriptions
2117	for medicines required under this chapter. It is expressly
2118	forbidden for the agency, an employer, or a carrier, or any
2119	agent or representative of the agency, an employer, or a carrier
2120	to select the pharmacy or pharmacist which the sick or injured
2121	employee must use; condition coverage or payment on the basis of
2122	the pharmacy or pharmacist utilized; or to otherwise interfere
2123	in the selection by the sick or injured employee of a pharmacy
2124	or pharmacist.
2125	(4) NOTICE OF TREATMENT TO CARRIER; FILING WITH
2126	DEPARTMENT.--
2127	(a) Any health care provider providing necessary remedial
2128	treatment, care, or attendance to any injured worker shall
2129	submit treatment reports to the carrier in a format prescribed
2130	by the department in consultation with the agency. A claim for
2131	medical or surgical treatment is not valid or enforceable
2132	against such employer or employee, unless, by the close of the
2133	third business day following the first treatment, the physician
2134	providing the treatment furnishes to the employer or carrier a
2135	preliminary notice of the injury and treatment in a formaton
2136	forms prescribed by the department in consultation with the
2137	agencyand, within 15 days thereafter, furnishes to the employer
2138	or carrier a complete report, and subsequent thereto furnishes
2139	progress reports, if requested by the employer or insurance
2140	carrier, at intervals of not less than 3 weeks apart or at less
2141	frequent intervals if requested in a formaton formsprescribed
2142	by the department in consultation with the agency.
2143	(b) Upon the request of the department or agency, each
2144	medical report or bill obtained or received by the employer, the
2145	carrier, or the injured employee, or the attorney for the
2146	employer, carrier, or injured employee, with respect to the
2147	remedial treatment, care, and attendance of the injured
2148	employee, including any report of an examination, diagnosis, or
2149	disability evaluation, must be produced by the health care
2150	provider tofiled with the department or agencypursuant to
2151	rules adopted by the department in consultation with the agency.
2152	The health care provider shall also furnish to the injured
2153	employee or to his or her attorney and the employer or carrier
2154	or its attorney, on demand, a copy of his or her office chart,
2155	records, and reports, and may charge the injured employee no
2156	more than 50 cents per page for copying the records and the
2157	actual direct cost to the health care provider or health care
2158	facility for X rays, microfilm, or other nonpaper recordsan
2159	amount authorized by the department for the copies. Each such
2160	health care provider shall provide to the agency ordepartment
2161	information about the remedial treatment, care, and attendance
2162	which the agency ordepartment reasonably requests.
2163	(c) It is the policy for the administration of the
2164	workers' compensation system that there shallbe reasonable
2165	access to medical information by all parties to facilitate the
2166	self-executing features of the law. An employee who reports an
2167	injury or illness alleged to be work-related waives any
2168	physician-patient privilege with respect to any condition or
2169	complaint reasonably related to the condition for which the
2170	employee claims compensation.Notwithstanding the limitations in
2171	s. 456.057 and subject to the limitations in s. 381.004, upon
2172	the request of the employer, the carrier, an authorized
2173	qualified rehabilitation provider, or the attorney for the
2174	employer or carrier, the medical records, reports, and
2175	information of an injured employee relevant to the particular
2176	injury or illness for which compensation is soughtmust be
2177	furnished to those persons and the medical condition of the
2178	injured employee must be discussed with those persons, if the
2179	records and the discussions are restricted to conditions
2180	relating to the workplace injury. Release of medical information
2181	by the health care provider or other physician does not require
2182	the authorization of the injured employee. If medical records,
2183	reports, and information of an injured employee are sought from
2184	health care providers who are not subject to the jurisdiction of
2185	the state, the injured employee shall sign an authorization
2186	allowing for the employer or carrier to obtain the medical
2187	records, reports, or information. Any such discussions or
2188	release of informationmay be held before or after the filing of
2189	a claim or petition for benefitswithout the knowledge, consent,
2190	or presence of any other party or his or her agent or
2191	representative. A health care provider who willfully refuses to
2192	provide medical records or to discuss the medical condition of
2193	the injured employee, after a reasonable request is made for
2194	such information pursuant to this subsection, shall be subject
2195	by the departmentagencyto one or more of the penalties set
2196	forth in paragraph (8)(b). The department may adopt rules to
2197	carry out this subsection.
2198	(5) INDEPENDENT MEDICAL EXAMINATIONS.--
2199	(a) In any dispute concerning overutilization, medical
2200	benefits, compensability, or disability under this chapter, the
2201	carrier or the employee may select an independent medical
2202	examiner. If the parties agree,the examiner may be a health
2203	care provider treating or providing other care to the employee.
2204	An independent medical examiner may not render an opinion
2205	outside his or her area of expertise, as demonstrated by
2206	licensure and applicable practice parameters. The employer and
2207	employee shall be entitled to only one independent medical
2208	examination per accident and not one independent medical
2209	examination per medical specialty. The party requesting and
2210	selecting the independent medical examination shall be
2211	responsible for all expenses associated with said examination,
2212	including, but not limited to, medically necessary diagnostic
2213	testing performed and physician or medical care provider fees
2214	for the evaluation. The party selecting the independent medical
2215	examination shall identify the choice of the independent medical
2216	examiner to all other parties within 15 days after the date the
2217	independent medical examination is to take place. Failure to
2218	timely provide such notification shall preclude the requesting
2219	party from submitting the findings of such independent medical
2220	examiner in a proceeding before a judge of compensation claims.
2221	The independent medical examiner may not provide followup care
2222	if such recommendation for care is found to be medically
2223	necessary. If the employee prevails in a medical dispute as
2224	determined in an order by a judge of compensation claims or if
2225	benefits are paid or treatment provided after the employee has
2226	obtained an independent medical examination based upon the
2227	examiner's findings, the costs of such examination shall be paid
2228	by the employer or carrier.
2229	(b) Each party is bound by his or her selection of an
2230	independent medical examiner, including the selection of the
2231	independent medical examiner in accordance with s. 440.134 and
2232	the opinions of such independent medical examiner. Each party
2233	andis entitled to an alternate examiner only if:
2234	1. The examiner is not qualified to render an opinion upon
2235	an aspect of the employee's illness or injury which is material
2236	to the claim or petition for benefits;
2237	2. The examiner ceases to practice in the specialty
2238	relevant to the employee's condition;
2239	3. The examiner is unavailable due to injury, death, or
2240	relocation outside a reasonably accessible geographic area; or
2241	4. The parties agree to an alternate examiner.
2242
2243	Any party may request, or a judge of compensation claims may
2244	require, designation of an agency medical advisor as an
2245	independent medical examiner. The opinion of the advisors acting
2246	as examiners shall not be afforded the presumption set forth in
2247	paragraph (9)(c).
2248	(c) The carrier may, at its election, contact the claimant
2249	directly to schedule a reasonable time for an independent
2250	medical examination. The carrier must confirm the scheduling
2251	agreement in writing with the claimant and thewithin 5 days and
2252	notifyclaimant's counsel, if any, at least 7 days before the
2253	date upon which the independent medical examination is scheduled
2254	to occur. An attorney representing a claimant is not authorized
2255	to schedule the self-insured employer's or carrier'sindependent
2256	medical evaluations under this subsection. Neither the self-
2257	insured employer nor the carrier shall be responsible for
2258	scheduling any independent medical examination other than an
2259	employer or carrier independent medical examination.
2260	(d) If the employee fails to appear for the independent
2261	medical examination scheduled by the employer or carrierwithout
2262	good cause and fails to advise the physician at least 24 hours
2263	before the scheduled date for the examination that he or she
2264	cannot appear, the employee is barred from recovering
2265	compensation for any period during which he or she has refused
2266	to submit to such examination. Further, the employee shall
2267	reimburse the employer orcarrier 50 percent of the physician's
2268	cancellation or no-show fee unless the employer orcarrier that
2269	schedules the examination fails to timely provide to the
2270	employee a written confirmation of the date of the examination
2271	pursuant to paragraph (c) which includes an explanation of why
2272	he or she failed to appear. The employee may appeal to a judge
2273	of compensation claims for reimbursement when the employer or
2274	carrier withholds payment in excess of the authority granted by
2275	this section.
2276	(e) No medical opinion other than the opinion of a medical
2277	advisor appointed by the judge of compensation claims or the
2278	departmentagency, an independent medical examiner, or an
2279	authorized treating provider is admissible in proceedings before
2280	the judges of compensation claims.
2281	(f) Attorney's fees incurred by an injured employee in
2282	connection with delay of or opposition to an independent medical
2283	examination, including, but not limited to, motions for
2284	protective orders, are not recoverable under this chapter.
2285	(g) When a medical dispute arises, the parties may
2286	mutually agree to refer the employee to a licensed physician
2287	specializing in the diagnosis and treatment of the medical
2288	condition at issue for an independent medical examination and
2289	report. Such medical examination shall be referred to as a
2290	"consensus independent medical examination." The findings and
2291	conclusions of such mutually agreed upon consensus independent
2292	medical examination shall be binding on the parties and shall
2293	constitute resolution of the medical dispute addressed in the
2294	independent consensus medical examination and in any proceeding.
2295	Agreement by the parties to a consensus independent medical
2296	examination shall not affect the employer's, carrier's, or
2297	employee's entitlement to one independent medical examination
2298	per accident as provided for in this subsection.
2299	(6) UTILIZATION REVIEW.--Carriers shall review all bills,
2300	invoices, and other claims for payment submitted by health care
2301	providers in order to identify overutilization and billing
2302	errors, including compliance with practice parameters and
2303	protocols of treatment established in accordance with this
2304	chapter, and may hire peer review consultants or conduct
2305	independent medical evaluations. Such consultants, including
2306	peer review organizations, are immune from liability in the
2307	execution of their functions under this subsection to the extent
2308	provided in s. 766.101. If a carrier finds that overutilization
2309	of medical services or a billing error has occurred, or there is
2310	a violation of the practice parameters and protocols of
2311	treatment established in accordance with this chapter, it must
2312	disallow or adjust payment for such services or error without
2313	order of a judge of compensation claims or the agency, if the
2314	carrier, in making its determination, has complied with this
2315	section and rules adopted by the agency.
2316	(7) UTILIZATION AND REIMBURSEMENT DISPUTES.--
2317	(a) Any health care provider, carrier, or employer who
2318	elects to contest the disallowance or adjustment of payment by a
2319	carrier under subsection (6) must, within 30 days after receipt
2320	of notice of disallowance or adjustment of payment, petition the
2321	agency to resolve the dispute. The petitioner must serve a copy
2322	of the petition on the carrier and on all affected parties by
2323	certified mail. The petition must be accompanied by all
2324	documents and records that support the allegations contained in
2325	the petition. Failure of a petitioner to submit such
2326	documentation to the agency results in dismissal of the
2327	petition.
2328	(b) The carrier must submit to the agency within 10 days
2329	after receipt of the petition all documentation substantiating
2330	the carrier's disallowance or adjustment. Failure of the carrier
2331	to timelysubmit the requested documentation to the agency
2332	within 10 days constitutes a waiver of all objections to the
2333	petition.
2334	(c) Within 60 days after receipt of all documentation, the
2335	agency must provide to the petitioner, the carrier, and the
2336	affected parties a written determination of whether the carrier
2337	properly adjusted or disallowed payment. The agency must be
2338	guided by standards and policies set forth in this chapter,
2339	including all applicable reimbursement schedules, practice
2340	parameters, and protocols of treatment,in rendering its
2341	determination.
2342	(d) If the agency finds an improper disallowance or
2343	improper adjustment of payment by an insurer, the insurer shall
2344	reimburse the health care provider, facility, insurer, or
2345	employer within 30 days, subject to the penalties provided in
2346	this subsection.
2347	(e) The agency shall adopt rules to carry out this
2348	subsection. The rules may include provisions for consolidating
2349	petitions filed by a petitioner and expanding the timetable for
2350	rendering a determination upon a consolidated petition.
2351	(f) Any carrier that engages in a pattern or practice of
2352	arbitrarily or unreasonably disallowing or reducing payments to
2353	health care providers may be subject to one or more of the
2354	following penalties imposed by the agency:
2355	1. Repayment of the appropriate amount to the health care
2356	provider.
2357	2. An administrative fine assessed by the agency in an
2358	amount not to exceed $5,000 per instance of improperly
2359	disallowing or reducing payments.
2360	3. Award of the health care provider's costs, including a
2361	reasonable attorney's fee, for prosecuting the petition.
2362	(8) PATTERN OR PRACTICE OF OVERUTILIZATION.--
2363	(a) Carriers must report to the agency all instances of
2364	overutilization including, but not limited to, all instances in
2365	which the carrier disallows or adjusts payment or a
2366	determination has been made that the provided or recommended
2367	treatment is in excess of the practice parameters and protocols
2368	of treatment established in this chapter. The agency shall
2369	determine whether a pattern or practice of overutilization
2370	exists.
2371	(b) If the agency determines that a health care provider
2372	has engaged in a pattern or practice of overutilization or a
2373	violation of this chapter or rules adopted by the agency,
2374	including a pattern or practice of providing treatment in excess
2375	of the practice parameters or protocols of treatment, it may
2376	impose one or more of the following penalties:
2377	1. An order of the agency barring the provider from
2378	payment under this chapter;
2379	2. Deauthorization of care under review;
2380	3. Denial of payment for care rendered in the future;
2381	4. Decertification of a health care provider certified as
2382	an expert medical advisor under subsection (9) or of a
2383	rehabilitation provider certified under s. 440.49;
2384	5. An administrative fine assessed by the agency in an
2385	amount not to exceed $5,000 per instance of overutilization or
2386	violation; and
2387	6. Notification of and review by the appropriate licensing
2388	authority pursuant to s. 440.106(3).
2389	(9) EXPERT MEDICAL ADVISORS.--
2390	(a) The agency shall certify expert medical advisors in
2391	each specialty to assist the agency and the judges of
2392	compensation claims within the advisor's area of expertise as
2393	provided in this section. The agency shall, in a manner
2394	prescribed by rule, in certifying, recertifying, or decertifying
2395	an expert medical advisor, consider the qualifications,
2396	training, impartiality, and commitment of the health care
2397	provider to the provision of quality medical care at a
2398	reasonable cost. As a prerequisite for certification or
2399	recertification, the agency shall require, at a minimum, that
2400	an expert medical advisor have specialized workers' compensation
2401	training or experience under the workers' compensation system of
2402	this state and board certification or board eligibility.
2403	(b) The agency shall contract with one or more entities
2404	that employ, contract with, or otherwise secureor employexpert
2405	medical advisors to provide peer review or expertmedical
2406	consultation, opinions, and testimonyto the agency or to a
2407	judge of compensation claims in connection with resolving
2408	disputes relating to reimbursement, differing opinions of health
2409	care providers, and health care and physician services rendered
2410	under this chapter, including utilization issues. The agency
2411	shall by rule establish the qualifications of expert medical
2412	advisors, including training and experience in the workers'
2413	compensation system in the state and the expert medical
2414	advisor's knowledge of and commitment to the standards of care,
2415	practice parameters, and protocols established pursuant to this
2416	chapter. Expert medical advisors contracting with the agency
2417	shall, as a term of such contract, agree to provide consultation
2418	or services in accordance with the timetables set forth in this
2419	chapter and to abide by rules adopted by the agency, including,
2420	but not limited to, rules pertaining to procedures for review of
2421	the services rendered by health care providers and preparation
2422	of reports and testimony orrecommendations for submission to
2423	the agency or the judge of compensation claims.
2424	(c) If there is disagreement in the opinions of the health
2425	care providers, if two health care providers disagree on medical
2426	evidence supporting the employee's complaints or the need for
2427	additional medical treatment, or if two health care providers
2428	disagree that the employee is able to return to work, the agency
2429	may, and the judge of compensation claims shall, upon his or her
2430	own motion or within 15 days after receipt of a written request
2431	by either the injured employee, the employer, or the carrier,
2432	order the injured employee to be evaluated by an expert medical
2433	advisor. The opinion of the expert medical advisor is presumed
2434	to be correct unless there is clear and convincing evidence to
2435	the contrary as determined by the judge of compensation claims.
2436	The expert medical advisor appointed to conduct the evaluation
2437	shall have free and complete access to the medical records of
2438	the employee. An employee who fails to report to and cooperate
2439	with such evaluation forfeits entitlement to compensation during
2440	the period of failure to report or cooperate.
2441	(d) The expert medical advisor must complete his or her
2442	evaluation and issue his or her report to the agency or to the
2443	judge of compensation claims within 1545days after receipt of
2444	all medical records. The expert medical advisor must furnish a
2445	copy of the report to the carrier and to the employee.
2446	(e) An expert medical advisor is not liable under any
2447	theory of recovery for evaluations performed under this section
2448	without a showing of fraud or malice. The protections of s.
2449	766.101 apply to any officer, employee, or agent of the agency
2450	and to any officer, employee, or agent of any entity with which
2451	the agency has contracted under this subsection.
2452	(f) If the agency or a judge of compensation claims orders
2453	determines thatthe services of a certified expert medical
2454	advisor are requiredto resolve a dispute under this section,
2455	the party requesting such examinationcarriermust compensate
2456	the advisor for his or her time in accordance with a schedule
2457	adopted by the agency. If the employee prevails in a dispute as
2458	determined in an order by a judge of compensation claims based
2459	upon the expert medical advisor's findings, the employer or
2460	carrier shall pay for the costs of such expert medical advisor.
2461	If a judge of compensation claims, upon his or her motion, finds
2462	that an expert medical advisor is needed to resolve the dispute,
2463	the carrier must compensate the advisor for his or her time in
2464	accordance with a schedule adopted by the agency.The agency may
2465	assess a penalty not to exceed $500 against any carrier that
2466	fails to timely compensate an advisor in accordance with this
2467	section.
2468	(10) WITNESS FEES.--Any health care provider who gives a
2469	deposition shall be allowed a witness fee. The amount charged by
2470	the witness may not exceed $200 per hour. An expert witness who
2471	has never provided direct professional services to a party but
2472	has merely reviewed medical records and provided an expert
2473	opinion or has provided only direct professional services that
2474	were unrelated to the workers' compensation case may not be
2475	allowed a witness fee in excess of $200 per day.
2476	(11) AUDITS BY AGENCY FOR HEALTH CARE ADMINISTRATION AND
2477	THE DEPARTMENT OF INSURANCE; JURISDICTION.--
2478	(a) The Agency for Health Care Administration may
2479	investigate health care providers to determine whether providers
2480	are complying with this chapter and with rules adopted by the
2481	agency, whether the providers are engaging in overutilization,
2482	andwhether providers are engaging in improper billing
2483	practices, and whether providers are adhering to practice
2484	parameters and protocols established in accordance with this
2485	chapter. If the agency finds that a health care provider has
2486	improperly billed, overutilized, or failed to comply with agency
2487	rules or the requirements of this chapter, including, but not
2488	limited to, practice parameters and protocols established in
2489	accordance with this chapter,it must notify the provider of its
2490	findings and may determine that the health care provider may not
2491	receive payment from the carrier or may impose penalties as set
2492	forth in subsection (8) or other sections of this chapter. If
2493	the health care provider has received payment from a carrier for
2494	services that were improperly billed, that constitute
2495	overutilization, or that were outside practice parameters or
2496	protocols established in accordance with this chapteror for
2497	overutilization, it must return those payments to the carrier.
2498	The agency may assess a penalty not to exceed $500 for each
2499	overpayment that is not refunded within 30 days after
2500	notification of overpayment by the agency or carrier.
2501	(b) The department shall monitor and audit carriers as
2502	provided in s. 624.3161, to determine if medical bills are paid
2503	in accordance with this section and department rules. Any
2504	employer, if self-insured, or carrier found by the division not
2505	to be within 90 percent compliance as to the payment of medical
2506	bills after July 1, 1994, must be assessed a fine not to exceed
2507	1 percent of the prior year's assessment levied against such
2508	entity under s. 440.51 for every quarter in which the entity
2509	fails to attain 90-percent compliance. The department shall fine
2510	or otherwise discipline an employer or carrier, pursuant to this
2511	chapter, the insurance code, or rules adopted by the department,
2512	for each late payment of compensation that is below the minimum
2513	95-percent90-percentperformance standard. Any carrier that is
2514	found to be not in compliance in subsequent consecutive quarters
2515	must implement a medical-bill review program approved by the
2516	division, and the carrier is subject to disciplinary action by
2517	the Department of Insurance.
2518	(c) The agency has exclusive jurisdiction to decide any
2519	matters concerning reimbursement, to resolve any overutilization
2520	dispute under subsection (7), and to decide any question
2521	concerning overutilization under subsection (8), which question
2522	or dispute arises after January 1, 1994.
2523	(d) The following agency actions do not constitute agency
2524	action subject to review under ss. 120.569 and 120.57 and do not
2525	constitute actions subject to s. 120.56: referral by the entity
2526	responsible for utilization review; a decision by the agency to
2527	refer a matter to a peer review committee; establishment by a
2528	health care provider or entity of procedures by which a peer
2529	review committee reviews the rendering of health care services;
2530	and the review proceedings, report, and recommendation of the
2531	peer review committee.
2532	(12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
2533	REIMBURSEMENT ALLOWANCES.--
2534	(a) A three-member panel is created, consisting of the
2535	Insurance Commissioner, or the Insurance Commissioner's
2536	designee, and two members to be appointed by the Governor,
2537	subject to confirmation by the Senate, one member who, on
2538	account of present or previous vocation, employment, or
2539	affiliation, shall be classified as a representative of
2540	employers, the other member who, on account of previous
2541	vocation, employment, or affiliation, shall be classified as a
2542	representative of employees. The panel shall determine statewide
2543	schedules of maximum reimbursement allowances for medically
2544	necessary treatment, care, and attendance provided by
2545	physicians, hospitals, ambulatory surgical centers, work-
2546	hardening programs, pain programs, and durable medical
2547	equipment. The maximum reimbursement allowances for inpatient
2548	hospital care shall be based on a schedule of per diem rates, to
2549	be approved by the three-member panel no later than March 1,
2550	1994, to be used in conjunction with a precertification manual
2551	as determined by the department, including maximum hours in
2552	which an outpatient may remain in observation status, which
2553	shall not exceed 23 hoursagency. All compensable charges for
2554	hospital outpatient care shall be reimbursed at 75 percent of
2555	usual and customary charges, except as otherwise provided by
2556	this subsection. Until the three-member panel approves a
2557	schedule of per diem rates for inpatient hospital care and it
2558	becomes effective, all compensable charges for hospital
2559	inpatient care must be reimbursed at 75 percent of their usual
2560	and customary charges.Annually, the three-member panel shall
2561	adopt schedules of maximum reimbursement allowances for
2562	physicians, hospital inpatient care, hospital outpatient care,
2563	ambulatory surgical centers, work-hardening programs, and pain
2564	programs. However, the maximum percentage of increase in the
2565	individual reimbursement allowance may not exceed the percentage
2566	of increase in the Consumer Price Index for the previous year.
2567	An individual physician, hospital, ambulatory surgical center,
2568	pain program, or work-hardening program shall be reimbursed
2569	either the usual and customary charge for treatment, care, and
2570	attendance, the agreed-upon contract price,or the maximum
2571	reimbursement allowance in the appropriate schedule, whichever
2572	is less.
2573	(b) It is the intent of the Legislature to increase the
2574	schedule of maximum reimbursement allowances for selected
2575	physicians effective January 1, 2004, and to pay for the
2576	increases through reductions in payments to hospitals. Revisions
2577	developed pursuant to this subsection are limited to the
2578	following:
2579	1. Payments for outpatient physical, occupational, and
2580	speech therapy provided by hospitals shall be reduced to the
2581	schedule of maximum reimbursement allowances for these services
2582	which applies to nonhospital providers.
2583	2. Payments for scheduled outpatient nonemergency
2584	radiological and clinical laboratory services that are not
2585	provided in conjunction with a surgical procedure shall be
2586	reduced to the schedule of maximum reimbursement allowances for
2587	these services which applies to nonhospital providers.
2588	3. Outpatient reimbursement for scheduled surgeries shall
2589	be reduced from 75 percent of charges to 60 percent of charges.
2590	4. Maximum reimbursement for a physician licensed under
2591	chapter 458 or chapter 459 shall be increased to 110 percent of
2592	the reimbursement allowed by Medicare, using appropriate codes
2593	and modifiers or the medical reimbursement level adopted by the
2594	three-member panel as of January 1, 2003, whichever is greater.
2595	5. Maximum reimbursement for surgical procedures shall be
2596	increased to 140 percent of the reimbursement allowed by
2597	Medicare or the medical reimbursement level adopted by the
2598	three-member panel as of January 1, 2003, whichever is greater.
2599	(c)(b)As to reimbursement for a prescription medication,
2600	the reimbursement amount for a prescription shall be the average
2601	wholesale price times 1.2plus $4.18 for the dispensing fee,
2602	except where the carrier has contracted for a lower amount. Fees
2603	for pharmaceuticals and pharmaceutical services shall be
2604	reimbursable at the applicable fee schedule amount. Where the
2605	employer or carrier has contracted for such services and the
2606	employee elects to obtain them through a provider not a party to
2607	the contract, the carrier shall reimburse at the schedule,
2608	negotiated, or contract price, whichever is lower. No such
2609	contract shall rely on a provider that is not reasonably
2610	accessible to the employee.
2611	(d)(c)Reimbursement for all fees and other charges for
2612	such treatment, care, and attendance, including treatment, care,
2613	and attendance provided by any hospital or other health care
2614	provider, ambulatory surgical center, work-hardening program, or
2615	pain program, must not exceed the amounts provided by the
2616	uniform schedule of maximum reimbursement allowances as
2617	determined by the panel or as otherwise provided in this
2618	section. This subsection also applies to independent medical
2619	examinations performed by health care providers under this
2620	chapter. Until the three-member panel approves a uniform
2621	schedule of maximum reimbursement allowances and it becomes
2622	effective, all compensable charges for treatment, care, and
2623	attendance provided by physicians, ambulatory surgical centers,
2624	work-hardening programs, or pain programs shall be reimbursed at
2625	the lowest maximum reimbursement allowance across all 1992
2626	schedules of maximum reimbursement allowances for the services
2627	provided regardless of the place of service.In determining the
2628	uniform schedule, the panel shall first approve the data which
2629	it finds representative of prevailing charges in the state for
2630	similar treatment, care, and attendance of injured persons. Each
2631	health care provider, health care facility, ambulatory surgical
2632	center, work-hardening program, or pain program receiving
2633	workers' compensation payments shall maintain records verifying
2634	their usual charges. In establishing the uniform schedule of
2635	maximum reimbursement allowances, the panel must consider:
2636	1. The levels of reimbursement for similar treatment,
2637	care, and attendance made by other health care programs or
2638	third-party providers;
2639	2. The impact upon cost to employers for providing a level
2640	of reimbursement for treatment, care, and attendance which will
2641	ensure the availability of treatment, care, and attendance
2642	required by injured workers;
2643	3. The financial impact of the reimbursement allowances
2644	upon health care providers and health care facilities, including
2645	trauma centers as defined in s. 395.4001, and its effect upon
2646	their ability to make available to injured workers such
2647	medically necessary remedial treatment, care, and attendance.
2648	The uniform schedule of maximum reimbursement allowances must be
2649	reasonable, must promote health care cost containment and
2650	efficiency with respect to the workers' compensation health care
2651	delivery system, and must be sufficient to ensure availability
2652	of such medically necessary remedial treatment, care, and
2653	attendance to injured workers; and
2654	4. The most recent average maximum allowable rate of
2655	increase for hospitals determined by the Health Care Board under
2656	chapter 408.
2657	(e)(d)In addition to establishing the uniform schedule of
2658	maximum reimbursement allowances, the panel shall:
2659	1. Take testimony, receive records, and collect data to
2660	evaluate the adequacy of the workers' compensation fee schedule,
2661	nationally recognized fee schedules and alternative methods of
2662	reimbursement to certified health care providers and health care
2663	facilities for inpatient and outpatient treatment and care.
2664	2. Survey certified health care providers and health care
2665	facilities to determine the availability and accessibility of
2666	workers' compensation health care delivery systems for injured
2667	workers.
2668	3. Survey carriers to determine the estimated impact on
2669	carrier costs and workers' compensation premium rates by
2670	implementing changes to the carrier reimbursement schedule or
2671	implementing alternative reimbursement methods.
2672	4. Submit recommendations on or before January 1, 2003,
2673	and biennially thereafter, to the President of the Senate and
2674	the Speaker of the House of Representatives on methods to
2675	improve the workers' compensation health care delivery system.
2676
2677	The division shall provide data to the panel, including but not
2678	limited to, utilization trends in the workers' compensation
2679	health care delivery system. The division shall provide the
2680	panel with an annual report regarding the resolution of medical
2681	reimbursement disputes and any actions pursuant to s. 440.13(8).
2682	The division shall provide administrative support and service to
2683	the panel to the extent requested by the panel.
2684	(13) REMOVAL OF PHYSICIANS FROM LISTS OF THOSE AUTHORIZED
2685	TO RENDER MEDICAL CARE.--The agency shall remove from the list
2686	of physicians or facilities authorized to provide remedial
2687	treatment, care, and attendance under this chapter the name of
2688	any physician or facility found after reasonable investigation
2689	to have:
2690	(a) Engaged in professional or other misconduct or
2691	incompetency in connection with medical services rendered under
2692	this chapter;
2693	(b) Exceeded the limits of his or her or its professional
2694	competence in rendering medical care under this chapter, or to
2695	have made materially false statements regarding his or her or
2696	its qualifications in his or her application;
2697	(c) Failed to transmit copies of medical reports to the
2698	employer or carrier, or failed to submit full and truthful
2699	medical reports of all his or her or its findings to the
2700	employer or carrier as required under this chapter;
2701	(d) Solicited, or employed another to solicit for himself
2702	or herself or itself or for another, professional treatment,
2703	examination, or care of an injured employee in connection with
2704	any claim under this chapter;
2705	(e) Refused to appear before, or to answer upon request
2706	of, the agency or any duly authorized officer of the state, any
2707	legal question, or to produce any relevant book or paper
2708	concerning his or her conduct under any authorization granted to
2709	him or her under this chapter;
2710	(f) Self-referred in violation of this chapter or other
2711	laws of this state; or
2712	(g) Engaged in a pattern of practice of overutilization or
2713	a violation of this chapter or rules adopted by the agency,
2714	including failure to adhere to practice parameters and protocols
2715	established in accordance with this chapter.
2716	(14) PAYMENT OF MEDICAL FEES.--
2717	(a) Except for emergency care treatment, fees for medical
2718	services are payable only to a health care provider certified
2719	and authorized to render remedial treatment, care, or attendance
2720	under this chapter. Carriers shall pay, disallow, or deny
2721	payment to health care providers in the manner and at times set
2722	forth in this chapter.A health care provider may not collect or
2723	receive a fee from an injured employee within this state, except
2724	as otherwise provided by this chapter. Such providers have
2725	recourse against the employer or carrier for payment for
2726	services rendered in accordance with this chapter. Payment to
2727	health care providers or physicians shall be subject to the
2728	medical fee schedule and applicable practice parameters and
2729	protocols, regardless of whether the health care provider or
2730	claimant is asserting that the payment should be made.
2731	(b) Fees charged for remedial treatment, care, and
2732	attendance, except for independent medical examinations and
2733	consensus independent medical examinations, may not exceed the
2734	applicable fee schedules adopted under this chapter and
2735	department rule. Notwithstanding any other provision in this
2736	chapter, if a physician or health care provider specifically
2737	agrees in writing to follow identified procedures aimed at
2738	providing quality medical care to injured workers at reasonable
2739	costs, deviations from established fee schedules shall be
2740	permitted. Written agreements warranting deviations may include,
2741	but are not limited to, the timely scheduling of appointments
2742	for injured workers, participating in return-to-work programs
2743	with injured workers' employers, expediting the reporting of
2744	treatments provided to injured workers, and agreeing to
2745	continuing education, utilization review, quality assurance,
2746	precertification, and case management systems that are designed
2747	to provide needed treatment for injured workers.
2748	(c) Notwithstanding any other provision of this chapter,
2749	following overall maximum medical improvement from an injury
2750	compensable under this chapter, the employee is obligated to pay
2751	a copayment of $10 per visit for medical services. The copayment
2752	shall not apply to emergency care provided to the employee.
2753	(15) PRACTICE PARAMETERS.--The practice parameters and
2754	protocols mandated under this chapter shall be the practice
2755	parameters and protocols adopted by the United States Agency for
2756	Healthcare Research and Quality in effect on January 1, 2003.
2757	(a) The Agency for Health Care Administration, in
2758	conjunction with the department and appropriate health
2759	professional associations and health-related organizations shall
2760	develop and may adopt by rule scientifically sound practice
2761	parameters for medical procedures relevant to workers'
2762	compensation claimants. Practice parameters developed under this
2763	section must focus on identifying effective remedial treatments
2764	and promoting the appropriate utilization of health care
2765	resources. Priority must be given to those procedures that
2766	involve the greatest utilization of resources either because
2767	they are the most costly or because they are the most frequently
2768	performed. Practice parameters for treatment of the 10 top
2769	procedures associated with workers' compensation injuries
2770	including the remedial treatment of lower-back injuries must be
2771	developed by December 31, 1994.
2772	(b) The guidelines may be initially based on guidelines
2773	prepared by nationally recognized health care institutions and
2774	professional organizations but should be tailored to meet the
2775	workers' compensation goal of returning employees to full
2776	employment as quickly as medically possible, taking into
2777	consideration outcomes data collected from managed care
2778	providers and any other inpatient and outpatient facilities
2779	serving workers' compensation claimants.
2780	(c) Procedures must be instituted which provide for the
2781	periodic review and revision of practice parameters based on the
2782	latest outcomes data, research findings, technological
2783	advancements, and clinical experiences, at least once every 3
2784	years.
2785	(d) Practice parameters developed under this section must
2786	be used by carriers and the agency in evaluating the
2787	appropriateness and overutilization of medical services provided
2788	to injured employees.
2789	(16) STANDARDS OF CARE.--The following standards of care
2790	shall be followed in providing medical care under this chapter:
2791	(a) Abnormal anatomical findings alone, in the absence of
2792	objective relevant medical findings, shall not be an indicator
2793	of injury or illness, a justification for the provision of
2794	remedial medical care or the assignment of restrictions, or a
2795	foundation for limitations.
2796	(b) At all times during evaluation and treatment, the
2797	provider shall act on the premise that returning to work is an
2798	integral part of the treatment plan. The goal of removing all
2799	restrictions and limitations as early as appropriate shall be
2800	part of the treatment plan on a continuous basis. The assignment
2801	of restrictions and limitations shall be reviewed with each
2802	patient exam and upon receipt of new information, such as
2803	progress reports from physical therapists and other providers.
2804	Consideration shall be given to upgrading or removing the
2805	restrictions and limitations with each patient exam, based upon
2806	the presence or absence of objective relevant medical findings.
2807	(c) Reasonable necessary medical care of injured employees
2808	shall in all situations:
2809	1. Utilize a high intensity, short duration treatment
2810	approach that focuses on early activation and restoration of
2811	function whenever possible.
2812	2. Include reassessment of the treatment plans, regimes,
2813	therapies, prescriptions, and functional limitations or
2814	restrictions prescribed by the provider every 30 days.
2815	3. Be focused on treatment of the individual employee's
2816	specific clinical dysfunction or status and shall not be based
2817	upon nondescript diagnostic labels.
2818
2819	All treatment shall be inherently scientifically logical and the
2820	evaluation or treatment procedure must match the documented
2821	physiologic and clinical problem. Treatment shall match the
2822	type, intensity, and duration of service required by the problem
2823	identified.
2824	(17) Failure to comply with this section shall be
2825	considered a violation of this chapter and is subject to
2826	penalties as provided for in s. 440.525.
2827	Section 16. Paragraphs (d) and (i) of subsection (1) and
2828	subsections (2), (6), (7), (8), (9), (10), (11), (17), and (25)
2829	of section 440.134, Florida Statutes, are amended to read:
2830	440.134 Workers' compensation managed care arrangement.--
2831	(1) As used in this section, the term:
2832	(d) "Grievance" means a written complaint, other than a
2833	petition for benefits, filed by the injured worker pursuant to
2834	the requirements of the managed care arrangement, expressing
2835	dissatisfaction with the medical care provided by aninsurer's
2836	workers' compensation managed care arrangement's refusal to
2837	provide medical care or the medical care providedarrangement
2838	health care providers, expressed in writing by an injured
2839	worker.
2840	(i) "Medical care coordinator" means a primary care
2841	provider within a provider network who is responsible for
2842	managing the medical care of an injured worker including
2843	determining other health care providers and health care
2844	facilities to which the injured employee will be referred for
2845	evaluation or treatment. A medical care coordinator shall be a
2846	physician licensed under chapter 458,oran osteopathic
2847	physician licensed under chapter 459, a chiropractic physician
2848	licensed under chapter 460, or a podiatric physician licensed
2849	under chapter 461.
2850	(2)(a) The self-insured employer or carrier may, subject
2851	to the terms and limitations specified elsewhere in this section
2852	and chapter, furnish to the employee solely through managed care
2853	arrangements such medically necessary remedial treatment, care,
2854	and attendance for such period as the nature of the injury or
2855	the process of recovery requires and which shall be in
2856	accordance with practice parameters and protocols established
2857	pursuant to this chapter. For any self-insured employer or
2858	carrier who elects to deliver the medical benefits required by
2859	this chapter through a method other than a workers' compensation
2860	managed care arrangement, the discontinuance of the use of the
2861	workers' compensation managed care arrangement shall be without
2862	regard to the date of the accident, notwithstanding any other
2863	provision of law or rule.
2864	(b) The agency shall authorize an insurer to offer or
2865	utilize a workers' compensation managed care arrangement after
2866	the insurer files a completed application along with the payment
2867	of a $1,000 application fee, and upon the agency's being
2868	satisfied that the applicant has the ability to provide quality
2869	of care consistent with the prevailing professional standards of
2870	care and the insurer and its workers' compensation managed care
2871	arrangement otherwise meets the requirements of this section. No
2872	insurer may offer or utilize a managed care arrangement without
2873	such authorization. The authorization, unless sooner suspended
2874	or revoked, shall automatically expire 2 years after the date of
2875	issuance unless renewed by the insurer. The authorization shall
2876	be renewed upon application for renewal and payment of a renewal
2877	fee of $1,000, provided that the insurer is in compliance with
2878	the requirements of this section and any rules adopted
2879	hereunder. An application for renewal of the authorization shall
2880	be made 90 days prior to expiration of the authorization, on
2881	forms provided by the agency. The renewal application shall not
2882	require the resubmission of any documents previously filed with
2883	the agency if such documents have remained valid and unchanged
2884	since their original filing.
2885	(6) The proposed managed care plan of operation must
2886	include:
2887	(a) A statement or map providing a clear description of
2888	the service area.
2889	(b) A description of the grievance procedure to be used.
2890	(c) A description of the quality assurance program which
2891	assures that the health care services provided to workers shall
2892	be rendered under reasonable standards of quality of care
2893	consistent with the prevailing standards of medical practice in
2894	the medical community. The program shall include, but not be
2895	limited to:
2896	1. A written statement of goals and objectives that
2897	stresses health and return-to-work outcomes as the principal
2898	criteria for the evaluation of the quality of care rendered to
2899	injured workers.
2900	2. A written statement describing how methodology has been
2901	incorporated into an ongoing system for monitoring of care that
2902	is individual case oriented and, when implemented, can provide
2903	interpretation and analysis of patterns of care rendered to
2904	individual patients by individual providers.
2905	3. Written procedures for taking appropriate remedial
2906	action whenever, as determined under the quality assurance
2907	program, inappropriate or substandard services have been
2908	provided or services that should have been furnished have not
2909	been provided.
2910	4. A written plan, which includes ongoing review, for
2911	providing review of physicians and other licensed medical
2912	providers.
2913	5. Appropriate financial incentives to reduce service
2914	costs and utilization without sacrificing the quality of
2915	service.
2916	6. Adequate methods of peer review and utilization review.
2917	The utilization review process shall include a health care
2918	facility'sfacilitiesprecertification mechanism, including, but
2919	not limited to, all elective admissions and nonemergency
2920	surgeries and adherence to practice parameters and protocols
2921	established in accordance with this chapter.
2922	7. Provisions for resolution of disputes arising between a
2923	health care provider and an insurer regarding reimbursements and
2924	utilization review.
2925	8. Availability of a process for aggressive medical care
2926	coordination, as well as a program involving cooperative efforts
2927	by the workers, the employer, and the workers' compensation
2928	managed care arrangement to promote early return to work for
2929	injured workers.
2930	9. A written plan allowing for the independent medical
2931	examination provided for in s. 440.13(5). Notwithstanding any
2932	provision to the contrary, the costs for the independent medical
2933	examination shall be paid by the carrier if such examination is
2934	performed by a physician in the provider network. Otherwise,
2935	such costs shall be paid in accordance with s. 440.13(5). An
2936	independent medical examination requested by a claimant and paid
2937	for by the carrier shall constitute the claimant's one
2938	independent medical examination per accident under s. 440.13(5).
2939	A process allowing employees to obtain one second medical
2940	opinion in the same specialty and within the provider network
2941	during the course of treatment for a work-related injury.
2942	10. A provision for the selection of a primary care
2943	provider by the employee from among primary providers in the
2944	provider network.
2945	11. The written information proposed to be used by the
2946	insurer to comply with subparagraph 8.
2947	(7) Written procedures to provide the insurer with timely
2948	medical records and information including, but not limited to,
2949	work status, work restrictions, date of maximum medical
2950	improvement, permanent impairment ratings, and other information
2951	as required, including information demonstrating compliance with
2952	the practice parameters and protocols of treatment established
2953	pursuant to this chapter.
2954	(8) Evidence that appropriate health care providers and
2955	administrative staff of the insurer's workers' compensation
2956	managed care arrangement have received training and education on
2957	the provisions of this chapter;andthe administrative rules
2958	that govern the provision of remedial treatment, care, and
2959	attendance of injured workers; and the practice parameters and
2960	protocols of treatment established pursuant to this chapter.
2961	(9) Written procedures and methods to prevent
2962	inappropriate or excessive treatment that are in accordance with
2963	the practice parameters and protocols of treatment established
2964	pursuant to this chapter.
2965	(10) Written procedures and methods for the management of
2966	an injured worker's medical care by a medical care coordinator
2967	including:
2968	(a) The mechanism for assuring that covered employees
2969	receive all initial covered services from a primary care
2970	provider participating in the provider network, except for
2971	emergency care.
2972	(b) The mechanism for assuring that all continuing covered
2973	services be received from the same primary care provider
2974	participating in the provider network that provided the initial
2975	covered services, except when services from another provider are
2976	authorized by the medical care coordinator pursuant to paragraph
2977	(d).
2978	(c) The policies and procedures for allowing an employee
2979	one change to another provider within the same specialty and
2980	provider network as the authorized treating physician during the
2981	course of treatment for a work-related injury, in accordance
2982	with the procedures provided in s. 440.13(2)(f), if a request is
2983	made to the medical care coordinator by the employee; and
2984	requiring that special provision be made for more than one such
2985	referral through the arrangement's grievance procedures.
2986	(d) The process for assuring that all referrals authorized
2987	by a medical care coordinator, in accordance with the practice
2988	parameters and protocols of treatment established pursuant to
2989	this chapter,are made to the participating network providers,
2990	unless medically necessary treatment, care, and attendance are
2991	not available and accessible to the injured worker in the
2992	provider network.
2993	(e) Assignment of a medical care coordinator licensed
2994	under chapter 458 or chapter 459 to manage care by physicians
2995	licensed under chapter 458 or chapter 459, a medical care
2996	coordinator licensed under chapter 460 to manage care by
2997	physicians licensed under chapter 460, and a medical care
2998	coordinator licensed under chapter 461 to manage care by
2999	physicians licensed under chapter 461 upon request by an injured
3000	employee for care by a physician licensed under chapter 458,
3001	chapter 459, chapter 460, or chapter 461.
3002	(11) A description of the use of workers' compensation
3003	practice parameters and protocols of treatmentfor health care
3004	services when adopted by the agency.
3005	(17) Notwithstanding any other provisions of this chapter,
3006	when a carrier provides medical care through a workers'
3007	compensation managed care arrangement, pursuant to this section,
3008	those workers who are subject to the arrangement must receive
3009	medical services for work-related injuries and diseases as
3010	prescribed in the contract, provided the employer and carrier
3011	have provided notice to the employees of the arrangement in a
3012	manner approved by the agency and the medical services are in
3013	accordance with the practice parameters and protocols
3014	established pursuant to this chapter. Treatment received outside
3015	the workers' compensation managed care arrangement is not
3016	compensable, regardless of the purpose of the treatment,
3017	including, but not limited to, evaluations, examinations, or
3018	diagnostic studies to determine causation between medical
3019	findings and a compensable accident, the existence or extent of
3020	impairments or disabilities, and whether the injured employee
3021	has reached maximum medical improvement,unless authorized by
3022	the carrier prior to the treatment date.
3023	(25) The agency shall adopt rules that specify:
3024	(a) Procedures for authorization and examination of
3025	workers' compensation managed care arrangements by the agency.
3026	(b) Requirements and procedures for authorization of
3027	workers' compensation arrangement provider networks and
3028	procedures for the agency to grant exceptions from accessibility
3029	of services.
3030	(c) Requirements and procedures for case management,
3031	utilization management, and peer review.
3032	(d) Requirements and procedures for quality assurance and
3033	medical records.
3034	(e) Requirements and procedures for dispute resolution in
3035	conformance with this chapter.
3036	(f) Requirements and procedures for employee and provider
3037	education.
3038	(g) Requirements and procedures for reporting data
3039	regarding grievances, return-to-work outcomes, and provider
3040	networks.
3041	Section 17. Subsections (1) and (4)and paragraph (b) of
3042	subsection (5) of section 440.14, Florida Statutes, are amended
3043	to read:
3044	440.14 Determination of pay.--
3045	(1) Except as otherwise provided in this chapter, the
3046	average weekly wages of the injured employee on the date of the
3047	accidentat the time of the injuryshall be taken as the basis
3048	upon which to compute compensation and shall be determined,
3049	subject to the limitations of s. 440.12(2), as follows:
3050	(a) If the injured employee has worked in the employment
3051	in which she or he was working on the date of the accidentat
3052	the time of the injury, whether for the same or another
3053	employer, during substantially the whole of 13 weeks immediately
3054	preceding the accidentinjury, her or his average weekly wage
3055	shall be one-thirteenth of the total amount of wages earned in
3056	such employment during the 13 weeks. As used in this paragraph,
3057	the term "substantially the whole of 13 weeks" means the
3058	calendarshall be deemed to mean and refer to a constructive
3059	period of 13 weeks as a whole, which shall be defined as the 13
3060	calendar weeks before the date of the accident, excluding the
3061	week during which the accident occurred.a consecutive period of
3062	91 days, andThe term "during substantially the whole of 13
3063	weeks" shall be deemed to mean during not less than 7590
3064	percent of the total customary full-timehours of employment
3065	within such period considered as a whole.
3066	(b) If the injured employee has not worked in such
3067	employment during substantially the whole of 13 weeks
3068	immediately preceding the accidentinjury, the wages of a
3069	similar employee in the same employment who has worked
3070	substantially the whole of such 13 weeks shall be used in making
3071	the determination under the preceding paragraph.
3072	(c) If an employee is a seasonal worker and the foregoing
3073	method cannot be fairly applied in determining the average
3074	weekly wage, then the employee may use, instead of the 13 weeks
3075	immediately preceding the accidentinjury, the calendar year or
3076	the 52 weeks immediately preceding the accidentinjury. The
3077	employee will have the burden of proving that this method will
3078	be more reasonable and fairer than the method set forth in
3079	paragraphs (a) and (b) and, further, must document prior
3080	earnings with W-2 forms, written wage statements, or income tax
3081	returns. The employer shall have 30 days following the receipt
3082	of this written proof to adjust the compensation rate, including
3083	the making of any additional payment due for prior weekly
3084	payments, based on the lower rate compensation.
3085	(d) If any of the foregoing methods cannot reasonably and
3086	fairly be applied, the full-time weekly wages of the injured
3087	employee shall be used, except as otherwise provided in
3088	paragraph (e) or paragraph (f).
3089	(e) If it is established that the injured employee was
3090	under 22 years of age when the accident occurredinjuredand
3091	that under normal conditions her or his wages should be expected
3092	to increase during the period of disability, the fact may be
3093	considered in arriving at her or his average weekly wages.
3094	(f) If it is established that the injured employee was a
3095	part-time worker on the date of the accidentat the time of the
3096	injury, that she or he had adopted part-time employment as a
3097	customary practice, and that under normal working conditions she
3098	or he probably would have remained a part-time worker during the
3099	period of disability, these factors shall be considered in
3100	arriving at her or his average weekly wages. For the purpose of
3101	this paragraph, the term "part-time worker" means an individual
3102	who customarily works less than the full-time hours or full-time
3103	workweek of a similar employee in the same employment.
3104	(g) If compensation is due for a fractional part of the
3105	week, the compensation for such fractional part shall be
3106	determined by dividing the weekly compensation rate by the
3107	number of days employed per week to compute the amount due for
3108	each day.
3109	(4) Upon termination of the employee or upon termination
3110	of the payment of fringe benefits of any employee who is
3111	collecting indemnity benefits pursuant to s. 440.15(2) or
3112	(3)(b), the employer shall within 7 days of such termination
3113	file a corrected 13-week wage statement reflecting the wages
3114	paid and the fringe benefits that had been paid to the injured
3115	employee, as provided in s. 440.02(27).
3116	(5)
3117	(b) The employee waives any entitlement to interest,
3118	penalties, and attorney's fees during the period in which the
3119	employee has not provided information concerning the loss of
3120	earnings from concurrent employment. Carriers are not subject to
3121	penalties by the division under s. 440.20(8)(b) and (c)for
3122	unpaid compensation related to concurrent employment during the
3123	period in which the employee has not provided information
3124	concerning the loss of earnings from concurrent employment.
3125	Section 18. Section 440.15, Florida Statutes, is amended
3126	to read:
3127	440.15 Compensation for disability.--Compensation for
3128	disability shall be paid to the employee, subject to the limits
3129	provided in s. 440.12(2), as follows:
3130	(1) PERMANENT TOTAL DISABILITY.--
3131	(a) In case of total disability adjudged to be permanent,
3132	66 2/3 percent of the average weekly wages shall be paid to the
3133	employee disabilityduring the continuance of such total
3134	disability. No compensation shall be payable under this section
3135	if the employee is engaged in, or is physically capable of
3136	engaging in, at least sedentary employment.
3137	(b) In the following cases, an injured employee is
3138	presumed to be permanently and totally disabled unless the
3139	employer or carrier establishes that the employee is physically
3140	capable of engaging in at least sedentary employment within a
3141	50-mile radius of the employee’s residence:
3142	1. Spinal cord injury involving severe paralysis of an
3143	arm, a leg, or the trunk;
3144	2. Amputation of an arm, a hand, a foot, or a leg
3145	involving the effective loss of use of that appendage;
3146	3. Severe brain or closed-head injury as evidenced by:
3147	a. Severe sensory or motor disturbances;
3148	b. Severe communication disturbances;
3149	c. Severe complex integrated disturbances of cerebral
3150	function;
3151	d. Severe episodic neurological disorders; or
3152	e. Other severe brain and closed-head injury conditions at
3153	least as severe in nature as any condition provided in sub-
3154	subparagraphs a.-d.;
3155	4. Second-degree or third-degree burns of 25 percent or
3156	more of the total body surface or third-degree burns of 5
3157	percent or more to the face and hands; or
3158	5. Total or industrial blindness.
3159
3160	In all other cases, in order to obtain permanent total
3161	disability benefits, the employee must establish that he or she
3162	is not able to engage in at least sedentary employment, within a
3163	50-mile radius of the employee's residence, due to his or her
3164	physical limitation. Entitlement to such benefits shall cease
3165	when the employee reaches age 75, unless the employee is not
3166	eligible for social security benefits under 42 U.S.C. s. 402 or
3167	s. 423 because the employee’s compensable injury has prevented
3168	the employee from working sufficient quarters to be eligible for
3169	such benefits, notwithstanding any age limits. If the accident
3170	occurred on or after the employee reaches age 70, benefits shall
3171	be payable during the continuance of permanent total disability,
3172	not to exceed 5 years following the determination of permanent
3173	total disability.Only a catastrophic injury as defined in s.
3174	440.02 shall, in the absence of conclusive proof of a
3175	substantial earning capacity, constitute permanent total
3176	disability. Only claimants with catastrophic injuries or
3177	claimants who are incapable of engaging in employment, as
3178	described in this paragraph,are eligible for permanent total
3179	benefits. In no other case may permanent total disability be
3180	awarded.
3181	(c) In cases of permanent total disability resulting from
3182	injuries that occurred prior to July 1, 1955, such payments
3183	shall not be made in excess of 700 weeks.
3184	(d) If an employee who is being paid compensation for
3185	permanent total disability becomes rehabilitated to the extent
3186	that she or he establishes an earning capacity, the employee
3187	shall be paid, instead of the compensation provided in paragraph
3188	(a), benefits pursuant to subsection (3). The department shall
3189	adopt rules to enable a permanently and totally disabled
3190	employee who may have reestablished an earning capacity to
3191	undertake a trial period of reemployment without prejudicing her
3192	or his return to permanent total status in the case that such
3193	employee is unable to sustain an earning capacity.
3194	(e)1. The employer's or carrier's right to conduct
3195	vocational evaluations or testing by the employer's or carrier's
3196	chosen rehabilitation advisor or providerpursuant to s. 440.491
3197	continues even after the employee has been accepted or
3198	adjudicated as entitled to compensation under this chapter and
3199	costs for such evaluations and testing shall be borne by the
3200	employer or carrier, respectively. This right includes, but is
3201	not limited to, instances in which such evaluations or tests are
3202	recommended by a treating physician or independent medical-
3203	examination physician, instances warranted by a change in the
3204	employee's medical condition, or instances in which the employee
3205	appears to be making appropriate progress in recuperation. This
3206	right may not be exercised more than once every calendar year.
3207	2. The carrier must confirm the scheduling of the
3208	vocational evaluation or testing in writing, and must notify the
3209	employee and theemployee's counsel, if any, at least 7 days
3210	before the date on which vocational evaluation or testing is
3211	scheduled to occur.
3212	3. Pursuant to an order of the judge of compensation
3213	claims,The employer or carrier may withhold payment of benefits
3214	for permanent total disability or supplements for any period
3215	during which the employee willfully fails or refuses to appear
3216	without good cause for the scheduled vocational evaluation or
3217	testing.
3218	(f)1. If permanent total disability results from injuries
3219	that occurred subsequent to June 30, 1955, and for which the
3220	liability of the employer for compensation has not been
3221	discharged under s. 440.20(11), the injured employee shall
3222	receive additional weekly compensation benefits equal to 35
3223	percent of her or his weekly compensation rate, as established
3224	pursuant to the law in effect on the date of her or his injury,
3225	multiplied by the number of calendar years since the date of
3226	injury. The weekly compensation payable and the additional
3227	benefits payable under this paragraph, when combined, may not
3228	exceed the maximum weekly compensation rate in effect at the
3229	time of payment as determined pursuant to s. 440.12(2).
3230	Entitlement to These supplemental payments shall not be paid or
3231	payable after the employee attainscease at age 62, regardless
3232	of whetherif the employee has applied for or is eligible to
3233	applyis eligible for social security benefits under 42 U.S.C.
3234	s.ss. 402 or s.and 423, unless the employee is not eligible
3235	for social security benefits under 42 U.S.C. s. 402 or s. 423
3236	because the employee’s compensable injury has prevented the
3237	employee from working sufficient quarters to be eligible for
3238	such benefitswhether or not the employee has applied for such
3239	benefits. These supplemental benefits shall be paid by the
3240	department out of the Workers' Compensation Administration Trust
3241	Fund when the injury occurred subsequent to June 30, 1955, and
3242	before July 1, 1984. These supplemental benefits shall be paid
3243	by the employer when the injury occurred on or after July 1,
3244	1984. Supplemental benefits are not payable for any period prior
3245	to October 1, 1974.
3246	2.a. The department shall provide by rule for the periodic
3247	reporting to the department of all earnings of any nature and
3248	social security income by the injured employee entitled to or
3249	claiming additional compensation under subparagraph 1. Neither
3250	the department nor the employer or carrier shall make any
3251	payment of those additional benefits provided by subparagraph 1.
3252	for any period during which the employee willfully fails or
3253	refuses to report upon request by the department in the manner
3254	prescribed by such rules.
3255	b. The department shall provide by rule for the periodic
3256	reporting to the employer or carrier of all earnings of any
3257	nature and social security income by the injured employee
3258	entitled to or claiming benefits for permanent total disability.
3259	The employer or carrier is not required to make any payment of
3260	benefits for permanent total disability for any period during
3261	which the employee willfully fails or refuses to report upon
3262	request by the employer or carrier in the manner prescribed by
3263	such rules or if any employee who is receiving permanent total
3264	disability benefits refuses to apply for or cooperate with the
3265	employer or carrier in applying for social security benefits.
3266	3. When an injured employee receives a full or partial
3267	lump-sum advance of the employee's permanent total disability
3268	compensation benefits, the employee's benefits under this
3269	paragraph shall be computed on the employee's weekly
3270	compensation rate as reduced by the lump-sum advance.
3271	(2) TEMPORARY TOTAL DISABILITY.--
3272	(a) Subject to subsection (7),in case of disability total
3273	in character but temporary in quality, 66 2/3 percent of the
3274	average weekly wages shall be paid to the employee during the
3275	continuance thereof, not to exceed 104 weeks except as provided
3276	in this subsection, s. 440.12(1), and s. 440.14(3). Once the
3277	employee reaches the maximum number of weeks allowed, or the
3278	employee reaches the date of maximum medical improvement,
3279	whichever occurs earlier, temporary disability benefits shall
3280	cease and the injured worker's permanent impairment shall be
3281	determined.
3282	(b) Notwithstanding the provisions of paragraph (a), an
3283	employee who has sustained the loss of an arm, leg, hand, or
3284	foot, has been rendered a paraplegic, paraparetic, quadriplegic,
3285	or quadriparetic, or has lost the sight of both eyes shall be
3286	paid temporary total disability of 80 percent of her or his
3287	average weekly wage. The increased temporary total disability
3288	compensation provided for in this paragraph must not extend
3289	beyond 6 months from the date of the accident; however, such
3290	benefits shall not be due or payable if the employee is eligible
3291	for, entitled to, or collecting permanent total disability
3292	benefits. The compensation provided by this paragraph is not
3293	subject to the limits provided in s. 440.12(2), but instead is
3294	subject to a maximum weekly compensation rate of $700. If, at
3295	the conclusion of this period of increased temporary total
3296	disability compensation, the employee is still temporarily
3297	totally disabled, the employee shall continue to receive
3298	temporary total disability compensation as set forth in
3299	paragraphs (a) and (c). The period of time the employee has
3300	received this increased compensation will be counted as part of,
3301	and not in addition to, the maximum periods of time for which
3302	the employee is entitled to compensation under paragraph (a) but
3303	not paragraph (c).
3304	(c) Temporary total disability benefits paid pursuant to
3305	this subsection shall include such period as may be reasonably
3306	necessary for training in the use of artificial members and
3307	appliances, and shall include such period as the employee may be
3308	receiving training and education under a program pursuant to s.
3309	440.491. Notwithstanding s. 440.02, the date of maximum medical
3310	improvement for purposes of paragraph (3)(b) shall be no earlier
3311	than the last day for which such temporary disability benefits
3312	are paid.
3313	(d) The department shall, by rule, provide for the
3314	periodic reporting to the department, employer, or carrier of
3315	all earned income, including income from social security, by the
3316	injured employee who is entitled to or claiming benefits for
3317	temporary total disability. The employer or carrier is not
3318	required to make any payment of benefits for temporary total
3319	disability for any period during which the employee willfully
3320	fails or refuses to report upon request by the employer or
3321	carrier in the manner prescribed by the rules. The rule must
3322	require the claimant to personally sign the claim form and
3323	attest that she or he has reviewed, understands, and
3324	acknowledges the foregoing.
3325	(3) PERMANENT IMPAIRMENT AND WAGE-LOSSBENEFITS.--
3326	(a) Impairment benefits.--
3327	1.Once the employee has reached the date of maximum
3328	medical improvement, impairment benefits are due and payable
3329	within 1420days after the carrier has knowledge of the
3330	impairment.
3331	(b)2.The three-member panel, in cooperation with the
3332	department, shall establish and use a uniform permanent
3333	impairment rating schedule. This schedule must be based on
3334	medically or scientifically demonstrable findings as well as the
3335	systems and criteria set forth in the American Medical
3336	Association's Guides to the Evaluation of Permanent Impairment;
3337	the Snellen Charts, published by American Medical Association
3338	Committee for Eye Injuries; and the Minnesota Department of
3339	Labor and Industry Disability Schedules. The schedule must
3340	shouldbe based upon objective findings. The schedule shall be
3341	more comprehensive than the AMA Guides to the Evaluation of
3342	Permanent Impairment and shall expand the areas already
3343	addressed and address additional areas not currently contained
3344	in the guides. On August 1, 1979, and pending the adoption, by
3345	rule, of a permanent schedule, Guides to the Evaluation of
3346	Permanent Impairment, copyright 1977, 1971, 1988, by the
3347	American Medical Association, shall be the temporary schedule
3348	and shall be used for the purposes hereof. For injuries after
3349	July 1, 1990, pending the adoption by rule of a uniform
3350	disability rating agency schedule, the Minnesota Department of
3351	Labor and Industry Disability Schedule shall be used unless that
3352	schedule does not address an injury. In such case, the Guides to
3353	the Evaluation of Permanent Impairment by the American Medical
3354	Association shall be used. Determination of permanent impairment
3355	under this schedule must be made by a physician licensed under
3356	chapter 458, a doctor of osteopathic medicine licensed under
3357	chapters 458 and 459, a chiropractic physician licensed under
3358	chapter 460, a podiatric physician licensed under chapter 461,
3359	an optometrist licensed under chapter 463, or a dentist licensed
3360	under chapter 466, as appropriate considering the nature of the
3361	injury. No other persons are authorized to render opinions
3362	regarding the existence of or the extent of permanent
3363	impairment.
3364	(c)3.All impairment income benefits shall be based on an
3365	impairment rating using the impairment schedule referred to in
3366	paragraph (b)subparagraph 2. Impairment income benefits are
3367	paid biweeklyweekly at the rate of 7550percent of the
3368	employee's average weekly temporary total disability benefit not
3369	to exceed the maximum weekly benefit under s. 440.12; provided,
3370	however, that such benefits shall be reduced by 50 percent for
3371	each week in which the employee has earned income equal to or in
3372	excess of the employee's average weekly wage. An employee's
3373	entitlement to impairment income benefits begins the day after
3374	the employee reaches maximum medical improvement or the
3375	expiration of temporary benefits, whichever occurs earlier, and
3376	continues until the earlier of:
3377	1.a.The expiration of a period computed at the rate of 3
3378	weeks for each percentage point of impairment; or
3379	2.b.The death of the employee.
3380
3381	Impairment income benefits as defined by this subsection are
3382	payable only for impairment ratings for physical impairments. If
3383	objective medical findings can substantiate a permanent
3384	psychiatric impairment resulting from the accident, permanent
3385	impairment benefits are limited for the permanent psychiatric
3386	impairment to 1-percent permanent impairment.
3387	(d)4.After the employee has been certified by a doctor as
3388	having reached maximum medical improvement or 6 weeks before the
3389	expiration of temporary benefits, whichever occurs earlier, the
3390	certifying doctor shall evaluate the condition of the employee
3391	and assign an impairment rating, using the impairment schedule
3392	referred to in paragraph (b)subparagraph 2. Compensation is not
3393	payable for the mental, psychological, or emotional injury
3394	arising out of depression from being out of work.If the
3395	certification and evaluation are performed by a doctor other
3396	than the employee's treating doctor, the certification and
3397	evaluation must be submitted to the treating doctor, the
3398	employee, and the carrier within 10 days after the evaluation.
3399	and The treating doctor must indicate to the carrieragreement
3400	or disagreement with the other doctor'scertification and
3401	evaluation.
3402	1.The certifying doctor shall issue a written report to
3403	the department, the employee,and the carrier certifying that
3404	maximum medical improvement has been reached, stating the
3405	impairment rating to the body as a whole, and providing any
3406	other information required by the department by rule. The
3407	carrier shall establish an overall maximum medical improvement
3408	date and permanent impairment rating, based upon all such
3409	reports.
3410	2. Within 14 days after the carrier's knowledge of each
3411	maximum medical improvement date and impairment rating to the
3412	body as a whole upon which the carrier is paying benefits, the
3413	carrier shall report such maximum medical improvement date and,
3414	when determined, the overall maximum medical improvement date
3415	and associated impairment rating to the department in a format
3416	as set forth in department rule.If the employee has not been
3417	certified as having reached maximum medical improvement before
3418	the expiration of 98102 weeks after the date temporary total
3419	disability benefits begin to accrue, the carrier shall notify
3420	the treating doctor of the requirements of this section.
3421	(e)5. The carrier shall pay the employee impairment income
3422	benefits for a period based on the impairment rating.
3423	(f)6. The department may by rule specify forms and
3424	procedures governing the method of payment of wage loss and
3425	impairment benefits under this sectionfor dates of accidents
3426	before January 1, 1994, and for dates of accidents on or after
3427	January 1, 1994.
3428	(b) Supplemental benefits.--
3429	1. All supplemental benefits must be paid in accordance
3430	with this subsection. An employee is entitled to supplemental
3431	benefits as provided in this paragraph as of the expiration of
3432	the impairment period, if:
3433	a. The employee has an impairment rating from the
3434	compensable injury of 20 percent or more as determined pursuant
3435	to this chapter;
3436	b. The employee has not returned to work or has returned
3437	to work earning less than 80 percent of the employee's average
3438	weekly wage as a direct result of the employee's impairment; and
3439	c. The employee has in good faith attempted to obtain
3440	employment commensurate with the employee's ability to work.
3441	2. If an employee is not entitled to supplemental benefits
3442	at the time of payment of the final weekly impairment income
3443	benefit because the employee is earning at least 80 percent of
3444	the employee's average weekly wage, the employee may become
3445	entitled to supplemental benefits at any time within 1 year
3446	after the impairment income benefit period ends if:
3447	a. The employee earns wages that are less than 80 percent
3448	of the employee's average weekly wage for a period of at least
3449	90 days;
3450	b. The employee meets the other requirements of
3451	subparagraph 1.; and
3452	c. The employee's decrease in earnings is a direct result
3453	of the employee's impairment from the compensable injury.
3454	3. If an employee earns wages that are at least 80 percent
3455	of the employee's average weekly wage for a period of at least
3456	90 days during which the employee is receiving supplemental
3457	benefits, the employee ceases to be entitled to supplemental
3458	benefits for the filing period. Supplemental benefits that have
3459	been terminated shall be reinstated when the employee satisfies
3460	the conditions enumerated in subparagraph 2. and files the
3461	statement required under subparagraph 4. Notwithstanding any
3462	other provision, if an employee is not entitled to supplemental
3463	benefits for 12 consecutive months, the employee ceases to be
3464	entitled to any additional income benefits for the compensable
3465	injury. If the employee is discharged within 12 months after
3466	losing entitlement under this subsection, benefits may be
3467	reinstated if the employee was discharged at that time with the
3468	intent to deprive the employee of supplemental benefits.
3469	4. After the initial determination of supplemental
3470	benefits, the employee must file a statement with the carrier
3471	stating that the employee has earned less than 80 percent of the
3472	employee's average weekly wage as a direct result of the
3473	employee's impairment, stating the amount of wages the employee
3474	earned in the filing period, and stating that the employee has
3475	in good faith sought employment commensurate with the employee's
3476	ability to work. The statement must be filed quarterly on a form
3477	and in the manner prescribed by the department. The department
3478	may modify the filing period as appropriate to an individual
3479	case. Failure to file a statement relieves the carrier of
3480	liability for supplemental benefits for the period during which
3481	a statement is not filed.
3482	5. The carrier shall begin payment of supplemental
3483	benefits not later than the seventh day after the expiration
3484	date of the impairment income benefit period and shall continue
3485	to timely pay those benefits. The carrier may request a
3486	mediation conference for the purpose of contesting the
3487	employee's entitlement to or the amount of supplemental income
3488	benefits.
3489	6. Supplemental benefits are calculated quarterly and paid
3490	monthly. For purposes of calculating supplemental benefits, 80
3491	percent of the employee's average weekly wage and the average
3492	wages the employee has earned per week are compared quarterly.
3493	For purposes of this paragraph, if the employee is offered a
3494	bona fide position of employment that the employee is capable of
3495	performing, given the physical condition of the employee and the
3496	geographic accessibility of the position, the employee's weekly
3497	wages are considered equivalent to the weekly wages for the
3498	position offered to the employee.
3499	7. Supplemental benefits are payable at the rate of 80
3500	percent of the difference between 80 percent of the employee's
3501	average weekly wage determined pursuant to s. 440.14 and the
3502	weekly wages the employee has earned during the reporting
3503	period, not to exceed the maximum weekly income benefit under s.
3504	440.12.
3505	8. The department may by rule define terms that are
3506	necessary for the administration of this section and forms and
3507	procedures governing the method of payment of supplemental
3508	benefits for dates of accidents before January 1, 1994, and for
3509	dates of accidents on or after January 1, 1994.
3510	(c) Duration of temporary impairment and supplemental
3511	income benefits.--The employee's eligibility for temporary
3512	benefits, impairment income benefits, and supplemental benefits
3513	terminates on the expiration of 401 weeks after the date of
3514	injury.
3515	(g) Notwithstanding paragraph (c), for accidents occurring
3516	on or after October 1, 2003, an employee's entitlement to
3517	impairment income benefits begins the day after the employee
3518	reaches maximum medical improvement or the expiration of
3519	temporary benefits, whichever occurs earlier, and continues for
3520	the following periods:
3521	1. Two weeks of benefits are to be paid to the employee
3522	for each percentage point of impairment from 1 percent up to and
3523	including 10 percent.
3524	2. For each percentage point of impairment from 11 percent
3525	up to and including 15 percent, 3 weeks of benefits are to be
3526	paid.
3527	3. For each percentage point of impairment from 16 percent
3528	up to and including 20 percent, 4 weeks of benefits are to be
3529	paid.
3530	4. For each percentage point of impairment from 21 percent
3531	and higher, 6 weeks of benefits are to be paid.
3532	(4) TEMPORARY PARTIAL DISABILITY.--
3533	(a) Subject to subsection (7),in case of temporary
3534	partial disability, compensation shall be equal to 80 percent of
3535	the difference between 80 percent of the employee's average
3536	weekly wage and the salary, wages, and other remuneration the
3537	employee is able to earn post injury, as compared weekly;
3538	however, the weekly temporary partial disabilitybenefits may
3539	not exceed an amount equal to 66 2/3 percent of the employee's
3540	average weekly wage at the time of accidentinjury. In order to
3541	simplify the comparison of the preinjury average weekly wage
3542	with the salary, wages, and other remuneration the employee is
3543	able to earn post injury, the department may by rule provide for
3544	payment of the initial installment of temporary partial
3545	disability benefits to be paid as a partial week so that payment
3546	for remaining weeks of temporary partial disability canthe
3547	modification of the weekly comparison so as tocoincide as
3548	closely as possible with the post injury employer's work week
3549	injured worker's pay periods. The amount determined to be the
3550	salary, wages, and other remuneration the employee is able to
3551	earn shall in no case be less than the sum actually being earned
3552	by the employee, including earnings from sheltered employment.
3553	Benefits shall be payable under this subsection only if overall
3554	maximum medical improvement has not been reached and the medical
3555	conditions resulting from the accident create restrictions on
3556	the injured employee's ability to return to work.
3557	(b) Within 5 business days after the carrier's knowledge
3558	of the employee's release to restricted work, the carrier shall
3559	mail to the employee and employer an informational letter,
3560	adopted by department rule, explaining the employee's possible
3561	eligibility and responsibilities for temporary partial
3562	disability benefits.
3563	(c) When an employee returns to work with the restrictions
3564	resulting from the accident and is earning wages less than 80
3565	percent of the preinjury average weekly wage, the first
3566	installment of temporary partial disability benefits is due 7
3567	days after the last date of the post injury employer's first
3568	biweekly work week. Thereafter, payment for temporary partial
3569	benefits shall be paid biweekly no later than the 7th day
3570	following the last day of each biweekly work week.
3571	(d) If the employee is unable to return to work with the
3572	restrictions resulting from the accident and is not earning
3573	wages, salary, or other remuneration, temporary partial
3574	disability benefits shall be paid no later than the last day of
3575	each biweekly period. The employee shall notify the carrier
3576	within 5 business days after returning to work. Failure to
3577	notify the carrier of the establishment of an earning capacity
3578	in the required time shall result in a suspension or nonpayment
3579	of temporary partial disability benefits until the proper
3580	notification is provided.
3581	(e)(b)Such benefits shall be paid during the continuance
3582	of such disability, not to exceed a period of 104 weeks, as
3583	provided by this subsection and subsection (2). Once the injured
3584	employee reaches the maximum number of weeks, temporary
3585	disability benefits cease and the injured worker's permanent
3586	impairment must be determined. If the employee is terminated
3587	from post injury employment based on the employee's misconduct,
3588	temporary partial disability benefits are not payable as
3589	provided for in this section. The department shallmayby rule
3590	specify forms and procedures governing the method and time for
3591	ofpayment of temporary disability benefits for dates of
3592	accidents before January 1, 1994, and for dates of accidents on
3593	or after January 1, 1994.
3594	(5) SUBSEQUENT INJURY.--
3595	(a) The fact that an employee has suffered previous
3596	disability, impairment, anomaly, or disease, or received
3597	compensation therefor, shall not preclude her or him from
3598	benefits, as specified in paragraph (b),for a subsequent
3599	aggravation or acceleration of the preexisting condition ornor
3600	preclude benefits for death resulting therefrom, except that no
3601	benefits shall be payable if the employee, at the time of
3602	entering into the employment of the employer by whom the
3603	benefits would otherwise be payable, falsely represents herself
3604	or himself in writing as not having previously been disabled or
3605	compensated because of such previous disability, impairment,
3606	anomaly, or disease and the employer detrimentally relies on the
3607	misrepresentation. Compensation for temporary disability,
3608	medical benefits, and wage-loss benefitsshall not be subject to
3609	apportionment.
3610	(b) If a compensable injury, disability, or need for
3611	medical carepermanent impairment, or any portion thereof, is a
3612	result of aggravation or acceleration of a preexisting
3613	condition, or is the result of merger with a preexisting
3614	condition, only the disabilities and medical treatment
3615	associated with such compensable injury shall be payable under
3616	this chapter, excluding the degree of disability or medical
3617	conditions existing at the time of the impairment rating or at
3618	the time of the accident, regardless of whether the preexisting
3619	condition was disabling at the time of the accident or at the
3620	time of the impairment rating and without considering whether
3621	the preexisting condition would be disabling without the
3622	compensable accidentimpairment, an employee eligible to receive
3623	impairment benefits under paragraph (3)(a) shall receive such
3624	benefits for the total impairment found to result, excluding the
3625	degree of impairment existing at the time of the subject
3626	accident or injury or which would have existed by the time of
3627	the impairment rating without the intervention of the
3628	compensable accident or injury. The degree of permanent
3629	impairment or disabilityattributable to the accident or injury
3630	shall be compensated in accordance with this section,
3631	apportioning out the preexisting condition based on the
3632	anatomical impairment rating attributable to the preexisting
3633	condition. Medical benefits shall be paid apportioning out the
3634	percentage of the need for such care attributable to the
3635	preexisting conditionparagraph (3)(a). As used in this
3636	paragraph, "merger" means the combining of a preexisting
3637	permanent impairment or disabilitywith a subsequent compensable
3638	permanent impairment or disabilitywhich, when the effects of
3639	both are considered together, result in a permanent impairment
3640	or disabilityrating which is greater than the sum of the two
3641	permanent impairment or disability ratings when each impairment
3642	or disability is considered individually.
3643	(6) OBLIGATION TO REHIRE.--If the employer has not in good
3644	faith made available to the employee, within a 100-mile radius
3645	of the employee's residence, work appropriate to the employee's
3646	physical limitations within 30 days after the carrier notifies
3647	the employer of maximum medical improvement and the employee's
3648	physical limitations, the employer shall pay to the department
3649	for deposit into the Workers' Compensation Administration Trust
3650	Fund a fine of $250 for every $5,000 of the employer's workers'
3651	compensation premium or payroll, not to exceed $2,000 per
3652	violation, as the department requires by rule. The employer is
3653	not subject to this subsection if the employee is receiving
3654	permanent total disability benefits or if the employer has 50 or
3655	fewer employees.
3656	(6)(7)EMPLOYEE REFUSES EMPLOYMENT.--If an injured
3657	employee refuses employment suitable to the capacity thereof,
3658	offered to or procured therefor, such employee shall not be
3659	entitled to any compensation at any time during the continuance
3660	of such refusal unless at any time in the opinion of the judge
3661	of compensation claims such refusal is justifiable. Time periods
3662	for the payment of benefits in accordance with this section
3663	shall be counted in determining the limitation of benefits as
3664	provided for in paragraphs (2)(a), (3)(c), and (4)(b).
3665	(7)(8)EMPLOYEE LEAVES EMPLOYMENT.--If an injured
3666	employee, when receiving compensation for temporary partial
3667	disability, leaves the employment of the employer by whom she or
3668	he was employed at the time of the accident for which such
3669	compensation is being paid, the employee shall, upon securing
3670	employment elsewhere, give to such former employer an affidavit
3671	in writing containing the name of her or his new employer, the
3672	place of employment, and the amount of wages being received at
3673	such new employment; and, until she or he gives such affidavit,
3674	the compensation for temporary partial disability will cease.
3675	The employer by whom such employee was employed at the time of
3676	the accident for which such compensation is being paid may also
3677	at any time demand of such employee an additional affidavit in
3678	writing containing the name of her or his employer, the place of
3679	her or his employment, and the amount of wages she or he is
3680	receiving; and if the employee, upon such demand, fails or
3681	refuses to make and furnish such affidavit, her or his right to
3682	compensation for temporary partial disability shall cease until
3683	such affidavit is made and furnished. If the employee leaves her
3684	or his employment while receiving temporary partial benefits
3685	without just cause as determined by the judge of compensation
3686	claims, temporary partial benefits shall be payable based on the
3687	deemed earnings of the employee as if she or he had remained
3688	employed.
3689	(8)(9)EMPLOYEE BECOMES INMATE OF INSTITUTION.--In case an
3690	employee becomes an inmate of a public institution, then no
3691	compensation shall be payable unless she or he has dependent
3692	upon her or him for support a person or persons defined as
3693	dependents elsewhere in this chapter, whose dependency shall be
3694	determined as if the employee were deceased and to whom
3695	compensation would be paid in case of death; and such
3696	compensation as is due such employee shall be paid such
3697	dependents during the time she or he remains such inmate.
3698	(9)(10)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER
3699	AND FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE ACT.--
3700	(a) Weekly compensation benefits payable under this
3701	chapter for disability resulting from injuries to an employee
3702	who becomes eligible for benefits under 42 U.S.C. s. 423 shall
3703	be reduced to an amount whereby the sum of such compensation
3704	benefits payable under this chapter and such total benefits
3705	otherwise payable for such period to the employee and her or his
3706	dependents, had such employee not been entitled to benefits
3707	under this chapter, under 42 U.S.C. ss. 402 and 423, does not
3708	exceed 80 percent of the employee's average weekly wage.
3709	However, this provision shall not operate to reduce an injured
3710	worker's benefits under this chapter to a greater extent than
3711	such benefits would have otherwise been reduced under 42 U.S.C.
3712	s. 424(a). This reduction of compensation benefits is not
3713	applicable to any compensation benefits payable for any week
3714	subsequent to the week in which the injured worker reaches the
3715	age of 62 years.
3716	(b) If the provisions of 42 U.S.C. s. 424(a) are amended
3717	to provide for a reduction or increase of the percentage of
3718	average current earnings that the sum of compensation benefits
3719	payable under this chapter and the benefits payable under 42
3720	U.S.C. ss. 402 and 423 can equal, the amount of the reduction of
3721	benefits provided in this subsection shall be reduced or
3722	increased accordingly. The department may by rule specify forms
3723	and procedures governing the method for calculating and
3724	administering the offset of benefits payable under this chapter
3725	and benefits payable under 42 U.S.C. ss. 402 and 423. The
3726	department shall have first priority in taking any available
3727	social security offsets on dates of accidents occurring before
3728	July 1, 1984.
3729	(c) No disability compensation benefits payable for any
3730	week, including those benefits provided by paragraph (1)(f),
3731	shall be reduced pursuant to this subsection until the Social
3732	Security Administration determines the amount otherwise payable
3733	to the employee under 42 U.S.C. ss. 402 and 423 and the employee
3734	has begun receiving such social security benefit payments. The
3735	employee shall, upon demand by the department, the employer, or
3736	the carrier, authorize the Social Security Administration to
3737	release disability information relating to her or him and
3738	authorize the Division of Unemployment Compensation to release
3739	unemployment compensation information relating to her or him, in
3740	accordance with rules to be adopted by the department
3741	prescribing the procedure and manner for requesting the
3742	authorization and for compliance by the employee. Neither the
3743	department nor the employer or carrier shall make any payment of
3744	benefits for total disability or those additional benefits
3745	provided by paragraph (1)(f) for any period during which the
3746	employee willfully fails or refuses to authorize the release of
3747	information in the manner and within the time prescribed by such
3748	rules. The authority for release of disability information
3749	granted by an employee under this paragraph shall be effective
3750	for a period not to exceed 12 months, such authority to be
3751	renewable as the department may prescribe by rule.
3752	(d) If compensation benefits are reduced pursuant to this
3753	subsection, the minimum compensation provisions of s. 440.12(2)
3754	do not apply.
3755	(10)(11)EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER
3756	WHO HAS RECEIVED OR IS ENTITLED TO RECEIVE UNEMPLOYMENT
3757	COMPENSATION.--
3758	(a) No compensation benefits shall be payable for
3759	temporary total disability or permanent total disability under
3760	this chapter for any week in which the injured employee has
3761	received, or is receiving, unemployment compensation benefits.
3762	(b) If an employee is entitled to temporary partial
3763	benefits pursuant to subsection (4) and unemployment
3764	compensation benefits, such unemployment compensation benefits
3765	shall be primary and the temporary partial benefits shall be
3766	supplemental only, the sum of the two benefits not to exceed the
3767	amount of temporary partial benefits which would otherwise be
3768	payable.
3769	(11)(12)FULL-PAY STATUS FOR CERTAIN LAW ENFORCEMENT
3770	OFFICERS.--Any law enforcement officer as defined in s.
3771	943.10(1), (2), or (3) who, while acting within the course of
3772	employment as provided by s. 440.091, is maliciously or
3773	intentionally injured and who thereby sustains a job-connected
3774	disability compensable under this chapter shall be carried in
3775	full-pay status rather than being required to use sick, annual,
3776	or other leave. Full-pay status shall be granted only after
3777	submission to the employing agency's head of a medical report
3778	which gives a current diagnosis of the employee's recovery and
3779	ability to return to work. In no case shall the employee's
3780	salary and workers' compensation benefits exceed the amount of
3781	the employee's regular salary requirements.
3782	(12)(13)REPAYMENT.--If an employee has received a sum as
3783	an indemnity benefit under any classification or category of
3784	benefit under this chapter to which she or he is not entitled,
3785	the employee is liable to repay that sum to the employer or the
3786	carrier or to have that sum deducted from future benefits,
3787	regardless of the classification of benefits, payable to the
3788	employee under this chapter; however, a partial payment of the
3789	total repayment may not exceed 20 percent of the amount of the
3790	biweekly payment.
3791	Section 19. Subsections (1), (2), and (3) of section
3792	440.151, Florida Statutes, are amended to read:
3793	440.151 Occupational diseases.--
3794	(1)(a) Where the employer and employee are subject to the
3795	provisions of the Workers' Compensation Law, the disablement or
3796	death of an employee resulting from an occupational disease as
3797	hereinafter defined shall be treated as the happening of an
3798	injury by accident, notwithstanding any other provisions of this
3799	chapter, and the employee or, in case of death, the employee's
3800	dependents shall be entitled to compensation as provided by this
3801	chapter, except as hereinafter otherwise provided; and the
3802	practice and procedure prescribed by this chapter shall apply to
3803	all proceedings under this section, except as hereinafter
3804	otherwise provided. Provided, however, that in no case shall an
3805	employer be liable for compensation under the provisions of this
3806	section unless such disease has resulted from the nature of the
3807	employment in which the employee was engaged under such
3808	employer,and was actually contracted while so engaged, and the
3809	nature of the employment was the major contributing cause of the
3810	disease. Major contributing cause must be shown by medical
3811	evidence only, as demonstrated by physical examination findings
3812	and diagnostic testing.meaning by "Nature of the employment"
3813	means that intothe occupation in which the employee was so
3814	engaged there is attached a particular hazard of such disease
3815	that distinguishes it from the usual run of occupations, or the
3816	incidence of such disease is substantially higher in the
3817	occupation in which the employee was so engaged than in the
3818	usual run of occupations. In claims for death under s. 440.16,
3819	death must occuror, in case of death, unless death follows
3820	continuous disability from such disease, commencing within the
3821	period above limited, for which compensation has been paid or
3822	awarded, or timely claim made as provided in this section, and
3823	results within 350 weeks after such last exposure. Both
3824	causation and sufficient exposure to a specific harmful
3825	substance shown to be present in the workplace to support
3826	causation shall be proven by clear and convincing evidence.
3827	(b) No compensation shall be payable for an occupational
3828	disease if the employee, at the time of entering into the
3829	employment of the employer by whom the compensation would
3830	otherwise be payable, falsely represents herself or himself in
3831	writing as not having previously been disabled, laid off or
3832	compensated in damages or otherwise, because of such disease.
3833	(c) Where an occupational disease is aggravated by any
3834	other disease or infirmity, not itself compensable, or where
3835	disability or death from any other cause, not itself
3836	compensable, is aggravated, prolonged, accelerated or in anywise
3837	contributed to by an occupational disease, the compensation
3838	shall be payable only if the occupational disease is the major
3839	contributing cause of the injury. Any compensationshall be
3840	reduced and limited to such proportion only of the compensation
3841	that would be payable if the occupational disease were the sole
3842	cause of the disability or death as such occupational disease,
3843	as a causative factor, bears to all the causes of such
3844	disability or death, such reduction in compensation to be
3845	effected by reducing the number of weekly or monthly payments or
3846	the amounts of such payments, as under the circumstances of the
3847	particular case may be for the best interest of the claimant or
3848	claimants. Major contributing cause must be demonstrated by
3849	medical evidence based on physical examination findings and
3850	diagnostic testing.
3851	(d) No compensation for death from an occupational disease
3852	shall be payable to any person whose relationship to the
3853	deceased, which under the provisions of this Workers'
3854	Compensation Law would give right to compensation, arose
3855	subsequent to the beginning of the first compensable disability,
3856	save only to afterborn children of a marriage existing at the
3857	beginning of such disability.
3858	(e) No compensation shall be payable for disability or
3859	death resulting from tuberculosis arising out of and in the
3860	course of employment by the Department of Health at a state
3861	tuberculosis hospital, or aggravated by such employment, when
3862	the employee had suffered from said disease at any time prior to
3863	the commencement of such employment.
3864	(2) Whenever used in this section the term "occupational
3865	disease" shall be construed to mean only a disease which is due
3866	to causes and conditions which are characteristic of and
3867	peculiar to a particular trade, occupation, process, or
3868	employment, and to exclude all ordinary diseases of life to
3869	which the general public is exposed, unless the incidence of the
3870	disease is substantially higher in the particular trade,
3871	occupation, process, or employment than for the general public.
3872	"Occupational disease" means only a disease for which there are
3873	epidemiological studies showing that exposure to the specific
3874	substance involved, at the levels to which the employee was
3875	exposed, may cause the precise disease sustained by the
3876	employee.
3877	(3) Except as hereinafterotherwise provided in this
3878	section, "disablement" means disability as described in s.
3879	440.02(13)the event of an employee's becoming actually
3880	incapacitated, partially or totally, because of an occupational
3881	disease, from performing her or his work in the last occupation
3882	in which injuriously exposed to the hazards of such disease; and
3883	"disability" means the state of being so incapacitated.
3884	Section 20. Subsections (1) and (7) of section 440.16,
3885	Florida Statutes, are amended to read:
3886	440.16 Compensation for death.--
3887	(1) If death results from the accident within 1 year
3888	thereafter or follows continuous disability and results from the
3889	accident within 5 years thereafter, the employer shall pay:
3890	(a) Within 14 days after receiving the bill, actual
3891	funeral expenses not to exceed $7,500$5,000.
3892	(b) Compensation, in addition to the above, in the
3893	following percentages of the average weekly wages to the
3894	following persons entitled thereto on account of dependency upon
3895	the deceased, and in the following order of preference, subject
3896	to the limitation provided in subparagraph 2., but such
3897	compensation shall be subject to the limits provided in s.
3898	440.12(2), shall not exceed $150,000$100,000, and may be less
3899	than, but shall not exceed, for all dependents or persons
3900	entitled to compensation, 66 2/3 percent of the average wage:
3901	1. To the spouse, if there is no child, 50 percent of the
3902	average weekly wage, such compensation to cease upon the
3903	spouse's death.
3904	2. To the spouse, if there is a child or children, the
3905	compensation payable under subparagraph 1. and, in addition, 16
3906	2/3 percent on account of the child or children. However, when
3907	the deceased is survived by a spouse and also a child or
3908	children, whether such child or children are the product of the
3909	union existing at the time of death or of a former marriage or
3910	marriages, the judge of compensation claims may provide for the
3911	payment of compensation in such manner as may appear to the
3912	judge of compensation claims just and proper and for the best
3913	interests of the respective parties and, in so doing, may
3914	provide for the entire compensation to be paid exclusively to
3915	the child or children; and, in the case of death of such spouse,
3916	33 1/3 percent for each child. However, upon the surviving
3917	spouse's remarriage, the spouse shall be entitled to a lump-sum
3918	payment equal to 26 weeks of compensation at the rate of 50
3919	percent of the average weekly wage as provided in s. 440.12(2),
3920	unless the $150,000$100,000limit provided in this paragraph is
3921	exceeded, in which case the surviving spouse shall receive a
3922	lump-sum payment equal to the remaining available benefits in
3923	lieu of any further indemnity benefits. In no case shall a
3924	surviving spouse's acceptance of a lump-sum payment affect
3925	payment of death benefits to other dependents.
3926	3. To the child or children, if there is no spouse, 33 1/3
3927	percent for each child.
3928	4. To the parents, 25 percent to each, such compensation
3929	to be paid during the continuance of dependency.
3930	5. To the brothers, sisters, and grandchildren, 15 percent
3931	for each brother, sister, or grandchild.
3932	(c) To the surviving spouse, payment of postsecondary
3933	student fees for instruction at any area technical center
3934	established under s. 1001.44 for up to 1,800 classroom hours or
3935	payment of student fees at any community college established
3936	under part III of chapter 1004 for up to 80 semester hours. The
3937	spouse of a deceased state employee shall be entitled to a full
3938	waiver of such fees as provided in ss. 1009.22 and 1009.23 in
3939	lieu of the payment of such fees. The benefits provided for in
3940	this paragraph shall be in addition to other benefits provided
3941	for in this section and shall terminate 7 years after the death
3942	of the deceased employee, or when the total payment in eligible
3943	compensation under paragraph (b) has been received. To qualify
3944	for the educational benefit under this paragraph, the spouse
3945	shall be required to meet and maintain the regular admission
3946	requirements of, and be registered at, such area technical
3947	center or community college, and make satisfactory academic
3948	progress as defined by the educational institution in which the
3949	student is enrolled.
3950	(7) Compensation under this chapter to aliens not
3951	residents (or about to become nonresidents) of the United States
3952	or Canada shall be the same in amount as provided for residents,
3953	except that dependents in any foreign country shall be limited
3954	to surviving spouse and child or children, or if there be no
3955	surviving spouse or child or children, to surviving father or
3956	mother whom the employee has supported, either wholly or in
3957	part, for the period of 1 year prior to the date of the injury,
3958	and except that the judge of compensation claims may, at the
3959	option of the judge of compensation claims, or upon the
3960	application of the insurance carrier, commute all future
3961	installments of compensation to be paid to such aliens by paying
3962	or causing to be paid to them one-half of the commuted amount of
3963	such future installments of compensation as determined by the
3964	judge of compensation claims, and provided further that
3965	compensation to dependents referred to in this subsection shall
3966	in no case exceed $75,000$50,000.
3967	Section 21. Subsection (9) of section 440.185, Florida
3968	Statutes, is amended, and subsection (12) is added to said
3969	section, to read:
3970	440.185 Notice of injury or death; reports; penalties for
3971	violations.--
3972	(9) Any employer or carrier who fails or refuses to timely
3973	send any form, report, or notice required by this section shall
3974	be subject to an administrative fine by the departmenta civil
3975	penalty not to exceed $1,000$500for each such failure or
3976	refusal. If, within 1 calendar year, an employer fails to timely
3977	submit to the carrier more than 10 percent of its notices of
3978	injury or death, the employer shall be subject to an
3979	administrative fine by the department not to exceed $2,000 for
3980	each such failure or refusal.However, any employer who fails to
3981	notify the carrier of the injury on the prescribed form or by
3982	letter within the 7 days required in subsection (2) shall be
3983	liable for the administrative finecivil penalty, which shall be
3984	paid by the employer and not the carrier. Failure by the
3985	employer to meet its obligations under subsection (2) shall not
3986	relieve the carrier from liability for the administrative fine
3987	civil penaltyif it fails to comply with subsections (4) and
3988	(5).
3989	(12) Upon receiving notice of an injury from an employee
3990	under subsection (1), the employer or carrier shall provide the
3991	employee with a written notice, in the form and manner
3992	determined by the department by rule, of the availability of
3993	services from the Employee Assistance and Ombudsman Office. The
3994	substance of the notice to the employee shall include:
3995	(a) A description of the scope of services provided by the
3996	office.
3997	(b) A listing of the toll-free telephone number of, the
3998	email address, and the postal address of the office.
3999	(c) A statement that the informational brochure referred
4000	to in subsection (4) will be mailed to the employee within 3
4001	days after the carrier receives notice of the injury.
4002	(d) Any other information regarding access to assistance
4003	that the department finds is immediately necessary for an
4004	injured employee.
4005	Section 22. Subsections (1) and (2) of section 440.192,
4006	Florida Statutes, are amended, and subsection (9) is added to
4007	said section, to read:
4008	440.192 Procedure for resolving benefit disputes.—
4009	(1) Subject to s. 440.191, Any employee may, for any
4010	benefit that is ripe, due, and owing,who has not received a
4011	benefit to which the employee believes she or he is entitled
4012	under this chapter shallfile by certified mail, or by
4013	electronic means approved by the Deputy Chief Judge, with the
4014	Office of the Judges of Compensation Claims a petition for
4015	benefits which meets the requirements of this section and the
4016	definition of specificity in s. 440.02. The department shall
4017	inform employees of the location of the Office of the Judges of
4018	Compensation Claims for purposes of filing a petition for
4019	benefits. The employee shall also serve copies of the petition
4020	for benefits by certified mail, or by electronic means approved
4021	by the Deputy Chief Judge, upon the employer and the employer's
4022	carrier. The DeputyChief Judge shall refer the petitions to the
4023	judges of compensation claims.
4024	(2) Upon receipt, the Office of the Judges of Compensation
4025	Claims shall review each petition and shall dismiss each
4026	petition or any portion of such a petition, upon the judge's own
4027	motion or upon the motion of any party,that does not on its
4028	face specifically identify or itemize the following:
4029	(a) Name, address, telephone number, and social security
4030	number of the employee.
4031	(b) Name, address, and telephone number of the employer.
4032	(c) A detailed description of the injury and cause of the
4033	injury, including the location of the occurrence and the date or
4034	dates of the accident.
4035	(d) A detailed description of the employee's job, work
4036	responsibilities, and work the employee was performing when the
4037	injury occurred.
4038	(e) The time period for which compensation and the
4039	specific classification of compensation were not timely
4040	provided.
4041	(f) Date of maximum medical improvement, character of
4042	disability, and specific statement of all benefits or
4043	compensation that the employee is seeking.
4044	(g) All specific travel costs to which the employee
4045	believes she or he is entitled, including dates of travel and
4046	purpose of travel, means of transportation, and mileage and
4047	including the date the request for mileage was filed with the
4048	carrier and a copy of the request filed with the carrier.
4049	(h) Specific listing of all medical charges alleged
4050	unpaid, including the name and address of the medical provider,
4051	the amounts due, and the specific dates of treatment.
4052	(i) The type or nature of treatment care or attendance
4053	sought and the justification for such treatment. If the employee
4054	is under the care of a physician for an injury identified under
4055	paragraph (c), a copy of the physician's request, authorization,
4056	or recommendation for treatment, care, or attendance must
4057	accompany the petition.
4058	(j) Specific explanation of any other disputed issue that
4059	a judge of compensation claims will be called to rule upon.
4060
4061	The dismissal of any petition or portion of such a petition
4062	under this section is without prejudice and does not require a
4063	hearing.
4064	(9) A petition for benefits must contain claims for all
4065	benefits that are ripe, due, and owing on the date the petition
4066	is filed. Unless stipulated in writing by the parties, only
4067	claims which have been properly raised in a petition for
4068	benefits and have undergone mediation may be considered for
4069	adjudication by a judge of compensation claims.
4070	Section 23. Section 440.1926, Florida Statutes, is created
4071	to read:
4072	440.1926 Alternate dispute resolution; claim
4073	arbitration.--Notwithstanding any other provision of this
4074	chapter, the employer, carrier, and employee may mutually agree
4075	to seek consent from a judge of compensation claims to enter
4076	into binding claim arbitration in lieu of any other remedy
4077	provided for in this chapter to resolve all issues in dispute
4078	regarding an injury. Arbitrations agreed to pursuant to this
4079	section shall be governed by chapter 682, the Florida
4080	Arbitration Code, except that, notwithstanding any provision in
4081	chapter 682, the term "court" shall mean a judge of compensation
4082	claims. An arbitration award in accordance with this section
4083	shall be enforceable in the same manner and with the same powers
4084	as any final compensation order.
4085	Section 24. Subsections (2), (3), (4), (6), and (8) and
4086	paragraph (d) of subsection (11) of section 440.20, Florida
4087	Statutes, are amended to read:
4088	440.20 Time for payment of compensation and medical bills;
4089	penalties for late payment.--
4090	(2)(a)The carrier must pay the first installment of
4091	compensation for total disability or death benefitsor deny
4092	compensability no later than the 14th calendarday after the
4093	employer receives notificationnotice of the injury or death,
4094	when disability is immediate and continuous for 8 calendar days
4095	or more after the injury. If the first 7 days after disability
4096	are nonconsecutive or delayed, the first installment of
4097	compensation is due on the 6th day after the first 8 calendar
4098	days of disability. The carrier shall thereafter pay
4099	compensation in biweekly installments or as otherwise provided
4100	in s. 440.15, unless the judge of compensation claims determines
4101	or the parties agree that an alternate installment schedule is
4102	in the best interests of the employee.
4103	(b) The carrier must pay, disallow, or deny all medical,
4104	dental, pharmacy, and hospital bills submitted to the carrier in
4105	accordance with department rule no later than 45 calendar days
4106	after the carrier's receipt of the bill.
4107	(3) Upon making initial payment of indemnity benefits, or
4108	upon suspension or cessation of payment for any reason, the
4109	carrier shall immediately notify the injured employee, the
4110	employer, and thedepartment that it has commenced, suspended,
4111	or ceased payment of compensation. The department may require
4112	such notification to the injured employee, employer, and the
4113	department in aanyformat and manner it deems necessary to
4114	obtain accurate and timely notificationreporting.
4115	(4) If the carrier is uncertain of its obligation to
4116	provide all benefits or compensation, it may initiate payment
4117	without prejudice and without admitting liability. the carrier
4118	shall immediately and in good faith commence investigation of
4119	the employee's entitlement to benefits under this chapter and
4120	shall admit or deny compensability within 120 days after the
4121	initial provision of compensation or benefits as required under
4122	subsection (2) or s. 440.192(8). Additionally, the carrier shall
4123	initiate payment and continue the provision of all benefits and
4124	compensation as if the claim had been accepted as compensable,
4125	without prejudice and without admitting liability.Upon
4126	commencement of payment as required under subsection (2) or s.
4127	440.192 (8), the carrier shall provide written notice to the
4128	employee that it has elected to pay all or part ofthe claim
4129	pending further investigation, and that it will advise the
4130	employee of claim acceptance or denial within 120 days. A
4131	carrier that fails to deny compensability within 120 days after
4132	the initial provision of benefits or payment of compensation as
4133	required under subsection (2) or s. 440.192(8) waives the right
4134	to deny compensability, unless the carrier can establish
4135	material facts relevant to the issue of compensability that it
4136	could not have discovered through reasonable investigation
4137	within the 120-day period. The initial provision of compensation
4138	or benefits, for purposes of this subsection, means the first
4139	installment of compensation or benefits to be paid by the
4140	carrier under subsection (2) or pursuant to a petition for
4141	benefits under s. 440.192(8).
4142	(6)(a)If any installment of compensation for death or
4143	dependency benefits, or compensation for disability benefits,
4144	permanent impairment, or wage losspayable without an award is
4145	not paid within 7 days after it becomes due, as provided in
4146	subsection (2), subsection (3), or subsection (4), there shall
4147	be added to such unpaid installment a punitivepenalty of an
4148	amount equal to 20 percent of the unpaid installment or $5,
4149	which shall be paid at the same time as, but in addition to,
4150	such installment of compensation. This penalty shall not apply
4151	for late payments resulting, unless notice is filed under
4152	subsection (4) or unless such nonpayment resultsfrom conditions
4153	over which the employer or carrier had no control. When any
4154	installment of compensation payable without an award has not
4155	been paid within 7 days after it became due and the claimant
4156	concludes the prosecution of the claim before a judge of
4157	compensation claims without having specifically claimed
4158	additional compensation in the nature of a penalty under this
4159	section, the claimant will be deemed to have acknowledged that,
4160	owing to conditions over which the employer or carrier had no
4161	control, such installment could not be paid within the period
4162	prescribed for payment and to have waived the right to claim
4163	such penalty. However, during the course of a hearing, the judge
4164	of compensation claims shall on her or his own motion raise the
4165	question of whether such penalty should be awarded or excused.
4166	The department may assess without a hearing the punitivepenalty
4167	against either the employer or the insurancecarrier, depending
4168	upon who was at fault in causing the delay. The insurance policy
4169	cannot provide that this sum will be paid by the carrier if the
4170	department or the judge of compensation claims determines that
4171	the punitive penalty should be paidmadeby the employer rather
4172	than the carrier. Any additional installment of compensation
4173	paid by the carrier pursuant to this section shall be paid
4174	directly to the employee by check or, if authorized by the
4175	employee, by direct deposit into the employee's account at a
4176	financial institution. As used in this subsection, the term
4177	"financial institution" means a financial institution as defined
4178	in s. 655.005(1)(h).
4179	(b) For medical services provided on or after January 1,
4180	2004, the department shall require that all medical, hospital,
4181	pharmacy, or dental bills properly submitted by the provider,
4182	except for bills that are disallowed or denied by the carrier or
4183	its authorized vendor in accordance with department rule, are
4184	timely paid within 45 calendar days after the carrier's receipt
4185	of the bill. The department shall impose penalties for late
4186	payments or disallowances or denials of medical, hospital,
4187	pharmacy, or dental bills that are below a minimum 95 percent
4188	timely performance standard. The carrier shall pay to the
4189	Workers' Compensation Administration Trust Fund a penalty of:
4190	1. Twenty-five dollars for each bill below the 95 percent
4191	timely performance standard, but meeting a 90 percent timely
4192	standard.
4193	2. Fifty dollars for each bill below a 90 percent timely
4194	performance standard.
4195	(8)(a)In addition to any other penalties provided by this
4196	chapter for late payment, if any installment of compensation is
4197	not paid when it becomes due, the employer, carrier, or
4198	servicing agent shall pay interest thereon at the rate of 12
4199	percent per year from the date the installment becomes due until
4200	it is paid, whether such installment is payable without an order
4201	or under the terms of an order. The interest payment shall be
4202	the greater of the amount of interest due or $5.
4203	(a) Within 30 days after final payment of compensation has
4204	been made, the employer, carrier, or servicing agent shall send
4205	to the department a notice, in accordance with a format and
4206	manner prescribed by the department, stating that such final
4207	payment has been made and stating the total amount of
4208	compensation paid, the name of the employee and of any other
4209	person to whom compensation has been paid, the date of the
4210	injury or death, and the date to which compensation has been
4211	paid.
4212	(b) If the employer, carrier, or servicing agent fails to
4213	so notify the department within such time, the department shall
4214	assess against such employer, carrier, or servicing agent a
4215	civil penalty in an amount not over $100.
4216	(b)(c)In order to ensure carrier compliance under this
4217	chapter and provisions of the Florida Insurance Code, the office
4218	department shall monitor, audit, and investigatethe performance
4219	of carriers by conducting market conduct examinations, as
4220	provided in s. 624.3161, and conducting investigations, as
4221	provided in s. 624.317. The officedepartment shall require
4222	establish by rule minimum performance standards for carriers to
4223	ensure that a minimum of 90 percent ofall compensation benefits
4224	are timely paid in accordance with this section. The office
4225	department shall impose penaltiesfine a carrier as provided in
4226	s. 440.13(11)(b) up to $50 for each late paymentspaymentof
4227	compensation that areis below athe minimum 9590 percent
4228	timely payment performance standard. The carrier shall pay to
4229	the Workers' Compensation Administration Trust Fund a penalty
4230	of:
4231	1. Fifty dollars per number of installments of
4232	compensation below the 95 percent timely payment performance
4233	standard and equal to or greater than a 90 percent timely
4234	payment performance standard.
4235	2. One hundred dollars per number of installments of
4236	compensation below a 90 percent timely payment performance
4237	standard.
4238
4239	This section does not affect the imposition of any penalties or
4240	interest due to the claimant. If a carrier contracts with a
4241	servicing agent to fulfill its administrative responsibilities
4242	under this chapter, the payment practices of the servicing agent
4243	are deemed the payment practices of the carrier for the purpose
4244	of assessing penalties against the carrier.
4245	(11)
4246	(d)1. With respect to any lump-sum settlement under this
4247	subsection, a judge of compensation claims must consider at the
4248	time of the settlement, whether the settlement allocation
4249	provides for the appropriate recovery of child support
4250	arrearages. An employer or carrier does not have a duty to
4251	investigate or collect information regarding child support
4252	arrearages.
4253	2. When reviewing any settlement of lump-sum payment
4254	pursuant to this subsection, judges of compensation claims shall
4255	consider the interests of the worker and the worker's family
4256	when approving the settlement, which must consider and provide
4257	for appropriate recovery of past due support.
4258	3. With respect to any lump-sum settlement under this
4259	subsection, any correspondence to a clerk of the circuit court
4260	of this state regarding child support documentation shall be
4261	exempt from any fees or costs ordinarily assessed by the clerk’s
4262	office.
4263	Section 25. Section 440.25, Florida Statutes, is amended
4264	to read:
4265	440.25 Procedures for mediation and hearings.--
4266	(1) Forty daysWithin 90 daysafter a petition for
4267	benefits is filed under s. 440.192, a mediation conference
4268	concerning such petition shall be held. Within 40 days after
4269	such petition is filed,the judge of compensation claims shall
4270	notify the interested parties by order that a mediation
4271	conference concerning such petition has been scheduledwill be
4272	held unless the parties have notified the judgeOffice of the
4273	Judges of compensation claims that a privatemediation has been
4274	held or is scheduled to be held. A mediation, whether private or
4275	public, shall be held within 130 days after the filing of the
4276	petition. Such order must give the date by whichthe mediation
4277	conference is tomustbe held. Such order may be served
4278	personally upon the interested parties or may be sent to the
4279	interested parties by mail. If multiple petitions are pending,
4280	or if additional petitions are filed after the scheduling of a
4281	mediation, the judge of compensation claims shall consolidate
4282	all petitions into one mediation.The claimant or the adjuster
4283	of the employer or carrier may, at the mediator's discretion,
4284	attend the mediation conference by telephone or, if agreed to by
4285	the parties, other electronic means. A continuance may be
4286	granted upon the agreement of the parties orif the requesting
4287	party demonstrates to the judge of compensation claims that the
4288	reason for requesting the continuance arises from circumstances
4289	beyond the party's control. Any order granting a continuance
4290	must set forth the date of the rescheduled mediation conference.
4291	A mediation conference may not be used solely for the purpose of
4292	mediating attorney's fees.
4293	(2) Any party who participates in a mediation conference
4294	shall not be precluded from requesting a hearing following the
4295	mediation conference should both parties not agree to be bound
4296	by the results of the mediation conference. A mediation
4297	conference is required to be held unless this requirement is
4298	waived by the Deputy Chief Judge. No later than 3 days prior to
4299	the mediation conference, all parties must submit any applicable
4300	motions, including, but not limited to, a motion to waive the
4301	mediation conference, to the judge of compensation claims.
4302	(3)(a)Such mediation conference shall be conducted
4303	informally and does not require the use of formal rules of
4304	evidence or procedure. Any information from the files, reports,
4305	case summaries, mediator's notes, or other communications or
4306	materials, oral or written, relating to a mediation conference
4307	under this section obtained by any person performing mediation
4308	duties is privileged and confidential and may not be disclosed
4309	without the written consent of all parties to the conference.
4310	Any research or evaluation effort directed at assessing the
4311	mediation program activities or performance must protect the
4312	confidentiality of such information. Each party to a mediation
4313	conference has a privilege during and after the conference to
4314	refuse to disclose and to prevent another from disclosing
4315	communications made during the conference whether or not the
4316	contested issues are successfully resolved. This subsection and
4317	paragraphs (4)(a) and (b) shall not be construed to prevent or
4318	inhibit the discovery or admissibility of any information that
4319	is otherwise subject to discovery or that is admissible under
4320	applicable law or rule of procedure, except that any conduct or
4321	statements made during a mediation conference or in negotiations
4322	concerning the conference are inadmissible in any proceeding
4323	under this chapter.
4324	(a)1. Unless the parties conduct a private mediation under
4325	paragraph (b)subparagraph 2., mediation shall be conducted by a
4326	mediator selected by the Director of the Division of
4327	Administrative Hearings from among mediators employed on a full-
4328	time basis by the Office of the Judges of Compensation Claims. A
4329	mediator must be a member of The Florida Bar for at least 5
4330	years and must complete a mediation training program approved by
4331	the Deputy Chief JudgeDirector of the Division of
4332	Administrative Hearings. Adjunct mediators may be employed by
4333	the Office of the Judges of Compensation Claims on an as-needed
4334	basis and shall be selected from a list prepared by the Director
4335	of the Division of Administrative Hearings. An adjunct mediator
4336	must be independent of all parties participating in the
4337	mediation conference. An adjunct mediator must be a member of
4338	The Florida Bar for at least 5 years and must complete a
4339	mediation training program approved by the Office of the Judges
4340	of Compensation ClaimsDirector of the Division of
4341	Administrative Hearings. An adjunct mediator shall have access
4342	to the office, equipment, and supplies of the judge of
4343	compensation claims in each district.
4344	(b)2. With respect to any private mediation occurring on
4345	or after January 1, 2003, if the parties agree or if mediators
4346	are not available under paragraph (a), pursuant to notice from
4347	the judge of compensation claims,subparagraph 1.to conduct the
4348	required mediation within the period specified in this section,
4349	the parties shall hold a mediation conference at the carrier's
4350	expense within the 130-day90-dayperiod set for mediation. The
4351	mediation conference shall be conducted by a mediator certified
4352	under s. 44.106. If the parties do not agree upon a mediator
4353	within 10 days after the date of the order, the claimant shall
4354	notify the judge in writing and the judge shall appoint a
4355	mediator under this subparagraph within 7 days. In the event
4356	both parties agree, the results of the mediation conference
4357	shall be binding and neither party shall have a right to appeal
4358	the results. In the event either party refuses to agree to the
4359	results of the mediation conference, the results of the
4360	mediation conference as well as the testimony, witnesses, and
4361	evidence presented at the conference shall not be admissible at
4362	any subsequent proceeding on the claim. The mediator shall not
4363	be called in to testify or give deposition to resolve any claim
4364	for any hearing before the judge of compensation claims. The
4365	employer may be represented by an attorney at the mediation
4366	conference if the employee is also represented by an attorney at
4367	the mediation conference.
4368	(b) The parties shall complete the pretrial stipulations
4369	before the conclusion of the mediation conference if the claims,
4370	except for attorney's fees and costs, have not been settled and
4371	if any claims in any filed petition remain unresolved. The judge
4372	of compensation claims may impose sanctions against a party or
4373	both parties for failing to complete the pretrial stipulations
4374	before the conclusion of the mediation conference.
4375	(4)(a) If the parties fail to agree touponwritten
4376	submission of pretrial stipulations at the mediation conference,
4377	the judge of compensation claims shall conduct a liveorder a
4378	pretrial hearing to occur within 14 days after the date of
4379	mediation ordered by the judge of compensation claims. The judge
4380	of compensation claims shall give the interested parties at
4381	least 147 days' advance notice of the pretrial hearing by mail.
4382	At the pretrial hearing, the judge of compensation claims shall,
4383	subject to paragraph (b), set a date for the final hearing that
4384	allows the parties at least 60 days to conduct discovery unless
4385	the parties consent to an earlier hearing date.
4386	(b) The final hearing must be held and concluded within 90
4387	days after the mediation conference is held, allowing the
4388	parties sufficient time to complete discovery. Except as set
4389	forth in this section,continuances may be granted only if the
4390	requesting party demonstrates to the judge of compensation
4391	claims that the reason for requesting the continuance arises
4392	from circumstances beyond the party's control. The written
4393	consent of the claimant must be obtained before any request from
4394	a claimant's attorney is granted for an additional continuance
4395	after the initial continuance has been granted. Any order
4396	granting a continuance must set forth the date and time of the
4397	rescheduled hearing. A continuance may be granted only if the
4398	requesting party demonstrates to the judge of compensation
4399	claims that the reason for requesting the continuance arises
4400	from circumstances beyond the control of the parties. The judge
4401	of compensation claims shall report any grant of two or more
4402	continuances to the Deputy Chief Judge.
4403	(c) The judge of compensation claims shall give the
4404	interested parties at least 147days' advance notice of the
4405	final hearing, served upon the interested parties by mail.
4406	(d) The final hearing shall be held within 210 days after
4407	receipt of the petition for benefits in the county where the
4408	injury occurred, if the injury occurred in this state, unless
4409	otherwise agreed to between the parties and authorized by the
4410	judge of compensation claims in the county where the injury
4411	occurred. However, the claimant may waive the timeframes within
4412	this section for good cause shown.If the injury occurred
4413	outside the state and is one for which compensation is payable
4414	under this chapter, then the final hearing may be held in the
4415	county of the employer's residence or place of business, or in
4416	any other county of the state that will, in the discretion of
4417	the Deputy Chief Judge, be the most convenient for a hearing.
4418	The final hearing shall be conducted by a judge of compensation
4419	claims, who shall, within 30 days after final hearing or closure
4420	of the hearing record, unless otherwise agreed by the parties,
4421	enter a final order on the merits of the disputed issues. The
4422	judge of compensation claims may enter an abbreviated final
4423	order in cases in which compensability is not disputed. Either
4424	party may request separate findings of fact and conclusions of
4425	law. At the final hearing, the claimant and employer may each
4426	present evidence with respect to the claims presented by the
4427	petition for benefits and may be represented by any attorney
4428	authorized in writing for such purpose. When there is a conflict
4429	in the medical evidence submitted at the hearing, the provisions
4430	of s. 440.13 shall apply. The report or testimony of the expert
4431	medical advisor shall be admitted into evidence in amade a part
4432	of the record of the proceeding and shall be given the same
4433	consideration by the judge of compensation claims as is accorded
4434	other medical evidence submitted in the proceeding;and all
4435	costs incurred in connection with such examination and testimony
4436	may be assessed as costs in the proceeding, subject to the
4437	provisions of s. 440.13. No judge of compensation claims may
4438	make a finding of a degree of permanent impairment that is
4439	greater than the greatest permanent impairment rating given the
4440	claimant by any examining or treating physician,except upon
4441	stipulation of the parties. Any benefit due but not raised at
4442	the final hearing which was ripe, due, or owing at the time of
4443	the final hearing is waived.
4444	(e) The order making an award or rejecting the claim,
4445	referred to in this chapter as a "compensation order," shall set
4446	forth the findings of ultimate facts and the mandate; and the
4447	order need not include any other reason or justification for
4448	such mandate. The compensation order shall be filed in the
4449	Office of the Judges of Compensation Claims at Tallahassee. A
4450	copy of such compensation order shall be sent by mail to the
4451	parties and attorneys of record at the last known address of
4452	each, with the date of mailing noted thereon.
4453	(f) Each judge of compensation claims is required to
4454	submit a special report to the Deputy Chief Judge in each
4455	contested workers' compensation case in which the case is not
4456	determined within 30 days of final hearing or closure of the
4457	hearing record. Said form shall be provided by the director of
4458	the Division of Administrative Hearings and shall contain the
4459	names of the judge of compensation claims and of the attorneys
4460	involved and a brief explanation by the judge of compensation
4461	claims as to the reason for such a delay in issuing a final
4462	order.
4463	(f)(g)Notwithstanding any other provision of this
4464	section, the judge of compensation claims may require the
4465	appearance of the parties and counsel before her or him without
4466	written notice for an emergency conference where there is a bona
4467	fide emergency involving the health, safety, or welfare of an
4468	employee. An emergency conference under this section may result
4469	in the entry of an order or the rendering of an adjudication by
4470	the judge of compensation claims.
4471	(g)(h)To expedite dispute resolution and to enhance the
4472	self-executing features of the Workers' Compensation Law, the
4473	Deputy Chief Judge shall make provision by rule or order for the
4474	resolution of appropriate motions by judges of compensation
4475	claims without oral hearing upon submission of brief written
4476	statements in support and opposition, and for expedited
4477	discovery and docketing. Unless the judge of compensation
4478	claims, for good cause, orders a hearing under paragraph (h)(i),
4479	each claim in a petition relating to the determination of the
4480	average weekly wagepayunder s. 440.14 shall be resolved under
4481	this paragraph without oral hearing.
4482	(h)(i)To further expedite dispute resolution and to
4483	enhance the self-executing features of the system, those
4484	petitions filed in accordance with s. 440.192 that involve a
4485	claim for benefits of $5,000 or less shall, in the absence of
4486	compelling evidence to the contrary, be presumed to be
4487	appropriate for expedited resolution under this paragraph; and
4488	any other claim filed in accordance with s. 440.192, upon the
4489	written agreement of both parties and application by either
4490	party, may similarly be resolved under this paragraph. A claim
4491	in a petition or $5,000 or less for medical benefits only or a
4492	petition for reimbursement for mileage for medical purposes
4493	shall, in the absence of compelling evidence to the contrary, be
4494	resolved through the expedited dispute resolution process
4495	provided in this paragraph. For purposes of expedited resolution
4496	pursuant to this paragraph, the Deputy Chief Judge shall make
4497	provision by rule or order for expedited and limited discovery
4498	and expedited docketing in such cases. At least 15 days prior to
4499	hearing, the parties shall exchange and file with the judge of
4500	compensation claims a pretrial outline of all issues, defenses,
4501	and witnesses on a form adopted by the Deputy Chief Judge;
4502	provided, in no event shall such hearing be held without 15
4503	days' written notice to all parties. No pretrial hearing shall
4504	be held and no mediation scheduled unless requested by a party.
4505	The judge of compensation claims shall limit all argument and
4506	presentation of evidence at the hearing to a maximum of 30
4507	minutes, and such hearings shall not exceed 30 minutes in
4508	length. Neither party shall be required to be represented by
4509	counsel. The employer or carrier may be represented by an
4510	adjuster or other qualified representative. The employer or
4511	carrier and any witness may appear at such hearing by telephone.
4512	The rules of evidence shall be liberally construed in favor of
4513	allowing introduction of evidence.
4514	(i)(j)A judge of compensation claims may, upon the motion
4515	of a party or the judge's own motion, dismiss a petition for
4516	lack of prosecution if a petition, response, motion, order,
4517	request for hearing, or notice of deposition has not been filed
4518	during the previous 12 months unless good cause is shown. A
4519	dismissal for lack of prosecution is without prejudice and does
4520	not require a hearing.
4521	(j)(k)A judge of compensation claims may not award
4522	interest on unpaid medical bills and the amount of such bills
4523	may not be used to calculate the amount of interest awarded.
4524	Regardless of the date benefits were initially requested,
4525	attorney's fees do not attach under this subsection until 30
4526	days after the date the carrier or self-insured employer
4527	receives the petition.
4528	(5)(a) Procedures with respect to appeals from orders of
4529	judges of compensation claims shall be governed by rules adopted
4530	by the Supreme Court. Such an order shall become final 30 days
4531	after mailing of copies of such order to the parties, unless
4532	appealed pursuant to such rules.
4533	(b) An appellant may be relieved of any necessary filing
4534	fee by filing a verified petition of indigency for approval as
4535	provided in s. 57.081(1) and may be relieved in whole or in part
4536	from the costs for preparation of the record on appeal if,
4537	within 15 days after the date notice of the estimated costs for
4538	the preparation is served, the appellant files with the judge of
4539	compensation claims a copy of the designation of the record on
4540	appeal, and a verified petition to be relieved of costs. A
4541	verified petition filed prior to the date of service of the
4542	notice of the estimated costs shall be deemed not timely filed.
4543	The verified petition relating to record costs shall contain a
4544	sworn statement that the appellant is insolvent and a complete,
4545	detailed, and sworn financial affidavit showing all the
4546	appellant's assets, liabilities, and income. Failure to state in
4547	the affidavit all assets and income, including marital assets
4548	and income, shall be grounds for denying the petition with
4549	prejudice. The Office of the Judges of Compensation Claims shall
4550	adopt rules as may be required pursuant to this subsection,
4551	including forms for use in all petitions brought under this
4552	subsection. The appellant's attorney, or the appellant if she or
4553	he is not represented by an attorney, shall include as a part of
4554	the verified petition relating to record costs an affidavit or
4555	affirmation that, in her or his opinion, the notice of appeal
4556	was filed in good faith and that there is a probable basis for
4557	the District Court of Appeal, First District, to find reversible
4558	error, and shall state with particularity the specific legal and
4559	factual grounds for the opinion. Failure to so affirm shall be
4560	grounds for denying the petition. A copy of the verified
4561	petition relating to record costs shall be served upon all
4562	interested parties. The judge of compensation claims shall
4563	promptly conduct a hearing on the verified petition relating to
4564	record costs, giving at least 15 days' notice to the appellant,
4565	the department, and all other interested parties, all of whom
4566	shall be parties to the proceedings. The judge of compensation
4567	claims may enter an order without such hearing if no objection
4568	is filed by an interested party within 20 days from the service
4569	date of the verified petition relating to record costs. Such
4570	proceedings shall be conducted in accordance with the provisions
4571	of this section and with the workers' compensation rules of
4572	procedure, to the extent applicable. In the event an insolvency
4573	petition is granted, the judge of compensation claims shall
4574	direct the department to pay record costs and filing fees from
4575	the Workers' Compensation Administration Trust Fund pending
4576	final disposition of the costs of appeal. The department may
4577	transcribe or arrange for the transcription of the record in any
4578	proceeding for which it is ordered to pay the cost of the
4579	record.
4580	(c) As a condition of filing a notice of appeal to the
4581	District Court of Appeal, First District, an employer who has
4582	not secured the payment of compensation under this chapter in
4583	compliance with s. 440.38 shall file with the notice of appeal a
4584	good and sufficient bond, as provided in s. 59.13, conditioned
4585	to pay the amount of the demand and any interest and costs
4586	payable under the terms of the order if the appeal is dismissed,
4587	or if the District Court of Appeal, First District, affirms the
4588	award in any amount. Upon the failure of such employer to file
4589	such bond with the judge of compensation claims orthe District
4590	Court of Appeal, First District, along with the notice of
4591	appeal, the District Court of Appeal, First District, shall
4592	dismiss the notice of appeal.
4593	(6) An award of compensation for disability may be made
4594	after the death of an injured employee.
4595	(7) An injured employee claiming or entitled to
4596	compensation shall submit to such physical examination by a
4597	certified expert medical advisor approved by the agency or the
4598	judge of compensation claims as the agency or the judge of
4599	compensation claims may require. The place or places shall be
4600	reasonably convenient for the employee. Such physician or
4601	physicians as the employee, employer, or carrier may select and
4602	pay for may participate in an examination if the employee,
4603	employer, or carrier so requests. Proceedings shall be suspended
4604	and no compensation shall be payable for any period during which
4605	the employee may refuse to submit to examination.Any interested
4606	party shall have the right in any case of death to require an
4607	autopsy, the cost thereof to be borne by the party requesting
4608	it; and the judge of compensation claims shall have authority to
4609	order and require an autopsy and may, in her or his discretion,
4610	withhold her or his findings and award until an autopsy is held.
4611	Section 26. Subsections (1), (2), and (3) of section
4612	440.34, Florida Statutes, are amended, and subsection (7) is
4613	added to said section, to read:
4614	440.34 Attorney's fees; costs.--
4615	(1) A fee, gratuity, or other consideration may not be
4616	paid for services rendered fora claimant in connection with any
4617	proceedings arising under this chapter, unless approved as
4618	reasonable by the judge of compensation claims or court having
4619	jurisdiction over such proceedings. Except as provided by this
4620	subsection,Any attorney's fee approved by a judge of
4621	compensation claims for benefits secured on behalf ofservices
4622	rendered toa claimant must equal to 20 percent of the first
4623	$5,000 of the amount of the benefits secured, 15 percent of the
4624	next $5,000 of the amount of the benefits secured, 10 percent of
4625	the remaining amount of the benefits secured to be provided
4626	during the first 10 years after the date the claim is filed, and
4627	5 percent of the benefits secured after 10 years. The judge of
4628	compensation claims shall not approve a compensation order, a
4629	joint stipulation for lump-sum settlement, a stipulation or
4630	agreement between a claimant and his or her attorney, or any
4631	other agreement related to benefits under this chapter that
4632	provides for an attorney's fee in excess of the amount permitted
4633	by this section. The judge of compensation claims is not
4634	required to approve any retainer agreement between the claimant
4635	and his or her attorney. The retainer agreement as to fees and
4636	costs may not be for compensation in excess of the amount
4637	allowed under this section.However, The judge of compensation
4638	claims shall consider the following factors in each case and may
4639	increase or decrease the attorney's fee if, in her or his
4640	judgment, the circumstances of the particular case warrant such
4641	action:
4642	(a) The time and labor required, the novelty and
4643	difficulty of the questions involved, and the skill requisite to
4644	perform the legal service properly.
4645	(b) The fee customarily charged in the locality for
4646	similar legal services.
4647	(c) The amount involved in the controversy and the
4648	benefits resulting to the claimant.
4649	(d) The time limitation imposed by the claimant or the
4650	circumstances.
4651	(e) The experience, reputation, and ability of the lawyer
4652	or lawyers performing services.
4653	(f) The contingency or certainty of a fee.
4654	(2) In awarding a reasonableclaimant's attorney's fee,
4655	the judge of compensation claims shall consider only those
4656	benefits secured byto the claimant that the attorney is
4657	responsible for securing. An attorney is not entitled to
4658	attorney's fees for representation in any issue that was ripe,
4659	due, and owing and that reasonably could have been addressed,
4660	but was not addressed, during the pendency of other issues for
4661	the same injury.The amount, statutory basis, and type of
4662	benefits obtained through legal representation shall be listed
4663	on all attorney's fees awarded by the judge of compensation
4664	claims. For purposes of this section, the term "benefits
4665	secured" means benefits obtained as a result of the claimant's
4666	attorney's legal services rendered in connection with the claim
4667	for benefits. However, such termdoes not include future
4668	medical benefits to be provided on any date more than 5 years
4669	after the date the claim is filed. In the event an offer to
4670	settle an issue pending before a judge of compensation claims,
4671	including attorney’s fees as provided for in this section, is
4672	communicated in writing to the claimant or the claimant's
4673	attorney at least 30 days prior to the trial date on such issue,
4674	for purposes of calculating the amount of attorney’s fees to be
4675	taxed against the employer or carrier, the term “benefits
4676	secured” shall be deemed to include only that amount awarded to
4677	the claimant above the amount specified in the offer to settle.
4678	If multiple issues are pending before the judge of compensation
4679	claims, said offer of settlement shall address each issue
4680	pending and shall state explicitly whether or not the offer on
4681	each issue is severable. The written offer shall also
4682	unequivocally state whether or not it includes medical witness
4683	fees and expenses and all other costs associated with the claim.
4684	(3) If any partythe claimantshould prevail in any
4685	proceedings before a judge of compensation claims or court,
4686	there shall be taxed against the nonprevailing partyemployer
4687	the reasonable costs of such proceedings, not to include the
4688	attorney's fees of the claimant. A claimant shall be
4689	responsible for the payment of her or his own attorney's fees,
4690	except that a claimant shall be entitled to recover a reasonable
4691	attorney's fee from a carrier or employer:
4692	(a) Against whom she or he successfully asserts a petition
4693	for medical benefits only, if the claimant has not filed or is
4694	not entitled to file at such time a claim for disability,
4695	permanent impairment, wage-loss, or death benefits, arising out
4696	of the same accident;
4697	(b) In any case in which the employer or carrier files a
4698	response to petition denying benefits with the Office of the
4699	Judges of Compensation Claims and the injured person has
4700	employed an attorney in the successful prosecution of the
4701	petition;
4702	(c) In a proceeding in which a carrier or employer denies
4703	that an accident occurred for which compensation benefits are
4704	payable, and the claimant prevails on the issue of
4705	compensability; or
4706	(d) In cases where the claimant successfully prevails in
4707	proceedings filed under s. 440.24 or s. 440.28.
4708
4709	Regardless of the date benefits were initially requested,
4710	attorney's fees shall not attach under this subsection until 30
4711	days after the date the carrier or employer, if self-insured,
4712	receives the petition. In applying the factors set forth in
4713	subsection (1) to cases arising under paragraphs (a), (b), (c),
4714	and (d), the judge of compensation claims must only consider
4715	only such benefits and the time reasonably spent in obtaining
4716	them as were secured for the claimant within the scope of
4717	paragraphs (a), (b), (c), and (d).
4718	(7) If an attorney's fee is owed under paragraph (3)(a),
4719	the judge of compensation claims may approve an alternative
4720	attorney's fee not to exceed $1,500 only once per accident,
4721	based on a maximum hourly rate of $150 per hour, if the judge of
4722	compensation claims expressly finds that the attorney's fee
4723	amount provided for in subsection (1), based on benefits
4724	secured, fails to fairly compensate the attorney for disputed
4725	medical-only claims as provided in paragraph (3)(a) and the
4726	circumstances of the particular case warrant such action.
4727	Section 27. Subsection (7) is added to section 440.38,
4728	Florida Statutes, to read:
4729	440.38 Security for compensation; insurance carriers and
4730	self-insurers.—
4731	(7) Any employer who meets the requirements of subsection
4732	(1) through a policy of insurance issued outside of this state
4733	must at all times, with respect to all employees working in this
4734	state, maintain the required coverage under a Florida
4735	endorsement using Florida rates and rules pursuant to payroll
4736	reporting that accurately reflects the work performed in this
4737	state by such employees.
4738	Section 28. Subsections (2) and (6) of section 440.381,
4739	Florida Statutes, are amended to read:
4740	440.381 Application for coverage; reporting payroll;
4741	payroll audit procedures; penalties.--
4742	(2) Submission of an application that contains false,
4743	misleading, or incomplete information provided with the purpose
4744	of avoiding or reducing the amount of premiums for workers'
4745	compensation coverage is a felony of the second degree,
4746	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
4747	The application must contain a statement that the filing of an
4748	application containing false, misleading, or incomplete
4749	information providedwith the purpose of avoiding or reducing
4750	the amount of premiums for workers' compensation coverage is a
4751	felony of the third degree, punishable as provided in s.
4752	775.082, s. 775.083, or s. 775.084. The application must contain
4753	a sworn statement by the employer attesting to the accuracy of
4754	the information submitted and acknowledging the provisions of
4755	former s. 440.37(4). The application must contain a sworn
4756	statement by the agent attesting that the agent explained to the
4757	employer or officer the classification codes that are used for
4758	premium calculations.
4759	(6)(a)If an employer understates or conceals payroll, or
4760	misrepresents or conceals employee duties so as to avoid proper
4761	classification for premium calculations, or misrepresents or
4762	conceals information pertinent to the computation and
4763	application of an experience rating modification factor, the
4764	employer, or the employer's agent or attorney, shall pay to the
4765	insurance carrier a penalty of 10 times the amount of the
4766	difference in premium paid and the amount the employer should
4767	have paid and reasonable attorney's fees. The penalty may be
4768	enforced in the circuit courts of this state.
4769	(b) If the department determines that an employer has
4770	materially understated or concealed payroll, has materially
4771	misrepresented or concealed employee duties so as to avoid
4772	proper classification for premium calculations, or has
4773	materially misrepresented or concealed information pertinent to
4774	the computation and application of an experience rating
4775	modification factor, the department shall immediately notify the
4776	employer's carrier of such determination. The carrier shall
4777	commence a physical onsite audit of the employer within 30 days
4778	after receiving notification from the department. If the carrier
4779	fails to commence the audit as required by this section, the
4780	department shall contract with auditing professionals to conduct
4781	the audit at the carrier's expense. A copy of the carrier's
4782	audit of the employer shall be provided to the department upon
4783	completion. The carrier is not required to conduct the physical
4784	onsite audit of the employer as set forth in this paragraph if
4785	the carrier gives written notice of cancellation to the employer
4786	within 30 days after receiving notification from the department
4787	of the material misrepresentation, understatement, or
4788	concealment and an audit is conducted in conjunction with the
4789	cancellation.
4790	Section 29. Subsection (3) of section 440.42, Florida
4791	Statutes, is amended to read:
4792	440.42 Insurance policies; liability.--
4793	(3) No contract or policy of insurance issued by a carrier
4794	under this chapter shall expire or be canceled until at least 30
4795	days have elapsed after a notice of cancellation has been sent
4796	to the department and to the employer in accordance with the
4797	provisions of s. 440.185(7). For cancellation due to nonpayment
4798	of premium, the insurer shall mail notification to the employer
4799	at least 10 days prior to the effective date of the
4800	cancellation.However, when duplicate or dual coverage exists by
4801	reason of two different carriers having issued policies of
4802	insurance to the same employer securing the same liability, it
4803	shall be presumed that only that policy with the later effective
4804	date shall be in force and that the earlier policy terminated
4805	upon the effective date of the latter. In the event that both
4806	policies carry the same effective date, one of the policies may
4807	be canceled instanter upon filing a notice of cancellation with
4808	the department and serving a copy thereof upon the employer in
4809	such manner as the department prescribes by rule. The department
4810	may by rule prescribe the content of the notice of retroactive
4811	cancellation and specify the time, place, and manner in which
4812	the notice of cancellation is to be served.
4813	Section 30. Paragraph (a) of subsection (4) of section
4814	440.49, Florida Statutes, is amended to read:
4815	440.49 Limitation of liability for subsequent injury
4816	through Special Disability Trust Fund.--
4817	(4) PERMANENT IMPAIRMENT OR PERMANENT TOTAL DISABILITY,
4818	TEMPORARY BENEFITS, MEDICAL BENEFITS, OR ATTENDANT CARE AFTER
4819	OTHER PHYSICAL IMPAIRMENT.--
4820	(a) Permanent impairment.--If an employee who has a
4821	preexisting permanent physical impairment incurs a subsequent
4822	permanent impairment from injury or occupational disease arising
4823	out of, and in the course of, her or his employment which merges
4824	with the preexisting permanent physical impairment to cause a
4825	permanent impairment, the employer shall, in the first instance,
4826	pay all benefits provided by this chapter; but, subject to the
4827	limitations specified in subsection (6), such employer shall be
4828	reimbursed from the Special Disability Trust Fund created by
4829	subsection (9) for 50 percent of all impairment benefits which
4830	the employer has been required to provide pursuant to s.
4831	440.15(3)(a)as a result of the subsequent accident or
4832	occupational disease.
4833	Section 31. Subsection (6) of section 440.491, Florida
4834	Statutes, is amended to read:
4835	440.491 Reemployment of injured workers; rehabilitation.--
4836	(6) TRAINING AND EDUCATION.--
4837	(a) Upon referral of an injured employee by the carrier,
4838	or upon the request of an injured employee, the department shall
4839	conduct a training and education screening to determine whether
4840	it should refer the employee for a vocational evaluation and, if
4841	appropriate, approve training and education or other vocational
4842	services for the employee. The department may not approve formal
4843	training and education programs unless it determines, after
4844	consideration of the reemployment assessment, pertinent
4845	reemployment status reviews or reports, and such other relevant
4846	factors as it prescribes by rule, that the reemployment plan is
4847	likely to result in return to suitable gainful employment. The
4848	department is authorized to expend moneys from the Workers'
4849	Compensation Administration Trust Fund, established by s.
4850	440.50, to secure appropriate training and education at a
4851	community college established under part III of chapter 240 or
4852	at a vocational-technical school established under s. 230.63, or
4853	to secureother vocational services when necessary to satisfy
4854	the recommendation of a vocational evaluator. As used in this
4855	paragraph, "appropriate training and education" includes
4856	securing a general education diploma (GED), if necessary.The
4857	department shall establish training and education standards
4858	pertaining to employee eligibility, course curricula and
4859	duration, and associated costs.
4860	(b) When it appears thatan employee who has attained
4861	maximum medical improvement is unable to earn at least 80
4862	percent of the compensation rate andrequires training and
4863	education to obtain suitable gainful employment, the employer or
4864	carrier shall pay the employee additional training and education
4865	temporary total compensation benefitswhile the employee
4866	receives such training and education for a period not to exceed
4867	26 weeks, which period may be extended for an additional 26
4868	weeks or less, if such extended period is determined to be
4869	necessary and proper by a judge of compensation claims. The
4870	benefits provided under this paragraph shall not be in addition
4871	to the 104 weeks as specified in s. 440.15(2).However, a
4872	carrier or employer is not precluded from voluntarily paying
4873	additional temporary total disability compensation beyond that
4874	period. If an employee requires temporary residence at or near a
4875	facility or an institution providing training and education
4876	which is located more than 50 miles away from the employee's
4877	customary residence, the reasonable cost of board, lodging, or
4878	travel must be borne by the department from the Workers'
4879	Compensation Administration Trust Fund established by s. 440.50.
4880	An employee who refuses to accept training and education that is
4881	recommended by the vocational evaluator and considered necessary
4882	by the department will forfeit any additional training and
4883	education benefits and any additional payment for lost wages
4884	under this chapter. The department shall adopt rules to
4885	implement this section, which shall include requirements placed
4886	upon the carrier to notify the injured employee of the
4887	availability of training and education benefits as specified in
4888	this chapter. The department shall also include information
4889	regarding the eligibility for training and education benefits in
4890	informational materials specified in ss. 440.207 and 440.40is
4891	subject to a 50-percent reduction in weekly compensation
4892	benefits, including wage-loss benefits, as determined under s.
4893	440.15(3)(b).
4894	Section 32. Section 440.525, Florida Statutes, is amended
4895	to read:
4896	440.525 Examination and investigation of carriers and
4897	claims-handling entities.--
4898	(1) The department may examine, or investigate anyeach
4899	carrier, third-party administrator, servicing agent, or other
4900	claims-handling entity as often as is warranted to ensure that
4901	it iscarriers are fulfilling itstheir obligations under this
4902	chapterthe law. The examination may cover any period of the
4903	carrier's operations since the last previous examination.
4904	(2) An examination may cover any period of the carrier's,
4905	third-party administrator's, servicing agent's, or other claims-
4906	handling entity's operations since the last previous
4907	examination. An investigation based upon a reasonable belief by
4908	the department that a material violation of this chapter has
4909	occurred may cover any time period, but may not predate the last
4910	examination by more than 5 years. The department may by rule
4911	establish procedures, standards, and protocols for examinations
4912	and investigations. If the department finds any violation of
4913	this chapter, it may impose administrative penalties pursuant to
4914	this chapter. If the department finds any self-insurer in
4915	violation of this chapter, it may take action pursuant s.
4916	440.38(3). Examinations or investigations by the department may
4917	address, but are not limited to addressing, patterns or
4918	practices of unreasonable delay in claims handling; timeliness
4919	and accuracy of payments and reports under ss. 440.13, 440.16,
4920	and 440.185; or patterns or practices of harassment, coercion,
4921	or intimidation of claimants. The department may also specify by
4922	rule the documentation to be maintained for each claim file.
4923	(3) As to any examination or investigation conducted under
4924	this chapter, the department shall have the power to conduct
4925	onsite inspections of claims records and documentation of a
4926	carrier, third-party administrator, servicing agent, or other
4927	claims-handling entity, and conduct interviews, both sworn and
4928	unsworn, of claims-handling personnel. Carriers, third-party
4929	administrators, servicing agents, and other claims-handling
4930	entities shall make all claims records, documentation,
4931	communication, and correspondence available to department
4932	personnel during regular business hours. If any person fails to
4933	comply with a request for production of records or documents or
4934	fails to produce an employee for interview, the department may
4935	compel production or attendance by subpoena. The results of an
4936	examination or investigation shall be provided to the carrier,
4937	third-party administrator, servicing agent, or other claims-
4938	handling entity in a written report setting forth the basis for
4939	any violations that are asserted. Such report is agency action
4940	for purposes of chapter 120, and the aggrieved party may request
4941	a proceeding under s. 120.57 with regard to the findings and
4942	conclusion of the report.
4943	(4) If the department finds that violations of this
4944	chapter have occurred, the department may impose an
4945	administrative penalty upon the offending entity or entities.
4946	For each offending entity, such penalties shall not exceed
4947	$2,500 for each pattern or practice constituting nonwillful
4948	violation and shall not exceed an aggregate amount of $10,000
4949	for all nonwillful violations arising out of the same action. If
4950	the department finds a pattern of practice that constitutes a
4951	willful violation, the department may impose an administrative
4952	penalty upon each offending entity not to exceed $20,000 for
4953	each willful pattern or practice. Such fines shall not exceed
4954	$100,000 for all willful violations arising out of the same
4955	action. No penalty assessed under this section may be recouped
4956	by any carrier in the rate base, the premium, or any rate
4957	filing. Any administrative penalty imposed under this section
4958	for a nonwillful violation shall not duplicate an administrative
4959	penalty imposed under another provision of this chapter or the
4960	Insurance Code. The department may adopt rules to implement this
4961	section. The department shall adopt penalty guidelines by rule
4962	to set penalties under this chapter.
4963	Section 33. Subsection (2) of section 627.162, Florida
4964	Statutes, is amended to read:
4965	627.162 Requirements for premium installments;
4966	delinquency, collection, and check return charges; attorney's
4967	fees.--
4968	(2) Insurers providing workers' compensation coverage
4969	under chapter 440 may charge the insured a delinquency and
4970	collection fee on each installment in default for a period of
4971	not less than 5 days in an amount not to exceed $25$10or 5
4972	percent of the delinquent installment, whichever is greater.
4973	Only one such delinquency and collection fee may be collected on
4974	any such installment regardless of the period during which it
4975	remains in default.
4976	Section 34. Section 627.285, Florida Statutes, is created
4977	to read:
4978	627.285 Independent actuarial peer review of workers'
4979	compensation rating organization.--The Financial Services
4980	Commission shall at least once every other year contract for an
4981	independent actuarial peer review and analysis of the ratemaking
4982	processes of any licensed rating organization that makes rate
4983	filings for workers' compensation insurance and the rating
4984	organization shall fully cooperate in the peer review. The
4985	contract shall require submission of a final report to the
4986	commission, the President of the Senate, and the Speaker of the
4987	House of Representatives by February 1. The first report shall
4988	be submitted by February 1, 2004. The costs of the independent
4989	actuarial peer review shall be paid from the Workers'
4990	Compensation Administration Trust Fund.
4991	Section 35. Effective July, 1, 2003, paragraphs (b), (c),
4992	and (d) of subsection (4) of section 627.311, Florida Statutes,
4993	are amended to read
4994	627.311 Joint underwriters and joint reinsurers.--
4995	(4)
4996	(b) The operation of the plan is subject to the
4997	supervision of a 9-member13-memberboard of governors. The
4998	board of governors shall be comprised of:
4999	1. Three members appointed by the Financial Services
5000	Commission. Each member appointed by the commission shall serve
5001	at the pleasure of the commission;
5002	2.1.TwoFiveof the 20 domestic insurers, as defined in
5003	s. 624.06(1), having the largest voluntary direct premiums
5004	written in this state for workers' compensation and employer's
5005	liability insurance, which shall be elected by those 20 domestic
5006	insurers;
5007	3.2.TwoFiveof the 20 foreign insurers as defined in s.
5008	624.06(2) having the largest voluntary direct premiums written
5009	in this state for workers' compensation and employer's liability
5010	insurance, which shall be elected by those 20 foreign insurers;
5011	3. One person, who shall serve as the chair, appointed by
5012	the Insurance Commissioner;
5013	4. One person appointed by the largest property and
5014	casualty insurance agents' association in this state; and
5015	5. The consumer advocate appointed under s. 627.0613 or
5016	the consumer advocate's designee.
5017
5018	Each board member shall serve a 4-year term and may serve
5019	consecutive terms. A vacancy on the board shall be filled in the
5020	same manner as the original appointment for the unexpired
5021	portion of the term. The Financial Services Commission shall
5022	designate a member of the board to serve as chair.No board
5023	member shall be an insurer which provides service to the plan or
5024	which has an affiliate which provides services to the plan or
5025	which is serviced by a service company or third-party
5026	administrator which provides services to the plan or which has
5027	an affiliate which provides services to the plan. The minutes,
5028	audits, and procedures of the board of governors are subject to
5029	chapter 119.
5030	(c) The operation of the plan shall be governed by a plan
5031	of operation that is prepared at the direction of the board of
5032	governors. The plan of operation may be changed at any time by
5033	the board of governors or upon request of the department. The
5034	plan of operation and all changes thereto are subject to the
5035	approval of the department. The plan of operation shall:
5036	1. Authorize the board to engage in the activities
5037	necessary to implement this subsection, including, but not
5038	limited to, borrowing money.
5039	2. Develop criteria for eligibility for coverage by the
5040	plan, including, but not limited to, documented rejection by at
5041	least two insurers which reasonably assures that insureds
5042	covered under the plan are unable to acquire coverage in the
5043	voluntary market. Any insured may voluntarily elect to accept
5044	coverage from an insurer for a premium equal to or greater than
5045	the plan premium if the insurer writing the coverage adheres to
5046	the provisions of s. 627.171.
5047	3. Require notice from the agent to the insured at the
5048	time of the application for coverage that the application is for
5049	coverage with the plan and that coverage may be available
5050	through an insurer, group self-insurers' fund, commercial self-
5051	insurance fund, or assessable mutual insurer through another
5052	agent at a lower cost.
5053	4. Establish programs to encourage insurers to provide
5054	coverage to applicants of the plan in the voluntary market and
5055	to insureds of the plan, including, but not limited to:
5056	a. Establishing procedures for an insurer to use in
5057	notifying the plan of the insurer's desire to provide coverage
5058	to applicants to the plan or existing insureds of the plan and
5059	in describing the types of risks in which the insurer is
5060	interested. The description of the desired risks must be on a
5061	form developed by the plan.
5062	b. Developing forms and procedures that provide an insurer
5063	with the information necessary to determine whether the insurer
5064	wants to write particular applicants to the plan or insureds of
5065	the plan.
5066	c. Developing procedures for notice to the plan and the
5067	applicant to the plan or insured of the plan that an insurer
5068	will insure the applicant or the insured of the plan, and notice
5069	of the cost of the coverage offered; and developing procedures
5070	for the selection of an insuring entity by the applicant or
5071	insured of the plan.
5072	d. Provide for a market-assistance plan to assist in the
5073	placement of employers. All applications for coverage in the
5074	plan received 45 days before the effective date for coverage
5075	shall be processed through the market-assistance plan. A market-
5076	assistance plan specifically designed to serve the needs of
5077	small good policyholders as defined by the board must be
5078	finalized by January 1, 1994.
5079	5. Provide for policy and claims services to the insureds
5080	of the plan of the nature and quality provided for insureds in
5081	the voluntary market.
5082	6. Provide for the review of applications for coverage
5083	with the plan for reasonableness and accuracy, using any
5084	available historic information regarding the insured.
5085	7. Provide for procedures for auditing insureds of the
5086	plan which are based on reasonable business judgment and are
5087	designed to maximize the likelihood that the plan will collect
5088	the appropriate premiums.
5089	8. Authorize the plan to terminate the coverage of and
5090	refuse future coverage for any insured that submits a fraudulent
5091	application to the plan or provides fraudulent or grossly
5092	erroneous records to the plan or to any service provider of the
5093	plan in conjunction with the activities of the plan.
5094	9. Establish service standards for agents who submit
5095	business to the plan.
5096	10. Establish criteria and procedures to prohibit any
5097	agent who does not adhere to the established service standards
5098	from placing business with the plan or receiving, directly or
5099	indirectly, any commissions for business placed with the plan.
5100	11. Provide for the establishment of reasonable safety
5101	programs for all insureds in the plan. All insureds of the plan
5102	must participate in the safety program.
5103	12. Authorize the plan to terminate the coverage of and
5104	refuse future coverage to any insured who fails to pay premiums
5105	or surcharges when due; who, at the time of application, is
5106	delinquent in payments of workers' compensation or employer's
5107	liability insurance premiums or surcharges owed to an insurer,
5108	group self-insurers' fund, commercial self-insurance fund, or
5109	assessable mutual insurer licensed to write such coverage in
5110	this state; or who refuses to substantially comply with any
5111	safety programs recommended by the plan.
5112	13. Authorize the board of governors to provide the
5113	services required by the plan through staff employed by the
5114	plan, through reasonably compensated service providers who
5115	contract with the plan to provide services as specified by the
5116	board of governors, or through a combination of employees and
5117	service providers.
5118	14. Provide for service standards for service providers,
5119	methods of determining adherence to those service standards,
5120	incentives and disincentives for service, and procedures for
5121	terminating contracts for service providers that fail to adhere
5122	to service standards.
5123	15. Provide procedures for selecting service providers and
5124	standards for qualification as a service provider that
5125	reasonably assure that any service provider selected will
5126	continue to operate as an ongoing concern and is capable of
5127	providing the specified services in the manner required.
5128	16. Provide for reasonable accounting and data-reporting
5129	practices.
5130	17. Provide for annual review of costs associated with the
5131	administration and servicing of the policies issued by the plan
5132	to determine alternatives by which costs can be reduced.
5133	18. Authorize the acquisition of such excess insurance or
5134	reinsurance as is consistent with the purposes of the plan.
5135	19. Provide for an annual report to the department on a
5136	date specified by the department and containing such information
5137	as the department reasonably requires.
5138	20. Establish multiple rating plans for various
5139	classifications of risk which reflect risk of loss, hazard
5140	grade, actual losses, size of premium, and compliance with loss
5141	control. At least one of such plans must be a preferred-rating
5142	plan to accommodate small-premium policyholders with good
5143	experience as defined in sub-subparagraph 22.a.
5144	21. Establish agent commission schedules.
5145	22. Establish fourthreesubplans as follows:
5146	a. Subplan "A" must include those insureds whose annual
5147	premium does not exceed $2,500 and who have neither incurred any
5148	lost-time claims nor incurred medical-only claims exceeding 50
5149	percent of their premium for the immediate 2 years.
5150	b. Subplan "B" must include insureds that are employers
5151	identified by the board of governors as high-risk employers due
5152	solely to the nature of the operations being performed by those
5153	insureds and for whom no market exists in the voluntary market,
5154	and whose experience modifications are less than 1.00.
5155	c. Subplan "C" must include all otherinsureds within the
5156	plan that are not eligible for subplan "A," subplan "B," or
5157	subplan "D."
5158	d. Subplan "D" must include any employer, regardless of
5159	the length of time for which it has conducted business
5160	operations, which has an experience modification factor of 1.10
5161	or less and either employs 15 or fewer employees or is an
5162	organization that is exempt from federal income tax pursuant to
5163	s. 501(c)(3) of the Internal Revenue Code and receives more than
5164	50 percent of its funding from gifts, grants, endowments, or
5165	federal or state contracts. The rate plan for subplan "D" shall
5166	be the same rate plan as the plan approved under ss. 627.091-
5167	627.151 and each participant in subplan "D" shall pay the
5168	premium determined under such rate plan, plus a surcharge
5169	determined by the board to be sufficient to ensure that the plan
5170	does not compete with the voluntary market rate for any
5171	participant, but not to exceed 25 percent. However, the
5172	surcharge shall not exceed 10 percent for an organization that
5173	is exempt from federal income tax pursuant to s. 501(c)(3) of
5174	the Internal Revenue Code.
5175	23. Provide for a depopulation program to reduce the
5176	number of insureds in subplan "D." If an employer insured
5177	through subplan "D" is offered coverage from a voluntary market
5178	carrier:
5179	a. During the first 30 days of coverage under the subplan;
5180	b. Before a policy is issued under the subplan;
5181	c. By issuance of a policy upon expiration or cancellation
5182	of the policy under the subplan; or
5183	d. By assumption of the subplan's obligation with respect
5184	to an in-force policy,
5185
5186	that employer is no longer eligible for coverage through the
5187	plan. The premium for risks assumed by the voluntary market
5188	carrier must be the same premium plus, for the first 2 years,
5189	the surcharge as determined in sub-subparagraph 22.d. A premium
5190	under this subparagraph, including surcharge, is deemed approved
5191	and is not an excess premium for purposes of s. 627.171.
5192	24. Require that policies issued under subplan "D" and
5193	applications for such policies must include a notice that the
5194	policy issued under subplan "D" could be replaced by a policy
5195	issued from a voluntary market carrier and that, if an offer of
5196	coverage is obtained from a voluntary market carrier, the
5197	policyholder is no longer eligible for coverage through subplan
5198	"D." The notice must also specify that acceptance of coverage
5199	under subplan "D" creates a conclusive presumption that the
5200	applicant or policyholder is aware of this potential.
5201	(d)1.The plan must be funded through actuarially sound
5202	premiums charged to insureds of the plan.
5203	2.The plan may issue assessable policies only to those
5204	insureds in subplan "C." and subplan "D." Subject to
5205	verification by the department, the board may levy assessments
5206	against insureds in subplan "C" or subplan "D," on a pro rata
5207	earned premium basis, to fund any deficits that exist in those
5208	subplans. Assessments levied against subplan "C" participants
5209	shall cover only the deficits attributable to subplan "C," and
5210	assessments levied against subplan "D" participants shall cover
5211	only the deficits attributable to subplan "D." In no event may
5212	the plan levy assessments against any person or entity, except
5213	as authorized by this paragraph.Those assessable policies must
5214	be clearly identified as assessable by containing, in
5215	contrasting color and in not less than 10-point type, the
5216	following statements: "This is an assessable policy. If the plan
5217	is unable to pay its obligations, policyholders will be required
5218	to contribute on a pro rata earned premium basis the money
5219	necessary to meet any assessment levied."
5220	3.The plan may issue assessable policies with differing
5221	terms and conditions to different groups within subplans "C" and
5222	"D"the planwhen a reasonable basis exists for the
5223	differentiation.
5224	4.The plan may offer rating, dividend plans, and other
5225	plans to encourage loss prevention programs.
5226	Section 36. Paragraphs (c) and (e) of subsection (3) of
5227	section 921.0022, Florida Statutes, are amended to read:
5228	921.0022 Criminal Punishment Code; offense severity
5229	ranking chart.--
5230	(3) OFFENSE SEVERITY RANKING CHART
5231	FloridaStatute FelonyDegree Description
5232	(c) LEVEL 3
5233	316.193(2)(b) 3rd Felony DUI, 3rd conviction.
5234	316.1935(2) 3rd Fleeing or attempting to elude law enforcement officer in marked patrol vehicle with siren and lights activated.
5235	319.30(4) 3rd Possession by junkyard of motor vehicle with identification number plate removed.
5236	319.33(1)(a) 3rd Alter or forge any certificate of title to a motor vehicle or mobile home.
5237	319.33(1)(c) 3rd Procure or pass title on stolen vehicle.
5238	319.33(4) 3rd With intent to defraud, possess, sell, etc., a blank, forged, or unlawfully obtained title or registration.
5239	327.35(2)(b) 3rd Felony BUI.
5240	328.05(2) 3rd Possess, sell, or counterfeit fictitious, stolen, or fraudulent titles or bills of sale of vessels.
5241	328.07(4) 3rd Manufacture, exchange, or possess vessel with counterfeit or wrong ID number.
5242	376.302(5) 3rd Fraud related to reimbursement for cleanup expenses under the Inland Protection Trust Fund.
5243	440.105(3)(b) 3rd Receipt of fee or consideration without approval by judge of compensation claims.
5244	440.1051(3) 3rd False report of workers' compensation fraud or retaliation for making such a report.
5245	501.001(2)(b) 2nd Tampers with a consumer product or the container using materially false/misleading information.
5246	697.08 3rd Equity skimming.
5247	790.15(3) 3rd Person directs another to discharge firearm from a vehicle.
5248	796.05(1) 3rd Live on earnings of a prostitute.
5249	806.10(1) 3rd Maliciously injure, destroy, or interfere with vehicles or equipment used in firefighting.
5250	806.10(2) 3rd Interferes with or assaults firefighter in performance of duty.
5251	810.09(2)(c) 3rd Trespass on property other than structure or conveyance armed with firearm or dangerous weapon.
5252	812.014(2)(c)2. 3rd Grand theft; $5,000 or more but less than $10,000.
5253	812.0145(2)(c) 3rd Theft from person 65 years of age or older; $300 or more but less than $10,000.
5254	815.04(4)(b) 2nd Computer offense devised to defraud or obtain property.
5255	817.034(4)(a)3. 3rd Engages in scheme to defraud (Florida Communications Fraud Act), property valued at less than $20,000.
5256	817.233 3rd Burning to defraud insurer.
5257	817.234(8)&(9) 3rd Unlawful solicitation of persons involved in motor vehicle accidents.
5258	817.234(11)(a) 3rd Insurance fraud; property value less than $20,000.
5259	817.505(4) 3rd Patient brokering.
5260	828.12(2) 3rd Tortures any animal with intent to inflict intense pain, serious physical injury, or death.
5261	831.28(2)(a) 3rd Counterfeiting a payment instrument with intent to defraud or possessing a counterfeit payment instrument.
5262	831.29 2nd Possession of instruments for counterfeiting drivers' licenses or identification cards.
5263	838.021(3)(b) 3rd Threatens unlawful harm to public servant.
5264	843.19 3rd Injure, disable, or kill police dog or horse.
5265	870.01(2) 3rd Riot; inciting or encouraging.
5266	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).
5267	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.
5268	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.
5269	893.13(6)(a) 3rd Possession of any controlled substance other than felony possession of cannabis.
5270	893.13(7)(a)8. 3rd Withhold information from practitioner regarding previous receipt of or prescription for a controlled substance.
5271	893.13(7)(a)9. 3rd Obtain or attempt to obtain controlled substance by fraud, forgery, misrepresentation, etc.
5272	893.13(7)(a)10. 3rd Affix false or forged label to package of controlled substance.
5273	893.13(7)(a)11. 3rd Furnish false or fraudulent material information on any document or record required by chapter 893.
5274	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.
5275	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.
5276	893.13(8)(a)3. 3rd Knowingly write a prescription for a controlled substance for a fictitious person.
5277	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.
5278	918.13(1)(a) 3rd Alter, destroy, or conceal investigation evidence.
5279	944.47(1)(a)1.-2. 3rd Introduce contraband to correctional facility.
5280	944.47(1)(c) 2nd Possess contraband while upon the grounds of a correctional institution.
5281	985.3141 3rd Escapes from a juvenile facility (secure detention or residential commitment facility).
5282	(e) LEVEL 5
5283	316.027(1)(a) 3rd Accidents involving personal injuries, failure to stop; leaving scene.
5284	316.1935(4) 2nd Aggravated fleeing or eluding.
5285	322.34(6) 3rd Careless operation of motor vehicle with suspended license, resulting in death or serious bodily injury.
5286	327.30(5) 3rd Vessel accidents involving personal injury; leaving scene.
5287	381.0041(11)(b) 3rd Donate blood, plasma, or organs knowing HIV positive.
5288
5289	440.10(1)(g) 2nd Failure to obtain workers' compensation coverage.
5290	440.105(5) 2nd Unlawful solicitation for the purpose of making workers' compensation claims.
5291	440.381(2) 2nd Submission of false, misleading, or incomplete information with the purpose of avoiding or reducing workers' compensation premiums.
5292	790.01(2) 3rd Carrying a concealed firearm.
5293	790.162 2nd Threat to throw or discharge destructive device.
5294	790.163(1) 2nd False report of deadly explosive or weapon of mass destruction.
5295	790.221(1) 2nd Possession of short-barreled shotgun or machine gun.
5296	790.23 2nd Felons in possession of firearms or electronic weapons or devices.
5297	800.04(6)(c) 3rd Lewd or lascivious conduct; offender less than 18 years.
5298	800.04(7)(c) 2nd Lewd or lascivious exhibition; offender 18 years or older.
5299	806.111(1) 3rd Possess, manufacture, or dispense fire bomb with intent to damage any structure or property.
5300	812.0145(2)(b) 2nd Theft from person 65 years of age or older; $10,000 or more but less than $50,000.
5301	812.015(8) 3rd Retail theft; property stolen is valued at $300 or more and one or more specified acts.
5302	812.019(1) 2nd Stolen property; dealing in or trafficking in.
5303	812.131(2)(b) 3rd Robbery by sudden snatching.
5304	812.16(2) 3rd Owning, operating, or conducting a chop shop.
5305	817.034(4)(a)2. 2nd Communications fraud, value $20,000 to $50,000.
5306	817.234(11)(b) 2nd Insurance fraud; property value $20,000 or more but less than $100,000.
5307	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.
5308	817.625(2)(b) 2nd Second or subsequent fraudulent use of scanning device or reencoder.
5309	825.1025(4) 3rd Lewd or lascivious exhibition in the presence of an elderly person or disabled adult.
5310	827.071(4) 2nd Possess with intent to promote any photographic material, motion picture, etc., which includes sexual conduct by a child.
5311	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.
5312	843.01 3rd Resist officer with violence to person; resist arrest with violence.
5313	874.05(2) 2nd Encouraging or recruiting another to join a criminal street gang; second or subsequent offense.
5314	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).
5315	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.
5316	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.
5317	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.
5318	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.
5319	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).
5320	Section 37. Report to the Legislature regarding
5321	outstanding enforcement issues.--The Department of Financial
5322	Services shall, no later than January 1, 2004, provide a report
5323	to the President of the Senate, the Speaker of the House of
5324	Representatives, the minority leaders of the Senate and the
5325	House of Representatives, and the chairs of the standing
5326	committees of the Senate and the House of Representatives having
5327	jurisdiction over insurance issues, containing the following
5328	information:
5329	(1) Any provision of chapter 440, Florida Statutes,
5330	relating to workers' compensation carrier compliance and
5331	enforcement, that the department finds it is unable to enforce.
5332	(2) Any administrative rule relating to workers'
5333	compensation carrier compliance and enforcement that the
5334	department finds it is unable to enforce.
5335	(3) Any other impediment to enforcement of chapter 440,
5336	Florida Statutes, resulting from the transfer of activities from
5337	the former Department of Labor and Employment Security to the
5338	department or the reorganization of the former Department of
5339	Insurance into the department.
5340	Section 38. Subsection (2) of section 946.523, Florida
5341	Statutes, is amended to read:
5342	946.523 Prison industry enhancement (PIE) programs.--
5343	(2) Notwithstanding any other law to the contrary,
5344	including s. 440.15(8)(9), private sector employers shall
5345	provide workers' compensation coverage to inmates who
5346	participate in prison industry enhancement (PIE) programs under
5347	subsection (1). However, inmates are not entitled to
5348	unemployment compensation.
5349	Section 39. Paragraph (c) of subsection (5) of section
5350	985.315, Florida Statutes, is amended to read:
5351	985.315 Educational/technical and vocational work-related
5352	programs.--
5353	(5)
5354	(c) Notwithstanding any other law to the contrary,
5355	including s. 440.15(8)(9), private sector employers shall
5356	provide juveniles participating in juvenile work programs under
5357	paragraph (b) with workers' compensation coverage, and juveniles
5358	shall be entitled to the benefits of such coverage. Nothing in
5359	this subsection shall be construed to allow juveniles to
5360	participate in unemployment compensation benefits.
5361	Section 40. (1) There is established a Joint Select
5362	Committee on Workers’ Compensation Rating Reform. The committee
5363	shall study the merits of requiring each workers’ compensation
5364	insurer to individually file its expense and profit portion of a
5365	rate filing, while permitting each insurer to use a lost cost
5366	filing made by a licensed rating organization. The committee
5367	shall also study options for the current prior approval system
5368	for workers’ compensation rate filings, including, but not
5369	limited to, rate filing procedures that would promote greater
5370	competition and would encourage insurers to write workers'
5371	compensation coverage in the state while protecting employers
5372	from rates that are excessive, inadequate, or unfairly
5373	discriminatory.
5374	(2) The committee shall be composed of three Senators
5375	appointed by the President of the Senate and three
5376	Representatives appointed by the Speaker of the House of
5377	Representatives. The appointed members of the committee shall
5378	elect a chair and vice chair. The Department of Financial
5379	Services shall provide information and assistance as requested
5380	by the committee.
5381	(3) The committee shall issue its final report and
5382	recommendations to the President of the Senate and the Speaker
5383	of the House of Representatives by December 1, 2003. The
5384	committee shall terminate on December 1, 2003.
5385	Section 41. The board of governors of the joint
5386	underwriting plan for workers’ compensation insurance created by
5387	s. 627.311(4), Florida Statutes, shall, by January 1, 2005,
5388	submit a report to the President of the Senate, the Speaker of
5389	the House of Representatives, the minority party leaders of the
5390	Senate and the House of Representatives, and the chairs of the
5391	standing committees of the Senate and the House of
5392	Representatives having jurisdiction over matters relating to
5393	workers’ compensation. The report shall include the board’s
5394	findings and recommendations on the following issues:
5395	(1) The number of policies and the aggregate premium of
5396	the workers’ compensation joint underwriting plan, before and
5397	after enactment of this act, and projections for future policy
5398	and premium growth.
5399	(2) Increases or decreases in availability of workers’
5400	compensation coverage in the voluntary market and the
5401	effectiveness of this act in improving the availability of
5402	workers’ compensation coverage in the state.
5403	(3) The board’s efforts to depopulate the plan and the
5404	willingness of insurers in the voluntary market to avail
5405	themselves of depopulation incentives.
5406	(4) Further actions that could be taken by the Legislature
5407	to improve availability of workers’ compensation coverage in the
5408	voluntary and residual markets.
5409	(5) Actions that the board has taken to restructure the
5410	joint underwriting plan and recommendations for legislative
5411	action to restructure the plan.
5412	(6) Projected surpluses or deficits and possible means of
5413	providing funding to ensure the continued solvency of the plan.
5414	(7) An independent actuarial review of all rates under the
5415	plan. The costs of the independent actuarial review shall be
5416	paid from the Workers' Compensation Administration Trust Fund,
5417	pursuant to a budget amendment approved by the Legislative
5418	Budget Commission. The board shall submit a plan for such review
5419	to the Legislative Budget Commission by October 1, 2003.
5420	(8) Such other issues as the board determines are worthy
5421	of the Legislature’s consideration.
5422	Section 42. Subsections (1) and (2) of section 443.1715,
5423	Florida Statutes, are amended to read:
5424	443.1715 Disclosure of information; confidentiality.--
5425	(1) RECORDS AND REPORTS.--Information revealing the
5426	employing unit's or individual's identity obtained from the
5427	employing unit or from any individual pursuant to the
5428	administration of this chapter, and any determination revealing
5429	such information, except to the extent necessary for the proper
5430	presentation of a claim or upon written authorization of the
5431	claimant who has a workers’ compensation claim pending or is
5432	receiving compensation benefits, must be held confidential and
5433	exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I
5434	of the State Constitution. Such information may be made
5435	available only to public employees in the performance of their
5436	public duties, including employees of the Department of
5437	Education in obtaining information for the Florida Education and
5438	Training Placement Information Program and the Office of
5439	Tourism, Trade, and Economic Development in its administration
5440	of the qualified defense contractor tax refund program
5441	authorized by s. 288.1045 and the qualified target industry tax
5442	refund program authorized by s. 288.106. Except as otherwise
5443	provided by law, public employees receiving such information
5444	must retain the confidentiality of such information. Any
5445	claimant, or the claimant's legal representative, at a hearing
5446	before an appeals referee or the commission shall be supplied
5447	with information from such records to the extent necessary for
5448	the proper presentation of her or his claim. Any employee or
5449	member of the commission or any employee of the division, or any
5450	other person receiving confidential information, who violates
5451	any provision of this subsection commits a misdemeanor of the
5452	second degree, punishable as provided in s. 775.082 or s.
5453	775.083. However, the division may furnish to any employer
5454	copies of any report previously submitted by such employer, upon
5455	the request of such employer, and may furnish to any claimant
5456	copies of any report previously submitted by such claimant, upon
5457	the request of such claimant, and the division is authorized to
5458	charge therefor such reasonable fee as the division may by rule
5459	prescribe not to exceed the actual reasonable cost of the
5460	preparation of such copies. Fees received by the division for
5461	copies as provided in this subsection must be deposited to the
5462	credit of the Employment Security Administration Trust Fund.
5463	(2) DISCLOSURE OF INFORMATION.—
5464	(a)Subject to such restrictions as the division
5465	prescribes by rule, information declared confidential under this
5466	section may be made available to any agency of this or any other
5467	state, or any federal agency, charged with the administration of
5468	any unemployment compensation law or the maintenance of a system
5469	of public employment offices, or the Bureau of Internal Revenue
5470	of the United States Department of the Treasury, or the Florida
5471	Department of Revenue and information obtained in connection
5472	with the administration of the employment service may be made
5473	available to persons or agencies for purposes appropriate to the
5474	operation of a public employment service or a job-preparatory or
5475	career education or training program. The division shall on a
5476	quarterly basis, furnish the National Directory of New Hires
5477	with information concerning the wages and unemployment
5478	compensation paid to individuals, by such dates, in such format
5479	and containing such information as the Secretary of Health and
5480	Human Services shall specify in regulations. Upon request
5481	therefor, the division shall furnish any agency of the United
5482	States charged with the administration of public works or
5483	assistance through public employment, and may furnish to any
5484	state agency similarly charged, the name, address, ordinary
5485	occupation, and employment status of each recipient of benefits
5486	and such recipient's rights to further benefits under this
5487	chapter. Except as otherwise provided by law, the receiving
5488	agency must retain the confidentiality of such information as
5489	provided in this section. The division may request the
5490	Comptroller of the Currency of the United States to cause an
5491	examination of the correctness of any return or report of any
5492	national banking association rendered pursuant to the provisions
5493	of this chapter and may in connection with such request transmit
5494	any such report or return to the Comptroller of the Currency of
5495	the United States as provided in s. 3305(c) of the federal
5496	Internal Revenue Code.
5497	(b)1. The employer or the employer’s workers’ compensation
5498	carrier against whom a claim for benefits under chapter 440 has
5499	been made, or a representative of either, may request from the
5500	division records of wages of the employee reported to the
5501	division by any employer for the quarter that includes the date
5502	of the accident that is the subject of such claim and for
5503	subsequent quarters. The request must be made with the
5504	authorization or consent of the employee or any employer who
5505	paid wages to the employee subsequent to the date of the
5506	accident.
5507	2. The employer or carrier shall make the request on a
5508	form prescribed by rule for such purpose by the division. Such
5509	form shall contain a certification by the requesting party that
5510	it is a party entitled to the information requested as
5511	authorized by this paragraph.
5512	3. The division shall provide the most current information
5513	readily available within 15 days after receiving the request.
5514	Section 43. Subsection (9) of section 626.989, Florida
5515	Statutes, is amended to read:
5516	626.989 Investigation by department or Division of
5517	Insurance Fraud; compliance; immunity; confidential information;
5518	reports to division; division investigator's power of arrest.--
5519	(9) In recognition of the complementary roles of
5520	investigating instances of workers' compensation fraud and
5521	enforcing compliance with the workers' compensation coverage
5522	requirements under chapter 440, the Department of Financial
5523	Services shallInsurance is directed toprepare and submit a
5524	joint performance report to the President of the Senate and the
5525	Speaker of the House of Representatives by November 1, 2003, and
5526	then by January 1 of each yearNovember 1 every 3 years
5527	thereafter, describing the results obtained in achieving
5528	compliance with the workers' compensation coverage requirements
5529	and reducing the incidence of workers' compensation fraud. The
5530	annual report must include, but need not be limited to:
5531	(a) The total number of initial referrals received, cases
5532	opened, cases presented for prosecution, cases closed, and
5533	convictions resulting from cases presented for prosecution by
5534	the Bureau of Workers’ Compensation Insurance Fraud by type of
5535	workers’ compensation fraud and circuit.
5536	(b) The number of referrals received from insurers and the
5537	Division of Workers’ Compensation and the outcome of those
5538	referrals.
5539	(c) The number of investigations undertaken by the office
5540	which were not the result of a referral from an insurer or the
5541	Division of Workers’ Compensation.
5542	(d) The number of investigations that resulted in a
5543	referral to a regulatory agency and the disposition of those
5544	referrals.
5545	(e) The number and reasons provided by local prosecutors
5546	or the statewide prosecutor for declining prosecution of a case
5547	presented by the office by circuit.
5548	(f) The total number of employees assigned to the office
5549	and the Division of Workers’ Compliance unit delineated by
5550	location of staff assigned and the number and location of
5551	employees assigned to the office who were assigned to work other
5552	types of fraud cases.
5553	(g) The average caseload and turnaround time by type of
5554	case for each investigator and division compliance employee.
5555	(h) The training provided during the year to workers’
5556	compensation fraud investigators and the division’s compliance
5557	employees.
5558	Section 44. Section 626.9891, Florida Statutes, is amended
5559	to read:
5560	626.9891 Insurer anti-fraud investigative units; reporting
5561	requirements; penalties for noncompliance.--
5562	(1) Every insurer admitted to do business in this state
5563	who in the previous calendar year, at any time during that year,
5564	had $10 million or more in direct premiums written shall:
5565	(a) Establish and maintain a unit or division within the
5566	company to investigate possible fraudulent claims by insureds or
5567	by persons making claims for services or repairs against
5568	policies held by insureds; or
5569	(b) Contract with others to investigate possible
5570	fraudulent claims for services or repairs against policies held
5571	by insureds.
5572
5573	An insurer subject to this subsection shall file with the
5574	Division of Insurance Fraud of the department on or before July
5575	1, 1996, a detailed description of the unit or division
5576	established pursuant to paragraph (a) or a copy of the contract
5577	and related documents required by paragraph (b).
5578	(2) Every insurer admitted to do business in this state,
5579	which in the previous calendar year had less than $10 million in
5580	direct premiums written, must adopt an anti-fraud plan and file
5581	it with the Division of Insurance Fraud of the department on or
5582	before July 1, 1996. An insurer may, in lieu of adopting and
5583	filing an anti-fraud plan, comply with the provisions of
5584	subsection (1).
5585	(3) Each insurers anti-fraud plans shall include:
5586	(a) A description of the insurer's procedures for
5587	detecting and investigating possible fraudulent insurance acts;
5588	(b) A description of the insurer's procedures for the
5589	mandatory reporting of possible fraudulent insurance acts to the
5590	Division of Insurance Fraud of the department;
5591	(c) A description of the insurer's plan for anti-fraud
5592	education and training of its claims adjusters or other
5593	personnel; and
5594	(d) A written description or chart outlining the
5595	organizational arrangement of the insurer's anti-fraud personnel
5596	who are responsible for the investigation and reporting of
5597	possible fraudulent insurance acts.
5598	(4) Any insurer who obtains a certificate of authority
5599	after July 1, 1995, shall have 18 months in which to comply with
5600	the requirements of this section.
5601	(5) For purposes of this section, the term "unit or
5602	division" includes the assignment of fraud investigation to
5603	employees whose principal responsibilities are the investigation
5604	and disposition of claims. If an insurer creates a distinct unit
5605	or division, hires additional employees, or contracts with
5606	another entity to fulfill the requirements of this section, the
5607	additional cost incurred must be included as an administrative
5608	expense for ratemaking purposes.
5609	(6) Each insurer writing workers’ compensation insurance
5610	shall report to the department, on or before August 1 of each
5611	year, on its experience in implementing and maintaining an anti-
5612	fraud investigative unit or an anti-fraud plan. The report must
5613	include, at a minimum:
5614	(a) The dollar amount of recoveries and losses
5615	attributable to workers’ compensation fraud delineated by the
5616	type of fraud: claimant, employer, provider, agent, or other.
5617	(b) The number of referrals to the Bureau of Workers’
5618	Compensation Fraud for the prior year.
5619	(c) A description of the organization of the anti-fraud
5620	investigative unit, if applicable, including the position titles
5621	and descriptions of staffing.
5622	(d) The rationale for the level of staffing and resources
5623	being provided for the anti-fraud investigative unit, which may
5624	include objective criteria such as number of policies written,
5625	number of claims received on an annual basis, volume of
5626	suspected fraudulent claims currently being detected, other
5627	factors, and an assessment of optimal caseload that can be
5628	handled by an investigator on an annual basis.
5629	(e) The in-service education and training provided to
5630	underwriting and claims personnel to assist in identifying and
5631	evaluating instances of suspected fraudulent activity in
5632	underwriting or claims activities.
5633	(f) A description of a public awareness program focused on
5634	the costs and frequency of insurance fraud and methods by which
5635	the public can prevent it.
5636	(7) If an insurer fails to submit a final anti-fraud plan
5637	or otherwise fails to submit a plan, fails to implement the
5638	provisions of a plan or an anti-fraud investigative unit, or
5639	otherwise refuses to comply with the provisions of this section,
5640	the department may:
5641	(a) Impose an administrative fine of not more than $2,000
5642	per day for such failure by an insurer, until the department
5643	deems the insurer to be in compliance;
5644	(b) Impose upon the insurer a fraud detection and
5645	prevention plan that is deemed to be appropriate by the
5646	department and that must be implemented by the insurer; or
5647	(c) Impose the provisions of both paragraphs (a) and (b).
5648	(8) The department may adopt rules to administer this
5649	section.
5650	Section 45. Section 440.1925, Florida Statutes, is
5651	repealed.
5652	Section 46. Paragraph (h) of subsection (2) of section
5653	112.19, Florida Statutes, is amended to read:
5654	112.19 Law enforcement, correctional, and correctional
5655	probation officers; death benefits.--
5656	(2)
5657	(h)1. Any employer who employs a full-time law
5658	enforcement, correctional, or correctional probation officer
5659	who, on or after January 1, 1995, suffers a catastrophic injury,
5660	as defined in s. 440.02, Florida Statutes 2002,in the line of
5661	duty shall pay the entire premium of the employer's health
5662	insurance plan for the injured employee, the injured employee's
5663	spouse, and for each dependent child of the injured employee
5664	until the child reaches the age of majority or until the end of
5665	the calendar year in which the child reaches the age of 25 if
5666	the child continues to be dependent for support, or the child is
5667	a full-time or part-time student and is dependent for support.
5668	The term "health insurance plan" does not include supplemental
5669	benefits that are not part of the basic group health insurance
5670	plan. If the injured employee subsequently dies, the employer
5671	shall continue to pay the entire health insurance premium for
5672	the surviving spouse until remarried, and for the dependent
5673	children, under the conditions outlined in this paragraph.
5674	However:
5675	a. Health insurance benefits payable from any other source
5676	shall reduce benefits payable under this section.
5677	b. It is unlawful for a person to willfully and knowingly
5678	make, or cause to be made, or to assist, conspire with, or urge
5679	another to make, or cause to be made, any false, fraudulent, or
5680	misleading oral or written statement to obtain health insurance
5681	coverage as provided under this paragraph. A person who violates
5682	this sub-subparagraph commits a misdemeanor of the first degree,
5683	punishable as provided in s. 775.082 or s. 775.083.
5684	c. In addition to any applicable criminal penalty, upon
5685	conviction for a violation as described in sub-subparagraph b.,
5686	a law enforcement, correctional, or correctional probation
5687	officer or other beneficiary who receives or seeks to receive
5688	health insurance benefits under this paragraph shall forfeit the
5689	right to receive such health insurance benefits, and shall
5690	reimburse the employer for all benefits paid due to the fraud or
5691	other prohibited activity. For purposes of this sub-
5692	subparagraph, "conviction" means a determination of guilt that
5693	is the result of a plea or trial, regardless of whether
5694	adjudication is withheld.
5695	2. In order for the officer, spouse, and dependent
5696	children to be eligible for such insurance coverage, the injury
5697	must have occurred as the result of the officer's response to
5698	fresh pursuit, the officer's response to what is reasonably
5699	believed to be an emergency, or an unlawful act perpetrated by
5700	another. Except as otherwise provided herein, nothing in this
5701	paragraph shall be construed to limit health insurance coverage
5702	for which the officer, spouse, or dependent children may
5703	otherwise be eligible, except that a person who qualifies under
5704	this section shall not be eligible for the health insurance
5705	subsidy provided under chapter 121, chapter 175, or chapter 185.
5706	Section 47. Paragraph (g) of subsection (2) of section
5707	112.191, Florida Statutes, is amended to read:
5708	112.191 Firefighters; death benefits.--
5709	(2)
5710	(g)1. Any employer who employs a full-time firefighter
5711	who, on or after January 1, 1995, suffers a catastrophic injury,
5712	as defined in s. 440.02, Florida Statutes 2002,in the line of
5713	duty shall pay the entire premium of the employer's health
5714	insurance plan for the injured employee, the injured employee's
5715	spouse, and for each dependent child of the injured employee
5716	until the child reaches the age of majority or until the end of
5717	the calendar year in which the child reaches the age of 25 if
5718	the child continues to be dependent for support, or the child is
5719	a full-time or part-time student and is dependent for support.
5720	The term "health insurance plan" does not include supplemental
5721	benefits that are not part of the basic group health insurance
5722	plan. If the injured employee subsequently dies, the employer
5723	shall continue to pay the entire health insurance premium for
5724	the surviving spouse until remarried, and for the dependent
5725	children, under the conditions outlined in this paragraph.
5726	However:
5727	a. Health insurance benefits payable from any other source
5728	shall reduce benefits payable under this section.
5729	b. It is unlawful for a person to willfully and knowingly
5730	make, or cause to be made, or to assist, conspire with, or urge
5731	another to make, or cause to be made, any false, fraudulent, or
5732	misleading oral or written statement to obtain health insurance
5733	coverage as provided under this paragraph. A person who violates
5734	this sub-subparagraph commits a misdemeanor of the first degree,
5735	punishable as provided in s. 775.082 or s. 775.083.
5736	c. In addition to any applicable criminal penalty, upon
5737	conviction for a violation as described in sub-subparagraph b.,
5738	a firefighter or other beneficiary who receives or seeks to
5739	receive health insurance benefits under this paragraph shall
5740	forfeit the right to receive such health insurance benefits, and
5741	shall reimburse the employer for all benefits paid due to the
5742	fraud or other prohibited activity. For purposes of this sub-
5743	subparagraph, "conviction" means a determination of guilt that
5744	is the result of a plea or trial, regardless of whether
5745	adjudication is withheld.
5746	2. In order for the firefighter, spouse, and dependent
5747	children to be eligible for such insurance coverage, the injury
5748	must have occurred as the result of the firefighter's response
5749	to what is reasonably believed to be an emergency involving the
5750	protection of life or property, or an unlawful act perpetrated
5751	by another. Except as otherwise provided herein, nothing in this
5752	paragraph shall be construed to limit health insurance coverage
5753	for which the firefighter, spouse, or dependent children may
5754	otherwise be eligible, except that a person who qualifies for
5755	benefits under this section shall not be eligible for the health
5756	insurance subsidy provided under chapter 121, chapter 175, or
5757	chapter 185.
5758	Section 48. The amendments to ss. 440.02 and 440.15,
5759	Florida Statutes, which are made by this act shall not be
5760	construed to affect any determination of disability under s.
5761	112.18, s. 112.181, or s. 112.19, Florida Statutes.
5762	Section 49. If any law amended by this act was also
5763	amended by a law enacted at the 2003 Regular Session of the
5764	Legislature, such laws shall be construed as if they had been
5765	enacted at the same session of the Legislature, and full effect
5766	shall be given to each if possible.
5767	Section 50. Except as otherwise provided herein, this act
5768	shall take effect October 1, 2003.