Workers Compensation Benefits

Whenever an employee is injured on the job and they have to file for temporary total workers compensation benefits they have available to them 104 weeks of paid time.  Anyone insured by their employers' Workers Compensation policy has had that amount of time since early in January of 1994.  But, on February 28th, that amount of time was ruled as unconstitutional by the First District Court of Appeal.  Unfortunately this ruling is only part of a case brought on by an individual that suffered serious injuries.  Even so, it is possible that this decision could have an impact on workers compensation.

In the case mentioned above, the claimant is a firefighter who became injured while on the job.  He was covered by insurance but the injuries he sustained to his back and to one of his knees were considered severe.  As a result, he had to have surgery and other medical treatments.  His time in the hospital plus the time that he needs to recover has exceeded the allowed 104 weeks.  On top of that he required additional surgery but his time had run out.  According to his doctors it was not yet possible for him to continue his work as a firefighter.  Therefore, he decided to apply for permanent disability benefits.

His request for those workers compensation benefits was reviewed by the Judge of Compensation Claims but he denied it for 2 reasons.  The first reason was that he had not reached what is called maximum medical improvement (MMI).  His body is still in the process of healing and doctors have not declared that he will never get better than he was at that time.  The second reason is, because he had not been declared as having reached MMI (assuming he does not fully recover) nobody could speculate on how much of a permanent disability he may or may not end up with.  Because of this, it was noted by the JCC that the firefighter falls into a statutory gap, meaning that there are no benefits available to him since he used up his temporary total benefits and has not reached eligibility for total disability benefits.

Apparently, this was not found to be acceptable by the still-recovering firefighter so he appealed the decision.  In the appeal, it was the opinion of the First District Court of Appeal (DCA) that, because of the cap, injured workers are deprived of court access in the administration of justice.  In addition, the cap requires that he stay home from work, go without any wages or disability pay and just wait.  According to the First DCA that goes against the notion of legal or natural justice so they ruled that the current limit of 104 weeks is unconstitutional.

Because of their ruling, the temporary disability benefits cap will revert back to the pre-1994 allowance of 260 weeks.  For the time being, though, everything else will remain as is.  Some anticipate that this decision will cause an appeal to be taken to the Florida Supreme Court, so the ruling may, for 18 – 24 months, hold the decision in abeyance.

Currently, the opinion of the First District Court of Appeals only applies “prospectively” so it cannot be applied to any rulings or findings made final before February 28, 2013 although some are hoping for or expecting the First DCA to come out with similar opinions as time goes on.

If you are in need of a Workers Compensation policy for your employees or if you would like to see if we can help you lower your premium, please give us a call at 305-270-2100.

At Filer Insurance, Inc., we have been providing Home, Auto and Business Insurance in Miami and South Florida since 1919.  We would very much like to have you as one of our customers.  Please give us call or come by our office for a free quote on your insurance.

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