February 2009


I know personally that many adjusters are both overworked and underpaid.  But, it is still important to be aware of the medical benefit “deadlines” that the W/C statute imposes on E/C’s.

A Carrier that fails to comply with these deadlines forfeits its ability to contest requested medical treatment, even if that treatment is not medically necessary. (more…)

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Its fair to say that this is well established point of law in Workers’ Compensation, therefore the fact pattern should not one that is heavily litigated.  However, whenever a new adjuster  looks at the situation, the response is disbelief.

I am referring to the recommendation of a diagnostic test (an MRI, X-Ray, Cat Scan, etc.) by an authorized doctor for a body part, injury, or condition that does not seem related to the compensable accident.  A lot of times I will get a call from an adjuster asking me if they should authorize a diagnostic test that is recommended by an authorized treater for a body part that Claimant did not report as an injury.   Many of those adjusters are surprised when I tell them they have to authorize it.  

And, I don’t blame them for that reaction. (more…)

It is one thing to blog about the First DCA decisions regarding W/C from the cozy confines of my desk.  It is quite another to actually pack up your self-proclaimed “analytical skills” and take them to Tallahassee to put them to the test in front of an appellate panel.  Yesterday, I had the opportunity to do such in my very first appeal–and oral argument–in front of the Court. 

Representing the appellant, Yaska Martinez Inc. and Unisource, I was attempting to reverse the JCC’s opinion in awarding Temporary Partial disability benefits to the claimant, Mr. Oscar Chaverri.   The case number is 1D08-1724.  You can view the docket here(more…)

It’s always the weird ones that make precedent.

In a case that must be read to insure its existence, the First DCA today found that a breast implant can be considered in the category of “prosthetic devices”.  Beyond the obvious snickers the case of Pamela Mullin v. 7-Eleven is a significant decision in how it defines prosthetic devices and whether apportionment–the principle of dividing liability between a compensable injury and Claimant’s pre-existing medical conditions–applies to prosthetic devices.

(more…)

For Employer/Carriers and Claimants, the point of disability called “statutory maximum medical improvement” was always a confusing moment.   Under section 440.15, a Claimant is deemed to be at maximum medical improvement (MMI) after a period of 104 weeks of temporary benefits (TTD or TPD) has been paid by the E/C. 

The problem for both sides was that Claimant often was not really at MMI from the point of view of his doctors.  Two years is a long time to be off work or on restricted work status, so a Claimant who exhausts the entire 104 weeks likely has severe, multiple injuries.  For many of these severe injuries the healing process to get Claimant at MMI is going to be much longer than that.  But, the statute says that Claimant is no longer entitled to future temporary indemnity benefits after 104 weeks of receiving temporary benefits.  What is a Claimant to do?  She cannot physically work, but she is not receiving any money from the E/C. 

For many, the only choice is to file for permanent total benefits. 

(more…)

I just came back from an informative Hillsborough County Bar Association, Workers’ Comp Section luncheon.  We had two of Tampa’s finest judges attend and speak to us about the Rules of Procedure (so affectionately referred to as the 60Q rules, for their prefix title).  You can review all of the 60Q Rules here.

In particular, the Judges talked about Rule 60Q-6.108 which deals with filing and service of petitions, response to petitions, and pleadings.  The Division of Administration Hearings (DOAH), which is the statewide agency governing the Judges of Compensation Claims, encourages Claimants and Employer/Carriers to electronically file petitions and pleadings which can ultimately be viewed online at the DOAH website.

Anyway, Rule 60Q-6.108 dictates that any document filed on the DOAH website or the JCC after 5 pm shall be deemed filed as of 8 am the following business day.  And, if you e-file on the DOAH website, you are responsible for any delay or disruption of web service. 

In other words, if you are an Employer Carrier and have to file a Response to a Petition for Benefits, a Response to a Fee Petition, or a Notice of Appeal and they file at the end of the day, the fact that the DOAH website is down is NOT an excuse.   Do not wait to file late in the day, at 4:55, and expect an instantaneous response.  Odds are you are going to miss the deadline because the website traffic is so high at the end of each day.  Keep in mind, not just other attorneys’ offices are e-filing at the end of the day, but every district office is e-filing their orders as well. 

The 60Q Rules are basic and easy to apply.  I encourage all Employer/Carriers to print a copy for their use.  Knowing these rules can make or break your claim.