Florida Workers’ Comp Limitation Ruled Unconstitutional

by Friedman Rodman Frank & Estrada, P.A.

A recent victory for injured Florida workers in a workers’ compensation case, Westphal v. City of St. Petersberg, has upset the insurance industry. In the case, a firefighter challenged an order denying his claim for permanent total disability benefits and the constitutionality of the entire system of workers’ compensation benefits. The firefighter (who was also a paramedic) suffered nerve damage in his legs that required spinal surgery and other treatment during the course of his work.

After the accident that gave rise to this claim, the firefighter’s employer, the City, accepted the claim and paid the firefighter benefits for total temporary disability. The firefighter was forced to abide by the City’s choice of doctors and their medical recommendations, or forgo workers’ compensation benefits that he needed. He required multiple complex surgical procedures.

Even after the most recent surgery, about three years out from the occurrence of the accident, the firefighter was not able to work or obtain employment. He had exhausted the state limit of 104 weeks of temporary benefits, but permanent total disability benefits only kicked in when he reached “maximum medical improvement.” His physicians could not determine his long-range medical prospects and could only speculate. He had not yet reached “maximum medical improvement” but his injuries were so severe that doctors also advised him not to work.

Accordingly, the firefighter was denied permanent total disability benefits. He fell into a “statutory gap” that is not rare, where he had surpassed the number of weeks he could claim temporary total disability, but he had not reached a state where the nature of his permanent disability could be assessed.

In reviewing this case, the First District Court of Appeal looked at other cases dealing with the “statutory gap” created by the 104-week limitation on temporary disability benefits and looked at other jurisdiction’s limits on the number of weeks benefits could be paid. In one of the earlier cases, City of Pensacola Firefighters v. Oswald, the court had tried to fix this issue by letting a severely injured employee try to prove he would ultimately be permanently disabled. The court ruled that the scheme that left him without coverage violated his constitutional right to access the court and “receive justice without denial or delay.”

The appellate court granted the firefighter benefits for 260 weeks, which is what he would have had before the 1994 amendments to the statute.

The insurance industry believes that the appellate court’s decision may increase costs to the workers’ compensation system by $65 million or 2.8 %. The National Council on Compensation Insurance (NCCI) released a report analyzing the effects and finding that there could be a “significant unfunded liability” once the ruling was applied to all injured workers receiving temporary benefits. In NCCI’s view, workers would have less incentive to return to work and there would be a delay in determining permanent impairment, which could in turn lead to more complications that would result in more permanent disability claims.

The First District Court of Appeals has granted a motion to have the entire 15-member court rehear the case. The issue of the statutory gap between temporary and permanent disability benefits is a very important one for workers’ rights in Florida. This issue may eventually be heard by the Florida Supreme Court.

If you have experienced a work injury, you may be entitled to workers’ compensation benefits and the ruling described above may apply to you. Call the aggressive South Florida workers’ compensation attorneys at Friedman, Rodman & Frank to speak to an experienced attorney about your case, call (877) 448-8585.