Workers' Compensation

Maximum Medical Improvement and Florida Workers Compensation Eligibility

Published on: November 25, 2019 | by Friedman Rodman Frank & Estrada, P.A.

Recently, Florida’s First District Court of Appeal issued an opinion addressing a claimant’s eligibility to temporary partial disability benefits after an expert medical advisor opined that he reached maximum medical improvement.

Under the Florida State Workers’ Compensation Program, employees who suffered injuries at their workplace or during the scope of their employment, have the right to recover costs associated with their medical expenses and lost wages. To collect benefits through the state’s workers’ compensation program, employees must report their injuries to their employer within 30 days of either the injury or when it was discovered to be related to work. Employees must provide as much information as possible, including details regarding the accident and the symptoms they are experiencing.

After reporting an injury, employers should contact their insurance company and send the employee to an occupational doctor of their choosing. The doctor will treat the patient until they reach “maximum medical improvement” (MMI). Under the statute, MMI is when a reasonable medical professional determines that an individual’s condition has reached a point where they should not expect any further recovery. A finding of MMI does not necessarily mean that an employee is fully recovered or that they are not experiencing functional limitations. Further, reaching MMI does not automatically terminate entitlement to treatment. However, reaching MMI is a critical point in the employee’s treatment, because once MMI is reached, an employee’s insurance carrier can reduce or terminate benefits. Issues arise because there are instances where doctors are under pressure to categorize patients as reaching MMI, even if that is not the case.

Can an Injured Florida Worker Request a Change of Doctor?

Published on: July 16, 2019 | by Friedman Rodman Frank & Estrada, P.A.

When someone is hurt in a Florida workplace accident, they can pursue a claim under the Florida Workers’ Compensation Act. If approved, a workers’ compensation claim provides an injured employee with medical treatment and ongoing compensation for the time they are unable to work. Doctors have a critical role in a workers’ compensation case because many of the determinations that dictate whether a claim is approved, the amount of benefits an injured worker receives, and the length of time that benefits will be paid are in a doctor’s hands.

Given the importance that the selected doctor plays in the claims process, one question that frequently arises in Florida workers’ compensation cases is whether an injured worker can request a change in doctors. The answer, as is often the case, is “it depends.” Generally speaking, an employer is able to select the treating physician except in cases of emergency medical care. However, there are several situations in which a worker can choose their own doctor. Both, however, require that an employer drop the ball when it comes to an employee’s request.

The first scenario involves a situation where an employee requests medical treatment, but an employer fails to provide treatment within a reasonable amount of time. In this case, an employee can seek out their own care, pay for it, and then ask to be reimbursed by their employer.

Can an Employee Hold a Co-Worker Responsible in a Florida Workplace Accident Case?

Published on: April 18, 2019 | by Friedman Rodman Frank & Estrada, P.A.

When someone is injured on the job, they can typically file a claim for compensation based on the injuries they sustained. There are two types of claims, Florida workers’ compensation claims and Florida personal injury claims. A workers’ compensation claim does not require an employee establish another party was at fault for their injuries. However, Florida workers’ compensation claims provide only for the recovery of medical expenses/disability benefits, meaning that an injured employee cannot recover for the pain and suffering the accident caused.

Alternatively, Florida personal injury cases allow accident victims to more fully recover for their injuries, including for non-economic losses. However, a plaintiff must be able to show that the defendant was negligent to recover these losses. In many Florida workplace accidents, the first question that arises is which type of claim should an injured employee pursue. In reality, it is less a question of “should” and more a question of “can.”

One way of thinking about this question is to consider who was at fault for the accident. In short, if an accident is caused by the negligence of the employer or the employee, an employee’s only remedy may be through a Florida workers’ compensation claim. This is because under Florida statutes section 440.11, while a qualifying employer is responsible for an employee’s injuries, a workers’ compensation claim is usually the injured employee’s “sole remedy.” This means that an employee whose injuries are the result of a covered accident may only be able to pursue a workers’ compensation claim. Section 440.11 extends this “sole remedy” provision to situations where an employee’s injuries are caused by a co-worker’s negligence.

Florida Court Rejects Employer’s Termination of Workers’ Comp Benefits after 15 Years

Published on: April 15, 2019 | by Friedman Rodman Frank & Estrada, P.A.

Workers’ compensation cases do not necessarily end when a claimant receives a decision in the case. Employers that originally agreed to pay for treatment may try to stop paying for treatment at some point. In a recent case before a Florida appeals court, the court rejected an employer’s termination of benefits after paying for benefits for 15 years.

According to the court’s opinion, the claimant had worked in a building in Orlando from 1995 to 1997. Employees in the building experienced breathing problems, and after asbestos was discovered, employees were removed from all floors except the claimant’s floor. The claimant was not provided any protective gear and later developed breathing problems. The employer subsequently accepted compensability of the injury under the Workers’ Compensation Act, and accepted liability for the claimant’s illness due to air quality problems.

The employer paid for the claimant’s treatment, until 15 years later when the employer terminated treatment to the claimant. The employer argued that the work accident was no longer a major contributing cause of the need for medical treatment and that the treatment was not medically necessary. A workers’ compensation judge found the treatment was not medically necessary, and the claimant appealed.

Florida Court Rejects Injured Employee’s Workers’ Compensation Claim for Temporary Partial Disability

Published on: April 11, 2019 | by Friedman Rodman Frank & Estrada, P.A.

When someone is injured in a Florida workplace accident and cannot immediately return to work, they may be entitled to Florida workers’ compensation benefits while they are recovering from their injuries. There are two types of temporary workers’ compensation benefits: temporary partial disability (TPD) benefits and temporary total disability (TTD) benefits.

Temporary partial disability benefits, also known as “wage loss” benefits are awarded when an injured employee can return to work in some capacity, but is not able to earn as much as they did before their injury. This may be because they can only work part-time or because the position they were reassigned to pays less than their pre-injury position.

Earlier this month, a state appellate court issued a written opinion in a Florida workers’ compensation case discussing an injured worker’s claim for temporary partial disability (TPD) benefits. Ultimately, the court concluded that the employee failed to establish that her post-injury wages were sufficiently reduced as a result of her injury, and thus the court rejected her claim for TPD benefits.

How the Jones Act May Help Injured Seamen Recover for Work-Related Injuries

Published on: February 4, 2019 | by Friedman Rodman Frank & Estrada, P.A.

When someone is injured in a Florida workplace accident, compensation may be available through several sources. One option for the injured employee is to apply for Florida workers’ compensation benefits. One good thing about workers’ compensation benefits is that an employee can obtain benefits without a showing of fault. However, these benefits are limited in that an employee can only recover economic damages. This means an employee is not able to obtain compensation for their emotional pain and suffering.

Another option for those who have been injured in a Florida workplace accident is to pursue a personal injury claim against their employer. However, as a general rule, an injured employee’s sole remedy against their employer is a workers’ compensation claim. Thus, many employees are foreclosed from pursuing a Florida personal injury claim against their employer.

That is not the case, however, for maritime workers. Under the Jones Act, those seamen who are injured or killed in the course of their employment may be able to pursue a claim against their employer. (Note: Florida railroad workers enjoy a similar benefit under the Federal Employment Liability Act.) It is important to note, however, that an employee who brings a claim under the Jones Act must establish that their employer was negligent. As a recent case illustrates, the duties that a maritime employer owes to its employees may be unfamiliar to those without advanced knowledge of the industry.

Court Limits Employer’s Duty in Recent Case Stemming from Pedestrian-Railroad Fatality

Published on: July 5, 2018 | by Friedman Rodman Frank & Estrada, P.A.

Recently, a state appellate court issued a written opinion in a Florida pedestrian accident case involving the duty a defendant employer owes to a plaintiff employee. The case presented the court with the opportunity to discuss the outer limits of an employer’s duty to protect an employee. Ultimately, the court concluded that the defendant employer owed no duty to the employee, and thus, could not be held liable for her death.

The Facts of the Case

The plaintiff worked for the defendant employer, a financial services firm. The defendant maintained a bar on-site to encourage employees to socialize and stay at work longer than they may otherwise have chosen to. One day, the plaintiff visited the defendant’s bar after work. After a few drinks, the plaintiff began to get agitated at other employees, and she was eventually told to leave and subsequently escorted out. Her access into the building was revoked.

The plaintiff then began to walk toward her home, which was ten miles away. She was walking along a set of railroad tracks when she was struck by an oncoming train. She was killed instantly.

When Can an Injured Employee Seek Compensation through a Workplace Injury Lawsuit?

Published on: August 21, 2017 | by Friedman Rodman Frank & Estrada, P.A.

Workplace injuries occur frequently in many professions, and this is especially the case for jobs in the construction and manufacturing industries. When a worker is injured on the job, there are several potential avenues that the worker can pursue to obtain compensation for their injuries.The first option is a workers’ compensation claim. Florida workers’ compensation claims are filed by an injured employee against an employer for an injury that occurred on the job while they were acting within the scope of their employment. If they are successful in a workers’ compensation claim, an injured worker can obtain temporary or permanent benefits while they are unable to return to work. However, once a worker is able to return to work, the benefits cease. Additionally, compensation for pain and suffering due to the accident will not be available through a Florida workers’ compensation claim. However, if a workers’ compensation claim is available to an injured worker, that will be his sole remedy, meaning that he will not be able to pursue compensation through a Florida personal injury case.

Workers who are injured due to the fault of a third party (i.e., not their employer) can seek benefits through a Florida personal injury claim against that negligent third party. If they are successful in a Florida personal injury case, an injured worker can recover compensation for medical expenses, lost wages, and any pain and suffering they endured as a result of the accident. A recent case illustrates how an injured employee unsuccessfully attempted to hold a third party liable for his workplace injuries.

Florida Appellate Court Holds Injured Employee’s Motion for Sanctions Was Not Premature

Published on: March 1, 2016 | by Friedman Rodman Frank & Estrada, P.A.

In Soca v. Advanced Auto Parts, an auto parts store employee was apparently injured during a robbery at work. Following the incident, the man filed three petitions for workers’ compensation benefits. Soon afterward, the man’s employer provided him with the benefits he requested, and the worker withdrew his petitions.

Next, the employer sought to tax the worker for costs under Section 440.34(3) of the Florida Statutes. Under the law, the nonprevailing party in a proceeding before a Judge of Compensation Claims (“JCC”) is required to pay the “reasonable costs” associated with the proceedings. According to the employer, the company was clearly the prevailing party in the workers’ compensation proceedings. The employee responded by filing a motion for sanctions against his employer pursuant to Section 440.32. In his motion, the worker argued the costs sought by his employer could not have been incurred in the company’s defense against his petition for workers’ compensation benefits.

Workers’ Compensation Benefits Denied Because Florida Man’s Need for Treatment was Caused by a Preexisting Condition

Published on: January 21, 2016 | by Friedman Rodman Frank & Estrada, P.A.

In Ceristaff, Inc. v. Owen, a worker who was employed as a gas appliance technician apparently hurt his shoulder when he fell at work in December 2013. Following the man’s workplace accident injury, the worker’s employer accepted compensability for the incident. As a result, the employee was authorized to seek medical treatment. After the worker was examined by a physician, however, the employer denied further workers’ compensation benefits due to the employee’s purported preexisting condition. According to the man’s treating doctor, the worker suffered from both osteoarthritis and rotator cuff arthropathy prior to his workplace accident.

After the man’s employer denied his request for additional medical care, the worker underwent an examination by his own designated medical expert. The expert recommended that the worker undergo additional shoulder surgery. According to the physician, the major contributing cause (“MCC”) for the employee’s need for a surgical procedure was his fall accident at work.