A workers’ compensation case that ended up in Florida’s First Court of Appeals and panicked insurers when the court declared time limits on certain benefits unconstitutional has gone before the appeals justices again, with the court effectively reversing its earlier ruling while also paving the way for the claimant to receive benefits he was denied.
The court’s initial ruling extended the number of weeks for temporary total disability payments from 104 to 260, a move the National Council on Compensation Insurance (NCCI) says could cost Florida’s workers’ compensation system an additional $65 million annually.
The case involved former St Petersburg firefighter/paramedic Bradley Westphal, who suffered on-the-job back and other injuries in 2009. After back surgeries and other treatment, Westphal reached the 104-week time limit for temporary total disability benefits. When he applied for permanent total disability benefits his claim was denied by a workers’ comp judge who ruled it had not been ascertained whether Westphal had reached his maximum medical improvement, making him ineligible for permanent total disability and leaving him without benefits for nearly nine months.
COUNSEL HELPS INJURED WORKERS WITH CLAIMS PROCESS
The case points to the importance of working with experienced legal counsel when persons are injured on the job and file workers’ compensation claims, say Ormond Beach attorneys Johnson & Gilbert, who note the system can be confusing and disheartening because many claims are initially denied, regardless of the injuries suffered.
The First Court of Appeals’ earlier finding regarding the constitutionality of the 104-week benefits limit was aimed at eliminating gaps in coverage for injured Florida workers whose maximum medical improvement status had not been determined by the time the two-year limit was reached. The court reconsidered the issue at the behest of business and insurance industry interest groups, citing the negative economic impact of extending temporary total disability benefits from two years to five years.
FINDING REAFFIRMS MEDICAL IMPROVEMENT DEADLINES
The court noted its latest finding does not extend temporary total disability benefits. Instead, it enables injured workers to apply for permanent total disability benefits without unnecessary delays in the process.
The court declared once the injured worker reaches the maximum number of weeks allowed or reaches the date of maximum medical improvement, whichever occurs earlier, temporary disability benefits will end and the worker’s permanent impairment determined.
In such situations, the court noted, “maximum medical improvement” becomes a legal definition rather than a medical one. The court said the time limit set by law was not designed to deny benefits through gaps in coverage, but rather to establish a deadline for resolving the issue of maximum medical improvement.
Working your way through Florida’s worker’s compensation system takes know-how, and the Ormond Beach worker’s compensation lawyers at Johnson & Gilbert, P.A., now have been successfully at it for more than 15 years. If you’ve been injured at work call them at 386.673.4412 or toll-free at 800.556.8890 for a free consultation.