Arrestable Offenses / Crimes under Fla. Stat. 440.105
S440.105 5 - PUBLIC ORDER CRIMES - ATTORNEY OR OTHER SOLICIT WORK COMP CLAIM - F: S
S440.105 2a1 - PUBLIC ORDER CRIMES - COERCE EMPL TO OBT CERTIF OF WORK COMP EXEMPT - M: F
S440.105 2a2 - PUBLIC ORDER CRIMES - FIRE NOT HIRE EMP APP BC FILED WORK COMP CLAIM - M: F
S440.105 2a3 - PUBLIC ORDER CRIMES - ADVER EMP ACTION BC REP VIOL OF WORK COMP REGS - M: F
S440.105 2a4 - PUBLIC ORDER CRIMES - REPEALED 7/1/06. 2006-305 - M: F
S440.105 2b - PUBLIC ORDER CRIMES - INS CO CANCEL INS BC EMP FILED WORK COMP CLAIM - M: F
S440.105 3a - PUBLIC ORDER CRIMES - FAIL UPDTE APP POST NOT RE WORK COMP COVERAGE - M: F
S440.105 3b - PUBLIC ORDER CRIMES - EMPLOYER HIRE EMPLOYEE WHO USED FALSE ID - M: F
S440.105 3c - PUBLIC ORDER CRIMES - ATTY OTHERS RECEIVE UNAPPROVED WORK COMP FEE - M: F
S440.105 4a1 - FRAUD-FALSE STATEMENT - EMPLYR FALSE CLAIM COMPLY EVID $20K-$100K - F: S
S440.105 4a1 - FRAUD-FALSE STATEMENT - EMPLOYER MAKE FALSE CLAIM OF COMPLIANCE $100K+ - F: F
S440.105 4a1 - FRAUD-FALSE STATEMENT - EMPLYR FALSE CLAIM COMPLY EVID LT $20K - F: T
S440.105 4b - FRAUD-FALSE STATEMENT - RENUMBERED. SEE REC # 8482 - F: T
S440.105 4b - FRAUD-FALSE STATEMENT - RENUMBERED. SEE REC # 8483 - F: S
S440.105 4b - FRAUD-FALSE STATEMENT - RENUMBERED. SEE REC # 8484 - F: F
S440.105 4b1 - FRAUD-FALSE STATEMENT - MAKE FALSE STATEMENT OBTAIN/DENY PAYMNT $100K+ - F: F
S440.105 4b1 - FRAUD-FALSE STATEMENT - MAKE FALSE STATEMNT OBTAIN/DENY PAYMNT LT $20K - F: T
S440.105 4b1 - FRAUD-FALSE STATEMENT - MAKE FALS STATEMT OBT/DENY PAYMT $20K-$100K - F: S
S440.105 4b2 - FRAUD-FALSE STATEMENT - PRESENT FALSE WC CLAIM PAYMENT BENEFIT $100K+ - F: F
S440.105 4b2 - FRAUD-FALSE STATEMENT - PRESENT FALSE WORKER COMP CLAIM $20K-$100K - F: S
S440.105 4b2 - FRAUD-FALSE STATEMENT - PRESENT FALSE WC CLAIM PAYMENT BENEFIT LT $20K - F: T
S440.105 4b3 - FRAUD-FALSE STATEMENT - PRESENT EMPLOYER INS CO FALSE WC STATE LT $20K - F: T
S440.105 4b3 - FRAUD-FALSE STATEMENT - PRESNT EMPLYR INS CO FLSE WC STATE $20K-$100K - F: S
S440.105 4b3 - FRAUD-FALSE STATEMENT - PRESENT EMPLOYER INS CO FALSE WC STATE $100K+ - F: F
S440.105 4b5 - FRAUD-FALSE STATEMENT - OMIT CONCEAL MAT INFO OBT WC PYMT PREM LT $20K - F: T
S440.105 4b5 - FRAUD-FALSE STATEMENT - OMIT CNCEAL MAT INF OBT WC PAY PREM $20K-$100K - F: S
S440.105 4b5 - FRAUD-FALSE STATEMENT - OMIT CONCEAL MATER INF OBT WC PAY PREM $100K+ - F: F
S440.105 4b7 - FRAUD-FALSE STATEMENT - EVID COMPLIAN ELIGIB FOR CERT EXEMP $20K-$100K - F: S
S440.105 4b7 - FRAUD-FALSE STATEMENT - EVID COMPLIANCE ELIGIB FOR CERT EXEMPT $100K+ - F: F
S440.105 4b7 - FRAUD-FALSE STATEMENT - EVID COMPLIANCE ELIGIB FOR CERT EXEMPT LT $20K - F: T
CopyCited 21 times | Published | Supreme Court of Florida | 2008 WL 4659381
...e carrier, responded *1054 by denying that any benefits were owed. At the hearing before the Judge of Compensation Claims (JCC), respondents contended that (1) no injury arose out of or in the course of employment; (2) the claim was fraudulent under section 440.105, Florida Statutes (2003), because petitioner provided an incomplete medical history; [1] (3) the major contributing cause of claimant's prolapsed uterus was from her experience giving birth; and (4) no costs, fees, or interest were owed....
...§
440.34(5), Fla. Stat. (2003). The amount of the reasonable appellate attorney fees shall be determined by the JCC. It is so ordered. QUINCE, C.J., and ANSTEAD, PARIENTE, and LEWIS, JJ., concur. CANADY and POLSTON, JJ., did not participate. NOTES [1] Section
440.105 provides in pertinent part that whoever knowingly makes a false statement or omits material information to obtain workers' compensation benefits commits the felony of insurance fraud. §
440.105(4)(b), (f), Fla....
CopyCited 13 times | Published | Florida 1st District Court of Appeal | 2002 WL 2030372
...When she saw her physician, however, she related that she had gone to the walk-in clinic for an unrelated condition. The JCC found appellant's testimony to be not credible and that claimant altered the prescription form. The JCC determined that appellant committed workers' compensation fraud under subparagraphs 440.105(4)(b)1....
...d to compensation or benefits under this chapter if any judge of compensation claims, administrative law judge, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in § 440.105 for the purposes of securing workers' compensation benefits. Section 440.105 in turn contains provisions prohibiting any person from committing fraud, by, e.g., making a false statement, to obtain workers' compensation benefits. [1] In the instant case, having held a hearing upon the employer's petition and having determined that appellant committed workers' compensation fraud in violation of section 440.105, the JCC determined under the above provision that appellant was no longer entitled to receive workers' compensation benefits....
CopyCited 12 times | Published | Supreme Court of Florida | 2005 WL 1403993
...statutory immunity provided by section
440.11, Florida Statutes (2000)." Id. at 468 (emphasis added). Nowhere in the decision below, either in the majority or the dissent, does Aguilera address the applicability of section 440.37 (or its successor, section
440.105) to the employee's claim....
...ageous and resulted in injuries separate and distinct from the work related injury [n. 3]. We disagree. [N. 2] If a carrier "lies" regarding available benefits, such statements constitute a criminal offense and subject the carrier to penalties under section 440.105, Florida Statutes (2000). The Department of Insurance is authorized to revoke or suspend the authority of a workers' compensation carrier for violation of Section 440.105....
...e investigation and litigation expenses, including attorney's fees at the trial and appellate courts. § 440.37(2)(c), Fla. Stat. (1989). Section 440.37 was repealed in 1993. See ch. 93-415, § 109, Laws of Fla. In its place, the Legislature enacted section 440.105, Florida Statutes (Supp.1994)....
...This statute, passed in 1990, provides that "[t]he workers' compensation system in Florida is based on a mutual renunciation of common-law rights and defenses by employers and employees alike." §
440.015, Fla. Stat. (2000). [12] As noted in footnote 7, section 440.37 was replaced in 1993 by section
440.105. However, section
440.105 is never discussed by the Third District below or the majority of this Court.
CopyCited 9 times | Published | Florida 3rd District Court of Appeal | 2002 WL 31870185
...eedings under the Act. See Old Republic Ins. Co. v. Whitworth,
442 So.2d at 1078, and cases cited therein. [2] If a carrier "lies" regarding available benefits, such statements constitute a criminal offense and subject the carrier to penalties under section
440.105, Florida Statutes (2000). The Department of Insurance is authorized to revoke or suspend the authority of a workers' compensation carrier for violation of Section
440.105....
CopyCited 9 times | Published | Florida 1st District Court of Appeal | 2004 WL 825603
...Taylor of Stiles, Taylor & Grace, P.A., Tallahassee, for Appellees. VAN NORTWICK, J. The claimant in this workers' compensation appeal, Marie Isaac, appeals a final order of the Judge of Compensation Claims (JCC) which finds that she is guilty of fraud within the meaning of section
440.105(4)(b), Florida Statutes (1999), and therefore not entitled to any past or future benefits from appellees Green Iguana, Inc., d/b/a Medical Billing Group, and Associated Industries Insurance Company, the employer and carrier respectively (employer/carrier), pursuant to section
440.09(4), Florida Statutes (1999)....
...nial of benefits under section
440.09(4) without giving her prior notice and an adequate opportunity to defend the charge. Under the circumstances below, we agree. Accordingly, we reverse and remand to the JCC to delete the finding of a violation of section
440.105(4)(b), Florida Statutes, and remove any reference to claimant's inability to pursue future benefits....
...She continued to collect workers' compensation benefits for two months while so employed. These facts were known by the employer/carrier at least eight months before the final merits hearing and at the time of the pre-trial conference; yet, the employer/carrier failed to raise a defense based upon sections
440.09(4) and
440.105(4)(b) prior to the merits hearing....
...explain her actions. The JCC found that claimant's actions constituted an alternative ground to deny benefits, ruling as follows: In addition to the previous grounds for denial of Claimant's claim, the Court finds an independent ground exists as per § 440.105(4)(b), that Claimant knowingly engaged in prohibited activity for the purposes of obtaining payment of indemnity benefits....
...and the Claimant's claim is DENIED IN ITS ENTIRETY. Section
440.09(4) provides that an employee will not be allowed compensation benefits if the JCC "determines that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105 for the purpose of securing workers' compensation benefits." Section
440.105(4)(b) contains numerous examples of false, fraudulent or misleading activity which are prohibited....
...Before the statute may be employed to deny benefits, a section
440.09(4) defense either must be raised by the employer/carrier pursuant to the applicable rules of procedure, if the facts supporting the defense are known by the employer/carrier; or must be raised by the JCC, if the actions violating section
440.105 occur before the JCC....
CopyCited 8 times | Published | Florida 3rd District Court of Appeal | 1997 WL 195226
...y the judge of compensation claims. See Old Republic Ins. Co. v. Whitworth,
442 So.2d at 1079. Plaintiff also argues that in alleging that Orkin made false statements about the availability of work, he has stated a cause of action under subparagraph
440.105(4)(b)1, Florida Statutes (1993), which provides: (4) Whoever violates any provision of this subsection commits a felony of the third degree, punishable as provided in s....
...§ 440.37(2)(e) (quoted in Sibley,
596 So.2d at 1050). Section 440.37, in other words, contained an express right of action. Effective January 1, 1994, the legislature repealed section 440.37. Ch. 93-415, § 109, Laws of Fla. In its place, the legislature enacted the similarly-worded section
440.105, Florida Statutes (Supp.1994). [1] In so doing, the legislature eliminated the express private right of action which had been contained in the earlier statute. We therefore conclude that there is no private right of action under section
440.105....
CopyCited 7 times | Published | Florida 1st District Court of Appeal | 2003 WL 22399572
...This provision sanctions workers' compensation claimants by denying benefits to which they might otherwise have been entitled, if a claimant, in seeking benefits, knowingly provides any false, misleading, fraudulent or incomplete information as set forth in section 440.105, Florida Statutes (Supp.1998)....
...rowed the application of the sanction beyond that intended by the legislature. In interpreting any statute, full effect must be given to the language chosen by the legislature. Section
440.09(4), provides that the commission of any act prohibited by section
440.105, results in the sanction. For instance, section
440.105(4)(b)2., Florida Statutes (Supp.1998), which doesn't use the word "fraud," imposes the sanction if the claimant, in support of his claim for benefits, makes an oral statement concerning a material fact that he knows is false, incomplete or misleading....
...false, misleading or, at the very least, incomplete. Regardless of whether the claimant was under oath, if, at the time he made any of these statements, he knew they were false, incomplete or misleading, then the statements fall within the scope of section
440.105(4)(b)2., and, pursuant to section
440.09(4), result in the loss of workers' compensation benefits....
...If the JCC finds the claimant knew he had been involved in prior accidents when he testified he had not, that would constitute a false statement involving a material fact. REVERSED and REMANDED with instructions. WOLF, C.J., and BROWNING, J., Concur. NOTES [1] Section 440.105(4)(b)2., provides: (b) It shall be unlawful for any person: * * * * 2....
CopyCited 6 times | Published | Florida 1st District Court of Appeal | 2005 WL 2452277
...The Employer/Carrier (E/C) appeals a non-final order determining compensability of a workers' compensation claim. Because we find that the trial court used the incorrect evidentiary standard, we reverse. The E/C alleges that Claimant violated sections
440.09(4) and
440.105(4)(b)2., Florida Statutes, by providing false, incomplete or misleading statements regarding his employment status while he was receiving temporary total disability benefits from an industrial injury....
...The JCC is only required to determine whether Claimant knowingly or intentionally made any false, fraudulent, incomplete, or misleading statement, whether oral or written, for the purpose of obtaining workers' compensation benefits, or in support of his claim for benefits. § 440.105(4)(b)2., Fla....
...(1999). See Village Apartments v. Hernandez,
856 So.2d 1140 (Fla. 1st DCA 2003). Significantly, it is not necessary that a false, fraudulent, or misleading statement be material to the claim; it only must be made for the purpose of obtaining benefits. §
440.105(4)(b)1., Fla....
...I write only to clarify the majority's point that the question for the JCC's resolution is not whether Claimant was employed by, or received payment for his association with, the strip club. The only question is whether Claimant knowingly or intentionally committed any of the acts prohibited by section 440.105, Florida Statutes....
...eering, and testified his activities at the club were connected with his evaluation as to whether he wished to invest in the club. Claimant's testimony and his activities at the club suggest the possible commission of at least two acts prohibited by section 440.105, Florida Statutes, and resulting in a forfeiture of any benefits or compensation pursuant to chapter 440....
CopyCited 6 times | Published | Florida 1st District Court of Appeal | 2000 WL 1527911
...Zientz, P.A., Miami, for Appellant. H. George Kagan and Elaine L. Thompson of Miller, Kagan, Rodriguez and Silver, P.A., West Palm Beach, for Appellees. WEBSTER, J. Following his conviction on two counts of workers' compensation fraud in violation of section 440.105(4)(b)1, Florida Statutes (Supp.1994), the claimant in this workers' compensation case filed a petition seeking various benefits....
...yee shall not be entitled to compensation or benefits under this chapter if any administrative hearing officer, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s. 440.105 for the purpose of securing workers' compensation benefits." The judge of compensation claims held that the claimant was barred from seeking any benefits, relying on the decision in Rustic Lodge v....
CopyCited 5 times | Published | Florida 5th District Court of Appeal | 2007 WL 3118841
...facts demonstrated that he did not direct, participate in, or procure Rothstein to tape record the meeting at Keating's office; (2) Keating's invasion of privacy claim was barred by the statute of limitations; (3) he was immune from liability under section
440.105 of the Florida Statutes for reporting evidence of suspected insurance fraud; [3] (4) he had a good *417 faith belief under section
934.10(2) of the Florida Statutes that the tape recording was permitted by law; (5) he had no duty to p...
...prior to the creation of the tapes. Further, even if Spangler had informed Locker of the existence of the tapes, there was no evidence showing that Spangler knowingly disclosed to Locker the contents of the tapes. Count III: Immunity under sections 440.105 and 440.1051 of the Florida Statutes Spangler was immune from liability because even if he disclosed the existence of the tape to the Division of Insurance Fraud, this conduct would be protected under section 440.105(1)(b) because it was in furtherance of the reporting requirement of the statute....
...stified that the tape played a role in filing a charging affidavit against Keating. Keating next argues that the trial court erred in ruling that Spangler was entitled to an immunity defense for reporting workers' compensation fraud. We again agree. Section 440.105(1) of the Florida Statutes (1995) provides as follows: 440.105....
...y other relevant tort by virtue of filing reports, without malice, or furnishing other information, without malice, required by this section or required by the bureau, and no civil cause of action of any nature shall arise against such person. . . . § 440.105(1), Fla....
...Wausau reissued the check but neither Keating nor the Dreggors ever cashed it. Eventually, Keating sent the check back to Spangler telling him that she could not accept a check for attendant care services because the Dreggors had not kept good records. [3] Section 440.105 of the Florida Statutes (1995) provides immunity for individuals who, in good faith, report insurance fraud....
CopyCited 5 times | Published | Florida 3rd District Court of Appeal | 2006 WL 3302513
...The State appeals from an order granting a sworn motion to dismiss an information charging Daisy Arnal with insurance fraud and grand theft in the third degree. We reverse. In July 2004, the State filed a two count information charging Arnal with violating section 440.105(4)(b) of the Florida Statutes which makes it unlawful to knowingly make false, fraudulent or misleading statements for the purpose of obtaining workers' compensation benefits or payments: It shall be unlawful for any person: 1....
...or conceal material information, required by s.
440.185 or s.
440.381, for the purpose of obtaining workers' compensation coverage or for the purpose of avoiding, delaying, or diminishing the amount of payment of any workers' compensation premiums. §
440.105(4)(b), Fla....
CopyCited 5 times | Published | Florida 1st District Court of Appeal | 2004 WL 502606
...4), Florida Statutes (1999). This section precludes all benefits to an employee who knowingly or intentionally provides any false, fraudulent, or misleading oral or written statements for the purpose of obtaining benefits under Chapter 440. See also § 440.105(4)(b)1, Florida Statutes (1999)....
...The JCC further found that Corea had exaggerated his injuries for the benefit of the court and ruled that Corea was physically capable of engaging in full-time gainful employment. The JCC concluded, however, Corea's conduct did not "rise to the level of fraud as contemplated by Florida Statutes, §
440.105(4)(b)" and, thus, his actions were not sanctionable under sections
440.105(4)(b) and
440.09(4)....
...uries and post-accident employment were false or misleading at the time the statements were made, or that he intended to make such statements in support of his claim for benefits, then the JCC should rule that the statements fall within the scope of section 440.105(4)(b)1....
CopyCited 5 times | Published | Florida 1st District Court of Appeal | 2000 WL 728679
...alluded to under section
440.09(7)(d) are followed. [3] The JCC's final order did not recite his ruling on the applicability of the intoxification presumption, but instead denied the claim in its entirety on the ground that the claimant had violated section
440.105, Florida Statutes, and was therefore barred by section
440.09(4) from entitlement to compensation. On appeal, this court reversed the order, finding that a JCC is not authorized under section
440.09(4) to make a *759 section
440.105 determination, and the case was remanded for further proceedings....
...We note that section
440.15(1)(e) authorizes the E/C to conduct rehabilitation evaluations even after the claimant has been accepted or adjudicated as entitled to PTD compensation. We decline the E/C's suggestion that we modify our prior decision in this case regarding the JCC's lack of authorization to make a section
440.105 determination....
CopyCited 5 times | Published | Florida 1st District Court of Appeal | 29 Fla. L. Weekly Fed. D 1076
...ationsbank and Royal & Sunalliance Insurance, cross-appeals, urging that because the judge of compensation claims (JCC) decided that claimant had made a false, fraudulent or misleading statement for the purpose of obtaining benefits, in violation of section
440.105(4)(b), Florida Statutes (Supp.1998), the JCC erred in refusing to dismiss the entire claim, as required by section
440.09(4), Florida Statutes (Supp.1998)....
...CC found that claimant had misrepresented her psychiatric condition, the provisions of section
440.09(4) [1] required her to dismiss the entire claim. It is not clear from our examination of the order whether the JCC found that claimant had violated section
440.105(4)(b)....
...or intentionally made false, incomplete or misleading statements concerning material facts for the purpose of obtaining benefits. If so, consistent with this court's decision in CDL, "the JCC should rule that the statements fall within the scope of section 440.105(4)(b)1." Id....
...NOTES [1] Section
440.09(4) provides in part: An employee shall not be entitled to compensation or benefits under this chapter if any judge of compensation claims ... determines that the employee has knowingly engaged in any of the acts described in s.
440.105 for the purpose of securing workers' compensation benefits. [2] Section
440.105(4)(b) 1....
CopyCited 5 times | Published | Florida 1st District Court of Appeal | 1999 WL 225948
...yee shall not be entitled to compensation or benefits under this chapter if any administrative hearing officer, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s. 440.105 for the purpose of securing workers' compensation benefits. Section 440.105(4)(b), Florida Statutes (Supp....
CopyCited 4 times | Published | Florida 3rd District Court of Appeal | 2006 Fla. App. LEXIS 19944, 2006 WL 3422355
...violation of section
817.49, Florida Statutes, by falsely accusing him of a crime; (2) committed defamation by falsely accusing him of a crime; (3) committed libel per se by writing e-mails falsely accusing him of a crime; (4) committed fraud under section
440.105(4)(b)(1), Florida Statutes, by lying to him about not having formal grievance procedures; (5) committed a negligence per se violation of section
440.134(15), Florida Statutes, by failing to have a grievance procedure to address worker...
CopyCited 4 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 6662, 2010 WL 1930119
...Claimant's attorney acknowledged that chapter 440 did not specifically provide for that sanction, but argued, in effect, that the JCC had inherent authority to make findings on the issue of fraud by the E/C and its attorney and impose appropriate sanctions. The JCC did not make any findings on this issue in the final order. Section 440.105(4)(b)1....
...[t]o knowingly make, or cause to be made, any false, fraudulent, or misleading oral or written statement for the purpose of obtaining or denying any benefit or payment under this chapter." A person who violates this statute is subject to criminal, civil, and administrative penalties. See §
440.09(4)(a),
440.105(4)(f),
440.106, Fla. Stat. The process by which an employee may be sanctioned for violating section
440.105 is set forth in section
440.09(4)....
...That statute, which is commonly referred to as the "fraud defense," provides that the employee is not entitled to any compensation or *107 benefits under chapter 440 if the JCC (or an administrative law judge, court, or jury) determines that the employee knowingly and intentionally engaged in any of the acts prohibited by section
440.105. See §
440.09(4)(a), Fla. Stat. Thus, not only does section
440.09(4) specifically authorize the JCC to determine whether an employee has violated section
440.105, but it also sets forth the sanction that the JCC is required to impose upon finding that a violation occurred. The process by which an attorney or carrier may be sanctioned for violating section
440.105 is set forth in section
440.106, which provides in pertinent part: (1) Whenever any circuit or special grievance committee acting under the jurisdiction of the Supreme Court finds probable cause to believe that an attorney has violated s.
440.105, such committee may forward to the appropriate state attorney a copy of the findings of probable cause and a copy of the report being filed in the matter. * * * (3) Whenever any group or individual self-insurer, carrier, rating bureau, or agent or other representative of any carrier or rating bureau is determined to have violated s.
440.105, the agency responsible for licensure or certification may revoke or suspend the authority or certification of the group or individual self-insurer, carrier, agent, or broker. §
440.106, Fla. Stat. This statute does not grant the JCC any authority to determine whether an attorney or carrier has violated section
440.105, nor does it give the JCC any authority to impose sanctions for such violations....
...1st DCA 1991) ("Unlike a court of general jurisdiction, a [JCC] does not have inherent judicial power but only the power expressly conferred by chapter 440."). And as the JCC recognized at the final hearing, [1] had the Legislature intended to give the JCC the authority to sanction an E/C or its attorney for violating section
440.105, it could have easily done so as it did in section
440.09(4) for fraud by employees....
CopyCited 4 times | Published | Florida 1st District Court of Appeal | 2004 Fla. App. LEXIS 3870, 2004 WL 587670
...that the claim should be denied in its entirety [because] .... [t]he evidence in its totality establishes that .... [c]laimant *291 knowingly made false or misleading oral and written statements for the purpose of obtaining benefits [in violation of section 440.105, Florida Statutes, (2002) ].......
...her evidence, including her history to Dr. Swanson. Section
440.09(4) precludes "compensation or benefits ... if any judge of compensation claims ... determines that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105 for the purpose of securing workers' compensation benefits." Section
440.105(4)(b)(1), Florida Statutes (2002) provides that "[i]t shall be unlawful for any person ......
...[t]o knowingly make, or cause to be made, any false, fraudulent, or misleading oral or written statement for the purpose of obtaining or denying any benefit or payment under this chapter." As was conceded by both parties at oral argument, the employer/carrier had the burden of proving a violation of section 440.105 by a preponderance of the evidence....
...laimant knowingly and intentionally made false statements to obtain worker's compensation benefits. Whenever a witness's testimony is rejected by the JCC, that witness would be guilty of making a fraudulent statement, and subject to sanctions, under section 440.105....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 2006 WL 3151582
...d two form notices of denial, one of which stated: "Carrier is suspending PTD[.] Claimant is able to work." The other, at issue here, [1] stated: "The claim [for medical and indemnity benefits] is denied in its entirety, pursuant to Florida Statutes 440.105 and 440.0[9]." Following clandestine, videotaped surveillance of Mr....
...On appeal, as below, Pavilion Apartments and Claims Center invoke section
440.09(4), Florida Statutes (2004), [2] *228 which renders an employee ineligible for workers' compensation benefits if it is "determine[d] that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105 . . . for the purpose of securing workers' compensation benefits." §
440.09(4)(a), Fla. Stat. (2004). Section
440.105 places requirements on claimants not unlike the duty of candor an attorney owes a tribunal she is addressing. See R. Regulating Fla. Bar 4-3.3(a) (2006) ("Candor Toward the Tribunal"). Section
440.105 provides in relevant part: (4) Whoever violates any provision of this subsection commits insurance fraud, punishable as provided in paragraph (f)....
...To present . . . any . . . oral statement as part of, or in support of, a claim for payment or other benefit . . . knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim. § 440.105(4)(b)(2.), Fla....
...1st DCA 2005), and those raising the defense have the burden of proof by a preponderance of the evidence. Id. The Workers' Compensation Act contains no authority for the suspension of benefits based on a payor's unilateral determination that a claimant has violated sections
440.09 and
440.105, Florida Statutes (2004)....
...timony given at depositions or the merits hearing." Village Apartments,
856 So.2d at 1141. "[I]f, at the time he made any of the[ ] statements, [a claimant] knew they were false, incomplete or misleading, then the statements fall within the scope of section
440.105(4)(b)2., and, pursuant to section
440.09(4), result in the loss of workers' compensation benefits." Id....
...As for the other issue they litigated and lost below, they have not appealed the determination based on uncontroverted evidence that the intrathecal, morphine pump was medically necessary. [2] Mr. Wetherington's compensable work injuries occurred on December 20, 1993, prior to the enactment of section 440.105, which took effect on January 1, 1994, see Ch....
...As amended by ch.2003-412, § 6, at 3877, Laws of Fla., section
440.09(4)(a) provides: An employee shall not be entitled to compensation or benefits under this chapter if any judge of compensation claims . . . determines that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105. . . . This section shall apply to accidents, regardless of the date of the accident. For injuries occurring prior to January 1, 1994, this section shall pertain to the acts of the employee described in s.
440.105 ....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1997 Fla. App. LEXIS 260, 1997 WL 26458
...Wiitala of Wiitala & Contole, P.A., North Palm Beach, for Appellant. Kimberly A. Hill of Conroy, Simberg & Ganon, P.A., Hollywood, for Appellees. ERVIN, Judge. Claimant, E.H., appeals the order by the Judge of Compensation Claims (JCC) denying coverage pursuant to sections
440.09(4) and
440.105(4)(b), Florida Statutes (Supp....
...two weeks preceding the industrial accident. Characterizing himself as an administrative hearing officer or court under section
440.09(4), the JCC determined that E.H. made these false statements for the purpose of obtaining benefits, thus violating section
440.105(4)(b), and concluded therefrom that E.H. was not entitled to compensation or benefits. This was error. Section
440.09(4) bars compensation or benefits when an "administrative hearing officer, court, or jury convened in this state" determines that a claimant has violated section
440.105. A JCC is not authorized to make a section
440.105 determination under the plain wording of this statute....
...This, of course, does not affect the JCC's obligation to evaluate E.H.'s credibility when considering the merits of his claim for benefits or the E/C's intoxication defense. We direct the JCC on remand to determine whether E.H. is entitled to compensation, without reference to either section
440.105 or
440.09(4)....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1997 WL 26470
...In this case of first impression, the employer and its insurance carrier (E/C) complain that the judge of compensation claims (JCC) erroneously failed to apply the defense set forth in section
440.09(4), Florida Statutes (Supp.1994), based on false statements claimant made contrary to section
440.105(4)(b), Florida Statutes (Supp.1994)....
...Section
440.09(4) provides: (4) An employee shall not be entitled to compensation or benefits under this chapter if any administrative hearing officer, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105 for the purpose of securing workers' compensation benefits. (Emphasis added.) Section
440.105(4) provides, in pertinent part: (b) It shall be unlawful for any person: 1....
...o the workers' compensation matter, by either an administrative agency or a court, that false or fraudulent statements were knowingly made, before its provisions can impact a claim for benefits. The correctness of this interpretation is supported by section 440.105(1)(a), which outlines the procedures that should be employed in obtaining such a collateral determination....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 2515, 2011 WL 680282
...Under the requirements of chapter 440 and the application signed by the Employer, the Employer was required to timely and regularly submit to Zenith quarterly employee earnings reports, see section
440.381(4), Florida Statutes, and, update his application monthly. The failure to update the application is a crime. See §
440.105(3)(a), Fla. Stat. (2007). Under the mandatory provisions of section
440.105(1)(a), Florida Statutes (2007), a carrier must report such omissions to the Division of Insurance Fraud, Bureau of Workers' Compensation Fraud, which in turn is required to investigate and report the criminal act to the prosecuting agencies "having jurisdiction" under chapter 440....
...Here, the Employer, in the three-plus years his policy with Zenith was active and in effect, never updated his application and never submitted his quarterly earnings reports. Yet, Zenith evidently did not comply with the mandatory reporting scheme imposed by section 440.105(1)(a), reported nothing to the Division of Insurance Fraud, Bureau of Workers' Compensation Fraud, and apparently chose not to avail itself to the right to cancel coverage....
CopyCited 3 times | Published | Florida 2nd District Court of Appeal | 1998 WL 210954
...775.083, or s.
775.084. The application shall contain a sworn statement by the employer attesting to the accuracy of the information submitted and acknowledging the provisions of s. 440.37(4). Section 440.37 has now been modified and recodified into section
440.105, Florida Statutes (1997), which provides:
440.105 Prohibited activities; penalties. .......
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2005 WL 2922140
...itled to compensation or benefits under this chapter if any judge of compensation claims, administrative law judge, court, or jury convened in this state determines that the employee knowingly or intentionally engaged in any of the acts described in section 440.105 for the purpose of securing workers' compensation benefits. Section 440.105(4)(b), Florida Statutes (2002), provides in part that it is unlawful for any person: 1....
...Village Apartments v. Hernandez,
856 So.2d 1140, 1141 (Fla. 1st DCA 2003). If, at the time a claimant makes any of the foregoing types of statements, he or she knew that they were false, incomplete, or misleading, the statements fall within the scope of section
440.105(4)(b)2....
...Accordingly, we reverse the final order. Cf. Chapman v. Nationsbank,
872 So.2d 390, 393 (Fla. 1st DCA 2004) (reversing the JCC's order and remanding because it was not clear from an examination of the order whether the JCC found that the claimant had violated section
440.105(4)(b) and directing that, on remand, the JCC should rule that the claimant's statements fall within the scope of section
440.105(4)(b) if the statements were knowingly or intentionally false, incomplete, or misleading, concerned material facts, and were made for the purpose of obtaining benefits)....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2015 WL 3464110
...him. Based on these
findings, the JCC referred Petitioner’s attorney to The Florida Bar for joinder in an
existing ethics complaint and to the fraud division at DFS for further investigation
for what was, in the JCC’s opinion, a violation of section 440.105(3)(c), Florida
Statutes (2014), which is a misdemeanor of the first degree.
Because the JCC here previously found that Petitioner’s attorney acted
dishonestly, had committed a crime (if not multiple crimes), and that he was...
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 826, 2006 WL 176731
...GAB suspended all indemnity payments on the day of his arrest, and filed a petition for modification under section
440.28, seeking to terminate his attendant care benefits. Later, the State Attorney for the Eleventh Judicial Circuit filed an information charging him with a criminal violation of section
440.105, Florida Statutes (1999)....
...Stat. (1999) ("An employee shall not be entitled to compensation or benefits under this chapter if any . . . court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts *255 described in s. 440.105....
...case and the comp case *258 which I don't think we can get around. Clearly, what resulted in the criminal prosecution were the underlying actions in the workers' compensation case." The criminal charges filed against Mr. Valdes alleged violations of section 440.105, Florida Statutes (1999); entitlement to the benefits at issue in the workers' compensation case turned on the same facts at issue in parallel proceedings in criminal court....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 543, 2010 WL 255982
...mend its pre-trial stipulation, asserting that the testimony of Claimant and his accountant during the final hearing revealed that Claimant had not reported all of his 2008 taxable income to the IRS, which, the E/C argued, constituted a violation of section
440.105(4)(b), and thus required a forfeiture of all workers' compensation benefits pursuant to section
440.09(4)(a)....
...The E/C filed a motion for rehearing, arguing that the JCC misapprehended this court's decision in Fast Tract Framing, Inc. v. Caraballo,
994 So.2d 355 (Fla. 1st DCA 2008), in finding Claimant complied with section
440.02(28), and that Claimant forfeited his rights to all workers' compensation benefits by allegedly violating section
440.105(4)(b)....
...reverse the final order as to this issue. The E/C's Misrepresentation Defense The E/C argues that the JCC abused her discretion in denying its post-hearing motion to amend its pre-trial stipulation to include a misrepresentation defense pursuant to section 440.105(4)(b)....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2001 WL 50501
...ompensation or benefits under this chapter if any judge of compensation claims, administrative hearing officer, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s. 440.105 for the purpose of securing workers' compensation benefits....
...Thus, the 1998 amendment to section
440.09(4) changes only one factor in the workers' compensation process: it adds the Judge of Compensation Claims as an entity authorized to determine whether a claimant "knowingly or intentionally engaged in any of the acts described in section
440.105, for the purpose of securing workers' compensation benefits." Id....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2004 WL 1920012
...We note, however, that even if we were to find section
440.205 ambiguous with respect to the issue at hand, legislative intent and public policy would still lead us to the same result. In support of its argument that the intent of chapter 440 supports its interpretation of section
440.205, appellee contends that section
440.105(2)(a)2., Florida Statutes (2000), reveals the limitations of section
440.205. Section
440.105(2)(a)2., which the Legislature enacted in 1993, declares it unlawful for an employer to knowingly "[d]ischarge or refuse to hire an employee or job applicant because the employee or applicant has filed a claim for benefits under this chapter." [2] As appellee contends, the language "refusal to hire" clearly anticipates a claim filed against a previous employer. According to appellee, the Legislature's choice of language in section
440.105(2)(a)2....
...indicates that the Legislature knows how to deal with employers who discharge an employee for having filed a past claim or employers who refuse to hire a job applicant for having filed a past claim. Appellee concludes then that, because the Legislature did not amend section
440.205 at the time it enacted section
440.105(2)(a)2., the Legislature did not intend for there to be a civil cause of action against an employer who discharges an employee for having filed a workers' compensation claim against a previous employer....
...to hire a job applicant for having filed a workers' compensation claim against a previous employer. Slip Op. 7. This concession by the majority is necessary because our Legislature certainly knows how to penalize refusal to hire, and has done so in section 440.105, Florida Statutes, a law purporting to criminalize (but not provide civil liability for) the act of "[d]ischarg[ing] or refus[ing] to hire an employee or job applicant because the employee or applicant has filed a claim for benefits under this chapter." § 440.105(2)(a)2., Fla....
...According to appellant, appellee's then-president wrote, "W/C Risk-File Open on W/C Claim" next to the reason for termination. [2] This statute took effect on January 1, 1994. See Ch. 93-415, § 112, at 215, Laws of Fla. When enacted, a violation of this section constituted a second-degree misdemeanor. See § 440.105(2)(a)2., Fla....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2006 WL 2612683
...PER CURIAM. In this workers' compensation case, the finding of the judge of compensation claims that appellant intentionally made false, fraudulent and misleading statements in an attempt to obtain benefits for her psychiatric condition in violation of section 440.105(4)(b), Florida Statutes (1997), is supported by competent, substantial evidence in the record....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 2676, 2005 WL 491319
...n, are considered the employer for the purposes of ss. Ipk0.105 or 0.106. §
440.02(16), Fla. Stat. (2002) (emphasis added). It is apparent from this language that an officer or shareholder can be treated as an “employer” only in an action under section
440.105 or
440.106....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2008 WL 623340
...However, the employer did not verify whether the social *1218 security number was valid. The E/C's witness claimed that the E/C did not find out the card was invalid until the day of the accident. The E/C argues that the JCC erred in its application of sections
440.105(4)(b)(9) and
440.09(4)(a), Florida Statutes. It argues that, pursuant to the plain and unambiguous language of those statutes, the fraudulent obtaining of employment by claimant pursuant to section
440.105(4)(b)(9) is sufficient to trigger the provisions of section
440.09(4)(a), thus mandating that claimant not be entitled to workers' compensation benefits. Whether the JCC erred in finding that claimant was entitled to workers' compensation benefits even though he was unlawfully employed depends on whether the JCC erred in its interpretation of sections
440.105(4)(b)(9) and
440.09(4)(a), Florida Statutes, which is a question of law....
...d to compensation or benefits under this chapter if any judge of compensation claims, administrative law judge, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s. 440.105 or any criminal act for the purpose of securing workers' compensation benefits. Section 440.105(4)(b)(9), Florida Statutes (2005), provides: (b) It shall be unlawful for any person: ....
...To knowingly present or cause to be presented any false, fraudulent, or misleading oral or written statement to any person as evidence of identity for the purpose of obtaining employment or filing or supporting a claim for workers' compensation benefits. It is undisputed that claimant violated section 440.105(4)(b)(9), Florida Statutes (2005)....
...The E/C, on one hand, asserts that section
440.09(4)(a) should be read to mean that an employee shall not be entitled to compensation or benefits under this chapter if a JCC determines that the employee has knowingly or intentionally engaged in any of the acts described in section
440.105. Thus, according to the E/C, because it is clear that claimant violated section
440.105(4)(b)(9) by procuring work with a false social security card, claimant should not be entitled to workers' compensation benefits....
...Claimant, on the other hand, interprets section
440.09(4)(a) differently. Specifically, claimant argues that pursuant to the statute, an employee shall not be entitled to compensation benefits only if a JCC determines that the employee has knowingly or intentionally engaged in any of the acts described in section
440.105 for the purpose of securing workers' compensation benefits. The question thus becomes whether the Legislature intended "for the purpose of securing workers' compensation benefits" to modify just "any criminal act" or, also, "any of the acts *1219 described in s.
440.105." Because at first glance both interpretations appear reasonable, the statute is ambiguous and this court must undergo an exercise in statutory interpretation....
...d to compensation or benefits under this chapter if any judge of compensation claims, administrative law judge, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s. 440.105 or any criminal act for the purpose of securing workers' compensation benefits. Accordingly, prior to the 2003 amendment to this statute, it was clear that "for the purpose of securing workers' compensation benefits" modified any act described in section 440.105....
...as "specifying effect of criminal acts." Ch. 2003-412, § 6, Laws of Fla. Accordingly, the act does not indicate that the Legislature intended the prepositional phrases "for the purpose of securing workers' compensation benefits" to no longer modify section
440.105, Florida Statutes, as they had previously. Instead, the addition of "or any criminal act" appears to have simply broadened the application of section
440.09(4)(a) to cover not only acts described in section
440.105, but also other criminal acts, as long as all of those acts are done for the purpose of securing workers' compensation benefits....
...1st DCA 2006), this court cited to section
440.09(4)(a), Florida Statutes (2004), and analyzed it as rendering a claimant ineligible for workers' compensation if it was determined "that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105 . . . for the purpose of securing workers' compensation benefits." The record contains no evidence that claimant violated section
440.105(4)(b)(9), Florida Statutes, for the purpose of obtaining workers' compensation benefits....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2017 WL 2438332, 2017 Fla. App. LEXIS 8148
...In contrast, the JCC
4
here, following the very brief telephone hearing, disapproved of the stipulated fee in
a seven-page order that assumed certain unestablished facts and strongly suggested
that the attorneys engaged in collusion to commit fraud under section 440.105(4),
Florida Statutes....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2006 WL 2056399
...ly broke. The third accident is at issue here. The employer and carrier (E/C) provided benefits for the claims in the first two accidents. The E/C never defended either of those claims on grounds that Claimant committed any of the acts prohibited in section 440.105(4)(b), Florida Statutes....
...Following an evidentiary hearing, the JCC concluded Claimant did suffer a workplace accident, which resulted in the claimed injury. However, the JCC denied the claim, finding Claimant made false, fraudulent, incomplete or misleading statements as defined in section 440.105(4)(b), to obtain workers' compensation benefits for the second workplace accident....
...Specifically, the JCC found Claimant misrepresented his physical capabilities while he was receiving temporary total disability benefits. Although competent, substantial evidence supports the JCC's conclusion that Claimant committed one of the prohibited acts of section
440.105(4)(b) in a different workers' compensation claim, the JCC erred in applying the exclusion of
440.09(4) to the instant workers' compensation claim. This court has interpreted section
440.105(4)(b) to include false, fraudulent, incomplete or misleading statements that are immaterial to the claim if the statements were made for the purpose of obtaining benefits....
...Palm Beach v. McKale,
911 So.2d 1282 (Fla. 1st DCA 2005). However, we have never applied the section
440.09(4) exclusion from coverage to a claim for workers' compensation benefits in a different workers' compensation case than the case in which the
440.105(4)(b) acts were committed....
...Pursuant to the statute, coverage may be limited or denied even when the requirements of subsection (1) have been met, if any of the exclusions or limitations of coverage found in subsections (2) through (8) apply. Section
440.09(4), at issue here, excludes coverage if the employee engaged in any of the acts described in section
440.105(4)(b). Logically, and from the statutory language, there is no indication that the Legislature intended the subsection (4) exclusion *1111 to apply to injuries unconnected with the acts proscribed in section
440.105. To require coverage be forever barred simply because the employee had, at one time, committed one of the
440.105 proscribed acts would be unduly harsh....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1431, 2009 WL 400388
...rney Fees" by which he sought to require the attorney for the employer and servicing agent to seek approval by the judge of *1286 compensation claims of any requests for attorney's fees made by the attorney to her clients. It is, however, clear that section 440.105(3)(c), Florida Statutes (2008), upon which claimant relied as authority for his motion does not require approval of any attorney's fee by the judge of compensation claims; rather, it merely makes it unlawful to receive a fee unless that fee has been approved. Because nothing in section 440.105(3)(c) (or in the rest of chapter 440) required the judge of compensation claims to take the action requested by claimant in his motion, the order denying that motion is affirmed. We find it unnecessary to decide whether the legislature intended section 440.105(3)(c) to apply to requests for payments made by attorneys representing employers, carriers and servicing agents, as well as to those made by attorneys representing claimants....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 1862, 2011 WL 479893
...ngineering, Inc., and to The Claims Center. We reverse the costs award as statutorily unauthorized; and reverse the order denying all of claimant’s attorney’s fees because, in defeating the affirmative defense contemplated by sections
440.09 and
440.105, the claimant prevailed on an issue of compensability....
...nefits that were still being provided when he filed the petition for additional benefits that began the present proceeding. The medical benefits are still payable because he prevailed in resisting the affirmative defense based on sections
440.09 and
440.105, “frequently referred to as the ‘fraud defense.’ ” Arreola v....
...The parties’ prehearing stipulation specified section “440.34(3)(b)(c),” as the basis for the attorney’s fees claim, a stated basis that did not change when Case Engineering, Inc., and The Claims Center were granted leave to amend the prehearing stipulation to raise the defense under sections
440.09 and
440.105 that the claimant eventually defeated....
...). Asserting entitlement to attorney’s fees on the basis of section
440.34(3)(e) adequately preserved for appeal denial of the attorney’s fees claimant sought for successfully defending against the fraud defense predicated on sections
440.09 and
440.105....
...pter 440, provides that “[a]n employee shall not be entitled to compensation or benefits under this chapter if any judge of compensation claims ... determines that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105 or any criminal act for the purpose of securing workers’ compensation benefits.” By order entered September 2, 2009, the judge of compensation claims granted a motion for leave to amend the pretrial stipulation to include the affirmative “defense of fraud per §
440.09(4), Fla. Stat.; §
440.105, Fla. Stat.; and §
440.09(a), Fla. Stat.” based on “discovery received after the filing of the pretrial stipulation.” When Case Engineering, Inc., and The Claims Center raised the defense based on sections
440.09 and
440.105, they placed coverage of the accident and resulting injuries — and thus compensability — at issue....
...rves the issue and successfully defends against a misrepresentation allegation, and all other requisite factors are present, the claimant would be entitled to payment of an appropriate fee.”). Setting up the fraud defense under sections
440.09 and
440.105 put com-pensability at issue — and did so at a time that the claimant was actually receiving palliative medical treatment not otherwise at issue....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2004 Fla. App. LEXIS 19705, 2004 WL 2964040
...ny given at depositions or the merits hearing." Village Apartments v. Hernandez,
856 So.2d 1140, 1141 (Fla. 1st DCA 2003). If such statements are knowingly false, fraudulent, incomplete, or misleading, benefits must be denied. See §§
440.09(4)(a),
440.105(4)(b)(1)-(2) & (5), Fla....
...red. Even if considered on the merits, Claimant had adequate notice of the issues and does not allege how his substantive due process rights were violated. Finally, to the extent that Claimant contests the constitutionality of sections
440.09(4) and
440.105(b), this court has determined section
440.09(4), in relation to section
440.105, does not violate due process....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 11323, 2009 WL 2475151
...District Court of Appeal of Florida, First District. August 14, 2009. *793 Nora Leto of Kaylor & Kaylor, P.A., Winter Haven, for Appellant. Kristin J. Longberry of Alvarez, Sambol, Winthrop & Madson, PA, Orlando, for Appellees. HAWKES, C.J. We are again asked to address the parameters of section 440.105, Florida Statutes, frequently referred to as the "fraud defense." The issue in this case involves Claimant's providing a false Social Security number on several occasions after his injury, in connection with treatment....
...The employer/carrier (E/C) argued that Claimant's actions were knowingly and intentionally committed in order to obtain workers' compensation benefits. The Judge of Compensation Claims (JCC) accepted the E/C's position and denied all claims under section
440.09, Florida Statutes, on the ground Claimant violated section
440.105, Florida Statutes. Because competent substantial evidence supports the JCC's findings, we affirm. It is prohibited by section
440.105(4)(b) for any person to "make, or cause to be made," any false, fraudulent, or misleading statements for the purpose of obtaining workers' compensation benefits. §
440.105(4)(b)1., Fla....
...An employee found to have knowingly or *794 intentionally committed one of these prohibited acts is not entitled to compensation or benefits under the workers' compensation statute. §
440.09(4)(a), Fla. Stat. (2006). Whether a claimant has violated section
440.105 is a factual determination to be made by the JCC, which is reviewed by this court for competent substantial evidence....
...In deciding this issue, the JCC had to answer two questions. The first is whether Claimant made or caused to be made false, fraudulent or misleading statements. The second is whether the statement was intended by Claimant to be for the purpose of obtaining benefits. Section 440.105(4)(b)1....
...does not require that the misrepresentation be material in actuality; rather, the relevant inquiry is whether a claimant's misrepresentation a misrepresentation the claimant thought would have a material impact on his case was made with the intent to secure benefits. § 440.105(4)(b)1., Fla....
CopyCited 1 times | Published | Florida 4th District Court of Appeal | 2014 WL 1686448, 2014 Fla. App. LEXIS 6220
KLINGENSMITH, J. Defendant, Francisco Brock, was charged with one count of fraud under section 440.105(4)(b)9, Florida Statutes (2012)....
...An investigation also revealed that Defendant was an illegal alien who had completed a “Homeland Security, 1-9, Employment Eligibility Verification form” that improperly listed this same social security number. For the reasons stated herein, we reverse the trial court’s pretrial order dismissing this charge. Section 440.105 delineates the prohibited activities, reports, penalties, and limitations of the Workers’ Compensation Law....
...ingly present or cause to be presented any false, fraudulent, or misleading oral or written statement to any person as evidence of identity for the purpose of obtaining employment or filing or supporting a claim for workers’ compensation benefits. § 440.105(4)(b)9, Fla....
...Under Defendant’s theory, merely presenting false documents to gain employment, without more, does not trigger a violation under the statute. 1 The trial court granted the motion to dismiss, stating that it appeared the purpose of the statute related to insurance coverage and insurance claims, and that section 440.105(4)(b)9 required that the obtaining of employment or filing or supporting a claim had to be connected to workers’ compensation benefits. The court ruled that to sustain a violation under section 440.105(4)(b)9, the State was required to plead and prove not only that Defendant obtained employment by a false, fraudulent, or misleading oral or written statement as evidence of identity, but that he did so with the intent to secure worker compensation benefits....
...are cogent reasons for believing that the letter [of the law] does not accurately disclose the [legislative] intent.” State ex rel. Hanbury v. Tunnicliffe,
98 Fla. 731, 735 ,
124 So. 279, 281 (Fla.1929). Here, the statute is clear and unambiguous. Section
440.105(4)(b)9 makes it a crime to “present ......
...intended to prohibit illegal aliens from using false identification information to obtain employment, and by doing so, specifically intended to close their gateway into the Florida worker’s compensation system. After considering the newly-enacted section 440.105(4)(b)9, 2 the Florida Senate Interim Project Report 2004-110 (December 2003) stated: As amended by Senate Bill 50-A, the law now provides that it is a felony and insurance fraud for a person to knowingly present any false or misleadin...
...Hernandez,
975 So.2d 1217 (Fla. 1st DCA 2008), in support of their respective positions. In that case, the parties did not dispute the supposed violation but did argue whether this violation was cause for forfeiture of compensation benefits. The First District analyzed section
440.105(4)(b)9 only as it applied to the denial of coverage under section
440.09(4)(a). To the extent that Matrix has any application to this case, it shows that a violation under
440.105(4)(b)9 should be considered distinctly separate from whether the violation was done for the purpose of obtaining benefits....
...urther proceedings. Reversed and Remanded. DAMOORGIAN, C.J., and GROSS, J., concur. . The State had agreed that there was no evidence that the Defendant specifically aimed for, nor did he claim or file for, workers' compensation benefits. . In 2003, section 440.105(4)(b) was amended to add subparagraph nine....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2016 WL 1578434, 2016 Fla. App. LEXIS 5990
...at
Claimant would pay her attorney an hourly fee once the $1,500 is exhausted – and
the other order on appeal determined that Claimant failed to establish she sustained
a compensable injury. Claimant challenges the constitutionality of sections
440.105
and
440.34, Florida Statutes, which limit attorney’s fees as applied to her....
...Notwithstanding that denial, the JCC allowed Claimant
to supplement the record and accepted the affidavits as proffered exhibits, noting
that even if he accepted them as evidence, his ruling would not change.
Legal Background
Paragraph 440.105(3)(c), Florida Statutes (2011), provides that an attorney
receiving a fee for services rendered in connection with proceedings under
chapter 440 commits a first-degree misdemeanor, unless the fee is approved by a
JCC....
...depends upon the particular claim. Because First Amendment rights are
fundamental, “we apply strict scrutiny to section
440.34, regarding its effect on these
First Amendment rights when taken in conjunction with section
440.105(3)(c).” Jacobson v....
...ent rights, because they completely
denied his right to hire an attorney given that no benefits could ever be secured as a
result of the cost hearing, even upon a successful defense against the E/C’s motion
to tax costs. Id. at 1048-49. Because section
440.105(3)(c), Florida Statutes, makes
it a crime for an attorney to accept a fee that is not approved by a JCC, and section
440.34, Florida Statutes, prohibits a JCC from approving a fee that is not tied to the
amount of benefits secured,...
...utory scheme, where a fee is paid only if the
prosecution of the claim is successful. The evidence is direct, unlike the evidence
rejected in Triplett,
494 U.S. at 723-24, and the evidence persuasively supports
Claimant’s argument that sections
440.105 and
440.34 thwart her First Amendment
rights, which can be adequately exercised only by obtaining legal representation.
Thus, because Claimant, a layperson, required legal counsel to pursue her
claim for benefits, and without counsel...
...than “compelling”) governmental interest, and (c) leave open alternative channels of
communication.”
113 So. 3d at 1049 (citing Clark v. Cmty. for Creative Non–
Violence,
468 U.S. 288, 293 (1984)).
Applying this test here, sections
440.105(3)(c) and
440.34 fail, because
[t]here is no significant governmental interest being served, because
there is no “benefit secured” associated with the fees at issue in this
case and, thus, no need to protect such from depletion....
...v. Fellows,
209 So. 2d 454,
458 (Fla.1968), and codified in the Rules Regulating the Florida Bar at rule 4–
1.5(b).” Jacobson,
113 So. 3d at 1052. Consequently, we hold that no attorney
accepting fees in this situation may be prosecuted under section
440.105(3)(c),
Florida Statutes.
Freedom to Contract
The Jacobson court also held that the statutes under review violated the
claimant’s right to contract for legal services....
...statutes prevented Claimant from retaining and paying an attorney with her own
funds (or those of her union) in an amount not based on the mandated statutory fee
20
schedule. The issue, therefore, is whether sections
440.105 and
440.34 are
constitutionally permissible restrictions on claimant-paid fees based on the State’s
police power.
“There is no settled formula for determining when the valid exercise of police
power stops and an impermissible encroachment on private property rights begins.”
Graham v....
...her, the restrictions on her right to contract for legal work in workers’ compensation
cases do not adequately prevent public harm, no longer promote the health, safety,
welfare, and morals of the public, and are being arbitrarily and capriciously applied,
sections
440.105 and
440.34 are not a valid exercise of the State’s police power, and
thus are unconstitutional violations of the right to contract.
23
Waiver
Florida...
...attorney’s fees and agree to pay her attorney with her own (or someone else’s) funds,
subject to a JCC’s finding that the fee is reasonable.
Conclusion
In conclusion, the restrictions in sections
440.105 and
440.34, when applied
to a claimant’s ability to retain counsel under a contract that calls for the payment of
a reasonable fee by a claimant (or someone on his or her behalf), are unconstitutional
violations of a claimant’s rights...
...s on those rights. Likewise,
those provisions also represent unconstitutional violations of a claimant’s right to
form contracts – and are not permissible police power restrictions on those rights.
Thus, we hold that the criminal penalties of section 440.105(3)(c), Florida Statutes,
are unenforceable against an attorney representing a workers’ compensation client
seeking to obtain benefits under chapter 440, as limited by other provisions
discussed above.
We conclude that the...
CopyPublished | Florida 1st District Court of Appeal
...medical opinions between his independent medical examiner
(“IME”)—Dr. Thomas Roush—and the E/C’s IME—Dr. Neil
Schechter. In short, Dr. Roush opined that the work accident was
2 The final order on appeal also denied the E/C’s defenses
under sections
440.09(4) and
440.105, Florida Statutes....
...Henson,
823 So. 2d at 108 (emphasis added) (quoting Henson,
787
So. 2d at 10). 9
Regarding application of section
440.29(4), considering Frye,
the supreme court found no conflict, reasoning as follows:
9 Additional argument encompassed section
440.105, Florida
Statutes (1995), that further provides, “It is the intent of the
Legislature that the Workers’ Compensation Law be interpreted
so as to assure the quick and efficient delivery of disability and
medical benefits to an injured worker ....
CopyPublished | Florida 1st District Court of Appeal | 2012 WL 4465233, 2012 Fla. App. LEXIS 16460
...has only those powers expressly provided by statute.”
35 So.3d at 106-07 . We concluded that “as the JCC recognized at the final hearing, had the Legislature intended to give the JCC the authority to sanction an E/C or its attorney for violating section
440.105, it could have easily done so as it did in section
440.09(4) for fraud by employees.” Id....
CopyPublished | Florida 1st District Court of Appeal
...tion with Dr. Weinberg, and to pay
Claimant’s attorney a fee of $1,500 and costs totaling $275.
The JCC approved the $1,750 Claimant-paid attorney’s fee associated with
the settlement, but denied approval of the $1,500 E/C-paid fee. See § 440.105(3)(c),
Fla....
CopyPublished | Supreme Court of Florida | 27 Fla. L. Weekly Supp. 795, 2002 Fla. LEXIS 1884, 2002 WL 31084673
...l compliance with the forms of these rules. The judge may request the EAO to assist unrepresented employees in filing a petition, as provided in section
440.192(2), Florida Statutes. (3) Notice. A petition shall contain the fraud notice contained in section
440.105(7), Florida Statutes, and shall personally be signed and attested to by the petitioner....
CopyPublished | Florida 2nd District Court of Appeal | 2013 WL 5224914, 2013 Fla. App. LEXIS 14797
ALTENBERND, Judge. Kenneth Michael Carroso appeals his judgment and sentence for workers’ compensation fraud involving a “monetary value” between $20,000 and $100,000. See § 440.105(4), Fla....
...ompensation proceeding or whether the judge of compensation claims took any action on the alleged misstatements in this deposition. 3 II. THE CRIMINAL PROCEEDING The State charged Mr. Carroso with insurance fraud in the second degree, under sections 440.105(4)(b)(l) and (4)(f)(2), Florida Statutes (2005). Section 440.105(4)(b)(l) states that it shall be “unlawful” for any person: “To knowingly make, or cause to be made, any false, fraudulent, or misleading oral or written statement for the purpose of obtaining or denying any benefit or payment under this chapter.” Section 440.105(4)(f) provides the penalties for violating this statute: If the monetary value of any violation of this subsection: 1....
...Thus, it was not enough for the State to prove that Mr. Carroso misstated facts or omitted facts in his deposition. The State was required to prove that he made misrepresentations *377 “for the purpose of obtaining ... any benefit or payment under this chapter.” § 440.105(4)(b)(l)....
...The State’s reliance on the noncriminal, administrative sanction in this trial tended to minimize the evidence on this element of intent. At any retrial, proof of this element may prove challenging for the State unless its evidence is substantially different from the evidence in this record. In this appeal, the focus is on section 440.105(4)(f)’s reference to a “monetary value.” That term is not defined in the statute....
...Section
440.09(4)(a) states: An employee shall not be entitled to compensation or benefits under this chapter if any judge of compensation claims, administrative law judge, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105 or any criminal act for the purpose of securing workers’ compensation benefits....
...f guilty or nolo contendere in criminal matters. This section shall apply to accidents, regardless of the *378 date of the accident. For injuries occurring prior to January 1, 1994, this section shall pertain to the acts of the employee described in s. 440.105 or criminal activities occurring subsequent to January 1,1994....
...s. This, of course, is not even consistent with the law established by the First District regarding section
440.09(4)(a), much less with the conclusion we reach today that section
440.09(4)(a) has no bearing on the measure of “monetary value” in section
440.105(4)....
CopyPublished | Florida 1st District Court of Appeal
...entered an invalid SSN on the form because she believed she
needed to do so to obtain authorized medical care.
Section
440.09(4)(a), Florida Statutes, prohibits an employee
from receiving workers’ compensation benefits if he or she commits
any act described in section
440.105, Florida Statutes, “for the
purpose of securing workers’ compensation benefits.” Section
440.105(4)(b) prohibits employees from making fraudulent, false,
or misleading statements. See, e.g., §
440.105(4)(b)9., Fla....
...[t]o knowingly present or cause
to be presented any false, fraudulent, or misleading oral or written
statement to any person as evidence of identity for the purpose of
obtaining employment or filing or supporting a claim for workers’
compensation benefits.”). The employer/carrier argued that
Claimant violated section 440.105(4)(b)9....
...The second is whether the statement was
intended by Claimant to be for the purpose of obtaining benefits.”
Arreola v. Admin. Concepts,
17 So. 3d 792, 794 (Fla. 1st DCA 2009).
The JCC answered both questions affirmatively and denied
Claimant’s claim.
On appeal, Claimant argues that section
440.105(4) is
unconstitutional as applied to her because it is preempted by the
Immigration Reform and Control Act of 1986 (IRCA), citing
Arizona v....
...Garcia, it does not
control, nor does Arizona. Here, Claimant does not allege that the
invalid SSN she provided to obtain workers’ compensation benefits
was ever previously provided for employment verification
purposes. 2 Instead, she argues that section 440.105(4) is
unconstitutional because her provision of a false SSN “implicates
and touches upon her immigration status” and thus is preempted
by IRCA....
CopyPublished | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 16135, 2009 WL 3491034
...raud statement, an OJCC number, or a verified motion for assignment of a substitute identification number, which were the reasons his first petition for benefits was dismissed without prejudice by the deputy chief judge. The deputy chief judge cited section 440.105(7), Florida Statutes, as authority for requiring a signed fraud statement. Section 440.105(7), Florida Statutes (2006), does not allow for dismissal when a claimant fails to sign a fraud statement....
...Instead, subsection (7) provides that “payments under this chapter shall be suspended until such signature is obtained.” A prior version of subsection (7) arguably permitted petitions for benefits to be dismissed on such grounds, but the statute was amended in 2003 with the current language. See § 440.105(7), Fla. Stat. (2002); Ch. 2003-412, § 11, at 27, Laws of Fla. Because the applicable version of the statute does not require dismissal for failure to personally sign a fraud statement, *126 the dismissal was in error to the extent it relied upon section 440.105(7)....
CopyPublished | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 16153, 2010 WL 4157257
...l” nature of his job were not objectively false and were accurate. Because disqualification from benefits under section
440.09(4)(a) is, for relevant purposes here, predicated on the intentional or knowing commission of a criminal offense found in section
440.105, Florida Statutes, and further, because the criminal offenses contained in section
440.105 are predicated on statements which are objectively false, fraudulent, or misleading, see Dieujuste v....
CopyPublished | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 16265, 2011 WL 4905742
...We GRANT the motion and, accordingly, withdraw our former opinion of July 22, 2011, and substitute the following opinion in its place. In this workers’ compensation case, Claimant challenges an order of the Judge of Compensation Claims (JCC) denying benefits on the ground she violated section 440.105, Florida Statutes (2006), by making false or misleading statements for the purpose of obtaining workers’ compensation benefits....
...nts, in violation of the statute. “It shall be unlawful for any person ... [t]o knowingly make ... any false, fraudulent, or misleading oral or written statement for the purpose of obtaining or denying any benefit or payment under this chapter.” § 440.105(4)(b), Fla....
...Here, the JCC found “Claimant intentionally or knowingly has made numerous false and misleading statements with regards to the extent of her current injuries and which were made for the purpose of obtaining workers’ compensation benefits in violation of section 440.105(4)(b), Fla....
CopyPublished | Supreme Court of Florida | 25 Fla. L. Weekly Supp. 866, 2000 Fla. LEXIS 2275, 2000 WL 1508551
...2t Give a specific explanation of-any-other-issues -the-judge should consider in connection -with the benefits claimed in this-petition-4hat--were-not-referenced above. SECTION I:-C-E-RT-I-F-ICATE OF PETITIONER OR PETITIONERS--ATTORNEY (SECTION 140.192(4),-FLORIDA STATUTES)-AND. PETITIONER’S ATTESTATION — (SECTION 440.105(7), FLORIDA STATUTES)....
CopyPublished | Florida 1st District Court of Appeal | 2016 WL 3001809, 2016 Fla. App. LEXIS 7984
...nt has job-related injuries and lost her job based on ideations (that amounted to “blowing off steam”) arising from her workplace injuries; in seeking benefits, she lost the usual privacy considerations that attach to’ medical information. See § 440.105(b), Fla....
CopyPublished | Supreme Court of Florida | 21 Fla. L. Weekly Supp. 223, 1996 Fla. LEXIS 827, 1996 WL 268079
...pliance with the forms of these rules. The judge may request the EAO to assist unrepresented employees in filing a petition, as provided in section
440.192(2), Florida Statutes. *637 (3) Notice. A petition shall contain the fraud notice contained in section
440.105(7), Florida Statutes, and shall personally be signed and attested to by the petitioner....
...Give a specific explanation of any other issues the judge should consider in connection with the benefits claimed in this petition that were not referenced above. SECTION I: CERTIFICATE OF PETITIONER OR PETITIONER’S ATTORNEY (SECTION
440.192(4), FLORIDA STATUTES) AND PETITIONER’S ATTESTATION (SECTION
440.105(7), FLORIDA STATUTES)....
...Give a specific explanation of any other issues the judge should consider in connection with the benefits claimed in this petition that were not referenced above. SECTION I: CERTIFICATE OF PETITIONER OR PETITIONER’S ATTORNEY (SECTION
440.192(4), FLORIDA STATUTES) AND PETITIONER’S ATTESTATION (SECTION
440.105(7), FLORIDA STATUTES)....
CopyPublished | Florida 1st District Court of Appeal | 2015 WL 1021122
...been denied by the employer or carrier. The inability to obtain a fee raises
constitutional issues. See Jacobson v. Se. Pers. Leasing,
113 So. 3d 1042, 1049,
1052 (Fla. 1st DCA 2013) (holding “that the prohibition on claimant-paid attorney’s
fees in section
440.105(3)(c) and
440.34 [is] unconstitutional, and thus
unenforceable, as they apply to cases where the fee is for legal services performed
in defense against an E/C’s motion to tax costs,” because such services would not
result in securing any benefits)....
CopyPublished | Florida 1st District Court of Appeal
...The JCC apparently believed that to prove misrepresentation, the E/C had to link the
allegedly false statements directly to the particular injury and benefits being sought,
to Claimant’s knee in this instance. But such a requirement is not found in the law.
Section
440.105, Florida Statutes, makes it illegal for any person to
“knowingly make, or cause to be made, any false, fraudulent, or misleading oral or
written statement for the purpose of obtaining or denying any benefit or payment
under this chapter” (emphasis added). And section
440.09(4)(a), Florida Statutes,
bars benefits for an employee found to have “knowingly or intentionally engaged
in any of the acts described in s.
440.105 ....
...Specificity of the E/C’s Misrepresentation Defense
The second error below relates to the requirement for pleading a
misrepresentation defense under rule 60Q-6.113(2)(h), which provides:
Any defense raised pursuant to Sections
440.09(4)(a) and
440.105,
F.S., and any affirmative defense, must be raised with specificity,
detailing the conduct giving rise to the defense, with leave to amend
within 10 days....
CopyPublished | Florida 1st District Court of Appeal | 2013 WL 2421065, 2013 Fla. App. LEXIS 8936, 38 Fla. L. Weekly Fed. D 1242
...er agreement between him and Michael J. Winer, under which Winer would have provided legal services to Claimant limited to representation in the defense to oppose the E/C’s motion to tax costs. Claimant challenges the constitutionality of sections
440.105(3) (c) and
440.34 insofar as these sections preclude him from contracting for legal services to defend against the E/C’s motion to tax costs. We conclude to the extent that sections
440.34 and
440.105(3)(c), Florida Statutes, prohibit Claimant from retaining counsel to defend a motion to tax costs against him, those statutes infringe upon Claimant’s constitutional rights under the First Amendment of the Constitution. Accordingly, as applied here, sections
440.34 and
440.105(3)(c) are unconstitutional....
...For the reasons set forth herein, we reverse the orders of the JCC, and remand for a new hearing on the motion to tax costs and motion to approve a retainer. On remand, the JCC has the authority to determine whether the proposed fee is reasonable. Legal Background Under section 440.105(3)(c), Florida Statutes (2007), an attorney may be guilty of a first-degree misdemeanor if the attorney receives payment for work relating to a workers’ compensation case, unless the payment is approved by a JCC....
...lication only to attorneys representing claimants, it has long been interpreted as such in practice. See Altstatt v. Fla. Dep’t of Agric.,
1 So.3d 1285, 1286 (Fla. 1st DCA 2009) (“We find it unnecessary to decide whether the legislature intended section
440.105(3)(c) to apply to requests for payments made by attorneys representing employers, carriers and servicing agents, as well as to those made by attorneys representing claimants.”)....
...J.P.,
907 So.2d 1101, 1109 (Fla.2004) (holding right is fundamental if it “has its source in and is explicitly guaranteed by the federal or Florida Constitution”). Therefore, we apply strict scrutiny to section
440.34, regarding its effect on these First Amendment rights when taken in conjunction with section
440.105(3)(e)....
...mate government interest and leaves open alternative channels of communication); DA Mortgage, Inc. v. City of Miami Beach,
486 F.3d 1254 (11th Cir.2007) (same); Montgomery v. State,
69 So.3d 1023 (Fla. 5th DCA 2011) (same). We conclude that sections
440.105(3)(c) and
440.34 do not constitute reasonable time, place, or manner restrictions on Claimant’s First Amendment rights to free speech, free association, and petition for redress....
...in, whereas if a public harm is prevented it is more likely an exercise of the police power.” Id. at 1381 . Factors 4 and 5, however, easily extend to consideration of intangible property such as the contract rights here. We conclude that sections
440.105(3)(c) and
440.34 are not a permissible exercise of the State’s police power to restrict Claimant’s First Amendment right to contract for legal services to defend against an E/C’s motion to tax costs....
...ht to freely contract,” is distinguishable because it concerned fees payable by the E/C to a claimant rather than claimant-paid fees. Conclusion For the above reasons, we conclude that the prohibition on claimant-paid attorney’s fees in sections
440.105(3)(c) and
440.34are unconstitutional, and thus unenforceable, as they apply to cases where the fee is for legal services performed in defense against an E/C’s motion to tax costs....
...Andonie,
101 So.3d 339, 347 (Fla.2012) (holding additional element of entitlement to homestead exemption, in section
196.031(1), Florida Statutes, is unenforceable to the extent it limits class of individuals eligible for homestead exemption). Although section
440.105(3)(c) prohibits such attorneys from receiving unapproved fees, section
440.34 does not, under our holding today, preclude a JCC’s approving a fee agreement when a claimant chooses to obtain legal representation to aid in defense against an E/C’s motion to tax costs....
CopyPublished | Florida 1st District Court of Appeal
...ase, Claimant, Tony Leggett, appeals an order
of the Judge of Compensation Claims (JCC) denying contested temporary total
disability (TTD) benefits on the grounds that Claimant made misrepresentations
forfeiting benefits under sections
440.09 and
440.105, Florida Statutes (2012)....
...erformed physical tasks consistent with
the construction of a dock. The E/C stopped paying TTD benefits as of December 2,
2013, and denied the entire claim (including the orthopedic evaluation), asserting a
fraud defense under sections
440.09 and
440.105, Florida Statutes....
...benefits ended before his demand for payment of benefits was adjudicated.”
Claimant appealed seeking the award of the evaluation and TTD benefits from
December 2, 2013, through July 11, 2014.
II.
Section
440.105(4)(b)(1) states it is illegal for any person to “knowingly
make, or cause to be made, any false, fraudulent, or misleading oral or written
statement for the purpose of obtaining or denying any benefit or payment under this
chapter.” Section
440.09(4) bars benefits for an employee found to have “knowingly
or intentionally engaged in” such acts “for the purpose of securing workers’
compensation benefits.” Notably, Claimant in this appeal does not challenge the
finding that he violated section
440.105(4)(b)(1); Claimant’s argument concerns the
date that forfeiture of benefits becomes effective (either the date of his
misrepresentation, July 11, 2014; or the date the JCC entered the order finding
3
misrepresentation, September 4, 2014)....
...entitled to compensation or benefits under this chapter if any judge of compensation
claims, administrative law judge, court, or jury convened in this state determines that
the employee has knowingly or intentionally engaged in any of the acts described in
s. 440.105 ....
CopyPublished | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 9199, 2010 WL 2541703
...over which the JCC has jurisdiction. *40 Under the Workers' Compensation Law, the JCC is required to approve all fees paid for a "claimant in connection with any proceedings arising under this chapter." See §
440.34(1), Fla. Stat. (2007). Moreover, section
440.105(3)(c), Florida Statutes (2007), makes it unlawful for any attorney or other person, in his or her individual capacity or in his or her capacity as a public or private employee, or for any firm, corporation, partnership, or association...
...uty Chief [JCC]. Id. (emphasis supplied). While Appellant's counsel may have provided valuable legal services in the dispute with Humana regarding a cause of action outside the scope of the JCC's jurisdiction, it is contrary to the plain language of section 440.105(3)(c), Florida Statutes, to declare that the services were provided "in connection with any proceeding[] arising under [the Florida Workers' Compensation Law]." A "proceeding" is defined as "[t]he regular and orderly progression of a...
CopyPublished | Florida 1st District Court of Appeal
...The JCC apparently believed that to prove misrepresentation, the E/C had to link the
allegedly false statements directly to the particular injury and benefits being sought,
to Claimant’s knee in this instance. But such a requirement is not found in the law.
Section
440.105, Florida Statutes, makes it illegal for any person to
“knowingly make, or cause to be made, any false, fraudulent, or misleading oral or
written statement for the purpose of obtaining or denying any benefit or payment
under this chapter” (emphasis added). And section
440.09(4)(a), Florida Statutes,
bars benefits for an employee found to have “knowingly or intentionally engaged
in any of the acts described in s.
440.105 ....
...Claimant challenged the E/C’s misrepresentation defense as failing to satisfy
the requirements for pleading a misrepresentation defense under rule 60Q-
6.113(2)(h), which provides:
Any defense raised pursuant to Sections
440.09(4)(a) and
440.105,
F.S., and any affirmative defense, must be raised with specificity,
detailing the conduct giving rise to the defense, with leave to amend
within 10 days....
CopyPublished | Florida 1st District Court of Appeal | 2008 Fla. App. LEXIS 12891, 2008 WL 2901344
...he amount of the fees. Although section
440.34 restricts the discretion of the JCC in setting a “reasonable” fee, see Wood v. Florida Rock Industries,
929 So.2d 542 (Fla. 1st DCA 2006), attorney’s fees under chapter 440 are not self-executing. Section
440.105(3)(c) expressly requires the JCC to approve the attorney’s fees, providing, in pertinent part, as follows: It is unlawful for any attorney or other person ......
CopyPublished | Florida 1st District Court of Appeal | 2014 WL 3709762, 2014 Fla. App. LEXIS 11571
...Appellate Procedure 9.315(a). Accordingly, the parties were directed to refrain from further briefing. Because the record evidence supports the JCC’s finding that Claimant was convicted and adjudicated guilty of workers’ compensation fraud under section
440.105, *896 Florida Statutes, in a court of competent jurisdiction, we find no error in the JCC’s conclusion that Claimant has, therefore, forfeited his entitlement to workers’ compensation benefits as directed by section
440.09(4)....
CopyPublished | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 9479, 1998 WL 427077
...ide the ease based on the evidence. See Stubbs v. State,
673 So.2d 964 (Fla. 1st DCA 1996) (general division en banc). The second issue appears to be one of first impression in Florida: whether conviction for both workers’ compensation fraud under section
440.105 1 and grand theft under section
812.014 is a double jeopardy violation....
...In determining whether a double jeopardy violation has occurred, the first dispositive question is whether the legislature intended to authorize separate punishments for the two crimes. See M.P. v. State,
682 So.2d 79, 81 (Fla.1996). The plain reading of section
440.105(5) evidences the legislature’s intent to allow a conviction for workers’ compensation fraud and any other applicable crime. Section
440.105(4) proscribes, among other things, any knowingly fraudulent statement made for the purpose of obtaining workers’ compensation benefits, providing that such constitutes a third degree felony, and paragraph (5) provides that “[t]his...
CopyPublished | Florida 1st District Court of Appeal | 2017 Fla. App. LEXIS 10681, 2017 WL 3160125
...novo. Palm Beach Cty. Sch. Dist. v. Ferrer,
990 So.2d 13, 14 (Fla. 1st DCA 2008); Matrix Emp. Leasing v. Hernandez,
975 So.2d 1217, 1218 (Fla. 1st DCA 2008); Mylock v. Champion Int’l,
906 So.2d 363, 365 (Fla. 1st DCA 2005). Sectioris
440.09(4) and
440.105, Florida Statutes, are often referred to as the mechanisms that created the “fraud defense.” This “misnomer appears to have narrowed the "application of the sanction beyond that intended by the legislature.” Village Apartments v. Hernandez,
856 So.2d 1140, 1141 (Fla. 1st DCA 2003). Not all prohibited acts in section
440.105 entail a “fraud” element. See §
440.105(4)(b)2.-3., Fla. Stat. In interpreting a statute, “full effect must be given to the language' selected by the' legislature.” Hernandez,
856 So.2d at 1141 . Accordingly, per section
440.09(4), the commission of “any” act of an employee prohibited by section
440.105 results in forfeiture of benefits, not just those statutorily designated as “fraudulent.” 2 'This Court has previously emphasized that the 2003 Amendments to section
440.09(4)(a), adding the phrase “or any criminal act,” broadened the subsection to cover not only acts described in section
440.105, but also other criminal acts, as long as “all of those acts are done for the purpose of securing workers’ compensation benefits.” Matrix Emp. Leasing,
975 So.2d at 1219 . Determining whether there has been a violation of section
440.105(4)(b) requires a two-part inquiry: 1) a finding as to whether a false (or fraudulent or misleading) oral or written statement was made by the person; and 2) a finding as to whether, at the time the statement was made, it was made with the required in *903 tent....
...cal information, regardless of the source. The JCC erred in placing an affirmative duty, not statutorily mandated, on the evaluating physicians to interrogate the -Claimant regarding known misrepresentations. Furthermore, a plain reading of sections-
440.105(4) and
440.09(4) provides no basis for the JCC’s exoneration of the misrepresentations. It matters not whether .the doctors were provided with accurate information regarding etiology of injuries or pre-existing medical conditions and treatment by a source other than the Claimant. The purpose of section
440.105(4) is to sanction “any person” who, with the requisite intent, .commits any of the enumerated, prohibited acts....
...n by asserting it was a work-related injury. Accordingly, Claimant’s misrepresentation to Shands regarding the cause of his sinus condition was not made for the purpose of the obtaining workers’ compensation benefits. This reasoning misconstrues section
440.105(4) and requires an immediate causal nexus not contemplated by the legislature. Section
440.09(4)(a) mandates forfeiture of benefits if the misrepresentations were made for “the purpose of securing workers’ compensation benefits.” Section
440.105(4) details those acts regarded as having been committed for “the purpose of seeming workers’ compensation benefits.” Section
440.105(4)(b) declares that it “shall be unlawful for any person:” 1....
...As this Court has previously explained, “such a requirement is not found in the law.” THG Rentals & Sales of Clearwater, Inc. v. Arnold,
196 So.3d 485, 487 (Fla. 1st DCA 2016). Furthermore, such an application is contrary to a plain reading of section
440.105(4)....
...nd adequately responsive. The Claimant’s argument on appeal that the E/C waived, expressly or impliedly, the misrepresentation defenses during the course of the merits hearing is without merit. Pursuant to section
440.09(4)(a), and having violated section
440.105, the Claimant is not entitled to workers’ compensation benefits....
...THOMAS, C.J., and WETHERELL, JJ., CONCUR. . The Claimant was terminated by the Employer in December 2014, based on a positive ■drug test for methamphetamine and amphetamines, after driving a backhoe so far into the water that it had to be towed out. . Section
440.105, Florida Statutes, lists prohibited activities of employees, employers, insurance entities, licensed medical providers, attorneys, and a broad reference to "any person.” However,' section
440.09(4), Florida Statutes, provides the sanction for employees who violate section
440.105, Florida Statutes.
CopyPublished | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 11454, 2011 WL 2937309
...Grant D. Petersen of Ogletree, Deakins, Nash, Smoak & Stewart, Tampa, for Appellees. PER CURIAM. In this workers' compensation case, Claimant challenges an order of the Judge of Compensation Claims (JCC) denying benefits on the ground she violated section 440.105, Florida Statutes (2006), by making false or misleading statements for the purpose of obtaining workers' compensation benefits....
...tation, and reverse the denial of TTD benefits, but affirm the denial of TPD benefits. It is illegal for any person to make "any false, fraudulent, or misleading oral or written statement" for the purpose of obtaining workers' compensation benefits. § 440.105(4)(b), Fla....
...t behavior identical to behaviors captured on surveillance in Dieujuste v. J. Dodd Plumbing, Inc.,
3 So.3d 1275 (Fla. 1st DCA 2009), which this court found could not serve as the predicate for disqualification from benefits under sections
440.09 and
440.105....
CopyPublished | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 11176, 2011 WL 2753773
PER CURIAM. In this workers’ compensation case, the Employer/Carrier (E/C) filed a motion seeking to terminate Claimant’s entitlement to benefits under chapter 440 on grounds Claimant violated section
440.105(4)(b), Florida Statutes (2006), and thus, pursuant to section
440.09(4)(a), Florida Statutes (2006), she was no longer entitled to any benefits....
...“a determination pursuant to Fla. Stat.
440.09(4) whether the Employee/Claimant had knowingly made false, fraudulent or misleading oral or written statements for the purposes of securing workers’ compensation benefits in violation of Fla. Stat.
440.105(4)(b).” Id....
...Because chapter 440 authorizes only employees to file pleadings invoking the jurisdiction of the JCC, whether the E/C here termed its pleading a motion or a petition for benefits, the relief sought was the same as it was in Polston — a determination that Claimant violated section 440.105(4)....
CopyPublished | Florida 1st District Court of Appeal | 2008 WL 244665
...e applicant received from the Mexican physician. [3] We do not comment on whether an unauthorized worker could be precluded from receiving benefits under the "fraud defense." See generally James F. Kidd & Rick Blystone, Not So Fast! A Closer Look at § 440.105(4)(B)(9) Reveals Unauthorized Workers Should be Precluded From Workers' Compensation Benefits, Under These Circumstances, 81 Fla....
CopyPublished | Florida 1st District Court of Appeal | 2017 Fla. App. LEXIS 498
PER CURIAM. In this workers’ compensation case, the Employer/Carrier (E/C) appeal an order of the Judge of Compensation Claims (JCC) rejecting their affirmative defense of misrepresentation under sections
440.09(4) and
440.105(4), Florida Statutes, and awarding benefits to Claimant....
...standard. It is illegal for any person to “knowingly make, or cause to be made, any false, fraudulent, or misleading oral or written statement for the purpose of obtaining or denying any benefit or payment” under the Workers’ Compensation Law. § 440.105(4)(b)l., Fla....
...And workers’ compensation benefits are barred for an employee found to have “knowingly or intentionally engaged in” such acts “for the purpose of securing workers’ compensation benefits.” §
440.09(4), Fla. Stat. (2013). Determining that there has been a violation of section
440.105(4) requires a two-part inquiry, encompassing first a finding as to whether a false (or fraudulent or misleading) statement was made by the claimant, and second a finding as to whether, at the time the statement was made, it was made with the intent to obtain benefits....
...illage Apartments v. Hernandez,
856 So.2d 1140, 1142 (Fla. 1st DCA 2003) (“Regardless of whether the claimant was under oath, if, at the time he made any of these statements, he knew they were false ... then the statements fall within the scope of section
440.105(4)(b)2.”)....
CopyPublished | Florida 1st District Court of Appeal | 2002 Fla. App. LEXIS 1117, 2002 WL 181273
BARFIELD, J. The order denying the employer/cam-er’s motion to dismiss under section
440.105(4)(b), Florida Statutes, on the ground that the Judge of Compensation Claims (JCC) lacked jurisdiction to apply section
440.09(4), Florida Statutes, to this worker’s compensation claim, is REVERSED and the case is REMANDED to the JCC for further proceedings in accordance with Russell Corp....
CopyPublished | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 1740, 2006 WL 317004
PER CURIAM. Marilyn Polston challenges an order entered by the Judge of Compensation Claims (JCC) finding that she violated section 440.105(4)(b)(2), Florida Statutes....
...The employer/carrier (E/C) filed a response asserting that they did not agree to a dismissal and they requested the JCC to determine whether Polston knowingly made false, fraudulent or misleading statements for the purpose of securing workers’ compensation benefits in violation of section 440.105....
...The E/C then filed a petition for benefits, requesting “a determination pursuant to Fla. Stat.
440.09(4) whether the Employee/Claimant has knowingly made false, fraudulent or misleading oral or written statements for the purposes of securing workers’ compensation benefits in violation *767 of Fla. Stat.
440.105(4)(b).” Polston filed a motion to dismiss the petition, in which she argued the JCC had no jurisdiction. This motion was denied. After a final hearing, the JCC issued an order finding Polston had violated section
440.105(4)(b)(2), and was not entitled to compensation or benefits pursuant to section
440.09(4)....
...The JCC found he lacked jurisdiction to consider the issue of authorization for surgery because Simpson had not exhausted the managed care grievance procedures. The JCC went on, however, to rule on the E/C’s affirmative defense of misrepresentation under section 440.105(4)(b)....
CopyPublished | Florida 1st District Court of Appeal | 2003 Fla. App. LEXIS 18677, 2003 WL 22880497
...ER CURIAM. The claimant appeals a workers’ compensation order by which a claim was denied upon a determination that the claimant made false, fraudulent, or misleading *368 statements and omitted or concealed material information, thereby violating section
440.105(4)(b)3, Florida Statutes, and being disqualified from receiving benefits pursuant to section
440.09(4), Florida Statutes....
CopyPublished | Court of Appeals for the Eleventh Circuit
...In 2014,
he and a co-defendant (Adalid Ramos-Rodriguez) were charged by criminal
information with one count of money laundering, in violation of Fla. Stat. §§
896.101(3)(a), (5)(c), and
777.011, and one count of workers’ compensation fraud,
in violation of Fla. Stat. §§
440.105(4)(b)(5), (4)(f)(3) 1, and
777.011....
...but no such subsection exists in the Florida code.
2
USCA11 Case: 19-13848 Date Filed: 12/30/2020 Page: 3 of 11
involved a monetary loss valued at $100,000 or more. See Fla. Stat. §§
440.105(4)(f)(3),
896.101(5)(c)....
...Garcia-Simisterra ultimately entered a plea of nolo
contendere to the money-laundering and workers-compensation fraud counts. In
exchange for his pleas, the State reduced the charges to third-degree felonies,
which involve a monetary loss of less than $20,000. Fla. Stat. §§
896.101(5)(a),
440.105(4)(f)(1)....
...As this
record reflects, Garcia-Simisterra agreed to plead guilty and ultimately pleaded
nolo contendere to both counts contained in the criminal information. The
information charged Garcia-Simisterra with workers’ compensation fraud with a
monetary value of “$100,000.00 or more.” See Fla. Stat. § 440.105(4)(f)(3); In re
Babaisakov, 24 I....
CopyPublished | Florida 1st District Court of Appeal | 1997 WL 740728
...Appellant explains that the award of prejudgment interest in Quality Engineered Installation was supported under the theory that the accrual of prejudgment interest could be avoided by tendering the fee. Appellant points out that under section
440.34(6), Florida Statutes (1989), which has since been transferred to section
440.105(3), Florida Statutes (Supp.1994), it is a misdemeanor for anyone to receive a fee in a workers' compensation case for services rendered unless the judge of compensation claims has approved the fee....
CopyPublished | Florida 1st District Court of Appeal | 2006 WL 3589004
...Therefore, we remand for factual findings regarding Claimant's reduction in hours and entitlement to TPD benefits under section
440.15(4), Florida Statutes (2002). We further find that the JCC erred in failing to rule on E/C's defense of fraud raised under sections
440.09 and
440.105, Florida Statutes (2002)....
...Both parties agree that fraud was an issue in this case and that Claimant's false statements affect his eligibility to TPD benefits; therefore, on remand, the JCC should consider whether Claimant knowingly made false, fraudulent, or misleading statements for the purpose of obtaining workers' compensation benefits. § 440.105(b), Fla....
CopyPublished | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 14004, 2006 WL 2402796
PER CURIAM. In this workers’ compensation appeal, Charles Weaver argues that sections *733
440.09(4) and
440.105, which allow a judge of compensation claims to determine whether a claimant has committed fraud, are facially unconstitutional because they violate a claimant’s right to equal protection of the law. Essentially, Weaver argues that these statutes deprive claimant of the procedures available to carriers accused of fraud under section
440.105. He also argues that these statutes impose stricter penalties on claimants accused of fraud than on carriers accused of fraud under section
440.105....
CopyPublished | Florida 1st District Court of Appeal | 2014 WL 1356792, 2014 Fla. App. LEXIS 5112
...ity and if want of jurisdiction appears at any state of the proceedings, original or appellate, the court should notice the defect and enter an appropriate order’ ” (citations omitted)). This court has previously reversed findings of fraud under section 440.105(4)(b), Florida Statutes, holding that a JCC has no jurisdiction over this *1151 affirmative defense in the absence of a pending PFB filed by the claimant....
CopyPublished | Florida 4th District Court of Appeal | 2014 WL 1686461, 2014 Fla. App. LEXIS 6219
PER CURIAM. Defendant Jordan Hector and co-defendant Francisco Brock were charged with one count of fraud under section 440.105(4)(b)9., Florida Statutes (2012)....
CopyPublished | District Court of Appeal of Florida
to commit that fraud, in violation of section
440.105(4)(f)3., Florida Statutes (2022);
CopyPublished | Supreme Court of Florida | 41 Fla. L. Weekly Supp. 197, 2016 WL 1700521, 2016 Fla. LEXIS 885
...nefits, seeking a compensability determination for temporary total or partial disability benefits, along with costs and attorney’s fees. The E/C filed a response to the petition, denying the claim based on sections
440.09(4) (intentional acts) and
440.105(4)(b)9....
...torney’s fee in excess of the amount permitted by this section.”). In fact, it is a crime for an attorney to accept any fee not approved by the JCC, which is of course constrained to award a fee only pursuant to the statutory fee . schedule. See § 440.105(3)(c), Fla....
...Stat.; and (7) the addition of an offer of settlement provision that allows only the employer, and not the claimant, to make an offer to settle, §
440.34(2), Fla. Stat. . We note that the First District Court of Appeal recently concluded in an as-applied constitutional challenge to sections
440.105 and
440.34’that the restrictions in those sections are unconstitutional violations of a claimant’s right to free speech, free association, petition, and right to form contracts, and held "that the criminal penalties of section
440.105(3)(c), Florida Statutes, are unenforceable against an attorney representing a workers’ compensation client seeking to obtain benefits under chapter 440, as limited by other provisions." Miles v....
CopyPublished | Florida 1st District Court of Appeal | 2015 WL 1578254
...secured including resolution of the claim
for authorization of medical treatment and payment of medical bills.
The JCC approved the Claimant-paid attorney’s fee associated with the
settlement, but denied approval of the E/SA-paid fee. See § 440.105(3)(c), Fla....
CopyPublished | Florida 1st District Court of Appeal | 2006 WL 908433
...Znosko, Esquire, Znosko & Reas, P.A., Maitland; Todd J. Sanders, Esquire, Orlando, for Appellees. PER CURIAM. Claimant appeals from a final compensation order entered by the judge of compensation claims (JCC) denying all workers' compensation benefits to claimant based on fraud pursuant to section 440.105, Florida Statutes (2002)....
...its from March 5, 2004 to June 3, 2004, the date maximum medical improvement was reached, and impairment benefits. The JCC ruled that claimant was barred from receiving these workers' compensation benefits based upon his finding of fraud pursuant to section 440.105, Florida Statutes....
...ANALYSIS Section
440.09(4), Florida Statutes (2002), provides that an employee is not entitled to workers' compensation benefits under chapter 440 if the JCC "determines that the employee has knowingly or intentionally engaged in any of the acts described in s.
440.105 [1] for the purpose of securing workers' compensation benefits." (Emphasis added)....
...March 1, 2004-March 4, 2004, and the obtaining of the doctor's excuse through Dr. Gustavo Bustamonte." However, the JCC made no finding that claimant, through his testimony at the hearing, knowingly or intentionally engaged in any acts described in section
440.105 for the purpose of securing workers' compensation benefits pursuant to section
440.09(4)....
...etent substantial evidence in the record, we reverse the final order entered by the JCC, and remand for further proceedings relating to claimant's petitions for benefits. REVERSED and REMANDED. ALLEN, VAN NORTWICK and POLSTON, JJ., concur. NOTES [1] Section 440.105(4)(b), Florida Statutes (2002), provides in part: It shall be unlawful for any person: 1....