CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1996 Fla. App. LEXIS 547, 1996 WL 34057
..., as amended November 9, 1995, because the JCC's order determines subject matter jurisdiction of the JCC. We find that the JCC has no jurisdiction to compel the claimant to attend an IME during the informal dispute resolution process provided for by section 440.191, Florida Statutes (1994 Supp.)....
...Disposition of the petition before us is therefore governed by the pertinent amendments to Chapter 440 effected by Chapter 93-415, Laws of Florida (1993), which have an effective date of January 1, 1994. [1] We have read and carefully considered the provisions of section 440.191, which creates the "Employee Assistance and Ombudsman Office" (EAO) within the Division of Workers' Compensation, together with related statutes....
...[2] Section
440.33(1), authorizes a Judge of Compensation Claims to do "all things conformable to law which may be necessary to enable him effectively to discharge the duties of his office." The key phrases are "conformable to law" and "duties of his office." There is no language in section
440.191 that either permits or requires the JCC to order an IME during the informal dispute resolution process, and nothing that suggests that the JCC has any "duties" or responsibilities during that process. This court has recently declined the invitation to read into section
440.191 authority on the part of a JCC to impose sanctions for a party's failure to attempt to resolve disputes in good faith or to cooperate with the settlement efforts of the EAO, or to find such power implied from the provisions of section
440.33(1). Plouffe v. Lake County Sheriff's Office,
653 So.2d 507 (Fla. 1st DCA 1995). We similarly decline in the case before us to, in effect, rewrite section
440.191 in the manner urged by the E/C....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1996 WL 27880
...The E/C then filed a Motion to Dismiss Claims for Average Weekly Wage and Medical Care Included in the Pre-Trial Stipulation. In the motion, the E/C asserted that Brooks had not filed a request for assistance and had not *1033 exhausted the procedures for informal dispute resolution as provided in section 440.191, Florida Statutes (Supp....
...Kilbourne, No. 93-3796, ___ So.2d ___ (Fla. 1st DCA Dec. 19, 1995); see McCabe v. Bechtel Power Corp.,
645 So.2d 1065 (Fla. 1st DCA 1994). A contrary result would prove highly inefficient and would frustrate the purpose of the Workers' Compensation Law. Section
440.191(1)(a), Florida Statutes (Supp....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1998 WL 874836
...petition for benefits. In 1995, Appellee (Claimant) sustained a compensable back injury and was assigned a 14% permanent impairment rating. E/C began paying Claimant permanent impairment benefits. Claimant filed a request for assistance pursuant to section 440.191, Florida Statutes, seeking permanent and total disability benefits; in response, E/C filed a notice of denial....
...(b) [i]n any case in which the employer or carrier files a notice of denial with the division and the injured person has employed an attorney in the successful prosecution of his claim .... [Emphasis supplied.] The request for assistance procedure is part of the informal dispute resolution process. Florida Statute section 440.191(2)(d) exempts employers or carriers from liability for attorney's fees for services rendered in connection with the Ombudsman's informal dispute resolution process, unless expressly authorized elsewhere in chapter 440....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1995 WL 704259
...As petitioners have failed to establish that the order is a departure from the essential requirements of law, the petition is denied. Claimant sustained a compensable accident on March 31, 1994, and filed a request for assistance with the Employee Assistance and Ombudsman Office (EAOO) as provided for in section 440.191, Florida Statutes (Supp....
...his court's recent decision in Southern Bakeries v. Cooper,
659 So.2d 339 (Fla. 1st DCA 1995). The e/c sought rehearing, arguing that claimant had never sought authorization of an IME physician through the statutory ombudsman procedures set forth in section
440.191 and
440.192....
...The e/c now petition this court for a writ of certiorari arguing that the JCC lacks subject matter jurisdiction to award a compensation benefit when the benefit is sought without first exhausting the administrative remedies and dispute resolution processes of the EAOO. The e/c assert that an IME is a medical service and section 440.191(2)(a) prohibits a claimant from filing a petition requesting any particular benefit until the employee has exhausted the procedures for informal dispute resolution....
...Petitioners have failed to demonstrate that the JCC's order constitutes a departure from the essential requirements of law. We find nothing in the statute to require the claimant to begin the administrative process anew simply because he makes a request for an IME. Nor is there any explicit language in *301 section
440.191 which would make it applicable to section
440.25 proceedings for mediation and hearings before the JCC....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1995 WL 488146
...("E/C") appeal an order entered by the judge of compensation claims ("JCC") awarding claimant's attorney a fee pursuant to the 21-day provision of section
440.34(3)(b), Florida Statutes (Supp. 1990). The E/C argue on appeal that the JCC erred (1) in holding that the procedural provisions of section
440.191, Florida Statutes (Supp....
...1994), did not preclude claimant's entitlement to an attorney's fee pursuant to section
440.34(3)(b), Florida Statutes (Supp. 1990); and (2) in determining that the docketing judge's dismissal of the claimant's claim for benefits based upon noncompliance with the procedural provisions of section
440.191, Florida Statutes (Supp....
...On June 1, 1994, the claimant mailed a claim for PTD benefits, costs and attorney's fees using a form acceptable for claims filed prior to the effective date of the 1994 amendments. On the same date, she requested assistance from the Employee Assistance and Ombudsman Office ("EAOO") pursuant to section 440.191, Florida Statutes (Supp....
...440.19(1)(e) on or before the 21st day after receiving notice of the claim, and the injured person has employed an *1231 attorney in the successful prosecution of his claim. The claimant in the present case complied with the procedure set forth in section 440.191, Florida Statutes (Supp....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 4290, 2005 WL 701091
...(1999), because the employer/carrier failed to pay the requested benefits within fourteen days of receiving the petition for benefits. The employer/carrier defended the claim, contending that pursuant to the informal dispute resolution provision of section 440.191(2)(d), Florida Statutes (1999), they had thirty days to investigate the claim before becoming liable for attorney's fees....
...* * * I have determined that the Employer/Servicing [Agent] had reasonable grounds for its belief that [it] enjoyed a 30[day] determination period from its receipt of the July 15, 2002 Petition for *889 Benefits to provide or deny the benefit requested. Prior to the July 1, 2002 amendments and pursuant to section 440.191(2)(d) (1994), employers and carriers could utilize a maximum time frame of 30 investigatory days before being exposed to liability for attorneys fees for denying a petition for benefits....
...1st DCA 2000); Integrated Health Servs. v. Hyde,
721 So.2d 1217 (Fla. 1st DCA 1998). With regard to the second finding, we must respectfully disagree because under the proper interpretation of the law, the employer/carrier's payment of PTD benefits was not timely. Section
440.191(2)(a), Florida Statutes (1999), contained a pre-petition process that was in place on the date of claimant's accident; however, the claimant filed her petition for benefits on July 15, 2002, after the effective date of the statutory amendment which removed this mandatory pre-petition requirement. The express language of former section
440.191(2)(a) described this pre-petition process as procedural in nature. [2] Further, this court has recognized that the informal dispute resolution procedure contained within section
440.191 is procedural, not substantive....
...A procedural change in the statute is applied after the effective date of the amendment, without regard to the date of the accident and injury. See Litvin v. St. Lucie County Sheriff's Department,
599 So.2d 1353, 1355 (Fla. 1st DCA 1992). Thus, because the amendments to section
440.191(2)(a) and section
440.191(2)(d) were effective prior to the filing of the petition for benefits in the instant case, claimant was not obligated to exhaust the procedures for informal dispute resolution and the employer/carrier was not entitled to the thirty-day grace period of section
440.191(2)(d). While the thirty-day pre-petition process under section
440.191(2) is procedural, this court has recently held that the 2002 amendment to section
440.34(3), permitting the employer/carrier thirty days within which to provide benefits before being responsible for payment of attorney's fees, is a substantive change to the statute and cannot be retroactively applied....
...DAVIS, VAN NORTWICK AND HAWKES, JJ., concur. NOTES [1] The parties on appeal do not challenge the portion of the final order awarding attorney's fees and costs for the claimant's procurement of medical benefits for physical therapy. Therefore, we affirm that part of the JCC's order. [2] Section 440.191(2)(a) provides: An employee may not file a petition requesting any benefit under this chapter unless the employee has exhausted the procedures for informal dispute resolution under this section.
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2000 WL 97483
...v. Hyde,
721 So.2d 1217 (Fla. 1st DCA 1998), we affirm. Andrew Smith sustained a compensable industrial injury on March 12, 1997, and commenced receiving indemnity benefits thereafter. On April 29, 1997, he filed a request for assistance pursuant to section
440.191, Florida Statutes (1995), seeking an increase in his average weekly wage (AWW) based upon prior employment in the industry and for payment of attorney's fees and costs....
...l with the division and the injured person has employed an attorney in the successful prosecution of his claim. ..." (Emphasis supplied). In Integrated Health Servs. v. Hyde , 721 at 1218, the *728 claimant filed a request for assistance pursuant to section 440.191, seeking permanent and total disability benefits; in response, the employer/carrier filed a notice of denial....
...In Integrated Health, we held that no fees were recoverable because a "successful prosecution" of a claim was not undertaken. We explained there that the request for assistance procedure is part of the informal dispute resolution process, and that section 440.191(2)(d), Florida Statute (Supp.1994), exempts employers or carriers from liability for attorney's fees for services rendered in connection with the informal dispute resolution process, unless expressly authorized elsewhere in chapter 440....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 1996 WL 465097
...Dion, General Counsel, Department of Labor & Employment Security, for appellee/intervenor Division of Workers' Compensation. ON MOTION TO DISMISS PER CURIAM. The appealed order dismissed a claim, filed after January 1, 1994, for failure to exhaust the procedures for informal dispute resolution, as required by section
440.191(2)(a), Florida Statutes, and for failure to comply with the pleading requirements of section
440.192, Florida Statutes....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 1995 WL 234666
...The Claimant, Robert Plouffe, appeals that portion of a workers' compensation order denying his request by motion for the imposition of sanctions against the Employer/Servicing Agent for their alleged failure to cooperate in good faith mediation with the Employee Assistance and Ombudsman Office (EAO) pursuant to section 440.191, Florida Statutes (Supp....
...a petition for benefits has been filed with the judge of compensation claims. Equally unavailing to Claimant is rule 4.150 of the Workers' Compensation Rules of Procedure, because the servicing agent in this case did not defy an order of the judge. Section 440.191 authorizes the EAO to compel parties to attend conferences, and precludes a claimant from filing a petition for benefits until exhausting the procedures authorized under this section, but it does not provide for imposition of any sanctions against a party that does not participate in good faith....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 1999 WL 41098
...Allen filed requests for assistance in obtaining the medical benefits that became the subjects of the petitions for benefits. Indeed, an "employee may not file a petition requesting any benefit under [the Workers' Compensation Law] unless the employee has exhausted the procedures for informal dispute resolution under [section 440.191, Florida Statutes (1997)]." § 440.191(2)(a), Fla....
...An employer or carrier who waits for the filing of a petition for benefits before honoring a request to furnish needed medical benefits must be prepared to incur liability for an injured worker's attorney's fees. After his requests were denied, Mr. Allen duly pursued his remedies under sections
440.191 and
440.192, Florida Statutes (1997), seeking to obtain authorization for treatment before the fact....
...employer or carrier files a notice of denial with the division and the injured person has employed an attorney in the successful prosecution of the claim[.] [3] While there exists a statutory duty "to attempt to resolve disagreements in good faith," § 440.191(1)(a), Fla....
...In any event, we infer from counsel's argument to the judge of compensation claims that AMC or Travelers knew of the requests for medical benefits for a substantial part of the (here at least 30-day) informal dispute resolution periods required by section 440.191, Florida Statutes (1997).
CopyPublished | Supreme Court of Florida | 27 Fla. L. Weekly Supp. 795, 2002 Fla. LEXIS 1884, 2002 WL 31084673
...of Labor and Employment Security. *794 (h) “Pocketing judge” means one or more judges designated-by the chief judge pursuant to section
440.45(3),■ -Florida Statutes (if) “EAO” means the Employee Assistance and Ombudsman Office created by section
440.191, Florida Statutes....
...440, Florida Statutes. (mj) “Impasse” means the parties’, inability to reach a mutually acceptable and voluntary agreement as to any matter at the mediation conference. (sk) “Informal dispute resolution” means the procedure established by section 440.191, Florida Statutes....
...Motions that do not seek adjudication of entitlement to benefits and are based upon stipulated facts requiring no other evidence also shall be treated as procedural motions. (yw) “Request for assistance” means the initiation of the informal dispute resolution procedure established by section 440.191, Florida Statutes....
...pose of a hearing or for any other purpose. Committee Notes 1996 Adoption. This rule defines the types of claims not included in a petition for benefits filed under section
440.192, Florida Statutes, that bypass the request-for-assistance process in section
440.191(2)(a), Florida Statutes, and the docketing judge’s review under section
440.45(3), Florida Statutes....
...e to resolve the dispute with the carrier. (5) Certificate of Completion of Informal Administrative Remedies. A petition shall also include a certificate that one of the following has occurred: (A) The informal dispute resolution process required by section 440.191, Florida Statutes, has been concluded....
..., (e), (f), (g), (h), (i), (j), Florida Statutes, or_. and is dismissed without prejudice with leave to amend within 30 days from the date of this order. ( ) Petitioner has failed to exhaust the procedures for informal dispute resolution under £Lgr section 440.191(2), Florida Statutes, before filing the petition and the petition is dismissed without prejudice....
...TITION IS FOR MEDICAL BENEFITS ONLY _ YES_ NO_ I. Jurisdiction: The judge has jurisdiction over the parties and the subject matter of this petition. II. It is certified that: The subject matter of this petition was presented to the EAO created under section 440.191, Florida Statutes, in a good-faith effort to resolve the disagreements between the parties....
CopyPublished | Supreme Court of Florida | 25 Fla. L. Weekly Supp. 866, 2000 Fla. LEXIS 2275, 2000 WL 1508551
...pose of a hearing or for any other purpose. Committee Notes 1996 Adoption. This rule defines the types of claims not included in a petition for benefits filed under section
440.192, Florida Statutes, that bypass the request-for-assistance process in section
440.191(2)(a), Florida Statutes, and the docketing judge’s review under section
440.45(3), Florida Statutes....
...(b) Generally. No agreement or stipulation shall be enforceable unless it is: (1) in writing and signed by the parties or their attorney; or (2) dictated on the record; or (3) in the case of a settlement agreement resulting from a conference pursuant founder section 440.191(2)(c), Florida Statutes, approved in writing by the docketin-ga judge....
...inding. An agreement or stipulation also is binding if it is dictated on the record. Again, specific approval by a judge is not required. The third alternative involves cases in which an agreement has been reached during an EAO conference held under section 440.191(2)(c), Florida Statutes, and the agreement has been submitted to a judge....
...440.192(2)(a), (b), (c), (d), (e), (f), (g), (h), (i), (j), or,-and is dismissed without prejudice with leave to amend within 30 days from the date of this order. ( ) Petitioner has failed to exhaust the procedures for informal dispute resolution under F.S. 440.191(2) before filing the petition and the petition is dismissed without prejudice....
...BOX 8000 — TALLAHASSEE, FL 32314-8000 FOR ASSISTANCE CALL 1-800-342-1741 [[Image here]] I. Jurisdiction: The judge has jurisdiction over the parties and the subject matter of this petition. II. It is certified that: The subject matter of this petition was presented to the EAO created under section 440.191, Florida Statutes, in a good-faith effort to resolve the disagreements between the parties....
CopyPublished | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 11581, 1995 WL 642666
...prior to the filing of a claim. The facts of this ease are not in dispute. On January 14, 1994, the claimant suffered an injury. On September 29, 1994, with the assistance of counsel, the claimant filed a Request for Assistance as now required under section 440.191, Florida Statutes (1994 Supp.)....
...Further, a Request for Assistance is filed with the Employee Assistance and Ombudsman Office, not the Division. In addition, the claimant may not begin litigation by filing a Petition for Benefits until the claimant has first exhausted the procedures of informal dispute resolution under section 440.191, Florida Statutes (1994 Supp.), which includes the submission of a Request for Assistance to the Employee Assistance and Ombudsman Office....
...We find that the reference to a filing of a “claim” in section
440.30, Florida Statutes (1993) should properly be construed as the filing of a Petition for Benefits under section
440.192, Florida Statutes (1994 Supp.) and not the filing of a Request for Assistance under section
440.191, Florida Statutes (1994 Supp.)....
CopyPublished | Supreme Court of Florida | 21 Fla. L. Weekly Supp. 223, 1996 Fla. LEXIS 827, 1996 WL 268079
...epartment of Labor and Employment Security. (h) “Docketing judge” means one or more judges designated by the chief judge pursuant to section
440.45(3), Florida Statutes. (i) “EAO” means the Employee Assistance and Ombudsman Office created by section
440.191, Florida Statutes....
...Motions that do not seek adjudication of entitlement to benefits and are based upon stipulated facts requiring no other evidence also shall be treated as procedural motions. (y) “Request for assistance” means the initiation of the informal dispute resolution procedure established by section 440.191, Florida Statutes....
...pose of a hearing or for any other purpose. Committee Notes 1995 Adoption. This rule defines the types of claims not included in a petition for benefits filed under section
440.192, Florida Statutes, that bypass the request-for-assistance process in section
440.191(2)(a), Florida Statutes, and the docketing judge’s review under section 440,45(3), Florida Statutes....
...to resolve the dispute with the carrier. (5) Certificate of Completion of Informal Administrative Remedies. A petition shall also include a certifícate that one of the following has occurred: (A) The informal dispute resolution process required by section 440.191, Florida Statutes, has been concluded....
...(b) Generally. No agreement or stipulation shall be enforceable unless it is: (1) in writing and signed by the parties or their attorney; (2) dictated on the record; or (3) in the case of a settlement agreement resulting from a conference pursuant to section 440.191(2)(c), Florida Statutes, approved in writing by the docketing judge....
...L Jurisdiction: The judge has jurisdiction over the parties and the subject matter of this petition. 2. Employee Assistance and Ombudsman Office (EAO) unable to resolve dispute. The subject matter of this petition was presented to the EAO created under section 440.191, Florida Statutes, in a good-faith effort to resolve the disagreements between the parties....
...L Jurisdiction: The judge has jurisdiction over the parties and the subject matter of this petition. 2. Employee Assistance and Ombudsman Office (EAO) unable to resolve dispute. The subject matter of this petition was presented to the EAO created under section 440.191, Florida Statutes, in a good-faith effort to resolve the disagreements between the parties....
CopyPublished | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 7558, 1999 WL 371355
...997), and therefore, under the facts of this case, there is no concurrent jurisdiction with the JCC. We disagree. Karell involved the quashing of a JCC’s order compelling a claimant to submit to an independent medical examination (IME) pursuant to section 440.191, Florida Statutes (Supp.1994)....
CopyPublished | Florida 1st District Court of Appeal | 1996 WL 378320
...t detailed pre-petition and post-petition procedure. Now, in the typical workers' compensation matter, an employee may not file a petition requesting benefits unless the employee has exhausted all preclaim procedures for informal dispute resolution. § 440.191(2)(a), Fla....
...In order to initiate the informal dispute resolution procedures, the employee must request the assistance of the Employee Assistance and Ombudsman Office of the Division of Workers' Compensation. The office then has thirty (30) days to assist the employee in resolving the dispute. § 440.191(2)(d), Fla....
CopyPublished | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 9517, 1999 WL 496150
...Claimant was injured during the course and scope of his employment in 1990. His attorney mailed to the Division of Workers’ Compensation of the Department of Labor and Employment Security, on October 25, 1996, a “Request for Assistance” which complied with section 440.191, Florida Statutes (Supp.1994)....
...e until after the effective date of the 1994 amendments to the Workers’ Compensation Act, he could not file a “Petition for Benefits” seeking those benefits until after he had first exhausted the informal dispute resolution process outlined in section 440.191, Florida Statutes (Supp.1994). See § 440.191(2)(a), Fla....
CopyPublished | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 467, 1999 WL 22448
PER CURIAM. This cause is before us on appeal from an order of the Judge of Compensation Claims (hereinafter JCC) waiving the 30-day informal dispute resolution period mandated by section 440.191(2)(a), Florida Statutes (1993)....
...She died shortly thereafter. Her beneficiaries are Appellees in the instant case. On December 24, 1997, five days before the statute of limitations would have expired, Appellees filed a Request for Assistance with the Employee Assistance and Ombudsman Office, as required by section 440.191, Florida Statutes (1993)....
...ute resolution process. The JCC exceeded her statutorily authorized jurisdiction by both entertaining and then granting Appellee’s motion during this period. See Karell v. Miami Airport Hilton/Miami Hilton Corp.,
668 So.2d 227 (Fla. 1st DCA 1996). Section
440.191(2)(a), Florida Statutes (1993), clearly states that an employee may not file a petition for benefits unless the employee has exhausted the informal dispute resolution process....
CopyPublished | District Court of Appeal of Florida | 1996 Fla. App. LEXIS 1477, 1996 WL 71124
...These forms were dated June 27,1994, and received by the Division of Workers’ Compensation, Employee Assistance Office, by certified mail on June 30,1994. Sanchez also filed a “Petition for Benefits” using the procedures set forth in the newly enacted section
440.191, Florida Statutes (Supp.1994), and section
440.192, Florida Statutes (Supp.1994), seeking the benefits set forth above....
...judge of compensation claims. They further urge that, under the 1994 law, such jurisdiction may only be invoked by a petition and, in turn, a petition may not be filed until an employee has exhausted procedures for informal dispute resolution under section 440.191, Florida Statutes (Supp.1994)....
...the Request for Assistance tolled the statute of limitations. To hold otherwise would effectively shorten the statute because a section
440.192 petition may not be filed until a claimant has exhausted the informal dispute resolution procedures under section
440.191, Florida Statutes (Supp.1994). These pretrial procedures may extend for 30 days or more, section
440.191(2)(d), Florida Statutes (Supp.1994), and the statute does not confer upon the JCC authority to impose sanctions for a party’s failure to attempt to resolve disputes in good faith or to cooperate with the employee assistance office in resolving disagreements....
CopyPublished | District Court of Appeal of Florida | 1998 Fla. App. LEXIS 11036, 1998 WL 546089
...It could also expedite payment of indemnity benefits. “[T]he Workers’ Compensation Law ... shall be construed to permit injured employees and employers ... to resolve disagreements without undue expense, costly litigation, or delay in the provisions of benefits.” § 440.191(l)(a), Fla....
CopyPublished | Florida 1st District Court of Appeal
...or inquiry regarding a matter or activity regulated under
the Florida Insurance Code . . . are confidential and
exempt from s.
119.07(1) and s. 24(a), Art. I of the State
Constitution[.]
1 Section
624.23 also exempts information regulated by
section
440.191, Florida Statutes (2016), which is not relevant to
the issues in this appeal.
2
“Personal health and financial information” is defined to include
“[t]he existence, identification, nature or va...
