CopyCited 14 times | Published | Florida 1st District Court of Appeal | 2005 WL 1832429
...This tolling period does not apply to the issues of compensability, date of maximum medical improvement, or permanent impairment. (3) The filing of a petition for benefits does not toll the limitations period set forth in this section unless the petition meets the specificity requirements set forth in s. 440.192....
...However, relying on the language of subsection (3) of the statute, claimant contends that running of the statute was tolled during the period between May 29, 2002, and February 7, 2003, when he voluntarily dismissed his two previous petitions (which, he argues, met the specificity requirements of section 440.192)....
...1st DCA 1988). However, claimant argues that our cases predate the enactment of section
440.19(3) in 1994 and are inconsistent with the plain language of that statute, to the effect that filing a petition meeting the specificity requirements set forth in section
440.192 tolls the limitations period....
...the tolling effect of an earlier [dismissed action] on the limitations period applicable to a later [action]." Fernon v. Itkin,
476 F.Supp. at 3. Similarly, section
440.19(3) merely states that a petition must be filed in compliance with the specificity requirements of section
440.192 to be timely for purposes of the applicable statute of limitations....
CopyCited 13 times | Published | Florida 1st District Court of Appeal | 1997 WL 564204
...[*] On the authority of Wuelling, we reverse the order under review, and remand for consideration of the merits of Ms. Brooks' claim. The carrier's failure to file a notice of denial with the division in response to a petition for benefits sent by certified mail violated section 440.192(8), Florida Statutes (Supp.1994), inasmuch as neither appellant paid the benefits the claimant requested....
...n with all its attendant risks. Reversed and remanded. KAHN, J., concurs. ERVIN, J., concurs with opinion. ERVIN, Judge, concurring. In Waffle House v. Hutchinson,
673 So.2d 883 (Fla. 1st DCA), review denied,
683 So.2d 486 (Fla.1996), we interpreted section
440.192(8), Florida Statutes (Supp.1994), to mean that an insurance carrier which fails to do anything after the lapse of 14 days from the service of a petition for benefits is deemed to have accepted the claimant's injuries as compensable....
...on of benefits is deemed to have denied the compensability of claimant's injuries. Thus, we place the employer/carrier (E/C) that does nothing in the identical position as the E/C that files a notice of denial. I must admit that this construction of section 440.192(8) was not apparent to me when I concurred with the result reached by the majority in Wuelling....
...I concurred, because I believed the decision should be limited to its facts involving an untimely notice of denial. I considered the majority had used language in its opinion broader than that necessary to its decision when it indicated that the "deemed-compensable" provisions of sections
440.192(8) and
440.20(4), Florida Statutes (Supp.1994), were inapplicable to the carrier which defaulted in its obligation to take any action, and that a carrier which did nothing could be subjected only to the penalties set out by it at
683 So.2d at 1092 n. 1. I considered that the deemer language in sections
440.192(8) and
440.20(4), when construed in pari materia, meant that the carrier which did not act should be regarded as having accepted the compensability of the employee's injuries to the same extent as the carrier that had untimely initiated the payment of benefits....
...struction of the statute. In fact, on further reflection, I believe that such interpretation is more consistent with the legislative purpose than my original interpretation. The explicitly stated legislative goals leading to the creation of sections
440.192(8) and
440.20(4), enacted by the 1993 special legislative session, as well as numerous other measures included within chapter 93-415, Laws of Florida, were the following: It is the intent of the Legislature to ensure the prompt delivery of benefits to the injured worker....
CopyCited 13 times | Published | Florida 1st District Court of Appeal | 2000 WL 712808
...NOTES [1] We make no determination as to whether doing nothing could be construed as a denial under section
440.20(4). Cf. Russell Corp. v. Brooks,
698 So.2d 1334, 1335 (Fla. 1st DCA 1997) (failure to file a notice of denial in response to a petition for benefits operates as a denial of every allegation therein under section
440.192(8)).
CopyCited 12 times | Published | Supreme Court of Florida | 2005 WL 1403993
...d find relief in section
440.25(4)(h) of the Florida Statutes (2000), see dissenting op. at 104, it fails to consider that this provision addresses procedures for mediation and hearings that are available after a petition for benefits is filed under section
440.192....
...ing of an adjudication by the judge of compensation claims. In addition to this emergency relief, section
440.20, Florida Statutes (2000), sets a deadline for the timely payment of compensation claims and establishes penalties for late payments. And section
440.192, Florida Statutes (2000), provides a procedure for resolving any benefit disputes between a carrier and a claimant and sets strict deadlines for dispute resolution....
...Section
440.20, Florida Statutes (2000), sets a deadline for the timely payment of compensation claims and establishes penalties for late payments. Pursuant to section
440.34(3), Florida Statutes (2000), a claimant can recover attorneys' fees from the carrier in a claim for medical benefits. Further, section
440.192, Florida Statutes (2000), provides a procedure for resolving any benefit disputes between a carrier and a claimant and sets strict deadlines for dispute resolution....
CopyCited 10 times | Published | Florida 1st District Court of Appeal | 2004 WL 726815
...The JCC awarded a total fee of $4,380.00, based upon 25 attorney-hours exerted, multiplied by $168.00 per hour, yielding a sum of $4,200.00, to which he added $180.00 for paralegal services. The JCC refused, however, to include within the fee assessed the lawyer's pre-petition time, concluding that the plain language of section 440.192(7), Florida Statutes (2001), precluded the consideration of same. Because the JCC's interpretation is one of law, our review standard is de novo. Section 440.192(7) states: Notwithstanding the provisions of s....
...Under the circumstances, the provisions of subsection (7) obviously cannot be considered in isolation from other pertinent statutory specifications, namely, those in section
440.34, relating to the factors to be considered in awarding claimant's attorney fees, and those in section
440.192(2), setting out the requisites of a petition for benefits....
...forms the other." See Brown v. State,
848 So.2d 361, 364 (Fla. 4th DCA 2003). In our judgment, subsection (7) is so interconnected with the subsection (2) criteria that the meaning of the former cannot be ascertained without reference to the latter. Section
440.192(2) clearly states that a petition shall be dismissed if it fails to comply with its filing requirements....
...led may be included in a fee awarded to a prevailing claimant. In the case at bar, the petition was not dismissed, nor has any contention been made that it did not meet the statute's *706 prescriptions. We therefore reverse the JCC's construction of section 440.192(7) as barring all attorney time expended before the filing of a petition that complies with the subsection (2) criteria....
...anded with directions that a fee be awarded consistent with the only evidence relating to such issue. The appellant next asserts the JCC erred in denying her, as the prevailing party, reimbursement of costs associated with certified mail mandated by section 440.192(1) for the filing and service of petitions for benefits....
CopyCited 9 times | Published | Florida 1st District Court of Appeal | 1996 WL 668438
...Taylor of McKenzie & Soloway, Pensacola, for Appellee. EN BANC BARFIELD, Chief Judge. The employer/carrier (E/C) appeal a workers' compensation order finding that the claimant's petition for benefits was not barred by the statute of limitations, based on application of section 440.192(8), Florida Statutes (Supp.1994)....
...On August 15, 1995, the carrier received a petition seeking payment of these medical expenses, but did not file its notice of denial, which was based on the statute of limitations, until October 25, 1995. In the challenged order, the judge of compensation claims found that section
440.192(8) is procedural, that the penalty for failure to timely respond to the petition for benefits is "forfeiture of the carrier's right to contest compensability of the petition" and that by asserting the statute of limitations defense, "[t]he E/C deny all benefits claimed and, in effect, denying (sic) compensability of the claim in its entirety." The JCC ruled that in the instant case, the "procedural default" aspects of section
440.192(8) "act to revive a claim previously barred by the statute of limitations under F.S.
440.19(2)(a)." He ordered the E/C to pay the medical bills detailed in the petition for benefits, plus interest, costs and a reasonable attorney's fee. Disposition of this case turns on the construction of the third sentence in section
440.192(8), which provides: "A carrier that does not deny compensability in accordance with s....
...d does not deny compensability within 120 days of providing requested benefits. We agree with the latter position. In doing so, we recede from our decision in Waffle House v. Hutchinson,
673 So.2d 883 (Fla. 1st DCA 1996), to the extent it holds that section
440.192(8) precludes the carrier from contesting compensability when it fails to file a notice of denial within 14 days after receipt of a petition for benefits. In construing the provision at issue, we must first understand the relationship between section
440.192(8) and section
440.20(4)....
...for up to 120 days while it conducts an investigation, provided it pays the requested benefits for which it is undertaking the period of investigation. If, at the end of 120 days, the carrier does not deny compensability, it loses its right to deny. Section 440.192 sets out the mechanism for the employee to recover the benefits which he has not received and to which he believes he is entitled. This action is initiated by serving a petition for benefits, which could occur during the 120 day period for investigation following the notice of injury, if the carrier has denied some benefits. Section 440.192(8) requires the carrier, within 14 days of the petition for benefits, to either pay the requested benefits or file a notice of denial....
...However, the payment of benefits is "without prejudice to its right to deny within 120 days." This "right to deny" refers to that right which may have arisen under the "pay and investigate" provision of
440.20(4) and may not have expired at the time of service of the petition for benefits. Accordingly, the third sentence of
440.192(8) which reads: "A carrier that does not deny compensability in accordance with s....
...The sanctions to be imposed upon a carrier who either files an untimely notice of denial or takes no action are found elsewhere in chapter 440. [1] As to the question of what the legislature intended by the term "compensability" in the context of sections
440.192 and
440.20, we note that section
440.20(1) refers to "compensability or entitlement to benefits," indicating that they are separate concepts, and that the last sentence of section
440.20(4) refers to "the issue of compensability," indicating a distinction from other issues. Having reviewed the uses of the terms "compensability" and "compensable" in the various sections of chapter 440, we conclude that "compensability" in the context of sections
440.192 and
440.20 is limited to a determination of whether the injury for which benefits are claimed arose out of, and occurred within the course and scope of, the claimant's employment. We find that the third sentence of section
440.192(8) does not apply in this case....
CopyCited 9 times | Published | Florida 1st District Court of Appeal | 2001 WL 85182
...ablish material facts relevant to the issue that could not have been discovered through reasonable investigation within the 120 day period. The carrier shall provide copies of the notice to the filing party, employer, and claimant by certified mail. § 440.192(8), Fla....
CopyCited 9 times | Published | Florida 1st District Court of Appeal | 2006 WL 344747
...tion for benefits. Because of the apparent confusion in this area and the potential conflict in the application of this court's decisions, the present case is being decided by this court en banc. As the earlier en banc opinion in Wuelling explained, section
440.192(8), Florida Statutes, must be read in conjunction with section
440.20(4), with regard to the statutory waiver of the right to deny compensability. Wuelling established that the recitation as to such a waiver in section
440.192(8) is merely a reiteration of the waiver provision in section
440.20(4), and that the failure to file a notice of denial in response to a claim under section
440.192(8) does not in itself result in a waiver....
...days of the initial provision of such compensation or benefits. And while an E/C's failure to respond to a petition for benefits might be treated as an implicit denial of the petition for certain other purposes, [1] an E/C's failure to respond to a section
440.192 petition does not interrupt the 120-day period and does not avoid the section
440.20(4) waiver provision. Similarly, a section
440.192(8) notice of denial which challenges entitlement to a claimed benefit but does not dispute compensability (the occurrence of an industrial accident resulting in injury) will not avoid the section
440.20(4) waiver....
...Bynum Transp., Inc. v. Snyder,
765 So.2d 752 (Fla. 1st DCA 2000). The 120-day period under section
440.20(4) thus commenced in the present case upon the E/C's initial provision of benefits. The JCC properly determined that the E/C's failure to respond to the section
440.192 petition requesting medical treatment with surgery did not constitute a denial of compensability as contemplated under section
440.20(4)....
CopyCited 9 times | Published | Florida 3rd District Court of Appeal | 2002 WL 31870185
...Section
440.20, Florida Statutes (2000), sets a deadline for the timely payment of compensation claims and establishes penalties for late payments. Pursuant to section
440.34(3), Florida Statutes (2000), a claimant can recover attorneys' fees from the carrier in a claim for medical benefits. Further, section
440.192, Florida Statutes (2000), provides a procedure for resolving any benefit disputes between a carrier and a claimant and sets strict deadlines for dispute resolution....
CopyCited 8 times | Published | Florida 5th District Court of Appeal | 2003 Fla. App. LEXIS 12560, 2003 WL 21990527
...The trial court found that Annulis' action of petitioning to change the schedule of payments did not evince a conscious intent to elect workers' compensation benefits or to waive her other rights. Acceptance of payments did not constitute a petition for benefits, as defined in section 440.192, Florida Statutes....
CopyCited 7 times | Published | Florida 1st District Court of Appeal | 2007 WL 2733823
...1st DCA 1986) ("We begin our analysis with the premise that workers' compensation is purely a creature of statute. All rights and liabilities under the system are created by chapter 440, Florida Statutes, as is the deputy's power to hear and determine issues in a workers' compensation case."). In this case, the JCC relied on section 440.192(2)(h), Florida Statutes, as support for its position that Judges of Compensation Claims have jurisdiction to order payment of medical bills associated with a claimant's treatment....
...that does not on its face specifically identity or itemize the following: * * * (h) Specific listing of all medical charges alleged unpaid, including the name and address of the medical provider, the amounts due, and the specific dates of treatment. § 440.192(2)(h), Fla. Stat. (2006). We agree with the E/C that section 440.192(2)(h) does not expressly grant the JCC jurisdiction, but rather provides only the basic procedural criteria required to present a facially sufficient petition for benefits....
CopyCited 6 times | Published | Florida 1st District Court of Appeal | 1999 WL 454456
...The judge of compensation claims (JCC) denied claimant's request for attorney's fees and costs during this period, because the carrier had paid benefits within 14 days of notice from Dr. Esposito that temporary benefits were due. This was error. *769 Under section 440.192(8), Florida Statutes (1995), a carrier that fails to respond to a claimant's petition for benefits within 14 days is deemed to have denied the claim....
CopyCited 6 times | Published | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 886, 1998 WL 17045
...Subsequently, Soriano sought attorney's fees under section
440.34(3)(b), Florida Statutes (1995), [1] which the JCC denied. Because Dr. Medero had testified that a neurosurgical consultation was not medically necessary, the JCC concluded that claimant's petition for benefits seeking authorization for such was not ripe under section
440.192(3), Florida Statutes (1995), which provides: A petition for benefits may contain a claim for past benefits and continuing benefits in any benefit category, but is limited to those in default and ripe, due, and owing on the date the petition is filed....
CopyCited 4 times | Published | Florida 2nd District Court of Appeal | 2008 WL 2038790
...*20 Thereafter, Coca-Cola denied further workers' compensation benefits. The medical evidence indicated that Mr. Montiel's condition no longer related to his work injury, but to a degenerative condition. Mr. Montiel did not claim further benefits under the workers' compensation statute. See § 440.192....
...Indeed, Coca-Cola denied further benefits only when medical evidence indicated that Mr. Montiel's condition no longer related to his work injury. Had Mr. Montiel thought himself entitled to further benefits, the statute provided a vehicle to seek relief. See § 440.192....
CopyCited 4 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1922, 2009 WL 559915
...However, we conclude the JCC erred as a matter of law by addressing the new repetitive trauma claim after acknowledging it was not ripe and the issue was not properly before her, and by relying on her findings related to this claim to deny Claimant's requested IME. Accordingly, we reverse and remand as to these issues. Section 440.192(9), Florida Statutes, allows only claims that have been listed in a petition for benefits and mediated to be adjudicated by a JCC....
CopyCited 4 times | Published | Florida 1st District Court of Appeal | 2000 WL 126351
...s a penalty as of that date. In response, Burnham argues that a penalty was assessed in the instant case on the ground that the employer/carrier failed to file a notice of denial within 14 days of the filing of the petition for benefits, pursuant to section 440.192(8), Florida Statutes (Supp....
CopyCited 4 times | Published | Florida 1st District Court of Appeal | 2004 WL 358477
...*543 Nora Leto of Kaylor & Kaylor, Winter Haven, for Appellant. Thomas P. Vecchio of Ross, Vecchio, & Trussell, P.A., Lakeland, for Appellees. KAHN, J. In this case we are asked to decide whether failure of an employer/carrier (E/C) to respond within 134 days to a section 440.192(8) petition for workers' compensation benefits waives the E/C's right to later contest the injured employee's entitlement to particular requested benefits....
...The JCC found that Bussey's lost earnings resulted from the termination for drug use rather than the work-related injury. He further found that the E/C's failure to respond to claimant's petition for benefits did not amount to a waiver of defenses under section
440.192(8) or section
440.20(4), Florida Statutes. On appeal, claimant argues that the E/C's failure to deny the petition for benefits mandates payment of the requested TPD benefits. Resolution of the issue requires a review of this court's previous decisions construing section
440.192(8) and
440.20(4). We focus upon the interpretation of statutory language relating to the "pay and investigate" rule and the effect of an E/C's failure to file a denial of a section
440.192(8) petition for benefits. Section
440.192 outlines the procedure for resolving benefit disputes. By its *544 terms, "any employee who has not received a benefit to which the employee believes she or he is entitled" may file a petition for benefits with the Office of the Judges of Compensation Claims. §
440.192(1), Fla....
...to its right to deny within 120 days from receipt of the petition or file a response to the petition.... A carrier that does not deny compensability in accordance with s.
440.20(4) is deemed to have accepted the employee's injuries as compensable." §
440.192(8), Fla....
...Wuelling, this court, sitting en banc, reversed an order holding that an E/C's failure to deny compensability within 14 days barred assertion of a statute of limitations defense against a claim for benefits.
683 So.2d 1090 (Fla. 1st DCA 1996). We analyzed the interrelationship between section
440.192(8) and section
440.20(4)....
...The carrier shall immediately and in good faith commence investigation of the employee's entitlement to benefits under this chapter and shall admit or deny compensability within 120 days after the initial provision of compensation or benefits as required under subsection (2) or s. 440.192(8).... A carrier that fails to deny compensability within 120 days after the initial provision of benefits or payment of compensation as required under subsection (2) or s. 440.192(8) waives the right to deny compensability. We noted, "the third sentence of 440.192(8) which reads: `A carrier that does not deny compensability in accordance with s....
...440.20(4) is deemed to have accepted the employee's injuries as compensable ...' refers to and is a reiteration of the waiver provision of
440.20(4) as it relates to the opportunity to pay and investigate." Wuelling,
683 So.2d at 1092. We concluded that neither section
440.192 nor section
440.20 imposed a penalty for failing to timely deny a petition for benefits or barred an E/C from defenses to a petition for benefits....
...1st DCA 1997) (holding that failure to respond does not amount to a procedural default). Thus, our precedent establishes that the E/C's decision not to respond within 14 days operates as a denial. Bussey, nevertheless, places a great deal of emphasis upon the language in section
440.192(8) referring to the 120-day "pay and investigate" period outlined in section
440.20(4)....
...Section
440.20(4) applies to a carrier that is "uncertain of its obligation to provide all benefits or compensation" and gives the E/C an option to pay benefits while reserving the right to later deny compensability after investigation. See Wuelling,
683 So.2d at 1092 (finding that the "deemed compensable" language in section
440.192(8) "refers to and is a reiteration of the waiver provision of
440.20(4) as it relates to the opportunity to pay and investigate " (emphasis added))....
...had discharged claimant for drug use. As a result, the 120-day period was never triggered in this case. Under section
440.20(4), the 120-day period is measured from the "initial provision of benefits or payment of compensation as required under ... s.
440.192(8)." Here, claimant filed her petition for benefits pursuant to section
440.192(8) and the E/C made no payments in response to that petition....
...I agree with the majority's conclusion that the payment of claimant's medical expenses for a period of time in excess of 120 days from the initial provision of same does not obligate the employer/carrier (E/C) to pay as well claimant's temporary partial disability (TPD) benefits. The clearly expressed language of sections
440.192(8) and
440.20(4), Florida Statutes (2001), when considered in pari materia, provides that an employer's waiver of its right to contest applies only to the compensability of an alleged injury, not to every claimed benefit requested....
CopyCited 4 times | Published | Florida 1st District Court of Appeal | 1996 WL 69104
...By petition for writ of certiorari, Brian Diestel seeks review of the judge of compensation claims' nonfinal order dismissing without prejudice that portion of Diestel's petition for benefits seeking medical treatment because he failed to exhaust the Employer's managed care grievance procedure as required by section 440.192(3), Florida Statutes (Supp.1994). Diestel supports his petition for writ of certiorari on his contention that section 440.192(3) is unconstitutional. As explained below, we deny the petition without reaching the constitutional issue. Section 440.192(3) provides in part that "[i]f the employer has elected to satisfy its obligation to provide medical treatment, care, and attendance through a managed care arrangement designated under [chapter 440], the employee must exhaust all mana...
...suant to section
440.25(4)(h), Florida Statutes (Supp.1994). The Employer and Carrier filed a motion to dismiss the petition for benefits on the basis that Diestel had not exhausted the grievance procedure prior to filing his petition as mandated by section
440.192(3)....
...Following a hearing on the motion, the judge of compensation claims entered an order dismissing without prejudice the "issues relating to remedial or palliative medical treatment, care or attendance," and instructing Diestel "to satisfy the managed care grievance procedures and follow the guidelines set forth in Section 440.192," should Diestel refile his claim....
CopyCited 4 times | Published | Florida 1st District Court of Appeal | 1996 WL 199691
...Langston of Moore, Hill, Westmoreland, Hook & Bolton, Pensacola, for Appellee. ZEHMER, Chief Judge. Waffle House and O'Steen Adjusting Services (Waffle House) appeal the final order of the judge of compensation claims ruling Lecia Hutchinson's claim compensable by operation of subsection 440.192(8), Florida Statutes (Supp.1994). Waffle House argues that subsection 440.192(8) is a substantive enactment and the judge therefore erred in applying it retroactively to Hutchinson's claim that arose prior to the enactment's January 1, 1994, effective date. We affirm. Subsection 440.192(8) provides as follows: (8) Within 14 days after receipt of a petition for benefits by certified mail, the carrier must either pay the requested benefits without prejudice to its right to deny within 120 days from receipt of the petition or file a notice of denial with the division....
...Waffle House did not file notices of denial with respect to these petitions, *885 however, nor did it at any time commence payment of compensation. At the final hearing held on January 26, 1995, the judge of compensation claims sua sponte raised the issue of the applicability of subsection 440.192(8) and ruled that even though Waffle House timely filed an initial notice of denial in December 1993, its failure to file a second notice after the filing of Hutchinson's petition for benefits subjected it to the "deemed compensable" provision of subsection (8)....
...In so ruling, the judge also rejected Waffle House's argument that the provision is substantive and therefore prospective in effect, holding simply that the provisions of subsection (8) "constitute a significant change in the workers' compensation law but the changes are procedural and not substantive." Subsection 440.192(8) does not impact the substantive rights of the parties or alter their statutory entitlement to benefits....
...denied,
613 So.2d 6 (Fla.1992), cert. denied,
508 U.S. 913,
113 S.Ct. 2350,
124 L.Ed.2d 258 (1993). We have already observed that "a carrier that neither pays nor timely denies compensability `is deemed to have accepted the employee's injuries as compensable'" under subsection
440.192(8)....
...Waffle House was given a fair opportunity to argue the issue and to correct the record by producing a second notice of denial, if one existed. Furthermore, the issue was extensively briefed on appeal and orally argued. Waffle House failed to show that it complied with the provisions of subsection 440.192(8) and therefore was properly deemed by operation of the statute to have accepted the claim as compensable....
...Howard,
657 So.2d 73 (Fla. 1st DCA 1995), postulates "a carrier that neither pays nor timely denies compensability `is deemed to have accepted the employee's injuries as compensable.'" Now faced with the task of directly construing the inartfully drawn section
440.192(8), Florida Statutes (Supp.1994), the court repeats this observation....
...Thus, we are strictly construing the statutory dictate to pay or deny within fourteen (14) days "after receipt of a petition for benefits...." NOTES [1] In City of Crestview v. Howard , we reversed the order finding the claimant's attorney entitled to a fee under subsections
440.192(8) and
440.34(3)(b), Florida Statutes (Supp.1994), holding that the December 1993 legislative repeal of the 21-day rule previously contained in subsection
440.34(3)(b) is substantive and, therefore, could not be retroactively applied to the claimant's claim....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1995 WL 410682
...Barry Silber of Myrick, Silber & Davis, P.A., Pensacola, for appellee. KAHN, Judge. The employer and carrier (E/C) seek review of an order entered by the Judge of Compensation Claims (JCC) finding that claimant's attorney is entitled to a fee under section 440.192(8), Florida Statutes (Supp....
...E/C argued that it mailed the checks on July 21, 1994, within 21 days of receiving the July 1, 1994 letter indicating MMI. Accordingly, no attorney's fees could be assessed under the 1989 statute. Claimant argued, however, that the 1989 version of section
440.34(3)(b) did not control. Rather, the JCC should look to section
440.192(8), Florida Statutes (Supp....
...s right to deny within 120 days from receipt of the petition or file a notice of denial with the Division. Claimant argued that because E/C had not acted in 14 days, liability for attorney's fees attached. The JCC held that the 14-day requirement of section 440.192(8), Florida Statutes (Supp....
...where "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." Section
440.34(3)(b), Florida Statutes (Supp. 1994). The legislature also enacted section
440.192(8), set out above, requiring payment of benefits within 14 days, or the filing of a notice of denial with the Division (of Workers' Compensation)....
...s (Supp. 1994), such carrier "is deemed to have accepted the employee's injuries as compensable, unless it can establish material facts relevant to the issue of compensability that could not have been discovered in the reasonable investigation... ." § 440.192(8), Fla....
...21, 1994, fell within the 21-day statutory period. Clay Hyder Truck Lines v. Atherton,
400 So.2d 1295 (Fla. 1st DCA 1981). Because the 1989 statute is substantive and was not violated by the E/C, no attorney's fees are due. The JCC erred by finding section
440.192(8), Florida Statutes (Supp....
...contains no provision for attorney's fees in the event E/C fails to pay benefits within the 14-day period. Rather, a carrier that neither pays nor timely denies compensability "is deemed to have accepted the employee's injuries as compensable... ." Section
440.192(8) does not include the additional "stick" of attorney's fees comparable to those provided by section
440.34(3)(b), Florida Statutes (1989)....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1996 Fla. App. LEXIS 547, 1996 WL 34057
...loyee Assistance and Ombudsman Office" (EAO) within the Division of Workers' Compensation, together with related statutes. We find no provision conferring jurisdiction upon the JCC to order an IME prior to the filing of a petition for benefits under section 440.192....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1996 WL 27880
...onference, referral to the Employee Assistance and Ombudsman Office (EAOO) would not effect the self-executing features of the system. Indeed, such referral would cause, rather than preclude, undue expense, costly litigation, and delay. Furthermore, section 440.192(2), Florida Statutes (Supp....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 2013 WL 427146, 2013 Fla. App. LEXIS 1684
...Because we conclude reversal is warranted on one of those arguments, we decline to address the other. Longley v. Miami-Dade County School Board,
82 So.3d 1098 (Fla. 1st DCA 2012), is dispositive. The facts of Longley are analogous to the facts here. In both cases, the claimants had filed a prior PFB, compliant with section
440.192, Florida Statutes, asserting both a claim for medical benefits and claims for attorney’s fees and costs....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1998 WL 874836
...eeking permanent and total disability benefits; in response, E/C filed a notice of denial. Claimant subsequently filed a Petition for Benefits, and E/C accepted Claimant as permanently and totally disabled within the 14-day statutory time frame. See § 440.192(8), Fla....
...a petition for benefits. Fla. R. Workers' Comp. P. 4.020(u)(w)(a petition for benefits, not a RFA, invokes the JCC's jurisdiction). E/C accepted Claimant as permanently and totally disabled within 14 days of receiving the petition for benefits. See § 440.192(8), Fla....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1998 WL 432630
...Additionally, the judge awarded the claimant benefits for "palliative care" in the form of an evaluation and treatment by a neurologist and a pain management specialist. These benefits were not claimed in the petition or addressed in the pretrial stipulation. Nor were they discussed during the hearing on the merits. Section 440.192(2), Florida Statutes (Supp.1994), states in material part that a petition for workers' compensation benefits shall itemize or identify "[t]he type or nature of treatment care or attendance sought and the justification for such treatme...
...sputed issue that a judge of compensation claims will be called to rule upon." Likewise, if payment is denied, the carrier must list "all benefits requested but not paid and explain its justification for nonpayment" in a formal notice of denial. See § 440.192(8) Fla....
CopyCited 3 times | Published | Florida 1st District Court of Appeal | 1995 WL 488146
....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. 1994), and section
440.192, Florida Statutes (Supp....
...Although the record is unclear, it appears the docketing judge treated claimant's claim as a petition. On June 10, 1994, the docketing judge entered an order dismissing claimant's petition, without prejudice, based upon failure to meet the specificity requirements of section 440.192(2), Florida Statutes (Supp. 1994), and for failure to include a certificate indicating that a good faith effort had been made to resolve the dispute as required by section 440.192(4), Florida Statutes (Supp....
CopyCited 3 times | Published | Florida 2nd District Court of Appeal | 36 I.E.R. Cas. (BNA) 814, 2013 WL 4253239, 2013 Fla. App. LEXIS 12860
...its to an injured worker and to facilitate the worker’s return to gainful reemployment at a reasonable cost to the employer.” §
440.015 (emphasis added). And chapter 440 sets forth a special “[pjrocedure for resolving benefit disputes.” See §
440.192. An employee seeking “any benefit that is ripe, due, and owing” initiates this procedure by filing “a petition for benefits” with the Office of the Judges of Compensation Claims. §
440.192(1)....
CopyCited 3 times | Published | Florida 1st District Court of Appeal
...filed
subsequent to a motion to dismiss under section
440.25(4)(i). The
motivating factor(s) to file a PFB is not pertinent to the analysis of
timeliness under section
440.19. The date of filing of a PFB, which
meets the specificity requirements of section
440.192, Florida
Statutes, is the determining factor....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2015 Fla. App. LEXIS 14510, 2015 WL 5714621
...gh reasonable investigation within the 120-day period.” §
440.20(4), Fla. Stat. (2011). See, e.g., McIntosh v. CVS Pharmacy,
135 So.3d 1157, 1159 (Fla. 1st DCA 2014); Bynum Transp., Inc. v. Snyder,
765 So.2d 752, 764 (Fla. 1st DCA 2000); see also §
440.192(8), Fla....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 18217, 2006 WL 3066797
...dentify or itemize the following: . . . . (g) All travel costs to which the employee believes he is entitled, including dates of travel and purpose of travel, means of transportation, and mileage. Ch. 93-415, § 25, at 137, Laws of Fla. (codified at §
440.192(2)(g), Fla. Stat. (Supp.1994)). In the decade since Bair was decided, the Legislature has left the pertinent language in sections
440.13(2)(a) and
440.192(2)(g) intact, other amendments to the Act notwithstanding....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2006 WL 1210063
...[1] Because claimant's attorney forwarded the grievances, a simple telephone call would have been sufficient to clarify the proper form and procedure for filing grievances and/or submitting a request for a change in physician. Instead, the carrier's staff did nothing. Although an aggrieved employee is *612 precluded by section 440.192(3), Florida Statutes (2003), from filing a petition for benefits under chapter 440 until the employee has exhausted the grievance procedure of the managed-care plan, the JCC's determination of estoppel is, in my opinion, an effective finding that claimant had exhausted the grievance procedures....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2006 WL 503232
...This tolling period does not apply to the issues of compensability, date of maximum medical improvement, or permanent impairment." [3] Florida Administrative Code Rule 60Q-6.105(1) provides that "[a] party commences a new case by filing a petition for benefits pursuant to Section 440.192, Florida Statutes, when there is not an existing case pertaining to the same claimant and date of accident." Subsection (2) provides in part, "any subsequent petition for benefits or claim relating to that claimant and date of acciden...
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2001 WL 788354
...Barry Keyfetz of Keyfetz, Asnis & Srebnick, P.A., Miami, for Appellant. Robert A. Ginsburg, Miami Dade County Attorney, Miami, for Appellees. PER CURIAM. In this appeal, appellant-claimant contends that appellee-employer's [hereafter E/C] failure to file a notice of denial within 14 days, as required by section 440.192(8), Florida Statutes (1997), constituted a "general denial," and that the E/C could not thereafter file a notice of a denial specifically asserting the statute of limitations as a defense, since the notice of denial was not the initial response to the petition....
...1st DCA 1997), we find no authority to support claimant's "general denial" theory. In fact, North River Insurance Co. v. Wuelling,
683 So.2d 1090 (Fla. 1st DCA 1996) (en banc), indicates a contrary conclusion. There this court explained that under section
440.192, Florida Statutes, an E/C must, within 14 days, either pay the requested benefits or file a notice of denial....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 2002 WL 1401897
...ay period allowed in section
440.20(4), Florida Statutes (2000). [1] We affirm as to this issue because *1015 we do not interpret section
440.20(4) to encompass applications for surgery, unless included within a petition for benefits, as provided by section
440.192, Florida Statutes (2000)....
...g the 120-day period for an investigation as to the compensability of the exacerbation, and not in regard to the compensability of a major surgical procedure related to the pre-existing condition. As applied to the facts before us, the provisions of section 440.192(8) are controlling....
..., in his pre-trial stipulation, and thereafter in his amended petition for benefits dated December 6, 2000, the E/C's denial of the request as of October 30, 2000, clearly complied with the 120-day provisions of section
440.20(4), as incorporated in section
440.192(8)....
CopyCited 2 times | Published | Florida 1st District Court of Appeal | 1996 WL 465097
...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 1 times | Published | Florida 1st District Court of Appeal | 2006 WL 3017240
...We concluded that the provisions of section
440.20(4) applied only to the compensability of the exacerbation of the condition, and not to a major surgical procedure which involved a condition that had pre-existed the work-related accident. We decided that under such circumstances, the provisions of section
440.192(8), Florida Statutes (2000), relating to the carrier's obligations in responding to a petition for benefits, governed, and because the carrier had timely denied the specifically requested surgery just after it had been claimed, it could not be deemed to have waived its right to contest....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2012 WL 4490866, 2012 Fla. App. LEXIS 16495
...along with this court’s prior application of this statute — compels the award of attorney’s fees where a claimant’s attorney is required to attend a deposition set by an employer or carrier when no petition for benefits has been filed under section
440.192, we conclude that the JCC erred in denying fees under section
440.30 for Shannon’s counsel’s attendance at the second deposition....
...Significantly, when this court was first confronted with an opportunity to interpret section
440.30 after the 1994 revisions to chapter 440, we held that the term “claim,” as used in section
440.30, is “properly construed as the filing of a petition for benefits under *1233 section
440.192.” See Wright v. Indus. Auto.,
662 So.2d 1321, 1322-23 (Fla. 1st DCA 1995). Further, although the term “claim” is not explicitly defined within chapter 440, the contextual use of the term in section
440.192(3), Florida Statutes (Supp.1994), illustrates that a “claim” is the (sub)part of a petition for benefits requesting the payment of benefits that are alleged to be due, ripe, and owing. See §
440.192(3), Fla. Stat. (Supp.1994) (“A petition for benefits may contain a claim for past benefits and continuing benefits in any category, but is limited to those in default and ripe, due, and owing on the date the petition is filed.”); see also
440.192(3), Fla....
...nces where a claimant’s attorney is required to attend a deposition set or compelled by an employer or carrier, when no petition for benefits — or other document that if timely filed would toll the statute of limitations — has been filed under section
440.192. We conclude that Shannon’s counsel’s motion for attorney’s fees was not a “claim” as the term is used in section
440.30; the motion was not filed in accordance with the requirements of section
440.192 nor was it contained within a petition for benefits, and it would not toll the limitation period regarding Shannon’s entitlement to benefits under the applicable statute of limitations, section
440.19(2), Florida Statute (2010)....
...the Judge is not divested of jurisdiction to award the fee by the withdrawal of the claim.”). Given our bright-line interpretation of the word “claim” as used in section
440.30 — whereby either a “claim” for benefits has been filed under section
440.192, or it has not (removing any reasonable debate regarding whether a fee is due under section
440.30) — we see no reason to recede in any way from our holding in Snack ....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2005 WL 2649201
...and other costs permitted by law." See also §
440.34(3), Fla. Stat. (2000) (providing for taxation against the employer of "reasonable costs of such proceedings," not including attorney's fees, where a claimant prevails in any proceeding before a JCC). Section
440.192(1), Florida Statutes (2000), calls for the service "by certified mail" of a petition for benefits by any employee who has not received a benefit to which he claims entitlement....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2004 WL 2481366
...rvenor Division of Workers' Compensation, in support of appellees. WOLF, C.J. Claimant, Ricardo Cagnoli, challenges a final order striking his petition for workers' compensation benefits for failing to include a social security number as required by section 440.192, Florida Statutes....
...anuary 1, 1975, if such disclosure was required under statute or regulation adopted prior to such date to verify the identity of an individual. 5 U.S.C. § 552a note. The exception provided in section 7(a)(2)(B) of the Privacy Act would not apply to section 440.192, Florida Statutes, requiring injured workers to list their social security number, because section 440.192 was not enacted until 1980....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2008 WL 4949269
...claims (JCC) erred on three grounds. First, the E/C argue the JCC erred in holding Claimant's claim for psychiatric treatment was not barred by res judicata. The remaining two grounds challenge the JCC's determination that sections
440.25(4)(d) and
440.192(9), Florida Statutes, are substantive rather than procedural. The challenge to section
440.192(9), Florida Statutes, was not ruled on by the JCC and is not necessary to be discussed in light of our holding....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 7242, 2011 WL 1879197
...volves the JCC's application of undisputed facts to the law because the JCC awarded benefits that he expressly found were not ripe, due, and owing. Thus, review is de novo. See Gilbreth v. Genesis Eldercare,
821 So.2d 1226, 1228 (Fla. 1st DCA 2002). Section
440.192, Florida Statutes (2009), provides in pertinent part: (1) Any employee may, for any benefit that is ripe, due, and owing, file by certified mail, or by electronic means approved by the Deputy Chief Judge, with the Office of the Judges...
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 1999 WL 41098
...ge loss or death benefits arising out of the same accident. No Petition or claim was pending for any form of indemnity benefits and no evidence was submitted indicating that the claimant was otherwise entitled to benefits of this nature. 6. However, § 440.192(8) provides that a carrier, within fourteen days after receipt of a Petition for Benefits by certified mail, must either pay the requested benefits or file a Notice of Denial....
...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....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2000 WL 1867569
...procedures established by the Agency for Health Care Administration. §§
440.134(1)(d) and
440.134(15)(a), Fla. Stat. (1997). The aggrieved employee may not file a petition for benefits under Chapter 440 until the grievance procedure is exhausted. §
440.192(3)....
CopyCited 1 times | Published | Florida 1st District Court of Appeal | 2012 WL 3763680, 2012 Fla. App. LEXIS 14643
...n attorney in the successful prosecution of the petition[.]” The E/C is deemed to have denied a PFB by failing to accept or deny it within 14 days of receipt. See McDonald’s Rest # 7160 v. Montes,
736 So.2d 768, 769 (Fla. 1st DCA 1999); see also §
440.192(8), Fla....
CopyAgo (Fla. Att'y Gen. 1996).
Published | Florida Attorney General Reports
...Garganese: On behalf of the City of Cocoa, you ask substantially the following questions: 1. May the city council and its attorney hold a closed-door meeting pursuant to section
286.011 (8), Florida Statutes, when discussing a workers' compensation claim where a petition for benefits has been filed pursuant to section
440.192 , Florida Statutes? 2....
...eeting pursuant to section
286.011 (8), Florida Statutes, to discuss settlement negotiations or strategy related to litigation expenditures for pending litigation involving a workers' compensation claim where a petition for benefits as prescribed in section
440.192 , Florida Statutes, has been filed against the city....
...40 is accomplished by filing of a "claim"). See also, s.
440.25 , Fla. Stat. (1995), setting forth the procedures for mediation and hearings involving workers' compensation claims and generally prescribing the judicial nature of the proceedings; and s.
440.192 , Fla....
CopyPublished | Florida 1st District Court of Appeal
...As typically is the case in a compensation appeal, we are called
upon to apply statutory text to a set of procedural facts. We have
here two statutes to consider: section
440.19, Florida Statutes,
containing both the statute of limitation and the relevant tolling
provision; and section
440.192, Florida Statutes, governing PFBs.
A
A PFB must be “filed within 2 years after the date on which
the employee knew or should have known that the injury or death
arose out of work performed in...
...PFBs untimely. Rice,
924
So. 2d at 884–85. If, however, there is a period of time when no
PFB is pending (rendering the entire “action” effectively
any other disputed issue that a judge of compensation claims will
be called to rule upon.” §
440.192(2), Fla....
...ter Murphy filed his
second PFB.
7
request for a compensability determination, his claims for medical
benefits and for compensation, but not his demand for attorney’s
fees. 4 To address this question, we turn to section 440.192.
B
A PFB is the statutory vehicle by which an employee may
claim “past benefits and continuing benefits in any benefit
category.” § 440.192(3), Fla....
CopyPublished | Supreme Court of Florida | 27 Fla. L. Weekly Supp. 795, 2002 Fla. LEXIS 1884, 2002 WL 31084673
...sation claims preside. (tr) “Parties” include the employee, claimant, employer, carrier, health care provider, and division. (us) “Petition for benefits” means a pleading meeting, specifically but not limited to, the requirements of sections 440.192(l)-(4), Florida Statutes, that invokes the jurisdiction of the judge....
...docketing judge. Claims shall be limited to the following subjects: (1) Modification of Prior Compensation Order. Application for modification of an order under section
440.28, Florida Statutes, shall be substantially in the form of a petition under section
440.192(2), Florida Statutes, and shall include a request for a hearing....
...y Trust Fund referred to in subdivision (a)(2), with any pending petition for the purpose 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....
...Counsel for each party and any unrepresented party shall be served under rule 4.030. Upon receipt of the petition, the division deputy chief judge shall forward it — immediately refer the petition for benefits to the presiding docketing -judge judge of compensation claims pursuant to section 440.192(2X1), Florida Statutes. (2) Form. A petition shall meet the specificity requirements of sections 440.192(2) and (3), Florida Statutes, shall include a request for a hearing, and shall be in substantial 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....
...on includes a claim for medical care under section
440.13(2)(a) and (b), Florida Statutes, the certificate must indicate that the grievance procedures required by section
440.134(15), Florida Statutes, were exhausted before filing the petition under section
440.192(3), Florida Statutes....
...(b) Review. After receiving the petition feom-fee- division, the docketing judge shall promptly r-evievMdie Upon receipt, the Office of the Judges of Compensation Claims shall review each petition and attachments to determine if the requirements of sections
440.192 and
440.32(3), Florida Statutes, have been met and the matters in dispute have been acted on- by the EAO. (c) Dismissal of Petitions Without Prejudice. If the issues raised in the petition do not meet the requirements of sections
440.192(2)-(4), Florida Statutes, or fee-petitioner did- not exhaust the EAO administrative — remedies, the docketing judge Office of the Judges of Compensation Claims shall, or the presiding judge of compensation claims may, upon their own motion...
...hich to file an amended petition. The dismissal of any petition or portion of such petition under this section does not require a hearing. (d) Dismissal of Petitions With Prejudice. If the petition does not meet the requirements — of- sections — 440.192(2)-(4), Florida Statute»;- and these rules, and U the judge intends to dismiss the petition with prejudice, the judge must conduct a hearing on the matter may-do-so only after first giving the parties areasonable-oppor-tu-nity -to-be heard 5 days’ written notice....
...all statutory requirements, the judge shall- so indicate and immediately forward -fee petition to *799 the appropriate district. — Judge -of-Com-pensatioa- ClaimsT, Committee Notes 1996 Adoption. The docketing judge’s ruling on specificity under section
440.192, Florida Statutes, or on the issue of whether the allegations contained in the petition were well grounded as required under section
440.32(3), Florida Statutes, is not a final determination on either issue. Subject to the time limitations of section
440.192(5), Florida Statutes, a motion to dismiss for lack of specificity or for failure to exhaust EAO remedies may be filed with the presiding judge....
...ng is shown. (2) Notwithstanding the — entry—of a docketing-order-under rule 4 .(^transmission of a petition for benefits from the deputy chief judge to the presiding judge, any motion to dismiss for lack of specificity must be filed pursuant to section 440.192(5), Florida Statutes, and comply with the requirements of subdivisions (a) and (b) of this rule....
...The First District Court of Appeal has stated that the requirements of subdivision (f)(3) may be waived by agreement of counsel. E-Z Serve Convenience Stores, Inc. v. Paul,
720 So.2d 301 (Fla. 1st DCA 1998). RULE 4.105. EXPEDITED HEARINGS (a) Generally. If a petition filed in accordance with section
440.192, Florida Statutes, involves a claim or petition of $5,000 or less, excluding attorney fees and costs, it shall be considered for resolution under section
440.25(4)(j), Florida Statutes....
...The application for expedited hearing shall be substantially the same as form 4.9091. A copy of this application shall be filed with the judge and served on all interested parties. (b) Other Claims. On written agreement of all parties and application of any party, any claim or petition filed in accordance with section 440.192, Florida Statutes, may be resolved as provided for in subdivision (a)....
...judge. PART II. MEDIATION PROCEEDINGS PROCEDURES RULE 4.310. MANDATORY MEDIATION (a) Initial Mandatory Mediation. Except as provided in this rule, an initial mandatory mediation conference is required to be held concerning every petition filed under section
440.192, Florida Statutes, that survives dismissal after review by a docketing judge under section
440.45(3), Florida Statutes, or a motion to dismiss filed under section
440.192(5), Florida Statutes. (b) Notice and Date of Mandatory Mediation Conference. (1) Within 7 days after a petition is filed under section
440.192, Florida Statutes, but in no event more than 7 days from the presiding judge’s receipt of the petition that survives a dismissal, the judge, or the mediator if the judge so designates, shall notify all interested parties of the date, time, and location of the initial mandatory mediation conference. The notice may be served personally or by mail upon the interested parties. (2) The mediation conference shall be held within 21 days after a petition is filed under section
440.192, Florida Statutes, but if continued or rescheduled, it shall be held and completed no later than 10 days before any scheduled pretrial hearing....
...DOCKETING ORDER TO BE COMPLETED BY-DOCKETING JUDGE ONLY- ( ) Petition is consistent with all statutory requirements and is referred to the appropriate judge of compensation claims for further review and consideration. ( ) Petition fails to specifically identify or itemize the information required under EJgr section 440.192(2)(a), (b), (c), (d), (e), (f), (g), (h), (i), (j), Florida Statutes, or_....
...before filing the petition and the petition is dismissed without prejudice. ( ) Petition failed to include a certification by the petitioner or the petitioner’s attorney indicating a good faith effort to resolve the dispute as required under Fygb-section 440.192(4), Florida Statutes, and the petition is dismissed without prejudice with leave to amend within 30 days from the date of this order....
...atutes, in a good-faith effort to resolve the disagreements between the parties. The request for assistance was dated -,-Despite these efforts, the matters were not resolved. Managed care grievance procedures, if required, have been exhausted under Ssection 440.192(3), Florida Statutes....
...__ Other issue(s) not referenced above:- The employee/petitioner, or the employee’s/petitioner’s attorney, hereby certify that a good-faith effort was made to resolve the dispute and was unable to resolve the dispute with the employer/carrier/servicing agent. In accordance with Ssection 440.192(1), Florida Statutes, a copy of this petition for benefits has been served by certified mail on the injured worker’s employer and the employer’s carrier, and the original on the Division of -Workers’ Compensation-Office of the J...
CopyPublished | Florida 1st District Court of Appeal | 1997 Fla. App. LEXIS 10621, 1997 WL 574616
...which the judge of compensation claims awarded Emanuel Starling temporary total disability benefits, past and future med *311 ical care, attorney’s fees, and taxable costs, because the employer/servicing agent did not comply with the provisions of section 440.192(8), Florida Statutes (1995), in that a notice of denial of compensability was not timely filed....
CopyPublished | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 16135, 2009 WL 3491034
...(JCC) erred by issuing a summary final order finding that his amended petition for benefits was barred by the statute of limitations; 2) and the deputy chief judge erred by dismissing his original petition for benefits for reasons not enumerated in section 440.192(2), Florida Statutes (2006)....
...Eckerd Drugs,
987 So.2d 1262, 1263 (Fla. 1st DCA 2008). We disagree with the JCC’s reliance on the deputy chief judge’s dismissal of Claimant’s original petition for benefits when finding that the Claimant did not comply with the statute of limitations. Claimant correctly argues section
440.192(2)(a)-(j), Florida Statutes, does not require the signing of a fraud 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....
...60Q-6.1G3(l)(d), 6.105(4). Claimant does not contest that his original petition did not comply with either rule 60Q-6.103(l)(d) or rule 60Q-6.105(4). Claimant argues, however, that petitions for benefits may only be dismissed for lack of specificity under section
440.192, Florida Statutes; thus, the deputy chief judge erred by dismissing his first petition. We agree. Section
440.192(1), Florida Statutes (2006), provides that a petition for benefits must meet “the requirements of this section and the definition of specificity in section
440.02” before being filed with the OJCC. Accord Fla. Admin. Code R. 60Q-6.105(1) (providing that a claimant commences a new case by filing a petition pursuant to section
440.192). Section
440.192(1) is silent as to whether rules 60Q-6.103(l)(d) and 60Q-6.105(4) must be complied with when filing a petition for benefits. In fact, Florida Administrative Code Rule 60Q-6.107(1), entitled “Amendment and Dismissal of Petitions for Benefits,” indicates petitions will be dismissed only for failure to comply with section
440.192(2)-(4), Florida Statutes. Section
440.192(2), Florida Statutes (2006), provides: the [OJCC] shall review each petition and shall dismiss each petition or any portion of such a petition that does not on its face specifically identify or itemize the following: (a) Name, address, telephone number, and social security number of the employee....
CopyPublished | Florida 1st District Court of Appeal | 2012 WL 4512762, 2012 Fla. App. LEXIS 16704
...(2011) (providing application for modification shall be handled “in accordance with the procedure prescribed in respect of claims in s.
440.25”); see also
440.25, Fla. Stat. (2011) (providing JCC’s duty to order mediation, hold hearing(s), and adjudicate claims, is predicated on filing of petition for benefits under section
440.192); Fla....
CopyPublished | Florida 1st District Court of Appeal
...In the present case, the employer or its insurance carrier accepted the injury
as compensable, without reservation. This election was binding. The statutory “pay
and investigate rule” requires:
Upon commencement of payment as required under
subsection (2) or s.
440.192(8), the carrier shall provide
written notice to the employee that it has elected to pay the
claim pending further investigation, and that it will advise
the employee of claim acceptance or denial within 120
days.
§
440.20(4), Fla....
...ng
on the pay and investigate provision at or before “commencement of payment.” Id.
“A carrier that does not deny compensability in accordance with s.
440.20(4) is
deemed to have accepted the employee’s injuries as compensable . . . .”
§
440.192(8), Fla....
CopyPublished | Florida 1st District Court of Appeal | 2014 WL 5099434
...or review an order of the
Judge of Compensation Claims (JCC) denying Appellant, Claimant’s former
attorney (Panzer), entitlement to an attorney’s fee based on the failure of the relevant
petition for benefits (PFB) to meet the requirements of section 440.192, Florida
Statutes (2006). Because the JCC erred by failing to give full effect to all of the
provisions of section 440.192, we reverse and remand for further proceedings.
Because the facts are not in dispute, our review is de novo....
...[i]n any case in which the employer or carrier files a response to
petition denying benefits with the Office of the Judges of Compensation Claims and
the injured person has employed an attorney in the successful prosecution of the
petition,” §
440.34(3)(b), Fla. Stat., while section
440.192, Florida Statutes (2006
and 2008), provided in part:
(1) Any employee may, for any benefit that is ripe, due,
and owing, file ....
...sions of s.
440.34, a [JCC]
may not award attorney’s fees payable by the carrier for
services expended or costs incurred prior to the filing of a
petition that does not meet the requirements of this section.
§
440.192, Fla....
...attorney in the
successful prosecution of the petition.” §
440.34(3)(b), Fla. Stat. (2006 and 2008).
Whenever a “physician’s request, authorization, or recommendation for
treatment, care, or attendance must accompany the petition,” §
440.192(2)(i), Fla.
Stat., the requirement that the claimed benefits be “ripe, due, and owing” is
inextricably intertwined with the subsection
440.192(2) specificity requirement....
...at 712.
In the present case, too, an attachment would both have established ripeness
and satisfied the specificity requirement, and the E/C’s failure to object to the
absence should be deemed a waiver of both legal defenses. Our conclusion in this
regard is buttressed by the Legislature’s adding to section
440.192 the language now
∗
We note that the relevant statute in Straw was the 1991 version of the
Workers’ Compensation Law and the statutory citations were to section
440.19, not
440.192. A comparison of the two subsections reveals, however, that the relevant
provisions are essentially identical. Section
440.192 first appeared in chapter 440 in
1993, moving the provisions relating to the “Procedure for Resolving Benefit
Disputes” from section
440.19 to section
440.192. See Ch. 93-415, § 25, at 137,
Laws of Fla.
5
found in subsection (5), when section
440.192 was first enacted in 1993—“Any
grounds for dismissal for lack of specificity under this section which are not asserted
within 30 days after receipt of the [PFB] are thereby waived.” §
440.192(5), Fla.
Stat.
Plainly “ripeness” and “specificity” will not be the same in every case. Here,
however, where section
440.192(2)(i) required that a copy of the request or
recommendation be attached to the PFB in order to meet the specificity requirement,
that same attachment would have established the ripeness of the PFB. Thus, because
the E/C failed to move to dismiss the PFB in a timely manner, the JCC erred in
failing to give effect to the waiver provision of section
440.192(5).
Accordingly, we REVERSE and REMAND this matter for proceedings
consistent with this opinion.
LEWIS, C.J., BENTON, and RAY, JJ., CONCUR.
6
CopyPublished | Supreme Court of Florida | 25 Fla. L. Weekly Supp. 866, 2000 Fla. LEXIS 2275, 2000 WL 1508551
...docketing judge. Claims shall be limited to the following subjects: (1) Modification of Prior Compensation Order. Application for modification of an order under section
440.28, Florida Statutes, shall be substantially in the form of a petition under section
440.192(2), Florida Statutes, and shall include a request for a hearing....
...y Trust Fund referred to in subdivision (a)(2), with any pending petition for the purpose 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....
...The judge shall enter an order on such motions without a hearing, unless good cause for the hearing is shown. (2) Notwithstanding the entry of a docketing order under rule 4.029, any motion to dismiss for lack of specificity must be filed pursuant to section 440.192(5), Florida Statutes, and comply with the requirements of subdivisions (a) and (b) of this rule....
...of evidence, proffers, exhibits, and post-hearing evidence now are contained in one rule and are applicable to all proceedings before judges of compensation claims. RULE 4.105. EXPEDITED HEARINGS (a) Generally. If a petition filed in accordance with section
440.192, Florida Statutes, involves a claim or petition of $5,000 or less, excluding attorney fees and costs, it aaayshaH be considered for resolution under section
440.25(4)(j), Florida Statutes....
...,9091. A copy of this application shall be filed with the .judge and served on all interested parties. (b) Application for Expedited Hearings, — Qn 'Written application of one party or-by-stipulation, any claim-or petition filed in accordance-with section
440.192, Florida Statutes, may be resolved under section
440.25(4), — Florida Statutes..The application — for--expedited -hearing shall be sub-stantia-H-y-the-same as form 4.9091. A copy of this application shall be filed with the judge and — served on all interested pat-tieSrOther Claims. On written agreement of all parties and application of any party, any claim or petition filed in accordance with section
440.192, Florida Statutes, may be resolved as provided for in subdivision (a)....
...ent of attorneys’ fees and costs. RULE 4.310. MANDATORY MEDIATION (a) Initial Mandatory Mediation. Except as hereinafter -provided in this rule, an initial mandatory mediation conference is required to be held concerning every petition filed under section
440.192, Florida Statutes, that survives dismissal after review by a docketing judge under section
440.45(3), Florida Statutes, or a motion to dismiss filed under section
440.192(5), Florida Statutes. (b) Notice and Date of Mandatory Mediation Conference. (1) Within 7 days after a petition is filed under section
440.192, Florida Statutes, but in no event more than 7 days from the presiding judge’s receipt of the petition that survives a dismissal, the judge, or the mediator if the judge so designates, shall notify all interested parties of the date, time, and location of the initial mandatory mediation conference. The notice may be served personally or by mail upon the interested parties. (2) The mediation conference shall be held within 21 days after a petition is filed under section
440.192, Florida Statutes, but if continued or rescheduled-as-hereinafter — provided, it shall be held and completed no later than 10 days before any scheduled pretrial hearing....
...T; .-f-pr-int-er type name of petitioner) or )))))))))))))))(print or-type name of-petitioner’s attorney) hereby-eer-tify-that-a good-faith effort was made-te resolve-the dispute and--that -(he)-(-she)-avas unable to resolve-the dispute with the employer/carrier/servicin-g — a-genh—In accordance with-section-440.192(l), Florida Statutes, a copy -of-this petition for benefits-has been served by certified — mail on the injured worker-s-employer and the employer’s carrier-,-and-the original and-one-copy on-the-Division of Workers’- Compensation In-Tallahassee on....
...(print or type name-el-petitioner)-or ....-'--(print- or-type -name of petitioner’s attorney) hereby certify that a-geed-faifh-effort-wa-s-made-to-resolve-the dispute-and-that-(-he)-(-she)-was-unable-to- *896 resolve the dispute with the employer/carrier/servicing agent. In accordance with section 440.192(1-) — Florida Statutes, a copy of.-this- ■petition for.benefits has ■ been served by-certified mail — on the injured worker’s employer and tile-employer’s carrier, and-the-or-iginal and-o-ne copy on the Division of Workers’ Compensation in Tallahassee on .....
...( ) Petition is consistent with all statutory requirements and is referred to the appropriate judge of compensation claims for further review and consideration. ( ) Petition fails to specifically identify or itemize the information required under F.S. 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....
...440.191(2) before filing the petition and the petition is dismissed without prejudice. ( ) Petition failed to include a certification by the petitioner or the petitioner’s attorney indicating a good faith effort to resolve the dispute as required under F.S. 440.192(4) and the petition is dismissed without prejudice with leave to amend within 80 days from the date of this order....
...utes, in a good-faith effort to resolve the disagreements between the parties. The request for assistance was dated ._, __Despite these efforts, the matters were not resolved. Managed care grievance procedures, if required, have been exhausted under Section 440.192(3), Florida Statutes....
..._Other issue(s) not referenced above: The employee/petitioner, or the employee’s/petitioner’s attorney, hereby certify that a good-faith effort was made to resolve the dispute and was unable to resolve the dispute with the employer/carrier/servicing agent. In accordance with Section 440.192(1), Florida Statutes, a copy of this petition for benefits has been served by certified mail on the injured worker’s employer and the employer’s carrier, and the original on the Division of Workers’ Compensation in Tallahassee o...
CopyPublished | Supreme Court of Florida | 2005 WL 2898733
...The First District Court of Appeal succinctly stated the relevant facts and reached a decision as follows: Claimant, Ricardo Cagnoli, challenges a final order striking his petition for workers' compensation benefits for failing to include a social security number as required by section 440.192, Florida Statutes....
...anuary 1, 1975, if such disclosure was required under statute or regulation adopted prior to such date to verify the identity of an individual. 5 U.S.C. § 552a note. The exception provided in section 7(a)(2)(B) of the Privacy Act would not apply to section 440.192, Florida Statutes, requiring injured workers to list their social security number, because section 440.192 was not enacted until 1980....
CopyPublished | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 11581, 1995 WL 642666
...s (1994 Supp.). On October 24, 1994, the appel-lee/employer took the claimant’s deposition. Counsel for the claimant prepared for and attended the claimant’s deposition. On November 28,1994, the claimant filed a Petition for Benefits pursuant to section 440.192, Florida Statutes (1994 Supp.)....
...s required to invoke the remedies under that chapter is accomplished by the filing of a “claim.” The pre-1994 amendment “Claim for Benefits” under section
440.19, Florida Statutes and the post-1994 amendment “Petition for Benefits” under section
440.192, Florida Statutes, both constitute “claims” as they are required to be filed with the Division, contain such information as will put the Division, the employer and the carrier on notice, and also operate to commence the litigation process....
...In serving this purpose, a Request for Assistance cannot be construed to constitute a claim under section
440.30, Florida Statutes (1993). 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 | District Court of Appeal of Florida | 1997 Fla. App. LEXIS 13287, 1997 WL 730286
...The third amended petition stated alternative theories of compensability and described the injuries Ms. Poutre allegedly sustained at work in considerable detail, even attaching an examining physician’s report. The third amended petition complied fully with the requirements of section 440.192(2), Florida Statutes (1995)....
CopyPublished | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 5734, 1995 WL 321849
PER CURIAM. Burdick appeals dismissal of his petition for workers’ compensation benefits. Finding no merit in the Appellant’s constitutional challenges, we affirm. The Appellant filed a petition for benefits pursuant to section 440.192(1), Florida Statutes (Supp.1994). Sitting as Docketing Judge, Judge of Compensation Claims John J. Lazzara dismissed without prejudice the petition for failure to comply with section 440.192(2)(b), (d), and (i), Florida Statutes (Supp.1994)....
...rmation was needed. The motion included a request for change of venue to Daytona Beach. Judge Lazzara relinquished jurisdiction to Judge of Compensation Claims Rand Hoch. Following a hearing, Judge Hoch found that the petition complied with sections 440.192(2)(b) and (d) but failed to comply with section 440.192(2)(i). The latter section requires specific information on the face of the petition identifying “[t]he type or nature of treatment care or attendance sought and the justification for such treatment.” Section 440.192(2)(i), Florida Statutes (Supp....
...Although, as conceded in his brief, the Appellant could have amended the petition to attempt to comply with the requirements of the statute, he informed the JCC that he would not amend the petition and requested dismissal with prejudice. The Appellant now challenges sections
440.192(2)(i) and
440.45(3) as impediments to his access to courts 1 and violations of due process....
CopyPublished | Florida 1st District Court of Appeal
...The E/C also denied compensability in reliance on the 120-day rule, but did
not provide written notice to Claimant of its intention to rely on that rule, as the rule
requires:
Upon commencement of payment as required under subsection (2) or
s.
440.192(8), the carrier shall provide written notice to the employee
that it has elected to pay the claim pending further investigation, and
that it will advise the employee of claim acceptance or denial within
120 days.
§
440.20(4), Fla....
...The pay-and-investigate period begins at “the initial
provision of compensation or benefits,” which the statute defines as “the first
installment of compensation or benefits to be paid by the carrier under subsection
(2) or pursuant to a petition for benefits under s. 440.192(8).” Id. Yet an
7
employer/carrier nonetheless must “elect” to rely on the rule, as both the rule itself
and case law indicate. See id.; see also § 440.192(8), Fla....
CopyPublished | Florida 1st District Court of Appeal | 2012 WL 1912414, 2012 Fla. App. LEXIS 8559
...In July 2010, she filed the first of three PFBs, all of which included claims for attorney’s fees. In response to this first PFB (July PFB), the E/C provided some benefits but then moved to dismiss the PFB, arguing Claimant had not made a good faith effort to resolve the dispute before filing the PFB, as is required by section 440.192(4), Florida Statutes (2008)....
...n of this ruling, and also moved for attorney’s fees based on obtaining the benefits requested *178 in the July and November PFBs. The E/C responded to the fee motion, asserting no fees were due on the July PFB because that PFB did not comply with section 440.192(4), and no fees were due on the November PFB because the E/C had provided the requested benefits within thirty days....
...by the January PFB, and awarded fees, but at a lower hourly rate than requested, and excluding time spent defending against the motion to dismiss the July PFB. On appeal, the E/C makes two arguments: that fees based on the July PFB are precluded by section 440.192(7), Florida Statutes (2008), which provides a JCC “may not award attorney’s fees payable by the carrier for services expended or costs incurred prior to the filing of a petition that does not meet the requirements of this section...
...rovides, “attorney’s fees shall not attach under this subsection until 30 days after the date the carrier or employer, if self-insured, receives the petition.” On cross-appeal, Claimant presents three arguments: that the July PFB complied with section 440.192(4) because it included on its face the required certification that she or her attorney “has made a good faith effort to resolve the dispute and ......
...g the E/C’s motion to dismiss the July PFB; and that no evidence supports the JCC’s finding as to the appropriate rate of hourly pay. We conclude Claimant’s first two arguments have merit. The JCC erred in dismissing the July PFB, both because section 440.192 does not independently give the JCC authority to “go behind” a counsel’s representations of good faith effort to resolve the dispute in a PFB, and because, although Florida Administrative Code Rule 60Q-6.125 arguably would permit the E/C to seek sanctions for failure to comply with section 440.192, the E/C did not meet the procedural requirements of that rule....
CopyPublished | Florida 1st District Court of Appeal | 2012 WL 1929914, 2012 Fla. App. LEXIS 8561
...1st DCA 2010), that the “initial response” “denied the claim in its entirety” evinces the need for an “initial response” to explicitly state a position either denying or conceding the particular claims therein. This reading of Certain fits with the requirement in section 440.192(8), Florida Statutes, that an E/C in a “response to benefits” must “list all benefits requested but not paid and explain its justification for nonpayment,” although that requirement does not appear to be intended as a definition....
...estoppel, whereas the burden rests on the E/C to prove it asserted the statute of limitations defense in its “initial response.” The JCC also found the E/C’s failure to respond to the petition for benefits within fourteen days, as required by section 440.192(8), waived the statute of limitations defense....
CopyPublished | Florida 1st District Court of Appeal | 1996 Fla. App. LEXIS 5458, 1996 WL 277020
...he stroke suffered by claimant was not com-pensable. * Spence filed a petition for benefits in July 1994 and an amended petition on August 18, 1994. Appellees did not file a notice of denial to either of these petitions. Spence now argues that under section
440.192(8), Florida Statutes (Supp.1994), compensability of her accident is deemed admitted because of the employer’s failure to file a notice of denial within fourteen (14) days after receipt of a petition for benefits. The JCC ruled that although section
440.192(8) is procedural, appellant was not prejudiced by the employer’s failure to file a notice of denial to the 1994 petitions because appellant knew early on in the case that the employer controverted the entire claim. In Waffle House v. Hutchinson,
673 So.2d 883 (Fla. 1st DCA 1996), we considered and rejected an argument that section
440.192(8) is a substantive enactment. We relied upon City of Crestview v. Howard,
657 So.2d 73 (Fla. 1st DCA 1995), and noted that “a earner that neither pays nor timely denies compensation ‘is deemed to have accepted the employee’s injuries as compensable’ ” under subsection
440.192(8)....
...r as against the 1994 *975 petitions for benefits. (Kahn, J., Concurring).
673 So.2d at 885 , Under the authority of Waffle House v. Hutchinson, we REVERSE and REMAND with directions that Brenda Spence’s claim be deemed compensable by operation of section
440.192(8), Florida Statutes (Supp.1994)....
CopyPublished | District Court of Appeal of Florida | 1996 Fla. App. LEXIS 5182, 1996 WL 262202
...Inc./FESA (the E/C), appeal an order of the judge of compensation claims (JCC), striking the E/C’s defense under Martin Co. v. Carpenter 1 and directing the E/C to pay benefits to the claimant, John H. Sheppard. As the JCC properly concluded that section 440.192(8), Florida Statutes (Supp.1994), is procedural and therefore applicable to claimant’s 1993 accident, we affirm the order....
...Once Sheppard reached maximum medical improvement on January 3, 1994, he filed a petition seeking permanent total disability benefits. In February 1995, nearly a year later, the E/C raised the Martin v. Carpenter defense. The JCC struck the defense as untimely, pursuant to section 440.192(8), which requires the E/C to either commence payment of requested benefits or file a notice of denial within 14 days after receipt of the petition for benefits. 2 *850 Section 440.192 took effect on January 1, 1994....
...d upon the occurrence of each period of wage loss, every WL period that occurs after the amended statute’s effective date is subject to its provisions. Id. at 1355-56. In applying the Litvin reasoning to the case at bar, the JCC observed, “Under section
440.192(8), Fla.Stat., the occurrence that invokes the need for a response within 14 days is the filing of a petition for benefits.” In our judgment, the instant case is controlled by this court’s recent decision in Waffle House v. Hutchinson,
673 So.2d 883 (Fla. 1st DCA 1996), wherein we applied the Lit-vin reasoning to the newly enacted section
440.192(8) and concluded that the statute was procedural and therefore should be retroactively applied to an industrial accident which occurred before the statute’s effective date. In so concluding, we observed that section
440.192(8) “merely alters the process by which the judge of compensation claims makes a determination of the parties’ rights or otherwise affects the parties’ burden of proof.” Id., at 885 . In other words, the new provision does not change the rights or defenses of either party; it simply prescribes the manner in which they may be asserted. AFFIRMED. ERVIN, BARFIELD and DAVIS, JJ., concur. .
132 So.2d 400 (Fla.1961). . Section
440.192(8) provides: Within 14 days after receipt of a petition for benefits by certified mail, the carrier must either pay the requested benefits without prejudice to its right to deny within 120 days from receipt of the petition or file a notice of denial with the division....
CopyPublished | Supreme Court of Florida | 21 Fla. L. Weekly Supp. 223, 1996 Fla. LEXIS 827, 1996 WL 268079
...ted with other claims not contained in a petition. Proposed rule 4.028(a)(5)(D) is amended to clarify that in cases in which an injured employee is required to exhaust all managed care grievance procedures before filing a petition for benefits under section
440.192(3), Florida Statutes (1995), any claims for benefits under section
440.13(2)(a) and (b), Florida Statutes (1995), brought after the grievance procedures required by section
440.134(15) are exhausted are to be determined by a judge of...
...(s) “Mediator” means the person who conducts a mediation conference. (t) “Parties” include the employee, claimant, employer, carrier, health care provider, and division. (u) “Petition for benefits” means a pleading meeting, specifically but not limited to, the requirements of sections 440.192(1)-(4), Florida Statutes, that invokes the jurisdiction of the judge....
...ocketing .judge. Claims shall be limited to the following subjects: (1) Modification of Prior Compensation Order. Application for modification of an order under section
440.28, Florida Statutes, shall be substantially in the form of a petition under section
440.192(2), Florida Statutes, *636 and shall include a reo[uest for a hearing....
...y Trust Fund referred to in subdivision (a)(2), with any pending petition for the purpose 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....
...n the employer, carrier, and the division in Tallahassee. Counsel for each party and any unrepresented party shall be served under rule 4.030. Upon receipt of the petition, the division shall forward it immediately to the docketing judge pursuant to section 440.192(2), Florida Statutes. (2) Form. A petition shall meet the specificity requirements of sections 440.192(2) and (3), Florida Statutes, shall include a request for a hearing, and shall be in substantial 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....
...ion includes a claim for medical care under section
440.13(2)(a) and (b), Florida Statutes, the certificate must indicate that the grievance procedures required by section
440.134(15), Florida Statutes, were exhausted before Sling the petition under section
440.192(3), Florida Statutes....
...ttachments filed with or received by the division to the docketing judge- lb) Review. After receiving the petition from the division, the docketing judge shall promptly review the petition and attachments to determine if the requirements of sections 440.192 and 440,32(3), Florida Statutes, have been met and the matters in dispute have been acted on by the EAO. (c) Dismissal of Petitions Without Prejudice. If the issues raised in the petition do not meet the requirements of sections 440.192(2)-(4), Florida Statutes, or the petitioner did not exhaust the EAO administrative remedies, the docketing judge shall summarily dismiss the petition without prejudice with leave to amend within 30 days. (d) Dismissal of Petitions With Prejudice. If the petition does not meet the requirements of sections 440.192(2)-(4), Florida Statutes, and these rules, and the judge intends to dismiss the petition with prejudice, the judge may do so only after first giving the parties a reasonable opportunity to be heard....
...If the docketing judge determines the petition meets all statutory requirements, the .judge shall so indicate and immediately forward the petition to the appropriate district. Committee Notes 1995 Adoption. The docketing judge’s ruling on specificity under section
440.192, Florida Statutes, or on the issue of whether the allegations contained in the petition were well grounded as required under section
440.32(3), Florida Statutes, is not a final determination on either issue. Subject to the time limitations of section
440.192(5), Florida Statutes, a motion to dismiss for lack of specificity or for failure to exhaust EAO remedies may be filed with the presiding judge....
...The judge shall enter an order on such motions without a hearing, unless good cause for the hearing is shown. (2) Notwithstanding the entry of a docketing order under rule 4.029, any motion to dismiss for lack of specificity must be filed pursuant to section 440.192(5), Florida Statutes, and comply with the requirements of subdivisions (a) and (b) of this rule....
...— This replaces rule 10, 1977 W.C.R.P., but is -substantially-t-he-same.- 1984 Amendment. — Provides that - a -party-lias the right to a pretrial conference.upon request. — Deletes---requirement-of—notice-of pretrial by-order- RULE 4.105. EXPEDITED HEARINGS (a) Generally. If a petition filed in accordance with section
440.192, Florida Statutes, involves a claim or petition of $5,000 or less, excluding attorney fees and costs, it may be considered for resolution under section
440.25(4)(j), Florida Statutes. (b) Application for Expedited Hearings. On written application of one party or by stipulation, any claim or petition filed in accordance with section
440.192, Florida Statutes, may be resolved under section
440.25(4), Florida Statutes....
...and subdivision (e) is from former rule 4.340(e). RULE 4.310. MANDATORY MEDIATION (a) Initial Mandatory Mediation. Except as hereinafter provided, an initial mandatory mediation conference is required to be held concerning every petition filed under section
440.192, Florida Statutes, that survives dismissal after review by a docketing judge under section
440.45(3), .Florida Statutes, or a motion to dismiss filed under section
440.192(5), Florida Statutes. (b) Notice and Date of Mandatory Mediation Conference. (1) Within 7 days after a petition is filed under section
440.192, Florida Statutes, but in no event more than 7 days from the presiding judge’s receipt of the petition that survives a dismissal, the judge, or the mediator if the judge so designates, shall notify all interested parties of the date, time, and location of the initial mandatory mediation conference. The notice may be served personally or by mail upon the interested parties. (2) The mediation conference shall be held within 21 days after a petition is filed under section
440.192, Florida Statutes, but if continued or rescheduled as hereinafter provided, it shall be held and completed no later than 10 days before any scheduled pretrial hearing....
...conference shall be entered-by-a-presiding-judge-upon the application.- (1) Notwithstanding attendance at a mandatory mediation conference, any interested party may request a mediation conference at any time following the filing of a petition under section 440.192, Florida Statutes, or any other claim subject to adjudication by a judge....
..._L The employer/carrier/servicing agent has denied the compensability of the claim.. _2. 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)....
...I, or (print or type name of petitioner) _hereby certify (print or type name of petitioner’s attorney) that a good-faith effort was made to resolve the dispute and that (he) (she) was unable to resolve the dispute with the employer/carrier/servicing agent. In accordance with section 440.192(1), Florida Statutes, a copy of this petition for benefits has been served by certified mail on the injured worker’s employer and the employer’s carrier, and the original and one copy on the Division of Workers’ Compensation in Tallahassee on_, 19 ....
..._L The employer/carrier/servicing agent has denied the compensability of the claim. _2. 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)....
...R_or (print or type name of petitioner) _hereby certify (print or type name of petitioner’s attorney) that a good-faith effort was made to resolve the dispute and that (he) (she) was unable to resolve the dispute with the employer/carrier/servicing agent. In accordance with section 440.192(1), Florida Statutes, a copy of this petition for benefits has been served by certified mail on the injured worker’s employer and the employer’s carrier, and the original and one copy on the Division of Workers’ Compensation in Tallahassee on_, 19 ....
CopyPublished | District Court of Appeal of Florida | 1998 Fla. App. LEXIS 5223, 1998 WL 233392
...to an attorney’s fee payable by the appellees, Orlando Shader Realty and Associated Industries Insurance Company, Inc. (jointly, the employer/earrier). The claimant argues that the JCC erred (i) in dismissing her petition for benefits pursuant to section 440.192(2), Florida Statutes (Supp. 1994); 1 and (ii) in denying her petition for attorney’s fees when the employer/earrier had first denied and then accepted claimant as permanently and totally disabled all within the 14-day period provided by section 440.192(8), Florida Statutes (Supp.1994). For the reasons that follow, we affirm. We conclude that the JCC did not err in dismissing the claimant’s petition for benefits because the petition clearly failed to comply with the filing requirements of section 440.192(2), Florida Statutes (Supp.1994). Both this statute and rule 4.029(c), Florida Rules of Workers’ Compensation Procedure, require the JCC, sitting as docketing judge, to promptly review the petition for benefits to determine whether the requirements of sections 440.192 have been satisfied and, when the petition fails to meet such requirements, to summarily dismiss the petition without prejudice and with leave to amend. See rules 4.029(b) and (c), Fla. R. Work. Comp. P. The employer/earrier is not required to file a motion to dismiss to trigger the JCC’s review of the petition, but may file a motion to dismiss pursuant to section 440.192(5)....
...mployer/carrier to understand the benefits sought, citing Orin Cummings Constr. Co. v. Beckman,
395 So.2d 629 (Fla. 1st DCA 1981) and Turner v. Keller Kitchen Cabinets Southern, Inc.,
247 So.2d 35 (Fla.1971). This argument is without merit. Sections
440.192(2) and (4) set forth basic information which the petition must identify or contain oh its face....
...e of the benefits sought by the claimant. The intent of the legislature is clear — in the event the requirements are not met, dismiss *158 al without prejudice is mandated. The cases on which claimant relies interpreted statutory provisions unlike section 440.192 before us and are not applicable to the workers’ compensation statutory design enacted in 1994....
...that the employer/earrier argued that the claim failed to comply with the specificity requirements of section
440.19(l)(e)l, Florida Statutes (1991). Further, the statute controlling Straw contained no prompt review requirement as is now mandated by section
440.192(2) and rule 4.029(b) and (c). In the instant ease, the merits of the petition for benefits were not litigated and the employer/earrier accepted the claimant as permanently and totally disabled within the 14-day time period provided by section
440.192(8), Florida Statutes (Supp. 1994). In addition, even though the employer/earrier initially denied the petition, no fee is payable here because section
440.192(7), Florida Statutes (Supp.1994), prohibits an award of attorney’s fees payable by the employer/earrier for services expended or costs incurred prior to the filing of a petition that does not meet the requirements of section
440.192....
CopyPublished | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 7558, 1999 WL 371355
...vered by the Hartford policy. Despite these allegations, Hartford continues to pay benefits to Robin Cleary as if she were an insured under the policy and thus it has been unnecessary for Robin Cleary to file a petition for benefits *568 pursuant to section 440.192, Florida Statutes (1997)....
...Miami Airport Hilton /Miami Hilton Corp.,
668 So.2d 227 (Fla. 1st DCA 1996), requires a reversal. Hartford contends that Karell stands for the proposition that the JCC’s jurisdiction is confined to proceedings after a petition for benefits has been filed pursuant to section
440.192, Florida Statutes (1997), and therefore, under the facts of this case, there is no concurrent jurisdiction with the JCC....
...t to an independent medical examination (IME) pursuant to section
440.191, Florida Statutes (Supp.1994). The court in Karell found no provision conferring jurisdiction upon the JCC to order an IME prior to the filing of a petition for benefits under section
440.192. See Karell,
668 So.2d at 228 . Nowhere does the court confine the JCC’s jurisdiction to section
440.192....
CopyPublished | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 10042, 2011 WL 2535337
...ential claims for PTD benefits without being barred by res judicata, nothing in Temples or Myers precludes a JCC from awarding PTD benefits on a continuing basis where there is an evidentiary foundation for disability, permanent in duration. Indeed, section 440.192(3), Florida Statutes (2007), contemplates such an award: “A petition for benefits may contain a claim for past benefits and continuing benefits in any benefits category, but is limited to those in default and ripe, due, and owing on...
CopyPublished | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 10850, 2006 WL 1735115
...h supplemental benefits. Claimant, Anna Ortega, cross-appeals the denial of her claim for penalties, contending the judge of compensation claims (JCC) erred in finding the E/C timely filed its notice of denial within the statutory period provided in section 440.192(8), Florida Statutes....
...ing a determination of PTD was correct. As to his denial of the claim for penalties, it clearly appears from the record that the employer did not file its notice of denial within 14 days after its receipt of the petition for benefits, as required by section 440.192(8), and the denial is reversed....
CopyPublished | Florida 1st District Court of Appeal | 2001 Fla. App. LEXIS 7575, 2001 WL 584343
...er of the Judge of Compensation Claims (JCC) awarding attorney’s fees. We hold, for purposes of this case, that Appellee’s filing of'his Motion for Emergency Conference, pursuant to section
440.25(4)(h), satisfied any pleading requirements under section
440.192....
CopyPublished | Florida 1st District Court of Appeal | 1996 WL 378320
...The office then has thirty (30) days to assist the employee in resolving the dispute. §
440.191(2)(d), Fla. Stat. (Supp.1994). If the dispute is not resolved, the employee may file a petition which must on its face specifically identify or itemize the matters set out in section
440.192(2), Fla....
...If a petition does not meet the specificity requirements of the statute, it must be dismissed by the Office of the Judges of Compensation Claims. The carrier is allowed fourteen (14) days after receipt of a petition for benefits in which to assume its defensive position or pay the requested benefits. § 440.192(8), Fla....
CopyPublished | Florida 1st District Court of Appeal
which, according to the JCC, he could not yet do. §
440.192(1), Fla. Stat. (specifying when a claimant may
CopyPublished | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 11176, 2011 WL 2753773
...The determination that the JCC lacked jurisdiction was based on “the absence of a pending petition for benefits filed by Polston.” Id. at 767 . The rules of procedure define a petition for benefits as “a pleading invoking the jurisdiction of the OJCC and subject to the requirements of Sections 440.192(1) through (4), Florida Statutes.” Fla. Admin. Code R. 60Q-6.102(1). Section 440.192 establishes the requirements for the filing of a petition for benefits, specifically restricting the filing to “any employee.” A JCC has no powers beyond those conferred by the statute....
CopyPublished | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 9517, 1999 WL 496150
...The informal dispute resolution process initiated by the “Request for Assistance” did not lead to the E/SA voluntarily paying claimant the PTD and PTD supplement benefits he sought. Claimant’s attorney, therefore, filed a “Petition for Benefits,” in accordance with section 440.192, Florida Statutes (Supp.1994), on December 16, 1996, seeking the PTD and PTD supplemental benefits previously sought in the “Request for Assistance.” On December 23, 1996, the E/SA voluntarily accepted claimant as permanently and totally disabled....
CopyPublished | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 244, 1999 WL 12964
...Volusia County Fire Services and County Risk Management, respectively the employer and carrier, seek reversal of a order of the Judge of Compensation Claims (JCC) awarding attorney’s fees to the claimant, Alan Eaby, appellee, on the authority of sections
440.34(3)(b) and
440.192(8), Florida Statutes (1995)....
...etermined that claimant had reached MMI as of September 3, 1996. The employer/carrier accepted claimant as permanently and totally disabled on March 14,1997. Claimant moved for an award of attorney’s fees pursuant to sections
440.34(3)(b) and *417
440.192(8)....
...Following a hearing, the JCC entered an order awarding fees finding that the employer/carrier denied a requested benefit (that is, PTD benefits), as indicated by the carrier’s letter of November 13, 1996, and, having denied a claim, the employer/carrier was therefore obligated under section 440.192(8) to file a notice of denial....
...The JCC found further that the carrier did not attempt to investigate the claim, but, rather, built a “wall of willful ignorance.” Given the unique facts of the instant case, the award of fees was contrary to statutory law. No authority has been cited to support fees here, and we do not read section 440.192(8), Florida Statutes (1995), as requiring the employer/carrier to file a notice of denial when it pays one of two alternative claims for indemnity benefits made in a single petition....
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....
...uest for Assistance, we nonetheless find that the actions undertaken by Sanchez in filing both the Claim for Benefits and 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)....
CopyPublished | Florida 1st District Court of Appeal | 2015 Fla. App. LEXIS 19393, 2015 WL 9438007
...e claimant was not given a specific physician’s name). In the order under review, the judge of compensation claims ruled that Ms. Jennings was not a prevailing party because the employer or its carrier provided benefits “timely” under sections
440.192(8) and
440.34(3), Florida Statutes (2014). Section
440.192(8) provides that, within fourteen days of the receipt of a petition for benefits, the employer (or carrier) must either pay the benefits requested or file a response to the petition....
...for benefits was equivalent to a notice of denial, entitling claimant to attorney’s fees under section
440.34(3)(b)). But entitlement to costs is distinct from entitlement to attorney’s fees, Whether benefits are timely furnished, either under subsection
440.192(8) or under subsection
440.34(3), is irrelevant on the separate question of whether a party prevails, entitling the party to costs....
...On the record before us, Ms. Jennings was the prevailing party. The claims adjuster received her petition for benefits on September 11, 2014, before the orthopedic evaluation the petition requested was furnished .on September 12, 2014. As required by statute, see section 440.192(4), Florida, Statutes (2014), her petition for benefits included certification (that was not challenged by the employer- or its carrier) that she (or her attorney) had made a good faith effort to resolve the dispute over benefits with the carrier, but was unable to do so....
CopyPublished | Florida 1st District Court of Appeal
...to file a petition seeking a benefit stemming from a compensable
injury, the two years running from “the date on which [he or she]
knew or should have known that the injury or death arose out of
work performed in the course and scope of employment.”
§
440.19(1), Fla. Stat.; cf. §
440.192(1), (3), Fla....
...l
compensable injury or death arising out of work performed in the
course and the scope of employment,” and requiring that “the
accidental compensable injury must be the major contributing
cause of any resulting injuries” (emphases supplied)); § 440.192(8),
Fla....
CopyPublished | Florida 1st District Court of Appeal
...Employer/Carrier (“E/C”) was not estopped from asserting the
statute of limitations (“SOL”) defense. Claimant concedes that the
limitations period had run but challenges the estoppel ruling,
arguing that it thwarts the presuit resolution process set forth in
section 440.192(4), Florida Statutes....
...rocess. The
presuit resolution process is a statutory requirement that a PFB
include a certification that claimant or his counsel “has made a
good faith effort to resolve the dispute and . . . was unable to
resolve the dispute with the carrier.” § 440.192(4), Fla....
CopyPublished | Florida 1st District Court of Appeal
...es, Florida Rule of
Appellate Procedure 9.180(c)(1), and the Rules Regulating the
Florida Bar. See Matrix Emp. Leasing, Inc. v. Pool,
46 So. 3d 1147
(Fla. 1st DCA 2010). Although only a pending petition for benefits
confers jurisdiction on a JCC per section
440.192(9), Florida
Statutes (2020), that jurisdiction persists....
CopyPublished | District Court of Appeal of Florida | 1996 Fla. App. LEXIS 8386, 1996 WL 454789
...Mays filed his claim. This language, which the 1955 legislature first placed in the statute, has since been deleted and the provisions of section
440.19, relating to the information required in a claim, were substantially revised by the creation of section
440.192, which took effect on January 1, 1994....
CopyPublished | Florida 1st District Court of Appeal | 2008 WL 1774157
...ivalent of a notice of denial," that justified an award of attorney's fees. See also Zabik v. Palm Beach County Sch. Dist.,
901 So.2d 887 (Fla. 1st DCA 2005). CTL and its servicing agent neither denied the claim nor elected to "pay and investigate": Section
440.192(8), Florida Statutes (1999), provides that "[w]ithin 14 days after receipt of a petition for benefits by certified mail, the carrier must either pay the requested benefits without prejudice to its right to deny within 120 days from re...
CopyPublished | Florida 1st District Court of Appeal | 2015 WL 1578254
...improper service, and attended the JCC-ordered mediation on that PFB.
The JCC also found that the claim was accepted timely. Again, the record
does not support this; the E/SA did not file a response to either PFB within fourteen
days of its receipt. See § 440.192(8), Fla....
CopyPublished | Florida 1st District Court of Appeal | 2003 Fla. App. LEXIS 5244, 2003 WL 1872490
...cedures prior to filing his petition. The judge of compensation claims (JCC) found otherwise and dismissed the petition for lack of jurisdiction, because appellant had not exhausted the grievance procedures before filing the petition, as required by section 440.192(3), Florida Statutes (1997). We find no basis to distinguish between petitions seeking remedial, as opposed to palliative, care for the purpose of complying with section 440.192(3)....
CopyPublished | Florida 1st District Court of Appeal | 2003 Fla. App. LEXIS 5243, 2003 WL 1872408
...Regarding the third issue, the JCC determined that he had no jurisdiction to decide claimant’s request for authorization of a medical-care provider, because claimant failed to present evidence that he had exhausted the managed-care grievance procedures before he filed his petition for benefits on May 21, 2001. See § 440.192(3), Fla....
CopyPublished | Florida 5th District Court of Appeal | 1995 Fla. App. LEXIS 3603, 1995 WL 155565
...locutory order as the original judge). ALLEN and DAVIS, JJ., and SMITH, Senior Judge, concur. . Appellee asserts that the order should be affirmed under the alternate ground that the e/c failed to move for dismissal within thirty days as required by section 440.192(5), Florida Statutes (Supp.1994)....