In Florida there is a 104-week time limit on temporary disability benefits. The problems with the way this limit was applied were first addressed in a 1998 case in which the claimant was almost at the end of the 104-week period, but he hadn’t reached maximum medical improvement.
The appellate court in that case held that an employee who had run out of temporary benefits had to show total disability and that total disability would exist after the date of maximum medical improvement in order to get permanent disability benefits. This was based on the idea that a claimant could not receive permanent total disability benefits if it had not been determined that he had reached his maximum medical improvement.
Certain claimants who were totally disabled when the temporary disability benefits were concluded could not prove that total disability would exist after maximum medical improvement. They would not be eligible for any benefits though they were unable to work.
In a recent case, an appellate court reconsidered its panel opinion and pulled away from the rule it had articulated in the 1998 case. The case arose when a firefighter felt a sharp pain in his back as he moved heavy furniture during a fire. When he got back to the fire station he had extreme pain and loss of feeling in his left leg. The city agreed to pay benefits.
The firefighter got temporary total disability benefits for 104 weeks. After that he was totally disabled still, and filed a petition for permanent and total disability benefits. The workers’ compensation judge denied the petition even though an independent medical examiner testified that the firefighter would be totally disabled at the time of maximum medical improvement.
Instead, the judge accepted the treating physician’s testimony that it was too soon to give an opinion on the nature of permanent work restrictions. The judge stated that the orthopedic surgeon who had actually performed a surgery on the claimant was in the best position to decide whether he had reached maximum medical improvement.
The judge also stated it was too speculative to decide whether the claimant would remain totally disabled after the date of medical maximum improvement.
The firefighter appealed. He argued that the 104-week limit resulted in an unconstitutional denial of access to the courts for workers who were totally disabled, but still improving when their temporary benefits expired.
The constitutionality issue prompted the court to hear the case initially. When the panel denied him his benefits, he requested that the court in its entirety hear the case.
The appellate court reasoned that it had interpreted the workers’ compensation law incorrectly in prior cases. There was nothing in the text of the law that suggested that the legislature intended to leave a gap during which a totally disabled worker could not receive benefits. In fact, such a gap would go against the purpose of workers’ compensation law.
The appellate court ruled that the plain language of the statute revealed that an injured worker who was still totally disabled at the end of his eligibility for temporary benefits was at maximum medical improvement by law. It did not matter whether the worker might someday be recovered enough to get back to work.
The claimant didn’t have to show maximum medical improvement but could immediately request permanent total disability benefits. The judge could award benefits if the worker proved total disability. The decision was reversed.
This court’s reconsideration of this issue is a major victory for seriously injured workers. If you are seriously injured on the job or elsewhere, contact the experienced personal injury and workers’ compensation attorneys at Friedman, Rodman & Frank toll-free for a free consultation at (877) 448-8585.
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