Florida Appeals Court Overturns Denial of Legal Fees in Workers’ Compensation Case

1156714_perscription_drug_case sxcu username foxumonIn Cuenca v. Nova Southeastern University, a Florida dental assistant was injured when she suffered a serious allergic reaction at work in 2013. According to the worker’s petition for benefits (“PFB”), the woman’s injury resulted after she came into contact with an adhesive spray during the course of her employment. As a result, the employee sought reimbursement for her resulting medical care and certain prescription medications.

After the worker filed her PFB, her employer changed servicing insurers. The employer also notified the woman that the previous insurance servicer had no further responsibility for her claim and the new insurer would handle her PFB going forward. In an order filed about two months after the dental assistant sought workers’ compensation benefits, a Judge of Compensation Claims (“JCC”) approved the employer’s change in servicing insurers.

About one month later, the worker filed another PFB seeking authorization for additional medical care and payment for past prescription and other health expenses. In her claim, the dental assistant listed both insurance companies as her employer’s carrier. Next, the parties engaged in mediation where they agreed upon a lump sum settlement. As part of the settlement, the employer agreed to pay the worker’s legal fees and costs totaling $1,775. In addition, the worker agreed to pay her remaining attorney fees and costs out of her settlement proceeds.

The JCC approved the parties’ settlement but denied the employer’s agreement to pay the worker’s attorneys’ fees. In his order, the JCC stated the employee was not entitled to additional legal fees because she listed the wrong servicing agent in her initial PFB and her employer timely acknowledged liability for her workers’ compensation claims. Despite this, the JCC stated the parties could “seek reconsideration or modification” of his denial by way of telephonic hearing.

Next, the woman unsuccessfully sought reconsideration of the JCC’s order. According to the woman, the insurance servicer failed to raise a notice defense. The woman also argued that her employer did not timely respond to or accept liability for her initial PFB. Instead, the servicer only agreed to process her benefits claim. Despite this, the JCC found that the woman’s motion did not establish a basis for a telephonic hearing. After that, the worker filed an appeal with Florida’s First District Court of Appeal.

On appeal, the court stated the JCC’s findings of fact would be upheld so long as it was based on the facts included in the record. Next, the court examined the relevant provisions of Florida law. According to the appeals court, Section 440.34(3)(a) of the Florida Statutes allows an employer or carrier to pay certain legal fees on behalf of an injured worker if the claimant successfully asserts a PFB that only seeks medical benefits, and the employee may not file a claim for indemnity benefits. In addition, the Florida court stated Section 440.34(7) allows a JCC to approve an alternative legal fee payment of up to $1,500 once per workplace accident.

After stating the worker’s PFB only requested medical benefits, the First District held that the JCC incorrectly presumed the servicing insurer failed to respond as a result of the worker’s error. The court said a lawyer acting on behalf of the servicer entered an appearance less than 14 days after the first PFB was filed and participated in the litigation process. Additionally, the court ruled the evidence did not support the JCC’s finding that the woman’s claim was accepted in a timely fashion.

Since the record did not support the JCC’s reasons for rejecting the parties’ legal fee stipulation, Florida’s First District Court of Appeal reversed the JCC’s order and remanded the case.

If you were hurt in a South Florida workplace accident, an experienced personal injury lawyer may be able to help you recover financial compensation for your injuries. To schedule a free consultation with a knowledgeable Miami workers’ compensation attorney today, give the veteran personal injury advocates at Friedman, Rodman & Frank, P.A. a call at (305) 448-8585 or contact us online.

Additional Resources:

Cuenca v. Nova Southeastern University, Fla: Dist. Court of Appeals, 1st Dist., 2015

More Blog Posts:

Florida Court Refuses to Dismiss First-Party Bad-Faith Claim Filed Against Auto Insurer, April 8, 2015, South Florida Personal Injury Lawyers Blog

Florida Appeals Court Holds Policy History is Irrelevant Where PIP Insurance was Cancelled for Nonpayment, April 2, 2015, South Florida Personal Injury Lawyers Blog

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