Recent Appellate Decisions Interpreting Florida’s Workers Compensation Statute

Written by: Rayford Taylor, Esq. 

The Hampton case established the mere fact an attorney fee amount has not been established does not prohibit the Statute of Limitations from operating to defeat payment of additional benefits.  The Tejeda case reaffirmed that a claimant who voluntarily changed their authorized physician cannot return to the prior physician for treatment and require the employer/carrier to pay for that unauthorized treatment.

Hospitals East, LLC, et al. v. Hampton, 1D20-20961 (Fla. 1st DCA), involved a dispute over attorneys’ fees and the Statute of Limitations.  The Employee sustained a compensable injury in 2011 and filed a Petition for Benefits (Petition) in 2013 seeking disability benefits and associated penalties, interests, costs, and attorneys’ fees.  The judge of compensation claims (JCC) entered an order in 2015 awarding the Employee benefits including entitlement to attorneys’ fees and costs, but reserved jurisdiction to determine the amount of those fees and costs.

In 2020, the Employee filed another Petition and the Employer/Carrier defended the claim on the basis that the Statute of Limitations barred the claims because no benefits had been provided since 2016.  The Employee contended that the 2015 Order reserving jurisdiction over the amount of fees and costs tolled the Statute of Limitations.  The First District Court of Appeal ruled the Employer/Carrier correctly applied the statute regarding the fact that the amount of fees and costs had not been determined did not toll the Statute of Limitations because amount and entitlement are distinct issues.  The Court stated payment of an attorneys’ fee is neither a payment of compensation nor the furnishing of medical benefits which are the only two ways the Statute of Limitations could be extended.

The Court recognized that when jurisdiction is reserved over entitlement to fees or costs, those fees and costs claims are subject to dismissal for lack of prosecution and it would make no logical sense that a claim for attorneys’ fees and costs on the amount would somehow preserve a statute that could be dismissed on the issue of entitlement.  The Court therefore held that the most recent claim by the Employee was denied based upon the Statute of Limitations.

Tejeda v. City of Hialeah et al., 1D21-0704 (Fla. 1st DCA) involved an employee that was injured in a motor vehicle accident while on the job as a firefighter.  The injuries were accepted as compensable and benefits were provided.  The Employee underwent various procedures to his for including surgeries with a specific physician.  Subsequently, another physician was designated as the new authorized physician and the first physician was deauthorized.

The parties stipulated that if the second physician concluded the Employee required further surgical intervention the Employer’s Servicing Agent would authorize the same and the Employee could decide if he wanted to undergo such a procedure.  In June 2020, the Employee, without an opinion from the new authorized treating physician, underwent spinal fusion surgery with the first physician.  He subsequently filed a Petition seeking payment of the surgery bill and copayments as medically necessary.  The JCC determined that the surgery was medically necessary but that the prior Stipulation was binding on the Employee and therefore denied reimbursement.

The Employee appealed and argued that even though his Petition sought reimbursement for the expenses of the surgery, the Stipulation effectively turned the claim into a reimbursement dispute which would be subject to the Division of Financial Services rather than the JCC.  The First District Court of Appeal upheld the ability of the JCC to interpret the meaning of the Stipulation because it had previously ruled that a judge may interpret contracts to decide whether workers’ compensation benefits existed.  The Court went onto uphold the JCC’s decision to deny reimbursement because those services were provided by an unauthorized physician.

For more information on Florida workers’ compensation law, please contact Rayford H. Taylor, Esq., (404) 954-6949, or by e-mail at rtaylor@hallboothsmith.com.