SUNLAND TRAINING CENTER AND DIVISION OF RISK MANAGEMENT, APPELLANTS,
v.
SALLIE MAE BROWN, APPELLEE
AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.
An employer/carrier appeals a workers' compensation order awarding benefits to an employee for injuries from two work-related accidents. The court reverses and remands, finding that the deputy commissioner failed to address the 1975 accident claim, improperly awarded medical bills without evidence of an emergency exception, and calculated compensation benefits that exceeded the statutory 80% cap when combined with social security disability benefits.
The court reversed the award as to all three issues: the deputy commissioner must enter an order disposing of the 1975 claim due to lack of evidence; the award of medical bills was improper because no competent evidence supported the emergency exception to the authorization requirement; and the compensation rate of $79.50 violated the statutory 80% cap and must be recalculated.
[1] A deputy commissioner must resolve all issues before them, but cannot rule on a claim for which no evidence has been presented.
[2] A claimant bears the burden of proving their workers' compensation claim.
Previewing 2 of 4 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.
Join FLexlaw to unlock all legal intelligence“a deputy commissioner should resolve all issues before him”
Establishes the general rule that all claims must be addressed, though exceptions apply when evidence is insufficient
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceAppellee filed two workers' compensation claims for accidents occurring on April 26, 1975, and October 16, 1976. The claims were consolidated at the h…
The full statement of facts, procedural history, and disposition for this case are member content.
Join FLexlaw to unlock all legal intelligence© FLexlaw, Inc. — AI-generated enrichments are proprietary. All rights reserved.
Explore caselaw by topic → Browse Social Security Disability Benefits Offset cases and more on FLexlaw
McCORD, Judge.
Appellants, employer/carrier, appeal from a workers’ compensation order awarding benefits to appellee/claimant. We reverse.
Appellee filed two claims for compensation, resulting from two separate work-related accidents which occurred on April 26,1975, and October 16,1976. In the notice of hearing on her claims, the deputy commissioner listed the dates of both accidents, thereby indicating that both accidents would be considered together. At the outset of the hearing, the parties agreed to consolidate the claims relating to both accidents.
However, when the deputy commissioner handed down his order, he ruled only as to the 1976 accident. Appellants cite as error the deputy commissioner’s failure to rule on the 1975 accident. Both parties agree that evidence was not presented as to the 1975 accident.
Therefore, the deputy commissioner had no evidence upon which to base a decision as to the 1975 accident. We recognize that a deputy commissioner should resolve all issues before him. See Davidson v. Nezelek, Inc., IRC Order 2-3229 (1977), and Andrews v. Strecker Body Builders, 92 So. 2d 521 (Fla.1957).
However, in this case, although the 1975 accident was in issue, appellee did not meet her burden of proving her claim as to that accident.
Therefore, we remand to the deputy commissioner for entry of an order disposing of the 1975 claim for lack of evidence.
As to the disposition of the claim relating to the 1976 accident, appellants have raised two points for review. In one point, appellants argue that the deputy commissioner erred in ordering employer/carrier to pay for past medical treatment by Dr. Sanchez and the bills from Union General Hospital and Gainesville Radiology Group. Without seeking authorization from her employer as required by § 440.13(1), Florida Statutes, appellee consulted Dr. Sanchez, who hospitalized her for tests. Appellee did not inform her employer of her hospitalization until after her discharge. Neither Dr. Sanchez, the hospital, nor the radiology group submitted the proper forms as required by § 440.13(1).
In ordering payment of the medical bills, the deputy commissioner found that the treatment and the hospitalization was the result of an emergency situation, thereby excusing noncompliance with § 440.13(1).
However, the record is void of competent substantial evidence indicating emergency.
Therefore, because of appellee’s noncompliance with § 440.13(1), the award of payment of those medical bills was error. In their last point on appeal, appellants assert that the deputy commissioner erred in.ordering employer/carrier to pay compensation at the rate of $79.50. The parties had stipulated to an average weekly wage of $132.50.
At the hearing, appellee testified that she received $257 per month in social security benefits. The deputy commissioner found that she received $250 per month in social security benefits.
Section 440.15(10), Florida Statutes, provides that weekly compensation payable to a claimant, when combined with the social security disability benefits, cannot exceed 80% of the employee’s average weekly wage. Mathematical computation reveals that the award of $79.50 per week, when combined with the social security disability benefits appellee receives, results in appel-lee receiving weekly compensation benefits in excess of 80% of her average weekly wage. .
We reverse the award of $79.50 temporary total disability benefits and re mand for entry of an award of temporary total disability benefits which comports with the requirements of § 440.15(10).
Reversed and remanded for entry of a new order consistent with this opinion.
SHIVERS and JOANOS, JJ., concur.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Cited By
-
Willard Kaufman Co. v. Rawlings, 414 So. 2d 641 (Fla. 1st DCA 1982)…d pursuant to Section 440.13(1), Florida Statutes. The deputy commissioner properly excused the filing requirements for good cause since, among other things, the treatment was rendered in an emergency situation. See Sunland Training Center v. Brown, 396 So. 2d 278 (Fla. 1st DCA 1981). We note that claimant was seen by Dr. Boswell on two occasions after his discharge from the hospital. These visits do not fit within this emergency situation context. However, we find that any error in excusing the filing requir…
-
Town & Country Farms & Liberty Mut. Ins. Co. v. Peck, 611 So. 2d 63 (Fla. 1st DCA 1992)…ause to excuse a health care provider’s failure to comply with the statutory reporting requirement based on the nature of claimant’s injury. Inn Service Corp., Inc. v. Diaz-Aller, 536 So. 2d 307 (Fla. 1st DCA 1988); Sunland Training Center v. Brown, 396 So. 2d 278 (Fla. 1st DCA 1981); Broward Industrial Plating, Inc. v. Weiby, 394 So. 2d 1117 (Fla. 1st DCA 1981). Here, the JCC made no finding at all regarding good cause to excuse the failure of claimant’s health care providers to furnish medical reports regar…
-
Ileen Sieracki v. Pizza HUT & The Kemper Grp., 599 So. 2d 678 (Fla. 1st DCA 1992)…mployer/carrier’s responsibility for emergency care, see Green v. Chromalloy-Turbocumbustor, 540 So. 2d 874, 876 (Fla. 1st DCA 1989); Ocean Manor Resort Hotel v. Garbalosa, 512 So. 2d 256, 257 (Fla. 1st DCA 1987); and Sunland Training Ctr. v. Brown, 396 So. 2d 278, 279 (Fla. 1st DCA 1981), and for that reason, Hooshmand’s failure to communicate the emergency nature of his evaluation when seeking authorization is irrelevant. Also irrelevant is the reasonableness of the claimant’s decision about where to obtain…
Previewing 3 of 5 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Andrews v. Strecker Body Builders, Inc., 92 So. 2d 521 (Fla. 1957)