SEALEY MATTRESS COMPANY AND HARTFORD INSURANCE COMPANY, APPELLANTS,
v.
SPENCER GAUSE, 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.
Sealey Mattress Company and Hartford Insurance Company appealed a workers' compensation order awarding an employee reimbursement for nonskilled attendant care services provided by his spouse and attorney's fees related to rehabilitation clinic authorization. The appellate court affirmed, holding that the services rendered went beyond ordinary household duties and that the employer had constructive notice of the need for attendant care.
The court held that the employer had constructive notice of the need for attendant care through the rehabilitation nurse's report as early as December 15, 1982, and the severity of the injury; that the services provided by the spouse constituted extraordinary services beyond ordinary household duties and were therefore compensable; and that attorney's fees were properly awarded on the medical-only rehabilitation clinic claim.
[1] Services rendered by a family member providing attendant care to a claimant may be compensable when they exceed ordinary household duties and include extraordinary servic…
[2] An employer or carrier is deemed to have knowledge of the need for attendant care services when a rehabilitation nurse's report indicates such a need, even if the service…
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“[QUOTE REDACTED — failed verbatim audit (paraphrase, not verbatim). See original_text for the text as originally displayed.]”
Establishes the legal test for distinguishing between gratuitous family services and compensable attendant care, and identifies what constitutes extraordinary services.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceSpencer Gause, age 26, sustained a severe brain injury on September 15, 1982, from a blow to the head by a co-employee with a metal pipe. After hospit…
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 Extraordinary Services cases and more on FLexlaw
MILLS, Judge.
Sealey Mattress Company and Hartford Insurance Company (E/C) appeal from a workers’ compensation order awarding Gause reimbursement for nonskilled attendant care services and attorney’s fees. The E/C contend they had no notice of the need for attendant care and, alternatively, the services rendered by Gause’s spouse are not compensable because primarily gratuitous in nature. The E/C also maintain the deputy commissioner erred in granting an attorney’s fee on the award of a rehabilitation clinic. We disagree and affirm.
Gause, a twenty-six year old married male, sustained a severe brain injury on 15 September 1982 from a blow to the head rendered by a co-employee with a metal pipe. Since the date of his hospital discharge on 22 September 1982, Gause has experienced severe slurring of speech, par tial paralysis of the right hand, complaints of vision loss in the right eye, severe disorientation, depression, dizzy spells, extreme headaches, and a multitude of other cognitive and psychological problems.
Following Gause’s return home, his wife provided him with the necessary attendant care. She testified that her services included administering medication, preparing meals, feeding Gause, and assisting him with various personal hygiene matters such as brushing his teeth, washing his face, bathing and dressing.
On 8 November 1982, Dr. Plovnich, a psychologist at the Head Injury Rehabilitation clinic, evaluated Gause for admission to its program. At that time, he issued a report recommending the clinic for a minimum of one year and stated that Gause was at a risk if left unattended due to a definite chance of overmedication, loss of direction and memory, and an inability to function independent of his wife’s attention. Following this, on 17 January 1984 the E/C authorized one week of the program and, thereafter, provided authorization for intermittent periods.
Gause sought nonskilled attendant care reimbursement and authorization for remedial care in the Head Injury rehabilitation clinic for its full course. The E/C controverted, contending all benefits due had been paid.
Where a familial member provides ordinary services to a claimant, the presumption is they are gratuitous in nature. Sheraton Bal Harbour v. Platis, 447 So. 2d 987 (Fla. 1st DCA 1984). However, as we stated in the recent case of Don Harris Plumbing Company, Inc. v. Henderson, 454 So. 2d 745 (Fla. 1st DCA 1984), when services rendered go beyond ordinary household duties, such as shopping and cooking, benefits for attendant care may be awarded. Extraordinary services include bathing, dressing, administering medication, and assisting with sanitary functions. Mrs. Gause performed all these services. Further, the number of hours she expended in providing attendance was conservatively estimated by the deputy, thereby eliminating the normal time spent by a spouse rendering gratuitous services.
Section 440.13(2)(b), Florida Statutes (1983), provides that an employee shall not be entitled to recover any amount personally expended for remedial treatment, care or attendance unless the employee requested the employer to provide such treatment or service and the employer failed to do so, or unless the nature of the injury required such treatment, nursing or services and the employer, having knowledge of such injury, neglected to provide the same. In the instant case, the E/C maintain that attendant care services were never requested and there was no showing by competent evidence that the employer either knew or should have known that such services were required.
This argument is without merit. The claims supervisor for the insurance carrier herein testified that as early as 15 December 1982 he had received a report from the rehabilitation nurse assigned to Gause’s case stating the need for attendant care services should be investigated. Despite this information and the numerous medical reports setting forth the severity of Gause’s head injury, no investigation was conducted or offer for attendance made.
As to the E/C’s last contention, because the request for treatment at the Head Injury Rehabilitation Center was a “medical only” claim, we must affirm the deputy’s award of attorney’s fees on its authorization. See, Section 440.34(3)(a), Florida Statutes (1981).
AFFIRMED.
JOANOS and BARFIELD, JJ., concur.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Cited By (11 total)
-
Aino's Custom Slip Covers & Nationwide Ins. Co. v. DeLUCIA, 533 So. 2d 862 (Fla. 1st DCA 1988)…2d 860 (Fla. 1st DCA 1982). The deputy must try to apportion the time spent so that the E/C pay [*866] only for attendant care rendered to the claimant, and not for the spouse’s performance of ordinary household duties. Sealey Mattress Co. v. Game, 466 So. 2d 399 (Pla. 1st DCA 1985). Moreover, attendant care benefits are not properly due the spouse for those periods when the claimant is being cared for by an attendant, therapist or nurse provided and paid for by the E/C. The award of 24-hour attendant care b…
-
Standard Blasting & Coating & Claims Ctr. v. Hayman, 476 So. 2d 1385 (Fla. 1st DCA 1985)…§ 440.13(2)(d) to make clear that this is its legislative intent.1 More recent cases state that the deputy must try to apportion the time so that employer/carrier pay for attendant care but not ordinary household duties. Sealy Mattress Co. v. Gause, 466 So. 2d 399 (Fla. 1st DCA 1985); Don Harris Plumbing Co. v. Henderson, 454 So. 2d 745 (Fla. 1st DCA 1984). The problem with this analysis is that Mrs. Hayman is, in effect, most probably doing two things at once. That is, even though she might be cooking or do…
-
Barnett Socolow v. Flanigans Enters. & Protegrity Servs., 877 So. 2d 742 (Fla. 1st DCA 2004)…dical necessity are generally considered gratuitous and not com-pensable. See, e.g., Montgomery Ward v. Lovell, 652 So. 2d 509, 511 (Fla. 1st DCA 1995); Marlowe v. Dogs Only Grooming, 589 So. 2d 990 (Fla. 1st DCA 1991); Sealey Mattress Co. v. Cause, 466 So. 2d 399 (Fla. 1st DCA 1985). Care is compensable only if it is “medically necessary.” § 440.13(2)(b), Fla. Stat. (1997). Generally, attendant care considered medically necessary includes only bathing, dressing, administering medication, and assisting with s…
Previewing 3 of 11 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- DON Harris Plumbing Co., Inc. v. Henderson, 454 So. 2d 745 (Fla. 1st DCA 1984)
- Sheraton BAL Harbour & Ins. Co. of N. Am. v. Platis, 447 So. 2d 987 (Fla. 1st DCA 1984)