CITY OF FERNANDINA BEACH AND PENINSULAR FIRE INSURANCE COMPANY, APPELLANTS,
v.
SCHOOL BOARD OF NASSAU COUNTY AND AMERICAN GUARANTY AND LIABILITY, APPELLEES
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In this workers' compensation appeal, the court clarified that section 440.15(5), Florida Statutes, does not bar apportionment of temporary disability and medical benefits between two carriers. The court affirmed the deputy commissioner's order permitting apportionment while establishing a framework to prevent windfalls for claimants.
Section 440.15(5) does not bar apportionment of temporary disability and medical benefits between carriers. The carrier at risk at the time of the accident must either controvert the claim or pay all benefits due before maximum medical improvement (MMI), and section 440.42(3) permits the paying carrier to seek reimbursement from another carrier found liable for the benefits paid.
[1] Section 440.15(5), Florida Statutes (1979), does not prohibit the apportionment of temporary disability and medical benefits between two workers' compensation carriers.
[2] A workers' compensation carrier at risk at the time of an accident must either controvert the claim as noncompensable or pay all temporary disability and medical benefits…
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Join FLexlaw to unlock all legal intelligence“We construe section 440.15(5) to require the carrier at risk at the time of the accident to either controvert the claim as noncompensable or to pay all temporary disability and medical benefits due before MMI. Section 440.-42(3) then permits the carrier paying such benefits (either voluntarily or in compliance with a deputy commissioner's order) to seek reimbursement from another carrier found to be liable for all or part of the benefits paid.”
Establishes the court's statutory interpretation that carriers have a duty to pay or controvert, with reimbursement available through section 440.42(3)
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Join FLexlaw to unlock all legal intelligenceA claimant had temporary disability and medical benefits at issue involving two workers' compensation carriers, each liable for benefits arising from …
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BARFIELD, Judge.
Appellants assert that section 440.15(5), Florida Statutes (1979), as interpreted by this court in Structural Systems, Inc. v. Worthen, 463 So. 2d 502 (Fla. 1st DCA 1985), bars apportionment of temporary disability and medical benefits between two carriers. This court has construed the statutory language otherwise, most recently in Flagship National Bank of Broward County v. Hinkle, 479 So. 2d 828 (Fla. 1st DCA 1985).
In Structural Systems, the court noted with apparent disapproval the possibility of the claimant engineering a windfall by reaching a washout settlement with the carrier at risk at the time of the second accident and then proceeding successfully against the carrier at risk at the time of the prior compensable accident. We construe section 440.15(5) to require the carrier at risk at the time of the accident to either controvert the claim as noncompensable or to pay all temporary disability and medical benefits due before MMI. Section 440.-42(3) then permits the carrier paying such benefits (either voluntarily or in compliance with a deputy commissioner’s order) to seek reimbursement from another carrier found to be liable for all or part of the benefits paid. Under this statutory construction, the claimant in Structural was entitled to receive no more than his settlement with the second carrier, who would then be entitled to seek reimbursement from the first carrier if the deputy were to find the latter was liable for the benefits paid by the former. This construction supports the disposition in Structural Systems and is consistent with this court’s statutory construction in Flagship and in the cases upon which it relies.
Structural Systems contains language to the effect that the 1979 amendments made changes which prohibit apportionment between carriers. This language is erroneous and totally unnecessary to the result reached in Structural Systems, and should be disregarded.
The deputy commissioner’s order, finding that section 440.15(5) does not bar apportionment of benefits in liability disputes between two carriers, is AFFIRMED.
NIMMONS and ZEHMER, JJ., concur.
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Cruise Quality Painting & Cigna Ins. Cos. v. Paige, 564 So. 2d 1190 (Fla. 1st DCA 1990)…n the ordinary circumstance of a second accident aggravating or exacerbating a previous permanent condition, compensable or otherwise. On the other hand, as previously held by this court in City of Fernandina Beach v. School Board of Nassau County, 488 So. 2d 871 (Fla. 1st DCA 1986), we have construed the statutory language of section 440.42(3) to allow the judge to order “apportionment” between carriers, i.e. in the sense of reimbursement, not only of medical benefits but of temporary disability benefits as…1 / 2
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Grand BAY Hotel & Am. Mut. Ins. Co. v. Nerida Guerra & Home Ins. Co., 605 So. 2d 134 (Fla. 1st DCA 1992)…authority to consider a washout settlement as to one carrier prior to apportionment. We would also note that the cases of Structural Systems v. Worthen, 463 So. 2d 502 (Fla. 1st DCA 1985), and City of Fernandina Beach v. School Bd. of Nassau County, 488 So. 2d 871 (Fla. 1st DCA 1986), relied on by appellant, involve disputes concerning apportionment of compensation benefits due prior to MMI. Those benefits are specifically not apportionable as to a dispute between the carrier and employee pursuant to § 440.15…
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Fla. Ins. Guar. Ass'n v. Fibercon Indus., Inc., 491 So. 2d 566 (Fla. 1st DCA 1986)…ith the disability.” Once the claimant attained maximum medical improvement, the deputy commissioner was free to apportion compensation and medical benefits between the respective carriers. City of Fernandina Beach v. School Board of Nassau County, 488 So. 2d 871 (Fla. 1st DCA 1986); Flagship National Bank of Broward County v. Hinkle, 479 So. 2d 828 (Fla. 1st DCA 1985); Hayward Trucking, Inc. v. Aetna Insurance Co., 466 So. 2d 437 (Fla. 1st DCA 1985); Deseret Ranches v. Crosby, 461 So. 2d 295 (Fla. 1st DCA 1…
Previewing 3 of 6 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Flagship Nat'l Bank OF Broward Cnty. & Peninsular Fire Ins. Co. v. Hinkle, 479 So. 2d 828 (Fla. 1st DCA 1985)
- Structural Sys., Inc. v. Worthen, 463 So. 2d 502 (Fla. 1st DCA 1985)