RUSTIC LODGE AND ASSOCIATED INDUSTRIES INSURANCE COMPANY, INC., APPELLANTS,
v.
PETER A. ESCOBAR, APPELLEE

Fla. 1st DCA | 1999-04-16
No. 98-2695
ERVIN, ALLEN and DAVIS, JJ., CONCUR.
729 So. 2d 1014 Florida District Court of Appeal, First District (1999) Positive Treatment
Cited by 18 cases

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Synopsis

The Florida District Court of Appeal affirmed that section 440.09(4), which bars workers' compensation benefits upon proof of fraud, is substantive legislation and cannot be retroactively applied to an employee whose injury predated the statute's enactment. The court held that the statute created a new forfeiture right rather than merely providing a new remedy for existing rights.


Holding

Section 440.09(4) is substantive legislation, not procedural or remedial, and therefore cannot be retroactively applied. The statute creates a new forfeiture of vested rights rather than merely providing a new remedy for existing rights, and applying it retroactively to Escobar would improperly deprive him of vested medical benefits.


Headnotes

[1] Substantive legislation cannot be retroactively applied.

[2] A statute barring compensation benefits upon proof of prohibited activities is substantive legislation.

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Key Quotes

“section 440.09(4), Florida Statutes (Supp.1994), which bars the recovery of compensation benefits upon proof that a claimant engaged in certain prohibited activities, is substantive legislation and thus cannot be retroactively applied”

States the core holding of the case

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Facts & Procedural History

Peter Escobar was injured in an industrial accident on November 4, 1990. In 1994, the employer and carrier settled the indemnity portion while preserv…

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Opinion of the Court
PER CURIAM.

PER CURIAM.

We affirm the order of the judge of compensation claims (JCC), holding that section 440.09(4), Florida Statutes (Supp.1994), which bars the recovery of compensation benefits upon proof that a claimant engaged in certain prohibited activities, is substantive legislation and thus cannot be retroactively applied.

Claimant, Peter A. Escobar, was injured in an industrial accident on November 4, 1990. In 1994, knowing that Escobar was under investigation for submitting fraudulent requests for wage-loss benefits, the employer and carrier, Rustic Lodge and Associated Industries Insurance Company (respectively, the E/C), settled the indemnity portion of the case, preserving Escobar’s entitlement to necessary medical benefits. On November 21, 1996, Escobar pled nolo contendere to workers’ compensation fraud, perjury and grand theft, whereupon the circuit court withheld adjudication of guilt and sentenced him to 18 months’ probation and 50 hours of community service.

Escobar filed petitions for medical benefits in 1996 and 1997. The E/C denied each, pursuant to section 440.09(4), which took effect January 1,1994, and provides:

An employee shall not be entitled to compensation or benefits under this chapter if any administrative hearing officer, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s. 440.105 for the purpose of securing workers’ compensation benefits.

Section 440.105(4)(b), Florida Statutes (Supp. 1994), provides, among other things, that it is unlawful for a claimant to knowingly make false, fraudulent or misleading statements for the purpose of obtaining benefits. The E/C contends that the above provision was procedural or remedial, because it simply redefined the procedure by which an E/C can seek a remedy for a claimant’s fraudulent conduct, as previously outlined in section 440.37(2)(c), Florida Statutes (1989), which provided:

Any person damaged as a result of a violation of any provision of this subsection [dealing with misrepresentation and fraudulent activities], when there has been a criminal adjudication of guilt, shall have a cause of action to recover compensatory damages, plus all reasonable investigation and litigation expenses, including attorney’s fees at the trial and appellate courts.

Contrary to the E/C’s argument, section 440.37(2)(e) differed substantially and substantively from section 440.09(4). Under the former provision, an E/C was required to file a civil action, in which claimant could raise any pertinent defenses, to recover those benefits paid ‘pursuant to the claimant’s misrepresentations or fraudulent activity. In contrast, section 440.09(4) requires no civil proceeding, and mandates that a claimant forfeit all compensation or benefits once there has been a finding of knowing or intentional fraud, and does not limit a claimant’s forfeiture to those benefits that may have been obtained by virtue of the claimant’s unlawful conduct. Remedial statutes simply confer or change a remedy in furtherance of existing rights and do not deny a claimant his or her vested rights. St. John’s Village I, Ltd. v. Department of State, Division of Corps., 497 So. 2d 990 (Fla. 5th DCA 1986). If the JCC had applied section 440.09(4), Escobar might have lost his vested right to medical benefits for treatment necessitated by his industrial injury, even in the absence of fraud or misrepresentation relating to his 1996 and 1997 medical-benefit claims.1

AFFIRMED.

ERVIN, ALLEN and DAVIS, JJ., CONCUR. . The E/C did not pay Escobar any wage-loss benefits pursuant to his fraudulent requests.


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Citator

Cited By

  • Russell Corp. & Gab Robins v. Jacobs, 782 So. 2d 404 (Fla. 1st DCA 2001)
    …change does not alter vested substantive rights, then it applies retroactively.” Id. “Remedial statutes simply confer or change a remedy in furtherance of existing rights and do not deny a claimant his or her vested rights.” Rustic Lodge v. Escobar, 729 So. 2d 1014, 1015 (Fla. 1st DCA 1999). The amendment to section 440.09(4), Florida Statutes (Supp.1998), became effective on January 1, 1999, and provides: An employee shall not be entitled to compensation or benefits under this chapter if any judge of compen…
  • Wright v. Uniforms FOR Indus., 772 So. 2d 560 (Fla. 1st DCA 2000)
    …in any of the acts described in s. 440.105 for the purpose of seeming workers’ compensation benefits.” The judge of compensation claims held that the claimant was barred from seeking any benefits, relying on the decision in Rustic Lodge v. Escobar, 729 So. 2d 1014, 1015 (Fla. 1st DCA 1999), where we said that “section 440.09(4) ... mandates that a claimant forfeit all compensation or benefits once there has been a finding of know>-ing or intentional fraud, and does not limit a claimant’s forfeiture to those b…
  • THG Rentals & Sales OF Clearwater v. Arnold, 196 So. 3d 485 (Fla. 1st DCA 2016)
    …t DCA 2005). Fraud “does not limit a claimant’s forfeiture to those benefits that may have been obtained by virtue of the claimant’s unlawful conduct.” Wright v. Unifs. for Indus., 772 So. 2d 560 (Fla. 1st DCA 2000) (quoting Rustic Lodge v. Escobar, 729 So. 2d 1014, 1015 (Fla. 1st DCA 1999)). Thus, if Claimant made any misrepresentation for the purpose of obtaining benefits, then he is barred from entitlement to benefits, even if the misrepresentation is unrelated to his knee injury or benefits based' on that…

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