RAUL ROJAS, APPELLANT,
v.
UNITED SHEET METAL AND ASSOCIATED INDUSTRIES INSURANCE COMPANY, APPELLEES
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.
A worker injured in a workplace accident sought temporary partial disability benefits for psychiatric treatment after reaching physical maximum medical improvement. The court reversed the denial of these benefits, holding that when a claimant has both orthopedic and psychiatric injuries, permanent disability benefits cannot be awarded until the claimant achieves MMI from both disorders, regardless of whether the psychiatric condition imposes work restrictions.
Yes. The court reversed, holding that where a claimant has both orthopedic and psychiatric injuries, permanent disability benefits cannot be awarded prior to the claimant's reaching MMI from both disorders, regardless of whether work restrictions stem solely from the physical injury.
[1] Permanent disability benefits cannot be awarded prior to a claimant reaching maximum medical improvement from all work-related disorders, including both physical and psyc…
[2] The absence of work restrictions stemming from a psychiatric condition does not preclude a claimant from receiving temporary disability benefits when the claimant has not…
Previewing 2 of 3 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“[W]here a claimant has both orthopedic and psychiatric injuries, permanent disability benefits cannot be awarded prior to the claimant's reaching MMI from both disorders.”
Establishes the controlling legal standard that MMI from both physical and psychiatric conditions is required before awarding benefits
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceClaimant was injured on July 7, 1998. The employer and carrier paid temporary disability benefits until April 8, 1999, when claimant reached physical …
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 Permanent Impairment Benefits cases and more on FLexlaw
PER CURIAM.
Appellant (“claimant”) challenges the denial of his claim for temporary partial benefits by the Judge of Compensation Claims (“JCC”). The employer and carrier (E/C) paid claimant temporary disability benefits from the date of his injury, July 7, 1998, to the date he reached maximum medical improvement (“MMI”) for his physical conditions, April 8, 1999. See § 440.15(2), Fla. Stat. (Supp.1998). After claimant reached physical MMI, E/C paid him permanent impairment benefits. See § 440.15(3), Fla. Stat. (Supp.1998). While E/C was paying permanent impairment benefits, claimant was referred to a psychiatrist and filed an additional claim for temporary disability benefits from April 8, 1999 through May 7, 2000, the stipulated date of his psychiatric MMI. The JCC denied the claim, stating: Claimant argues that we should reverse, citing Korody v. Quality Steel and Claims Center, 694 So. 2d 40 (Fla. 1st DCA 1997). We agree.
In light of the fact that Claimant was placed at physical MMI as of April 8, 1999, and Dr. Miller’s [the psychiatrist] uncontroverted testimony that Claimant did not have any psychiatric work restrictions, Claimant’s request for temporary partial benefits must be denied. In the undersigned’s view, a contrary ruling is not required simply because Dr. Miller did not place him at psychiatric MMI where Claimant had no psychiatric work restrictions, and was already at physical MMI and released to work with certain physical restrictions.
The court, in Korody, reversed the JCC’s award of wage loss benefits before the claimant achieved overall MMI, “notwithstanding the lack of restrictions imposed as a result of claimant’s psychiatric condition.” 694 So. 2d at 41. The court ruled:
“[Wjhere a claimant has both orthopedic and psychiatric injuries, permanent disability benefits cannot be awarded prior to the claimant’s reaching MMI from both disorders.” Entenmann’s Bakery v. Smith, 620 So. 2d 1049, 1051 (Fla. 1st DCA 1993)(emphasis in original). The fact that the claimant’s work restrictions all stem from his physical injuries rather than his psychiatric condition is not relevant to this issue.
694 So. 2d at 41-42 (emphasis added). Because the JCC denied the claim solely on the basis that there were no work restrictions from his psychiatric condition, as in Korody, we reverse.1
Because the JCC did not reach the issue of whether there is a causal connection between a work-related injury and a resulting wage loss from April 8, 1999 through May 7, 2000, see Vencor Hospital v. Ahles, 727 So. 2d 968 (Fla. 1st DCA 1998), we do not reach that issue.
REVERSED and REMANDED.
VAN NORTWICK and POLSTON, JJ., concur; WOLF, J., dissents with opinion.
. We are not persuaded by E/C's argument that Korody was overruled by the 1994 legislative changes in the workers compensation statutes.
WOLF, J.,
dissenting
I respectfully dissent.
The claimant in the instant case received permanent impairment benefits for his physical condition resulting from the job related injury. The award of those benefits has not been challenged. The existence of claimant’s psychiatric injuries became known after permanent impairment benefits had been paid. The only issue is whether the claimant is entitled to additional temporary partial disability (TPD) benefits as a result of his psychiatric condition. Absent proof of further disability resulting from the psychiatric condition, claimant was not entitled to further temporary benefits.
In Korody v. Quality Steel, 694 So. 2d 40 (Fla. 1st DCA 1997), the issue was whether the claimant was entitled to wage loss benefits prior to achieving maximum medical improvement (MMI) as to both physical and psychiatric conditions. In the instant case, the claimant is not claiming entitlement to additional permanent benefits nor is the propriety of the original award of permanent benefits questioned. Korody, is not, therefore, controlling.
To be eligible to receive TPD benefits an employee must show a causal connection between a work-related condition and a resulting inability to earn pre-injury wages. See Vencor Hospital v. Ahles, 727 So. 2d 968 (Fla. 1st DCA 1998). As this court noted, “[T]he 1994 revision did not change the fact that temporary partial disability benefits are ‘compensation for disability.’ ” Id. at 969 (emphasis in original). Entitlement to temporary indemnity benefits is based upon a claimant’s ability to establish a causal connection or a relationship between a specific injury and the resulting reduction in income. See Vencor, 727 So. 2d at 969; Betancourt v. Sears Roebuck & Co., 693 So. 2d 680 (Fla. 1st DCA 1997).
There was competent substantial evidence to support the JCC’s finding that no work restrictions were placed upon appellant as -a result of his psychiatric condition. I would affirm.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Cited By
-
Caldwell v. Wal-Mart Stores, 980 So. 2d 1226 (Fla. 1st DCA 2008)…in the proceedings below, the JCC did not reach this issue. Rather, the court found Dr. Ciano’s report was a peer review, and did not consider whether her report was an IME. Thus, I would decline to reach the issue. Cf. Rojas v. United Sheet Metal, 832 So. 2d 174, 175-176 (Fla. 1st DCA 2002) (“Because the JCC did not reach the issue of whether there is a causal connection between a work-related injury and a resulting wage loss ... we do not reach that issue.”). Therefore, I would grant certiorari, quash the…
-
Sapp v. Berman Bros., 884 So. 2d 1080 (Fla. 1st DCA 2004)…as reached physical MMI and has physical work restrictions, but has not reached psychiatric MMI, a JCC cannot deny a claim for temporary disability benefits, based solely on the lack of psychiatric work restrictions. See Rojas v. United Sheet Metal, 832 So. 2d 174, 175 (Fla. 1st DCA 2002). See also Greber v. Tallahassee Dev. Center, 778 So. 2d 999, 1000 (Fla. 1st DCA 2000) (claimant cannot be denied temporary benefits unless there is CSE of both physical and psychiatric MMI). After noting the psychiatrist fo…
-
Mason v. Home Shopping Network & RSKCo., 837 So. 2d 578 (Fla. 1st DCA 2003)…nied by the Judge of Compensation Claims (“JCC”). Because there is no indication that claimant has reached overall MMI, the JCC erred in denying the claim on the basis that the ankle injury did not cause wage loss. See Rojas v. United Sheet Metal, 832 So. 2d 174 (Fla. 1st DCA 2002)(reversing the JCC’s denial of temporary partial benefits because the claimant was not at overall MMI, even though the claimant was at physical MMI and had no work restrictions from the subsequent psychiatric injuries); Korody v.…
Authorities Cited
- Betancourt v. Sears Roebuck & Co. & Kemper Ins. Co., 693 So. 2d 680 (Fla. 1st DCA 1997)
- Vencor Hosp. & Sentry Claims Serv. v. Ahles, 727 So. 2d 968 (Fla. 1st DCA 1998)
- Korody v. Quality Steel & Claims Ctr., 694 So. 2d 40 (Fla. 1st DCA 1997)
- Entenmann's Bakery & the Hartford Ins. Co. v. Smith, 620 So. 2d 1049 (Fla. 1st DCA 1993)