CITY OF HIALEAH/SEDGWICK CMS, APPELLANTS,
v.
TONY BONO, 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.
The Florida First District Court of Appeal reversed a Judge of Compensation Claims' decision that rejected an employer's affirmative defense of misrepresentation in a workers' compensation case. The court held that the JCC applied the wrong legal standard by using civil fraud analysis instead of the statutory two-part test required under sections 440.09(4) and 440.105(4).
The court held that the JCC erred by applying civil fraud case law instead of the statutory two-part test. To establish a violation, the JCC must first find whether false, fraudulent, or misleading statements were made by the claimant, and second, whether those statements were made with the intent to obtain benefits at the time they were made.
[1] A violation of Florida Statutes section 440.105(4) requires a two-part inquiry: first, whether a false, fraudulent, or misleading statement was made by the claimant, and…
[2] Workers' compensation benefits are barred for an employee who knowingly or intentionally makes false, fraudulent, or misleading statements for the purpose of securing ben…
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“Determining that there has been a violation of section 440.105(4) requires a two-part inquiry, encompassing first a finding as to whether a false (or fraudulent or misleading) statement was made by the claimant, and second a finding as to whether, at the time the statement was made, it was made with the intent to obtain benefits.”
Establishes the proper statutory standard the JCC must apply on remand.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceAn employee (Claimant/Tony Bono) sought workers' compensation benefits. The Employer/Carrier raised an affirmative defense of misrepresentation, alleg…
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 Affirmative Defense cases and more on FLexlaw
In this workers’ compensation case, the Employer/Carrier (E/C) appeal an order of the Judge of Compensation Claims (JCC) rejecting their affirmative defense of misrepresentation under sections 440.09(4) and 440.105(4), Florida Statutes, and awarding benefits to Claimant. Because the JCC applied the wrong legal analysis, we reverse the order, and remand for findings under the proper standard.
It is illegal for any person to “knowingly make, or cause to be made, any false, fraudulent, or misleading oral or written statement for the purpose of obtaining or denying any benefit or payment” under the Workers’ Compensation Law. § 440.105(4)(b)l., Fla. Stat. (2013). And workers’ compensation benefits are barred for an employee found to have “knowingly or intentionally engaged in” such acts “for the purpose of securing workers’ compensation benefits.” § 440.09(4), Fla. Stat. (2013). Determining that there has been a violation of section 440.105(4) requires a two-part inquiry, encompassing first a finding as to whether a false (or fraudulent or misleading) statement was made by the claimant, and second a finding as to whether, at the time the statement was made, it was made with the intent to obtain benefits. See Arreola v. Admin. Concepts, 17 So.3d 792, 794 (Fla. 1st DCA 2009) (“In deciding this issue, the JCC had to answer two questions. The first is whether Claimant made or caused to be made false, fraudulent or misleading statements. The second is whether the statement was intended by Claimant to be for the purpose of obtaining benefits.”); see also Village Apartments v. Hernandez, 856 So.2d 1140, 1142 (Fla. 1st DCA 2003) (“Regardless of whether the claimant was under oath, if, at the time he made any of these statements, he knew they were false ... then the statements fall within the scope of section 440.105(4)(b)2.”).
Instead of engaging in this two-part analysis, the JCC applied civil case law on fraud, and the JCC made no mention of whether Claimant actually made specific false or misleading statements, instead characterizing the “inconsistencies” in Claimant’s testimony as “impeachment.” Thus, remand is needed for the JCC to apply the proper standard of law. On remand, the JCC is charged to revisit the evidence and make findings under the proper standard.
REVERSED and REMANDED for further proceedings in accordance with this opinion.
ROBERTS, C.J., ROWE, and WINOKUR, JJ., CONCUR.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Authorities Cited
- Vill. Apts. & Protegrity Servs., Inc. v. Hernandez, 856 So. 2d 1140 (Fla. 1st DCA 2003)
- Agustin Arreola v. Admin. Concepts & S. Eagle Ins. Co., 17 So. 3d 792 (Fla. 1st DCA 2009)