SPECIAL DISABILITY TRUST FUND, PETITIONER,
v.
FLEET TRANSPORT COMPANY ET AL., RESPONDENTS
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The Florida Supreme Court clarified the proper method for calculating reimbursement from the Special Disability Trust Fund when an employer pays workers' compensation to an injured employee whose pre-existing disability merges with a new workplace injury. The Court held that the Fund reimburses only the excess amount the employer paid due to the merger effect, not compensation attributable to the pre-existing uncompensated injury.
The Fund reimburses the employer for the difference between: (1) what the employer actually paid in compensation and medical benefits for both injuries combined, and (2) what the employer would have paid based on the new accident alone, without the merger effect. The employer remains responsible for compensation attributable to the pre-existing uncompensated injury regardless of whether a subsequent injury occurs.
[1] The Special Disability Trust Fund is intended to encourage the employment of the physically handicapped by protecting employers from excess liability when an injury merge…
[2] The entitlement of an injured employee to compensation is determined without regard to the Special Disability Trust Fund provisions; these provisions are only considered…
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Join FLexlaw to unlock all legal intelligence“It is the purpose of this subsection to encourage the employment of the physically handicapped by protecting employers from excess liability for compensation and medical expense when an injury to a handicapped worker merges with his pre-existing permanent physical impairment to cause a greater disability than would have resulted from the injury alone.”
Establishes the Legislative intent and scope of the Special Disability Trust Fund statute
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Join FLexlaw to unlock all legal intelligenceCharles Jupin was injured on February 21, 1969, and returned to work on October 6, 1969, with residual disability but no permanent partial disability …
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ADKINS, Justice.
On petition for writ of certiorari, we review an Order of the Industrial Relations Commission which reversed a compensation order of the Judge of Industrial Claims in favor of the petitioner, the Special Disability Trust Fund. We have jurisdiction pursuant to Fla.Const., art. V, § 3(b)(3), F.S.A. The sole issue before the Judge of Industrial Claims, the Industrial Relations Commission, and this Court is the proper method for applying the Special Disability Trust Fund pursuant to Fla.Stat. § 440.49(4), F.S.A. Claimant in this cause, Charles E. Jupin, was injured February 21, 1969, and returned to work for the same employer-respondent on October 6, 1969, with no finding having been made as to permanent partial disability resulting from the accident, but with the employer having full knowledge that there was some resultant disability.
On November 12, 1969, claimant was again injured. Payment had been made to claimant on the original injury for medical costs and for temporary total disability. Payment was also made for medical costs and temporary total disability on the second accident. The total remaining claim which claimant had against respondent was then settled by stipulation between the parties as adopted by compensation order of the Judge of Industrial Claims, with the settlement being $15,000, of which $13,720 was identified as covering permanent partial disability compensation, and $1,280 was identified as covering future medical care.
The sole medical testimony was that the first accident had resulted in a permanent 12% per cent disability of the body as a whole, and that the two accidents merging together had resulted in a total disability of 25 per cent of the body as a whole. The second accident alone would have caused only minimal permanent disability, according to the opinion of the sole medical witness.
The Judge of Industrial Claims relied upon the decision of this Court in Stephens v. Winn-Dixie Stores, Inc., 201 So. 2d 731 (Fla.1967), in holding that the Fund would reimburse the employer only for that amount that
“[Wjould have been apportioned out of the claimant’s award of compensation had it been an apportionment situation.”
The Industrial Relations Commission properly reversed the Judge of Industrial Claims on the reliance of this test, but failed to provide a proper test for the Judge to utilize on remand.
As we determined in the case of Jackson v. Nat. Harrison Associates, 283 So. 2d 27 (Fla.1973), filed this date, Stephens v. Winn-Dixie Stores, Inc., supra, is no longer controlling since the apportionment statute (Fla.Stat. § 440,15(5)(c), F.S.A.) has been substantially altered since the rendition of the Stephens’ opinion. With the inconsistency which required the result in Stephens corrected by statute, Fla.Stat. § 440.49(4), F.S.A., can now be applied as a simple reading of its terms dictates.
The Legislative intent in the adoption of Fla.Stat. § 440,49(4)(a), F.S.A., is set forth in the statute and provides:
“It is the purpose of this subsection to encourage the employment of the physically handicapped by protecting employers from excess liability for compensation and medical expense when an injury to a handicapped worker merges with his pre-existing permanent physical impairment to cause a greater disability than would have resulted from the injury alone. It shall not be construed to create or provide any benefits for injured employees or their dependents not otherwise provided by this chapter. The entitlement of an injured employee or his dependents to compensation under this chapter shall be determined without regard to this subsection, the provisions of which shall be considered only in determining whether an employer or carrier who has paid compensation under this chapter is entitled to reimbursement from the special disability trust fund.”
Only two facts are really necessary for the proper functioning of the Fund.
First, it must be determined how much the employer has been required to pay in compensation and medical benefits.
Second, it must be determined how much the employer would have had to pay had the claimant not suffered from the pre-existing permanent physical impairment. The latter is the amount properly borne by the employer, and the difference between the former and the latter is the amount for which the employer can properly seek reimbursement from the Fund, if that amount exceeds the minimum requirement of $1,500. Fla.Stat. § 440.49(4) (f), F.S.A.
Thus, for purposes of implementing Fla. Stat. § 440.49, F.S.A., the Judge of In dustrial Claims must make findings of fact as to the dollar amount of compensation and medical benefits actually paid by the employer, and as to the amount of compensation and medical benefits which would have been paid on the basis of the accident alone without the merger effect with the pre-existing permanent physical impairment. It is only the ratio of compensation which was actually paid to compensation which would have been paid for the accident alone — without consideration of medical benefits — which determines the portion of temporary disability compensation to be borne by the Fund.
The Judge of Industrial Claims hearing the claim for reimbursement shall make findings of fact independent from any made in the award of compensation to the claimant. The judge should hold a separate hearing or allow the filing of separate arguments for this purpose because the Special Disability Trust Fund would not be a proper party to the hearings and order on the issue of compensation. The interests of the Fund must be protected in a later hearing.
However, where, as in the case sub pidice, the payment of compensation by employer was made on the basis of joint stipulations for a lump sum pursuant to Fla.Stat. § 440.20(10), F.S.A., the payment thus made shall be considered the proper and reasonable compensation due to the claimant for purposes of determining what reimbursement from the Fund, if any, is due.
The case sub judice presents one final issue in that the pre-existing permanent disability of claimant which gave rise to the merger effect was a compensable injury attributable to the same employer, and the injury had not been compensated or even rated. Accordingly, the Judge of Industrial Claims must also find what dollar amount the employer must bear in relation to the first, uncompensated accident. For this is a responsibility which the employer would bear whether or not the second accident occurred. To require the Special Disability Trust Fund to bear the cost of the first accident merely because there was a second accident would be to go beyond the clear meaning of the statute and to create a windfall for the employer and a burden on the Fund which the Legislature did not intend.
The decision of the Industrial Relations Commission is affirmed and the cause is returned to the Commission for remand to the Judge of Industrial Claims for further proceedings not inconsistent herewith.
It is so ordered.
CARLTON, C. J., and ERVIN, BOYD and DREW (Retired), J J., concur.
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Jackson v. NAT Harrison Assocs. & the Fla. Indus. Relations Comm'n, 283 So. 2d 27 (Fla. 1973)…er to be reimbursed to him from the special disability fund — is easily determined. It is the amount by which the compensation ultimately awarded exceeds the minimum allowable. Our opinion in Special Disability Trust Fund v. Fleet Transport Company, 283 So. 2d 31 (Fla.1973), issued this date, outlines the procedure for applying § 440.-49 to determine the amount to be reimbursed. Returning to the case sub judice, the cause will have to be remanded to the Judge of Industrial Clains for necessary findings of f…
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Special Disability Tr. Fund v. Tropicana Prods., Inc., 358 So. 2d 1 (Fla. 1978)…to litigate the claimant’s entitlement to the settlement benefits in a later, independent proceeding, and (2) that the settlement figure does not conclusively establish the Fund’s liability. See Special Disability Trust Fund v. Fleet Transport Co., 283 So. 2d 31 (Fla.1973). As the Fund demonstrates, Section 440.49(4)(g) has an extremely limited effect on this proceeding and does not bar Fund joinder. We hold the Fund may have a right to intervene in workmen’s compensation lump sum settlement proceedings wh…
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Allen United Enters. and/or C. E. Allen & Sons, Inc. v. Special Disability Fund, 288 So. 2d 204 (Fla. 1974)…nst the Special Disability Trust Fund to recover the difference between the amount paid pursuant to the second stipulation and that which would have been paid for the second injury alone. See Special Disability Trust Fund v. Fleet Transport Company, 283 So. 2d 31 (Fla.1973). The Judge of Industrial Claims found that the first accident had resulted in a twenty-five percent permanent physical impairment to the claimant’s lower back; that the employer had knowledge of the pre-existing permanent physical impair…
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Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Clyde v. Stephens, 201 So. 2d 731 (Fla. 1967)
- Jackson v. NAT Harrison Assocs. & the Fla. Indus. Relations Comm'n, 283 So. 2d 27 (Fla. 1973)