Court Reverses Prior Ruling in Workers’ Compensation Temporary Disability Benefits Case

 

Yesterday, September 23, 2013, the First District Court of Appeal, sitting en banc (the entire court) reversed its previous ruling in the Westphal v. City of St. Petersburg case that had heretofore extended temporary disability benefits in workers’ compensation claims from 104 weeks to 260 weeks.  The prior decision had found recent legislative changes to be unconstitutional.

In yesterday’s ruling, the First District Court receded from its prior three-judge decision and reasoned that the law never intended to create a gap in coverage.  It therefore did not reach the issue of whether the changes were constitutional, inasmuch as this was no longer necessary. Rather, the Court concluded that workers who “max out” on their temporary benefits can immediately claim permanent ones even if they were still experiencing “maximum medical improvement.”  

The Court also certified the following question to the Florida Supreme Court as being of great public importance:

“Is a worker who is totally disabled as a result of a workplace accident, but still improving from a medical standpoint at the time temporary total disability benefits expire, deemed to be at maximum medical improvement by operation of law and therefore eligible to assert a claim for permanent and total disability benefits?”

To view the complete ruling, click here.

Today’s news coverage from THE NEWS SERVICE OF FLORIDA (via FloridaToday.com) is reprinted below.

 

Should you have any questions or comments, please contact Colodny Fass& Webb.

 

Court shifts its course in workers comp case

Appeals court still supports firefighter in battle for benefits

By Jim Saunders
THE NEWS SERVICE OF FLORIDA

TALLAHASSEE – A divided appeals court Monday backed away from a ruling that found part of Florida’s workers compensation insurance system unconstitutional, but continued to support an injured St. Petersburg firefighter in his legal fight about disability benefits.

The full 1st District Court of Appeal scuttled a three-judge panel’s earlier ruling about the constitutionality of a law dealing with temporary disability benefits.  But a majority of the full court also asked the Florida Supreme Court to take up the case, which centers on Bradley Westphal, a firefighter who injured his back and leg while on duty in 2009.

The three-judge panel in March struck down a law that placed a two-year limit on temporary disability benefits.  That limit cut off disability payments in 2011 to Westphal, who was unable to work because of injuries, but also couldn’t meet a standard to qualify for permanent disability benefits.  That standard is known as being at “maximum medical improvement.”

But, in Monday’s opinion, a majority of the full appeals court said it didn’t need to rule on the constitutionality of the law because it could find for West­phal on other grounds.

“We hold that a worker who is totally disabled as a result of a workplace accident and remains totally disabled by the end of his or her eligibility for temporary total disability benefits is deemed to be at maximum medical improvement by operation of law and is therefore eligible to assert a claim for permanent and total disability benefits,” said the majority opinion, written by Judge Philip Padovano and seven other judges.

But three judges dissented fully and two others dissented in part.

Judge Brad Thomas concurred that Westphal was entitled to the benefits but wrote that he “vigorously” dissented from part of the ruling that he said violated the constitutional separation of powers between the courts, the Legislature and the executive branch.

“The majority opinion enacts new substantive law that creates a legal entitlement to permanent total disability benefits at the expiration of temporary total disability benefits, regardless of whether the claimant will remain totally disabled when reaching maximum medical improvement,” Thomas wrote.

The workers’ compensation system is designed to serve as a way to provide medical care and other benefits to injured people without going through lawsuits.  But Florida has highly complex workers compensation laws that include different types of benefits and limits–and in the past have touched off fierce legislative battles that included business groups, insurers, trial lawyers, medical providers and labor unions.

As a sign of the interest in Westphal’s case, the state House and Senate signed onto briefs in support of the city of St. Petersburg, as did groups and businesses such as Associated Industries of Florida, the Florida Chamber of Commerce, the National Federation of Independent Business and Publix.  Among those supporting Westphal:  the Florida Justice Association, Florida Workers Advocates and the Police Benevolent Association.

Westphal’s disability payments ran out in December 2011. One of his attorneys said earlier this year that the city of St. Petersburg agreed in November 2012 that Westphal would get permanent disability benefits–and made them retroactive to September 2012–but that left about a nine-month income gap.

The majority opinion Monday said nothing in state law suggests the Legislature intended to create a “gap.”

“It is unreasonable to assume that the Legislature meant to create a gap in benefits, during which a disabled worker is not compensated for a disability, even though there is no dispute that the worker is totally disabled,” the opinion said.

But Judge T. Kent Wetherell, who fully dissented, wrote that the Legislature should have the responsibility for addressing the “gap” issue.

“The solution to this problem–assuming one is needed–is for the Legislature to revise the statute,” wrote Wetherell, who was joined in the full dissent by judges L. Clayton Roberts and Lori Rowe.

 

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