There is a lot of noise starting to build in the industry about what the FL Legislature may do with WC this session. Right now there are two main bills, one in the House (HB 1399) and one in the Senate (SB 1636). There is no guarantee either will pass, and if so, no guarantee they will pass in their current form. The House and Senate would have to agree on a reconciled bill, and then the Governor would have to sign it.
Here is a brief summary of a few of the key components of each bill. Don’t fret or salivate, no guarantees that anything will change at all:
Both House and Senate Bills have:
- Adds more specificity requirements to the filing of a PFB, including showing the claimant’s calculation of the AWW (show your work).
- Clmt must show evidence a good faith effort was made prior to filing a PFB, not just a signature that it was done.
- Clmt must sign a bold-faced type agreement that they understand they are responsible for paying their atty
- An authorized doctor can provide up to $500 in DME and supplies without carrier approval first
- The 3 day/10 day rule is changed that you must accept, deny or tell the doc of the “material deficiencies that prevent authorization or denial” or you waive medical necessity
- TTD can be extended beyond 260 if not at MMI, if TPD still at 260 must pay rating
- PFB must state the benefit was denied
- Onus is on the JCC to dismiss on their own for lack of specificity
- Clmt paid attorney fees (Miles fees) do not require JCC approval
- Represented settlements do not require JCC approval, just approval of the child support allocation (payment 14 days after that approval)
- If not at MMI at 260, must pay estimated IB’s
- For expedited hearings on claims worth less than $5,000, the clmt atty must produce their hours before the hearing
- Increases the time to respond to a PFB to avoid fees from 30 to 45 days
- The clmt atty can get hourly fees from the E/C, capped at $150 an hour, and only if the E/C “disputes the claim, award or compensation order” and the clmt prevails
We will see what passes if anything.
Morgan Indek | Partner