Greetings, Sometimes, it can be difficult to obtain medical records and DWC-25’s timely from doctors’ offices so we can ensure we are following the work status and not creating over or underpayments.  Well, the FL WC statute (along with the Dept of Financial Services regulations) does give you some guidance on how you can encourage […]

Greetings, An issue comes up when there is a gap in treatment, resulting in a gap in indemnity benefits.   The most common gaps I see are: From a pure technical claims handling standpoint, you do not owe the indemnity during any of these gaps IF that is all the evidence/information you have at that point. […]

Greetings and Happy New Year, I have been asked to do a refresher on responding to PFB’s.  (For those of you that want more details, we do offer a CEU that we can present on this topic). Here are a few key things to remember: Of note, you can file an amended PFB response within […]

Greetings, DOAH (Division of Administrative Hearings) just published their annual report, and it is a great study of where WC is today in Florida.  Below is a link to the report, but do not hit print unless you have a spare ream of paper just laying around, it is 282 pages. The study covers DOAH’s […]

Greetings,  a few year-end news, notes and reminders: “The maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2024 shall be $1,260.” https://www.myfloridacfo.com/docs-sf/workers-compensation-libraries/workers-comp-documents/bulletins/max-comp-rate-2024-information-bulletin.pdf That’s a $63 increase from 2023’s rate of $1,197.  This affects claims with a date of accident 1/1/24 or thereafter. For dates of accident from 10/1/2003 […]

Greetings, Tis the season…for WC injuries at Employer holiday events.   Compensable?  It depends. (This same analysis applies to all events throughout the year, not just holiday parties.) For an injury to be compensable from a recreational/social activity, two things must be true about the event: 440.092 (1) RECREATIONAL AND SOCIAL ACTIVITIES.—Recreational or social activities are not […]

Greetings, Once again, as we prepare to gather with family and friends to celebrate the season, we must be on our toes for 1-time change shenanigans over Thanksgiving. As we are all aware, based on multiple 1st DCA decisions interpreting the 1-time change section of the FL WC statute (440.13(2)(f)), we have 5 calendar days […]

Greetings,  thought it would be a good day to reflect on the things that scare me most these days in handling a FL WC claim: Watch out for the claimant to just cite the statute, “a doctor per 440.13(2)(f)”.   The request can be in a fax, email, PFB, etc.  but you still only have 5 […]

Greetings,   Under the current state of the Florida law, a claimant can request an advance of up to $2,000 in their claim, even if the claim has been denied, and regardless of whether or not the E/C will be able to recoup it.  (There is a 2nd layer of advance of up to $7,500 […]

Greetings, I get quite a few compensability questions about accidents that occur on breaks/lunch breaks.   Per the caselaw there is a difference between a regular “15 minute” type break and a lunch break.   The issue of whether it is a paid or unpaid break is not really the determinative issue.   The main factor in whether […]