Workers’ Compensation
Am I able to select my own doctor under Florida’s workers’ compensation system? No. Doctor selection in workers’ compensation cases has experienced dramatic changes over the past 25 years. There was a time when injured workers could select their own doctors, including specialists, at the employer/carrier’s expense. This changed in 1996 with a move towards a managed care system. Even then, claimants had a good deal of flexibility in choosing decent and qualified doctors. Wholesale changes were made in 2003. The selection process was given over fully to the insurance companies. The carriers were given the right to select all medical providers — treating doctors, physical therapist, and diagnostic testing facilities.
Do I have to pay taxes on the bi-weekly lost wages checks I receive from workers’ compensation? No. Depending on your disability status — TPD or TTD — the check you receive from workers’ compensation is supposed to be 80% of 80% of your lost wages or 66-2/3% of your lost wages. The reduction accounts for taxes that would normally being taken out of your paycheck.
Must I return to work before I am fully healed? If your authorized workers’ compensation doctor releases you to perform modified duty work, you must give your employer an opportunity to put you back to work within the restrictions imposed by the doctor. If you fail to try to perform work offered by the employer the workers’ compensation carrier will stop paying lost wage benefits. Put another way, the insurance company will “deem” wages against you. If the employer does not have work within your restrictions or your doctor says you cannot perform the duties offered by the employer, you should continue to receive checks from the workers’ compensation insurance carrier. The issue of returning to work before reaching maximum medical improvement (MMI — F.S. 440.02(1)) is one of the most common we hear in our wc cases and can only be handled on a case-by-case basis. There is no one-size-fits-all answer.
May I sue a fellow-employee for causing the accident? Unless the fellow-employee was grossly negligent, he or she is protected from suit by Florida Statute § 440.10(1)(e)(2). See also § 440.11(1)(b)(2). Gross negligence is (1) a composite of circumstances which, together, constitute a clear and present danger; (2) an awareness of such danger by the subcontractor; and (3) a conscious voluntary act or omission by the subcontractor that is likely to result in injury. See Pyjek v. Valleycrest Landscape Development, Inc., So.3d , 38 FLW D1064 (Fla. 2nd DCA 5-15-2013); and Villalta v. Cornn Int’l, Inc., 109 So. 3d 305 (Fla. 1st DCA 2013) (citing Glaab v. Caudill, 236 So. 2d 180, 185 (Fla. 2d DCA 1970)); cf. Merryman v. Mattheus, 529 So. 2d 727, 729 (Fla. 2d DCA 1988) (explaining that mere knowledge of vulnerability of employee to the possibility of injury is insufficient to amount to gross negligence; there must be a likelihood of injury from employee’s vulnerability greater than mere danger, rising to a “clear and present danger”). Gross negligence is different than simple negligence.
Are workers’ compensation benefits exempt from all claims and creditors? Yes (and No). The No first. WC benefits are not exempt from claims based on an award of child support or alimony. While it is up to the creditor to take action, WC money can be garnished to satisfy these obligations. The amount that can be garnished is determined by a formula contained in the garnishment laws (Chapter 77). In addition, portions of lump sum settlements will be applied against child support amounts in arrears. The rule of thumb is that up to 1/2 of the Claimant’s share of the lump sum settlement proceeds will be applied against the arrears. In all other instances, workers’ compensation benefits, both benefits paid and payable, are exempt from claims and creditors. The Florida Statute addressing this issue is 440.22. The leading Florida case on the issue is Broward v. Jacksonville Medical Center, 690 So.2d 589 (Fla. 1997).