car-insurance-policyFlorida law requires every owner or registrant of an operable personal use motor vehicle to maintain Personal Injury Protection and Property Damage – Liability insurance. See Florida Statute 627.733 Required security. While other types of coverage are available under the standard Florida motor vehicle insurance policy, these are the only two that are mandatory. While premiums are charged for the additional coverage, the value can be worthwhile. For example, the minimum mandatory coverage (PIP & PD – Liability) does not keep an at-fault insured from losing driving privileges when injuries are involved. Bodily Injury (BI) insurance does.

Here is a summary of the various types of coverage available under the standard Florida motor vehicle insurance policy:

Personal Injury Protection (PIP).
This coverage is outlined in Florida Statute 627.736. For in-state accidents, PIP covers the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in such motor vehicle, and other persons struck by such motor vehicle while not occupying a self-propelled vehicle. For out-of-state accidents occurring within the U.S. and Canada, PIP covers the named insured and resident relatives if occupying a listed vehicle. Remember this: Out-of-state, out-of-vehicle, out-of-luck.

PIP pays:

  • 80 percent of reasonable or allowable accident-related medical expenses
  • 60 percent of lost wages
  • $5,000 death benefits

The typical PIP policy limit is $10,000 per person with a deductible of up to $2,000.

Property Damage Liability (F.S. 324.022). Covers damage to a third party’s property, including motor vehicles, walls, telephone poles, buildings, etc. The coverage travels with the insured, meaning it applies (with exceptions) when the insured is operating a non-listed vehicle. It may also cover a permissive user of a listed vehicle. The minimum policy limit is $10,000.

Bodily Injury Liability (BI) (324.021). Not mandatory in Florida. However, for those convicted of DUI, it is mandatory for a period of three years after  license reinstatement. For convictions before October 1, 2007, the minimum coverage limits are $10,000 per person/$20,000 per accident. On or after October 1, 2007: $100,000/$300,000.

BI covers for injuries and loss of life caused by the insured while operating certain listed vehicles. It may also afford coverage to the insured while operating a non-listed vehicle, like a friend’s car. An added bonus of maintaining BI is that the insurance carrier will furnish a legal defense on its tab. The minimum BI coverage limits are $10,000/$20,000. The maximum can be whatever the insured desires and can afford. Umbrella insurance is a way of increasing limits while saving on cost.
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worker2On April 28, 2016, the Florida Supreme Court declared unconstitutional the mandatory fee schedule in section 440.34, Florida Statutes (2009), which eliminated the requirement of a reasonable attorney’s fee to a successful claimant. The ruling, in Castellanos v. Next Door Company, et al., sent shock waves through the workers’ compensation community. Many within the business and insurance industries instantly began howling that the sky was falling. Their protestations, amounting to hyperbole, are overblown.

Marvin Castellanos was injured in the course and scope of his employment. His employer’s workers’ compensation insurance carrier denied benefits, raising twelve defenses. Through the assistance of an attorney, Mr. Castellanos prevailed in his workers’ compensation claim. The Judge of Compensation Claims (JCC) determined that claimant’s attorney devoted 107.2 hours of “reasonable and necessary” time litigating the complex case. However, because section 440.34 limited a claimant’s ability to recover attorney’s fees to a sliding scale based on the amount of workers’ compensation benefits obtained, the fee awarded to Castellanos’ attorney amounted to $164.54, or $1.53 per hour.

The JCC had no choice. Section 440.34 barred him from awarding a reasonable attorney’s fee. The Florida Supreme Court considered this arbitrary and capricious constraint as unconstitutional under both the Florida and United States Constitutions.

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Republicans have held the reins of power in Florida since 1999. Unashamedly, they have abused that power to crush the rights of individuals in favor of Big Business.

One of the areas which has experienced the greatest abuse is the state’s workers’ compensation system. Mercifully, thanks to the Florida Supreme Court the pendulum is beginning to swing in favor of fairness and decency. On April 28, 2016, in Castellanos v. Next Door Company, et al., the court found § 440.34, Florida Statutes unconstitutional. This statute had barred claimants’ attorneys from receiving reasonable attorney’s fees. Literally. The effect of the statute was that Claimants were as helpless as turtles on their backs. By finding this ridiculous law unconstitutional, Castellanos has become the single most important case in the annals of Florida workers’ compensation cases.

The positive momentum continues. Today, in Westphal v. City of St. Petersburg, et al. , the Supreme Court found another outrageous Republican statute, section 440.15(2), Florida Statutes (2009), unconstitutional.

FloatI remember the night, in 1964, that a young Cassius Clay defeated world champion Sonny Liston at the Miami Beach Convention Center. I waited anxiously by the radio for a report of the outcome. He was expected to be eaten alive by the big bad bear Liston and become a footnote in the history books. I was more relieved that he wasn’t hurt than excited about the victory. The next day Cassius Clay became Muhammad Ali, and the rest is much, much more than a footnote in the history books.

While his ring exploits are legendary — Olympic Gold Medal, the Thrilla in Manila, dismantling George Foreman in 8 rounds in Zaire, Africa in the fight known as The Rumble in the Jungle — his greatness came from the character he demonstrated both in the ring and out. In refusing to participate in an unconscionable conflict — the United States never formally declared war in the so-called Vietnam War — in defiance of White Establishment America, he was stripped of his world title, barred from fighting for three and a half years during the prime of his physical prowess, and convicted of draft evasion and sentenced to five years in prison. Instead of complaining, he fought the conviction all the way to the United States Supreme Court and had it reversed by an 8-0 vote.

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scales of justiceOn April 28, 2016, the Florida Supreme Court, in Castellanos v. Next Door Company, righted a wrong thirteen years in the making. The court decided that the due process edicts embodied in the Federal and Florida constitutions mandate that judges who decide workers’ compensation cases be allowed to award reasonable attorney’s fees to claimants attorneys. (Pre-Castellanos, judges of workers’ compensation claims (JCC) were prohibited from awarding reasonable fees.)
Not surprisingly, the right-wing propaganda machine quickly went on the attack. This morning I awoke to an article, Workers-comp rates could jump in Florida, published in my local newspaper, the Miami Herald, containing some of the falsehoods we can expect to hear. I sent an email to the author of the article addressing the biggest of those falsehoods.
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Dear Mr. Saunders:
This morning I read your article of the above title in the Miami Herald. I feel the need to respond to a quote in the article from Associated Industries CEO Tom Feeney, the highly controversial right-wing Republican partisan notorious for his role in the 2000 presidential election fiasco. According to Feeney, the Supreme Court’s opinion permits “unbridled hourly rate attorney fees.” This is complete and utter hogwash. If you read the subject opinion, Castellanos v. Next Door Company, and the workers’ compensation attorney’s fee statute (F.S. 440.34), you will see that the hourly attorney fee rate will be anything but “unbridled” as a result of the Castellanos decision.

IMG_2410The legal principle of respondent superior makes employers liable in civil damages for the negligence of their employees.

The typical large-scale construction project is manned by workers employed by many different companies. However, the theories of vertical and horizontal immunity contained in Florida Statute Sections 440.10(1)(b)&(e) exempt construction site employers from respondent superior liability for worker on worker accidents.*

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scales of justice.jpgOver the years, but especially since 1998, it has gotten progressively more difficult for workers injured on the job to be fairly compensated under Florida’s workers’ compensation system.  Republican governors (Jeb Bush, Charlie Crist, Rick Scott) backed by Republican-dominated legislatures have made every effort to limit and eliminate workers’ rights. Occasionally, the First District Court of Appeal and the Florida Supreme Court will throw workers a bone, but even they cannot fully contend with the overwhelming onslaught from the executive and legislative branches.

Examples of this point:

Two different types of wage loss benefits are available under Florida’s workers’ compensation system. See Florida Statute 440.15. The line of demarcation between the two is maximum medical improvement (MMI).

“Date of maximum medical improvement” means the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated, based upon reasonable medical probability. 440.02(10)

While the injured worker is in the pre-MMI recovery stage, he or she is eligible to receive what is known as temporary disability benefits, either temporary partial (TPD; F.S. 440.15(4) ) or temporary total (TTD; 440.15(2)) depending on work status per the treating doctor or doctors. However, once the employee reaches MMI, eligibility for temporary benefits ends and the only available indemnity (wage loss) benefit is permanent total disability (PTD; F.S. 440.15(1)). (At the point of MMI, the treating doctor is required to assign an impairment rating for permanent injuries. The rating is expressed in terms of a percentage (%), and permanent impairment benefits (F.S. 440.15(3)) are paid thereafter according to the rating. While this is a monetary benefit, it is not an indemnity payment based on wage loss.) Except in rare instances, PTD ends at age 75. Continue reading

barricadeWhile a recent Florida Supreme Court decision has leveled the playing field for injured workers in workers’ compensation cases — read Jeffrey P. Gale, P.A. // Another Jeb Bush Law Bites the Dust — a better remedy can sometimes be achieved through the civil justice system under negligence law principles.

Florida Statute 440.11 immunizes most employers and fellow-employees from being sued for simple negligence, limiting the remedies available to injured workers to those outlined in Chapter 440, Florida Statutes, Florida’s body of workers’ compensation laws.

‘”[S]imple negligence is that course of conduct which a reasonable and prudent man would know might possibly result in injury to persons . . ..”‘ Carraway v. Revell, 116 So. 2d 16, 22 (Fla. 1959) (quoting Bridges v. Speer, 79 So. 2d 679, 682 (Fla. 1955)).

The two jurisprudential systems, negligence and workers’ compensation, provide very different remedies to injured victims. One of the main differences is that the workers’ compensation system does not compensate for pain and suffering, while the negligence system does. (No Compensation for Pain & Suffering Under Florida’s Workers’ Compensation System.)

Chapter 440 is a no fault system for providing benefits. It was designed to assure  “the quick and efficient delivery of disability and medical benefits to an injured worker.” § 440.015, Fla. Stat. (2009). Even so, its shortcomings are many. Read these blogs:

In spite of these drawbacks, Florida Statute 440.11 usually bars other options.
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scales of justiceOn April 28, 2016, the Florida Supreme Court announced its decision in Marvin Castellanos v. Next Door Company, et al. The case involved a challenge to the constitutionality of Florida Statute 440.34, the law that prescribes the payment of fees to attorneys who represent injured workers.

In 2009, Marvin Castellanos, then forty-six years old, suffered an injury during the course of his employment as a press break operator for Next Door Company. When the employer, and Amerisure, as Next Door’s insurance carrier (collectively, the “E/C”), failed to authorize its own doctor’s recommendations,  Castellanos subsequently filed a petition for benefits, seeking a compensability determination for temporary total or partial disability benefits, along with costs and attorney’s fees. The E/C raised twelve defenses, including 440.09(4) (intentional acts) and 440.105(4)(b)9. (fraud), Florida Statutes (2009), ultimately asserting that Castellanos was responsible for his own injuries.

A final hearing was then held before the JCC, in which numerous depositions, exhibits, and live testimony were submitted for consideration. The Judge of Compensation Claims (“JCC”) ruled in favor of Castellanos, determining, therefore, that he was entitled to recover attorney’s fees and costs from the E/C.

Based on the JCC’s finding of compensability, Castellanos filed a motion for attorney’s fees, seeking an hourly fee of $350 for the services of his attorney. However, constrained by Section 440.34, the JCC awarded a statutory fee of $1.53 per hour.

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worker2Two competing principles have always been at play when determining whether injuries, medical conditions, and death are compensable under Florida’s workers’ compensation system. One of the principles was described by the Florida Supreme Court, in Protectu Awning Shutter Co. v. Cline, 16 So. 2d 342 (Fla., 1944): “The purpose of the act [Chapter 440 Workers’ Compensation] is to shoulder on industry the expense incident to the hazards of industry; … and to ultimately pass on to the consumers of the products of industry such expense.” The other principle was described in General Properties Co. v. Greening, 154 Fla. 814, 18 So.2d 908, 911 (Fla. 1944): “This very valuable statute, [Chapter 440, Florida Statutes] while fulfilling a long standing public need, was not designed to take the place of general health and accident insurance.”

What these competing principles represent is that there must be some industrial causation for an injury or death to be compensable — i.e., only “personal injury or death by accident arising out of and in the course of employment” are covered under Florida’s workers’ compensation system. See§ 440.02(19) Florida Statutes.

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