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law books.jpgMcCall vs. Alabama Bruno’s, Inc., 647 So.2d 175 (Fla. 1st DCA 1994): Florida follows the general rule that the employer of an independent contractor is not liable for the contractor’s negligence because the employer has no control over the manner in which the work is done, except when one of three exceptions apply. Those exceptions involve:

  1. Negligence in selecting, instructing or supervising the contractor;
  2. Non-delegable duties arising out of some relation toward the public or the particular plaintiff;
  3. Work which is specially, peculiarly, or “inherently” dangerous.

Peculiar does not mean that the risk must be one which is abnormal to the type of work done, or that it must be an abnormally great risk, but instead refers to a special recognizable danger arising out of the work itself. In order for the vicarious liability rules to apply, it is not essential that the work which the contractor is employed to do be in itself an extra-hazardous or abnormally dangerous activity, or that it involve a very high degree of risk to those in the vicinity. It is sufficient that it is likely to involve a peculiar risk of physical harm unless special precautions are taken, even though the risk is not abnormally great. A “peculiar risk” differs from common risks to which persons in general are commonly subjected by the ordinary forms of negligence which are usual in the community. It must involve some special hazard resulting from the nature of the work done, which calls for special precautions. Restatement (2d) Torts Sect. 416. Rules imposing vicarious liability on employers for the acts of independent contractors arise “in situations where, for reasons of policy, the employer is not permitted to shift the responsibility for the proper conduct of the work to the contractor” and it is commonly stated that “the employer is under a duty which he is not free to delegate to the contractor.” Nondelegable duties have been found under Florida law to arise out of “inherently dangerous activity,” activity involving “inherently dangerous elements,” or out of the creation of an “inherently dangerous condition.”

Webb vs. Priest, 413 So.2d 43 (Fla. 3rd DCA 1982): The general rule in Florida is that an owner is not liable for the acts of an independent contractor except when (a) the activity is inherently dangerous (see Ferguson vs. Westinghouse, 408 So.2d 659 (Fla. 3rd DCA 1981)); (b) the owner/employer had contractually assumed responsibility (Levitz vs. Continental Equities, 411 So.2d 221 (Fla. 3rd DCA 1982)); (c) there is legally imposed responsibility (Concord Florida vs. Lewin, 341 So.2d 242 (Fla. 3rd DCA 1977)); (d) the owner/employer knew or had reason to know that the independent contractor would not perform in a satisfactory manner (Williams vs. Wometco Enterprises, 287 So.2d 353 (Fla. 3rd DCA 1974)); (e) where the independent contractor had apparent authority to act on behalf of the owner/employer (Thomkin Corp. vs. Miller, 156 Fla. 388, 24 So.2d 48 (Fla. 1945).
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hospital.jpgOnce a hospital is paid by Medicare, it is barred from balance-billing the patient except for a small co-payment. Because Medicare pays less than “reasonable value” for services charged by Florida hospitals, where a hospital believes that the patient is likely to receive a monetary recovery in a personal injury case, it may refuse to bill Medicare. Hospitals do this hoping to receive more from personal injury cases than from Medicare.

Unfortunately, this conduct is legal. There appear to be no rules, statutes or case law barring this conduct.

The law is less clear with regard to Medicaid. Some believe that Medicaid must be billed, while others do not. As with Medicare, hospitals are not allowed to balance-bill after being paid by Medicaid.

Where Medicare or Medicaid pay and a personal injury recovery follows, both will be reimbursed from the recovery. Accordingly, neither (namely, taxpayers) loses out.

Hence, where hospitals refuse to bill Medicare, the consumer/patient ends up paying more.
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rick scott.jpgIn the 2011 legislative session, the Republican-dominated Legislature approved $1,000,000 in funding for 25 legal aid organizations that reached into all 67 Florida counties. On May 26, Gov. Rick Scott vetoed the funding.

It will be only the second time in 10 years that Florida will not be providing any state funds to help poor families with their civil difficulties.

According to data, in fiscal year 2009-2010 $1,000,000 in state funding to the 25 legal agencies was used to assist with 3,848 cases, including 1,435 family law cases, 1,111 cases seeking access to federal benefits, 191 domestic violence cases, and 33 elder abuse cases. In addition, the grant money paid for educational programs that reached 5,979 people.
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us supreme court.jpgIn Rent-A-Center, West, Inc. v. Jackson, 130 S. Ct. 2772 (2010), the U.S. Supreme Court considered whether, under the Federal Arbitration Act (FAA or Act), 9 U.S.C. §§ 1-16, a district court may decide a claim that an arbitration agreement is unconscionable where the agreement explicitly assigns that decision to the arbitrator.

In a 5-4 split decision, the Court answered the question in the negative.

Antonio Jackson had filed a discrimination action against his employer. The employer moved to dismiss the complaint and compel arbitration, arguing that Mr. Jackson, in pre-employment documents, had agreed to arbitrate all “past, present or future” disputes arising out of Jackson’s employment with Rent-A-Center, including “claims for discrimination” and “claims for violation of any federal… law.”

Jackson opposed the motion on the ground that “the arbitration agreement in question is clearly unenforceable in that it is unconscionable” under Nevada law. Rent-A-Center responded that because Jackson had agreed to let the arbitrator make that decision, in a clause referred to as a “delegation provision,” the District Court was not authorized to make the decision. The provision reads as follows:

“[t]he Arbitrator, and not any federal, state, or local court or agency, shall have exclusive authority to resolve any dispute relating to the interpretation, applicability, enforceability or formation of this Agreement including, but not limited to any claim that all or any part of this Agreement is void or voidable.”

The District Court agreed with the employer. That decision was appealed to the Court of Appeal for the Ninth Circuit, which ruled in favor of Jackson. In turn, the employer petitioned the U.S. Supreme Court to accept the case on certiorari, which it did.
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mri.jpgFlorida Rule of Civil Procedure (FRCP) 1.360(a)(1)(A) allows the defendant in a personal injury case to have a qualified expert of its own choosing perform a medical examination on the plaintiff with regard to the injury or injuries in controversy. This type of examination has come to be referred to as a “compulsory medical examination,” or “CME.”

The notice of the examination is served by the defendant on the plaintiff’s attorney. The Rule provides that the request “shall specify a reasonable time, place, manner, conditions, and scope of the examination….” The reason for the specificity requirement is to give the plaintiff the opportunity to impose objections to the request if necessary.

The question often arises as to whether or not the CME doctor is allowed to perform invasive testing such as X-rays. The answer is a conditional Yes.

In Schagrin v. Nacht, 683 So. 2d 1173 (Fla. 4th DCA 1996), paragraph 4 of the defendant’s request read as follows:

The scope of the examination is of a urological nature concerning conditions of the Plaintiff relating to the accident which is the subject matter of this lawsuit. The exam shall include any such tests that the doctor feels are necessary for a complete and thorough examination of the Plaintiff.

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thumbing nose.jpgIn 2004, more than 80-percent of Florida voters passed Amendment 7, technically Article 10 Section 25 of Florida’s Constitution, commonly known as the “Patients’ Right to Know Act.” The amendment provides that “patients have a right to have access to any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident.”

Not surprisingly, a number of hospitals quickly lined up to challenge the scope of the voter-approved constitutional amendment. In essence, they sought to keep from having to produce documents relating to the investigation of adverse medical incidents, and in one of the cases, relating to the selection, retention, or termination of a doctor accused of medical negligence.

In 2008, The Florida Supreme Court, in Florida Hosp. Waterman, Inc. v. Buster, 984 So. 2d 478 (Fla., 2007), ruled against the hospitals, declaring that the shroud of privilege that existed in Florida with regard to medical records had been lifted by Amendment 7 to “allow patients to better determine from whom they should seek health care, evaluate the quality and fitness of health care providers currently rendering service to them, and allow them access to information gathered through the self-policing processes during the discovery period of litigation filed by injured patients or the estates of deceased patients against their health care providers.” (The quoted language was used by the Supreme Court from the written opinion of Judge Sawaya in Florida Hospital Waterman, Inc. v. Buster, 932 So.2d 344 (Fla. 5th DCA 2006).
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doctor conference.jpgThe question often arises in civil cases as to which witnesses the Plaintiff’s lawyer is prohibited from communicating with outside the presence of the Defendant’s counsel. The answer is governed by Florida Rule of Professional Conduct 4-4.2.

The Rule was put to the test in the context of a medical malpractice case in Lee Memorial Health System, d/b/a Healthpark Medical Center v. Jeffrey Smith and Melissa Smith, individually, and as Parents and Natural Guardians of Kiarra Summer Smith, a minor, 40 So.3d 106 (Fla. 2d DCA 2010). The Smiths filed a medical malpractice action on behalf of their daughter against Lee Memorial. In their complaint, they alleged that the hospital fell below the standard of care in calculating nutritional solutions. The injuries alleged in the complaint included permanent neurological damage, lack of normal head growth, and cerebral palsy.

While the suit was ongoing, the child was receiving care and treatment from a pediatric neurologist and several other physicians who were employed by Lee Memorial. The child’s lawyers tried to meet with the doctors to discuss her medical condition. Lee Memorial asked the court to prohibit the meetings. The circuit court refused, so Lee Memorial petitioned the district court of appeal to do so. It also refused, reasoning as follows:

The prohibition against communicating with members of a represented organization [like Lee Memorial] is applicable to only three categories of persons or employees: (1) those who supervise, direct, or regularly consult with the organization’s lawyer concerning the matter; (2) those who have the authority to obligate the organization with respect to the matter; or (3) those whose act or omission in connection with the matter may be imputed to the organization for purposes of civil or criminal liability.

The court decided that none of the child’s treating doctors fell within any of these categories.
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doctor.jpgUninsured Motorist (UM) coverage is 1st party insurance maintained for the benefit of individuals injured by uninsured motorists.

See these blogs:

An insurance policy is a contract. Unless preempted by a statute or case law, the terms of the policy determine the rights and responsibilities of the parties to the contract, namely the insurer and the insured.

A common policy requirement is for the insured to submit to what is called a Compulsory Medical Examination (CME). A CME is where the insured, who is seeking compensation under the policy for an injury or injuries, is examined by a doctor selected by the insurance company. When requested by the insurer, submitting to the CME is a condition precedent to receiving benefits under the policy, meaning that the insurance company can deny benefits to the insured for failing to attend the CME.

Disputes have arisen between insurer and insured over what is allowed by the CME provision. How frequently may the insurer force the insured to attend CMEs? How far can the carrier make the insured travel to attend the CME? Is there limit on the type of doctor who may perform the CME?
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Florida lawyers who represent individuals injured in accidents must be aware that some of the proceeds recovered in a case may have to be reimbursed to entities who have paid for accident-related medical care. If benefits were paid through an individual health insurance plan, whether and to what extent the carrier has a right of subrogation is a matter of contract (the insurance policy) and state law, Florida Statute 768.76. With regard to group policies provided in connection with employment, it was long believed that subrogation rights were exclusively a matter of contract, the Plan Summary, and federal law, the Employment Retirement Income Security Act (ERISA). It was felt that Florida Statute 768.76 played no role in determining group insurance subrogation rights.

Coleman v. Blue Cross and Blue Shield of Alabama, Inc. So.3d , 35 FLW D2718 (Fla. 1st. DCA 12-8-2010) may have changed the landscape.

After successfully settling a personal injury action in federal court, Coleman (the plaintiff and a member of a group plan) filed a complaint in state court requesting a declaratory judgment prohibiting the insurer from seeking subrogation against the settlement proceeds. The plaintiff’s complaint alleged that the insurer had not met the pre-subrogation requirements of Florida’s Collateral Source Statute Section 768.76(7). Therefore, according to the plaintiff, Blue Cross Blue Shield had waived its right to subrogation.
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scales of justice.jpgFlorida employers who maintain workers’ compensation insurance in accordance with the requirements of Chapter 440 of the Florida Statutes, generally are immune from being sued civilly for damages by employees injured in the course and scope of their employment. See Florida Statute 440.11. (For an explanation of the differences between workers’ compensation cases and civil cases, see these blogs: The Differences Between Florida Workers’ Compensation and Personal Injury Cases; Legal Distinctions Between Florida’s Workers’ Compensation System and Wrongful Death Act for Loss of Life.)

For some employers, the immunity afforded by Florida law is not enough to satisfy their quest to deny benefits altogether to those who have been seriously injured in accidents. Not only will the employer try to deny that the accident happened in the course and scope of employment, but when a civil suit is brought after workers’ compensation benefits have been denied, the employer asserts the defense of workers’ compensation immunity in the civil suit. What the employer is doing is denying on the one hand that the injured person is entitled to workers’ compensation benefits, while claiming on the other hand in the civil case that the plaintiff’s only available remedy is through the workers’ compensation system.

Contradictory. Hypocritical. Thankfully, it doesn’t work in Florida.

In Rush v. BellSouth Telecommunications Inc. d/b/a AT&T Florida, 18 FLWCLB 22 (N.D. Fla. 2011), this tactic was attempted by the employer. In a well-reasoned and sensible decision, the United States District Court shot it down.

Ms. Rush first filed a workers’ compensation Petition alleging “exposure to toxic mold, MRSA [methicillin-resistant staphyloccus aureus], and other complications related to `sick building.'” BellSouth responded to the Petition by asserting that “the exposure did not occur in the course and scope of her employment.” Rather than fight this defense through the workers’ compensation system, Ms. Rush dismissed the Petition and filed a negligence action in which she alleged “that BellSouth was negligent in its cleaning, maintenance, and operation of the Garden Street workplace; and that this negligence caused Rush to suffer injury and resulting damages.”
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