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A Florida appellate court has ruled the state's limit of 104 weeks for temporary total disability benefits is unconstitutional and granted up to 260 weeks of benefits for an injured worker whose temporary benefits had lapsed.
Bradley Westphal worked as a firefighter and paramedic for the city of St. Petersburg, Fla., court records show. He suffered severe injuries to his back and knee while working in 2009, and received back surgery and additional medical treatment for nerve damage in his legs.
Mr. Westphal reached Florida's 104-week limit for TTD benefits after his treating physicians declared him to be totally disabled while recovering from surgery, records show. Because he was deemed unable to work, Mr. Westphal applied for permanent total disability benefits.
A workers comp judge initially denied Mr. Westphal's claim. The judge determined that Mr. Westphal had not reached maximum medical improvement, and that it was “too speculative” to determine whether he would be permanently and totally disabled.
The judge's ruling noted that Mr. Westphal fell into a “statutory gap” for indemnity benefits, in which he no longer qualified for TTD benefits but was not yet eligible for PTD benefits. Records show that Mr. Westphal received no disability payments for nine months before he eventually was approved for PTD.
On appeal, Florida's 1st District Court of Appeal was asked to consider whether the benefit gap is constitutional.
In a unanimous decision Thursday, the appellate court found that the time limit is unconstitutional because it denies severely injured workers the “right to the administration of justice 'without sale, denial or delay'” under the Florida constitution.
The court ruled that Florida's TTD time limit can leave injured workers without recourse after 104 weeks. While workers comp is the exclusive remedy for worker injuries under Florida law, many are required to do without workers comp benefits before receiving a PTD determination, the ruling said.
“A system of redress for injury that requires the injured worker to legally forgo any and all common law right of recovery for full damages for an injury, and surrender himself or herself to a system which, whether by design or permissive incremental alteration, subjects the worker to the known conditions of personal ruination to collect his or her remedy, is not merely unfair, but is fundamentally and manifestly unjust,” the court ruled.
The court found that Florida's TTD time limit, enacted in 1994 workers comp law reforms, is “significantly lacking in providing disability payments to severely injured workers.” The ruling cited TTD limits from neighboring states including Alabama, Louisiana and Georgia, and found that no state provided fewer than 400 weeks of TTD benefits.
“When an employee sustains serious injuries that require prolonged or complicated medical treatment, it is not unusual for that claimant to exhaust entitlement to 104 weeks of temporary disability benefits before reaching maximum medical improvement (the status of full medical recovery) — paradoxically leaving only seriously injured individuals without compensation for disability while under medical instructions to refrain from work that cannot be ignored lest a defense of medical noncompliance be raised,” the court ruled.
The court also noted that workers comp premiums have fallen 56% in Florida since 2003, saying that there is “no public necessity, much less an overpowering one, that has been demonstrated to justify such a fundamentally unjust system of redress for injury.”
The appellate court granted 260 weeks of TTD benefits to Mr. Westphal, based on the limit that was in effect prior to the 104-week limit in the 1994 reforms.