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Florida comp bill would require medical specificity

Florida comp bill

A bill introduced in the Florida House of Representatives on Tuesday would impose mandates on good faith discussions before a workers compensation petition can be filed and would require physicians to provide much more specificity on an injured worker’s treatment plan to insurers.

H.B. 1399, sponsored by Rep. Cord Byrd, R-Jacksonville, proposes extensive changes to the medical section of the state’s workers compensation system and requires providers to specify the amount of each requested benefit and the calculation used to determine that amount. The bill also allows for a judge of compensation claims to dismiss a petition if it is determined that the claimant or claimant’s attorney failed to make a good faith effort to resolve the dispute, requires insurers to provide the total amount of attorney hours and fees paid for petitions, and ties outpatient surgery, care and hospitalization reimbursement to a percentage of Medicare rates.

In addition, the bill clarifies caps on temporary total disability benefits, which have been open to interpretation since the 2016 Florida Supreme Court decision in Westphal v. City of St. Petersburg, which found that the state’s 104-week cap on temporary total disability benefits was unconstitutional.

The House bill would place an overall 260-week cap on total temporary benefits, but allows for an additional 26 weeks if the injured worker has not reached maximum medical improvement by the end of those five years.

The Florida Senate is also considering workers compensation legislation. On Friday, Sen. Keith Perry, R-Gainesville, introduced S.B. 163, which provides similar language regarding the total temporary benefits cap — minus the 26-week extension — good faith discussions and specificity, but does not address medical fee schedules.

The Senate bill does, however, cap employer and insurer liability for attorneys fees based on a statutory percentage. The House bill is silent on attorney fee schedules, which have been a subject of contention in workers comp in the state since the 2016 Florida Supreme Court decision in Castellanos v. Next Door Co., which held that the state’s mandatory attorney fee schedule — which limited a claimant’s ability to recover attorney fees to a sliding scale based on the amount of benefits obtained — was unconstitutional.

The last time similar workers comp bills were introduced in both the Florida House and Senate was in 2017, when lawmakers were unable to breach the divide between the House bill’s cap on attorney fees at $150 per hour and the Senate’s cap of $250 per hour.

“I think a great benefit … in these bills is the specificity provision — the more information you can push on the front end, the better off the decisionmakers are as to what needs to be done next (for the injured worker),” said David Langham, deputy chief judge of the Florida Office of Judges of Compensation Claims in Tallahassee. “There’s nothing more difficult than breakdowns in communication.”

However, he noted that the bills are still very different and have been introduced late in the process.

“Whether they will become reality all comes down to what compromises can be made,” he said.







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