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Florida Court Orders Advance On Workers Compensation Benefits

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Florida Court Orders Advance On TTD

I was reading an article recently that referred to a Florida Court case where  a Florida school system was ordered to pay a claimant  an advance on benefits.  For an adjuster to pay benefits in advance in usually verboten in most cases.The case was HATTIE BONNER,Appellant v. MIAMI DADE PUBLIC SCHOOLS.  This is one of the decisions that once again can harm a Workers Compensation system.  There have been other decisions of this type in Florida. The full decision is below.   Notice the dissent at the end.  I apologize ahead of time for the spacing.

Vector Badge of Florida Court Orders Advance
Wikimedia Commons – Florida Supreme Court

HATTIE BONNER,

Appellant,
v.
MIAMI DADE PUBLIC
SCHOOLS/GALLAGHER
BASSETT SERVICES, INC.,
Appellee.IN THE DISTRICT COURT OF APPEAL
FIRST DISTRICT, STATE OF FLORIDA
NOT FINAL UNTIL TIME EXPIRES TO
FILE MOTION FOR REHEARING AND
DISPOSITION THEREOF IF FILED
CASE NO. 1D14-1200
_____________________________/
Opinion filed October 7, 2014.
An appeal from an order of the Judge of Compensation Claims.
Ralph J. Humphries, Judge.
Date of Accident: April 9, 2012.
Kimberly A. Hill of Kimberly A. Hill, P.L., Fort Lauderdale, for Appellant.
Michael J. Ring of the Law Office of Michael J. Ring, LLC, Pompano Beach, for
Appellee.PER CURIAM.In this workers’ compensation appeal, Claimant argues that the Judge of
Compensation Claims (JCC) erred in denying her request for a $2,000 advance. We
agree that the JCC erred in denying the advance.

Picture of Florida Court of Appeal
Wikipedia

Section 440.20(12), Florida Statutes (2011), permits advances of up to $2,000
on the following proof:(c) In the event the claimant has not returned to the same or
equivalent employment with no substantial reduction in wages or
has suffered a substantial loss of earning capacity or a physical
impairment, actual or apparent:
. . . .
2. An advance payment of compensation not in excess of
$2,000 may be ordered by any [JCC] . . . after giving due
consideration to the interests of the person entitled thereto.
The advance must, of course, “have some plausible nexus to” “medical and related
financial needs arising from workplace injuries.” ESIS/ACE Am. Ins. Co. v. Kuhn,
104 So. 3d 1111, 1114-15 (Fla. 1st DCA 2012). Here, the JCC concluded that “the
nexus between the accident and the circumstances suggesting the need for an
advance is missing” because Claimant’s “difficulty in managing those [financial]
circumstances is unrelated to her workplace injury.” Thus, the JCC has found that
Claimant has both a financial need and difficulty in managing her financial
circumstances. But from whence does that difficulty spring? Solely from
Claimant’s reduction in earnings, which – it is undisputed – is due to her workplace
injury.2  Claimant’s uncontroverted testimony was that she was off work for “more
than 18 months on sick leave,” that she returned to work at a reduction in total pay,
and that an advance “would put me up to date . . . so that I could put food in my
refrigerator, for one thing, gas in my car, and to pay my bills.” By this testimony,
which the JCC did not reject, Claimant has met her burden of proof.
The JCC’s conclusion that Claimant’s difficulty in managing her finances is
unrelated to her injury is seemingly based on his categorization of some of
Claimant’s monthly bills as “luxury expenses.” But whether an item is classified as
a “luxury” is not a proper factor for consideration under section 440.20(12)(c)2.
These small advances are merely a stopgap to help a claimant avoid defaulting with
creditors while awaiting the potential distribution of workers’ compensation
benefits, when the reduction in income is caused by the injury. A claimant is not
required to live a pauper’s life to be eligible for an advance of up to $2,000 under
section 440.20(12)(c)2.

Picture of Florida Court Gun Gesture Pointing Towards Legal Concept
StockUnlimited

Advances in excess of $2,000 are permitted under subsections 440.20(12)(c)3.
and (12)(d), and those subsections mandate that a JCC inquire into the
reasonableness of those larger advances. In contradistinction to advances over
$2,000, advances in a smaller amount do not permit this inquiry, but involve only a
consideration of the claimant’s interests; the burden of proof on the claimant is
lighter precisely because the financial burden on the employer or carrier is lighter.
3 As we made clear in Lopez v. Allied Aerofoam, 48 So. 3d 888, 889 (Fla. 1st
DCA 2010), “[s]ection 440.20(12)(c)2. requires the JCC to consider the ‘interests of
the person entitled [to the advance].’” We distinguish Worthy v. Jimmie Crowder
Excavating, 100 So. 3d 727 (Fla. 1st DCA 2012), on the ground that there the JCC
“was unable to adequately consider Claimant’s interests” without additional
evidence, which was Worthy’s burden to produce and prove, whereas here the JCC
found he had sufficient evidence to give Claimant’s interests due consideration.
Accordingly, we REVERSE the order denying the advance and REMAND
this matter for entry of an order awarding the requested $2,000 advance.
PADOVANO and CLARK, JJ., CONCUR; THOMAS, J., DISSENTS WITH
OPINION.

Building Of Florida Court Picture
Wikipedia – Brandonrush

4THOMAS, J., DISSENTS.
I dissent. This case presents nothing more than a failure of proof on
Claimant’s part, who bore the burden of persuasion. See Fitzgerald v. Osceola Cnty.
Sch. Bd., 974 So. 2d 1161, 1164 (Fla. 1st DCA 2008) (“Claimant bore the burden
over the course of the proceedings below to prove her entitlement to workers’
compensation benefits.”); Mitchell v. XO Commc’ns, 966 So. 2d 489, 490 (Fla. 1st
DCA 2007) (“Claimant has the burden to prove entitlement to . . . benefits. . . .
Accordingly, Claimant must present evidence the JCC finds persuasive.”). The JCC
found that Claimant’s “income and expenses roughly equate,” the record supports
that finding, and in the absence of any evidence of specific indebtedness connected
to the workers’ compensation case, the JCC properly denied the
advance. See Worthy v. Jimmie Crowder Excavating, 100 So. 3d 727, 728-29 (Fla.
1st DCA 2012) (noting claimant did not “provide any evidence to show that $2,000,
as opposed to something less than that, was appropriate in his situation”). Thus, I
respectfully dissent.
5

An order to advance workers compensation funds is highly unusual even in a Florida court. 

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

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