Matrix Emp. Leasing ,Inc. v. Hadley, No. 1D09–3360.

CourtCourt of Appeal of Florida (US)
Writing for the CourtWETHERELL
Citation78 So.3d 621
PartiesMATRIX EMPLOYEE LEASING, INC. and First Commercial Claims Services, Appellants, v. Shawn HADLEY, Appellee.
Docket NumberNo. 1D09–3360.
Decision Date06 January 2012

78 So.3d 621

MATRIX EMPLOYEE LEASING, INC. and First Commercial Claims Services, Appellants,
v.
Shawn HADLEY, Appellee.

No. 1D09–3360.

District Court of Appeal of Florida, First District.

Nov. 29, 2011.Opinion on Rehearing and Certification Denied Jan. 6, 2012.


[78 So.3d 622]

David R. Drill of Kelley, Kronenberg, Gilmartin, Fichtel & Wander, Bamdas, Eskalyo & Dunbrack, P.A., Jacksonville, for Appellants.

Bill McCabe, Longwood, and Erika L. Brenneman, Tallahassee, for Appellee.

EN BANC
WETHERELL, J.

In this workers' compensation case, the Employer and Carrier (E/C) appeal a final order awarding Shawn Hadley (Claimant) permanent total disability (PTD) benefits. The E/C argue that the Judge of Compensation Claims (JCC) erred in awarding PTD benefits because Claimant has not yet reached maximum medical improvement (MMI) and he did not prove that he would be permanently and totally disabled after reaching MMI. We agree with the E/C and conclude this case is controlled by our decision in City of Pensacola Firefighters v. Oswald, 710 So.2d 95 (Fla. 1st DCA 1998), and its progeny. Upon consideration of this case en banc,1 we decline to depart from that settled precedent. Accordingly, we reverse the order on appeal.

I. FACTUAL BACKGROUND

On January 18, 2007, Claimant injured his left knee and leg in a compensable

[78 So.3d 623]

accident. Claimant underwent a number of surgeries on the leg as a result of complications from the initial surgery. Claimant's authorized treating physician, Dr. Farid Hakim, anticipates that Claimant will need additional surgeries, and he testified that Claimant is not yet at MMI. In May 2009, Claimant was placed on a no-work status pending the additional surgeries. Dr. Hakim was unable to provide a definitive opinion of Claimant's disability status once he reaches MMI, although he did testify that Claimant will “most probably” be able to go back to at least light-duty work at some point in the future and that Claimant will “probably” have only a 10% to 15% impairment rating after MMI.

The E/C paid Claimant 104 consecutive weeks of temporary total disability (TTD) benefits, until January 18, 2009, when entitlement to such benefits terminated by statute. At that point, the E/C began paying Claimant impairment benefits. Claimant thereafter filed a petition for benefits seeking an award of PTD benefits from January 18, 2009, and continuing, because he remains in a total disability status per Dr. Hakim. The E/C denied the claim, asserting that Claimant must first reach MMI to make the issue of PTD ripe for adjudication because the Workers' Compensation Law does not authorize the payment of pre-MMI “temporary PTD benefits.”

In the order on appeal, the JCC acknowledged that “case law holds that there is no creature in the workers['] compensation law known as ‘temporary permanent total disability,’ ” but the JCC nevertheless awarded Claimant PTD benefits based on his view that “the Legislature did not intend to leave a claimant such as Mr. Hadley out in the cold with no basis for indemnity benefits when that worker is totally disabled for more than 104 weeks.” The JCC explained his decision as follows:

The indefiniteness in the medical testimony as to when he may reach physical MMI, what final degree of permanent impairment he may suffer, and when or if he may return to gainful employment leave[s] too much to chance. The concrete evidence before me is that the claimant has a permanent disability and is incapable of engaging in employment at the present time. I choose to take the words “permanent” and “total” out of the context of the medical testimony and the legal requirements to find that the claimant is currently “permanent total” and is entitled to indemnity benefits in that classification, plus the supplemental benefits attendant thereto. While there may be a change in condition in the future, the claimant presently meets the requirements of the law to establish entitlement to permanent total disability indemnity benefits.

This timely appeal followed.

II. ANALYSIS

JCCs are bound by the decisions of this court interpreting the Workers' Compensation Law unless and until the decision is overruled by the Florida Supreme Court or this court recedes from the decision en banc. See Pardo v. State, 596 So.2d 665, 666 (Fla.1992); Hoffman v. Jones, 280 So.2d 431, 433–34 (Fla.1973). Accordingly, a JCC lacks the authority to craft and apply a rule of law that directly contravenes this court's settled precedent. That, however, is precisely what the JCC did in this case by awarding PTD benefits based on Claimant's present disability status, rather than his status after reaching MMI as required by the statutes and case law discussed below. This was error.2

[78 So.3d 624]

Section 440.15, Florida Statutes, governs the payment of disability benefits to injured employees. Pertinent to this case, subsection (1) of the statute provides for the payment of PTD benefits to employees who have a “total disability adjudged to be permanent,” and subsection (2) provides for the payment of TTD benefits to employees whose disability is “total in character but temporary in quality.” § 440.15(1)-(2), Fla. Stat. (2006) 3 (emphasis added). PTD benefits are expressly limited to “claimants with catastrophic injuries or claimants who are incapable of engaging in employment.” § 440.15(1)(b), Fla. Stat. (“In no other case may [PTD] be awarded.”). TTD benefits are payable for no more than 104 weeks, after which the employee's permanent impairment 4 rating must be determined. See § 440.15(2)(a), Fla. Stat. (“Once the employee reaches the maximum number of weeks allowed, ... [TTD] benefits shall cease and the injured worker's permanent impairment shall be determined.”); § 440.15(3)(d), Fla. Stat. (“After the employee has been certified by a doctor as having reached [MMI] or 6 weeks before the expiration of temporary benefits, whichever occurs earlier, the certifying doctor shall evaluate the condition of the employee and assign an impairment rating....”). The permanent impairment rating is used to pay “impairment income benefits,” commencing on “the day after the employee reaches [MMI] or after the expiration of temporary benefits, whichever occurs earlier,” and continuing for a period determined by the employee's percentage of impairment. See § 440.15(3)(g), Fla. Stat.

The statutory scheme in section 440.15 works seamlessly when the injured employee reaches MMI prior to the expiration of the 104 weeks of temporary disability benefits. But where, as here, the employee is not at MMI at the expiration of the 104 weeks, there is the potential for a “gap” in disability benefits because TTD benefits cease by operation of law after 104 weeks and entitlement to PTD benefits is generally not ripe until the employee reaches MMI. We recognized this “gap” in Oswald and attempted to ameliorate its impact as much as possible within the confines of the applicable statutory language.

Oswald reversed a final order awarding PTD benefits to an employee who was not yet at MMI and who failed to prove that he would be totally disabled upon reaching MMI. See 710 So.2d at 96. We began the opinion by noting that “[t]he predicate for total disability benefits is catastrophic injury, which by definition entails permanent impairment.” Id. Then, after recognizing the “venerable rule” that a claim for PTD benefits is premature if the injured employee has not yet reached MMI, id. at 97, we concluded that the 1994 amendments to chapter 440 “have given rise to a narrow but necessary exception” to this rule allowing an employee whose 104 weeks of temporary benefits are about to expire to establish

[78 So.3d 625]

entitlement to PTD benefits by proving that he or she will be permanently and totally disabled after MMI. Id. at 97–98 (referring to statutory requirement now codified in section 440.15(3)(d) that the employee's permanent impairment rating be assigned six weeks prior to expiration of temporary benefits). We held that, under this exception, “to be eligible for [PTD] benefits, an employee whose temporary benefits have run out—or are expected to do so imminently—must be able to show not only total disability upon the cessation of temporary benefits but also that total disability will be ‘existing after the date of [MMI].’ ” Id. at 98 (quoting definition of “permanent impairment” in section 440.02(19), Florida Statutes (1994 Supp.), which is now codified in section 440.02(22)).

Oswald squarely rejected the interpretation adopted by the JCC in this case and advocated by the dissent, i.e., that a claimant's entitlement to PTD benefits should be based on his or her condition at the end of the eligibility period for temporary benefits, rather than his or her condition at MMI. On this issue, Judge Padovano's concurring opinion in Oswald succinctly explained:

The remaining question is whether section 440.15(3)(a) 4. [now section 440.15(3)(d) ] requires an evaluation of the impairment at the time of the medical examination (during the six-week period before the temporary benefits expire), or at the time the employee will subsequently reach [MMI]. As the court explains, the answer to this question is that the doctor must evaluate the injured employee to determine the prospective level of impairment when the employee is at [MMI]. The opinion will be subjective, but no more so than other kinds of projections we ask medical experts to make. In any event, the evaluation must be made prospectively to preserve the distinction between temporary and permanent benefits.

If we were to construe section 440.15(3)(a) 4. [now section 440.15(3)(d) ] to mean that the doctor must determine the degree of impairment at the time of the medical examination, we would then subvert the two-year limit in section 440.15(2)(a) for the payment of temporary benefits. An injured worker may have a high impairment rating at the time of the examination, and yet have a low impairment rating...

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7 practice notes
  • Westphal v. City of St. Petersburg, No. 1D12–3563.
    • United States
    • Court of Appeal of Florida (US)
    • September 23, 2013
    ...2013 WL 718653 (Fla. 1st DCA Feb. 28, 2013), and recede from our previous en banc opinion in Matrix Employee Leasing, Inc. v. Hadley, 78 So.3d 621 (Fla. 1st DCA 2011). We hold that a worker who is totally disabled as a result of a workplace accident and remains totally disabled by the end o......
  • Haridopolos v. Citizens for Strong Sch., Inc., No. 1D10–6285.
    • United States
    • Court of Appeal of Florida (US)
    • January 6, 2012
    ...J., dissenting)). The court pointed out one additional caveat: “the absence of justiciable standards could engage the court in a morass [78 So.3d 621] comparable to the decades-long struggle of the Supreme Court of New Jersey that has attempted to define what constitutes the ‘thorough and e......
  • Westphal v. City of St. Petersburg, No. SC13–1930
    • United States
    • United States State Supreme Court of Florida
    • June 9, 2016
    ...interpretation of City of Pensacola Firefighters v. Oswald, 710 So.2d 95 (Fla. 1st DCA 1998), and Matrix Employee Leasing, Inc. v. Hadley, 78 So.3d 621 (Fla. 1st DCA 2011). In Oswald, the First District held that to receive permanent total disability benefits, “an employee whose temporary b......
  • Westphal v. City of St. Petersburg, No. SC13-1930
    • United States
    • United States State Supreme Court of Florida
    • June 9, 2016
    ...of City of Pensacola Firefighters v. Oswald, 710 So. 2d 95 (Fla. 1st DCA 1998), and Matrix Employee Leasing, Inc. v. Hadley, 78 So. 3d 621 (Fla. 1st DCA 2011). In Oswald, the First District held that to receive permanent total disability benefits, "an employee whose temporary benefits ......
  • Request a trial to view additional results
7 cases
  • Westphal v. City of St. Petersburg, No. 1D12–3563.
    • United States
    • Court of Appeal of Florida (US)
    • September 23, 2013
    ...2013 WL 718653 (Fla. 1st DCA Feb. 28, 2013), and recede from our previous en banc opinion in Matrix Employee Leasing, Inc. v. Hadley, 78 So.3d 621 (Fla. 1st DCA 2011). We hold that a worker who is totally disabled as a result of a workplace accident and remains totally disabled by the end o......
  • Haridopolos v. Citizens for Strong Sch., Inc., No. 1D10–6285.
    • United States
    • Court of Appeal of Florida (US)
    • January 6, 2012
    ...J., dissenting)). The court pointed out one additional caveat: “the absence of justiciable standards could engage the court in a morass [78 So.3d 621] comparable to the decades-long struggle of the Supreme Court of New Jersey that has attempted to define what constitutes the ‘thorough and e......
  • Westphal v. City of St. Petersburg, No. SC13–1930
    • United States
    • United States State Supreme Court of Florida
    • June 9, 2016
    ...interpretation of City of Pensacola Firefighters v. Oswald, 710 So.2d 95 (Fla. 1st DCA 1998), and Matrix Employee Leasing, Inc. v. Hadley, 78 So.3d 621 (Fla. 1st DCA 2011). In Oswald, the First District held that to receive permanent total disability benefits, “an employee whose temporary b......
  • Westphal v. City of St. Petersburg, No. SC13-1930
    • United States
    • United States State Supreme Court of Florida
    • June 9, 2016
    ...of City of Pensacola Firefighters v. Oswald, 710 So. 2d 95 (Fla. 1st DCA 1998), and Matrix Employee Leasing, Inc. v. Hadley, 78 So. 3d 621 (Fla. 1st DCA 2011). In Oswald, the First District held that to receive permanent total disability benefits, "an employee whose temporary benefits ......
  • Request a trial to view additional results

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