Mays v. Packers
| Decision Date | 14 August 1996 |
| Docket Number | No. 95-2045,95-2045 |
| Citation | 677 So.2d 992 |
| Parties | 21 Fla. L. Weekly D1828 Clarence MAYS, Appellant, v. Dixie PACKERS and Crawford & Company, Appellees. |
| Court | Florida District Court of Appeals |
Harold E. Regan, Tallahassee, for Appellant.
Christopher J. DuBois and Mary E. Cruickshank of McConnaughhay, Roland, Maida & Cherr, Tallahassee, for Appellees.
Claimant Clarence Mays appeals a workers' compensation order that denied his petition for attorney's fees, which was filed under section 440.34(3)(a), Florida Statutes (1989), in connection with a claim for medical benefits only. The reason the judge of compensation claims (JCC) gave for the denial was that the medical benefits claim contained an incorrect date of injury, contrary to the provisions of section 440.19(1)(d), Florida Statutes (1989). As we consider that the initial claim for medical benefits sufficiently apprised the employer/carrier (E/C) of the actual date, we reverse the order denying fees and remand the case with directions that a reasonable attorney's fee be determined.
In his March 25, 1993 claim for medical benefits, claimant erroneously stated on the face of the claim that the accident occurred on August 26, 1990, when in fact, the correct date was May 16, 1990. The claim also referred to and had attached to it a medical note from claimant's attending physician which twice accurately identified the date of injury as May 1990. Thereafter, on April 29, 1993, the E/C issued a notice of denial stating that it had no knowledge or documentation of claimant suffering an injury on August 26, 1990. Claimant filed an amended claim for benefits listing the correct accident date as May 16, 1990. The E/C once again served a notice of denial, but advised that it had authorized the requested surgery as of April 29, 1993.
In denying the subsequently filed petition for attorney's fees, the JCC explained that the initial claim for medical benefits was required by the statute to contain the correct date of injury in order to place the E/C sufficiently on notice in regard to the identity of the parties and the details of the benefits alleged to be due. He further found that the E/C had properly denied the initial claim, which was incorrect because claimant had not suffered any injury on the date alleged. Finally, he concluded that because the E/C had timely authorized the requested medical care before the amended claim was filed, no valid ground existed on which a fee could be earned. In our judgment, based on applicable case law, no competent, substantial evidence supports the above findings.
Despite the incorrect date listed on the face of the claim for medical benefits, the E/C had actual knowledge at the time it served its notice of denial that claimant's accident had in fact occurred on May 16, 1990. This knowledge is evidenced by the physician's medical note attached to the initial claim, which stated the correct date of the accident. Additionally, the record discloses that during several months immediately preceding the filing of the claim, claimant's attorney had written three letters to the carrier requesting authorization for the requested surgery, all of which contained the correct date of accident. Moreover, on January 23, 1991, claimant filed a prior claim for benefits ensuing from the May 16, 1990 industrial accident, which resulted in the voluntary payment of temporary total benefits. During the pendency of the 1991 claim, the carrier forwarded a letter to claimant's attorney on April 19, 1991, acknowledging the accident date of May 16, 1990.
Under the circumstances, we cannot accept the interpretation which the judge below appears to have placed upon section 440.19(1)(d): that a claim must be denied if the correct date of the accident is not stated on the face of the claim for benefits. We conclude that if information is contained within a claim which provides an employer with reasonable information permitting ascertainment of the correct date of injury, or if the E/C is otherwise provided with actual notice of the correct date, the claim should not be dismissed. In reaching our decision, we are strongly persuaded by that portion of subsection (1)(d), which requires specific factual details, or "such equivalent information as will put the division and the employer on notice." (Emphasis added.)
The legislative purpose, we believe, in requiring that an employee furnish the information designated in section 440.19(1)(d) is to protect an employer from being unfairly disadvantaged in defending a claim for benefits. Once, however, evidence is adduced from which one can decide that an employer has received reasonable or actual notice of the facts required to be provided in the claim, the reason for exact specificity disappears. In creating the "equivalent information" language in section 440.19, 1 we consider that the legislature required some showing of prejudice in order to defeat a claim for benefits.
Our conclusion in this regard is supported by case law both from the Florida Supreme Court and our own. In its interpretation of section 440.19, Florida Statutes (1957), which contained a provision similar to that in the statute now on review, this court, in A.B. Taff & Sons v. Clark, 110 So.2d 428, 433 (Fla. 1st DCA 1959), made the following observations:
It is well recognized that the Workmen's Compensation Law is so administered that formal pleadings, such as attorneys are versed in preparing, are quite unnecessary in order to activate the question of an employee's right to compensation and other benefits under the Act, and that any paper lodged with the commission indicating a probability that the employee has not received such compensation or benefits is treated as a "claim" and processed as such in the same manner as if it were filed with all the niceties of expert legal attention.
(Emphasis added.)
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