What's Hot in Workers' Comp
Because claimant’s mental injury manifested itself within six months of reaching physical MMI and claimant was not receiving impairment benefits for the physical injury after reaching that point, the statutory cap in section 440.093(3) does not apply.
The claimant was injured on January 7, 2019, while working in a correctional facility after an inmate attacked her, causing neck and throat injuries. She reached physical maximum medical improvement (MMI) two weeks later and had no permanent impairment rating. She was then referred for psychiatric treatment and psychological care. She was diagnosed with acute stress and post-traumatic stress disorder. On November 11, 2019, the psychologist placed the claimant on a no-work status until she reached psychological MMI. The employer/carrier discontinued indemnity benefits six months after the claimant reached physical MMI. The claimant then filed a claim for temporary benefits for the period of July 25, 2019, and continuing.
The Judge of Compensation Claims found that temporary indemnity benefits for mental injuries are limited to six calendar months after a claimant reaches physical MMI, pursuant to section 440.093(3). The judge also relied on Utopia Home Care/Guarantee Ins. Co. v. Alverez, 230 So.3d 72 (Fla. 1st DCA 2017). Additionally, because the claimant’s claim was for a time period commencing more than six months post physical MMI, the judge concluded that the statute precluded her entitlement to any additional indemnity benefits.
On appeal, the First District Court of Appeal found that the judge had erred and reversed the decision. The appellate court noted that the judge was correct in finding that the six-month limit on temporary benefits begins from the time a claimant reaches physical MMI, as opposed to being a bank of time. However, they found he erred in finding that the limit applied in this case because the claimant had not received any impairment benefits.
In W.G. Roe & Sons v. Razo-Guevara, 999 So.2d 708 (Fla. 1st DCA 2008), this court held in no uncertain terms that this statutory provision does not apply to a claimant not being paid impairment benefits. Therefore, because the claimant’s mental injury manifested itself within six months of reaching physical MMI and she was not receiving impairment benefits for her physical injury after reaching that point, the statutory cap in section 440.093(3) does not apply. Cf. Alvarez, 230 So.3d at 72 (in which claimant received impairment benefits for her physical injury); Sch. Bd. of Lee Cnty. v. Huben, 165 So.3d 865 (Fla. 1st DCA 2015) (in which claimant’s mental injury manifested more than six months after reaching physical MMI and she received impairment benefits for her physical injury).
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