We are always reading stories or posting stories about fraud. We usually are always seeing a worker claiming to be injured collecting compensation while also working a side job for income. These are probably 90% of the stories we read about, but fraud can happen from all angles and for a variety of reasons.
Read More Here to examine a few of the different ways that fraud can and does occur.
Levy & Levy
Florida Workers’ Compensation Digest:
In Clayton v. Lakeland Police Department, OJCC Case #13-16219MES, D/A 10/30/12, Judge Sojourner on 1/27/14 awarded IBs for a 10% PIR. The claimant had a previous atrial fibrillation disability in 2006 and received benefits under that date of accident. The claimant was again hospitalized for atrial fibrillation on 10/30/12, for which the E/C paid under the 2006 date of accident. The JCC held that for occupational diseases the date of disability determines the date of the accident. Each period of disablement results in a new date of accident. See Orange County Fire Rescue v. Jones, 959 So.2d 785 (Fla. 1st DCA 2007). Therefore, the new 10/30/12 disability was a new date of accident. There was a medical conflict between the claimant’s medical opinion of a 40% rating and the E/C’s medical opinion of a 10% rating. According to the Florida impairment guidelines, the claimant’s range was appropriate where the claimant has marked physical limitations, and the E/C’s where there are no resulting limitations. Both medical opinions had the claimant on no work status. Therefore, the JCC resolved the conflict for the E/C’s 10% opinion. The JCC allowed a credit for the IBs already paid under the 2006 accident. Comment: Creating a new date of accident for each new period of disability 1) minimizes the strength of a statute of limitations defense, and 2) maximizes litigation exposure in occupational disease cases.
Tallahassee, FL – The Florida Department of Economic Opportunity has determined the statewide average weekly wage paid by employers subject to the Florida Reemployment Assistance Program Law to be $827.08 for the four calendar quarters ending June 30, 2013.
Section 440.12(2), Florida Statutes, expressly provides that, for injuries occurring on or after August 1, 1979, the weekly compensation rate shall be equal to 100 percent of the statewide average weekly wage, adjusted to the nearest dollar, and that the average weekly wage determined by the Agency for Workforce Innovation for the four calendar quarters ending each June 30th shall be used in determining the maximum weekly compensation rate with respect to injuries occurring in the calendar year immediately following.
Accordingly, the maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2014 shall be $827.00.
Source: FL DFS
Boca Raton, FL – NCCI recently released the 2013 update to their report on Temporary Total Disability Indemnity Benefit Duration in Workers’ Compensation. Previous NCCI studies of Temporary Total Disability (TTD) indemnity benefits duration showed an increase in nationwide average duration following the onset of the Great Recession in 2007.
As this updated, post-recession research shows, Accident Year (AY) 2009 was the nationwide peak at 143 days, and average duration has since declined to 140 days in AY 2012. Average durations have risen or fallen in step with the national unemployment rate.
Other key findings include:
A free copy of the complete report is available here: NCCI: Workers Compensation Temporary Total Disability Indemnity Benefit Duration—2013 Update (PDF)
Source: NCCI