DIVISION OF RISK MANAGEMENT, STATE OF FLORIDA, APPELLANT/CROSS-APPELLEE,
v.
NATIONWIDE INSURANCE COMPANY, FRANK MASIARCZYK AND KEITH LLOYD CALVIN, APPELLEES/CROSS-APPELLANTS

Fla. 1st DCA | 1986-12-31
No. BJ-143
WIGGINTON and BARFIELD, JJ., concur.
504 So. 2d 11 Florida District Court of Appeal, First District (1986)

AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.

Synopsis

The Division of Risk Management appealed an equitable distribution order that limited its recovery of workers' compensation benefits paid to an injured employee who settled a third-party personal injury claim for $25,000. The court reversed, holding that the workers' compensation carrier is entitled to full recovery of all past and future benefits paid, up to the net settlement amount, unless the employee demonstrates she did not recover full damages due to comparative negligence, insurance limits, or collectibility issues.


Holding

The workers' compensation carrier is entitled to full recovery of all past and future workers' compensation benefits paid or to be paid, up to the net amount received by the employee in settlement of the third-party claim, unless the employee demonstrates she did not recover the full value of damages due to comparative negligence, insurance limits, or collectibility issues. The burden is on the employee to prove one of these statutory exceptions.


Headnotes

[1] A workers' compensation carrier is entitled to recover 100 percent of past and future benefits paid to an injured employee from a third-party settlement, unless the emplo…

[2] The burden of demonstrating that a third-party settlement did not represent the full value of damages rests with the injured employee.

Previewing 2 of 3 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.

Join FLexlaw to unlock all legal intelligence

Key Quotes

“100 percent of what it has paid and future benefits to be paid, unless the employee ... can demonstrate to the court that he did not recover the full value of damages sustained because of comparative negligence or because of limits of insurance coverage or collectibility.”

The statutory language of Section 440.39(3)(a) establishing the default rule for recovery and placing the burden on the employee to prove exceptions.

Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.

Join FLexlaw to unlock all legal intelligence

Facts & Procedural History

In November 1980, Enid Rathburn, an employee of the Department of Labor and Employment Services, was injured in an automobile accident. She filed a wo…

The full statement of facts, procedural history, and disposition for this case are member content.

Join FLexlaw to unlock all legal intelligence

© FLexlaw, Inc. — AI-generated enrichments are proprietary. All rights reserved.


Opinion of the Court
ERVIN, Judge.

ERVIN, Judge.

The Division of Risk Management, the workers’ compensation carrier for the employer of an injured employee, appeals an order of equitable distribution, requiring it to pay 95 percent of all future workers’ compensation benefits to Enid Rathburn, the claimant-employee, notwithstanding Rathburn’s earlier settlement agreement with the third-party tortfeasors in a personal injury action. We find that the lower court erred in its application of the statutory requirements of Section 440.39, Florida Statutes (1979), and reverse and remand.

In November 1980, Rathburn, an employee of the Department of Labor and Employment Services, was injured in an automobile accident. She subsequently filed a workers’ compensation claim, and ultimately received from her employer $3,301.16 in benefits. While the claim was pending, Rathburn brought a personal injury action against the driver of the other vehicle involved in the accident, the vehicle’s owner, and the owner’s insurance carrier, Nationwide. Following negotiations, a settlement of $25,000 was reached, and appellant filed its petition for equitable distribution of both past workers’ compensation benefits paid by it and any future benefits that it may be obligated to pay.

The order of equitable distribution not only permitted the employer/carrier (e/c) to recover the entire amount paid by it to Rathburn, but also directed it to pay 95 percent of any future benefits owing to her by reason of the injury.. The direction of the payment of future benefits by the e/e was under the circumstances clearly contrary to the provisions of section 440.-39(3)(a), which provides in part that, subject to deduction for costs and attorney’s fees, the e/c shall recover from the judgment “100 percent of what it has paid and future benefits to be paid, unless the employee ... can demonstrate to the court that he did not recover the full value of damages sustained because of comparative negligence or because of limits of insurance coverage or collectibility.” (e.s.) The statute expressly places the burden of such demonstration on the employee.

The record before us discloses that the employee failed to meet her burden. Although Rathburn settled her personal injury claim against the third-party tortfeasors in the amount of $25,000, the settlement did not exhaust the limit of insurance coverage available to her, which was in the amount of $100,000. Moreover she failed to present any evidence that she did not recover the full value of damages sustained due to any of the other statutory exceptions. Accordingly, appellant is entitled to full recovery of all past and future workers’ compensation amounts paid or to be paid by it, up to the net amount received by Rathburn in settlement of her personal injury claim, following the deduction of attor ney’s fees and costs. See Zurich Insurance Co. v. Martin, 452 So. 2d 978 (Fla. 5th DCA 1984); Maryland Casualty Insurance Co. v. Reeves, 418 So. 2d 1257 (Fla. 4th DCA 1982); Department of Health and Rehabilitative Services v. Culmer, 402 So. 2d 1273 (Fla. 3d DCA 1981).

REVERSED AND REMANDED for entry of judgment consistent with this opinion.

WIGGINTON and BARFIELD, JJ., concur.


Cases With Similar Vibessemantic neighbors from the corpus


Citator

Authorities Cited

Full citator, related cases, and AI research tools

Open in FLexlaw