BOBBY WILLIS, APPELLANT,
v.
PUBLIX SUPER MARKETS, INC., AND PUBLIX RISK MANAGEMENT, APPELLEES
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.
Bobby Willis appealed a workers' compensation judge's order finding that his employer/carrier (Publix) complied with the 120-day "pay and investigate" rule under Florida law when denying compensability for neck and back injuries. The court affirmed the evidentiary ruling on an updated IME but reversed the 120-day compliance finding, holding that Publix waived its right to deny compensability by failing to deny within 120 days.
The court reversed the JCC's finding that the employer/carrier complied with the 120-day rule. Because the employer/carrier failed to deny compensability within 120 days and did not establish material facts that it could not have discovered through reasonable investigation within that period, it waived its right to deny compensability.
[1] An employer/carrier waives its right to deny compensability for a claimed condition if it fails to deny compensability within 120 days of the claimant's petition for bene…
[2] The 120-day period for an employer/carrier to pay and investigate a workers' compensation claim begins to run when the claimant specifically requests the benefit.
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“Because the record does not show that the E/C "establish[ed] material facts relevant to the issue of compensability that it could not have discovered through reasonable investigation within the 120-day period," the E/C waived its right to deny compensability.”
Establishes the standard for waiver under the 120-day rule—the employer must show it discovered facts within 120 days that it could not have discovered through reasonable investigation.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceBobby Willis, a meat cutter at Publix Supermarkets, suffered a work-related accident on March 17, 2001, claiming neck pain, back pain, and carpal tunn…
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PER CURIAM.
The claimant, Bobby Willis, appeals the judge of compensation claims’s (“JCC”) order and argues that the JCC erred by (i) finding that the employer/carrier (“E/C”) complied with the 120-day “pay and investigate” rule of section 440.20(4), Florida Statutes (2001), and (ii) allowing the “updated IME” of a psychiatrist into evidence. We affirm the JCC’s evidentiary ruling on the updated IME without further comment. The JCC’s 120-day ruling is reversed.
The claimant, employed by Publix Supermarkets, Inc., as a meat cutter, alleged work-related neck pain, back pain, and carpal tunnel syndrome from a March 17, 2001 accident under a repetitive trauma theory. The E/C accepted compensability for the carpal tunnel syndrome but denied the claimant’s petition for medical indemnity benefits for his neck and back pain.
The claimant initially sought medical treatment under his group health insurance and was treated by several doctors who diagnosed him with work-related problems. The claimant received surgery on June 25, 2001, for carpel tunnel syndrome. Also on June 25, 2001, the claimant initiated a petition for workers’ compensation benefits for his neck and back conditions. Publix decided to pay and investigate pursuant to the 120-day provision contained in section 440.20(4), Fla. Stat. (2001).
An independent medical evaluation (“IME”) was conducted on October 25, 2001,123 days after the claimant first notified Publix that he was filing a petition for benefits. The IME physician opined that the claimant had osteoarthritis and that his neck and back conditions were preexisting, not work-related. Based on this recommendation, the E/C denied compensability on November 1, 2001, 130 days after the claimant first sought workers’ compensation benefits for his neck and back conditions. The JCC found that the E/C’s denial of the neck and back conditions was within 120 days of the claimant’s petition for benefits. The JCC also found that a four-day extension for the employer to deny compensability was warranted, thus recognizing that the E/C did not deny compensability within the time period.
The claimant contends that it was error for the JCC to allow the E/C to deny compensability for the neck and back conditions claimed on June 25, 2001, when the E/C failed to deny compensability within 120 days as required by section 440.20(4), Florida Statutes (2001). We agree and, therefore, reverse on this issue. Because the record does not show that the E/C “establish[ed] material facts relevant to the issue of compensability that it could not have discovered through reasonable investigation within the 120-day period,” the E/C waived its right to deny compensability. See Clements v. Walt Disney World Co., 819 So. 2d 1014, 1016 (Fla. 1st DCA 2002) (holding that the 120-day period begins to run when the claimant specifi cally requests the benefit); Franklin v. Northwest Airlines, 778 So. 2d 418, 421-22 (Fla. 1st DCA 2001) (requiring the E/C to pay benefits even though injury did not arise out of employment because the E/C did not comply with 120-day requirement).
AFFIRMED in part; REVERSED in part and REMANDED.
WOLF, C.J., PADOVANO and POLSTON, JJ., concur.
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Wintz v. Goodwill & Summit Claims Mgmt., 898 So. 2d 1089 (Fla. 1st DCA 2005)…JJ„ concur. . In her petition for benefits, Claimant asserted the accident date was February 24, 2003, and just prior to the merits hearing, Claimant asked the-JCC to amend the accident date to January 2003. . Willis v. Publix Super Markets, Inc., 871 So. 2d 941 (Fla. 1st DCA 2004); Singletary v. Yoder's and Ameritrust Ins. Corp., 871 So. 2d 289 (Fla. 1st DCA 2004); Hutchinson v. Lykes Smithfield Packing, 870 So. 2d 144 (Fla. 1st DCA 2004); Travelers Ins. Co. v. Collins, 825 So. 2d 451 (Fla. 1st DCA 2002);…
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Tomaskovich v. Lapointe, 904 So. 2d 538 (Fla. 1st DCA 2005)…IME IS NOT TREATMENT Clearly, when the E/C fail to controvert a claim within 120 days after the initial provision of benefits, they are es-topped from denying compensability. See § 440.20(4), Fla. Stat. (2001); Willis v. Publix Super Markets, Inc., 871 So. 2d 941 (Fla. 1st DCA 2004). However, the benefit that triggers the 120-day period must actually be provided, not merely authorized. See Osceola County Sch. Bd. v. Arace, 884 So. 2d 1003 (Fla. 1st DCA 2004). Here, the record unequivocally indicates Dr. Wol…
Authorities Cited
- Franklin v. Nw. Airlines & Liberty Mut., 778 So. 2d 418 (Fla. 1st DCA 2001)
- Clements v. Walt Disney World Co. & Walt Disney World Workers' Comp., 819 So. 2d 1014 (Fla. 1st DCA 2002)