CLIFFORD SIMPSON, APPELLANT,
v.
AMERICAN CUSTOM INTERIORS, APPELLEE

Fla. 1st DCA | 2004-12-30
No. 1D04-0304
BOOTH, VAN NORTWICK and PADOVANO, JJ., Concur.
911 So. 2d 794 Florida District Court of Appeal, First District (2004) Positive Treatment
Cited by 7 cases

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Synopsis

Clifford Simpson appealed a workers' compensation decision denying him future benefits based on factual misrepresentation. The court held that the judge of compensation claims lacked jurisdiction to rule on the misrepresentation defense because the only remaining claim before the court—authorization for surgery—was outside the judge's jurisdiction under managed care procedures.


Holding

The judge lacked jurisdiction to rule on the misrepresentation defense. Having found no jurisdiction over the surgery authorization request, the only claim before him, the judge should have dismissed the petition without ruling substantively on the misrepresentation defense. The employer may raise the defense again in any future petition filed after exhaustion of managed care procedures.


Headnotes

[1] A judge of compensation claims lacks jurisdiction to rule on an affirmative defense when the underlying claim over which the judge has jurisdiction has been withdrawn.

[2] A judge of compensation claims should dismiss a petition for benefits for lack of jurisdiction without ruling on the merits of a defense to the claim.

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Key Quotes

“the judge exceeded his jurisdiction by ruling on the misrepresentation defense. Having found that he lacked jurisdiction to rule on the request for surgery, he should have simply dismissed the petition without ruling on whether Simpson actually committed a misrepresentation.”

Establishes the core holding that a judge cannot rule on an affirmative defense when lacking jurisdiction over the underlying claim

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Facts & Procedural History

In April 2003, Simpson filed a petition for workers' compensation benefits seeking indemnity benefits and surgery authorization for a lower-back injur…

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Opinion of the Court
PER CURIAM.

PER CURIAM.

The appellant, Clifford Simpson, challenges a determination that he is not entitled to recover workers’ compensation benefits in the future because he made a misrepresentation of fact, in violation of sections 440.09(4) and 440.105(4)(b)(l), Florida Statutes. We conclude that the judge of compensation claims lacked jurisdiction to rule on the underlying indemnity claim. Therefore, the petition for benefits should have been dismissed without a ruling on the merits of the misrepresentation defense.

In April of 2003, Simpson filed a petition for benefits seeking indemnity benefits and authorization for surgery for a lower-back injury. The employer and carrier had previously accepted the injury as compensable but refused to authorize surgery. Shortly before the hearing on his petition began, Simpson withdrew the claim for indemnity benefits, leaving only the request for surgery to be decided.

The judge found that he lacked jurisdiction to consider the medical issue of the authorization for surgery, because Simpson had not exhausted the managed care grievance procedures. However, he went on to rule on the employer and carrier’s affirmative defense of factual misrepresentation. The judge found that Simpson had committed a misrepresentation for the purpose of securing benefits, because he had not been truthful about the fact that he had been earning money during the time that he was receiving indemnity benefits. Given this finding, the judge further ruled that Simpson was not entitled to any future workers’ compensation benefits.1 The judge denied the request for surgery, based on both the lack of jurisdiction to consider medical issues and on the finding of misrepresentation.

We conclude that the judge exceeded his jurisdiction by ruling on the misrepresentation defense. Having found that he lacked jurisdiction to rule on the request for surgery, he should have simply dismissed the petition without ruling on whether Simpson actually committed a misrepresentation. Although the judge would have had jurisdiction over the indemnity issue, Simpson had withdrawn that claim, so it was no longer before the judge. The employer and carrier may raise the misrepresentation defense again if Simpson files another petition for benefits in the future, after exhausting the managed care grievance procedures. But for now, with no jurisdiction over the only claim before him, the judge lacked jurisdiction to rule on the defense to that claim.

Therefore, we reverse that part of the order ruling substantively on the misrepresentation defense and concluding that the appellant is not entitled to any future benefits. On remand, the judge shall dismiss the petition for lack of jurisdiction.

Reversed and remanded.

BOOTH, VAN NORTWICK and PADOVANO, JJ., Concur. . Section 440.09(4) denies workers’ compensation benefits to any worker who knowingly or intentionally engages in any of the acts set forth in 440.105, for the purpose of securing workers' compensation benefits.


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Citator

Cited By

  • Schmachtenberg v. Schmachtenberg, 34 So. 3d 28 (Fla. 3d DCA 2010)
    …easonably inferred from the terms of the contract, the agreement is ambiguous.” Id. (citing Miller v. Kase, 789 So. 2d 1095, 1097-98 (Fla. 4th DCA 2001)). “[W]hether an ambiguity exists in a contract is a question of law.” Essex Ins. Co. v. Simpler, 911 So. 2d 794, 794 (Fla. 1st DCA 2004). Therefore, “the standard of review applicable to the determination of whether a contract is ambiguous is the de novo standard of review.” Weisfeld-Ladd, v. Estate of Ladd, 920 So. 2d 1148, 1150 (Fla. 3d DCA 2006) (quoting W…
  • Weisfeld-Ladd v. In re Est. OF Norman K. Ladd, 920 So. 2d 1148 (Fla. 3d DCA 2006)
    …sion of evidence extrinsic to the contract bearing upon the intent of the parties.”). Upon review of the Prenuptial Agreement, we agree with the trial court’s determination that the Prenuptial Agreement was ambiguous. See Essex Ins. Co. v. Simpler, 911 So. 2d 794 (Fla. 1st DCA 2004) (“[T]he standard of review applicable to the determination of whether a contract is ambiguous is the de novo standard of review.”); Wagner v. Wagner, 885 So. 2d 488 (Fla. 1st DCA 2004) (holding that “whether an ambiguity exists i…
  • Torwest, Inc. v. Killilea, 942 So. 2d 1019 (Fla. 4th DCA 2006)
    …ned the compensation portion of the agreement was not ambiguous and awarded Killilea commissions of $650,899.27. Whether an ambiguity exists in a contract is a question of law subject to a de novo standard of review. See Essex Ins. Co. v. Simpler, 911 So. 2d 794 (Fla. 1st DCA 2004); Wagner v. Wagner, 885 So. 2d 488, 492 (Fla. 1st DCA 2004). Language in a contract is ambiguous where it is “fairly susceptible to more than one interpretation.” McInerney v. Klovstad, 935 So. 2d 529, 531-32 (Fla. 5th DCA 2006).…

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