Court: District Court of Appeal of Florida; February 26, 1992; Florida; State Appellate Court
The Special Disability Trust Fund (Fund) contests workers’ compensation orders that granted employer/carriers reimbursement from the Fund for supplemental permanent total disability benefits under section 440.15(l)(e)1, Florida Statutes (Supp. 1984). The cases were consolidated for appeal due to the shared issue. The claimants in both cases sustained compensable injuries in 1984 and continue to receive permanent total disability benefits. Since these injuries occurred after July 1, 1984, the employer/carriers also provided supplemental benefits as mandated by the statute. Claimants had preexisting permanent physical impairments, prompting employer/carriers to seek reimbursement from the Fund under section 440.49(2), Florida Statutes (1983). Although the Fund reimbursed for some benefits under section 440.15(l)(a), it denied reimbursement for supplemental benefits under section 440.15(l)(e)1. The primary issue was whether reimbursement for permanent total benefits under section 440.49(2)(c) included supplemental benefits. The judge of compensation claims ruled in favor of the employer/carriers, determining that the Fund must reimburse for supplemental benefits. This decision aligns with the statutory provisions, which outline the compensation structure for permanent total disability and the intent to limit employer liability for subsequent injuries affecting handicapped workers.
The division is tasked with notifying employers about the fund's existence and functions, interpreting eligibility requirements broadly. In cases of permanent total disability, if an employee with a preexisting permanent physical impairment sustains a subsequent impairment due to work-related injury or disease, the employer must initially pay all relevant benefits. However, the employer may seek reimbursement from the Special Disability Trust Fund for compensation exceeding 175 weeks of permanent total disability payments. The Fund asserts its reimbursement authority is limited to situations explicitly defined by the legislature, arguing that supplemental permanent total disability benefits are not included under section 440.49(2)(c). The Fund references a past case, Special Disability Trust Fund v. Motor and Compressor Company, to support its position but finds that case inapplicable. It contends that the amendments made in 1984 to require employers to pay supplemental permanent total disability benefits did not alter the reimbursement provisions of section 440.49(2). The statute clearly states that an employer is entitled to reimbursement for compensation related to permanent total disability when a preexisting impairment merges with a new impairment. Compensation is defined as monetary payments to employees or their dependents under the chapter's provisions. The analysis emphasizes that the language of the statute supports the employer's right to reimbursement for permanent total disability benefits.
Provisions in this subsection specify the percentage of average weekly wages payable for total disability findings, define total disability, outline the duration of payments, and address benefits if an employee regains earning capacity. It establishes that additional or supplemental benefits apply to injuries occurring between June 30, 1955, and July 1, 1984, funded by the Workers’ Compensation Administration Trust Fund, while benefits for injuries after July 1, 1984, are the employer's responsibility. The placement of supplemental benefits under 'Compensation for Disability' indicates legislative intent for these to be considered compensation for permanent total disability, thus qualifying for reimbursement from the Fund as per Section 440.49(2)(c)3. The question of whether the Special Disability Trust Fund must reimburse employers for supplemental benefits under Section 440.15(l)(e)1 is certified as one of great public importance. The orders appealed are affirmed by Judges BOOTH, SMITH, and BARFIELD. Historical arguments regarding the provisions’ development hold some merit; however, the applicable statutes are clear. Prior to July 1, 1984, supplemental benefits were disbursed from the Administrative Trust Fund, which is funded through assessments from insurers and self-insurers, without reimbursement provisions from the Special Disability Trust Fund. Following an amendment in Chapter 84-267, employers became responsible for these benefits for injuries post-June 30, 1984. The Special Disability Trust Fund's reimbursement provisions were unchanged and funded similarly through assessments. Section 440.49(2)(h)2 outlines the annual assessment process necessary for maintaining the fund.
Legislative history indicates that the amendment was intended to transfer the responsibility for supplemental benefit payments from the Division of Workers’ Compensation to employers. A Senate staff analysis states that the amendment would shift the cost of the five percent supplemental benefit payments for injuries occurring after July 1, 1984, from the Division to the employer/carrier. Although this may increase insurance costs for employers, the overall fiscal impact is expected to be neutral, as the Division Trust Fund's assessments on insurers will decrease due to reduced liability. Employers have been indirectly paying these benefits through regulatory assessments, which are passed on as higher premiums.
Individual employer costs may vary based on their number of employees with permanent total disabilities. The Division of Workers’ Compensation will no longer bear the costs of supplemental benefit payments for injuries after the specified date. Historical data shows a significant increase in the amounts paid from the Administrative Trust Fund for supplemental permanent total disability benefits.
The key legal question remains whether employers/carriers are entitled to reimbursement for these supplemental benefits under section 440.49(2)(c). The judges of compensation claims concluded that the Fund must reimburse employers for these payments, which is supported by section 440.15 of the Florida Statutes, outlining compensation for permanent total disability, including an additional five percent for qualifying injuries post-June 30, 1955.
Supplemental benefits for injuries occurring between June 30, 1955, and July 1, 1984, will be paid by the Workers’ Compensation Administration Trust Fund. For injuries on or after July 1, 1984, these benefits are the responsibility of the employer. According to Section 440.49(2) of the Florida Statutes (1983), the Special Disability Trust Fund aims to incentivize the employment of physically handicapped individuals by limiting employer liability for compensation and medical expenses when a new injury worsens a preexisting physical impairment. The division is tasked with informing employers about the fund and interpreting eligibility broadly.
In cases of permanent total disability resulting from a combination of a new injury and a preexisting impairment, the employer is required to pay all benefits initially, but can seek reimbursement from the Special Disability Trust Fund for compensation exceeding 175 weeks of permanent total disability. The Fund asserts its authority to reimburse only for legislatively specified situations and argues that supplemental permanent total disability benefits are not included in the reimbursement provisions of Section 440.49(2)(c). The Fund's position cites a precedent case, Special Disability Trust Fund v. Motor and Compressor Company, but its reliance on this case is deemed misplaced, as it primarily addressed different benefits not specified for reimbursement under the statute. Unlike in that case, the legislative amendments regarding supplemental benefits imply a broader reimbursement scope that includes these payments.
Section 440.49(2)(c)3 mandates that employers of employees with a preexisting permanent physical impairment are entitled to reimbursement from the Special Disability Trust Fund for all compensation related to permanent total disability when this preexisting impairment combines with a later permanent impairment. "Compensation" is defined as monetary benefits payable to the employee or their dependents under this chapter (Section 440.026). Judge Steven P. Cullen's order highlights that Section 440.15 outlines permanent total disability benefits, detailing the percentage of average weekly wages payable, criteria for total disability, duration of payments, implications of regaining earning capacity, and the provision for additional or supplemental benefits based on the date of injury. The legislation indicates that these supplemental benefits are intended as compensation for permanent total disability, making them reimbursable by the Fund under Section 440.49(2)(c)3.
The question certified for appellate review concerns whether the Special Disability Trust Fund must reimburse employers for supplemental permanent total disability benefits under Section 440.15(1)(e)1. The appellate court affirmed the orders, indicating that the statutory provisions are clear and unambiguous, despite potential merit in the appellant's historical arguments regarding the provisions prior to July 1, 1984, when supplemental benefits were sourced from the Workers’ Compensation Administration Trust Fund, which is funded through assessments on insurance companies and self-insurers. Notably, there is no reimbursement provision from the Special Disability Trust Fund for amounts disbursed from the Administrative Trust Fund.
Chapter 84-267 of Florida law amended section 440.15(l)(e)l, establishing that employers are responsible for paying supplemental permanent total disability benefits for injuries occurring after June 30, 1984. This legislation, titled to make employers accountable for these benefits, did not alter section 440.492 concerning the Special Disability Trust Fund reimbursement. No funds were shifted from the Administrative Trust Fund to the Special Disability Trust Fund, which remains financed by annual assessments on insurance companies and self-insurers.
The annual assessment amount, determined by the Division, aims to cover administrative costs and maintain the Special Disability Trust Fund, ensuring it is equal to disbursements from the previous three years, supplemented by any surplus over $100,000 in the fund. Legislative history suggests an intent to transfer the financial burden of these supplemental benefits entirely to employers. Analyses from both the Senate and House indicate that while the overall costs to employers should remain unchanged, individual employer expenses may vary based on the incidence of permanent total disabilities among their employees. The Division of Workers’ Compensation will no longer bear the costs associated with these benefits for post-July 1, 1984 injuries, contrasting with the increasing financial burden observed from $2.2 million in 1979-80 to $5.8 million in 1983-84. However, the analyses did not address the Special Disability Trust Fund, raising questions about the completeness of the legislative intent regarding the 1984 amendments.
