Welcome to the Roundtable Roundup, the most active discussions, highlights and summary of all the action on the Workers Compensation Roundtable last week. We appreciate your thoughts, comments, and participation in the WC Roundtable. We look forward to featuring you!
One of the cases upon which the Sate of Florida has focused over the last year has been decided. The Third District Court of Appeal today (June 24, 2015) rendered its REVERSAL of the trial judge in The State of Florida v. Florida Workers' Advocates (Commonly referred to as Padgett).
Fraud, when discussed in the context of workers’ compensation, is an interesting thing that many can’t seem to agree on. Some injured workers will tell you that there is virtually no such thing as workers’ comp fraud (except for all the fraud committed against them by the entire world – insurers, employers, regulators, Starbucks Baristas and assorted Disney characters). They will grudgingly admit that in the event it does exist at all, it is so inconsequential, so infinitesimal, that it doesn’t even deserve the time of day. Some on the professional side seem to believe that any claim is a fraudulent one, and that injured workers’ are “guilty until proven innocent”. They view every claim through a suspicious microscope, and look for any indicator that someone is trying to pull the wool over their eyes.
- Great topic as always Bob……several factors are at play…first, as you know we are in a pay or deny business.
- Definitely an unrealistic timeline for adjusters. We are the big bad insurance company trying to take advantage of the "working man" so the court system is already geared to favor claimants.
- Just to share a frustrating real life example of how our legal actually works. Plaintiff, under oath, breaks down and cries, admitting she filed for workers compensation simply because her short disability had run out.
- Defense attorneys, insurers and employers, all wish more fraud cases were prosecuted and the criminals punished appropriately
- Allison, I could not have said it better myself. We can diligently work feverishly and do everything by the book and within the timeframe and yet because we are seen as the 'enemy' in the judge's eyes, we are already wrong before we set foot at a hearing.
There's so much to comment on this morning that I'm feeling a bit schizophrenic. But there's a common theme: workers' compensation seems to exist in this vertical vacuum surrounded by a vortex of outside forces that tug and pull on the funnel like a tornado traveling across Oklahoma's prairie lands, taking out interests along the ways, but randomly sparing others.
- So true
- Totally agree!
Earlier today (June 24th), Florida’s Third District Court of Appeal reversed and completely repudiated the decision of Judge Jorge E. Cueto, Circuit Court for Miami-Dade County, that had, on August 19, 2014, held the exclusive remedy provision of the state’s Workers’ Compensation Law [Fla. Stat. § 440.11] was unconstitutional [see State of Florida v. Florida Workers’ Advocates, et al., Case No. 3D14-2062, Lower Tribunal No. 11-13661, 2015 Fla. App. LEXIS 9531 (“Padgett”)].
- This is a clearly written and easy-to-understand primer on how Padgett became Padgett. Thanks to Tom for educating us all. I agree that the 3rd DCA got it right. But like many others, I still question whether the "grand bargain" no longer exists in this country for both employees and employers.
The Roundtable Roundup is brought to you by your group managers:
Michael Stack & Rebecca Shafer; Founders of COMPClub (http://workerscompclub.com); Authors of Amaxx Workers Comp Resource Center (http://reduceyourworkerscomp.com) and Your Ultimate Guide to Mastering Workers Comp Costs (http://wcmanual.com)
Bob Wilson; Author of Bob’s Cluttered Desk (http://www.workerscompensation.com/compnewsnetwork/from-bobs-cluttered-desk/index.1.html) and CEO of Workerscompensation.com – The Workers Comp Compliance Center (http://workerscompensation.com)