Articles Posted in Disability

openphotonet_IMG_0318Although most claimants for disability benefits never imagine that the resolution of their claims will create much in the way of buzz, one injured firefighter’s request for benefits has led him all the way to the Supreme Court of Florida. On June 5, the Supreme Court of Florida heard oral argument in Westphal v. City of St. Petersburg, which addresses a recurring problem for claimants currently receiving temporary total disability benefits and seeking to acquire permanent total disability benefits. Specifically, the case deals with a “statutory gap” created by the provisions § 440.15 of the Florida Statutes, which leaves certain disabled workers without any form of disability benefits as they transition from temporary to permanent total disability.

Bradley Westphal, a firefighter and paramedic, injured his knee and back while moving heavy furniture during a fire. Westphal’s severe injuries resulted in nerve damage and required both spine surgery – specifically, a five-level fusion of the lumbar spine – and a host of other medical treatments. His employer accepted his injury as compensable and paid Westphal temporary total disability benefits pursuant to § 440.15(2)(a). Entitlement to temporary total disability benefits is limited to 104 weeks, and Westphal, who remained unable to work per medical advice, filed a claim for permanent total disability benefits towards the end of his temporary benefit entitlement window. To establish entitlement to permanent total disability benefits, one must show “not only total disability upon the cessation of temporary benefits but also that total disability will be existing after the date of maximum medical improvement.” City of Pensacola Firefighters v. Oswald, 710 So. 2d 95 (Fla. 1st DCA 1998). Westphal’s claim was denied based on the testimony of the physician who performed Westphal’s second surgery and stated that Westphal was still recovering from his second surgery and, thus, it was too soon to determine whether he had attained maximum medical improvement. Accordingly, although Westphal was presently “totally disabled” and could very well remain totally disabled even with maximum improvement in condition, he could not receive permanent benefits because improvement beyond total disability was still conceivable. Westphal would therefore have to wait until evidence was conclusive that he would remain totally disabled even after attaining maximum medical improvement before he could receive benefits.

Westphal appealed the denial of his claim to Florida’s First District Court of Appeal. The original panel of three judges unanimously held that the denial of benefits amounted to an unconstitutional denial of access to the courts under article I, section 21, of the Florida Constitution. However, the full panel of judges of the First District Court of Appeal granted a motion for rehearing en banc. In this later decision, the en banc court withdrew the panel decision but still found in Westphal’s favor. The court reversed an earlier appeals court precedent and adopted a new statutory construction of the disability provisions, holding that “a worker who is totally disabled as a result of a workplace accident and remains totally disabled by the end of his or her eligibility for temporary total disability benefits is deemed to be at maximum medical improvement by operation of law and is therefore eligible to assert a claim for permanent and total disability benefits.” Finding that their decision concerns a question of great public importance, the court then certified the case for review by the Supreme Court of Florida.

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