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What's Hot in Workers' Comp

Fifth District Court of Appeal Clarifies Civil Suit Bar: Workers Must First Seek Comp Benefits Before Suing Employers

Steak ‘N Shake, Inc. v. Amber Nicole Spears, Fla. 5th DCA, No. 5D2024-0148, June 13, 2025

July 1, 2025

by Blake J. Hood

A three-judge panel of the Fifth District Court of Appeal issued an intriguing opinion concerning employers’ civil suit immunity and compensability determinations. The opinion sets forth a process for claimants seeking to file civil liability suits against their employers and identifies the final arbiters of workers’ compensation compensability determinations. It does so, acknowledging that no other court has addressed this specific issue.

Under Florida law, with limited exceptions, employers are immune from civil liability when employees are injured at work. § 440.11(1), FLA STAT. (2024). Employees, likewise, may seek only those remedies available under the workers’ compensation statute, though such remedies are available under a no-fault basis, again with limited exceptions. This is the so-called “bargain” struck in Florida’s legislative system: limited economic remedies for employers in exchange for employees’ access to no-fault remedies. 

In Steak ‘N Shake, Spears was held at gunpoint while at work and was forced into a backroom where a gunman threatened to kill her. The gunman grabbed Spears by the shoulder and neck during the encounter. Spears experienced severe emotional distress as a result of the robbery, but rather than pursue a claim for workers’ compensation benefits, she sued her employer for civil damages. She argued that her case was not compensable because elsewhere in Florida’s Workers’ Compensation Act mental injuries are deemed non-compensable if they are not accompanied (or caused) by physical injuries. § 440.093, FLA. STAT. (2024). The employer/carrier argued, however, that Spears could not make the compensability determination on her own and was required to at least request benefits within the workers’ compensation system as a necessary condition to filing a civil suit. The civil trial court agreed with Spears and ruled that she was permitted to file a civil suit premised on its determination that her accident and injuries were not compensable.

The Fifth District Court of Appeal disagreed. As the opinion acknowledges, the District Court has exclusive jurisdiction over most workers’ compensation cases. Of note, however, is the opinion’s author, Judge Makar, who was appointed to the First District Court of Appeal in 2012 and recommissioned to the Fifth District Court of Appeal in 2023. Thus, Judge Makar, while no longer sitting on the First District Court, authored this opinion with extensive familiarity with workers’ compensation jurisprudence. Moreover, other circuit courts and District Courts of Appeal routinely issue rulings and opinions on cases that broach workers’ compensation issues. 

It is with this background that the three-judge panel confronted a new question and announced a new rule, at least within the Fifth District: employees may not file tort claims against their employers in circuit court without first seeking a determination of whether they are entitled to workers’ compensation benefits. The court highlighted language in Florida Statutes § 440.13(1)(d), which states that compensability questions are determined by only two entities, a “carrier” or “judge of compensation claims.” A Florida circuit judge, therefore, lacks such authority.

As well, claimants may not unilaterally determine that their claims are non-compensable; they may not serve as their own judge of compensation claims and thus bypass the limitations of recovery under the Workers’ Compensation Act. 

In the Steak ‘N Shake case, while Spears alleged in her civil suit that she had no physical injury that required medical treatment, the Fifth District Court of Appeal held that, in the first instance, such factual matters about compensability must be reviewed by a carrier or judge of compensation claims. Because Spears did not initially submit a claim under the workers’ compensation system as her first step in seeking a remedy, neither the carrier nor a judge of compensation claims made a compensability determination. The Fifth District Court, thus, held that she thereby “leapfrogged” the statutory framework, and it remanded the case to the trial court to find whether a claim for workers’ compensation benefits had been filed with the carrier in the interim. If not, the carrier would be entitled to dismissal.

It should be noted that this case does not appear to disturb the well-established line of cases holding that claimants may pursue civil suits against their employers when the employers/carriers affirmatively deny compensability. Thus, employers/carriers will still be estopped from taking mutually exclusive positions regarding compensability and civil immunity in different legal forums. In other words, even under Steak ‘N Shake, employers and carriers may not deny compensability of a workers’ compensation claim and subsequently assert civil immunity if the claimant sues in civil court. 

This Fifth District Court of Appeal case does hold, however, that employees must first pursue workers’ compensation benefits, receive an adverse determination from either a carrier or a judge of compensation claims, and only then has the right to pursue civil remedies against their employers for accidents and injuries that, at first glance, appear to be work related.  


 

What’s Hot in Workers’ Comp, Vol. 29, No. 7, July 2025, is prepared by Marshall Dennehey to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We would be pleased to provide such legal assistance as you require on these and other subjects when called upon. ATTORNEY ADVERTISING pursuant to New York RPC 7.1 Copyright © 2025 Marshall Dennehey, all rights reserved. No part of this publication may be reprinted without the express written permission of our firm. For reprints or inquiries, or if you wish to be removed from this mailing list, contact tamontemuro@mdwcg.com.

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Thought Leadership

Appellate Division Reversed Trial Judge's Orders Granting a Plaintiff's Section 40 Summary Judgement Motion

In Haskins v. Casey, et al., the plaintiff Dane Haskins worked for defendant Ekornes, Inc. (Ekornes) as a material handler. In June 2021, he filed a workers’ compensation claim petition for benefits due to a left shoulder injury in December 2020. He then resolved his workers’ compensation claim in November 2022 under an Order Approving Settlement. In January 2023, he filed a lawsuit against Ekornes and later amended to add additional claims and name other defendants, including the Ekornes president, chief financial officer, and director of human resources. In May 2025, a second amended complaint alleged that after he filed the workers compensation claim, Ekornes placed him on leave under the Family and Medical Leave Act (FMLA), denied his request for a work accommodation, and ultimately terminated him from employment in December 2021. He pleaded several causes of action asserting violations of the New Jersey Law Against Discrimination (LAD) as well as fraudulent concealment and wrongful discharge. The plaintiff then moved for partial summary judgment, seeking an order enforcing Section 40 of the Workers’ Compensation Act (WCA) as well as summary judgment on his FMLA claims. The defendants opposed the motions and cross-moved for summary judgment on the FMLA claims. After arguments, the court entered an order in December 2025, denying the FMLA motion and cross motion and granting the plaintiff’s Section 40 motion. In the order, the court permitted the plaintiff to pursue compensatory damages at trial in connection with the bodily injury claim. The court also allowed the plaintiff to present evidence of any workers’ compensation benefits to support his claim. The court then denied the defendant's subsequent reconsideration motion in February 2026. The defendants that appealed the Section 40 aspect of the orders. In reviewing the appeal de novo, the Appellate Division rejected the plaintiff's argument that the work-related injury arose out of his discrimination claims under the LAD. The plaintiff argued that he should be able to pursue a personal injury claim as a part of his LAD claim, noting that the employer’s compensation carrier would be able to assert a lien against any recovery against his LAD claims. In distinguishing between the Richter vs. Oakland Board of Education, 246 N.J. 507 (2021) case, in which the Court found that any recovery would be subject to a Section 40 lien as the allegation was that the defendants failed to accommodate her pre-existing diabetic condition, which resulted in bodily injury. In this case, the Appellate Division indicated that there was no bodily injury caused by Ekornes’ failure to accommodate a pre-existing disability. Rather, the shoulder injury was a result of a workers compensation claim, for which he received appropriate benefits previously. The Appellate Division noted that if the plaintiff was successful in proving his LAD claims, he would be entitled to damages caused by the discriminatory discriminatory conduct such as lost wages and emotional distress damages and that there will be no Section 40 lien. In addition, the Appellate Division disagreed that the petitioner could present evidence about and seek damages for his shoulder injury at trial. Although the petitioner argued that a defendant who retaliated against an employee for filing a workers’ compensation claim should not benefit from the exclusivity provision of the WCA, the Appellate Division noted that the Legislature did not include this type of scenario in the statue nor did any of the case law recognize this type of claim as a remedy. As such, the Appellate Division reversed the December 2025 order granting the the plaintiff’s Section 40 summary judgment motion as well as the February 2026 reconsideration motion order. The Appellate Division noted that they did not intend to limit the plaintiff in his pursuit of his other claims on under the LAD, FMLA, and workers’ compensation retaliation causes of action.

Thought Leadership

WCJ Improperly Refused to Conduct C&R Hearing and Erroneously Required Settlement of All Pending Petitions

In this case, the claimant sustained injuries in the course and scope of her employment as a registered nurse. The employer acknowledged the injury by a Notice of Compensation Payable (NCP).  Subsequently, a Workers’ Compensation Judge (WCJ) expanded the description of injury. The employer then filed a Termination Petition, alleging the claimant was fully recovered from the injuries. Providers filed Utilization Review (UR) Petitions, challenging UR determinations finding their chiropractic treatment to be not reasonable and necessary. A settlement of the claim was eventually reached, and the employer filed a Petition to Seek Approval of a Compromise and Release (C&R) Agreement. The C&R outlined that the agreement fully resolved all future workers’ compensation claims except for the termination and UR Petitions. Briefs were filed and one day later, the WCJ issued an Interlocutory Order which stated if instructions were not followed regarding filing of a C&R, a settlement hearing date would not be given. The employer complied with the order, and filed the C&R. Subsequently, the WCJ notified the parties that the C&R must resolve all issues in the petitions, or would not be entertained. A settlement hearing was never held, and the WCJ then issued a decision, granting the Termination Petition and dismissing the UR Petitions. The WCJ also said that the Petition for Approval of a C&R was dismissed without prejudice, as the issues in the Termination and UR Petitions went to a decision. The claimant appealed to the Workers’ Compensation Appeal Board (Board). The Board granted the claimant’s appeal, finding that the WCJ violated the requirement of Section 449 that an expedited hearing be held when a Petition for Approval of a C&R is filed.  The Board further held that it was legally incorrect for the WCJ to insist that the C&R resolve all issues raised by the pending Petitions. The Board remanded the case to a new WCJ, and Employer appealed to the Commonwealth Court. The court affirmed the Board and held that the WCJ erred, as a matter of law, by refusing to hold an expedited hearing within 30 days, once the Petition for Approval of a C&R was filed.  The court noted that the language of Section 449(b) is mandatory, and a settlement hearing is not discretionary or dependent on a party’s separate request for a stay, or whether the record has been closed. The court further rejected Employer’s argument that the case should not be remanded to a new WCJ for a new decision on the termination and and UR Petitions, as the Board passed no judgment on whether the C&R Agreement resolved the termination and UR Petitions, and left it for the WCJ to decide in connection with the Petition for Approval of a C&R.

Thought Leadership

Commonwealth Court Reaffirms the Constitutionality of Act 111's IRE Provisions

In this case, the claimant sustained a work injury of January 6, 1994, which was acknowledged by Notice of Compensation Payable (NCP). After the claimant’s receipt of 104 weeks of temporary total disability benefits, the employer filed a Request for an Impairment Rating Examination (IRE). The IRE was performed in May 2023 and the IRE physician found that the claimant had a 5% whole person impairment, under the AMA Guides. The employer filed a Petition based on the IRE results, and the Petition was granted by the WCJ. During litigation, the claimant argued that the IRE provisions of Act 111 (Section 306(a.3) of the Act) were not applicable to her injury, since it predated June 24, 1996, the date Act 57 went into effect, and that the IRE provisions were unconstitutional. The Workers’ Compensation Judge (WCJ)) granted the Petition and the Board affirmed. On appeal to the Commonwealth Court, the claimant argued that Act 111 violated the nondelegation doctrine and that its retroactive application to the claimant’s injury was unconstitutional. The court rejected the arguments on the basis that they had already found the same arguments without merit in multiple, prior cases. The court also addressed an argument made by the claimant that Act 111 was procedurally defective under the Pennsylvania Constitution because it was only considered on two days in each House after having undergone amendments and reassignments. The court noted that the Pennsylvania Constitution requires every bill to be considered on three different days in each House. The claimant maintained that, according to the legislative history, the bill did not receive three separate days of consideration from each House when it was assigned a new bill number. The court pointed out, however, that the bill number, H.B. 1840 remained constant and was considered on three occasions by the House. Further, the court concluded that minor amendments to the bill were germane to its original subject, which was to modify the Act’s IRE process, in accordance with Protz II.