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What's Hot in Workers' Comp

First District Court of Appeal Enforces Statutory Provision Divesting Judges of Compensation Claims of Subject Matter Jurisdiction

Sapp v. Sims Crane & Equip. Co./Bridgefield Cas. Ins. Co., Fla. 1st DCA 2025, No: 1D2024-0300, May 7, 2025

June 1, 2025

by Blake J. Hood

In a per curium opinion from the First District Court of Appeal on May 7, 2025, the court addressed what at first glance appeared to be an arcane case about collective bargaining agreements. Yet, this case addressed the fundamental source and scope of jurisdiction in Florida workers’ compensation cases. 

While employed as a crane operator, the claimant was involved in an accident on October 29, 2020. The first recorded activity with the Office of Judges of Compensation Claims took place when the employer/carrier filed a motion to preserve blood and urine samples within a few days of the accident. The employer/carrier thereafter provided benefits, though the claimant later filed four petitions for benefits a few years later, between June and October of 2023. The claimant requested indemnity and medical benefits, and the employer/carrier provided some, but not all, of the benefits requested. In certain of its responses, the employer/carrier also stated that subject matter jurisdiction was lacking because the “case is governed by Collective Bargaining Agreement authorized per FL Statute 440.211.” The employer/carrier filed a motion for summary final order, requesting that the judge of compensation claims dismiss any pending claims for lack of subject matter jurisdiction. This motion was denied due to factual disputes regarding the existence of the collective bargaining agreement. A final hearing regarding certain benefits in dispute was scheduled, and the parties agreed to bifurcate the issues, with the issue of subject matter jurisdiction to be addressed first.

The claimant argued that the type of collective bargaining agreement (CBA) at issue, a so-called Negotiated Workers’ Compensation Insurance Program (NWCIP), was not in place. He also argued that the employer/carrier waived any right to invoke the NWCIP by initiating proceedings before the judge of compensation claims, to preserve evidence in the immediate aftermath of the industrial accident, but before the claimant filed petitions for benefits. The judge determined that a valid NWCIP was in place and rejected the waiver argument.

In affirming the judge, the First District Court of Appeal explained the unique jurisdictional issues in workers’ compensation cases. Unlike courts established by Article V of the Florida Constitution, the judge of compensation claims is created by statute, specifically § 440.45(1)(a), Fla. Stat. (2020). The Florida Constitution does authorize the judge of compensation claims’ existence and their authority to exercise quasi-judicial power, but their operative powers have a statutory origin. Prior case law has consistently established that a judge of compensation claims has only those powers expressly provided by statute and, conversely, has no jurisdiction or authority beyond that which is specifically conferred by statute.

The Florida Legislature also enacted statutory provisions that explicitly divest the judge of compensation claims of jurisdiction when a NWCIP is in place. The NWCIP at issue in the Sapp case was a CBA created pursuant to section 440.211 of Florida Statutes, which provides as follows:

(1) ... [A] provision that is mutually agreed upon in any collective bargaining agreement between an individually self-insured employer or other employer upon consent of the employer's carrier and a recognized or certified exclusive bargaining representative establishing any of the following shall be valid and binding:
(a) An alternative dispute resolution system to supplement, modify, or replace the provisions of this chapter which may include, but is not limited to, conciliation, mediation, and arbitration. Arbitration held pursuant to this section shall be binding on the parties.
(b) The use of an agreed-upon list of health care providers of medical treatment which may be the exclusive source of all medical treatment under this chapter.
(c) The use of a limited list of physicians to conduct independent medical examinations which the parties may agree shall be the exclusive source of independent medical examiners pursuant to this chapter.
(d) A light-duty, modified-job, or return-to-work program.
(e) A vocational rehabilitation or retraining program.

§ 440.211(1) Fla. Stat. (2020) (emphasis supplied). The District Court affirmed the judge of compensation claims’ order on both grounds. 

Regarding the waiver question, the court held that a party's conduct cannot confer jurisdiction on the judge where the law does not authorize such jurisdiction. The court noted a bedrock principle that “judge of compensation claims always have jurisdiction (and an obligation) to determine the existence and scope of their own jurisdiction. The court reiterated that subject matter jurisdiction is never waivable or dependent upon the parties’ actions.” 

Thus, even in cases such as Sapp in which employers/carriers take the first actions to invoke jurisdiction in workers’ compensation cases and continue to litigate and even provide benefits over an extended period of time, subject matter jurisdiction is not thereby created if it never actually existed in the first place. 


 

What’s Hot in Workers’ Comp, Vol. 29, No. 6, June 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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Ohio Supreme Court Holds That a Binding Appraisal Award May Not Be Set Aside Absent Specific Evidence of Manifest Mistake or Fraud

On July 23, 2026, the Ohio Supreme Court issued a rare opinion on the binding effect of an appraisal award in a property insurance policy.  The Court in One Church held: A binding appraisal award will not be set aside unless an error is so palpably wrong that it undermines the intent of the agreement, such as corruption or gross mistake, not a mere error of judgment—To plead a claim of mistake with particularity as required by Civ.R. 9(B), facts alleged in a complaint must constitute the elements of mistake—Allegation that additional, hidden damage was discovered after appraisal award failed to state a claim of mistake that could justify setting aside binding appraisal.  The case arose out of a claim brought by One Church against its insurer, Brotherhood Mutual Insurance Company for roof damage from a storm. Pursuant to the terms of the insurance policy, the parties agreed to submit the matter to appraisal. The two appraisers inspected the building, and both appraisers agreed that the damages were $313,271.98. The insurer paid the agreed appraised amount.  Thereafter, the insured submitted a claim for an additional $206,663.09 in damages. The insured argued that these additional damages were not discovered until after the repairs began, and that they should be permitted to submit an additional claim, even though there had already been a binding appraisal of damages. The insurer refused to pay the additional damages, and the insured sued for breach of contract and bad faith.  In the trial court, the insurer moved to dismiss for failure to state a claim, arguing that the binding appraisal award barred any further claims. The insured took the position that additional hidden damages could not be discovered until after the repairs began, and therefore there was a mutual mistake. The trial court dismissed the case on the insurer’s motion, because there was no “evidence of fraud, misfeasance, or mistake”. The Court of Appeals agreed that appraisal awards are generally binding, but noted that an appraisal award can be set aside for fraud or manifest mistake. The Court of Appeals reversed and remanded the case to the trial court, finding that the insured had pled mistake with sufficient particularity. The insurer appealed to the Ohio Supreme Court. On appeal, the Ohio Supreme Court reversed the Court of Appeals, and reinstated the trial court decision dismissing the case for failure to state a claim upon which relief can be granted. The Supreme Court found that since the insured had already demanded appraisal, and the appraisal award was binding, “something more than error of judgement, such as corruption in the arbitrator, or gross mistake” must be pled with particularity, and proven for the insured to override the appraisal award. Since the complaint did not allege fraud or manifest mistake with sufficient particularity, something more than a mere error of judgment, the complaint was insufficient to state a claim.  The complaint in this case did not challenge the appraisal award. It pled that additional damages were discovered that were not apparent when the appraisal was done. It did not specify “who discovered the damages, how they were discovered, where they were found, why they were previously hidden, or why they rise to the level of a manifest mistake that the “appraiser would have corrected...had it been called to his attention”. Id at ¶22 citing Lakewood Mfg. Co. v. Home Ins. Co. of New York, 422 F.2d 796, 798 (6th Cir. 1970). Cases deciding the effect of appraisal awards are unusual. The Ohio Supreme Court’s decision in One Church relies primarily on 19th century case law for its conclusion. This emphasizes the fact that there is minimal case law deciding the effect of binding appraisal clauses in property insurance policies, and makes this case all the more significant. A lengthy dissent was written by Justice Fisher, who would have affirmed the Court of Appeals decision reversing and remanding the case for a decision on the merits. Of course, the decision works both ways, and an insurer dissatisfied with a binding appraisal award will likewise be without further recourse absent evidence of corruption, fraud, misfeasance, or manifest mistake, which must be pled with particularity. To constitute manifest mistake, “the mistake must be of such character that the arbitrator or appraiser would have corrected it had it been called to his attention.”  Lakewood Mfg. Co. v. Home Ins. Co. of New York, 422 F.2d 796, 798 (6th Cir. 1970).  The majority opinion does not specifically identify what would have been sufficient to plead mistake with particularity, or if the insured could have amended the complaint to overcome the deficiencies. The dissent argues that this was not really a case alleging mistake, but rather a question of contract interpretation. The insured did not challenge the appraisal, but argued that the hidden damage was not part of the appraisal, and the appraisal only covered the known damages.  However, this argument did not carry the day with the majority.  *Thomas F. Glassman, a shareholder in Marshall Dennehey’s Cincinnati office, filed a brief in the Ohio Supreme Court on behalf of the Ohio Association of Civil Trial Attorneys, in support of the insurer’s position.

Result

No-Cause Jury Verdict Secured in Wrongful Death Trial

We successfully obtained a no-cause jury verdict in a 13-day wrongful death trial. The decedent, a 59-year-old man, was admitted to the emergency room on February 15, 2019, with complaints of abdominal pain, decreased appetite, and constipation, despite the use of laxatives. The patient did not complain of any nausea, vomiting, or diarrhea. He had a significant medical history including diabetes, hypertension, prior coronary artery stenting, morbid obesity (with past gastric bypass surgery), longstanding ventral hernia, and back pain. A CT scan revealed multiple hernias and a potential closed-loop bowel obstruction, leading to a surgery consultation. Our client, an emergency general surgeon, interpreted that the patient did not have a closed loop or any significant obstruction and recommended non-surgical management. The patient was approved to have clear liquids, and had a vomiting incident shortly after, but our client was not notified. The patient was returned to NPO status, and after improving overnight, he was returned to “clears” and additional medical and renal consults were ordered. Our client did not receive any communications from the residents/nurses of any changes in the patient’s condition. On February 18, 2019, two rapid responses were called due to increased heart rate and vomiting. It is believed that the vomiting resulted in aspiration, causing sepsis, ultimately leading to the patient’s death. During the trial, the plaintiff’s sole medical expert highlighted imaging on the wrong hernia, which called into question all of his opinions in the case. We made key objections related to the expert testimony, limiting what the allegations were, and preventing new allegations from being made. After approximately two and a half hours of deliberating, the jury returned a no-cause verdict.