.

What's Hot in Workers' Comp

TOP 10 DEVELOPMENTS IN FLORIDA WORKERS’ COMPENSATION IN 2022

What’s Hot in Workers’ Comp, Vol. 26, No. 12, December 2022

December 1, 2022

by Linda Wagner Farrell

1.    Rita Noa v. City of Aventura and Florida League of Cities, DCA#: 21-0549; Decision date: January 26, 2022 

The claimant argued that an annual merit bonus should be included in her average weekly wage. The First District Court of Appeal agreed and reversed the lower court opinion denying inclusion. The court held that the claimant’s merit bonus was analogous to profits or commissions at issue in prior cases and indicated it should be treated in a like manner. They held that the claimant’s average weekly wage should include a pro rata share of her annual performance bonus.

2.    Silberberg v. Palm Beach Cty. Sch. Bd., (47 Fla. L. Weekly D461); February 2022
 
A companion opinion to the Soya case below, the First District Court of Appeal attempted to clarify compensability in trip and fall cases following the 2019 Valcourt-Williams decision, which they described as “a narrow, trip and fall/comfort break accident case.” The court noted in Silberberg that compensability always turns on whether the employment led to the risk of the injury. If an accident occurs and does not involve a comfort break, only the presence of an idiopathic condition would trigger the “increased hazard” test.

3.    Soya v. Health First, Inc., (47 Fla. L. Weekly D 489); February 2022

In this compassion case to Silberberg, the court clarified that in cases where the claimant is injured while engaged in work activities and there are no pre-existing conditions, or competing causes of an injury, then work is the major contributing cause of the injury. Under the premises rule, injuries at the workplace are compensable if the injury occurred while performing activities, incidental to their job, such as going into work, or leaving work.

4.    Kelly Air Systems, LLC, Amtrust North America and Technology Ins. Co. v. Dorinda Kohlun, as claimant for Aaron Kohlun, Injured Employee, DCA# 21-0976; Decision date: March 16, 2022

This case involved the going and coming rule. The First District Court of Appeal felt that this case presented an opportunity to analyze the application of the statutory language as prior decisions did not offer substantive guidance on the definition or interpretation of “exclusive personal use.” An employee is not in travel status when he is traveling to or from work, which means that an injury suffered while traveling to and from work, even where the employee regularly works in a travel status, are not compensable. The claimant in this case was traveling in an employer-provided vehicle available for his exclusive personal use for travel to and from work, and he was not compensated for his travel. Therefore, the injury was not compensable.

5.    Joseph Guerrera v. Becton Dickinson & Co. and Sedgwick CMS, DCA#: 21-1788; Decision date: May 4, 2022

The First District Court of Appeal overruled the lower court judge and held that the average weekly wage can be increased even if the resulting compensation rate remains at the maximum. They also found that fee entitlement was still owed even though the increase in the average weekly wage was less than what the claimant had requested. The law does not require an exact match between the claim and the award. They disagreed with the judge who ruled that “no actual real benefit was secured.”

6.    LFI Ft. Pierce and ESIS WC Claims v. Dewayne Holmes, Blue Goose Growers LLC/FFVA Mutual Insurance Company, DCA#: No. 1D18-5243; Decision date: May 6, 2022

The claimant chose to ride home with a co-worker, who fainted at the wheel, causing a serious motor vehicle accident. Both employees were leased employees. The client company asserted immunity and the special hazard exception to the going and coming rule in a civil action. The leasing company was dismissed from that claim. In the worker’s compensation claim, the leasing company argued there was no exception and that the claim was barred by the going and coming rule. The Judge of Compensation Claims ruled that the leasing company was estopped from asserting their arguments because the client company had argued to the contrary in the circuit court matter. The judge also said that the leasing company benefited from the client company’s argument by being dismissed and held that two employers shared a special relationship. The judge further found that the going and coming rule did not apply because the co-worker’s fainting was a “special hazard.” The judge also held that the fainting experienced by the co-worker arose directly out of the employment. The leasing company challenged all of the judge’s rationales and holdings, and the First District Court of Appeal found merit in all. 

The appellate court held that neither estoppel, nor the special hazard doctrine, applied because the claimant did not establish the required elements. Further, estoppel did not apply because the two employers have adverse interests in a workers’ compensation setting. Further, an injury might be compensable when the employer sets its cause in motion, within the course and scope of employment, of the injured worker. That may apply to the co-worker who fainted, but it does not extend to the claimant because it was not foreseeable. The claimant’s decision to ride with a co-worker does not result in finding that the accident arose out of the course and scope of his employment.

7.    Sophia Sandifort v. Akers Custom Homes, Inc. and Amerisure Insurance, DCA#: 20-1892; Decision date: July 13, 2022

This case involved a minor who died on his first day of his very first job. The mother sought death benefits. The employer accepted compensability of the workplace death and paid medical and funeral costs but denied death benefits. The employer asserted that the mother and her other children were not dependent on her son. The mother had been supporting herself and her children with SSI benefits her deceased son received because of a learning disability. The First District Court of Appeal held that SSI benefits did not constitute dependency for the purpose of death benefits.

8.    Kelly Girardin v. AN Fort Myers Imports, LLC d/b/a AutoNation Toyota Fort Myers/Gallagher Bassett, No. 1D21-3405; Decision date: August 10, 2022    

This case involved yet another issue of attendant care where a judge and carrier attempted to adhere to the strict language of the statute. The First District Court of Appeal held that the statute requires a written prescription with certain information, but said that same does not relieve an employer/carrier of its obligation to “monitor a claimant’s injuries and provide needed benefits“ or excuse any “attempt to hide behind a wall of Will for willful ignorance.“

9.    Ismael Tiburcio v. Hillsborough County Sheriff’s Office/Commercial Risk Management, No. 1D21-1330; Decision date: August 17, 2022

This case involved the heart/lung presumption. The employer/carrier argued that the officer departed in a material fashion from the prescribed course of treatment of his personal physician. Because the claimant was seeking compensability for heart disease and his alleged noncompliance with his personal physician’s recommendations were for conditions other than heart disease, the First District Court of Appeal held that the judge erred by applying the reverse presumption provision and the case was remanded and reversed.

10.    Eddy Junior Bonhomme v. Staff Team Hotels, Corp. and Frank Winston Crum Insurance, Inc., No. 1D21-881; Decision date: October 12, 2022

This case involved a claimant working as a laundry attendant at a hotel and was very factually intensive. The claimant testified about a very specific incident that occurred on May 22, 2019. He did not report the injury and treated at the emergency room on June 3, June 9, and June 25. When he returned for treatment on July 17, that was the first mention of any neck or back pain. He then filed a claim for workers’ compensation benefits. The Judge of Compensation Claims held that the claimant did not know about his injury until July 17, when the diagnosis was first mentioned in the medical records. The First District Court of Appeal disagreed and held the diagnosis from the emergency room does not necessarily start the clock and pointed out that the claimant was very clear that he knew at the moment in May that his pain began and never went away.

 

What’s Hot in Workers’ Comp, Vol. 26, No. 12, December 2022 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 © 2022 Marshall Dennehey Warner Coleman & Goggin, 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.

Firm Highlights

Thought Leadership

Featured Conversations... Key Takeaways from A.M. Best’s Webinar on the Misuse Defense in Product Liability Claims, Featuring Michael Salvati

Michael Salvati, shareholder in our Philadelphia office, was a panelist for the April A.M. Best webinar, “The Misuse Defense: Strategic Approaches to Defending Product Liability Claims for Insurers.” During the program, Michael and his fellow panelists offered practical, jurisdiction‑specific guidance on how misuse and failure‑to‑warn theories intersect in modern product liability litigation. Michael emphasized the unique challenges these claims present—particularly in states like Pennsylvania, where evidentiary rules diverge sharply from those applied in many other jurisdictions. Failure to Warn as the “Flip Side” of Misuse Salvati explained that failure‑to‑warn allegations often arise as a direct counter to a misuse defense. As he noted, “If our misuse defense is that the plaintiff didn't use a product properly or safely, then the failure to warn claim is that we didn't tell them how to use it properly.” He emphasized that these claims can stem from either the absence of warnings or criticisms of existing warnings, such as insufficient specificity or lack of clarity about risks. Pennsylvania’s Unique Evidentiary Landscape One of Salvati’s most notable points was the stark difference in how Pennsylvania treats evidence of compliance with industry standards. He highlighted that Pennsylvania is “one of the only states…where that evidence is not admissible” in strict liability cases. Manufacturers cannot rely on compliance with ANSI, UL, ISO, or even federal safety standards to defend the product against a strict liability claim—because the focus is solely on the product itself, not the manufacturer’s conduct. Salvati acknowledged the challenge this creates for defense counsel and clients who expect such compliance to carry weight. Understanding the Three Defect Theories Salvati also walked through the three primary defect theories recognized in many jurisdictions: - Design defect – a flaw in the product’s intended design - Manufacturing defect – a deviation affecting a specific unit - Failure to warn – inadequate instructions or warnings He noted that warnings claims are increasingly significant and sometimes stand alone when design or manufacturing theories are weak. As he put it, plaintiffs often default to warnings claims because “the default position seems to be, ‘If I got hurt, there must be something wrong.’” Warranties and State‑by‑State Variations Salvati addressed how breach‑of‑warranty claims fit into the broader framework, explaining that implied warranties—such as merchantability—often overlap with strict liability in Pennsylvania. He emphasized the importance of understanding local nuances, as warranty law and admissibility rules vary widely across states. Looking Ahead: The Growing Importance of Warnings In his closing remarks, Salvati stressed that warnings should never be treated as an afterthought in product liability defense. He observed that warnings‑only claims are becoming more common and urged manufacturers and insurers to continually evaluate the clarity and completeness of their instructions and warnings. His takeaway: “We should always be talking about what are the instructions that come with our products…to bolster a misuse defense.” Listen to the complete webinar here: https://www3.ambest.com/conferences/events/eventregister.aspx?event_id=WEB1074.

Thought Leadership

Legal Update for Special Education Law: Recent Positive Outcomes From the Group

Hearing Officer Confirms District Acted Appropriately Under IDEA and Section 504 William J. McPartland (Scranton) obtained a finding in favor of our client, a school district, on all issues following a due process hearing. The parent had filed a due process complaint alleging that the school district had breached its child find duty under the IDEA and Section 504, that the school district had discriminated against the student on the basis of disability in violation of Section 504, and that the school district had denied a free and appropriate public education to the student both by developing inadequate IEPs and via an actionable procedural violation.  Specifically, the student had received a Section 504 evaluation in October 2023, after a number of behavioral infractions culminating in a fight in September 2023, was identified as having anxiety and a sleep disorder, and received appropriate Section 504 accommodations. The student had never previously demonstrated signs of a learning disability, and the parent denied the school district permission to evaluate the student for special education needs in November 2023, and January 2024. The parent granted the district permission to evaluate the student in October 2024, after a private psychologist diagnosed the student with Attention Deficit Hyperactivity Disorder, possible Oppositional Defiance Disorder, a learning disorder, and anxiety. The school district issued a special education evaluation report in December 2024, finding that the student had an emotional disturbance and other health impairment, and an IEP providing an itinerant level of emotional support, as well as instruction in academics and social skills, was issued in January 2025, and amended in February, March, and April 2025. The student withdrew from the school district in April 2025, to attend a cyber charter school. The hearing officer determined that the school district had not violated its child find duty to the student in violation of either the IDEA or Section 504 where the district developed a Section 504 plan for the student within a month and a half of the parent’s first request for a Section 504 evaluation and where the parent repeatedly denied consent to conduct an IDEA evaluation of the student. The hearing officer noted that the student’s sporadic record of behavioral infractions prior to September 2023, did not suggest that the student had a disability prior to the parent’s initial request for an evaluation. The hearing officer further determined that no evidence had been produced to suggest that the student was discriminated against on the basis of disability in violation of Section 504. Additionally, the hearing officer determined that the IEP offered to the student was substantively adequate and that, to the extent the social and emotional programming offered by the school district was not received by the student, this resulted from the parent’s refusal to accept the same. The hearing officer finally determined that the school district did not commit an actionable procedural violation by delaying development of an IEP for the student where the parent repeatedly denied consent to evaluate the student. Court Dismisses Three of Four Claims Against School District Christopher J. Conrad and Daniel P. McGannon (Harrisburg) achieved a significant early victory on behalf of a school district client in. The team successfully obtained dismissal of three of the four claims asserted in the plaintiff’s amended complaint. The former district superintendent brought multiple claims arising out of his alleged “forced resignation,” including age discrimination under the ADEA, a Section 1983 Equal Protection claim, a Pennsylvania Whistleblower claim, and breach of contract. On behalf of the district, the defense team moved to dismiss the complaint in part, arguing: The plaintiff failed to plead sufficient facts to support a prima facie case of age discrimination. The equal protection claim was barred because the ADEA provides the exclusive federal remedy for age-based employment claims. The breach of contract claim could not stand because the underlying employment agreement had expired prior to the alleged breach. The court agreed, dismissing the ADEA, equal protection, and breach of contract claims in their entirety. As a result, only a single claim under the Pennsylvania Whistleblower Law remains pending. This outcome substantially narrows the scope of the litigation and positions the client for a more efficient defense moving forward.

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.