Benefits for Mental or Nervous Injury

Benefits for Mental or Nervous Injury

Posted By Marko Crespo || 5-Oct-2017

The First District Court of Appeals recently rendered a decision that is consistent with prior rulings regarding the payment of benefits for a mental or nervous injury stemming form a compensable physical accident in Utopia Home Care/Guarantee Insurance Company v. Beatriz Alvarez.

The Florida Statute that was analyzed in Alvarez was the following:

Section 440.093(3): Subject to the payment of permanent benefits under s. 440.15, in no event shall temporary benefits for a compensable mental or nervous injury be paid for more than 6 months after the date of maximum medical improvement for the injured employee’s physical injury or injuries, which shall be included in the period of 104 weeks as provided in s. 440.15(2) and (4). Mental or nervous injuries are compensable only in accordance with the terms of this section.

In Alvarez, the First DCA explained that the first part of the statute, “[s]ubject to the payment of permanent benefits under s. 440.15,” requires a connection between mental or nervous injuries and an underlying compensable physical injury that is permanent in nature. The First DCA noted that Section 440.15 provides for payment of permanent benefits for permanent total disability or for permanent impairments remaining after the date of MMI. § 440.15(1), (3) Fla. Stat. (2011). The First DCA then concluded that when a claimant attains physical MMI and the physical injury qualifies for a permanency rating, the claimant is entitled to, and “subject to the payment of permanent benefits” under, section 440.15. (emphasis added)

The Court rejected the claimant’s arguments in Alvarez that section 440.093(3) does not apply because it applies only to claimants who are receiving permanent impairment benefits during the weeks in which they would be receiving the temporary psychiatric disability payments. The Court indicated that under claimant’s argument, the temporary psychiatric disability benefits that the Legislature intended to limit would instead become unlimited.

The First DCA further explained that the portion of the Florida Statute, Section 440.093(3), at question is the following: “in no event shall temporary benefits for a compensable mental or nervous injury be paid for more than six months after the date of maximum medical improvement for the injured employee’s physical injury or injuries.” The question that the Court was faced with was whether this was a six-month “bank of time” or whether it was calendar based and begun upon physical maximum medical improvement and ended six months later.

In 2008, the Court rejected the “bank of time” argument in the case School Board of Lee County v. Huben, due to the plain language of the statute and opined similarly in this case. The Court noted that the correct six month time frame is calendar based and begins on the date that physical maximum medical improvement is assigned. In Alvarez, the Court noted that this may seem unfair and possibly in discord with the purpose of the workers’ compensation law but the Court further noted that this limitation on temporary psychiatric benefits has justification and is not unreasonable on it’s face.

This may be an issue that is consistently brought upon appeal due to the argument of unfairness for the claimant. However, this is a matter that is unlikely to change unless the Legislature decides to amend the current statute.

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