This is an update on a recent decision published by the First District Court of Appeal (First DCA) in Gauthier v. Florida International University and Division of Risk Management, State of Florida.  In this decision, the First DCA addressed the statute of limitations defense.

 In this case, the Claimant appealed a JCC’s Order denying her claims for benefits on the grounds that same were barred by the statute of limitations.  The Judge’s decision was based on the fact that over one year (approximately 14 months) elapsed between Claimant’s appointments with her authorized provider, the Bascom Palmer Eye Institute.

 Claimant argued, at the Final Hearing, that the E/C should be estopped from asserting the statute of limitations defense.  She advanced multiple theories of estoppel, only one of which the First DCA found meritorious: the E/C’s failure to obtain a date of MMI and a PIR from Claimant’s authorized physician.  At hearing, the E/C introduced the testimony of the nurse case manager to establish that there were at least two attempts to obtain a date of maximum medical improvement (MMI) and a permanent impairment rating (PIR) from the treating physicians.  Bascom Palmer failed to respond, however.  Medical evidence later adduced demonstrated claimant reached MMI with some degree of permanent impairment on June 21, 2007 (at the latest), also the date of her last authorized appointment.

 Surprisingly, the First DCA agreed with the Claimant’s position as to the estoppel issue.  It cited its Wood v. McTyre Trucking Co., Inc,. decision for the proposition that “an employer is under a continuing obligation, once it has knowledge of an employee’s injury, to place needed benefits in the hands of the injured worker.”  This obligation includes that to “offer or furnish benefits when the employer knows, or reasonably should know from facts properly and diligently investigated, that such benefits are due.”  The Court extended this duty to obtaining a date of MMI and a PIR, as “permanent impairment benefits are designed to result in an automatic payment of benefits with no participation from the claimant.”  Finding that the E/C essentially “abandoned that duty [to obtain a date of MMI and a PIR],” the Court concluded that the E/C was estopped from relying on the statute of limitations defense, because the Claimant showed, by uncontested evidence, that the E/C failed to act when it was under a duty to do so and that the Claimant was misled to her detriment due to the E/C’s omission.

 Obviously, this recent decision is quite troubling.  You will note that it further abrogates the already limited statute of limitations defense in finding yet another ground for estoppel.  What is not clear from the opinion is exactly how much effort the employer must undertake in order to find benefits to award the claimant; apparently, however, “at least two attempts” by the nurse case manager are insufficient.  I would note that this decision is not yet final, as both parties have 15 days from the June 22, 2010 date of issuance to move for re-hearing. 

Please contact me with any questions or concerns regarding this opinion.

Kristen L. Magana 
Broussard, Cullen & DeGailler, P.A.