Florida JCC May Not Deny TD Benefits Because Worker Received Full Pay From His Sick Leave Account

A Florida appellate court recently held that a JCC erred in refusing to award temporary disability benefits to an injured worker based on the fact that the worker received “full pay” for the relevant period from the worker’s accumulated sick leave account with his employer [Medina v. Miami Dade County, 2020 Fla. App. LEXIS 10146 (1st DCA, July 15, 2020)]. The court also held the JCC lacked authority to order the employer to reinstate the injured worker’s sick leave balances. Rather, the JCC should have awarded TD benefits under § 440.09(1), Fla. Stat., and, if the employer raised the issue of an offset in a timely and proper manner, the JCC could have entered an appropriate order for such an allowance.

Background

In 2017, Claimant, a corrections officer, slipped and fell on the stairs of a prisoner transport bus. The self-insured employer accepted compensability of Claimant’s multiple injuries. Claimant underwent compensable, right-knee surgery in January 2019. His work status as temporarily disabled from the date of his surgery to the date of the final hearing was undisputed.

Claimant had worked for the employer for some 25 years and had accumulated 1,000 hours of sick time. Following the surgery, the employer made two payments of TD compensation benefits to Claimant, but did not issue checks for other periods. Claimant did, however, receive “full pay,” from his bank of accumulated sick time. An adjuster testified that eventually Claimant’s bank of personal leave time would be restored for the amounts he received while recuperating. The adjuster, of course, had no actual authority over Claimant’s personnel records or status.

Claimant requested TD benefits and, following a hearing, the JCC denied the request, finding that in accordance with the employer’s policies, the accumulated sick leave balance would be reinstated. Accordingly, no interest or penalties were owed to Claimant as the JCC held he had continued to receive his benefits in uninterrupted fashion. Claimant sought reversal, contending the employer did not pay workers’ compensation benefits as required by § 440.09(1), Fla. Stat., and the JCC lacked subject matter jurisdiction to direct reinstatement of his sick leave.

Appellate Court Decision

The appellate court agreed with Claimant. Because the employer did not pay workers’ compensation benefits as required by § 440.09(1), or pay wages in lieu of those benefits, the JCC erred in denying the temporary disability benefits to Claimant for the periods for which he received full pay funded by his personal sick leave. The court acknowledged that while § 440.09(1) dictated an employer may not avoid paying workers’ compensation by offering alternative benefits, an injured worker may not receive benefits from the employer and other collateral sources that, when totaled, exceed 100% of his average weekly wage.

Proving entitlement to an offset is the burden of the party seeking such offset. Additionally, an employer must timely raise the defense. The court stressed that here, the employer did not raise the offset defense in the event workers’ compensation benefits were awarded, and no evidence was introduced that the alternate benefits received by Claimant were of a qualifying nature.

The JCC lacked subject matter jurisdiction to direct reinstatement of personal leave. Because the full wages received by Claimant for the periods at issue were funded by his personal sick and vacation leave and did not constitute payment of workers’ compensation benefits as required by § 440.09(1), the JCC’s order was reversed. The case was remanded for entry of an order for payment of TD benefits for the relevant time periods.