On Thursday, April 28, 2016, 540 days since oral arguments, the Florida Supreme Court handed down its landmark decision in Castellanos v. Next Door Company. Essentially, this allows Claimant’s attorney’s to collect a “reasonable” fee from the Employer/Carrier when successfully securing benefits.
Previously, a Claimant’s attorney fee was based on a percentage of the value of the benefits secured. For example, your doctor recommends an MRI and the insurance company is late in providing it. You need the MRI to know what it wrong with you so you can get the proper treatment. If your attorney spends twenty hours fighting with the insurance company to get you that MRI which typically costs $450.00, he would be entitled to $90.00 or $4.50 per hour. No attorney, or any other business for that matter can survive on such a construct. The injured worker needs the MRI but the way the law was previously written, it would operate to restrict his access to attorneys who simply could not afford to fight for such benefits when the compensation is so little.
The facts of Castellanos were even more drastic. Here, you had an injured worker who was originally authorized to treat via the workers compensation insurance carrier and was ultimately denied authorization of xrays, medications, and physical therapy. While these benefits may not have a huge money benefit, they are invaluable to Mr. Castellanos who absolutely needed these treatments for his health and well being. His attorney successfully fought for him and ultimately won. His attorney put in 107.20 hours and was paid $1.53 per hour under the law as it related to attorney fees. No one can work in any industry for $1.53 per hour. Countless injured workers were in the same situation where they were wrongfully denied benefits but had no recourse or way to fight because an attorney simply could not take the case and survive financially.
How does the Castellanos case help an injured worker? Immensely. The workers compensation law in Florida is anything but great for the injured worker. It is extremely frustrating, complex, and the deck seems to be stacked against the worker before an injury even occurs. The Supreme Court recognizes this and stated in their holding “in reality, the workers’ compensation system has become increasingly complex to the detriment of the claimant.” The Court goes on to state “it is undeniable that without the right to an attorney with a reasonable fee, the workers’ compensation law can no longer assure the quick and efficient delivery of disability and medical benefits to an injured worker.”
Day in and day out, Claimant’s attorneys will file Petitions for Benefits with the Office of the Judge of Compensation Claims requesting a much needed benefit whether medical or lost wages. A response should be filed within fourteen days and the requested benefit provided within thirty. Often times, the response and benefit will either be provided late, or not at all, leaving the injured worker, the person this law is meant to protect, waiting and potentially getting worse.
What is the incentive for the insurance company to provide the benefit timely? Previously, not much. As used in the example above, typically, at most they would owe the Claimant’s attorney is a disproportionately small amount for providing the benefit untimely.
What was their potential reward for waiting? They would hope that the injured worker gets frustrated and just gives up and goes away or goes out and gets in a subsequent accident that would get them off the hook completely.
The Supreme Court also recognizes this and opined that “oftentimes the worker experiences delay and resistance either by the employer or the carrier. Without the likelihood of an adequate attorney’s fee award, there is little disincentive for a carrier to deny benefits or raise multiple defenses.” The Court goes further to state: “the employer under the worker’s compensation law has the prerogative to raise a whole host of defenses to denying benefits, while the employee is at the mercy of the E/C in being required to see the doctors chosen by the E/C…to navigate the current workers’ compensation system, after a denial by the E/C of benefits, would be an impossibility without the assistance of an attorney.”
The scales are leveling out. Now attorneys will be willing to accept cases and prosecute Employer/Carriers for not providing benefits because they will now be entitled to a reasonable attorney fee. Most importantly, this will make the Employer/Carrier start providing much needed benefits to injured workers timely which will in turn help injured workers get the treatment and lost wages they need and get back to their lives.
Additionally, Employer/Carriers may now offer more money to settle and close a case rather than risk paying even more in attorney’s fees later.
Over the past seventeen years Mr. Masnikoff has been practicing, he has seen the law change many times, usually for the worse. This time the law has changed for the better to help injured workers. These situations can become extremely complex. We take the time to make sure that you fully understand this complex and frustrating law. We would love to discuss your case and explain all of your options to make sure that you receive the benefits that you are entitled to under the law. If you or someone you know is in this situation, please give us a call at (877) 8174127.
The entire opinion can be found at:
https://www.floridasupremecourt.org/decisions/2016/sc132082.pdf
