Workers’ Compensation Case Law Update – Attorney Fee Exposure and Payment of Medical Expenses

February 21, 2017 by on News

In a case concerning attorney fees, the First DCA addressed the situation when an employer/carrier accepts responsibility for medical expenses within thirty days of receiving a petition for benefits but does not actually pay the medical bills until after thirty days.  Sansone v. Frank Crum/Frank Winston Crum Ins., Inc., 201 So. 3d 1289 (Fla. 1st DCA 2016). The court held that so long as the employer/carrier accepts responsibility for medical expenses within the thirty-day grace period, it is not liable under section 440.34(3)(b) for fees associated with those benefits.

The claimant argued that “successful prosecution” under section 440.34(3) is not achieved until there has been acceptance and payment.  The court acknowledged its prior cases holding that timeliness of payment of benefits is determined not by the date on which the employer/carrier notifies a claimant’s attorney that the claim is accepted and benefits will be paid, but by the date checks of payment are placed in the mail. However, those cases addressed claims for benefits payable directly to claimants.  In the Sansone case, the payment at issue was to the hospital—not to the claimant.  Thus, the court held that “when it comes to medical benefits, a claimant’s successful prosecution ends when the employer/carrier accepts responsibility, regardless of when the carrier or employer actually pays the medical providers.”

Boyd & Jenerette – Workers’ Compensation & Employment

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