Sec. 69L-3.0194 - Permanent Total and Permanent Total Supplemental Benefits for Dates of Accident Prior to October 1, 2003

ยง 69L-3.0194. Permanent Total and Permanent Total Supplemental Benefits for Dates of Accident Prior to October 1, 2003

(1)

(a) Permanent total benefits paid for injuries occurring prior to July 1, 1955, shall not be made in excess of 700 weeks. Permanent total benefits paid for injuries occurring on or after July 1, 1955, shall continue during the continuance of the employee's entitlement.

(b) When a permanently and totally disabled employee re-establishes an earning capacity and undertakes a trial period of re-employment pursuant to paragraph 440.15(1)(d), F.S., the employee may be eligible for impairment income and supplemental benefits pursuant to subsection 440.15(3), F.S.

(2) Permanently and totally disabled employees are entitled to permanent total disability supplemental benefits when the injury occurred subsequent to June 30, 1955, and the liability of the employer has not been discharged pursuant to subsection 440.20(12), F.S. Such benefits shall be equal to 5% of the employee's weekly compensation rate which was in effect on the date of the employee's injury, multiplied by the number of calendar years since the date of injury.

(a) When the date of the employee's injury and acceptance or adjudication of permanent total disability is within the same calendar year, supplemental benefits are payable January 1st of the next calendar year.

(b) When acceptance or adjudication is in a calendar year other than the year of injury, supplemental benefits are payable as of the date the employee was accepted or adjudicated permanently and totally disabled.

(3)

(a) Permanent total supplemental benefits shall be paid by the Division, unless the claim administrator made an election to pay such benefits, to an injured employee whose accident occurred subsequent to June 30, 1955, and before July 1, 1984. Permanent total supplemental benefits are not payable for any period prior to October 1, 1974.

(b) Permanent total supplemental benefits shall be paid by the claim administrator for injury occurring on or after July 1, 1984. The claim administrator is not required to pay permanent total supplemental benefits for any period prior to October 1, 1974.

(c) An injured employee entitled to or receiving permanent total supplemental benefits shall have such benefits increased by 5% each January 1 after the commencement of such entitlement. However, when permanent total supplemental benefits are combined with the compensation rate, the combination of benefits shall not exceed the maximum compensation rate in effect for the year in which the combined benefits are being paid.

(d)

1. The injured employee is entitled to full permanent total supplemental and compensation benefits as of the employee's 62nd birthday for dates of accident prior to July 1, 1990. The employee's entitlement to permanent total supplemental benefits shall cease on the employee's 62nd birthday if the employee is eligible for social security benefits under 42 U.S.C. Sections 402 and 423, whether or not the employee has applied for benefits when the employee's date of accident occurred on or after July 1, 1990.

2. All permanent total benefits shall cease when the employee becomes an inmate of a public institution, unless the employee has dependents as defined in Chapter 440, F.S. Dependent benefits shall be determined for each dependent as though the employee were deceased.

3. When the injured employee receives a full or partial lump-sum advance of the employee's permanent total disability compensation benefits, the employee's permanent total supplemental benefits shall be computed on the employee's weekly compensation rate as reduced by the lump-sum advance.

4. Neither the claim administrator, employer, or Division of Workers' Compensation shall pay any permanent total benefits for as long as the injured employee willfully fails or refuses to file a completed Form DFS-F2-DWC-19, or Form DFS-F2-DWC-14, or Form DFS-F2-DWC-30, as adopted in Rule 69L-3.025, F.A.C., within 21 days after the employee received the request.

(4) The social security offset of permanent total disability benefits shall be calculated as follows:

(a) Convert monthly social security benefit to weekly benefit by dividing the monthly amount by 4.3 (monthly amount divided by 4.3).

(b) Add the Compensation Rate (CR) plus the Principal Insurance Amount (PIA) or the Maximum Family Benefits (MFB) if the employee has dependents plus 5% permanent total supplemental benefits due at the time of permanent total acceptance or adjudication.

(c) Subtract the greater of 80% of average weekly wage (AWW), or 80% of weekly average current earnings (ACE). The resulting difference is the offset amount.

(5)

(a) Neither the claim administrator nor the Division shall take the social security offset until after the Social Security Administration has removed its offset.

(b) Social security offset shall not be applied retroactively nor shall social security annual cost of living increases or initial lump-sum payments be included in any offset.

(c) The Division shall have priority over the claim administrator in taking any available social security offset on dates of accident prior to July 1, 1984.

(d) No social security offset shall be taken which is greater than the offset that would otherwise be taken by the Social Security Administration.

(e)

1. Within 14 days after request by the Division, the claim administrator shall file a completed Form DFS-F2-DWC-35, as adopted by reference in Rule 69L-3.025, F.A.C., with the Division's Permanent Total Section.

2. Within 14 days after request by the Division, the claim administrator shall file a completed Form DFS-F2-DWC-33, as adopted by reference in Rule 69L-3.025, F.A.C., with the Division's Permanent Total Section.

(New 8-29-94, Amended 5-14-95, Formerly 38F-24.027, 38F-3.0194, 4L-3.0194, Amended 1-10-05, Amended by Florida Register Volume 40, Number 117, June 17, 2014 effective 6-30-14.)

Rulemaking Authority 440.15(1)(f) 2.a., (2), 440.591 FS. Law Implemented 440.15(1) FS.

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