Florida Regulations 69L-3.01945
§ 69L-3.01945 Permanent Total and Permanent Total Supplemental Benefits For Dates of Accident On or After October 1, 2003
|(1) Permanent total benefits paid for injuries occurring on or after October 1, 2003,
shall cease at age 75. If it is determined that the injury prevented the employee from working sufficient quarters to be eligible for social security benefits under 42 U.S.C. Sections 402 or 423, benefits will continue to be paid in accordance with the requirements of Chapter 440, F.S. If the accident occurred on or after the employee reaches age 70, benefits shall be payable during the continuance of permanent total disability, not to exceed 5 years from the date of permanent total disability.
(2) Permanent total benefits paid for injuries occurring on or after October 1, 2003, shall continue during the continuance of the employee's entitlement.
(a) When a permanently and totally disabled employee re-establishes an earning capacity and undertakes a trial period of re-employment pursuant to Section 440.15(1)(d), F.S., the employee may be eligible for impairment income benefits pursuant to Section 440.15(3), F.S.
(3) Permanently and totally disabled employees are entitled to permanent total disability supplemental benefits, if the liability of the employer has not been discharged pursuant to Section 440.20(12), F.S. Such benefits shall be equal to 3% 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 1 of the next calendar year. (b) When acceptance or adjudiciation 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.
(4) (a) Permanent total supplemental benefits shall be paid by the claims- handling entity. (b) An injured employee entitled to or receiving permanent total supplemental benefits shall have such benefits increased by 3% each January 1 after the commencement of such entitlement. However, when the 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. (c) For injuries occurring on or after October 1, 2003, the employee's entitlement to specific benefits shall cease when any of the following occurs:
1. Permanent total supplemental benefits shall cease on the employees 62nd birthday, regardless of whether the employee has applied for or is eligible to apply for social security benefits under 42 U.S.C., Sections 402 or 423. If it is determined that the injury prohibited the employee from qualifying for social security benefits, supplemental benefits will continue to be paid as long as the employee remains eligible. 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 such 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 claims-handling entity, 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 receives 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) + Principal Insurance Amount (PIA) or the Maximum Family Benefits (MFB) if the employee has dependents + 3% permanent total supplemental benefits due at the time of permanent total acceptance or adjudication. (c) Subtract the greatest 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 claims-handling entity nor the Division shall take the social security offset until after the Social Security Administration has removed its offset. (b) The 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) No social security offset shall be taken which is greater than the offset that would otherwise be taken by the Social Security Administration. (d) 1. Within 14 days after request by the Division, the claims-handling entity shall file a completed Form DFS-F2-DWC-35, as adopted 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 claims-handling entity shall file a completed Form DFS-F2-DWC-33, as adopted in Rule 69L- 3.025, F.A.C., with the Division's Permanent Total Section.