The Issue The issues to be determined in this case are whether Respondent Lockhart Builders, Inc., violated state laws applicable to workers’ compensation insurance coverage by failing to secure coverage for three employees and failing to produce records requested by Petitioner Department of Financial Services, Division of Workers’ Compensation (Department) and, if so, what penalty should be assessed for the violations.
Findings Of Fact Petitioner is the state agency responsible for the enforcement of the workers’ compensation insurance coverage requirements established in Chapter 440, Florida Statutes (2007).1 Respondent is a Florida corporation with its office in Bradenton. William Lockhart is Respondent’s president. Respondent is licensed to engage in construction activity in Florida. Respondent was engaged to construct a two-story duplex at 2315 Gulf Drive in Bradenton. Respondent began work at the job site on or about February 21, 2007. On August 22, 2007, Lockhart received a proposal from Burak Yavalar, owner of BY Construction, to do the exterior stucco work on the duplex building for a flat fee of $10,750. The proposal was accepted by Respondent on August 23, 2007. Yavalar presented Lockhart with a certificate of liability insurance which indicated that he had obtained workers’ compensation coverage for his employees. The certificate was issued by Employee Leasing Solutions, Inc. (ELS), a professional leasing company in Bradenton. ELS provides mainly payroll services and workers’ compensation insurance coverage for its clients. Lockhart did not ask for, and Yavalar did not provide Lockhart with, a list of the names of the BY Construction employees who were covered by the insurance. Lockhart made a call to ELS to verify that BY Construction had workers’ compensation insurance coverage, but he did not ask for a list of BY Construction employees covered by its insurance policy. BY Construction began work at Respondent’s job site on or about September 10 or 11, 2007. On September 12, 2007, BY Construction had eight employees at the job site. One employee, Justin Ormes, had previously worked for BY Construction, had quit for a while, and had just returned. Two other employees, Carlos Lopez and Jaime Alcatar, had been working on a nearby job site and were asked by Yavalar to come to work at Respondent’s job site. Yavalar claims that on the morning of September 12, 2007, Ormes, Lopez, and Alcatar had not yet been employed or authorized to start work for BY Construction. On September 12, 2007, Petitioner’s investigators Germaine Green and Colleen Wharton performed a random compliance check at Respondent’s job site. Without being specific about what particular work was being performed at the site by Ormes, Lopez, and Alcatar, the investigators testified that when they arrived at the job site they observed all eight men performing stucco work. The investigators spoke to Yavalar, Lockhart and the workers at the job site to determine their identities and employment status. Yavalar told the investigators his eight employees had workers’ compensation insurance coverage through ELS. However, upon checking relevant records, the investigators determined that insurance coverage for Ormes, Lopez, and Alcatar had not been secured by either BY Construction or Respondent. Wharton issued a statewide stop-work order to BY Construction for its failure to obtain workers’ compensation coverage for the three employees. After the stop work order was issued, Yavalar left the job site with Lopez and Alcatar to complete their paperwork to obtain insurance coverage through ELS. Yavalar’s wife was able to re-activate Ormes’ insurance coverage with ELS over the telephone. By the end of the day on September 12, 2007, insurance coverage was secured by BY Construction for Ormes, Lopez, and Alcatar. The business records of BY Construction produced for the Department indicated that Ormes had been paid by BY Construction in the period from March to July 2007, and then on September 12, 2007; Lopez had been paid on August 24, 2007, and then on September 12, 2007; Alcatar had been paid on September 12, 2007. All three men were paid only $28 on September 12, 2007. This evidence supports the testimony of Yavalar that these three had arrived at Respondent’s job site for the first time on September 12, 2008. BY Construction was later served with an amended order of penalty for its failure to obtain workers’ compensation coverage for the three employees. It arranged with the Department to pay the penalty through installments and was conditionally released from the stop-work order. When the Department's investigators were at the job site on September 12, 2007, they informed Lockhart about the stop-work order being issued to BY Construction and gave Lockhart a Request for Production of Business Records for the purpose of determining whether Respondent had obtained proof of workers’ compensation insurance coverage from BY Construction before BY Construction commenced work at Respondent’s job site. Respondent produced the requested records. As discussed in the Conclusions of Law, Florida law charges a contractor with the duty to secure workers’ compensation insurance coverage for any uninsured employees of its subcontractors. On this basis, the Department served Respondent with a Stop-Work Order and an Order of Penalty Assessment on September 21, 2007, for failing to secure coverage for Ormes, Lopez, and Alcatar. On September 21, 2007, the Department served a Request for Production of Business Records for Penalty Assessment Calculation to Respondent. The Department’s request asked Respondent to produce records for the preceding three years, including payroll records, tax returns, and proof of insurance. Respondent produced some records in response to this second request, which the Department deemed insufficient to calculate a penalty. However, the evidence shows Respondent produced the only records that it possessed regarding its association with BY Construction. The Department’s proposed penalty does not include an assessment based solely on Respondent’s failure to produce requested records. When an employer fails to provide requested business records within 15 days of the request, the Department is authorized to assess a penalty by imputing the employer's payroll using "the statewide average weekly wage as defined in Section 440.12(2), multiplied by l.5." § 440.107(7)(e), Fla. Stat., and Fla. Admin. Code R. 69L-6.028. Imputing the gross payroll for Ormes, Lopez and Alcatar for the years 2004, 2005, 2006, and 2007, by using the average weekly wage for the type of work, the Department assessed Respondent with a penalty of $138,596.67 and issued an Order of Penalty Assessment to Respondent on October 31, 2007. Petitioner later amended the penalty to $70,272.51, based on the fact that BY Construction was not incorporated until January 1, 2006, and issued a Second Amended Order of Penalty Assessment on December 20, 2007.
Recommendation Based on the Findings of Fact and Conclusions of Law, it is recommended that the Department enter a final order that amends its penalty assessment to reflect one day of non-compliance by Respondent. DONE AND ENTERED this 31st day of March, 2008, in Tallahassee, Leon County, Florida. BRAM D. E. CANTER Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 31st day of March, 2008.
The Issue The issue to be determined is whether Respondent violated section 626.611(5), (7), (9), and (10), and section 626.621(6) and (9), Florida Statutes (2002), as alleged in the Administrative Complaint, and if so, what penalty should be imposed?
Findings Of Fact The Department is the state agency charged with the licensing and regulation of insurance agents in the State of Florida, and is responsible for administering the disciplinary provisions of chapter 626, Florida Statutes, pursuant to section 20.121(2)(g) and (h). Respondent has been licensed as a life, including variable annuity and health, agent (2-15), life, including variable annuity, agent (2-16), and a life and health agent (2- 18) at all times relevant to this proceeding. During the period relevant to these proceedings, Respondent was the president of BCMI, Inc. Pamela Johnson was employed by the Volusia County Sheriff's Department and on duty when she was involved in a motor accident on I-95 on September 4, 1998. Ms. Johnson was injured in the accident and was unable to continue working as a result. Ms. Johnson filed suit against the company owning the truck that hit her, and in 2000 received a compensatory award of approximately $650,000. She hired an investment advisor to handle the award, and placed her funds in a money market account. Until that time, she had no prior investment experience. Ms. Johnson describes herself as a person who wants to take very few risks with her money. She wanted all of her investments to be very safe and conservative. In 2002, she spoke to Respondent regarding possible investments. She was acquainted with Respondent through her sister. After Respondent met with her at her home, she decided to remove $100,000 from her money market account and invest in an annuity that Respondent was offering. She received a check for $100,000 from the money market account and signed it over to Respondent. Respondent assisted her in filling out an application for an annuity. He then deposited the check into his business account. Respondent did not, however, actually purchase the annuity with the funds entrusted to him. Ms. Johnson did not receive any paperwork regarding her purchase of the annuity, other than her initial application, and asked Respondent when she would receive the paperwork. At first, Respondent told her that he had received his copy and she should receive hers in the mail. She did not. Ms. Johnson called Respondent repeatedly and made several appointments with him between June and October, 2002, in order to obtain more information regarding her investment. Ms. Johnson was finally able to meet with Respondent in October of 2002, and learned for the first time that Respondent had not purchased on her behalf the annuity for which she had applied. Instead, he decided (without input from her) to use the money in a real estate investment. He represented to her that she had already made $5,000 on her investment. At this time, Respondent told Ms. Johnson that if she still wanted to purchase an annuity, she would have to write him another check. She did so, this time directly to Transamerica Life and Annuity instead of to Respondent. She has since moved the management of that annuity to another insurance agency. Ms. Johnson continued to seek documentation for her first investment, to no avail. She told Respondent she needed some documentation in order to complete her taxes, so in February 2003, he showed her a sheet of paper entitled "Account Summary," which listed her two investments. The first investment was her annuity with Transamerica Life and Annuity. The second investment is entitled "Corporate Note," with "real estate" in parenthesis, an identification number (which is her social security number), and an account balance of $105,000. The document stated at the bottom below Respondent's name and address, "**No taxes are due on these accounts at this time." Despite multiple contacts by both Ms. Johnson and a friend of Ms. Johnson, no further documentation regarding her investment has ever been provided. Finally, in May of 2004, Respondent told Ms. Johnson that an employee of the real estate company had embezzled all of the funds and that her entire investment was lost. Both the Financial Industry Regulatory Authority (FINRA) and Ms. Johnston eventually filed complaints with DFS regarding Respondent's handling of her first $100,000 investment. Respondent has offered several payment plans to Ms. Johnson over the years, but he has never actually returned any money to her. He did not have her permission to invest in a real estate transaction. He only had permission to purchase an annuity.
Recommendation Upon consideration of the facts found and conclusions of law reached, it is RECOMMENDED that the Department of Financial Services enter a Final Order finding Respondent guilty of violating section 626.611(5), (7), (9), and (10) and section 626.621(6); revoking his license; and requiring that he make restitution to Pamela Johnson in the amount of $100,000 pursuant to the authority in section 626.692. DONE AND ENTERED this 23rd day of June, 2011, in Tallahassee, Leon County, Florida. S LISA SHEARER NELSON Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 23rd day of June, 2011.
The Issue The issue is whether Respondent is liable for a penalty of $4,741.76 for the alleged failure to maintain workers’ compensation insurance for its employees in violation of Chapter 440, Florida Statutes (2008).1
Findings Of Fact Petitioner is the state agency responsible for enforcing the statutory requirement that employers secure the payment of workers’ compensation for the benefit of their employees in accordance with the requirements of Section 440.107. Respondent is a Florida corporation engaged in the construction business. The corporate officers of Respondent in 2007 were: Julie Magill, Glen Magill, Jamie Guerrero, and Richard Magill. The corporate officers after amendment on June 12, 2008, were: Julie Magill, Albert Farradaz, and Farid O’Campo. Corporate officers are eligible to obtain exemption from the requirements of workers’ compensation through the process described in Section 440.05. Construction exemptions are valid for a period of two years. The expiration date of each exemption is printed on an exemption card issued to each card holder. Julie Magill, Glen Magill, and Jaime Guererro obtained construction exemptions as officers of Respondent, pursuant to Section 440.05. Julie Magill acknowledged receiving a card for each exemption with the expiration date printed on each exemption card. The exemption for Julie Magill expired on June 2, 2008. The exemption for Glen Magill expired on May 29, 2008, and the exemption for Jaime Guererro expired on May 29, 2008. Petitioner notifies exemption holders at least 60 days prior to the expiration date. Petitioner sent the Notice of Expiration to Julie Magill at Respondent's current mailing address. On October 5, 2009, an investigator for Petitioner interviewed Mr. Cliff Chavaria, an installer and repairer of air-conditioner units. Mr. Chavaria was an employee of Respondent. Respondent did not maintain workers’ compensation insurance coverage for Mr. Chavaria in violation of Chapter 440. It is undisputed that Mr. Chavaria did not have any type of coverage for workers’ compensation insurance. Mr. Jaime Guererro and Mr. Glen Magill also had no exemptions and no workers’ compensation insurance coverage. Respondent offered tax records for 2007 as Exhibit 8 at the hearing to show gross payroll for Julie and Richard Magill. The offered exhibit was an attempt to re-create tax information from an internet website. Respondent was given 10 days following the date of the hearing to produce an authenticated version of this document. No documentation was received.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Financial Services, Division of Workers’ Compensation, issue a final order imposing a penalty assessment in the amount of $4,741.76. DONE AND ENTERED this 15th day of April, 2010, in Tallahassee, Leon County, Florida. S DANIEL MANRY Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 15th day of April, 2010.
Findings Of Fact At all times pertinent to this matter, the Respondent has been licensed by the Florida Department of Insurance as an ordinary life, including disability, agent and a general lines agent. During the years 1977 and 1978, the Respondent operated an insurance agency known as Florida Commercial Underwriters. During May, 1977, the Respondent was a general lines agent providing insurance coverages for The Fronton, Inc., West Palm Beach, Florida. During June, 1977, The Fronton, Inc., delivered a check to the Respondent in the amount of $41,229.00 as a premium payment for various insurance coverages to be provided by the Respondent. Approximately $23,795.00 of that amount represented the premium payment for Policy No. 7485844, issued by the Insurance Company of the State of Pennsylvania. The Insurance Company of the State of Pennsylvania issued the policy to The Fronton, Inc., for the policy period from May 1, 1977, through May 1, 1978. The Insurance Company of the State of Pennsylvania had a firm policy during this period that premiums would be due within forty-five days from inception of the policy, or within fifteen days from the date of billing, whichever was later. Due to errors on its part, the Insurance Company of the State of Pennsylvania did not submit its bill to the Respondent until November 30, 1977. The notice on the face of the bill itself indicated that the premium was due within fifteen days of the date of the bill. The Respondent did not pay the premium in accordance with the bill. By notice dated January 31, 1978, the Insurance Company of the State of Pennsylvania advised The Fronton, Inc., that its policy would be cancelled effective February 17, 1978, because the premium had not been paid. Donald Roberts, the Assistant General Manager of The Fronton, Inc., immediately contacted the Respondent. The Respondent advised Roberts that the problem was apparently of a bookkeeping sort, and that the premium had been paid. Within four or five days of the time that he received the Notice of Cancellation, Roberts again contacted the Respondent and requested that the Respondent produce the cancelled check verifying that the premium had been paid. Roberts followed that telephone contact with a visit to the Respondent's office approximately forty-five minutes later. The Respondent searched for a cancelled check, but told Roberts that he would need to get it from the bank. Roberts told him to produce the cancelled check later that day. When the Respondent failed to do that, Roberts took the matter to the office of the State Attorney. Despite the fact that he told Roberts that the policy had been paid, the Respondent had not paid the premium. In fact, he did not pay the premium until May 8, 1978, after he had raised some money from another source. He paid the premium by delivering the check personally to the insurance company's office in Atlanta. Apparently mindful of the fact that the Respondent was acting as its agent, and that the Respondent's receipt of the premium was thus binding upon it, the Insurance Company of the State of Pennsylvania reinstated the policy, and has acknowledged that despite its Notice of Cancellation, the policy was in full force and effect during its entire term. The Respondent had suffered financial reverses during this period of time. He had apparently forgotten that the premium had not been paid between the time that he received the check from The Fronton, Inc., and the bill from the Insurance Company of the State of Pennsylvania. When he received the bill, he did not have sufficient funds available to pay it. He had in effect used the money paid by The Fronton, Inc., to cover other debts that he had. Since May, 1978, the Respondent has been working as an employee with another insurance agency. His employer assisted him in paying off the obligations that the Respondent incurred in connection with his former business. It does not appear that the Respondent has had problems of this sort in his new position, and he currently teaches an insurance agent's course at a local school.
Findings Of Fact The Petitioner, Ecker Enterprises, is a corporation licensed to do business in Florida with home offices in Chicago, Illinois. It has, in the past, and up until the approximate time of this proceeding, properly authenticated its ability to provide its own insurance or funds to cover any worker's compensation exposure emanating from its operations within the State of Florida in a manner sufficient to comply with Chapter 440, Florida Statutes, and Chapter 35-5, Florida Administrative Code. The corporation, however, failed to file required financial statements and other financial information with the Bureau of Self-Insurance of the Department for 1980. On August 18, 1980 the Chief of the Bureau of Worker's Compensation, Self-Insurance issued a revocation of the corporation's privilege to be self- insured in the State of Florida pursuant to Rule 38-5.12(5) Florida Administrative Code. The financial statements involved were filed at a later time, although not timely, but did not comport with the subject rules on self-insurers in that they were not certified and did not contain the required information as to financial disclosure. The Department stipulated that it would forebear from revoking the privilege for forty-five days and allow the self-insurance privilege to remain in force provided the corporation filed the necessary documentation pursuant to Section 440.51(12) Florida Statutes, and the above-cited rule, within that period of time, to which the Petitioner agreed. The time stipulated by which the filings were to be made has elapsed and the Petitioner has failed to comply with the stipulation.
Recommendation Having considered the evidence in the record the candor and demeanor of the witnesses, the foregoing Findings of Fact and Conclusions of Law, and arguments of counsel, it is therefore RECOMMENDED that the revocation of privilege of self-insurance in the State of Florida previously imposed against the Petitioner herein was proper and should therefore stand unchanged. DONE and ENTERED this 6th day of January, 1981, in Tallahassee, Florida. P. MICHAEL RUFF Hearing Officer Division of Administrative Hearings Room 101 Collins Building Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 6th day of January, 1981. COPIES FURNISHED: Jack C. Inman, Esquire Post Office Box 1294 Orlando, Florida 32302 Douglas P. Chance, Esquire Dept. of Labor and Employment Security 2562 Executive Center Circle, East Tallahassee, Florida 32301 Mr. Wallace E. Orr Secretary Department of Labor and Employment Security Suite 206 Berkley Building 2690 Executive Center Circle, East Tallahassee, Florida 32301
The Issue Whether the Respondent committed the violations alleged in the Administrative Complaint and, if so, what penalty should be imposed.
Findings Of Fact The Department is the state agency charged with the responsibility of regulating the insurance industry within the State of Florida. At all times material to the allegations of this case, the Respondent was licensed in Florida as a life and variable annuity agent; life, health and variable annuity agent; life insurance agent; life and health insurance agent; and health insurance agent. All such activities are regulated pursuant to Chapter 626, Florida Statutes. Aurore Giroux is approximately 86 years of age. She currently lives in an assisted living facility in Waltham, Massachusetts. At all times material to the allegations of this case, Mrs. Giroux resided at 12 Cozumel Lane, Port St. Lucie, Florida. By way of her background, Mrs. Giroux attended grade school but did not complete high school. Although well spoken, she is not well-educated either by formal school or training. She has limited retirement income, and is not particularly well versed in investment opportunities. At the time of her husband's death in 1989, Mrs. Giroux had a life savings of approximately $230,000. This was accomplished primarily due to her modest life style and careful spending habits. At all times material to the allegations of this case, Mrs. Giroux's income was limited to social security and her husband's retirement. Her total monthly income does not exceed $1,300. In order to afford the costs of her current residence, Mrs. Giroux must use portions of her savings every month. Mrs. Giroux is an independent person and has never wanted to rely on others for her financial care. Although she maintains close relationships with her children, Mrs. Giroux has always written checks on her account to pay her own bills and has managed her own funds without the interference of the children. Following her husband's death, Mrs. Giroux began spending two months in the summer with her daughter, Elaine O'Toole, in Massachusetts. Mrs. O'Toole also would visit her mother in Florida on occasion. After Mr. Giroux passed away, the Respondent contacted Mrs. Giroux under the guise of offering her Medicare supplement insurance. Mrs. Giroux purchased a supplement from the Respondent. Thereafter, the Respondent would from time to time go by and visit Mrs. Giroux. Over the course of time the Respondent developed a relationship with Mrs. Giroux and he offered her other insurance products for purchase. Among those known are the annuities and the viatical which are the subject of the instant case. Additionally, the Respondent sold Mrs. Giroux a second Medicare supplement policy in 1998 that contained a life insurance benefit in the amount of $2500. The premium for that life insurance benefit was $50 per month. Although she spent over $60,000 to purchase the viatical from the Respondent, Mrs. Giroux did not recall investing that amount and is unable to explain what the product is. Although she signed a "Statement of Understanding of Viaticals" dated September 21, 1998, Mrs. Giroux was unaware of the illiquid nature of the viatical product. Moreover, if the viator lives more than 12 months beyond his estimated date of demise, Mrs. Giroux was unaware that she would be required to remit the premiums to the insurance company for the policy. Failing same, Mrs. Giroux will lose her entire investment. To attempt to cover the questionable prudence of the viatical investment, the Respondent had Mrs. Giroux write and sign several documents, none of which were remembered by her. Similarly, the Respondent sold Mrs. Giroux two annuities. She liquidated certificates of deposit to purchase the annuities based upon documents the Respondent brought her to sign. Again, Mrs. Giroux has no recollection of signing the authorization forms that were presented to the bank. Prior to selling Mrs. Giroux the viatical and the annuities, the Respondent did not perform a written client financial analysis to determine if there were valid tax reasons for either type of investment. In fact, there are no tax advantages to Mrs. Giroux. Although the annuities were subsequently refunded to her, there is no credible evidence that they would have been preferable to the return earned by the certificates of deposit. As to the viatical, unless the viator dies within 12 months of the estimate dated of death, Mrs. Giroux will have to remit the premium amounts to keep the policy in effect just to preserve her investment. Thus the unknown return and illiquid nature of the investment may prove a significant hardship for her. Family concerns regarding Mrs. Giroux's investments arose after Mrs. O'Toole learned of the viatical purchase. During a visit to Florida Mrs. O'Toole met with the Respondent to attempt to gather information regarding her mother's investments. Of particular concern was the fact that Mrs. Giroux's understanding of the terms of the annuities did not match the paperwork Mrs. O'Toole was able to locate. Mrs. Giroux's annuities did not allow for any annual withdrawal of principal despite the Respondent's assertions that Mrs. Giroux could draw down funds. When challenged on that point, the Respondent maintained that the company issued the wrong policy. He did not take responsibility for the error until the administrative charges were filed with the Department by Mrs. O'Toole. He then assisted all parties in securing the refund of the annuity amounts. In fact, as of the date of hearing, such amounts had been refunded to Mrs. Giroux. As to the viatical, Mrs. Giroux does not know who the viator is. Presumably the viator is alive. How her estate would benefit should Mrs. Giroux predecease the viator is unknown. It is known, however, that Mrs. Giroux is not in a tax bracket mandating tax consideration of tax deferred income opportunities. The total amount of funds invested by Mrs. Giroux in reliance on the Respondent's suggestions was $131,000, over one-half of her life savings. The Respondent has had his insurance license previously disciplined for misrepresentation. Nevertheless, prior to allowing Mrs. Giroux, an elderly, uneducated, and unsophisticated investor to purchase the products described herein, he did nothing to encourage her to seek the independent advice that might be obtained from an accountant, a lawyer, a banker, or family member.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Insurance enter a final order revoking the Respondent's license and eligibility for license. DONE AND ENTERED this 26th day of October, 2001, in Tallahassee, Leon County, Florida. J. D. PARRISH Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 26th day of October, 2001. COPIES FURNISHED: David J. Busch, Esquire Department of Insurance 645A Larson Building 200 East Gaines Street Tallahassee, Florida 32312 Lawrence H. Sussman 56 Southwest Riverway Boulevard Palm City, Florida 34990 Honorable Tom Gallagher State Treasurer/Insurance Commissioner Department of Insurance The Capitol, Level 02 Tallahassee, Florida 32399-0300 Mark Casteel, General Counsel Department of Insurance The Capitol, Lower Level 26 Tallahassee, Florida 32399-0307
The Issue The issues in this case are whether Professional Staffing and Payroll Services, LLC, failed to secure the payment of workers' compensation coverage for its employees in violation of chapter 440, Florida Statutes (2014), and, if so, the penalty that should be imposed.
Findings Of Fact Petitioner, Department of Financial Services, Division of Workers' Compensation, is the state agency responsible for enforcing the requirement that employers in the State of Florida secure the payment of workers' compensation insurance coverage for their employees, pursuant to chapter 440, Florida Statutes. Respondent, Professional Staffing and Payroll Services, LLC, is a registered Florida limited liability company. At all times relevant to this proceeding, its business address was 1400 Colonial Boulevard, Suite 260, Fort Myers, Florida. Respondent actively engaged in business during the period from February 1, 2015, to June 17, 2015. On June 2, 2015, Petitioner's compliance investigator, Jack Gumph, conducted a workers' compensation compliance investigation at a worksite located at 8530 Palacio Terrace North, Lot 67, Hacienda Lakes, Naples, Florida. At the worksite, Gumph observed five workers nailing down plywood on the trusses of the roof of a house under construction. One of the workers, Fernando Fernandez, identified himself as the job foreman. Mr. Fernandez and the other four workers were employed by J.S. Valdez, Inc. ("JSV"). These workers were engaged in carpentry work installing plywood. This type of carpentry work is classified as National Council on Compensation Insurance ("NCCI") class code 5403 and is considered a type of construction activity under Florida Administrative Code Rule 69L-6.021(2)(cc). The evidence established that JSV was a client company of Global Staffing Services, LLC ("GSS"), and that GSS supplied the workers to JSV. The evidence further established that all five workers Gumph observed at the Palacio Terrace jobsite were employees of GSS. Using the State of Florida's Coverage and Compliance Automated System ("CCAS") computer database, Gumph determined that JSV did not have workers' compensation insurance covering any of its employees, and that GSS had workers' compensation coverage only for two secretarial/clerical employees. Through research in the Florida Department of State, Division of Corporations Sunbiz database ("Sunbiz"), Gumph discovered that GSS was part of three related——as Gumph characterized it, "commingled"——business entities; these entities were GSS, Global Staffing Payroll, LLC ("GSP"), and Professional Staffing and Payroll Services, LLC, the named Respondent in this case. Ivan Hernandez was shown in Sunbiz as being the managing member of GSS and GSP. At that time, the managing member of Respondent was shown as being Martha Coloma. Gumph suspected that Respondent was leasing construction workers, who are engaged in hazardous work, through a staffing company that was characterized as a secretarial/clerical business (NCCI code 8810)——a substantially less hazardous occupation. The effect of classifying of these business as "secretarial/clerical" is that a much lower workers' compensation premium rate applies.2/ Gumph prepared requests for production of business records ("RPBR") for each of the related business entities and visited the business address listed in Sunbiz for GSS to personally serve them on Hernandez. The business was located in a strip mall that housed various types of businesses. As he was entering the business, he noted that the name shown at the entrance was "Professional Staffing." The business manager explained that GSS was opened in 2013, and that on February 1, 2015, the business name had been changed to Professional Staffing and Payroll Services——the named Respondent in this proceeding. Upon inquiry, Gumph was told that Hernandez was "out of state." Almost as soon as he left Respondent's business office, Gumph received a call from Hernandez, who confirmed that he was the owner and chief executive officer of both GSS and Respondent. Gumph scheduled an appointment with Hernandez for June 16, 2015. However, Hernandez did not keep that appointment or call Gumph back to reschedule the appointment. It was obvious to Gumph that Hernandez was avoiding him. In researching the Sunbiz records for Respondent, Gumph also noted that on June 16, 2015, the managing member's name had been changed from Martha Coloma to Ivan Hernandez. He also rechecked the CCAS and NCCI databases for Respondent and noted that only a few days before, a workers' compensation policy had been issued for Respondent. The policy listed the business as "secretarial/clerical" and had a total exposure of $143,000 to cover four secretarial/clerical employees. He also noted that GSS had a workers' compensation policy that was effective from August 15, 2014, to August 15, 2015, and that this policy did not cover any additional insured entities, so its coverage did not extend to Respondent or its employees. Gumph contacted Martha Coloma, who was employed by All Florida Financial Services, LLC, a payroll preparation and bookkeeping firm. Coloma told Gumph that in January 2015, Hernandez had asked her to amend the Sunbiz records for Respondent to be shown as Respondent's managing member. Coloma also told Gumph that Hernandez requested that she find a Professional Employer Organization ("PEO") leasing company that would secure workers' compensation coverage for approximately 40 to 50 of his employees who were engaged in construction work.3/ Coloma was unsuccessful, so Hernandez directed her to obtain another policy for secretarial/clerical employees. She obtained the policy covering the four secretarial/clerical employees. Thereafter, Gumph spoke directly with Hernandez, who confirmed that he employed 40 to 50 construction workers. He told Gumph that he had tried to obtain a policy but had been unable to do so. On June 17, 2015, Gumph issued a Stop-Work Order and Order of Penalty Assessment to Respondent, and also served a RPBR on Respondent. In response, Respondent provided business records consisting of bank statements from a Regions Bank account covering the period from February 1, 2015, to February 28, 2015. Respondent did not provide any copies of checks written during this period. Respondent also provided business records consisting of bank statements and copies of checks from a Fifth Third Bank payroll account for Respondent for the period of March 1, 2015, through June 17, 2015. The evidence establishes that between February 1, 2015, and June 12, 2015, Respondent employed 437 employees—— the great majority of whom worked in construction jobs——for whom Respondent failed to secure workers' compensation insurance coverage. For the period between June 13, 2015, and June 17, 2015, Respondent secured workers' compensation coverage for four secretarial/clerical employees. Based on the business records provided, Lynne Murcia, Petitioner's penalty auditor, calculated the penalty to be assessed against Respondent. Pursuant to section 440.107(7)(d)1., the penalty for failing to secure workers' compensation is equal to two times the amount the employer would have paid in premium when applying approved manual rates to the employer's payroll during the period for which the employer failed to secure coverage during the two-year period preceding issuance of the Stop-Work Order. Here, because Respondent became a business entity on or about February 1, 2015, the penalty period applicable to this proceeding commenced on February 1, 2015, and ran through June 17, 2015, the date on which the Stop-Work Order and Penalty Assessment were served on Respondent.4/ Respondent did not obtain any exemptions from the workers' compensation coverage requirement for the period between February 1, 2015, and June 17, 2015. The business records Respondent provided in response to the RPBR were not sufficient to enable Petitioner to calculate Respondent's payroll for the period commencing on February 1, 2015, and ending on February 28, 2015. Accordingly, Petitioner imputed the gross payroll for Respondent's employees identified in the taxable wage report for the period covering February 1, 2015, through February 28, 2015, the statewide average weekly wage effective at the time of the Stop-Work Order, multiplied by two. The imputed wages for these employees over this period amounted to $2,544,907.68. For the period commencing on March 1, 2015, and ending on June 17, 2015, Respondent provided records sufficient to enable Petitioner to determine Respondent's actual gross payroll. For this period, Respondent's gross payroll amounted to $1,202,781.88. The evidence shows that for the period from February 1, 2015, through June 12, 2015, Respondent failed to secure workers' compensation coverage for any of its employees. On June 13, 2015, Respondent secured workers' compensation covering four secretarial/clerical employees. This coverage did not extend to Respondent's employees engaged in work other than secretarial/clerical work. For the period from June 13, 2015, to June 17, 2015, Respondent's gross payroll was calculated as $22,507.37. In calculating the applicable penalty, Respondent received a credit of $923.98 for the premium paid on the policy secured on June 12, 2015. This amount was deducted from the penalty owed. In calculating the penalty, Murcia determined the NCCI class code applicable to each employee according to his or her job, and applied the pertinent approved NCCI rates to determine the amount of the evaded premium for each employee. Pursuant to this method, Murcia calculated a total penalty of $645,019.36, which was reflected in the Amended Order of Penalty Assessment. In sum, Petitioner demonstrated, by clear and convincing evidence, that Respondent failed to secure workers' compensation coverage for its employees, in violation of chapter 440. The clear and convincing evidence further establishes that Petitioner correctly calculated a penalty of $645,019.36 to be assessed against Respondent pursuant to sections 440.107(7)(d)1. and 440.107(7)(e) and rule 69L-6.028.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that: The Department of Financial Services, Division of Workers' Compensation, enter a final order determining that Respondent Professional Staffing and Payroll Services, LLC, violated the requirement in chapter 440, Florida Statutes, to secure workers' compensation coverage and imposing a penalty of $645,019.36. DONE AND ENTERED this 10th day of February, 2016, in Tallahassee, Leon County, Florida. S CATHY M. SELLERS Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 10th day of February, 2016.
The Issue Whether Respondent, Forgue General Contracting, Inc., violated the provisions of chapter 440, Florida Statutes, by failing to secure the payment of workers’ compensation coverage; and, if so, what penalty is appropriate.
Findings Of Fact The Department is the state agency charged with enforcing workers’ compensation coverage requirements in Florida, including the requirement that employers secure the payment of workers’ compensation coverage for their employees. See § 440.107(3), Fla. Stat. Respondent operates a construction company in Florida, and Respondent has been in business since 2004. On October 31, 2018, Margaret Cavazos, a compliance investigator with the Department, conducted a random workers’ compensation check at a worksite located at 1172 East State Road 434 in Winter Springs, Florida. The worksite is a two-story commercial building with five individual storefronts. Investigator Cavazos arrived at the worksite at 8:30 a.m. There, she observed four individuals who she believed were preparing the exterior of the building for painting. One person was covering a window with tape and brown construction paper. Two more individuals were standing in the bucket of a boom lift approximately 15 feet above the ground next to the building. They appeared to be placing blue tape over a sign of one of the businesses in the building. A fourth person was positioned by a truck supervising the activity. Investigator Cavazos further noticed that several of the business names had already been covered with construction paper and tape. Investigator Cavazos approached the person standing by the truck and introduced herself. He identified himself as Jose Luis Chachel. Mr. Chachel informed Investigator Cavazos that he and the other three individuals at the worksite were working for a company called RC Painting Services, Inc. (“RC Painting”). Mr. Chachel further stated that they were preparing the building to be painted. The other three individuals at the worksite identified themselves to Investigator Cavazos as Juan Carlos Vasquez Garcia, Artemia Vasquez, and Jenny Araque. Investigator Cavazos watched the four individuals work at the jobsite for about an hour, then they departed. Investigator Cavazos, however, did not obtain any information from Mr. Chachel or the other individuals concerning how long they had worked for RC Painting, when they had arrived at the jobsite, their rate of pay, or whether RC Painting had actually paid them for their work. At the final hearing, Investigator Cavazos testified that her duties for the Department include inspecting businesses and worksites to determine whether a business has obtained the required workers’ compensation insurance coverage. Investigator Cavazos explained that a business that performs construction- related work must have workers’ compensation coverage. Therefore, Investigator Cavazos believed that, prior to beginning the painting activities, RC Painting should have secured sufficient workers’ compensation coverage for all four individuals identified at the worksite. After learning the name of the business that arranged for the presence of the four individuals at the jobsite, Investigator Cavazos consulted the Department’s Coverage and Compliance Automated System (“CCAS”) database for information on RC Painting. CCAS is a Department database that tracks workers’ compensation insurance coverage. CCAS contains coverage data from insurance carriers, as well as any workers’ compensation exemptions on file with the Department. Insurance providers are required to report coverage and cancellation information, which the Department uses to update CCAS. CCAS had no record that RC Painting carried any workers’ compensation coverage for the four individuals Investigator Cavazos observed at the worksite. While reviewing CCAS, Inspector Cavazos also noted that the Department did not have on file any request from RC Painting for an “exemption” from workers’ compensation coverage. An exemption is a method by which a business’s corporate officer may exempt him or herself from the requirements of chapter 440. See § 440.05, Fla. Stat. CCAS also revealed to Investigator Cavazos that on the date of her inspection, RC Painting had an active employee leasing agreement with SouthEast Personnel Leasing (“SouthEast Leasing”), an employee staffing company. At the final hearing, Inspector Cavazos explained that a business is not required to obtain workers’ compensation insurance for its employees if coverage is properly provided by or through an employee leasing company’s workers’ compensation policy. However, in order for an employee leasing company to become responsible for the workers’ compensation coverage of a particular employee, the business seeking coverage for that employee must ensure that the employee submits an application to the leasing company. Thereafter, if (and only if) the leasing company accepts the application, the leasing company becomes accountable for the workers’ compensation insurance coverage for that employee. Investigator Cavazos contacted SouthEast Leasing. SouthEast Leasing provided Investigator Cavazos an active roster of employees it leased to RC Painting. However, neither Mr. Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, nor Jenny Araque were listed on this roster. Therefore, Investigator Cavazos concluded that none of the four individuals she identified at the worksite were covered by workers’ compensation insurance under RC Painting’s leasing arrangement with SouthEast Leasing on October 31, 2018. After determining that neither CCAS nor SouthEast Leasing recorded any workers’ compensation coverage for the persons at the worksite, Investigator Cavazos contacted RC Painting’s owner, Roberto Chavez. (Mr. Chachel provided Investigator Cavazos with his phone number during her inspection.) Investigator Cavazos testified that, during their phone call, Mr. Chavez confirmed that the four individuals worked for him. Mr. Chavez further informed Investigator Cavazos that RC Painting had been hired by Respondent to paint the building. At that point, Investigator Cavazos called Respondent to inquire about workers’ compensation coverage for Jose Luis Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, and Jenny Araque. Investigator Cavazos spoke with one of Respondent’s employees, Anthony Gonzalez. Mr. Gonzalez confirmed that Respondent engaged RC Painting to paint the building. Continuing to search for active workers’ compensation coverage, Investigator Cavazos discovered that Respondent also had an employee leasing agreement with SouthEast Leasing. Investigator Cavazos reviewed SouthEast Leasing’s roster which recorded only two covered employees for Respondent, Anthony Gonzalez and Edward Forgue (Respondent’s president). As with RC Painting’s leasing agreement, Respondent’s leasing agreement with SouthEast Leasing did not cover Jose Luis Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, or Jenny Araque on October 31, 2018. As detailed below, under section 440.10(1), a contractor is liable for, and is required to secure, workers’ compensation coverage for all employees of a subcontractor to whom the contractor sublets work. (Section 440.10(1)(c) also directs the contractor to require a subcontractor to provide evidence of workers’ compensation insurance.) Therefore, as a contractor hiring a subcontractor for construction work, Respondent was required to exercise due diligence to ensure that all RC Painting’s employees who were painting the building were covered by workers’ compensation insurance. On October 31, 2018, based on her findings, Investigator Cavazos issued a Stop-Work Order to RC painting. Later that day, Mr. Chavez ventured to the Department’s local office to determine how his business could be released from the Stop-Work Order. There, he met with district supervisor, Salma Qureshi. Ms. Qureshi informed Mr. Chavez that, in order for his company to return to work, he needed to pay a $1,000 fine and complete an Affirmation. She explained to Mr. Chavez that on the Affirmation, he was to describe how RC Painting intended to come into full compliance with workers’ compensation coverage requirements. Mr. Chavez had, in fact, brought with him a cashier’s check for $1,000. (The amount was included on the Stop-Work Order.) Mr. Chavez then completed an Affirmation before Ms. Qureshi. On the Affirmation, Mr. Chavez wrote the names of the four individuals Investigator Cavazos identified at the jobsite. Next to each name, Mr. Chavez wrote “$20.” Below the names, he wrote “I am terminating.” Mr. Chavez then signed and dated the Affirmation. At the final hearing, Ms. Qureshi expressed that Mr. Chavez told her that he was going to pay each of the four individuals $20 for the day’s work they performed on October 31, 2018, and then he was terminating them. In addition to issuing the Stop-Work Order to RC Painting, on October 31, 2018, Investigator Cavazos issued a Stop-Work Order for Specific Worksite Only to Respondent, which was served on November 2, 2018. Investigator Cavazos also served Respondent with a Request for Production of Business Records for Penalty Assessment Calculation. Through this document, the Department requested several categories of business records from Respondent for the period of November 1, 2016, through October 31, 2018. The requested documents pertained to: employer identification, payroll documents, account documents, disbursements, workers’ compensation coverage, professional employer organization records, temporary labor service, exemptions, subcontractor records, and subcontractors’ workers’ compensation coverage. Based on Investigator Cavazos’s investigation, the Department determined that Respondent failed to secure adequate workers’ compensation coverage for its employees. Therefore, the Department proceeded to calculate a penalty based on Respondent’s lack of compliance with chapter 440. The Penalty Calculation: Nathaniel Hatten, the penalty auditor who determined the penalty the Department seeks to impose on Respondent, testified regarding his computation. Mr. Hatten explained that the penalty essentially consists of the “avoided” premium amount, or the actual premium the employer would have paid in workers’ compensation insurance for the uncovered employees, multiplied by two. To calculate the appropriate penalty for Respondent’s failure to secure workers’ compensation coverage, the Department first ascertained Respondent’s period of non-compliance. To determine this time frame, the Department referred to Florida Administrative Code Rule 69L-6.028(2), which directs that: The employer’s time period or periods of non-compliance means the time period(s) within the two years preceding the date the stop-work order was issued to the employer within which the employer failed to secure the payment of compensation pursuant to chapter 440, F.S., and must be either the same time period as set forth in the business records request for the calculation of penalty or an alternative time period or period(s) as determined by the Department, whichever is less. The employer may provide the Department with records from other sources, including, but not limited to, the Department of State, Division of Corporations, the Department of Business and Professional Regulation, licensing offices, and building permitting offices to show an alternative time period or period(s) of non- compliance. Based on these instructions, the Department deduced that Respondent’s period of non-compliance ran from November 1, 2016, through October 31, 2018, which was the two-year period preceding the date of the Stop-Work Order. (This two-year period was also the time for which the Department requested business records from Respondent.) After determining Respondent’s period of non- compliance, the Department then calculated the monetary penalty it should impose upon Respondent. In accordance with section 440.107(7)(d)1., the Department must assess against an employer: a penalty equal to 2 times the amount the employer would have paid in premium when applying approved manual rates to the employer’s payroll during periods for which it failed to secure the payment of workers’ compensation required by this chapter within the preceding 2-year period or $1,000, whichever is greater. Therefore, the Department reviewed the business records Respondent provided to ascertain the amount of Respondent’s payroll during the two-year period of non-compliance. In response to the Department’s request for documents, Respondent produced its client leasing agreement with SouthEast Leasing. This leasing agreement, however, only covered Mr. Forgue and Mr. Gonzalez. Further, the leasing agreement was only in effect from February 7, 2018, through October 30, 2018, for Mr. Forgue and February 21, 2018, through October 30, 2018 for Mr. Gonzalez. No evidence establishes that Respondent made any other payments for workers’ compensation insurance coverage outside of the SouthEast Leasing agreement. Consequently, the evidence in the record establishes that Respondent had no workers’ compensation coverage for any of its employees, officers, or subcontractor employees from November 1, 2016, through February 6, 2018. And, only Mr. Forgue and Mr. Gonzalez were covered from February 2018 through October 30, 2018. Further, Respondent did not provide any payroll information to the Department per its request for business records. Consequently, the documentation was not comprehensive enough for the Department to determine all the wages Respondent paid to its employees, or the work they performed for the period of November 1, 2016, through October 31, 2018. Therefore, the Department determined that Respondent did not provide business records sufficient for it to calculate Respondent’s complete payroll or the actual employee wages it paid over the two-year period of non-compliance. Accordingly, the Department exercised its option to “impute” Respondent’s weekly payroll from November 1, 2016, through October 31, 2018. To calculate Respondent’s imputed weekly payroll, section 440.107(7)(e) directs that the gross payroll for an employer who provides insufficient business records is imputed at the statewide average weekly wage, multiplied by 1.5, for each employee who worked during the period requested for the penalty calculation. Therefore, the Department obtained the statewide average weekly wage effective at the time of the Stop- Work Order ($917.00)2/ for each identified employee, corporate officer, and subcontractor, then multiplied that number by 1.5. See § 440.107(7)(e), Fla. Stat.; and Fla. Admin. Code R. 69L- 6.028(3)(a). The Department imputed the payroll for all four individuals Investigator Cavazos observed at the worksite on October 31, 2018 (Jose Luis Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, and Jenny Araque), for all periods of non- compliance (November 1, 2016 through October 31, 2018). No evidence established that these individuals were covered under a workers’ compensation policy either through Respondent, RC Painting, or SouthEast Leasing. The Department also included Mr. Forgue for a period of non-compliance from January 22, 2018, through February 8, 2018. The Department imputed his payroll during this period of time explaining that Respondent did not have an active workers’ compensation exemption on file for Mr. Forgue. Neither was he covered by SouthEast Leasing’s policy during this brief timeframe. Therefore, Respondent was required to carry workers’ compensation for Mr. Forgue from January 22, 2018, through February 8, 2018. See Fla. Admin. Code R. 69L-6.028(3)(b). To calculate a penalty based on the imputed payroll, the Department assigned Respondent’s employees the highest rated workers’ compensation classification code. The classification code is based on either the business records submitted or the investigator’s observation of the employees’ activities. In this case, the business records Respondent provided to the Department were not sufficient to categorize the exact type of work that the identified workers performed for Respondent over the two-year period of non-compliance. However, during her investigation of the jobsite on October 31, 2018, Investigator Cavazos observed the four employees engaging in activities associated with “painting.” According to the Scopes Manual issued by the National Council on Compensation Insurance, Inc. (“NCCI”), class code 5475 is applied to “painting contractors engaged in painting.”3/ Consequently, the Department used class code 5474 for all Respondent’s employees and corporate officer for the penalty period. See Fla. Admin. Code R. 69L-6.028(3)(b) and 69L- 6.021(2)(jj)(painting is classified as “construction activity”). Therefore, to calculate the premium amount for the workers’ compensation insurance Respondent should have paid for its “employees” (Jose Luis Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, and Jenny Araque) and officer (Mr. Forgue), the Department applied the manual rates corresponding to class code 5474. Thereafter, based on: 1) the total periods of non- compliance, 2) Respondent’s calculated payroll for the periods of non-compliance, and 3) the estimated premium for workers’ compensation insurance, the Department issued the Amended Order of Penalty Assessment (“Penalty Assessment”) on November 30, 2018, which was served on Respondent on February 28, 2019. The Penalty Assessment seeks to impose a penalty of $129,089.60 against Respondent. At the final hearing, Respondent argued that the individuals Investigator Cavazos identified at the worksite on October 31, 2018, were never hired by Respondent’s subcontractor, RC Painting. Therefore, they are not “employees” under chapter 440, and Respondent is not an “employer” for purposes of securing workers’ compensation coverage. Consequently, Respondent argues that the penalty the Department seeks to assess against Respondent is not warranted. Mr. Chavez testified at the final hearing for Respondent describing his employment relationship with Jose Luis Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, and Jenny Araque. Initially, Mr. Chavez confirmed that Respondent hired RC Painting to paint the exterior of the shopping plaza. Regarding the four individuals Investigator Cavazos identified at the jobsite, however, Mr. Chavez denied that they were “employees” of RC Painting on October 31, 2018. Mr. Chavez explained that he used SouthEast Leasing to “hire” his employees. Mr. Chavez asserted that before he puts someone to work, he requires them to complete an employment application with SouthEast Leasing. Only after SouthEast Leasing approved the employee would he allow the individual to work on a job. In this matter, Mr. Chavez denied that he had ever worked with Mr. Chachel before, or ever met the other three individuals that Mr. Chachel brought with him to the jobsite. Mr. Chavez maintained that he called Mr. Chachel on the evening of October 30, 2018, about the prospective painting job. He then asked Mr. Chachel to bring two other workers and meet him at the jobsite the following morning. Mr. Chavez testified that he instructed Mr. Chachel that he would need to send information to SouthEast Leasing before anyone actually started working on the project. Mr. Chavez further contended that he did not have any discussion with Mr. Chachel about wages or the rate of pay for the job. He declared that he never commits to paying any prospective employee before ascertaining what type of skills they possess. Mr. Chavez explained that, “anyone can tell you, ‘I’ve been painting all of my life,’ and they show up and don’t know how to paint, or they don’t know how to do anything.” In response to Inspector Cavazos’s testimony, Mr. Chavez exclaimed that he never told her that the four individuals were his “employees.” He merely relayed that they were “with” him. Mr. Chavez also insisted that he never authorized Mr. Chachel or his crew to start preparing the building for painting prior to meeting with him. Mr. Chavez further relayed that Respondent provided the boom lift for the job. But, he never instructed Mr. Chachel to begin using it. Mr. Chavez arrived at the shopping plaza around 9:30 a.m. However, by that time Investigator Cavazos had issued the Stop- Work Order, and only Mr. Chachel remained at the scene. Regarding the Affirmation he completed at the Department’s district office, Mr. Chavez testified that, other than Mr. Chachel, he did not know the names of individuals who Investigator Cavazos identified at the jobsite. He asserted that he wrote their names on the Affirmation only after Ms. Qureshi spelled them out for him on a sticky note. Mr. Chavez further professed that he only penned “$20” by each name because Ms. Qureshi told him that the Department would not release him from the Stop-Work Order until he added the wages he paid to each individual. Mr. Chavez claimed that Ms. Qureshi specifically instructed him to insert a number by each employee. Mr. Chavez declared that he felt like he had no choice but to include “$20” on the Affirmation if he wanted to return to work. In actuality, however, Mr. Chavez insisted that he did not pay Jose Luis Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, or Jenny Araque anything for their activities on October 31, 2018. Ms. Qureshi testified for the Department on rebuttal. She credibly voiced that she did not write out the names of the four “employees” for Mr. Chavez to list on his Affirmation. Neither did she suggest a wage amount for their work, or force Mr. Chavez to write that he “terminated” them. On the contrary, Ms. Qureshi attested, clearly and without hesitation, that Mr. Chavez independently completed his sworn Affirmation, and he did not ask for her assistance with the specific information he wrote down. Ms. Qureshi persuasively stated that Mr. Chavez knew the names of Jose Luis Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, and Jenny Araque when he composed the Affirmation. Further, Mr. Chavez expressly told her that he was going to pay the four individuals $20 for the day, and that he was terminating them. The competent substantial evidence in the record establishes that Jose Luis Chachel, Juan Carlos Vasquez Garcia, Artemia Vasquez, and Jenny Araque were “employees” of RC Painting under section 440.02(15) on October 31, 2018. Based on this finding, the Department demonstrated, by clear and convincing evidence, that Respondent failed to secure workers’ compensation insurance coverage or a workers’ compensation exemption for four employees for the period of November 1, 2016, through October 31, 2018, as well as its corporate officer from January 22, 2018, through February 8, 2018. Accordingly, the Department met its burden of proving that Respondent violated chapter 440 and should be penalized.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Financial Services, Division of Workers’ Compensation, enter a final order determining that Respondent, Forgue General Contracting, Inc., violated the requirement in chapter 440 to secure workers’ compensation coverage, and imposing a total penalty of $129,089.60. DONE AND ENTERED this 18th day of October, 2019, in Tallahassee, Leon County, Florida. S J. BRUCE CULPEPPER Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 18th day of October, 2019.
The Issue Whether Petitioner should be dismissed from employment by Respondent?
Findings Of Fact Petitioner was an employee of Respondent's from December 8, 1984, until May 31, 1988. Respondent is a water management district created pursuant to Section 373.069, Florida Statutes Respondent provides health insurance to its employees through, what is, in effect, a self-insurance program. An employee who elects to receive single individual coverage under the health insurance program, receives the coverage for free. An employee choosing family coverage pays $59.00 per month to Respondent. Payment is made through payroll deductions. Petitioner participated in the health insurance program. Petitioner elected to receive family coverage for herself, her husband, and her minor child by a prior marriage, and had $59.00 deducted from her paycheck to cover the cost of family coverage. Under the provisions of 42 USCS Sec. 300bb (COBRA), Respondent is required, if certain conditions are met, to offer continuation coverage to beneficiaries of its health insurance program who would have otherwise lost their coverage under the plan. A beneficiary electing to receive continuation coverage is required to pay Respondent a premium amount not exceeding 102 percent of the amount it costs the program to provide coverage for beneficiaries of the plan. Continuation coverage for a single individual would have cost $111.20 after June 1, 1988, and approximately $107.00 prior to June 1, 1988. On March 4, 1987, Respondent prepared a memorandum addressed to all "Employees and Spouses" of Respondent's. The memorandum provided an explanation of the continuation coverage provisions of COBRA. Also, Respondent held a staff meeting to explain the COBRA provisions to employees. However, not all of Respondent's employees received the memorandum, attended the meeting, or were otherwise advised of the COBRA provisions. Petitioner was one of these employees. In July 1987, Petitioners husband suffered a neck injury for which he received medical treatment during 1987. Petitioner's insurance coverage with Respondent paid the bills related to this treatment. After several consultations with neurosurgeons, it was decided that Petitioner's husband should undergo surgery. The surgery was initially scheduled for the week before Thanksgiving, 1987. However, because of a problem with scheduling the operating room, the surgery was rescheduled for December 4, 1988. Sometime in the fall of 1987, Petitioner had filed for divorce. Sometime in November 1987, Petitioner was informed that her divorce was on the judge's desk and would become final shortly. Petitioner wanted her husband's surgery to be covered by her health insurance. Upon receiving notice that the divorce would become final shortly, she became concerned about what would happen if the divorce became final prior to the surgery taking place. Petitioner went to Respondent's personnel office to find out what options there were for her husband to be covered by insurance in the event the surgery took place after the divorce became final. At that time, Ms. Carol Donaldson was in charge of handling employee insurance matters for Respondent. Ms. Donaldson, however, was not in the office when Petitioner came in, and Petitioner spoke with Ms. Jean Osterhout. Ms. Osterhout's position with the Respondent was as a Personnel Service Specialist in employee relations. At the time of her conversation with Petitioner, her duties did not specifically include insurance matters. However, when Ms. Donaldson left Respondent in mid-December, 1987, Ms. Osterhout was one of two people who handled the insurance office until a replacement was hired on February 2, 1988. After explaining her concerns, Petitioner was told by Ms. Osterhout that under the COBRA act her husband could be covered by the insurance program if he paid the premiums. Petitioner asked what the premiums would be, and Ms. Osterhout responded she did not know, that she needed to investigate. Petitioner asked Ms. Osterhout to investigate the price and to send her the proper forms to continue the coverage. Ms. Osterhout agreed to do this and told Petitioner to continue paying the premiums for family coverage until they got all the forms together. In anticipation of her divorce, Petitioner had made arrangements for her son to be covered by his father's (her prior husband's) employer's insurance. In this manner, Petitioner could save $59.00 per month, since insurance coverage for her alone was provided at no charge. On December 16, 1987, Petitioner's divorce became final. About a month after her conversation with Ms. Osterhout, Petitioner asked Ms. Osterhout about the forms. Ms. Osterhout told Petitioner that she had been busy and had not had a chance to get them together, and for Petitioner to continue to pay the family premium. Petitioner continued to have $59.00 deducted from her paycheck until her employment with Respondent ended. The surgery which had been scheduled for December 4, 1987, was also cancelled. Petitioner's husband (now ex- husband) underwent surgery in March 1988. At the time of the operation, Petitioner believed her ex-husband was covered by Respondent's insurance. On March 16, 1988, Petitioner accompanied her ex-husband to the hospital and signed the hospital's Agreement for Treatment, Insurance Assignments, Release of Information, Responsibility for Personal Items and Payment of Charges" as the insured party. Petitioner signed the document where she was told to sign by the hospital. At the time she signed it, the document did not contain the circle around the words "Spouse" and "Guardian." Petitioner signed the document as the "Insured," since she believed that her insurance with Respondent still covered her husband. In April Respondent paid $8,109.35 under its insurance agreement as reimbursement for payment of Petitioner's ex-husband's surgery bills. On April 6, 1988, Ms. Melanie West, Respondent's employee then responsible for handling insurance matters, asked Petitioner to complete a claim form for the surgery. Upon receiving the claim form, Petitioner went to see Ms. West and told her that the surgery was related to an accident that had happened in 1987 and that she had filled out claim form in 1987. Ms. West told Petitioner she needed a new claim form. A new claim form was needed because it was the first claim that had been received in 1988 with respect to Petitioner's ex-husband's accident. Petitioner asked Ms. West for a copy of the claim form she had filled out in 1987 and used this claim form to fill out the new claim form on April 6, 1988, with exactly the same information that she had included in the claim form filed in 1987. In doing so, Petitioner indicated on the claim form that she was married, since that is what the 1987 claim form showed. Petitioner wanted the claim forms to be exact because of concerns that her ex-husband might sue over the accident. In May 1988, Respondent's finance and accounting department notified Ms. West that there may be a problem with the insurance claim for the surgery, since it was possible that Petitioner was no longer married. After confirming with the Putnam County Courthouse that Petitioner had been divorced on December 16, 1987, Ms. West asked Petitioner to come to her office. When Petitioner arrived, Ms. West told her there appeared to be a problem with the claim for the surgery expenses because she had been told that Petitioner was no longer married. Ms. West asked Petitioner when she had been divorced. Petitioner initially responded that she had been divorced in April 1988, but upon being asked for written proof, Petitioner told Ms. West that the divorce had taken place in December 1987. After several meetings took place between Petitioner and different persons in Respondents upper management, a meeting took place between Mr. Dean, Respondent's Executive Director; Mr. Flowers, the General Counsel; Ms. Horton and Mr. Wheeley, Assistant Executive Directors; Mr. Parker, Director of the Office of Employee Relations; and Mr. Elledge, Director of the Department of Resource Management. After reviewing and discussing the facts as they knew them, the group concluded that Ms. Willis had falsified the claim form and had lied to Ms. West. The group decided that disciplinary action was warranted. After discussing a range of possible actions, Mr. Dean decided Petitioner should be given two options. Petitioner could either accept a five-day suspension without pay and agree to reimburse the $8,109.35, or be terminated. After being informed of her options, Petitioner responded that she could not pay the money back. Therefore, she was terminated immediately, effective May 31, 1988. The termination letter states that the basis for dismissal was falsification of records. During the time Petitioner was employed by the Respondent, she was an excellent, hardworking, reliable employee. Her immediate supervisor considered her to be honest. Finally, she was not the type of employee who would try to hide her mistakes. After her divorce became final, Petitioner did not try to hide the fact that she was divorced. She attended Respondent's Christmas party with someone other than her ex-husband, and numerous employees of Respondent's knew she was divorced.
Recommendation Based on the foregoing Findings and of Fact and Conclusions of Law, it is RECOMMENDED that Respondent enter a Final Order reinstating Petitioner to her employment DONE and RECOMMENDED this 3rd day of February, 1989, in Tallahassee, Florida. JOSE A. DIEZ-ARGUELLES Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904)488-9675 Filed with the Clerk of the Division of Administrative Hearings this 3rd day of January, 1989. APPENDIX CASE NUMBER 88-3535 The parties submitted proposed findings of fact which are addressed below. Paragraph numbers in the Recommended Order are referred to as "RO ." Petitioner's Proposed Findings of Fact Proposed Finding of Fact Number Ruling and RO Paragraph Accepted. RO1. and 29. Accepted. RO2. Accepted. RO4. Accepted. RO7. and 8. (There are 2 paragraphs numbered 4 on page 5). Accepted. RO8. Accepted. RO9 -13. Accepted generally. See RO14. Accepted generally.' See RO15. and 30. Accepted. ROI6. Accepted. RO17. Accepted generally. ROI8 and 19-23. Accepted generally. R024-26. Accepted. R028. Rejected as irrelevant. Respondent's Proposed Findings of Fact Proposed Findings of Fact Number Ruling and RO Paragraph Accepted generally. RO2. Accepted. See Conclusions of Law section of the RO. Accepted. RO1. Subordinate to facts found. See RO3. Accepted generally. RO5. Rejected as not supported by the weight of the evidence. See RO6. Supported by the evidence but unnecessary to the decision rendered. Accepted. RO4 and 17. Accepted. RO7. First sentence and first part of second sentence accepted. End of second sentence, rejected. Petitioner disclosed the problem to Ms. Osterhout. Accepted. RO8 and 9. Accepted. RO10. Accepted generally. RO10. Rejected. See RO11-13, for the facts found on these issues. Accepted. 15 and 18. Accepted generally, but Petitioner did inform the insurance office twice through Ms. Osterhout. Supported by competent evidence but unnecessary to the decision reached. The evidence also shows that Petitioner did not file medical claims on her son's behalf even though she was still paying for the coverage. Rejected as not supported by the evidence. Petitioner believed her ex-husband was still covered. 19-20. Accepted. RO18 and 19. Petitioner believed her ex- husband was covered by her insurance. Accepted. RO21. Accepted. R022. Accepted. R023. As to the third sentence, Petitioner continued to believe he was eligible. Accepted. R024. Accepted. RO25. Supported by competent evidence, but unnecessary to the decision reached. Accepted. RO25. Accepted. R025. Accepted, generally. Petitioner also never hid the fact she was divorced and it was common knowledge to Respondent s employees. 30-31. Subordinate to facts found. See R026. Accepted. RO26. Accepted. RO27. Accepted. R028. Accepted. RO28. Accepted. R028. COPIES FURNISHED: Joe H. Pickens, Esquire 113 North Fourth Street Post Office Box 2128 Palatka, Florida 32078-2128 John W. Williams, Esquire Office of Legal Services St. Johns River Water Management District Palatka, Florida 32078-1429 Henry Dean Executive Director St. Johns River Water Management Post Office Box 1429 Palatka, Florida 32078-1429
The Issue Whether Respondent violated the provisions of chapter 440, Florida Statutes (2017), by failing to secure the payment of workers’ compensation coverage as alleged in the Stop-Work Order and Second Amended Order of Penalty Assessment and, if so, what penalty is appropriate.1/
Findings Of Fact The Department is the state agency responsible for the enforcement of the workers’ compensation insurance coverage requirements established in chapter 440. On September 14, 2017, Investigator Murvin conducted a random workers’ compensation compliance check at a residential construction site at 8256 Lake James Drive in Lakeland, Florida. During the course of the compliance check, Investigator Murvin observed two individuals--Donald Steven Paul, Jr. and Dean Wayne Paul--painting the home. It is undisputed that Respondent had been subcontracted to perform painting services at this site; and that these two individuals were, at the time of Investigator Murvin’s visit, employed by Respondent. After speaking to Donald and Dean Paul, Investigator Murvin used the Department’s database to verify that Respondent did not have workers’ compensation insurance coverage, nor did Donald or Dean Paul have an exemption from the coverage requirements. Donald Paul admitted to Investigator Murvin at the hearing that he did not have workers’ compensation coverage for himself or Dean Paul. Donald Paul explained that he believed that his incorporation with the state and securing of liability insurance provided compliance of all insurance requirements. Based on the information provided by Dean and Donald Paul, and from the database, Investigator Murvin issued a SWO to Respondent on the same day as the site visit. A Request for Production of Business Records was also issued to Respondent. In response to the request for documentation, Respondent provided bank statements that indicated the business began in August 1, 2016. The bank statements also established that there was money being deposited and being paid out, but there was no indication what the money was for or how it was allocated. In other words, there was no way to discern whether the money paid out of the bank account was for employee salaries or other business expenses. In support of its Second Amended Order of Penalty Assessment, the Department prepared a penalty calculation worksheet showing a total penalty owed of $2,090.14. At the hearing, Respondent did not challenge the accuracy or method of calculating the assessed penalty, but only asserted that it believed it had the appropriate coverage and that the penalty was “too high.” Based on the evidence, it is clear Respondent provides construction services and has at least one employee; therefore, it was required to secure workers’ compensation insurance. The Department established by clear and convincing evidence that Respondent failed to secure the payment of workers’ compensation as required by chapter 440. The Department has established through the records submitted and testimony of Auditor Murcia, the appropriate penalty for Respondent’s failure to obtain workers’ compensation coverage is $2,090.14 for the audit period of August 1, 2016, to August 14, 2017.
Recommendation Based on the Findings of Fact and Conclusions of Law set forth herein, it is RECOMMENDED that the Department of Financial Services, Division of Workers’ Compensation, enter a final order finding that Respondent, Donald Steven Paul d/b/a/ D. P. Painting of Lakeland, violated the provisions of chapter 440 by failing to secure the payment of workers’ compensation and assessing against Respondent a penalty in the amount of $2,090.14. DONE AND ENTERED this 20th day of April, 2018, in Tallahassee, Leon County, Florida. S HETAL DESAI Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 20th day of April, 2018.
