The Issue Whether the Florida Department of Agriculture and Consumer Services (Respondent or Department) discriminated against Deborah Owens (Petitioner) by denying her reasonable accommodation and discharging her based on her disability.
Findings Of Fact Petitioner was a Career Service employee of the Department as an Environmental Specialist II from 2009 until her termination on May 5, 2016. As an Environmental Specialist II, commonly referred to as an “inspector,” Petitioner worked in the Department’s Division of Agricultural Environmental Services, Bureau of Inspection and Incident Response (Department’s Bureau). As an inspector, Petitioner spent approximately 40 percent of her time performing inspections and investigations pursuant to chapters 388 (mosquito control), 482 (pest control), 487 (pesticide regulation and safety), 576 (agricultural fertilizers), 578 (seed), and 580 (commercial feed and feedstuff), Florida Statutes,1/ and related administrative regulations. The rest of Petitioner’s duties consisted of preparing reports based on her inspections and investigations, and maintaining knowledge of applicable statutes and rules. All of the inspectors in the Department’s Bureau were required to be physically capable of performing assigned inspections. While the amount of climbing varied from month to month and place of inspection, Environmental Specialist IIs, as part of their job as inspectors, are required to climb. In the case of fertilizer inspections, inspectors are required to take samples from fertilizer plants, storage vehicles, and trailers in the field. While climbing is not required at those fertilizer plants that have sampling rooms, not all fertilizer plants have sampling rooms. Therefore, inspectors need to be prepared to climb at fertilizer plants. In addition, inspectors are required to climb atop Killebrew trailers2/ or similar equipment in the field to take samples. For inspection of Killibrews, which have separate storage compartments housing fertilizer, an inspector must use a ladder to climb to the top of the Killibrew and obtain samples. Seed inspections may also involve climbing, depending on how the seed is arranged. In some cases, bagged seed is stacked on large pallets, in which case, unless it can be moved, an inspector may have to climb in order to take a sample. During Petitioner’s tenure as an inspector, chapter 482 pest control inspections were added to the inspection duties of Environmental Specialist II following a reorganization of the Department’s Bureau. While, at the time of the hearing, climbing for those types of inspections had been put on hold, fumigation inspections have, at times, required climbing on a ladder into attic spaces or to reach higher exterior portions of a building. Climbing is a variable part of every inspector’s job. The amount of climbing that is required increases during heavy agricultural growing seasons. Although a variable activity, when climbing for inspections is required, it can be laborious. All of the testifying witnesses, who were inspectors for the Department’s Bureau, reported they were required to climb in performing their jobs for the Department. In applying for her Environmental Specialist II position, on a document entitled “Pesticide Compliance Environmental Specialist II Self-Screening/Willingness Questionnaire,” which listed requirements necessary for all candidates, Petitioner affirmatively acknowledged that she was willing and able to “[c]limb and work on top of delivery and application equipment to obtain samples when necessary.” While the climbing requirement varies in frequency, climbing was a necessary part of Petitioner’s job duties as an inspector for the Department, and is a necessary component of an Environmental Specialist II’s job. In 2015, Petitioner took medical leave and underwent double knee replacement surgery. Historically, Department management meets each fiscal year to review inspection numbers by region for purposes of determining and assigning the minimum number of inspections for each inspector for the fiscal year. At the meeting for the 2015-2016 fiscal year, Petitioner was assigned a reduced number of inspections based on the understanding that she would be absent from work for approximately six months due to her medical leave in 2015. Instead of a full fiscal year of goals, Petitioner was given six months of performance goals, reducing the total number of inspections assigned to Petitioner based on her medical leave of absence. Upon her return to work in November 2015, Petitioner had physical limitations stemming from her knee surgery. Petitioner presented to her then-supervisor at the Department, “Dusty” Markham, a doctor’s note dated November 20, 2015. The doctor’s note, from Petitioner’s treating physician, Dr. Richard Vlasak, on UF Health Physician’s stationary, stated, in pertinent part: Deborah Owens has been under my care for treatment of bilateral knee DJD, which included surgery S/P bilateral total knee arthroplasties performed 5/20/15. Limitations: Patient may return to work as of 11/20/15 with restrictions. No cannot [sic] climb on fertilizer trailers, killbrews [sic] no climbing ladders. The above limitations are temporary for 3 months after return to work. Patient is expected to make a full recovery and resume all activities after 3 months time. Upon her return, based on medical information Petitioner provided to the Department’s management, Petitioner was assigned only those inspections that she was medically capable of performing. In February 2016, Petitioner was assigned to the Department’s Region I, and Bryan Smithey, an environmental manager with the Department, became Petitioner’s direct supervisor. Mr. Smithey oversees all of Region I, a territory stretching from Levy County, northward, and westward to Escambia County. Mr. Smithey supervised Petitioner and eight other environmental specialists. Petitioner was assigned a territory within Region I consisting of Gilchrist, Dixie, and Levy Counties. Petitioner’s assigned territory included a fertilizer plant in Trenton, Florida. This plant did not have a sampling room. Because of Petitioner’s temporary restrictions on climbing, other inspectors were assigned to cover Petitioner’s inspections at the Trenton plant. One of the inspectors who covered for Petitioner was Andreas Coveney. Mr. Coveney conducted numerous inspections for Petitioner at the Trenton plant. In order to conduct the Trenton plant inspections, Mr. Coveney had to drive over two hours, one-way, from his home. Another inspector, Ed Harris, conducted over 40 inspections for Petitioner at the Trenton plant. In doing so, Mr. Harris had to drive from his assigned area of Ocala. The inspections that Mr. Coveney and Mr. Harris conducted for Petitioner were additional inspections, separate and apart from their regularly assigned duties. The inspections conducted for Petitioner were not accommodations for her disability. Rather, they were temporary assistances provided for Petitioner at a time when Petitioner was unable to perform the essential duty of climbing as an inspector. Petitioner argues in her Proposed Recommended Order that an e-mail dated November 19, 2015, in which she suggested working from home “while the matter gets cleared up” was a request for accommodation for her disability. It is found, however, that Petitioner’s suggestion was a request for permission to do some work from home for a short time, before actually returning to work, because she was out of sick leave; and it was not a request for accommodation of her disability. In March 2016, Petitioner presented another doctor’s note to management. This note, dated March 10, 2016, was also from Dr. Vlasak. The note again stated that Petitioner “[c]annot climb on fertilizer trailers, killbrews [sic] or climbing ladders.” The new letter, however, stated: “The above limitations are permanent.” Respondent has a policy governing Inefficiency or Inability to Perform Job Duties in Administrative Policy and Procedure (AP&P) No. 5-3. The policy states, “Employees shall, at a minimum, be able to perform duties in a competent and adequate manner.” Id. A violation of this standard can result in termination. By letter dated April 1, 2016 (Intent to Terminate Letter), the Department informed Petitioner of its intention to dismiss her. The Intent to Terminate Letter explained, in part: On March 10, 2016 we received a letter from your physician stating that you are permanently restricted from climbing on fertilizer trailers, killibrews and ladders. While your medical condition is not being questioned, you are expected to, at the minimum, be able to perform duties in a competent and adequate manner. As an employee with the department since December 11, 2009, you are aware that you must be able to perform the essential duties of your position. Your actions constitute a violation of AP&P No. 5-3, Section V, Inefficiency or Inability to Perform Assigned Duties, (Page 3). The Intent to Terminate Letter further informed Petitioner of her right to attend a meeting to be conducted pursuant to section 110.227(5)(a), Florida Statutes, on April 26, 2016 (Predetermination Conference), where she would be allowed to answer, orally or in writing, the charges against her. On April 12, 2016, prior to the scheduled Predetermination Conference, Petitioner provided to Department management another letter regarding her work status. The letter, dated April 12, 2016, was not signed by her physician. Rather, it was signed by a licensed practical nurse (LPN). The April 12, 2016, letter states that it is a “revised work status letter.” The letter restates the previous “[c]annot climb on fertilizer trailers, killbrews [sic] or climbing ladders,” but, instead of advising that the restrictions were permanent, states that “[t]he above limitations are temporary for 12 months as of 3/10/16 at which time we will re-evaluate work status.” The April 12, 2016, letter was apparently authorized by Petitioner’s treating physician, as the LPN’s signature appears above Dr. Vlasak’s signature block, and the letter bears the same UF Health Physician’s letterhead as previous letters from Dr. Vlasak. Petitioner attended the Predetermination Conference, during which she advised that she was currently unable to climb. The April 12, 2016, letter was considered at the Predetermination Conference. The Department’s memorandum dated April 27, 2016, regarding the Predetermination Conference, authored by the Department’s assistant director of Division of Food Safety, states in part: A subsequent letter dated April 12, 2016, from a member of the physician’s staff specified that these same limitations were temporary for the next 12 months at which time they will be re-evaluated. Even though the April 12, 2016, letter was considered, the assistant director supported the recommendation to terminate Petitioner. As he explained in the April 27, 2016, memorandum: In considering the information provided, I looked at Ms. Owens current position description and considered the physical requirements of the inspector position. The position requires someone with full physical capability. Ms. Owens has been medically limited from performing certain duties for almost a year already and is expected to be limited for at least another full year or possibly permanently. Therefore, I am supporting the recommendation for termination for inability to perform assigned duties. Consistent with the Intent to Terminate Letter and the assistant director’s support for termination, by letter dated May 5, 2016, signed by the chief of the Department’s Bureau of Personnel Management, Petitioner was terminated from her position with the Department. Petitioner never requested an accommodation for a disability prior to her termination.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Florida Commission on Human Relations enter a final order dismissing Petitioner's Complaint of Discrimination and Petition for Relief consistent with the terms of this Recommended Order. DONE AND ENTERED this 13th day of March, 2018, in Tallahassee, Leon County, Florida. S JAMES H. PETERSON, III 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 13th day of March, 2018.
Findings Of Fact During times material hereto, Respondent, Ray C. Dorman, is the owner and administrator of Scarlet Manor. Scarlet Manor is an adult congregate living facility at 13009 Lake Carl Drive in Hudson, Florida. The facility has a census of 40 beds and of that census, two residents are elderly patients and the remaining 38 residents are "hard core" mental patients who require intensive and specialized nursing care. Ray Dorman (Respondent) is named as the confirmed perpetrator of neglect (FPSS No. 90-091417) based on a finding that Respondent neglected a resident at the ACLF. A certified letter from Petitioner dated September 22, 1990, which was received by Respondent on September 27, 1990, advised Respondent that he could challenge the confirmed finding of neglect if he considered that the classification was inaccurate or that it should otherwise be amended or expunged. Although Petitioner maintains that Respondent failed to challenge the confirmed finding of neglect, Respondent and his wife, Winifred Dorman, credibly testified that on October 10, 1990, she accompanied Respondent to an HRS office in Clearwater to deliver a written request to challenge the finding of neglect. While the office which would have addressed Respondent's challenge (Mr. Morton's office) is situated in St. Petersburg, on that point, it appears that Respondent's wife was either unclear as to exactly where the Respondent's challenge to the confirmed classification was delivered and nothing more. Respondent's facility has been the subject of regular survey reports wherein it was determined that Respondent's facility was deficient in maintaining minimum licensure requirements based on inspection surveys dating back to September, 1989. Mrs. Diane Cruz, a human services surveyor specialist employed by Petitioner, was part of a three (3) member team of surveyors at Respondent's facility during late September, 1989. During the September, 1989 survey, it was determined that Respondent's facility was deficient in several areas including fiscal policies, facility records, client records, medication records, staffing, food service standards, maintenance and housekeeping standards, resident care, admission criteria and fire safety standards. In all of the cited areas, Respondent corrected the deficiencies and no cited deficiency was outstanding at the time of the hearing herein. Significantly, of the numerous deficiencies that Respondent was cited, only three of the deficiencies were repeat deficiencies during the annual 1990 annual survey. Respondent's facility is a fairly new and modern facility and Respondent prides himself in providing his residents the high degree of nursing services which the residents of his ACLF require. In this regard, in each instance wherein Respondent was cited for deficiencies, the matter was corrected by the time that the follow-up survey was conducted with only two exceptions. Regarding those exceptions, Respondent credibly testified that he had undertaken a good faith effort to correct the deficiency by the time of the follow-up survey. In any event, all of the cited deficiencies were corrected and Respondent has abided by the terms of any restrictions including the payment of any administrative fines which were imposed by Petitioner. Such conduct evidences that Respondent is conscientious in the operation of his adult congregate living facility and, to his credit, more than one of and Petitioner's witnesses testified that Respondent operates a good ACLF.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that: Petitioner enter a final order granting Respondent a conditional license to operate Scarlet Manor as an adult congregate living facility. 1/ Afford Respondent an opportunity to challenge the confirmed classification naming him as the perpetrator in FPSS Report No. 90-091417 as soon as practical. DONE and ENTERED this 30th day of October, 1991, in Tallahassee, Leon County, Florida. JAMES E. BRADWELL Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, FL 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 30th day of October, 1991.
Findings Of Fact Sunlight Temple, Inc., is a Florida corporation which is licensed by the State of Florida, Department of Business Regulation, Division of Hotels and Restaurants, under License No. 52-00041H, which license was current at all times pertinent to the matters at issue here. On February 15, 1982, the Sunlight Temple facility, located at 638 N.W. First Street, Ocala, Florida, consisting of a two-story building containing a meeting room and kitchen on the ground floor, as well as several sleeping rooms and cooking facilities on the second floor,, was inspected by Philip D. Saunders, a codes enforcement inspector with the City of Ocala Building Department. This routine inspection was bade in conjunction with Housing/Sanitation Inspector Thurman Cox. As a result, certain deficiencies were noted, as follows: (See Pages 3 and 4 of this Recommended Order.)* These deficiencies were forwarded to the Respondent in a letter dated February 16, 1982. On or about February 16, 1982, the Temple facility was also inspected joy L. K. McLemore, a City of Ocala Fire Inspector. He also noted deficiencies, as follows: (See Page 5 of this Recommended Order.)* These violations, which directly parallel those listed in Paragraph 2 above, were forwarded to the Temple by letter on February 16, 1982. No further recorded inspections of the facility were made until October 27, 1982, when Mr. William B. Dickson, an inspector with the Division of Hotels and Restaurants, made a routine inspection of this facility. Mrs. Josephine Magwood was also present. During this inspection, Mr. Dickson found many deficiencies. These were recorded on DBR Form 226, a Public Lodging Inspection Record, and include items in the safety, sanitation, and general areas. All discrepancies were rated as major and included electrical deficiencies, appliances badly installed, building repair/painting requirements, hot and cold water requirements, plumbing defects, termite infestation, and the overall unsanitary and hazardous condition of the building. An insufficient number of outlets resulted in the unsafe use of extension cords. Gas stoves in the kitchen did not have any safety cutoff. Gas appliances were not vented. Mr. Dickson requested that they all be checked for safety by the gas company. The floors, ceilings, and walls on the second floor were loose and unstable, springy, unsafe, and appeared to have considerable dry rot. The access to the fire escapes appeared unsafe. In the upstairs kitchen, the floor covering had curled, and the sub-floor was rotted, apparently due to water. The bathroom floors were weak, and one bathroom had no hot water. Throughout the building, it appeared to Mr. Dickson that there was termite infestation, although he readily admits he is not an expert in that area. These discrepancies had not been cited previously by Mr. Dickson because on a prior inspection, Temple officials had indicated they had a plan to remodel the building, and these defects would be taken care of. In furtherance of that, a building permit had been issued in September, 1981, and some work had been done. New interior doors had been installed on some of the sleeping rooms, and there were some building materials on hand, but the work was progressing slowly, and on this inspection of October 27, 1982, it appeared to have stopped. Mr. Dickson gave a copy of his findings to Mrs. Magwood, an official of Sunlight Temple. Thereafter, on November 18, 1982, Mr. Dickson served a Notice to Show Cause and a Notice of Informal Conference on Mrs. Magwood. This notice was to advise the Temple of an informal conference on the violations listed in the Notice to Show Cause to be held at the Marion County Building on December 7, 1982, at 11:00 a.m. On December 6, 1982, Mr. Dickson went back to the Temple to see what corrective action had been taken. It appeared that none had been taken. Mrs. Magwood was present on this visit and signed a receipt for a copy of the call-back/reinspection report, which reflected that the proposed corrective action had not been taken. Notwithstanding that Mrs. Magwood had said she would see that Reverend Lee, the president of the organization, would get the notice, when the informal hearing was held on December 7, 1982, as scheduled, no one from the Sunlight Temple appeared. Mr. Dickson indicated that on his follow-up visit, he noticed the walls had tracks broken into them which contained electrical wires. Reverend Lee explained, and I so find, that these tracks, which did not appear as a discrepancy on the October 27, 1982, report, were made to insert electrical wiring in an attempt to correct the previous deficiency regarding extension cords. Reverend Lee, who has been president of the Respondent organization since July, 1982, was not aware of many of these complaints being filed. Notwithstanding the promise of Mrs. Magwood to get the notice of the December 7 hearing to him, he did not learn of it until December 12, 1982, when the hearing was already over. It has not been the intention of the Respondent society to operate a lodging house or restaurant. The Sunlight Pall Bearers Charitable Society and its Auxiliaries, Inc., operated the building as its headquarters and meeting hall; and the sleeping rooms on the second floor were intended to provide accommodations to visiting members from out-of-town severe, they decided to provide rooms to migrant workers on a charity basis. At the present time, some rooms are rented out, but not constantly. It is still intended by the society to be primarily a charitable operation. It has been, for a long time, the concern of the society to make all necessary repairs to the facility, and some repairs were made. However, since it is a charitable society, it has only limited funds to work with and cannot do all that is needed at one time. In July, 1982, when the new governing board came into office, they decided to borrow the necessary funds and have all the work done by a contractor. Arrangements were made and a loan approved by a lending institution in late January, 1983, conditioned upon the personal signatures of Reverend Lee, Mr. Johnson, and Mr. Taylor. However, before the loan could be consummated, because of their disagreement with certain aspects of the Temple operation, Mr. Johnson and Mr. Taylor withdrew their commitment to borrow the funds. On February 12, 1983, the building committee of the Temple met and decided to submit an appeal to other lodges for the borrowing of funds with which to finish what corrective work was needed. The society intends to do all it can to make the required corrections. There is a substantial amount of love and commitment by the members involved, and they want to keep the operation going. Though some work has been done, the majority of the work identified by Mr. Dickson, Mr. Saunders, and Capt. McLemore still remains unaccomplished.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED: That Respondent's license to operate a public lodging facility be suspended until such time as Respondent's facility can meet required health and sanitation standards. RECOMMENDED this 15th day of March, 1983, in Tallahassee, Florida. ARNOLD H. POLLOCK, Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 15th day of March, 1983. COPIES FURNISHED: Janice G. Scott, Esquire Department of Business Regulation 725 South Bronough Street Tallahassee, Florida 32301 Reverend George W. Lee President Sunlight Temple, Inc. 515 N.W. Sixth Terrace Ocala, Florida 32675 Mr. Sherman S. Winn Director, Division of Hotels `and Restaurants Department of Business Regulation 725 South Bronough Street Tallahassee, Florida 32301 Mr. Gary R. Rutledge Secretary Department of Business Regulation 725 South Bronough Street Tallahassee, Florida 32301 * NOTE: DEFICIENCIES listed on pages 3-5 of the original Recommended Order are not a part of this ACCESS document, they are available for review from the Division's Clerk's Office.
The Issue The issue in this case is whether the unused balance in a state employee’s flexible spending account must be forfeited as a result of her failure to file claims exhausting the account before the April 15, 2002, deadline.
Findings Of Fact The State of Florida has established a Salary Reduction Cafeteria Plan (“Plan”) for the benefit of its employees. The Plan, which is set forth in a formal written document that was most recently amended and restated as of September 20, 2000, is designed to take advantage of provisions in the Internal Revenue Code that permit the exclusion of reimbursement for various specified expenses——such as medical and dependent care costs—— from the gross income of employees who participate in a “cafeteria plan”1 that meets all the conditions prescribed under federal tax law. Simply put, the Plan allows state employees to pay for certain qualified expenses with pretax dollars by electing to have a predetermined amount deducted from each paycheck and deposited into a “flexible spending account,” out of which qualified expenses can be reimbursed, tax free, according to the terms of the Plan. Pursuant to authority granted under Section 110.161, Florida Statutes, the Florida Department of Management Services (“DMS”) operates and administers the Plan. The Division of State Group Insurance (“Division”) is designated in the Plan document as the Plan’s “Administrator.” Petitioner Elsa Lopez (“Mrs. Lopez”) is a state employee. She works as a secretary in the Office of the Public Defender for the Fifteenth Judicial Circuit, in West Palm Beach, Florida. During the “open enrollment” period2 in 1998, Mrs. Lopez elected to participate in the Plan during “plan year”3 1999, authorizing the state to reduce her salary by $2,500 over the course of the plan year, the money to be placed in a flexible spending account for the purpose of reimbursing her (with pretax dollars) for dependent care expenses. In this way, Mrs. Lopez effectively sheltered $2,500 from federal income tax. In late 1999, in order to continue paying for dependent care with pretax dollars, Mrs. Lopez again chose to participate in the Plan, authorizing the state to reduce her salary by $3,500 during plan year 2000. Mrs. Lopez made the above-described elections by signing, in each instance, an Open Enrollment Form. She signed the first of these forms on October 15, 1998, and the second on September 30, 1999. On both forms, an “employee certification” appears just above Mrs. Lopez’s signature. This certification states in pertinent part: I understand that I will forfeit any balance(s) remaining in my account(s) at the end of the Plan Year in accordance with the Internal Revenue Code Section 125. If eligible expenses are not incurred during my eligible period of participation equal to the[4] account balance and/or if claims for the expenses are not filed with the Division of State Group Insurance by the claims filing deadline date (April 15), I will forfeit any remaining balance(s). The risk of forfeiture to which the certification refers is an important condition for the favorable tax treatment accorded flexible spending accounts established under cafeteria plans. Federal law requires that, to qualify for the tax break, a cafeteria plan cannot provide for deferred compensation. See 26 U.S.C. § 125(d)(2)(A). The Internal Revenue Service has determined that plans which allow participants to carry over unused contributions from one plan year to another operate to enable participants to defer the receipt of compensation——and thus do not meet the conditions for excluding contributions from income. See Prop. Treas. Reg. § 1.125-1, Q/A-7 (49 F.R. 19321, 19324, 1984 WL 139403). Consequently, employees participating in a qualified plan must timely “use or lose” their respective contributions in exchange for the benefit of paying for health and/or child care expenses5 with pretax dollars. To preserve the tax-exempt status of the Plan, DMS has promulgated rules intended to prevent the Plan from providing deferred compensation. For example, Rule 60P-6.0081(3), Florida Administrative Code, provides that nitial requests for reimbursement for expenses incurred during a participant’s period of coverage must be postmarked or received if not mailed, at the Department no later than April 15 following the prior Plan Year. DMS has also mandated that “if unused portions of the participant’s annual election remain in an account for which otherwise eligible claims are not received prior to the claims filing deadline, these funds shall be forfeited.” Rule 60P- 6.010, Florida Administrative Code (emphasis added). The term “claim filing deadline” is elsewhere defined as “April 15 following the participant’s period of eligibility.” Rule 60P- 6.006(1), Florida Administrative Code. Faithful to the foregoing rules, the Plan document prescribes a reimbursement procedure for dependent care expenses that provides in pertinent part: (a) Expenses That May Be Reimbursed. Under the Dependent Care Component, a Participant may receive reimbursement for [covered costs] incurred during the Plan Year for which an election is in force. * * * Use-It-Or-Lose-It Rule. If a Participant does not submit enough expenses to receive reimbursements for the full amount of coverage elected for a Plan Year, then the excess amount will be forfeited[.] Applying for Reimbursements. A Participant who has elected to receive dependent care benefits for a Plan Year may apply for reimbursement by submitting an application in writing to the Administrator in such form as the Administrator may prescribe, during the Plan Year but not later than by April 15 following the close of the Plan Year in which the expense arose[.] Plan § 7.5 Mrs. Lopez understood that her funds were subject to forfeiture under the “use it or lose it rule.” She also knew that the claim filing deadline for plan years 1999 and 2000 was April 15 following each respective plan year. What Mrs. Lopez did not know, she insists, is that the claim filing deadline for plan year 2001 was April 15, 2002. Mrs. Lopez chose to participate in the Plan during plan year 2001, not by submitting an Open Enrollment Form, as in previous years, but by doing nothing, which resulted, by operation of the Plan, in a “rollover election.” A rollover election occurs, pursuant to the provisions of Section 4.4(b) of the Plan document, when an existing participant fails timely to submit an Open Enrollment Form, which inaction is deemed to constitute an election of the same type of coverage as was in effect for the previous plan year. In accordance with Section 4.4(b), Mrs. Lopez was deemed to have authorized the state to deduct $3,500 from her salary for plan year 2001, such untaxed amount to be used for the reimbursement of dependent care expenses. Mrs. Lopez does not complain that the rollover election thwarted her actual intent. In fact, Mrs. Lopez desired to participate in the Plan during plan year 2001. Because she did not submit an Open Enrollment Form for plan year 2001, however, there is no document bearing Mrs. Lopez’s signature below an “employee certification” acknowledging the April 15, 2002, claim filing deadline——a date which, as just mentioned, she denies having been aware of. Mrs. Lopez goes beyond merely disclaiming knowledge of the deadline; she charges that the state misled her into believing that she could file claims for reimbursement through June of 2002. According to Mrs. Lopez, she placed a telephone call to the Division in February 2002 to request claims forms and inquire about the deadline for filing claims, which she knew from experience was approaching. The person with whom she spoke, says Mrs. Lopez, told her that claims incurred during plan year 2001 could be submitted until June 2002. Needless to say, the Division disputes Mrs. Lopez’s account of this purported conversation. However, because Mrs. Lopez has not been able to identify the person with whom she claims to have spoken, the date and time of the alleged call, or even the phone number she dialed, the Division was hard-pressed to present evidence directly refuting Mrs. Lopez’s testimony. Therefore, the Division adduced evidence concerning the routine practices and procedures of its customer service employees. This evidence persuaded the undersigned (who hereby finds) that it is highly unlikely Mrs. Lopez was informed by a customer service representative6 that the claim filing deadline was in June of 2002.7 That said, the undersigned accepts Mrs. Lopez’s testimony (and finds) that she was told about a June 2002 deadline. Resolving conflicts in the evidence, he finds that what happened, more likely than not, was that the customer service person informed Mrs. Lopez, correctly, that the claim filing run-out period lasted through the end of June 2002. (The “claim filing run-out period” is the “period during which [DMS] will accept documentation in support of claims filed within the claim filing deadline. This period will not extend beyond June 30 following the end of the prior plan year.” Rule 60P- 6.006(2), Florida Administrative Code (emphasis added). The claim filing run-out period gives a participant whose timely filed claim lacks proper documentation a little extra time to submit such documentation and thereby prevent denial of the claim. See Rule 60P-6.0081(4), Florida Administrative Code.) For reasons that cannot be determined, the customer service representative probably believed, mistakenly but not unreasonably, that Mrs. Lopez wanted to know whether additional documentation (such as the child care provider’s invoice8) relating to an already, or soon-to-be, filed claim for reimbursement could be submitted at a later date. While the customer service person most likely answered a different question than the one Mrs. Lopez meant to ask, there is no evidence that he or she acted improperly, negligently, or with the intent to deceive Mrs. Lopez. Mrs. Lopez failed to submit her claim before the April 15, 2002, deadline. This forced the Division, as the Plan’s Administrator, to declare her unused balance of $3,500 forfeited under the “use it or lose it rule.”
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that that Division enter a final order denying all claims for reimbursement of dependent care expenses incurred in plan year 2001 that Mrs. Lopez submitted after the claim filing deadline of April 15, 2002, and declaring the entire unused balance remaining in her account for that year forfeited. DONE AND ENTERED this 3rd day of June, 2003, in Tallahassee, Leon County, Florida. JOHN G. VAN LANINGHAM 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 3rd day of June, 2003.
