The Issue The issue in this proceeding is whether Petitioner was the subject of an unlawful employment practice by Respondent based on her sex.
Findings Of Fact Bay is a nursing home and rehabilitation center for those in medical need of such services. It is located in Port. St. Joe, Florida. The facility has a number of residents staying at the facility who require help with mobility, standing and walking. The payroll services for Bay are performed by Signature Payroll Services, LLC, which is affiliated with Bay through a parent company. Bay offers all employees a package of employment benefits, including disability benefits. Section 7.2 of the Stakeholder Handbook states: Short & Long Term Disability In the event Stakeholders become disabled due to sickness, pregnancy or accidental injury, the company offers disability insurance . . . Short Term Disability provides for 60% of the Stakeholder's gross weekly wages up to a maximum of twenty four (24) weeks post fourteen (14) days of accident/injury. Long Term Disability provides for 60% of the Stakeholder's monthly wages up to one hundred eight[sic] (180) days after exhausting the Short Term Disability benefit. Please see Human Resources to review detailed summary plan documents for maximums. All new employees are offered the opportunity to enroll in Bay's employment benefit package for 90 days after their employment date. Each employee must affirmatively elect the employment benefits they wish to have and must pay any premiums for those benefits. After 90 days, an employee can only make changes to his or her benefit plan during the employee's annual enrollment period. In addition to the benefit plan, Bay also offers all employees Family Medical Leave for up to 12 weeks and/or a personal leave of absence when the employee is not eligible for leave under other company policies. Leave is addressed in section 8 of the Stakeholder Handbook. Petitioner is a Certified Nurse Assistant (CNA). She was employed by Bay on August 25, 2007. As a CNA, Petitioner was responsible for the direct care of residents at Bay. Her duties included lifting and moving residents as needed. Because of her duties, Petitioner was required to be able to lift a minimum of 50 pounds. Over that amount of weight, Petitioner had extra help and devices to assist with lifting. Throughout her employment, Petitioner was considered a diligent employee that performed her duties well. When Petitioner was hired, Bay offered her the opportunity to enroll in all of the benefits in its employment benefit plan, including disability insurance. Petitioner elected to enroll in life, health, dental and vision insurance. At the time of her hire, the only disability insurance offered to any employee by Bay was insurance under a MetLife group policy for Disability Income Insurance: Long Term Benefits issued to Signature Payroll. There was no evidence of any short-term disability insurance benefit offered to any of Bay's employees other than the MetLife policy described above. Given that there was no short-term disability insurance available to Bay's employees, it was not a discriminatory act for Respondent to not offer Petitioner short-term disability insurance. The insurance was simply not part of the benefit package offered by Bay at the time Petitioner was hired and Petitioner did not elect to enroll in either short term or long-term disability insurance. Petitioner did not change her enrollment elections during the 90-day period after her employment. She was therefore not eligible to add disability insurance to her benefit plan until late 2008. In November or December 2007, Ms. Mills sometimes worked with another CNA named Courtney Preston. At the time, Ms. Preston was pregnant. When Petitioner asked for some help lifting a resident, Ms. Preston told Petitioner that she was on light-duty due to her pregnancy. The charge nurse for the unit, who is the unit supervisor for any given shift, confirmed that Ms. Preston was on light-duty. However, the charge nurse had no authority to place an employee on light-duty. Additionally, there was no evidence in Ms. Preston?s personnel file that she had officially been placed on light-duty by anyone with the authority to do so. At best, it appears that Ms. Preston was simply being treated kindly by her fellow employees and was not officially placed on light-duty by a person with authority to do so. Ms. Preston eventually lost her baby while Petitioner was employed at Bay. The evidence was not clear as to the cause of Ms. Preston's miscarriage. However, the evidence established that Ms. Preston had a risky pregnancy of which the staff at Bay was aware. Later, Ms. Preston again became pregnant and again had a risky pregnancy. She was counseled on several occasions for her excessive absenteeism. In order to help Ms. Preston with her absenteeism, she was offered on-call status with less duty hours if she wanted it. Eventually, sometime after April 30, 2008, Bay terminated Ms. Preston for excessive absences caused, in part, by her pregnancy. On the other hand, Ms. Preston was clearly accommodated during both of her pregnancies while she was employed at Bay. In January or February 2008, Petitioner became pregnant. On February 15, 2008, Petitioner visited her doctor and was given a doctor?s note to limit her lifting to no more than 20 pounds even though she was not having any difficulty performing her job duties. The evidence was unclear as to why the doctor placed Petitioner under lifting restrictions since the doctor, within one to two weeks, raised those restrictions to not over a minimum of 50 pounds after Petitioner told him about the impact the lower-weight restrictions had on her job with Bay. On February 16, 2008, Petitioner gave a copy of the doctor?s note with the 20-pound lifting restrictions to the personnel department. On February 18, 2008, she discussed the lifting restrictions with her supervisors, Cathy Epps and Shannon Guy. They thought light-duty work could be arranged. On February 20, 2008, she discussed the lifting restrictions with David Kendrick, the corporate director of human resources, who was visiting Bay that day. He also thought that some light- duty work might be arranged. However, all of these supervisors wanted other higher-level corporate officials to have input on whether light-duty work was available. Eventually, the corporate legal counsel and the corporate risk manager were consulted on the issue of whether light-duty work was available. Petitioner did not receive light-duty work. Instead, on February 21, 2008, Petitioner was called into a meeting with Cathy Epps and Shannon Guy. Ms. Guy was very upset and tearfully told Petitioner that no light-duty was available and that Petitioner was terminated. Ms. Guy was upset because Petitioner was a good employee that she did not want to lose. Ms. Epps also wanted to keep Petitioner as an employee. Ms. Guy explained that someone from the corporate office decided Petitioner was terminated because they were afraid Petitioner was too much of a risk to employ since she could not meet the minimum-lifting requirements and "as a CNA she would be expected to assist residents, and . . . if we had a resident who was falling and she would be presented with a choice of either go to help the resident or run the risk of hurting herself or, . . . not helping the resident and, . . . allowing something to happen." Ms. Guy told Ms. Mills that she could return to work once her pregnancy was over. Importantly, Petitioner had been performing her normal duties without any problems or need for assistance throughout the several days that the corporate office was making a decision about whether light-duty work was available to Petitioner. This activity alone shows Petitioner was still qualified for her job since she continued to perform her job duties. During this period, no one from the corporate office or on the facility's premises expressed any concern that Petitioner continued to perform her regular job duties. Clearly, no one was relying on the restrictions in the doctor's note. There was no evidence to suggest that Petitioner would ignore any resident's needs while she was pregnant or would try to protect herself more than any other employee at the facility did. As indicated, Petitioner was simply terminated. There was no consideration given to whether she could still perform her duties as she clearly could do. She was not offered any leave time or even allowed to request leave as mentioned in Section 8 of the Stakeholder Handbook. The abruptness of the termination when Petitioner could still perform her job duties and the failure to offer leave were discriminatory acts on the part of Bay against Petitioner based on her pregnancy. Around February 29, 2008, eight days after her termination, Petitioner called David Kendrick to ask him about receiving light-duty. He told her that light-duty was available only for employees injured on the job. This policy is neutral on its face and there was no evidence that demonstrated the restriction of light-duty work to employees who are injured on the job had a disparate impact on pregnant women. Petitioner told Mr. Kendrick that her doctor had raised her lifting restrictions to 50 pounds. However, the new restriction did not satisfy the corporate perception that she was too much of a risk and could not perform her required duties even though she met the minimum job qualifications and had been a good employee. In ignoring the fact that she was qualified to perform her duties, Mr. Kendrick's reasoning is further evidence of Respondent's earlier intent to discriminate against Petitioner based solely on her pregnancy. Mr. Kendrick also advised Petitioner that she could not obtain the disability insurance employee benefit because she had not been an employee for more than a year and had not elected to enroll in the coverage during the 90-day period from when she was hired. There was no evidence that demonstrated Bay's denial of disability insurance coverage to Petitioner was a discriminatory act since Petitioner, like all of Bay's employees, had been offered the insurance when she was hired, had not selected the insurance as a benefit within 90 days after her hire date, and could not make changes to her benefit plan until sometime in late 2008. On or about April 28, 2008, Ms. Mills filed a complaint with FCHR/EEOC alleging gender discrimination based on sex due to her pregnancy. In early May 2008, Ms. Mills suffered a miscarriage and lost her baby. Sometime around June 1, 2008, a few weeks after her miscarriage, Ms. Mills returned to Bay and met with Cathy Epps and Gayle Scarborough. She asked to be rehired since she was no longer pregnant. Both were aware of the Petitioner's pending EEOC/FCHR complaint. Ms. Scarborough told Petitioner that she could possibly be rehired if she dropped her EEOC claim. Later, Ms. Scarborough called Ms Guy and spoke with her about rehiring Petitioner. Ms. Guy asked David Kendrick, who inquired further in the corporation. Ms. Guy does not recall receiving a response to her inquiry. However, she later called Petitioner asking if she would display a negative attitude if she were rehired and asking if she had dropped her EEOC claim. Petitioner was so discouraged by the phone call that she did not pursue getting rehired further. Because she was not rehired by Bay, Petitioner was out of work for an extended period of time. She eventually was hired and has continued her employment with a variety of employers. She was and is required to travel some distance to maintain her employment at greater expense than if she were employed in Port St. Joe. Because she lives in Port St. Joe, she wants to be reinstated to her earlier position. Petitioner is entitled to reinstatement as a CNA and to back wages and benefits until she is reinstated, less any unemployment compensation, wages and benefits earned during said period.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Florida Commission on Human Relations issue a Final Order requiring: Reinstatement of Petitioner's employment with Respondent with all seniority and benefits as if she had not been terminated; and Payment of lost wages to Petitioner from the date of termination to reinstatement less any unemployment compensation, wages and benefits she received during the same period. DONE AND ENTERED this 7th day of October, 2010, in Tallahassee, Leon County, Florida. S DIANE CLEAVINGER 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 7th day of October, 2010. COPIES FURNISHED: Sandra Adams, Esquire Home Quality Management 2979 PGA Boulevard Palm Beach Gardens, Florida 33410 Ashley Nicole Richardson, Esquire McConnaughhay, Duffy, Coonrod Pope & Weaver, P.A. 1709 Hermitage Boulevard, Suite 200 Tallahassee, Florida 32302 Cecile M. Scoon, Esquire Peters & Scoon 25 East Eighth Street Panama City, Florida 32401 Denise Crawford, Agency Clerk Florida Commission on Human Relations 2009 Apalachee Parkway, Suite 100 Tallahassee, Florida 32301 Larry Kranert, General Counsel Florida Commission on Human Relations 2009 Apalachee Parkway, Suite 100 Tallahassee, Florida 32301
Findings Of Fact Having listened to the testimony and considered the exhibits presented in this cause, it is found as follows: Since 1964, Petitioner has been employed by the State of Florida, Department of Transportation. His duties consist of operating a tractor pulling a rotary mower which cuts grass on the rights of way of primary and interstate highways. Exhibits 2, 3 and 4. Prior to 1970, Petitioner was a member of the State and County Officers and Employees Retirement System, under which he was not covered for in line of duty disability retirement benefits. In 1967, while employed by the State of Florida, Department of Transportation, Petitioner injured his lower back and left leg when a tractor fell off the back of a lowboy trailer. Exhibits 1, 3, 4 and 11. In 1970, Petitioner transferred from the State and County Officers and Employees Retirement System to the Florida Retirement System (FRS). Exhibit 17. During his regular working hours in March of 1974, Petitioner again injured his back while moving road material. Exhibits 1, 3, 4, 8 and 13. On October 31, 1974, Petitioner applied for disability retirement on the basis of the March of 1974 injury. Exhibit 1. Mr. W. W. Ray, Engineer II with the Department of Transportation, completed a "Statement of Disability by Employer" form on October 21, 1974, answering affirmatively the question of whether petitioner was, prior to his alleged disability, able to perform all of the duties of his position fully and completely. It was further stated by Mr. Ray that petitioner "has been very good employee during his employment. Had worked up to lead worker in his mowing crew." Mr. Ray concluded that "most any job which we have would require a certain amount of working with hand tools and stooping over or standing for long periods of time which could be painful for persons with back problems." Exhibit 2. Two Florida licensed physicians submitted Florida Retirement System Physician's Reports. Form FR-13b. Dr. W. J. Newcomb stated that Petitioner "had strained his back and aggravated the degenerative arthritic condition that existed in his back." He had no "definite indication of proof that the original injury of 1966 [sic] or the subsequent injury of 1974 caused his degenerated condition." Dr. Newcomb felt "it was just probably aggravated by the related accidents." It was opined that Petitioner could do the duties of his occupation in a protected manner, but he would have chronic difficulty with his back. The performance of Petitioner's duties would produce pain because of his current illness or injury. Exhibit 3. Dr. Howard T. Currie opined that Petitioner was unable to, perform any of the duties of his occupation because of his current illness or injury. Exhibit 4. On June 5, 1975, a letter was sent to Petitioner by Administrator, Robert L. Kennedy, Jr., under the signature of David W. Ragsdale, Supervisor, Disability Determination Unit. This letter notified Petitioner that the State Retirement Director was unable to approve his application for in line of duty disability retirement benefits "[s]ince your injury is an aggravation of a preexisting condition and since your initial injury occurred prior to the Florida Retirement System..." However, it was determined that Petitioner did meet the requirements for regular disability retirement as described in F.S. 121.091(4)(b) Exhibit A. In accordance with F.S. Chapter 120, the Petitioner filed a petition requesting a hearing and the Respondent requested the Division of Administrative Hearings to conduct the hearing.
Recommendation Based upon the above findings of fact and conclusions of law, it is my recommendation that Petitioner be awarded the greater benefits allowable for a member totally and permanently disabled in line of duty. Respectfully submitted and entered this 9th day of September, 1975, in Tallahassee, Florida. DIANE D. TREMOR, Hearing Officer Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304 (904) 488-9675 COPIES FURNISHED: George Ralph Miller, Esquire P.0. Box 112 DeFuniak Springs, Florida 32433 L. Keith Pafford, Esquire Division of Retirement 530 Carlton Building Tallahassee, Florida 32304
Findings Of Fact Petitioner, Dr. Juan C. Costa, is a physician who is currently retired because of a physical disability involving emphysema and arthritis. Before retiring, he- worked for a period of time as a physician at the Department of Corrections' Marion Correctional Institution near Ocala, Florida. His last day of actual work was December 15, 1984, but he remained on the payroll after that time because of vacation and sick leave time accrued. His actual termfnation date was some time in January, 1985. Dr. Costa is disabled. His disability is classified as a regular disability - not "in line of duty." Feeling that the provisions of the disability and survivor benefit program of the Florida Retirement System applied to him, on March 5, 1985, he applied to the State of Florida for disability retirement. Submitted with his application were statements from his employer and two physician reports indicating that he was, in fact, disabled. His application and the supporting documents submitted therewith were prepared in accordance with the terms of a letter Dr. Costa received from the State of Florida, Division of Retirement, which told him what must be submitted. In addition to the above, he also submitted a copy of a form submitted to the Social Security Administration for completion by that agency and return to the Division of Retirement which was a "Report of Confidential Social Security Benefit Information." This form, when filled out, was submitted to the Division of Retirement as support for Petitioner's application for retirement benefits. In addition to the above, Dr. Costa also submitted a letter which he received from Teresa Bender, Medical Examiner for Respondent's Disability Determination Section which indicates that it is unable to process his application because of an insufficiency of information regarding his social security credits. Dr. Costa was born on May 12, 1912. When he terminated his service with the Department of Corrections, he was 72 years old. He had been receiving Social Security Retirement benefits since age 70. However, he never applied for nor received Social Security Disability Benefits and would not have been awarded them had he applied for them after attaining age 65. Once an individual has reached age 65, he is no longer eligible for disability retirement benefits under the Social Security program. He may continue to earn money without limit at age 70, regardless of whether he is disabled or not. The issue of disability goes not to the issue of earnings but to the issue of the ability to work. If an individual under the age of 65, who is retired on disability benefits, goes back to work, those disability benefits may be lost. However, an individual who is disabled, but is age 70 or beyond, would not lose benefits because benefits after age 65 are based not on disability but on retirement and at age 70, the limitation on amount earned is removed. His Social Security Retirement Benefits checks began arriving in January, 1983. Because of his age, he continued to work without penalty after his benefits began. By deposition, Waymen D. Sewell, the District Manager for the Social Security Administration in Tallahassee, Florida indicated that the benefits received by an individual on the basis of disability will, upon that individual's reaching the age of "retirement," age 65, be converted automatically from disability benefits to retirement benefits. There will be no reduction in the amount of benefit received. The only change will be that the money forming the source of the payment will stop coming from the Disability Trust Fund and start coming from the Retirement Trust Fund. As far as the recipient is concerned, nothing changes. There is an additional qualification for disability retirement. An individual, in order to claim and receive disability retirement under social security, in addition to being fully insured, must have 20 quarters of work credit out of the 10 year period up to the quarter in which the onset of disability was established. Here, Petitioner is retired and receiving retirement benefits from Social Security. He initially filed for retirement benefits in January of 1981 and was paid retroactively to April, 1980. At the time, he had 24 quarters of credit. Since based on his birth date, he needed 24 quarters of enrollment, he had exactly what he needed and retired at the earliest possible time. Had Dr. Costa been under 65 at the time he retired, he would have needed 20 quarters within the last 10 year period prior to retirement in order to qualify for disability. According to the records on Petitioner, he did not have 20 quarters of credit during that period. The 24 quarters he had was over a period greater than 10 years and a part of it was earned after he became age 65. The quarters he earned after age 65 did not count toward the 20 quarter retirement because once an applicant turns 65, he is paid strictly on the basis of retirement and not disability. In substance, Dr. Costa was never eligible for disability retirement under Social Security until after he became age 65 at which point he became eligible for retirement benefits which would eliminate any entitlement to disability benefits. According to David Ragsdale, who works with Division of Retirement, under the Florida Retirement System statute there are two types of disability retirement (1) "in line of duty," and (2) "regular" retirement." "In line of duty" does not require more than one day service. "Regular" retirement initially required five years service prior to July 1, 1980. However, in July, 1980, the law was amended to add an alternative 10 year total service criteria as well as an exception from these criteria for those not drawing or eligible to draw Social Security disability. It is the policy of the Division of Retirement, as to the Social Security exception, that if an individual can get a Social Security benefit, he cannot secure retirement benefits from the State under the Social Security exemption. This is interpreted by the Division of Retirement to mean either Social Security type benefit - either retirement or disability and the receipt of either one disqualifies an individual from State disability retirement eligibility under the Social Security exception. Though some people receive State disability retirement while drawing Social Security benefits, they were not qualified for their State retirement under the Social Security exception. They had either worked more than five years as of July 1, 1980 or had 10 years total service. Dr. Costa's application was received by the Division of Retirement, but no determination as to his qualification for disability retirement from a medical standpoint was made. His application was not accepted because, on the face of it, he did not meet the service requirement in that he had neither 5 years service by July 1, 1980, nor 10 years service overall. He was also disqualified because he was receiving a Social Security benefit, albeit the benefit was the retirement benefit and not the disability benefit.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is, therefore RECOMMENDED that the Respondent, Department of Administration, Division of Retirement, accept and process Petitioner's application for regular disability retirement benefits. RECOMMENDED this 1st day of November,1985, 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 1st day of November,1985. COPIES FURNISHED: James M. Donohoe, Jr., Esq. P. O. Box 906 Gainesville, FL 32602 Stanley M. Danek, Esq. Assistant Division Attorney Division of Retirement Cedars Executive Center 2639 N. Monroe Street Suite 207 - Building C Tallahassee, FL 32303 Gilda Lambert Secretary Department of Administration 435 Carlton Building Tallahassee, FL 32301 ================================================================ =
Findings Of Fact Petitioners', Joseph and Shelly Grainger, are husband and wife. They have one five year old son, Christopher Grainger. Joseph Grainger is the primary wage-earner for the family. At present, Joseph Grainger is unemployed due to a back problem. His previous employment was with a parcel shipping company. Due to his unemployment, Mr.Grainger is receiving approximately $653.00 a month in unemployment benefits. He will receive unemployment benefits until December, 1990, when his unemployment benefits terminate. As a recipient of unemployment benefits, Mr. Grainger must actively seek employment and is considered to be employable by the State. Proposed Rule 10C-1.11 Florida Administrative Code, implements federal and State law requiring the Department to furnish Aid to Families with Dependent children to indigent families whose principal wage-earner is unemployed (AFDC- UP). The law and the proposed Rule require the principal wage-earner to participate in the Job opportunities and Basic Skills program (JOBS). Florida has mandated that the spouse of the principal wage-earner also participate in the JOBS program, if funds are available. For AFDC-UP purposes, the Graingers constitute a three person assistance group. The assistance group determines the amount of benefits an applicant1 may receive if the applicant qualifies under the myriad eligibility requirements of the AFDC-UP program. The assistance group also sets the amount of income an assistance group may not exceed and still qualify for AFDC-UP. In this case, the Graingers' income limit is $294.00. Clearly, because of the amount of unemployment benefits Mr. Grainger is receiving, the Graingers do not now qualify for AFDC benefits and are not now receiving AFDC benefits which will be impacted by the proposed Rule. Since the Graingers are not now qualified for the AFDC-UP program and Mr. Grainger is employable, they have not established that they will suffer an injury from the proposed Rule's implementation of sufficient immediacy to entitle them to a hearing under s 120.54, Florida Statutes. See Agrico Chemical v. Department of Environmental Regulation, 406 So.2d 478 (Fla. 2d DCA 1981); Department of Health and Rehabilitative Services v. Alice P., 367 So.2d 1045, (Fla. 1st DCA 1979); Florida Department of Offender Rehabilitation v. Jerrv, 353 So.2d 1230 (Fla. 1st DCA 1978); and Village Park Mobile Home Association v. State Department of Business Regulation, 506 So.2d 426 (Fla. 1st DCA 1987). Accordingly, the Graingers do not have standing to challenge the proposed rule. Based on the foregoing Findings of Fact and Conclusions Of Law and being otherwise fully advised in the premises, IT IS ORDERED that the Petitions filed in Case Nos. 90-5157RP and 5158R are dismissed and the Division's files closed. DONE and ORDERED this 2nd day of October, 1990, in Tallahassee, Florida. DIANA CLEAVINGER 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 2nd day of October, 1990. COPIES FURNISHED: Cindy Huddleston Florida Legal Services, Inc. 2121 Delta Way Tallahassee, Florida 32303 Scott LaRue Department of Health and Rehabilitative Services 1323 Winewood Boulevard Building 1, Suite 407 Tallahassee, Florida 32399-0700 Liz Cloud, Chief Bureau of Administrative Code The Capitol, Room 1802 Tallahassee, Florida 32399-0250 Carroll Webb, Executive Director Administrative Procedures Committee Holland Building, Room 120 Tallahassee, Florida 32399-1300
Findings Of Fact The parties entered into a stipulation, which is attached hereto and made a part hereof, but is quoted for the sake of clarity: Stipulated Facts Petitioner is Charles E. Kellum whose address is 10420 SW 119th Street, Miami, Florida. Petitioner is a forty-two (42) year-old male whose education consists of a graduate equivalency degree received while serving in the Air Force from 1954 through 1958. His Air Force work and training was as a fire fighter in the Crash Rescue and Fire Department of the United States Air Force. In 1959, Petitioner became employed with the Sheriff's Department of Dade County, Florida, as a motorcycle officer and first joined the Florida retirement system then in effect for county employees. Later, Petitioner changed to what is now known as the Florida Retirement System. While employed by Dade County, while on duty, and while a member of the Florida Retirement System or its predecessor, Petitioner was involved in four (4) accidents. The accidents and injuries sustained are as follows: In 1964, Petitioner was in a motorcycle accident for which he first received treatment from Dr. Samartino for abrasions and contusions; In a separate motorcycle accident, on February 16, 1965, Petitioner sustained a fractured radial head of the right elbow. In surgery that month the radial head was removed. In April, 1965, the end of the ulna was removed. In November, 1965, certain reconstructive surgery was attempted to increase the motion in his right arm. Subsequent reconstructive surgery was attempted in February, 1966. (Deposition of Dr. Samartino, pages 8 - 11); In an on-duty accident in March, 1970, Petitioner fell and injured his knee and underwent surgery on the knee in April of 1970. In May, 1974, Petitioner was involved in an accident wherein, while making an arrest, he fell on a rocky terrain and suffered re- injury to his arm and knee and injury to his back. (Deposition of Kellum, pages 4 - 5). That Petitioner was retired from Dade County for medical reasons in May, 1974. He has not been employed since, except for approximately one year he was operating a small lawn maintenance business with the help of his son and another helper. His activities are limited to driving a truck and soliciting business. Stipulated Evidence Exhibit 1 - The deposition of Charles Kellum, Petitioner Exhibit 2 - The application for retirement benefits filed December 9, 1974, and the employer's statement of disability dated December 6, 1974. Exhibit 3 - The reports of Dr. Toth dated December 9, 1974, and August 6, 1974. Exhibit 4 - The reports of Dr. Gilbert dated December 9, 1974, and October 30, 1974. Exhibit 5 - The reports and deposition of Dr. Samartino. Exhibit 6 - The reports and deposition of Dr. Jacobson. Exhibit 7 - The deposition of Harry Windler, pages 8 - 14 and pages 19 - 36. Exhibit 8 - The letter from the Director of Retirement dated April 10, 1975. Upon a consideration of the evidence further findings of fact are: The various in-line-of-duty injuries and back pain suffered by Petitioner caused his involuntary retirement from the Dade County Department of Public Safety in 1974, after an injury on May 4, 1974. Petitioner applied for work with the police department, and wants and has wanted to return to some kind of law enforcement or police work. Respondent through its administrator, as provided in Section 121.091(4), Florida Statutes, denied Petitioner Kellum's disability retirement benefits by letter dated April 10, 1975, a copy of which is marked Exhibit "A" and make a part hereof. Petitioner requested an administrative hearing in April of 1975. The Respondent denied the petition as being untimely but thereafter revoked the denial and requested the Division of Administrative Hearings to hold a hearing on the issues presented. The employer, Metropolitan Dade County Department of Public Safety, in its statement of disability stated that "physicians' statements indicate that this employee is unable to perform police duties." It also stated that no other jobs in the organization, suitable to the applicant's abilities, exist consistent with his classification. The departmental policy of the Metropolitan Dade County Department of Public Safety is to phase out employees who have become liabilities from an insurance risk management point of view. Because of the stringent minimum physical requirements imposed upon law enforcement officers in Dade County, Florida, Petitioner cannot perform his duties as a policeman or law enforcement officer and could not be re- employed in that position. There are no permanent sheltered positions for law enforcement personnel. Doctors Alex Toth and Robert G. Gilbert stated that Petitioner's condition is "prognosis guarded." They both stated that Petitioner was unable to perform regular duties. Dr. Toth stated Petitioner was "completely disabled," and Dr. Gilbert stated "for all intent and purposes, this patient is totally disabled." Dr. G. Thomas Samartino, in answer to the question, "At this time, in 1977, do you forecast any further degeneration in his health due to that particular diagnosis?" (degenerative arthrosis of the right elbow), answered "Yes." He further stated that he could not really forecast disability but that "it may stay pretty much the way it is or get a whole lot worse," and noted that there has been no improvement since 1966. He stated Petitioner suffered a 35 percent disability of the upper right extremity and a 30 percent disability of the body as a whole, which includes pain. All three physicians stated that they felt the Petitioner should not be employed as a policeman. Dr. Robert E. Jacobson, a neurologic surgeon, stated that from the functional standpoint the Petitioner would be unable to return to work as a combat policeman, although he could do other type of work. He also stated that the numerous injuries and back and neck complaints would add up to a more marked problem than any one would imply. Petitioner's training was as a fire fighter in the crash rescue fire department while in service of his country from 1954 to 1958. He joined the service immediately out of high school and, before his discharge, took the GED test to get a high school certificate. His employment and further training has been in police work, being employed by the Metropolitan Dade County Public Safety Department in October of 1959, a position he filled for fifteen, (15) years. His training after Air Force service consists of little more than on- the-job training for his employment as a motorcycle officer. Petitioner was self-employed, driving a truck and soliciting business together with two other persons in the yard maintenance work. He applied without success for at least two positions with private employers, but he has not applied for rehabilitative training. His remuneration from his self- employment was approximately $6,000.00 per year, substantially lower than he earned as a police officer, which pay classification is approximately $8,000.00 to $20,000.00. Petitioner is totally and permanently disabled from rendering useful and efficient service as an employee in police and law enforcement work, but he can perform a useful work service. Petitioner contends: That he is permanently and totally disabled from doing the police or law enforcement work for which he is trained and for which he had been employed for some fifteen (15) years, and that his disability arose from his work; That he is unable to perform materially or substantially all or any of the remunerative duties for which he is educated and trained, and which might permit him to be compensated at or near the compensable rate of a Dade County policeman; and That he is entitled to the disability benefits authorized by Section 121.091(4), inasmuch as he is totally and permanently disabled to perform duties as a police or law enforcement officer because of injuries he received while on such duty. Respondent contends: That Petitioner is not totally and permanently disabled hut only partially disabled, and can and does work and earn an income although he is disabled from performing the duties of his normal occupation; and That a showing that Petitioner is incapable of performing duties of his usual occupation is not sufficient to obtain disability retirement benefits under the statute.
Recommendation Grant Petitioner Charles E. Kellum disability retirement benefits. DONE and ORDERED this 24th day of May, 1979, in Tallahassee, Leon County, Florida. DELPHENE C. STRICKLAND Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301 (904) 488-9675 COPIES FURNISHED: Melvin R. Horne, Esquire Post Office Drawer 1140 Tallahassee, Florida 32302 Stephen S. Mathues, Esquire Division of Retirement 530 Carlton Building A Tallahassee, Florida 32301 ================================================================= AGENCY FINAL ORDER ================================================================= STATE OF FLORIDA DIVISION OF RETIREMENT CHARLES E. KELLUM, Petitioner, vs. DOAH CASE NO. 77-465 DIVISION OF RETIREMENT, Respondent. /
The Issue Whether Petitioner is entitled to disability retirement benefits calculated as if she had reached the age of 65, irrespective of her true age.
Findings Of Fact From April 1969 until March 1996, Petitioner, Bobbie Jones Scott, was employed as a school teacher by the Okaloosa County School Board. She served 27 years as an elementary school teacher, teaching at the same Okaloosa County elementary school for her entire tenure. Prior to commencing her teaching career, Petitioner served as a library aide in Okaloosa County for the full 9-month term of that position in the 1967-1968 school year. Petitioner is a member of the TRS. The TRS was closed to new members on December 1, 1970. Since closure, teachers have been enrolled in the Florida Retirement System (FRS). At some point, Petitioner purchased retirement credits in TRS for the school year during which Petitioner served as a library aide. Early retirees under both TRS and FRS, retiring without disability, have their retirement benefits actuarially reduced by five percent per year or five-twelfths percent per month for each year or fraction of year that the retiree is under the age of 62. See, Section 121.021(30), Florida Statutes and Rule 6S-7.003, Florida Administrative Code. Petitioner first inquired about retirement in 1993, when her husband, also a teacher, retired. She requested and obtained from the Division an estimate of early retirement benefits. In 1993, the early retirement penalty reduced Petitioner's retirement benefit to 67.9 percent of her normal retirement benefit. The reduction was so great that Petitioner elected to keep teaching. On October 16, 1994, Petitioner severely injured her arm when she slipped on a freshly waxed floor at the elementary school. Several surgical procedures were required over the next two years as a result of this accident. Despite extensive physical therapy, Petitioner did not regain full range of motion and full use of her dominant right arm. Petitioner could not raise her arm above shoulder level and could not raise it high enough to write on a blackboard. The injury clearly interfered significantly with Petitioner's ability to teach. In December 1994, because of her injury, Petitioner requested an estimate of retirement benefits. Again, the early retirement penalty reduced the retirement benefit to 77.9 percent of normal benefits. The reduction was so great that Petitioner could not afford to retire. Approximately three months after her accident on January 17, 1995, the Petitioner returned to teaching. Her physical therapy and surgical treatment continued. In June 1995, while recuperating from the third operation on her arm, Petitioner called the Division of Retirement to request information on disability retirement. She specifically told the person she spoke with that she was a member of TRS. Petitioner was sent an application form and instructions for retirement under FRS instead of an application and instructions for TRS. At that time, the Petitioner did not submit the application because a decision on the application would not be reached before the start of the 1995-1996 school year. Petitioner wished to avoid commencing the school year, only to leave teaching several weeks into the school year, necessitating finding and hiring a replacement teacher and disrupting the students’ course of studies. In November 1995, Petitioner was diagnosed with diabetes. Teaching was becoming detrimental to Petitioner's health. At the urging of her physician she elected to pursue disability retirement. The Petitioner reviewed a booklet sent to her by Respondent entitled "Florida Retirement System Disability Benefits." The Petitioner relied on the statement on page 27 of the booklet which states, "Disability benefits are not reduced for early retirement." Based on that statement Petitioner applied for disability retirement and submitted the disability retirement application which she had received earlier along with the requisite supporting documentation on January 10, 1996. Neither the FRS disability retirement application form nor the FRS Disability Retirement Handbook informed Petitioner that there would be an early retirement penalty for disability retirees. However, the FRS literature also indicates that employees who are members of other retirement systems may be governed by different rules and should look to those other retirement systems. Unfortunately, Petitioner had been given the wrong information by the Division of Retirement even though she had specified she was a member of TRS. On February 9, 1996, after receiving Petitioner's application, the Division of Retirement sent a letter to Petitioner advising her that the incorrect disability retirement application form had been used. A TRS Disability Retirement Application form was enclosed with the letter. Only the title of the application was changed. In essence, the TRS application was the same as the FRS application. No booklet or pamphlet explaining the TRS system was provided. On February 14, 1996, immediately upon her receipt of the February 9, letter and the TRS Disability Retirement Application form, Petitioner telephoned the Division of Retirement and spoke with Mark Sadler, a retirement administrator in the disability determination section within the Division of Retirement. The Petitioner explained that she had used the disability retirement forms provided to her by the Division. She inquired as to whether an additional 30 days would be needed to process her application. She also indicated that the reason she was still working and had not retired previously is that she could not afford to be assessed the early retirement penalty. Mr. Sadler informed the Petitioner that she would need to submit the correct TRS Disability Retirement application. However, Mr. Sadler agreed to accept the physician’s report of disability already submitted with the FRS form and to expedite her request for disability retirement since the medical information which Petitioner had submitted met the TRS requirements for disability documentation. On or about March 7, 1996, Petitioner received notification from the Division of Retirement that her application for disability retirement had been approved. The next day, Petitioner met with Virginia Bowles, a benefits specialist with the Okaloosa County School Board, to obtain an estimate of her retirement benefits under Plan E of the TRS system. Mrs. Bowles prepared an estimate of Petitioner’s benefits. The estimate did not show any reduction of benefits for early retirement. The form Ms. Bowles prepared was clearly labeled "estimate" and provided, inter alia, that Petitioner would receive a calculation of her retirement benefits from the Division of Retirement in approximately three weeks. While in Mrs. Bowles’ office, Petitioner insisted on confirmation from the Division of Retirement that an early retirement penalty would not be imposed on her benefits. In the Petitioner’s presence, Mrs. Bowles called the Division of Retirement to verify that there was no early retirement penalty for disability retirees. Mrs. Bowles was assured that there was no such penalty. Mrs. Bowles immediately relayed that information to Petitioner. Based on this representation, Petitioner immediately resigned her position on March 8, to be effective March 13, 1996.1 Had Petitioner known there would be a reduction in her disability retirement benefits and had she not received incorrect information from both the Division of Retirement and the Okaloosa County School Board, she would have found some way to continue working to avoid the early retirement penalty even though continued employment would have been detrimental to her health.2 At the time of her retirement, Petitioner had attained the age of 58 years and 4 months, 44 months short of the normal retirement of age 62. The estimate prepared by Ms. Bowles reflected that Petitioner's monthly retirement benefit would fall between $1,458.20 and $1,512.41. At the time of her resignation, Petitioner was earning over $39,000 per year as an experienced teacher. Once Petitioner resigned her position, she could not immediately return to work. Board policy required her to wait one year before re-employment and then she could be rehired at a starting teacher’s salary of about $21,000. A couple of weeks after resigning her position, Petitioner received a calculation of her retirement benefits from the Division of Retirement. The benefits were significantly lower than the estimate of benefits prepared by Mrs. Bowles. Retirement benefits under Plan E are calculated by, first, determining an "average final compensation," or AFC, for an employee by averaging the 10 highest years of salary in the employee’s last 15 years of employment. The employee’s compensation percentage, or "comp percent," is then determined by assigning a 2 percent value for every year of creditable service. The AFC is then multiplied by the comp percent to arrive at a retirement benefits figure. In Petitioner’s case, the Division calculated AFC as $32,601.10. The Division, based on 27.9 years of service, arrived at a comp percent of .558, resulting in a normal retirement allowance of $18,191.41 per year or $1,515.95 per month.3 However, because Ms. Scott fell into the early retirement category under TRS her benefits were reduced. In calculating Petitioner’s disability benefits, the Division of Retirement reduced the otherwise normal retirement benefit calculation by 18.33 percent to 81.667 percent of her normal benefit. The reduction resulted in a monthly retirement benefit of $1,238.03. The reduction is the result of a five- twelfths of one percent reduction for each month that Petitioner was short of age 62 and is the correct benefit calculation under TRS. See Rule 6S-7.003, Florida Administrative Code.
Recommendation Based upon the findings of fact and conclusions of law, it RECOMMENDED: That the Division of Retirement calculated Petitioner’s benefits correctly and is not estopped from reducing Petitioner’s benefits based on her status as a disability retiree. DONE AND ENTERED this 30th day of July, 1997, in Tallahassee, Leon County, Florida. DIANE CLEAVINGER Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (904) 488-9675 SUNCOM 278-9675 Fax Filing (904) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 30th day of July, 1997.
The Issue Whether an employee who has retired on ordinary early retirement and cashed more than 30 retirement checks should be heard on a claim made some two years or more after he retired that he is entitled to disability retirement benefits?
Findings Of Fact On January 15, 1983, petitioner Tommy Gene Grantham left the Escambia County Sheriff's Department after more than 14 years as a deputy sheriff. Respondent gave petitioner notice on April 27, 1983, of its intention to deny his application for disability benefits, which he had made on grounds he was "unable to lift, stand, or perform any type of physical exertion." Respondent's Exhibit No. 7. Petitioner took appropriate steps to cause his application for disability benefits to be placed on the agenda of the State Retirement Commission for its December 13, 1983, meeting. On the following day, the Commission entered a final order dismissing cause, which had the effect of denying the application. Respondent received petitioner's application for service retirement on December 4, 1986. Petitioner made this application because he needed the money. He had only recently been released from the Pavilion, a mental ward at a hospital in Pensacola, where he had been confined in a padded cell from November 15 to December 1, 1966. On December 10, 1986, respondent acknowledged receipt of the application. Respondent's Exhibit No. 4. The form acknowledgment said, "[O]nce you retire you can not add additional service nor change options. Retirement becomes final when the first benefit check is cashed." Respondent's Exhibit No. 4. By the time of the hearing in this matter, respondent had cashed more than 30 monthly retirement checks. Nancy Grantham has been married to the petitioner for 15 1/2 years although, between September 5, 1986, and February of 1987, she and her husband were legally separated. Over the years, according to Mrs. Grantham, her husband has suffered from serious mental problems. It was she who took him to the Pavilion on November 15, 1986, when, she recalls, he was "talking crazy," anxious, depressed, and apparently suicidal. At no time has any court adjudicated the petitioner incompetent. The respondent's policy is to honor elections made by retirement system members, even members seeking disability retirement on psychiatric grounds, in the absence of an adjudication of incompetency.
Recommendation It is, accordingly, RECOMMENDED: That respondent dismiss petitioner's application for disability retirement benefits. DONE and ENTERED this 21st day of November, 1989, in Tallahassee, Florida. ROBERT T. BENTON, II 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 21st day of November, 1989. APPENDIX With respect to petitioner's proposed findings of fact Nos. 1 and 6, the agency actions were not final at those times. Petitioner's proposed findings of fact Nos. 2, 4 and 5 have been adopted, in substance, insofar as material. With respect to petitioner's proposed finding of fact No. 3, it is not clear when the application was mailed. COPIES FURNISHED: Tommy G. Grantham 2266 Berrydale Road Cantonment, FL 32533 William A. Frieder, Esquire Department of Administration Carlton Building Tallahassee, FL 22399-1550
The Issue Whether Respondent, G and G General Contracting, Inc., failed to comply with the coverage requirements of the Workers’ Compensation Law, chapter 440, Florida Statutes, by not obtaining workers’ compensation insurance for its employees, and, if so, what penalty should be assessed against Respondent pursuant to section 440.107, Florida Statutes (2014).
Findings Of Fact The Department is the state agency responsible for enforcing the requirement of the Workers’ Compensation Law that employers secure the payment of workers’ compensation coverage for their employees and corporate officers. § 440.107, Fla. Stat. G and G General Contracting, Inc. (Respondent or G and G), is a domestic business corporation organized on July 5, 2013, pursuant to the laws of the State of New York. Respondent’s primary business address is 88 Lincoln Avenue, Ardsley, New York. Gino Uli is Respondent’s President. Respondent is not a Florida corporation. On December 4, 2014, the Department’s investigator, Aysia Elliott, conducted a random workers’ compensation compliance check at a worksite in Naples, Florida. Ms. Elliott observed seven men at the worksite engaged in interior and exterior painting of a newly-constructed residence. The residence was but one in a large residential subdivision under construction. The central issue in this case, and one that is fiercely contested, is whether the painters Ms. Elliott observed at the worksite were employees of G and G. In response to her verbal inquiries to the painters on site, Ms. Elliott testified that the workers first identified Pacific Construction as their employer. Ms. Elliott attempted to contact Pacific Construction, but her calls to that company were not returned. Ms. Elliott testified that upon her further inquiry, one of the painters, Leonardo Gudiel, stated he was an employee of G and G. At this point, Ms. Elliott was unsure which company to investigate for workers’ compensation coverage for the painters at the worksite. The permit sign at the worksite identified Minto Communities as the general contractor. Ms. Elliott contacted Minto Communities via telephone to determine the name of the company to which painting had been subcontracted. At hearing, Ms. Elliott was unable to recall the names of any of the companies identified by Minto Communities as subcontractors for the job. Ms. Elliott did recall that at least two subcontractors were identified by Minto. Mr. Gudiel gave Ms. Elliott a telephone number for a man named “Edison,” alleged to be the foreman. Ms. Elliott called Edison, and testified that he informed her he was on another call and would have to call her back. Edison did not return Ms. Elliott’s call. Ms. Elliott next received a phone call from Mr. Uli. Ms. Elliott testified that, during that phone conversation, Mr. Uli identified the painters at the worksite as employees of his company, G and G. Mr. Uli denied having ever told Ms. Elliott the painters were his employees. Mr. Uli provided Ms. Elliott with the certificate of insurance demonstrating workers’ compensation insurance coverage for employees of G and G. Mr. Uli told Ms. Elliott he would be in Florida in a few days and would meet with Ms. Elliott in person. Ms. Elliott verified the existence of G and G through the State of New York Division of Corporations’ website. Ms. Elliott then verified, through the Department’s Coverage and Compliance Automated System, that G and G had no workers’ compensation coverage in Florida, nor any exemption from coverage requirements for any of its corporate officers. Ms. Elliott also contacted the New York insurance carrier identified by Mr. Uli and confirmed that the carrier did not cover any G and G employees in Florida. On December 8, 2014, Ms. Elliott reviewed the results of her December 4, 2014, workers’ compensation investigation with Maria Seidler, the Ft. Myers district Supervisor. A determination was made that sufficient evidence and information existed to issue a Stop-Work Order against G and G for failure to provide workers’ compensation insurance, as required by chapter 440. Ms. Elliott met with Mr. Uli on December 8, 2014. Ms. Elliott personally served Mr. Uli with a Stop-Work Order for the construction site in Naples and a request for specified business records on which to base the penalty calculation. Mr. Uli did not provide any records to the Department in response to the records request. The Department’s penalty auditor, Lyna Ty, was assigned to calculate the penalty to be assessed against G and G for failure to secure workers’ compensation insurance during the penalty period. The penalty period was for the two years prior to the date the Stop-Work Order was issued: December 9, 2012 to December 8, 2014. Having no employer records from G and G, Mr. Ty imputed the statewide average weekly wage as Respondent’s payroll for the seven painters at the worksite on December 4, 2014. Mr. Ty calculated a penalty of two times the workers’ compensation insurance premium that would have applied to the purchase of insurance for those specific employees during the penalty period. § 440.107(7)(e), Fla. Stat. Mr. Ty assigned NCCI code 5474, which is the classification code for painting contractors according to the SCOPES manual adopted by the Department for imputing wages associated with various occupations. On January 9, 2015, the Department issued an Amended Order of Penalty Assessment against G and G in the amount of $254,697.38 However, because G and G was not formed until July 5, 2013, the original penalty calculation was based on an incorrect penalty period. Mr. Ty recalculated the penalty based on a penalty period from July 5, 2013 through December 8, 2014. On May 26, 2015, the Department issued a Second Amended Order of Penalty Assessment against G and G in the amount of $185,354.68. Mr. Uli’s testimony provided no more clarity than Ms. Elliott’s as to the identity of the employer for the painters at the worksite on December 4, 2014. Mr. Uli previously lived in Florida for seven years and was engaged in “restaurant business.” Mr. Uli met Leonardo Gudiel, a contractor, while he was living in Florida. While living in Florida, Mr. Uli also met James Cartisano, the purported owner of Facility Construction. When Mr. Uli relocated to New York, he stayed in touch with Mr. Gudiel. According to Mr. Uli, he planned to give to Mr. Gudiel any work G and G obtained in Florida and asked Mr. Gudiel to “be registered as a vendor with [him].” Mr. Uli testified that Mr. Cartisano contacted him in New York and told him that he had been engaged by Minto Communities (Minto) to paint a model home in a new residential neighborhood under construction in Naples, Florida. Presumably, if Mr. Cartisano’s work was satisfactory to Minto, Facility Construction would be hired for the larger job. According to Mr. Uli, he referred Mr. Cartisano to Mr. Gudiel to supply painters for the job. Mr. Uli described himself as the “middle man.” Upon inquiry from the undersigned as to how Mr. Uli or G and G construction would profit from his position as the middle man, Mr. Uli stated, “No arrangement as per se on paper, Judge, but this is on – on [Mr. Cartisano’s] word to me; that if you get me the right guys down there that can do this for me, I’ll take care of you.”1/ On December 4, 2014, when Ms. Elliott conducted her random worksite inspection, Mr. Uli received a telephone call from Mr. Gudiel informing him that Ms. Elliott was onsite asking questions about workers’ compensation insurance. According to Mr. Uli, he called Mr. Cartisano, who “did not want to deal with this.”2/ Mr. Uli explained that he telephoned Ms. Elliott on December 4, 2014, to explain that the guys onsite were painting a model home for Minto, and if Minto was satisfied, Facility Construction would get the overall job (estimated at 700 houses). At hearing, Mr. Uli strongly denied that he told Ms. Elliott the workers were his employees, either on the phone on December 4, 2014, or when he met with her in person on December 8, 2014. The evidence, or lack thereof, leaves the undersigned with many unresolved questions: Why would Facility Construction contact a contractor in New York to provide painters for a job in Florida? Why did Mr. Uli supply Ms. Elliott with a copy of his certificate of insurance for workers’ compensation insurance in New York? Moreover, if the painters were not his employees, why did Mr. Uli travel to Florida from New York and meet with Ms. Elliott? From the evidence as a whole, it can be inferred that Mr. Uli had a significant interest in the work being done at the Naples worksite on December 4, 2014. However, it cannot be inferred that G and G was the employer of the painters at the worksite. That fact must be proven by the Department.
Recommendation Having considered 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 dismissing the Stop-Work Order and Second Amended Penalty Assessment against Respondent, G and G Contracting, Inc., for its failure to secure and maintain required workers’ compensation insurance for its employees. DONE AND ENTERED this 13th day of November, 2015, in Tallahassee, Leon County, Florida. S SUZANNE VAN WYK 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 November, 2015. 1/ T.83:12-15.
The Issue Whether DHRS may compel Ronald H. Pollard to pay the maintenance fee. Whether DHRS properly determined the amount of maintenance fee.
Findings Of Fact Herman Pollard is hospitalized at Florida State Hospital, Chattahoochee, Florida, and has been since July 26, 1989. Herman is competent, but has suffered from a mental illness diagnosed as schizophrenia for many years and has been institutionalized periodically for the treatment of this disease over the years. He has spent more years with his family than he has spent being institutionalized. Herman Pollard receives monthly Social Security Disability Income (SSDI) benefits from the Social Security Administration (SSA). His father had been appointed Representative Payee by SSA to receive Herman's SSDI benefits. For several years prior to 1988, Herman Pollard lived in North Carolina. After his father died, Herman relocated to Tallahassee, Florida, and lived with his brother, Ronald Pollard, and his brother's wife. The brother's 62-year-old mother resides in another Florida city. She is unable to care for Herman, and Ronald is the only living relative able to care for Herman. Ronald was appointed Representative Payee for his brother. A Representative Payee receives and disburses Social Security benefits on behalf of a social beneficiary. A Representative Payee has a fiduciary duty under federal law to disburse the money received to pay for the actual recipient's needs and care. However, the federal law prohibits any legal action by a creditor to enforce payment of a debt by a creditor or any assignment of future benefits. A Representative Payee may be criminally prosecuted by the Federal Government for violation of his fiduciary duty. Although Ronald acceded to his father's request to take care of Herman, Ronald has not adopted Herman or been made his legal custodian or guardian. Ronald Pollard is not legally responsible for his brother's support. A Responsible Party is legally responsible for a patient's financial support. Upon moving to Tallahassee, Herman lived in an apartment with Ronald and his wife. He spent the day in an adult day care program. However, his behavior became increasingly disturbing to the other adults requiring care; and Herman had to cease his participation. Ronald's apartment provided cramped living quarters for the three of them. Ronald and his wife purchased a three-bedroom home to provide Herman with his own bedroom. Herman is unable to drive, and Ronald and his wife provide transportation for Herman for treatment and doctors' visits. Ronald informally apportions one-third of the expenses, e.g., mortgage and car payments, food, clothing, and utilities, to Herman. The $346.00 in SSDI, which Ronald received in benefits for Herman, is less than one-half of the monthly expenses of $700.00 incurred in Herman's behalf. Because of Herman's mental illness, he was determined to be in need of more specialized temporary care than was available at home and was placed in a local treatment facility. Subsequently, it was determined that a more restrictive setting was required; and Herman was involuntarily placed in the Florida State Hospital. On July 24, 1990, a Final Order was issued authorizing continued involuntary placement for Herman. In re: Herman Pollard, Case No. 90-4023(B). On October 1, 1989, DHRS provided Ronald Pollard with a Notice of Maintenance Fee, having identified Ronald as the Responsible Party. The Notice advised Ronald of monthly billings of $296.00 for Herman's stay at the Hospital. On November 27, 1989, Ronald responded with a request that the "billings be adjusted to no liability" against him. (Hearing Officer's emphasis. On March 12, 1990, DHRS' Fee Waiver Committee recommended denial of Ronald's request for a fee waiver, stating that: Discussions with appropriate staff indicate client's treatment is expected to be long term. Also, the brother's current apartment (sic) was purchased after the client was admitted. Ronald advised Ronald E. Rohan, Florida State Hospital's Accounting Supervisor and Acting Chairman of the Fee Waiver Committee, that he and his wife purchased their house before Herman was hospitalized. DHRS stipulates they did. On March 21, 1990, DHRS' District Administrator denied Ronald's request for a fee waiver. On March 29, 1990, Ronald was advised that this request had been disapproved because, "Discussions with appropriate staff indicate client's treatment is expected to be long term." On April 4, 1990, Ronald requested an administrative hearing. DHRS arrives annually at a daily charge for medical and personal services for its patients. This charge is currently $200.00 per day. The State is charged by law to assess and collect for the services which the Hospital provides. DHRS determined Herman's maintenance fee generally based upon disposable income. DHRS computes disposable income based upon Rule 10-6.020, Florida Administrative Code. Domestic expenses such as rent, automobile payments or transportation costs for Herman were not considered by DHRS because it did not consider Herman as having domestic expenses. DHRS included Herman's SSDI benefits as income and after allowing $50.00 for his personal use, set his maintenance fee at $296.00. Rule 10-6.010(19), Florida Administrative Code, excludes SSDI benefits from income. DHRS uses a combination of persuasion, threat of court action, and court action to recover payment of maintenance fees from a Responsible Party. DHRS may obtain a lien against the Responsible Party's real property in favor of DHRS pursuant to Section 402.17, Florida Statutes, and Rule 10-6.023(6), Florida Administrative Code. In this case, DHRS is treating the Representative Payee, Ronald Pollard, as a Responsible Party. On June 25, 1990, Kingsley R. Ross, an Assistant Secretary of DHRS, acknowledged that charging, assessing or collecting fees by DHRS from social security benefits may be in conflict with federal statutes.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is recommended that DHRS assess the maintenance fee in accordance with its formula at zero; amend its records to reflect that Ronald Pollard is not liable for the treatment or debts of Herman Pollard; and cease its efforts in this matter since collection is barred by federal law DONE and ENTERED this 18 day of October, 1990, in Tallahassee, Florida. STEPHEN F. DEAN 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 18 day of October, 1990. APPENDIX TO RECOMMENDED ORDER IN CASE NO. 90-2999 Petitioner's Proposed Findings of Fact Unnumbered paragraph numbers 1-10 are substantially adopted but reorganized and rewritten. Respondent's Proposed Findings of Fact 1-7. Adopted. Rejected, as contrary to the facts. Herman lived with Ronald, Herman had domestic expenses. Rejected. As discussed in the Conclusions of Law, Ronald is not the Responsible Party. Rejected. There has been a legal claim asserted. To the extent that these proceedings are legal actions, Petitioner and Respondent are engaged in litigating this dispute. COPIES FURNISHED: George Drumming, Jr., Esquire 317 E. Park Avenue Tallahassee, FL 32301 Gene Stephens Assistant Hospital Attorney Florida State Hospital Chattahoochee, FL 32324 Sam Power Clerk Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, FL 32399-0700 Linda Harris General Counsel Department of Health and Rehabilitative Services 1323 Winewood Boulevard Tallahassee, FL 32399-0700
The Issue The issue is whether Petitioner, William Bright, is entitled to receive retirement benefits of his deceased son, Ronald Bright.
Findings Of Fact Petitioner, William Bright (Petitioner/William Bright), is the 84-year-old father and beneficiary of Ronald Bright. Ronald Bright was an employee of Brevard County with approximately 29.5 years of creditable service in the Florida Retirement System (FRS), which is administered by the Division. Ronald Bright was diagnosed with lung cancer in December 2001, and two months later, he underwent surgery to have a lung removed. Thereafter, he received radiation treatments and chemotherapy. Despite his being diagnosed and treated for cancer, Ronald Bright was optimistic about his future and continued to work part-time for the Brevard County Planning Department. In October 2002, Ronald Bright entered the hospital and underwent further surgery, when it was determined that his cancer had spread to his colon. After five days in the hospital, he was placed in intensive care. On October 28, 2002, William Bright first learned from Ronald Bright's doctor that his son was terminally ill. That same day, Joanne Adams, Ronald Bright's supervisor in the Brevard County Planning Department, also first learned that Ronald Bright was terminally ill. Upon learning that his son, Ronald Bright, was terminally ill, Petitioner requested a meeting with the Brevard County Human Resources Department (Human Resources) staff to discuss and apply for disability retirement benefits on behalf of his son. The meeting was held on October 31, 2002, in the office of Human Resources. In addition to Petitioner, Joanne Adams, Fannie Gray, and other Brevard County staff attended the meeting. Kathryn Patterson was the primary person in Human Resources charged with the responsibility for assisting employees in filing for retirement benefits, including disability retirement benefits. However, Ms. Patterson did not attend the October 31, 2003, meeting because she was on leave that day. In Ms. Patterson's absence, Fannie Gray, who 12 years before had primary responsibility for assisting employees with retirement applications, provided disability retirement application forms for Ronald Bright to Petitioner. The package of forms Ms. Gray provided to Petitioner on October 31, 2001, did not include an FRS-11o form, Option Selection Form (FRS-11o form). During the October 31, 2002, meeting, Petitioner executed the forms, including the disability retirement application, that were provided to him. These forms were completed by Petitioner pursuant to the durable power of attorney executed by Ronald Bright on March 26, 2003, three months after he was diagnosed with cancer. On October 31, 2002, Ms. Gray faxed to the Division the disability retirement application package for Ronald Bright. The fax cover sheet contained a handwritten legend that said: "This is urgent[.] Thank you." On November 4, 2002, Ms. Patterson returned to work after a short period of leave. Upon her return, she called the Division and spoke with Frederica Edwards to confirm the receipt of Ronald Bright's disability application. Ms. Patterson was informed by Ms. Edwards that only part of the facsimile transmittal had been received. Apparently, the facsimile transmittal initially received and filed by the Division included only the signature page of the application, the facsimile cover sheet, and part of the power of attorney document. Ms. Patterson then immediately re-sent, by facsimile, the disability application, the power of attorney, and the previously-submitted cover sheet with the original handwritten notation, "This is urgent[.]" The disability application package that was re-sent to the Division by facsimile on November 4, 2002, did not include the FRS-11o form. Although the FRS-11o form, could have been filed at the same time as the application, that form was not required for the Division to determine if Ronald Bright was eligible for disability retirement. On November 5, 2002, Frederica Edwards sent a letter to Ronald Bright at his home address informing him that two physician statements were required to make a disability determination. The letter further advised him of items that would be required if the application was approved, including an FRS-11o form. Blank copies of all of the forms mentioned were included with the letter. On November 5, 2002, the same day the Division sent the letter and forms described in paragraph 14, the Human Resource staff sent, by facsimile, one physician report to the Division. That physician's report, completed by Dr. Acosta noted that "[T]his patient [Ronald Bright] is terminal." The following day, November 6, 2002, Human Resources received and faxed to the Division a second physician's statement which also attested to Ronald Bright's disability. Ronald Bright never received the letter and enclosed forms sent out by the Division on November 5, 2002, because he was confined to the hospital, where he remained until his death on November 9, 2002. On November 14, 2002, Ms. Patterson called Ms. Howell and inquired about the status of the application. Ms. Howell informed Ms. Patterson that everything needed for a disability determination had been received. Notice was also given to Ms. Howell of Ronald Bright's passing. Based on this telephone conversation with Ms. Howell, the Human Resources staff believed that all information required to process Ronald Bright's disability retirement application had been received. On or about November 14 or 15, 2002, a few days after Ronald Bright's death, Petitioner received the November 5, 2002, letter from the Division and the forms included with it. The delay in receipt of the letter was because Petitioner had executed a mail-forwarding directive to the U.S. Postal Service, effective November 6, 2002, directing that all mail for his son be forwarded to Petitioner's residence. Upon receipt of the Division's November 5, 2002, letter and enclosed documents, Petitioner contacted Human Resources regarding the FRS-11o form. As he had done previously, Petitioner relied on Human Resources for assistance and guidance in the disability retirement application process. The FRS-11o form adopted, pursuant to Section 121.091(6), Florida Statutes (2001), provides for four options: Option 1 provides for full benefits for the life of the member; Option 2 is a reduced benefit for ten years with those benefits payable to a beneficiary in the event the member dies before the end of ten years; Option 3 applies to a deceased member who is survived by a joint annuitant, which is defined in Section 121.021(28), Florida Statutes (2001), as a spouse, or children, or a parent, or other person over age 25, for whom the member is the legal guardian and dependent upon the member for over one- half of his or her support; and Option 4 is applicable if there is a joint annuitant and the member desires to elect that the survivor of them would receive a reduced benefit of 66 and 2/3 percent. The FRS-11o form incorporates the following statements in its instructions: "What Retirement Option Should You Choose," which accompany the FRS-11o form. Under Option 2, it states: Option 2 would be particularly appropriate if you are in ill health and your beneficiary does not qualify as a joint annuitant. Anyone can be named as a beneficiary under Option 2, as well as charities, organizations, or your estate or trust. Ronald Bright was a single person who had never been married, had no children, and there was no parent for which he was legal guardian or who was dependent upon him for support. Due to his terminal condition and his family status, the only viable option on the FRS-11o form was Option 2, if an election was made. On October 28, 2002, when Ronald Bright knew that his condition was terminal, in a conversation with Petitioner and with his supervisor, Ms. Adams, he stated his intent that his father receive a ten-year payout of his retirement benefits in the event of his untimely death, which he knew to be imminent. On or about November 18, 2002, after talking to the Human Resources staff and reviewing the FRS-11o form, Petitioner executed the form election, as attorney-in-fact for Ronald Bright, choosing Option 2 benefits for Ronald Bright, with Petitioner as beneficiary. Human Resources then sent the executed FRS-11o form, by facsimile, to the Division. The FRS-11o form executed by Petitioner as attorney- in-fact, on November 18 or 19, 2002, was invalid as a matter of law, pursuant to Section 709.08(3)(b), Florida Statutes (2001), because it was executed after the death of Ronald Bright. On December 26, 2002, Ronald Bright's application for disability benefits was approved and his effective retirement date was November 1, 2002. However, after Ronald Bright's application was approved, the Division determined that the FRS-11o form, was executed after the death of Ronald Bright and was, therefore, invalid. As a result, no continuing benefit under Option 2 was available. On February 4, 2003, the Division officially denied Petitioner's request for payment of the Option 2 retirement benefits of Ronald Bright. The Division receives many disability retirement applications from FRS members that contain the word "Urgent," due to the fact that these members have terminated employment and may have no income. Because of this, employees in the Division's Disability Determination Section process applications with the notation "Urgent," or similar language, like any other application. The Division has no rules or procedures that address or govern expediency in processing disability applications where an FRS member is terminally ill. However, when the Division is notified by telephone, either by a member, a member's family, or an employer that an applicant is terminal and has only a short time to live, the Division's Disability Determination Section's practice is to process that application out-of-order. Because of the Division's practice of disregarding written notations indicating that a particular application is urgent, when the disability retirement application of Ronald Bright was faxed to the Division on October 31, 2002, and again on November 4, 2002, the Division took no special action regarding the application. Moreover, no special action was taken based on the physician's statement faxed to the Division on November 5, 2002, which noted that Ronald Bright was terminal. The Division is responsible for administering the provisions of Chapter 121, Florida Statutes (2001). In accordance with its duties, the Division, which has over 600,000 members, disseminates information handbooks and forms regarding retirement issues to members of the FRS. The Division also provides forms, information, handbooks, and training regarding retirement issues to governmental entities whose employees are a member of the Florida Retirement System. The Division also provides governmental employers with various publications, such as the Employer Handbook and various forms relative to retirement. The Employer Handbook was provided to and used by Brevard County. The introduction of the Employer Handbook contains the following on Page XIII: TO PAYROLL AND PERSONNEL OFFICERS You are the key link between the Division of Retirement and the employees of your organization to ensure that your employees receive information from the Division that informs them of their choices and rights under the Florida Retirement System (FRS) and that the permanent retirement records maintained by the Division are accurate, you must be thoroughly informed of FRS procedures. However, as agency representatives, you are not agents of the Division. The Division will be not be responsible for an erroneous information you may provide to members. Although the governmental employers are liaisons between the Division and FRS members, these entities are not considered agents of the Division.
Recommendation Based upon the foregoing findings of fact and conclusions of law, it is RECOMMENDED that the Division of Retirement issue a final order denying benefits to Petitioner under Option 2. DONE AND ENTERED this 30th day of January, 2004, in Tallahassee, Leon County, Florida. S CAROLYN S. HOLIFIELD 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 30th day of January, 2004. COPIES FURNISHED: Wayne L. Allen, Esquire Wayne L. Allen & Associates, P.A. 700 North Wickham Road, Suite 107 Melbourne, Florida 32935-8865 Thomas E. Wright, Esquire Department of Management Services Division of Retirement 4050 Esplanade Way, Suite 260 Tallahassee, Florida 32399-0950 Sarabeth Snuggs, Interim Director Division of Retirement Department of Management Services Cedars Executive Center, Building C 2639 North Monroe Street Tallahassee, Florida 32399-1560 Alberto Dominquez, General Counsel Department of Management Services 4050 Esplanade Way Tallahassee, Florida 32399-1560
