Court upholds denial of man's mental health benefits claim

By Scott Holland | Apr 5, 2019

TALLAHASSEE — A Florida appeals panel has upheld the denial of mental health treatment as part of a worker’s compensation claim.

William Kneer hurt his back at work on June 30, 2014, leading to extensive surgery. In January 2016 doctors determined he’d reached maximum medical improvement, had a permanent 10-percent impairment and was given restrictions on his ability to lift, carry and stand.

In August 2017, Kneer filed a petition for benefits seeking psychological treatment for depression linked to the injury. Lincare and Travelers Insurance authorized treatment. 

In December 2017, Kneer filed another petition seeking temporary partial disability for his mental injury backdated to January 2016. Lincare and Travelers opposed that petition, saying the claim wasn’t supported by evidence in Kneer’s record and precluded by the state compensation law, which cuts off temporary benefits for psychiatric injuries six months after a claimant reaches maximum medical improvement (MMI).

Compensation Claims Judge Stephen Rosen sided with Lincare and Travelers. That prompted Kneer’s appeal, in which he said the state law is unconstitutional and that evidence supports his request for temporary partial disability.

Judge Timothy Osterhaus wrote the panel’s opinion, issued April 3. Judges James Wolf and Harvey Jay concurred.

“Under the system, injured workers can receive temporary disability benefits for mental injuries that accompany qualifying physical injuries for up to 260 weeks,” Osterhaus wrote. “But if the mental injury outlasts physical MMI, temporary benefits are payable for only six more months after reaching MMI (up to the 260-week maximum).”

The panel said Kneer could have qualified for the benefits he sought had his “psychiatric injury developed contemporaneously or closer in time with his physical injuries,” including for up to six months after reaching maximum medical improvement.

Osterhaus wrote that Kneer was wrong to rely on the 2016 Florida Supreme Court decision in Westphal v. City of St. Petersburg. Although the court there determined a man’s right of access to the courts was denied when the state indefinitely withheld disability benefits, it also recognized the idea of a tipping point, “when the diminution of workers’ compensation benefits — measured from the 1968 Constitution’s adoption of the right of access to courts — renders the workers’ compensation system unconstitutional.”

Unlike Westphal, Kneer has permanent benefits and also is able to work. Further, the psychiatric condition for which he sought additional benefits are not only devoid of work restrictions, but his “doctors think it’s in his best interest from a psychiatric perspective to return to work,” Osterhaus wrote.

The panel said the state has a legitimate interest in establishing time limits for benefits linked to psychiatric injuries, which led it to reject Kneer’s due process and equal protection challenges to the state compensation law.

With respect to Kneer’s contention about the facts of his medical record, the panel pointed to two different psychiatric evaluations showing the depression did not warrant a work restriction.

Representing Kneer were Dean Burnetti, of Lakeland, and Bill McCabe, of Longwood.

Representing Lincare and Travelers was Steven H. Preston of Jicks, Porter, Ebenfeld & Stein, P.A., of Miami.

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