Why did the Judge close a particular workers' compensation case? If a party disagrees with that decision, what is the appropriate method for voicing that disagreement?
The answer regarding "why" is generally a perception on the judge's part that all the pending issues have been resolved or adjudicated. That does not mean that issues may not remain outstanding, but for whatever reason those potential (outstanding) issues are perceived as perhaps not ripe for either a mediation or a hearing. Mediations and hearings are essentially what the Office of Judges of Compensation Claims (OJCC) does. The Florida OJCC is a litigation system. Thus, the dismissal of a petition for a surgical procedure may not mean that surgery is unnecessary. It may just mean that particular dispute is not in need of resolution today.
Certainly, there are ample opportunities for individuals involved in disputes to escape litigation through resolution, by negotiation or mediation. But, the purpose of this agency is disputes. It is noteworthy that the majority of workers' compensation claims in Florida are likely never in the OJCC system. The majority exist in an administrative environment where desires are expressed by doctors or patients, benefits are provided by employers or carriers, and there is no need for petitions, mediators, or judges.
Notices of injury are not even filed on all workers' compensation accidents. This reporting is only required for accidents that involve medical care beyond first aid, lost time from work, or death. See Rule 69L-56.401 F.A.C. Thus, many less-serious injuries are treated on-site and do not require a physician's intervention. These are referred to as "first aid cases."
Some are more serious (They involve injury reports to the Florida Division of Workers' Compensation, the provision of benefits by employers or their insurance carriers, etc.). These may be "medical only" or "lost time," but they remain in the administrative process. There are documents filed with the Division, but the provision of benefits nonetheless proceeds without petitions or formal dispute.
The Division publishes a System Guide to assist both employees and employers with understanding how that all works. According to the Workers' Compensation Claims Statistics Database, in 2018 there were 52,318 cases "for which a DWC-1, First Report of Injury or Illness was reported." The database will provide a variety of statistics for any set of selected parameters, time, type of accident, etc.
In 2018 only 30,470 "new cases" were filed with the Florida OJCC. Not all of them involved a date of accident or injury occurring in 2018. Some cases were filed on injuries that occurred in prior years. But, even if all of those 2018 "new cases" involved accidents that occurred that year, then only 58% (30,470/52,318) of those injuries that required the filing of a "First Report" were brought to the attention of the OJCC. That is only 58% became litigated. And, because this comparison of 2018 accidents to 2018 OJCC filings is imperfect, the 58% is likely an overstatement.
It is also worth noting that some of the 30,470 "new cases" that come to the OJCC each year are not filed because of benefit disputes. There are OJCC cases opened for approval of a settlement, for resolution of discovery disputes, or other ancillary issues. It is therefore likely, overall, that less than half of the accidents serious enough to require filing a "First Report" with the Division are actually ever litigated.
The law requires that petitions include only claims for benefits that are "ripe, due, and owing" at that time. Claims for benefits that may one day become due are premature. Section 440.192, Florida Statutes. So, when a petition for benefits is filed, the matter is scheduled for a mediation. This is the chance for the parties to negotiate an outcome that is likely not completely acceptable to either, but reasonable enough for each to accept as a compromise. If that process is unsuccessful, then there will be a final hearing. Either mediation or hearing can result in resolution of the various issues; by the same token, the parties are free to reach resolution of those issues at any point before trial.
Thus, a fair number of claims are dismissed. When the claims that have been filed are resolved, it will likely appear to the assigned Judge of Compensation Claims (JCC) that closure of the OJCC case is appropriate. That closure does not mean that all potential issues related to an accident have been dealt with, but that the current issues, the ripe issues, that were filed have been. The closure of the OJCC file is not an end to the case; an OJCC case can thereafter be opened again upon the filing of another petition or for further proceedings. Whether to re-activate a case is a decision within the discretion of the assigned judge. If a filing does not result in re-activation, a party could file a motion seeking that with the judge, Rule 60Q6.115.
The point of the closure order is two-fold. It informs the case's parties that the judge perceives there are no issues at that moment that require the OJCC services ("ripe," requiring mediation or trial). If that is a misperception, the parties are thus prompted to communicate with the JCC by filing a motion and moving the issues back onto the path for mediation or adjudication. Second, the closure allows the Judges and staff to focus on the other claims assigned to that division, and to work on solving other parties' claims, differences, and disagreements.
The appropriate reactions to a close order are therefore acknowledgment (received the close order, there are no pending issues, wait and contact the OJCC later if issues later arise), and objection (there are pending issues, the closure is a mistake, ask for reconsideration). But, there is no purpose served in asking a judge to re-open a case for a prospective, hypothetical, or speculative future need. That is, it is inappropriate to ask the assigned judge to keep the case "active" just in case some future dispute may arise.
It would be equally inappropriate for the OJCC to have a case file for each of the (at least) 42% of reported injuries/accidents that are never litigated. Those cases do not have ripe issues for judicial determination. There is no reason for this Office to have a file or case regarding each of them. When it is time for this Office to have a case, the parties will file a petition or motion. When the case is later closed, if further issues arise in the future, the filing of a new petition will similarly reopen the case. If a future dispute necessitates the case activation, then such reactivation will be appropriate. But there is no necessity or logic to the OJCC case remaining open and active in the meantime, just in case.
When a close order is received, it is not the end. It signals the current status perceived. If that is a misperception and adjudication is required, say so. If not, then there is no reason to object to the closure. The OJCC case can be re-activated when the need arises.
