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Florida Administrative Code (Last Updated: April 18, 2024) |
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69. Department of Financial Services |
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69L. Division of Workers' Compensation |
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69L-10. Claim For Reimbursement Against The Special Disability Trust Fund |
1(1) Statements submitted to meet the proof requirement of this rule section and Section 15440.49(2)(f), F.S., 17shall be by deposition, as authorized by Section 25440.30, F.S., 27or by an original affidavit.
32(2) Except as provided in Section 38440.49(2)(f), F.S., 40the claimant shall submit the sworn statement of the employer showing that the employer had reached an informed conclusion prior to the occurrence of the subsequent injury or occupational disease that the employee’s pre-existing condition was permanent and was, or was likely to be, a hindrance or obstacle to employment. The employer’s statement must fully explain the factual conditions under which the informed conclusion was made and further fully explain how the employer believed the pre-existing permanent condition was, or was likely to be, a hindrance or an obstacle to employment. The claimant shall support this statement with appropriate documentation, when possible.
142(3) For those conditions or instances specified in Section 151440.49(2)(f)1., F.S., 153giving rise to the conclusive presumption, the claimant shall submit the sworn statement of the employer showing that the employer had knowledge of the condition prior to the occurrence of the subsequent injury or occupational disease. The claimant shall support this statement with all available documentation.
199(4) Affidavits filed pursuant to this section shall include the following statement: “Under penalty of perjury, I declare that I have read the foregoing; that the facts as alleged are true, to the best of my knowledge and belief; and that a representative of the Special Disability Trust Fund is authorized to contact me to confirm the truthfulness of this statement.” The affidavit will also include the address and telephone number of the affiant. This requirement shall apply to affidavits or depositions taken after July 19, 1992. Before any contact is made with any person who has made a sworn knowledge statement by affidavit or deposition, the SDTF shall first provide notice to the claimant’s counsel of record that contact is desired.
321Specific Authority 323440.30, 324440.49(2)(f), 325440.591 FS. 327Law Implemented 329440.49(2), 330440.30 FS. 332History–New 4-19-92, Amended 8-18-93, Formerly 38F-10.011, 4L-10.011.
