Definitions, Procedures for Filing Documents, Electronic Filing of Workers' Compensation Forms, First Report of Injury or Illness: Claims-handling Entity's Responsibility to Record and Report Accidents, Notice of Action/Change, Notice of Denial, ...

 

DEPARTMENT OF FINANCIAL SERVICES

Division of Worker’s Compensation

RULE NOS.:RULE TITLES:

69L-3.002Definitions

69L-3.003Procedures for Filing Documents

69L-3.0033Electronic Filing of Workers' Compensation Forms

69L-3.0045First Report of Injury or Illness: Claims-handling Entity’s Responsibility to Record and Report Accidents

69L-3.0091 Notice of Action/Change

69L-3.012Notice of Denial

69L-3.016Claim Cost Report

69L-3.0193Supplemental Income Benefits (Dates of Accident January 1, 1994 through September 30, 2003)

69L-3.025Forms

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 40, No. 23, February 4, 2014 issue of the Florida Administrative Register.

Paragraph 69L-3.025(1)(n), F.A.C., lists and identifies the incorporated form DFS-F2-DWC-61, titled, “Informacion Importante De Seguro De Indemnizacion Por Accidentes De Trabajo Para Los Trabajadores De La Florida.”

Form DFS-F2-DWC-61, is revised to fully reflect the information contained in its English-language equivalent, form DFS-F2-DWC-60, titled, “Important Workers’ Compensation Information for Florida’s Workers.” The aforementioned change is made in response to comments received at a March 3, 2014 hearing on proposed amendments to Rule Chapter 69L-3, F.A.C. Also, the statement found under subsections 69L-3.003(7), 3.0045(3), 3.0091(14), 3.012(9) and 3.016(4), F.A.C., is changed to read as follows: This rule does not supersede Division filing requirements found in Rule Chapter 69L-56, F.A.C., and the filing requirements found herein only apply to circumstances under which a petition for variance or waiver has been granted, pursuant to section 120.542, F.S. Note: In lieu of repeating a general reference to Rule Chapter 69L-56, F.A.C., the aforementioned statement is modified to include references to the specific sections of Rule Chapter 69L-56, F.A.C., applicable to each subsection of Chapter 69L-3, F.A.C., that is listed above. This notice also includes technical changes made in response to written comments received from the Joint Administrative Procedures Committee concerning references to Rule Chapter 69L-56, F.A.C., and to North American Industry Classification System (NAICS), 2007 and 2012 Editions, incorporated by reference in subsection 69L-3.002(22), F.A.C. As a result, certain references to Rule Chapter 69L-56, F.A.C., are revised to reflect the specific applicable rule sections listed under the aforementioned rule chapter. Additionally, the website address providing access to the NAICS, 2007, 2012 Edition, materials, discussed above, has been revised.

 

69L-3.002 Definitions.

When used in this chapter, the following terms have the following meanings:

(1) though (11) No change.

(12) “Filing Period for Supplemental Income Benefits” means a period of 13 consecutive weeks (approximately 3 months) for which the employee reports any earnings and files a claim for supplemental income benefits. The filing period shall represent a “quarter” as set out in subparagraph Section 440.15(3)(b)7., F.S. (1994), which is incorporated herein by reference, except for the second filing period, which may consist of less than 13 weeks if the first payment period was pro-rated. The “initial filing period” is the filing period which occurs during the last 13 weeks of impairment income benefits.

(13) through (16) No change.

(17) “Initial Payment of Supplemental Income Benefits” means payment of supplemental income benefits for the first whole or partial calendar month immediately following the expiration of the impairment income benefit period. The initial payment of supplemental income benefits shall cover the time beginning with the day after the expiration of impairment income benefits and ending with the last date in the initial calendar month pursuant to Section 440.15, F.S. (1994), which is incorporated herein by reference.

(18) through (21) No change.

(22) “NAICS Code” means the 5 or 6-digit code published in the North American Industry Classification System (NAICS) 2007 and 2012 2002 Editions, hereby incorporated by reference, that represents the nature of the employer’s business. Classification information may be obtained by contacting the NAICS Association, 341 East James Circle, Sandy, Utah 84070, or visiting the website: https:/www.census.gov/eos/www/naics/ www.naics.com.

(23) through (28) No change.

 

69L-3.003 Procedures for Filing Documents.

(1) through (6) No change.

(7) This rule does not supersede Division filing requirements found in Rules 69L-56.301, 69L-56.304, 69L-56.3045, 69L-56.3012 and 69L-56.3013, F.A.C., and the filing requirements found herein only apply to circumstances under which a Petition for Variance or Waiver has been granted pursuant to Section 120.542, F.S.

 

69L-3.0033 Electronic Filing of Workers’ Compensation Forms.

Forms DFS-F2-DWC-1, DFS-F2-DWC-4, DFS-F2-DWC-12 and DFS-F2-DWC-13, as incorporated in Rule 69L-3.025, F.A.C., shall be may be alternatively reported to the Division using Electronic Data Interchange (EDI). Requirements for EDI reporting are located in Rules 69L-56.301, 69L-56.304, 56.3045, 69L-56.3012 and 69L-56.3013, F.A.C.

 

69L-3.0045 First Report of Injury or Illness: Claim Administrator’s Claims-Handling Entity Responsibility to Record and Report Accidents.

(1) through (2) No change.

(3) This rule does not supersede Division filing requirements found in Rule 69L-56.301, F.A.C., and the filing requirements found herein only apply to circumstances under which a Petition for Variance or Waiver has been granted pursuant to Section 120.542, F.S.

 

69L-3.0091 Notice of Action/Change.

The claim administrator claims-handling entity shall send Form DFS-F2-DWC-4, as adopted in Rule 69L-3.025, F.A.C., to the Division as specified in this section for any industrial accident or injury filed for lost time cases as defined in subsection 69L-3.0045(2), F.A.C., within 14 days of the claim administrator’s claims-handling entity knowledge of the action or change which it is reporting. The claim administrator claims-handling entity shall complete the applicable fields for each required Form DFS-F2-DWC-4; the “Remarks” section may only be used to supplement the information reported. The claim administrator claims-handling entity shall send to the employee and the employer copies of Form DFS-F2-DWC-4, for each action or change required by this section within 14 days of the claim administrator’s claims-handling entity knowledge of the action or change which it is reporting to the Division.

(1) through(13) No change.

(14) This rule does not supersede Division filing requirements found in Rules 69L-56.304 and 69L-56.3045, F.A.C., and the filing requirements found herein only apply to circumstances under which a Petition for Variance or Waiver has been granted pursuant to Section 120.542, F.S.

 

69L-3.012 Notice of Denial.

(1) through (8) No change.

(9) This rule does not supersede Division filing requirements found in Rule 69L-56.3012, F.A.C., and the filing requirements found herein only apply to circumstances under which a Petition for Variance or Waiver has been granted pursuant to Section 120.542, F.S.

 

69L-3.016 Claim Cost Report.

(1) through (3) No change.

(4) This rule does not supersede Division filing requirements found in Rule 69L-56.3013, F.A.C., and the filing requirements found herein only apply to circumstances under which a Petition for Variance or Waiver has been granted pursuant to Section 120.542, F.S.

 

69L-3.0193 Supplemental Income Benefits (Dates of Accident January 1, 1994 through September 30, 2003).

An employee may be eligible to receive Supplemental Income Benefits if an impairment rating of 20% or more has been assigned in accordance with paragraph Section 440.15(3)(b), F.S., (1994).

(1) through (2) No change.

(3) Payment of Supplemental Income Benefits:

(a) through (d) No change.

(e) The monthly supplemental income benefit payable shall not exceed the maximum weekly benefit amount as set out in subsection Section 440.12(2), F.S., multiplied by 4.3.

(4) through (7) No change.

 

69L-3.025 Forms.

(1) The following forms are to be used with this rule chapter and are hereby incorporated by reference:

(a) through (m) No change.

(n) Form DFS-F2-DWC-61 02/14 03/10 Informacion Importante De Seguro De Indemnizacion Por Accidentes De Trabajo Para Los Trabajadores De La Florida

(o) through (p) No change.

 

The remainder of the rules reads as previously published.