Case Title: Florida Birth-Related Neurological Injury Compensation Association v. Florida Division Of Amdinistrative Hearings, Et Al.

Citation: 

Docket Number: SC04-227

State: florida

Court: Florida Supreme Court

Date: 2007-01-11T00:00:00Z

Document:
Supreme Court of Florida 
 
 
____________ 
 
No. SC04-227 
____________ 
 
FLORIDA BIRTH-RELATED NEUROLOGICAL INJURY 
COMPENSATION ASSOCIATION, 
Petitioner, 
 
vs. 
 
FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS, et al., 
Respondents. 
 
____________ 
 
No. SC04-666 
____________ 
 
 
FLORIDA BIRTH-RELATED NEUROLOGICAL INJURY 
COMPENSATION ASSOCIATION, 
Petitioner, 
 
vs. 
 
MARIA FERGUSON, et al., 
Respondents. 
 
[January 11, 2007] 
 
BELL, J. 
In this consolidated case, we review two decisions of the Second District 
Court of Appeal: All Children’s Hospital, Inc. v. Department of Administrative 
Hearings, 863 So. 2d 450 (Fla. 2d DCA 2004), and Florida Birth-Related 
Neurological Injury Compensation Ass’n v. Ferguson, 869 So. 2d 686 (Fla. 2d 
DCA 2004).  In each case, the Second District certified conflict with decisions 
from the Third, Fourth, and Fifth District Courts of Appeal on an issue regarding 
the subject matter jurisdiction of administrative law judges under the Florida Birth-
Related Neurological Injury Compensation Act as found in sections 766.301 
through 766.316, Florida Statutes (1997 & Supp. 1998) (NICA).  See Univ. of 
Miami v. M.A., 793 So. 2d 999 (Fla. 3d DCA 2001); Gugelmin v. Div. of Admin. 
Hearings, 815 So. 2d 764 (Fla. 4th DCA 2002); Behan v. Fla. Birth-Related 
Neurological Injury Comp. Ass’n, 664 So. 2d 1173 (Fla. 4th DCA 1995); O’Leary 
v. Fla. Birth-Related Neurological Injury Comp. Ass’n, 757 So. 2d 624 (Fla. 5th 
DCA 2000).1
We frame the question in conflict as follows:  
Does an administrative law judge (ALJ), when considering a NICA 
claim, have jurisdiction to determine whether or not a health care 
provider has complied with the “notice to obstetrical patients of 
participation in the plan”  
as required by section 766.316?   
In the two cases before us, the Second District held that the NICA statute, as it 
existed prior to the 2003 amendment, did not give the ALJ any jurisdiction to 
                                          
 
1.  We have jurisdiction.  See art. V, § 3(b)(4), Fla. Const. 
 
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determine this notice issue.2  The Third, Fourth, and Fifth Districts had reached the 
opposite conclusion; and, subsequent to the Second District’s certification of 
conflict, the First District issued an opinion aligning itself with the Third, Fourth, 
and Fifth Districts.   See Tabb v. Fla. Birth-Related Neurological Injury Comp. 
Ass’n, 880 So. 2d 1253 (Fla. 1st DCA 2004).    
  As explained below, we hold that when notice is raised as part of a claim 
filed under NICA, an ALJ has jurisdiction to make findings regarding whether a 
health care provider has satisfied the “notice to obstetrical patients” requirement of 
section 766.316, Florida Statutes (Supp. 1998).  In light of this holding, we quash 
the Second District’s decision in All Children’s Hospital, Inc. and remand that case 
for further proceedings consistent with this opinion.  However, because the conflict 
question has become moot in Ferguson, we dismiss that case. 
I. FACTUAL AND PROCEDURAL BACKGROUND 
As stated, we have before us two decisions from the Second District.  In All 
Children’s Hospital, Inc., Christopher Glenn and Anna Glenn, now Anna Lentini, 
                                          
 
2.  However, in light of these statutory amendments, the Second District 
later reached the opposite conclusion.  In Weinstock v. Houvardas, 924 So. 2d 982 
(Fla. 2d DCA 2006), the Second District held that for claims made on or after 
September 15, 2003, an ALJ in a NICA proceeding has exclusive jurisdiction to 
determine whether the health care provider has given notice as required by section 
766.316.  This decision rested upon the 2003 amendments made to section 766.309 
by chapter 2003-416, section 77 at 89, Laws of Florida (2003), and the September 
15, 2003, effective date expressly provided for therein.  The pertinent language of 
these 2003 amendments, as well as an amendment in 2006, is provided in footnote 
18. 
 
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filed a civil suit in circuit court against All Children’s Hospital, Inc. (All 
Children’s) alleging that the medical malpractice of All Children’s neonatal nurses 
caused injuries to their newborn infant.  863 So. 2d at 452.3  In Ferguson, Maria 
and Garry Ferguson brought a similar suit in circuit court against Morton Plant 
Mease Health Care Hospital (Morton Plant) and nurse Lenore V. McCall, the 
certified nurse midwife, alleging medical malpractice in the delivery of their infant.  
869 So. 2d at  687. 
The relevant facts of each case are essentially the same.  In each case, the 
infant’s parents filed a medical malpractice suit against the health care provider 
who assisted in the delivery of the infant.4  The defending health care provider 
responded by raising the affirmative defense that the civil suit was brought in 
violation of NICA’s exclusive remedy provision, section 766.303(2), Florida 
Statutes (1997).  In each case, the respective circuit court abated the medical 
malpractice action and ordered the parents to file a claim for compensation under 
the injury compensation plan established by section 766.303, Florida Statutes (the 
                                          
 
3.  Courtney Ann Glenn was born on September 30, 1997, at Bayfront 
Medical Center.  All Children’s Hosp., Inc., 863 So. 2d at 452.  The neonatal 
nurses who assisted in the delivery and postdelivery resuscitation of Baby Glenn 
were provided to Bayfront Medical Center by All Children’s Hospital.  Id.   
 
4.  Baby Glenn’s family filed suit in circuit court on June 30, 1998, and their 
third amended complaint named only All Children’s Hospital as a defendant.  863 
So. 2d at 452.  The Fergusons filed suit on May 26, 1999.  
 
 
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NICA Plan).  Claims under the NICA Plan are heard and determined 
administratively as set forth in sections 766.301-.316. 
In each case, the parents complied with the circuit court’s order but did so 
under protest.  They filed NICA claims but alleged that the health care providers 
had not provided them with the notice required by section 766.316, Florida 
Statutes (Supp. 1998).  This statutorily mandated notice informs obstetrical 
patients of “the limited no-fault alternative for birth-related injuries” under the 
NICA Plan.  Specifically, section 766.316, entitled “Notice to obstetrical patients 
of participation in the plan,” provides: 
 
Each hospital with a participating physician on its staff and 
each participating physician, other than residents, assistant residents, 
and interns deemed to be participating physicians under s. 
766.314(4)(c), under the Florida Birth-Related Neurological Injury 
Compensation Plan shall provide notice to the obstetrical patients as 
to the limited no-fault alternative for birth-related neurological 
injuries.  Such notice shall be provided on forms furnished by the 
association and shall include a clear and concise explanation of a 
patient’s rights and limitations under the plan.  The hospital or the 
participating physician may elect to have the patient sign a form 
acknowledging receipt of the notice form.  Signature of the patient 
acknowledging receipt of the notice form raises a rebuttable 
presumption that the notice requirements of this section have been 
met.  Notice need not be given to a patient when the patient has an 
emergency medical condition as defined in s. 395.002(8)(b) or when 
notice is not practicable.  
If a health care provider complies with this notice provision, according to section 
766.303, compensation under the plan is the exclusive remedy for the covered 
injuries.   Therefore, in light of this allegation by the parents that the statutory 
 
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notice was not provided, the health care providers were allowed to intervene in the 
administrative proceedings. 
After an administrative hearing in each case, the ALJ found that the required 
notice was not provided.  Given this finding, the ALJ then ordered the parents to 
elect their remedy––either waive the notice issue and pursue an award under NICA 
or pursue the medical malpractice action in circuit court.  In both cases, the health 
care providers appealed the ALJ’s order to the Second District Court of Appeal.  
The Second District reversed the ALJ’s orders because it determined that NICA 
did not give the ALJ jurisdiction to make findings regarding notice.   
The procedural history of the two cases varied on appeal.  All Children’s 
Hospital, Inc. was the first case decided by the Second District.  863 So. 2d 450.  
All Children’s sought to challenge the substance of the ALJ’s findings regarding 
notice.  The Second District never reached this substantive claim.  Instead, as 
stated above, it held that NICA does not give an ALJ jurisdiction to make findings 
regarding notice.   Specifically, the Second District wrote: 
 
On appeal, All Children’s contends the ALJ erred in 
determining that its immunity from suit under NICA was dependent 
on notice from both the mother’s obstetrician and Bayfront.  We 
decline to reach that issue, because we conclude that, under the 
governing statutory language, the ALJ’s jurisdiction was restricted to 
determining whether the claim was covered by NICA and did not 
extend to the issue of whether a provider is entitled to invoke the 
exclusive remedy provision of the statute.
All Children’s Hosp., Inc., 863 So. 2d at 454. 
 
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Ferguson was decided next by the Second District.  869 So. 2d 686.  In 
Ferguson, the Florida Birth-Related Neurological Injury Compensation  
Association (the Association) 5 and Morton Plant appealed the ALJ’s order.  Before 
oral argument, the Fergusons and Morton Plant notified the Association and the 
Second District that they had entered into a settlement agreement.  The case 
proceeded, however,6 and in accord with All Children’s Hospital Inc., the Second 
District again held that the ALJ did not have jurisdiction to make findings 
regarding notice.  Id. at 688-89.  
The Association requested that this Court review the decisions of the Second 
District and resolve the certified conflict.   
II.  ANALYSIS  
                                          
 
5.  As explained below, NICA claims are initially filed with the Association, 
the administrator of the NICA Plan.  The Association makes an initial 
recommendation on whether the claim is compensable.  See § 766.302(1), Fla. 
Stat. (1997); §§ 766.305, .308, .315, Fla. Stat. (Supp. 1998).  The Association’s 
recommendation on Baby Ferguson’s injuries was that they were compensable 
under the NICA Plan.  The Association joined Morton Plant in its appeal when the 
ALJ failed to consider whether the claim was compensable.  To the contrary, the 
Association’s recommendation as to Baby Glenn’s injuries was that they were not 
compensable, and, therefore, the Association did not join All Children’s in its 
appeal of the ALJ’s order to the Second District. 
 
6.  The Fergusons unsuccessfully argued that the Association lacked 
standing to continue with its appeal.  See Ferguson, 869 So. 2d at 689. 
   
 
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Again, the issue in conflict is whether an ALJ, when considering a NICA 
claim, has jurisdiction to determine if a health care provider has complied with the 
“notice to obstetrical patients” required by section 766.316.  Because resolving this 
conflict requires the interpretation of a statute, our standard of review is de novo.  
B.Y. v. Dep’t of Children & Families, 887 So. 2d 1253, 1255 (Fla. 2004).  As 
previously stated, we conclude that when a health care provider’s compliance with 
the notice requirement of section 766.316 is raised as an issue in a NICA claim, an 
ALJ has jurisdiction to make this determination. 
To resolve the conflict question, we will (1) contextualize the certified 
conflict by briefly outlining the purpose, structure, and relevant provisions of 
NICA as they existed in 1998; (2) summarize the analytical basis for the conflict 
between the district courts of appeal; and (3) set forth the statutory analysis we find 
most appropriate.  We do this in the context of All Children’s Hospital, Inc. 
because Ferguson is moot. 
A.  Ferguson
The issue raised in Ferguson is now moot; therefore, we dismiss the 
Association’s petition for review.  “An issue is moot when the controversy has 
been so fully resolved that a judicial determination can have no actual effect.”  
Godwin v. State, 593 So. 2d 211, 212 (Fla. 1992).  The Fergusons waived their 
challenge to the adequacy of the hospital’s notice and agreed to accept an award 
 
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under NICA.7  Thus, our holding regarding the ALJ’s jurisdiction under NICA will 
have no bearing on the Fergusons’ case.  Accordingly, the Association’s petition 
for review as to the Ferguson case is hereby dismissed.8   
B.  All Children’s Hospital
1. The Purpose and Structure of NICA 
 
NICA was enacted in 1988 to address the adverse impact that the high cost 
of medical malpractice insurance premiums was having on the delivery of obstetric 
services in Florida.  See § 766.301, Fla. Stat. (Supp. 1998).  In NICA, the 
Legislature established the NICA Plan, § 766.302(8), Fla. Stat. (1997), “for the 
purpose of providing compensation, irrespective of fault, for birth-related 
neurological injury claims.”  § 766.303(1), Fla. Stat. (1997).  The NICA Plan is 
administered by the Association.9
                                          
 
7.  The Association has stipulated that the Fergusons’ claim is compensable.  
Although both the Association and Morton Plant initially appealed, Morton Plant 
settled with the Fergusons prior to oral argument before the Second District.  
Morton Plant and the Fergusons voluntarily dismissed their appeal and cross-
appeal, respectively, and the Fergusons notified the Second District and NICA of 
their intent to accept a NICA award.  The record is not clear whether the other 
defendant, nurse McCall, has also settled with the Fergusons, but she did not join 
in the appeal below or in this proceeding.  
 
8.  Although the Association has stipulated that the Fergusons’ claim is 
compensable, the ALJ has not made any findings regarding the compensability of 
the claim.   
 
9.  See § 766.302 (1), Fla. Stat. (1997); see also §§ 766.314-.315, Fla. Stat. 
(Supp. 1998) (detailing Plan funding and Association Board of Directors). 
 
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When an infant suffers what may be a birth-related neurological injury,10 
NICA provides that the claimant (usually the infant’s parent)11 must file a claim for 
compensation under the NICA Plan with the Association.  § 766.305, Fla. Stat. 
(Supp. 1998).12  The claim is then reviewed by a medical advisory panel.  The 
panel makes a written recommendation as to whether the claim is compensable 
under the NICA Plan.  § 766.308, Fla. Stat. (Supp. 1998).  After the panel makes 
its recommendation, the claim is then heard and determined in an administrative 
hearing before an ALJ.  § 766.307, Fla. Stat. (1997).13  The ALJ must consider, but 
                                                                                                                                        
 
10.  A “birth-related neurological injury” is defined as an 
 
injury to the brain or spinal cord of a live infant weighing at least 
2,500 grams at birth caused by oxygen deprivation or mechanical 
injury occurring in the course of labor, delivery, or resuscitation in the 
immediate postdelivery period in a hospital, which renders the infant 
permanently and substantially mentally and physically impaired. 
§ 766.302(2), Fla. Stat. (1997). 
11.  “Claimant” is defined in applicable part as “any person who files a 
claim pursuant to s. 766.305 for compensation for a birth-related neurological 
injury to an infant.  Such a claim may be filed by any legal representative on behalf 
of an injured infant.”  § 766.302(3), Fla. Stat. (1997).  
  
 
12.  The statute of limitations for any civil action that might otherwise be 
brought for the injury is tolled by the filing of a NICA claim.  See section 766.306, 
Fla. Stat. (1997). 
 
13.  See § 766.301(1)(d), Fla. Stat. (Supp. 1998) (“The issue of whether such 
claims are covered by this act must be determined exclusively in an administrative 
proceeding.”); § 766.304, Fla. Stat. (1997) (“The [ALJ] shall hear and determine 
all claims filed pursuant to ss. 766.301-766.316.”). 
 
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is not bound by, the recommendation of the medical advisory panel.  § 766.308(1), 
Fla. Stat. (Supp. 1998). 
 
Under the 1998 version of NICA, the ALJ is expressly required to make 
three independent findings “based upon all available evidence.”  § 766.309(1), Fla. 
Stat. (1997).  First, the ALJ must determine whether the claim is a birth-related 
neurological injury.  § 766.309(1)(a), Fla. Stat. (1997).  Second, the ALJ must 
determine whether the injury was caused by a participating health care provider, as 
defined in section 766.302(7).  § 766.309(1)(b), Fla. Stat.  Finally, if the first and 
second requirements are met, the ALJ must determine the amount of the award 
without any regard for fault.  §§ 766.309(1)(c), 766.31(1), Fla. Stat. (1997).   
If the ALJ determines that a claim is compensable, compensation under the 
NICA Plan becomes the claimant’s exclusive remedy.  See § 766.303(2), Fla. Stat. 
(1997) (“The rights and remedies granted by this plan . . . shall exclude all other 
rights and remedies of such infant . . . at common law or otherwise, against any 
person or entity directly involved with the labor, delivery, or immediate 
postdelivery resuscitation during which such injury occurs.”).  A claimant may not 
bring or maintain a civil suit in violation of NICA’s exclusive remedy provision.  § 
766.304, Fla. Stat. (Supp. 1998).  (“[N]o civil action may be brought or continued 
in violation of the exclusiveness of remedy provisions of s. 766.303.”).  If the 
claim is ultimately determined to be compensable, NICA’s exclusive remedy 
 
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provision shields participating health care providers from a civil tort action based 
upon the same claim.  See § 766.302(6)-(7), Fla. Stat. (1997).   
However, as previously determined by this Court, there is a condition 
precedent to NICA’s exclusivity.  Predelivery notice of the health care provider’s 
participation in the NICA Plan must be given as required by section 766.316.  See 
Galen of Fla., Inc. v. Braniff, 696 So. 2d 308, 309-10 (Fla. 1997) (“[T]he only 
logical reading of the statute is that before an obstetrical patient’s remedy is limited 
by the NICA plan, the patient must be given pre-delivery notice of the health care 
provider’s participation in the plan. . . .  [T]he purpose of the notice is to give an 
obstetrical patient an opportunity to make an informed choice between using a 
health care provider participating in the NICA plan or using a provider who is not a 
participant and thereby preserving her civil remedies.”).  Section 766.316 provides 
that, except in the case of emergency or impracticability, a participating health care 
provider is required to furnish each obstetrical patient with notice that the NICA 
Plan’s “limited no-fault alternative for birth-related neurological injuries” may be 
the patient’s exclusive remedy or means of receiving compensation for those 
injuries.  This notice must be made using a form provided by the Association. 
2. The Analytical Basis of the Conflict Question 
 
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In both All Children’s Hospital, Inc. and Ferguson, the Second District 
certified conflict with O’Leary, M.A., and Behan.  The conflict is based on 
divergent views over the scope of the ALJ’s duties in the NICA claims process. 14
The Second District held that “[t]here is nothing in section 766.309 or 
elsewhere in NICA that gives the ALJ any responsibility or authority to determine 
 . . . that notice under section 766.316 was or was not properly given.”  All 
Children’s Hosp., Inc., 863 So. 2d at 456.15   In essence, the Second District 
viewed the ALJ’s subject matter jurisdiction as limited to making the three 
determinations mandated by section 766.309(1).  Under the 1998 statute, the three 
                                          
 
14.  In addition in Ferguson, the Second District certified conflict with the 
Fourth District’s opinion in Gugelmin on the conflict question.  815 So. 2d at 764.  
However, because Ferguson is moot and because the Second District did not 
certify conflict with Gugelmin in All Children’s Hospital, Inc., we do not address 
Gugelmin in resolving this conflict.  In Gugelmin, the Fourth District held that an 
ALJ may make findings of fact regarding whether notice was provided as required 
by section 766.316, but the ALJ cannot comment upon the legal effect of these 
findings on the claimant’s common law remedies and, in turn, the health care 
provider’s right to immunity from tort by requiring the claimant to make an 
election of remedies.  815 So. 2d at 768.  The Second District may not have 
certified conflict with Gugelmin in All Children’s Hospital, Inc. because of its 
reliance on Gugelmin.  The Second District cites Gugelmin for the proposition that 
“this court is authorized to set aside or modify a final administrative order, if there 
has been an erroneous interpretation of NICA or the ALJ has exceeded the scope 
of his authority.”  All Children’s Hosp., Inc., 863 So. 2d at 454 (citing Gugelmin, 
815 So. 2d at 767).    
 
15.  The Second District reiterated this holding in Florida Health Sciences 
Center, Inc., v. Division of Administrative Hearings, 871 So. 2d 1062, 1065 (Fla. 
2d DCA 2004) (“No part of the NICA statute confers on the ALJ any authority to 
determine issues related to notice.”). 
 
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determinations mandated by section 766.309(1) were (a) whether the injury 
claimed is a birth-related neurological injury; (b) whether the obstetrical services 
were delivered by a health care provider that participates in the NICA Plan; and (c) 
the amount of any compensation.  According to the Second District, since the 
ALJ’s jurisdiction was limited to these three tasks (which it viewed as related 
solely to whether an injury is compensable under NICA and, if so, the amount of 
compensation), the ALJ had no authority to determine anything related to notice.  
In other words, the Second District reasoned that instead of being relevant to 
compensability, notice is relevant solely to whether the NICA Plan is the exclusive 
remedy for the covered injuries. 
The other district courts of appeal took a broader view of the ALJ’s subject 
matter jurisdiction.  Each of these courts found jurisdiction in other provisions of 
the NICA statutory scheme, outside of section 766.309(1).  The Fifth District was 
the first to do so in O’Leary, 757 So. 2d 624.  That court held that the ALJ has 
exclusive jurisdiction to make findings regarding whether the notice provided for 
by section 766.316 was either given or excused.  Id. at 627.  The Fifth District 
based its holding largely upon its analysis of three 1998 amendments to the NICA 
statute.  Id. at 626-27.  According to the Fifth District, these amendments were 
made in response to this Court’s decisions in Florida Birth-Related Neurological 
Injury Compensation Ass’n v. McKaughan, 668 So. 2d 974 (Fla. 1996), and Galen 
 
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of Florida, Inc. v. Braniff, 696 So. 2d 308 (Fla. 1997).  O’Leary, 757 So. 2d at 627.  
Specifically, the Fifth District viewed the 1998 amendments as indicating the 
Legislature’s intent to authorize the ALJ to make all determinations regarding a 
claim under NICA.  Id. at 627-28.  In reaching this conclusion, the Fifth District 
first presented the language of the 1998 amendments as follows: 
In 1998, after the McKaughan and Braniff decisions, the 
legislature, in chapter 98-113, amended sections 766.301, 766.304, 
and 766.316, as follows: 
. . . . 
Be It Enacted by the Legislature of the State of Florida: 
Section 1.  Paragraph (d) of subsection (1) of Section 
766.301, Florida Statutes, is amended to read: 
766.301 Legislative findings and intent.–– 
(1) The Legislature makes the following findings: 
(d) The costs of birth-related neurological injury claims 
are particularly high and warrant the establishment of a 
limited system of compensation irrespective of fault.  The 
issue of whether such claims are covered by this act must 
be determined exclusively in an administrative 
proceeding.  
Section 2.  Section 766.304, Florida Statutes, is amended 
to read: 
766.304 Administrative law judge to determine 
claims.–– 
The administrative law judge shall hear and determine all 
claims filed pursuant to ss. 766.301-766.316 and shall 
exercise the full power and authority granted to her or 
him in chapter 120, as necessary, to carry out the 
purposes of such sections.  The administrative law judge 
has exclusive jurisdiction to determine whether a claim 
 
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filed under this act is compensable.  No civil action may 
be brought until the determinations under s. 766.309 have 
been made by the administrative law judge.  If the 
administrative law judge determines that the claimant is 
entitled to compensation from the association, no civil 
action may be brought or continued in violation of the 
exclusiveness of remedy provisions of s. 766.303.  If it is 
determined that a claim filed under this act is not 
compensable, the doctrine of neither collateral estoppel 
nor res judicata shall prohibit the claimant from pursuing 
any and all civil remedies available under common law 
and statutory law.  The findings of fact and conclusions 
of law of the administrative law judge shall not be 
admissible in any subsequent proceeding; however, the 
sworn testimony of any person and the exhibits 
introduced into evidence in the administrative case are 
admissible as impeachment in any subsequent civil action 
only against a party to the administrative proceeding, 
subject to the Rules of Evidence.  An action may not be 
brought under ss. 766.301-766.316 if the claimant 
recovers or final judgment is entered.  The division may 
adopt rules to promote the efficient administration of, and 
to minimize the cost associated with, the prosecution of 
claims. 
Section 4.  Section 766.316, Florida Statutes, is amended 
to read: 
766.316 Notice to obstetrical patients of participation 
in the plan.–– 
Each hospital with a participating physician on its staff 
and each participating physician, other than residents, 
assistant residents, and interns deemed to be participating 
physicians under s. 766.314(4)(c), under the Florida 
Birth-Related Neurological Injury Compensation Plan 
shall provide notice to the obstetrical patients thereof as 
to the limited no-fault alternative for birth-related 
neurological injuries.  Such notice shall be provided on 
forms furnished by the association and shall include a 
clear and concise explanation of a patient’s rights and 
 
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limitations under the plan.  The hospital or the 
participating physician may elect to have the patient sign 
a form acknowledging receipt of the notice form.  
Signature of the patient acknowledging receipt of the 
notice form raises a rebuttable presumption that the 
notice requirements of this section have been met.  
Notice need not be given to a patient when the patient has 
an emergency medical condition as defined in s. 
395.002(8)(b) or when notice is not practicable.
Section 6.  The amendments to sections 766.301 and 
766.304, Florida Statutes, shall take effect July 1, 1998, 
and shall apply only to claims filed on or after that date 
and to that extent shall apply retroactively regardless of 
the date of birth. 
Section 7.  Amendments to section 766.316, Florida 
Statutes, shall take effect July 1, 1998, and shall apply 
only to causes of action accruing on or after that date. 
O’Leary, 757 So. 2d at 626-27. 
The Fifth District then interpreted the applicability of these 1998 
amendments to the conflict question by stating: 
The language used by the legislature in its amendment to the 
Act indicates that the administrative judge is to determine all matters 
relative to a claim.  Notably, the determination of the adequacy of 
notice is not excluded from the duties of the administrative law judge.  
Section 766.304 states that the administrative law judge shall hear all 
claims and shall exercise the full power and authority granted that is 
necessary to carry out the purposes of the section.  The section further 
grants exclusive jurisdiction to the administrative law judge to 
determine whether a claim is compensable and precludes any civil 
action until the issue of compensability is determined.  We believe 
that under these amendments, any issue raising the immunity of a 
health provider, including the issue of whether the health provider 
satisfied the notice requirements of the Plan is an issue to be decided 
by the administrative law judge as one which relates to the question of 
whether the claim is compensable under the Plan.  We recognize that 
 
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lack of proper notice does not affect a claimant’s ability to obtain 
compensation from the Plan.  However, a health provider who 
disputes a plaintiff’s assertion of inadequate notice is raising the issue 
of whether a claim can only be compensated under the plan.  All 
questions of compensability, including those which arise regarding the 
adequacy of notice, are properly decided in the administrative forum. 
Our conclusion that the administrative forum is the intended 
exclusive forum to determine the notice question eliminates the “ping-
pong effect,” that is, the trial court and the administrative law judge 
each throwing the case back to the other on this question.  We also 
note that a section 766.316 notice issue is peculiar to a NICA claim.  
The 766.316 notice is not applicable to a common law tort or contract 
action.  We also believe that it is economical and practicable to both 
the litigants and judicial system to have all NICA issues determined 
by one tribunal. 
Id. at 627-28. 
 
This interpretation by the Fifth District in O’Leary was substantially 
followed by the First and Third Districts.16  However, the Second District expressly 
                                          
 
16.  The Fourth District’s decisions in Behan and Gugelmin are also, in large 
part, aligned with the First, Third, and Fifth Districts’ holdings that an ALJ has 
jurisdiction under NICA to determine whether notice was adequately provided.  
However, Behan rests upon a nuance that the First District takes into account but 
that is not considered by the other decisions.  The Fourth District decided Behan in 
1995, before this Court issued its decision in McKaughan, a decision later 
abrogated by the Legislature as noted by the Fifth District in O’Leary.  In Behan, 
the Fourth District held that an ALJ must determine whether notice is adequate 
pursuant to section 766.316 before exercising jurisdiction to make any 
determination with regard to a claim under NICA.  664 So. 2d at 1174.  The First 
District in Tabb cites a similar rationale for finding that an ALJ has exclusive 
jurisdiction over notice issues.  880 So. 2d at 1256-57 (“In order to ‘hear and 
determine’ a claim, an ALJ must, almost of necessity, decide whether notice was 
given, because if no notice was given, the exclusivity provision of the statute does 
not apply. . . . As established law provides, an ALJ must have jurisdiction to 
determine whether the ALJ has jurisdiction.”) (citations omitted); see discussion of 
Judge Kahn’s analysis in part II.B.3, infra.  
 
- 18 -
considered and rejected this analysis in All Children’s Hospital, Inc.  Though it 
agreed that “[s]ince the adoption of the 1998 amendments, NICA is very clear that 
the determination of whether an injury is compensable is exclusively within the 
province of the ALJ,” it found that “[n]othing in the 1998 amendments to NICA 
did anything to extend the jurisdiction of the ALJ to the issues of notice and 
immunity from tort liablility.”  All Children’s Hosp., Inc., 863 So. 2d at 455-56.  
Instead, the Second District found that “[t]he issue of immunity from tort liability 
and the related issue of notice are an entirely different matter” from whether an 
injury is compensable under NICA.  Id. at 456.   
                       3. Resolving the Conflict Question 
Again, the narrow question we must resolve is whether the 1998 version of 
NICA gives the ALJ jurisdiction to determine if the notice mandated by section 
766.316 was provided.  As previously stated, we disagree with the Second 
District’s holding that “[t]here is nothing in section 766.309 or elsewhere in NICA 
that gives the ALJ any responsibility or authority to determine . . . that notice under 
section 766.316 was or was not properly given.”  All Children’s Hosp., Inc., 863 
So. 2d at 456.  Instead, we agree with Judge Kahn’s analysis of this question in 
Tabb, 880 So. 2d 1253, where he wrote: 
 
- 19 -
 
The ALJ’s authority derives from section 766.304, Florida 
Statutes (2001):17
The administrative law judge shall hear and determine all 
claims filed pursuant to ss. 766.301-766.316 and shall 
exercise the full power and authority granted to her or 
him in chapter 120, as necessary to carry out the purposes 
of such sections.  The administrative law judge has 
exclusive jurisdiction to determine whether a claim filed 
under this act is compensable.  No civil action may be 
brought until the determinations under s. 766.309 have 
been made by the administrative law judge.  If the 
administrative law judge determines that the claimant is 
entitled to compensation from the association, no civil 
action may be brought or continued in violation of the 
exclusiveness of remedy provisions of s. 766.303.  If it is 
determined that a claim filed under this act is not 
compensable, neither the doctrine of collateral estoppel 
nor res judicata shall prohibit the claimant from pursuing 
any and all civil remedies available under common law 
and statutory law . . . .  
(emphasis added).  In order to “hear and determine” a claim, an ALJ 
must, almost of necessity, decide whether notice was given, because if 
no notice was given, the exclusivity provision of the statute does not 
apply.  See § 766.316, Fla. Stat. (2001); Galen, 696 So. 2d at 310-11.  
Further, an ALJ has “exclusive jurisdiction” to determine whether a 
claim is compensable under the NICA Plan.  In the absence of notice, 
the Plan does not apply.  Given these provisions, we are led to 
conclude that an ALJ has jurisdiction to determine whether notice was 
given.  As established law provides, an ALJ must have jurisdiction to 
determine whether the ALJ has jurisdiction.  See, e.g., Sun Ins. Co. v. 
Boyd, 105 So. 2d 574, 575 (Fla. 1958) (explaining that “a tribunal 
always has jurisdiction to determine its own jurisdiction”). 
Notably, in 2003, the Legislature amended the NICA statute to 
add section 766.309(4), Florida Statutes: 
                                          
 
17.  The 1998 and 2001 versions of section 766.304 are identical. 
 
- 20 -
If it is in the interest of judicial economy or if requested 
to by the claimant, the administrative law judge may 
bifurcate the proceeding addressing compensability and 
notice pursuant to s. 766.316 first, and addressing an 
award pursuant to s. 766.31, if any, in a separate 
proceeding.  The administrative law judge may issue a 
final order on compensability and notice which is subject 
to appeal under s. 766.311, prior to issuance of an award 
pursuant to s. 766.31. 
Ch. 03-416, § 77, at 4117, Laws of Fla.  In passing the amendment, 
the Legislature implicitly acknowledged the existing case law 
indicating that an ALJ has jurisdiction to determine whether notice 
was provided pursuant to section 766.316.  See generally, e.g., City of 
Hollywood v. Lombardi, 770 So. 2d 1196, 1202 (Fla. 2000) 
(explaining that the Legislature is presumed to know the judicial 
construction of a law when passing a new version of the law and to 
have adopted the prior judicial construction unless a contrary intent is 
expressed). 
Other district courts of appeal had, before 2003, indicated that 
an ALJ has jurisdiction to determine whether the notice requirement 
was satisfied in a particular case.  See O’Leary v. Fla. Birth-Related 
Neurological Injury Comp. Ass’n, 757 So. 2d 624, 627 (Fla. 5th DCA 
2000) (“The language used by the legislature in its amendment to the 
Act indicates that the administrative judge is to determine all matters 
relative to a claim.  Notably, the determination of the adequacy of 
notice is not excluded from the duties of the administrative law 
judge . . . . [A]ny issue raising the immunity of a health provider, 
including the issue of whether the health provider satisfied the notice 
requirements of the Plan is an issue to be decided by the 
administrative law judge as one which relates to the question of 
whether the claim is compensable under the Plan.”); Univ. of Miami 
v. M.A., 793 So. 2d 999 (Fla. 3d DCA 2001) (adopting decision in 
O’Leary ).  See also Gugelmin v. Div. of Admin. Hearings, 815 So. 
2d 764 (Fla. 4th DCA 2002); Behan v. Fla. Birth-Related 
Neurological Injury Comp. Ass’n, 664 So. 2d 1173 (Fla. 4th DCA 
1995). 
Tabb, 880 So. 2d at 1256-57. 
 
- 21 -
Given our agreement with this analysis of NICA in Tabb, we hold that when 
notice is raised as part of a claim filed under NICA, an ALJ has jurisdiction to 
make findings regarding whether a health care provider has satisfied the notice 
requirements of section 766.316, Florida Statutes.18   
                                          
 
18.  Our resolution of the conflict question is based upon the language of the 
NICA statute as it existed in 1998.  However, for the sake of completeness, we 
note that our resolution is supported by the 2003 and 2006 amendments to section 
766.309.   
In 2003, section 766.309 was amended to add subsection (4) which states, in 
applicable part, that “[t]he administrative law judge may issue a final order on 
compensability and notice which is subject to appeal under s. 766.311, prior to 
issuance of an award pursuant to s. 766.31.”  When the Second District decided 
Ferguson, it stated that it had no opinion as to whether the 2003 amendment 
addressed the issue of whether an ALJ has jurisdiction over notice issues under 
NICA.  869 So.2d at 690 n.2.  However, as we noted earlier in footnote 2, the 
Second District subsequently held that an ALJ has exclusive jurisdiction over 
notice issues involving NICA claims made on or after September 15, 2003, the 
effective date of the 2003 amendments.  See Weinstock,  924 So. 2d at 984. 
Most recently, on May 2, 2006, chapter 2006-8, Laws of Florida, became 
law.  Chapter 2006-8 added subsection (d) to section 766.309(1) as follows:  
 
 
(1) The administrative law judge shall make the following 
determinations based upon all available evidence: 
 
(d) Whether, if raised by the claimant or other party, the factual 
determinations regarding the notice requirements in s. 766.316 are 
satisfied.  The administrative law judge has the exclusive jurisdiction 
to make these factual determinations. 
Ch. 2006-8, § 1, at 194, Laws of Fla.  Section 2 states that this amendment 
“clarifies that since July 1, 1998, the administrative law judge has had the 
exclusive jurisdiction to make factual determinations as to whether the notice 
requirements in s. 766.316, Florida Statutes, are satisfied.”  Ch. 2006-8, § 2, at 194, 
Laws of Fla.   
 
 
- 22 -
III.  CONCLUSION 
In conclusion, when the issue of whether notice was adequately provided 
pursuant to section 766.316 is raised in a NICA claim, we conclude that the ALJ 
has jurisdiction to determine whether the health care provider complied with the 
requirements of section 766.316.  Therefore, we quash the Second District’s 
decision in All Children’s Hospital, and remand for further findings consistent with 
this opinion.  We dismiss the petition to review Ferguson as moot.   
It is so ordered.     
WELLS, QUINCE, and CANTERO, JJ., concur. 
LEWIS, C.J., dissents with an opinion, in which ANSTEAD and PARIENTE, JJ., 
concur. 
ANSTEAD, J., dissents with an opinion, in which LEWIS, C.J., concurs. 
PARIENTE, J., dissents with an opinion, in which LEWIS, C.J., and ANSTEAD, 
J., concurs. 
 
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION, AND 
IF FILED, DETERMINED. 
 
 
LEWIS, C.J., dissenting. 
I dissent from the majority’s conclusion that the ALJ possessed jurisdiction 
to determine whether the notice mandated by section 766.316 of the Florida 
Statutes was provided in this case.  Rather, I would conclude that the Second 
District’s decision in All Children’s Hospital, Inc. v. Department of Administrative 
Hearings, 863 So. 2d 450 (Fla. 2d DCA 2004), holding that “[i]t is the circuit court 
which must address th[is] issue[] in deciding whether a civil action will be allowed 
 
- 23 -
to proceed in the circuit court,” should be approved.  Id. at 457 (emphasis 
supplied). 
In interpreting the jurisdiction of the circuit court to determine notice under 
NICA, this Court should look to the workers’ compensation system for guidance, 
as it has so often in the past.  See, e.g., Fla. Birth-Related Neurological Injury 
Compensation Ass’n v. McKaughan, 668 So. 2d 974, 979 (Fla. 1996) (“[B]ecause 
both the [NICA] Plan and the workers’ compensation system possess common 
purposes and characteristics and are aimed at accomplishing similar results, albeit 
in different contexts, we may regard and construe them in pari materia.”).  This 
Court has previously determined that “because the [NICA] Plan, like the Workers’ 
Compensation Act, is a statutory substitute for common law rights and liabilities, it 
should be strictly construed to include only those subjects clearly embraced within 
its terms.”  Fla. Birth-Related Neurological Injury Compensation Ass’n v. Fla. Div. 
of Admin. Hearings, 686 So. 2d 1349, 1354 (Fla. 1997) [hereinafter DOAH] 
(emphasis supplied) (quoting Humana of Fla., Inc. v. McKaughan, 652 So. 2d 852, 
859 (Fla. 2d DCA 1995), approved sub nom. Fla. Birth-Related Neuro. Injury 
Comp. Ass’n v. McKaughan, 668 So. 2d 974 (Fla. 1996)).  Under the version of 
NICA that is applicable in the instant case, the ALJ possesses exclusive 
jurisdiction solely to determine whether a claim is compensable under NICA.  See 
§ 766.301, Fla. Stat. (Supp. 1998) (“The issue of whether such claims are covered 
 
- 24 -
by this act must be determined exclusively in an administrative proceeding.”).  
Under the specific language of NICA, a determination of compensability entails 
assessing:  (1) whether the injury claimed is a birth-related neurological injury; (2) 
whether obstetrical services were delivered by a NICA participating physician; and 
(3) how much compensation should be awarded.  See § 766.309, Fla. Stat. (1997).   
There is no mention whatsoever of notice in the version of section 766.309 that is 
applicable to the instant case.  Since notice is not expressly listed as one of the 
issues that the ALJ must determine pursuant to section 766.309, we should not 
interpret NICA to remove the right of individuals to have this issue heard and 
decided by a circuit court.  Rather, NICA should be strictly construed to limit the 
jurisdiction of the ALJ to those items expressly relegated under section 766.309.  
See DOAH, 686 So. 2d at 1354. 
My conclusion is further bolstered by the fact that we have stated “[b]ecause 
the assertion of NICA exclusivity is an affirmative defense, factual disputes 
concerning notice should be submitted to the jury where a jury trial is requested on 
all questions of fact.”  Galen of Florida, Inc. v. Braniff, 696 So. 2d 308, 311 (Fla. 
1997).  This Court has previously determined that “allowing a circuit court to 
determine the exclusivity of [NICA] as an affirmative defense will not result in a 
frustration of the legislature’s purpose in enacting the Plan.”  McKaughan, 668 So. 
2d at 979 (quoting lower court’s opinion).  In reaching this determination, we 
 
- 25 -
compared NICA to the workers’ compensation system and concluded that “we are 
not aware of any documented evidence indicating that the legislative goal of this 
system has been frustrated by the long established law that workers’ compensation 
immunity is an affirmative defense to a traditional tort action.”  Id. (quoting lower 
court’s opinion); see also Mandico v. Taos Constr., Inc., 605 So. 2d 850, 854 (Fla. 
1992) (“The assertion that the plaintiff’s exclusive remedy is under the workers’ 
compensation law is an affirmative defense, and its validity can only be determined 
in the course of litigation. The court has jurisdiction to decide the question . . . .”).  
The 1998 amendments to NICA in no way altered this Court’s holding in Braniff 
because those amendments did not expressly delegate to the ALJ the authority to 
determine this issue of whether the notice mandated by section 766.316 was 
provided.  Rather, the 1998 amendments granted an ALJ the exclusive jurisdiction 
solely to determine whether a birth-related injury is compensable under NICA.  
See § 766.301, Fla. Stat. (Supp. 1998). 
Further, as noted in All Children’s Hospital, whether an entity is precluded 
from raising NICA as an affirmative defense for failure to give notice is a 
completely distinct issue from whether an injury is compensable under NICA.  See 
863 So. 2d at 455.19  This is evidenced by the fact that an individual who was not 
provided notice is not excluded from receiving compensation under NICA.  See 
                                          
 
 
19.  Judge Canady’s well-written analysis is quoted at length in Justice 
Anstead’s dissenting opinion.   
 
- 26 -
Braniff v. Galen of Florida, Inc., 669 So. 2d 1051, 1053 n.2 (Fla. 1st DCA 1995) 
(“The presence or absence of notice will neither advance nor defeat the claim of an 
eligible NICA claimant who has decided to invoke the NICA remedy by making 
this filing . . . .”), approved, 696 So. 2d 308 (Fla. 1997).  Additionally, it is not 
necessary under NICA for an ALJ to determine whether a party received notice 
pursuant to section 766.316 in order to decide whether a birth-related injury is 
compensable under NICA.  See id.  To decide the latter issue, the ALJ is only 
required to analyze the three elements listed in section 766.309.  Hence, absent 
specific language, we should not assign duties to the ALJ that have traditionally 
been delegated to the exclusive province of the circuit courts.  See Braniff, 696 So. 
2d at 311. 
Like workers’ compensation, NICA “is a statutory substitute for common 
law rights and liabilities,” and, therefore, “it should be strictly construed to include 
only those subjects clearly embraced within its terms.”  DOAH, 686 So. 2d at 1354 
(quoting McKaughan, 652 So. 2d at 859).  Therefore, the NICA plan must be 
interpreted narrowly so as not to sacrifice the common law rights of patients to a 
statutory substitute.  I believe that the majority has erred in concluding that the 
ALJ possesses jurisdiction to determine whether the notice mandated by section 
766.316 was provided because there is no express language in section 766.309 
dictating such.   Rather, I would conclude that the Second District in All Children’s 
 
- 27 -
Hospital properly determined that the issue of notice under the version of NICA 
applicable to the instant case can only be resolved by the circuit court. 
Therefore, I dissent.    
ANSTEAD and PARIENTE, JJ., concur. 
 
 
ANSTEAD, J., dissenting. 
 
I would approve the thorough and well-reasoned opinion of Judge Canady 
for the unanimous panel of Second District Court of Appeal judges in the decision 
below.  In my view, the majority has ignored the conceptual differences between 
administrative proceedings structured to determine NICA claims versus the 
entirely distinct judicial proceedings for malpractice claims in which the 
exclusivity provisions of NICA may be invoked as an affirmative defense.  In 
doing so, the majority has failed to adhere to this Court’s prior controlling decision 
in Galen of Florida, Inc. v. Braniff, 696 So. 2d 308 (Fla. 1997). 
 
Because I find Judge Canady’s opinion compelling, I adopt it as my own.  
Further, I set out here that portion of the opinion that I believe so clearly 
distinguishes the function of administrative proceedings under NICA (as those 
functions existed under the controlling law to be applied at the time of the 
underlying events involved in the Second District’s ruling) from the function of 
judicial proceedings.  Judge Canady explains: 
 
C. The Limits of ALJ Jurisdiction Under NICA 
 
- 28 -
 
In the instant case, the ALJ did something NICA gave him no 
authority to do and failed to do what the statute required him to do. 
There is no basis in NICA for the ALJ’s foray into the issue of 
immunity from tort liability under section 766.303(2) and the related 
issue of notice under section 766.316.  And there is no justification 
under NICA for the ALJ’s failure to make a determination concerning 
the compensability of the injury which is the subject of the underlying 
claim. 
 
The responsibilities of the ALJ are succinctly set forth in 
section 766.309.  The ALJ must address the two basic questions 
which determine if a claim is compensable under the plan:  (1) 
“[w]hether the injury claimed is a birth-related neurological injury,” § 
766.309(1)(a); and (2) “[w]hether obstetrical services were delivered 
by a [covered person] in the course of labor, delivery, or resuscitation 
in the immediate post-delivery period in a hospital,” § 766.309(1)(b).  
If both of these questions are answered in the affirmative, the injury is 
compensable under the plan.  If either question is answered in the 
negative, the injury is not compensable.  Since the adoption of the 
1998 amendments, NICA is very clear that the determination of 
whether an injury is compensable is exclusively within the province of 
the ALJ, see § 766.304, Fla. Stat. (Supp. 1998)––subject, of course, to 
the right to pursue an appeal of the ALJ’s determination, see § 
766.311, Fla. Stat. (1997). 
 
The issue of immunity from tort liability and the related issue of 
notice are an entirely different matter.  There is nothing in section 
766.309 or elsewhere in NICA that gives the ALJ any responsibility 
or authority to determine either (a) that notice under section 766.316 
was or was not properly given, or (b) that a provider is or is not 
entitled to invoke the immunity from tort liability provided for in 
section 766.303(2).  These issues are entirely distinct and separate 
from the issue of compensability under the plan. 
 
The issue of notice is only relevant to the issue of whether a 
provider is eligible under section 766.303(2) for immunity from tort 
liability.  See Galen, 696 So. 2d at 309-11.  Thus, the provision of 
notice has no bearing whatsoever on whether a claim is compensable.  
The availability of compensation under the plan is alike available to 
claimants who received proper notice under section 766.316 and to 
claimants who did not receive such notice.  See, e.g., O’Leary v. Fla. 
Birth-Related Neurological Injury Comp. Ass’n, 757 So. 2d 624, 627 
(Fla. 5th DCA 2000) (“recogniz[ing] that lack of proper notice does 
 
- 29 -
not affect a claimant’s ability to obtain compensation from the 
[p]lan”).  A claimant cannot be deprived of compensation under the 
plan due to the failure of a provider to give the required notice.  See 
id.  
 
Nothing in the 1998 amendments to NICA did anything to 
extend the jurisdiction of the ALJ to the issues of notice and immunity 
from tort liability.  Insofar as those amendments addressed the issue of 
the jurisdiction of the ALJ, they simply made clear that--contrary to 
the holding in McKaughan--the ALJ “has exclusive jurisdiction to 
determine whether a claim filed under [NICA] is compensable.”  § 
766.304.  The 1998 amendments also established that “[n]o civil 
action may be brought until the determinations [regarding 
compensability] under s. 766.309 have been made by the [ALJ].”  Id. 
No change was made in the determinations the ALJ is required to 
make under section 766.309. 
 
In cases such as the instant one, where the potential claimant 
wishes to pursue tort remedies and to forgo any compensation from 
the plan, the task of the ALJ is limited to determining whether the 
injuries were compensable under section 766.309(1), and thus 
“covered by [NICA],” in accord with section 766.301(1)(d) 
(Supp.1998).  In cases where the claimant seeks compensation from 
the plan, once an injury is determined to be compensable, the ALJ 
must go on to determine the amount of compensation that is 
awardable.  See §§ 766.309(1)(c), .31. 
 
If the ALJ determines that a claim is not compensable under 
NICA, there can, of course, be no immunity from liability under 
section 766.303(2).  If the ALJ determines that a claim is 
compensable but the potential claimant desires to forgo compensation 
under NICA and to pursue a civil action for tort remedies, a 
determination must then be made concerning whether that civil action 
is “in violation of the exclusiveness of remedy provisions of s. 
766.303.”  § 766.304.  That determination concerning tort immunity 
will turn on whether proper notice was given as required by section 
766.316.  Galen, 696 So. 2d at 311 (stating that propriety of provider’s 
NICA notice must be determined on a “case-by-case basis[,] [b]ecause 
the assertion of NICA exclusivity is an affirmative defense [in a civil 
suit and] factual disputes concerning notice should be submitted to the 
[trier of fact]”). 
 
The factual and legal issues related to notice and tort immunity 
are within the jurisdiction of the circuit court in which a tort claim is 
 
- 30 -
brought.  They are not within the jurisdiction of the ALJ.  Those 
issues are entirely irrelevant to the determination the ALJ must make 
concerning whether compensation is available from the association for 
a particular claim.  It is the circuit court which must address those 
issues in deciding whether a civil action will be allowed to proceed in 
the circuit court.  It, therefore, was error for the ALJ in the instant 
case to determine that the notice given was insufficient and that All 
Children’s was not entitled to immunity from tort liability. 
 
The ALJ further erred in requiring the claimants to make an 
“election of remedies.”  See Bayfront Med. Ctr., Inc. v. Div. of 
Admin. Hearings, 841 So. 2d 626, 628 (Fla. 2d DCA 2003) (reversing 
ALJ’s “rulings regarding the election of remedies and the finding 
regarding [NICA’s] exclusivity of remedy provisions”); cf. Gugelmin, 
815 So. 2d at 768 (reversing administrative order of ALJ “requiring 
[claimants] to elect between remedies and denying the hospital 
statutory immunity despite its timely notice under the [p]lan”). 
Finally, the ALJ’s errors of addressing the issues of notice, immunity, 
and election of remedies led him into the error of failing to carry out 
his responsibility to determine whether the injury was compensable 
under NICA. 
 
We realize that in O’Leary the Fifth District held that the 
adequacy of a provider’s notice is part of a compensability 
determination and that notice is thus a matter within the exclusive 
province of the ALJ.  757 So. 2d at 626-28.  The O’Leary court 
observed that its “conclusion that the administrative forum is the 
intended exclusive forum to determine the notice question eliminates 
the ‘ping-pong effect,’ that is, the trial court and the [ALJ] each 
throwing the case back to the other on this question.”  Id. at 627.  For 
the reasons already stated, however, we conclude that the text of 
NICA does not support the conclusion reached by the Fifth District in 
O’Leary that the question of proper notice is part of the 
compensability determination the ALJ is required to make.  Insofar as 
the supposed “ ‘ping-pong effect’ ” is concerned, we simply note that 
we are constrained to follow the ball wherever the legislature chooses 
to send it. 
All Children’s Hospital, Inc. v. Dept. of Admin. Hearings, 863 So. 2d 450, 455-57 
(Fla. 2d DCA 2004). 
 
LEWIS, C.J., concurs. 
 
- 31 -
 
PARIENTE, J., dissenting. 
 
The issue in this case is a very narrow one: whether the Administrative Law 
Judge (ALJ) has jurisdiction to determine whether obstetrical patients were given 
the required notice under section 766.316, Florida Statutes (Supp. 1998).  The 
answer is based on principles of statutory interpretation.  And the answer affects 
only a small number of cases because the language of the statute was amended in 
2003.  There is no question that as of 2006, the Legislature has unambiguously 
vested exclusive jurisdiction in the ALJ to make all factual determinations as to 
whether the notice requirements of section 761.316 were satisfied.  See majority 
opinion at 22 n. 18.   
 
 Both the majority and the dissents base their conclusions as to whether the 
circuit court or the ALJ has jurisdiction to determine notice on the language of the 
statute.  I conclude that the reasoning of Chief Justice Lewis’s dissent and Justice 
Anstead’s dissent, which incorporates Judge Canady’s opinion, is more persuasive 
than the majority’s reasoning.  First, the actual language vesting jurisdiction in the 
ALJ to make determinations on the compensability of a claim lists only three 
specific findings that the ALJ must make, none of which include the issue of 
notice.  See § 766.309, Fla. Stat. (Supp. 1998).  Second, whether an obstetrical 
patient received the required notice is completely distinct from the compensability 
of a claim.   
 
- 32 -
Third, as Chief Justice Lewis points out, this Court has previously 
determined that because the NICA statute limits common law rights, it must be 
strictly construed.  See Florida Birth-Related Neurological Injury Compensation 
Ass’n v. McKaughan, 668 So. 2d 974, 979 (Fla. 1996).   Further, as we explained 
in McKaughan, we take into consideration that this statute abridges Florida’s 
constitutional guarantee of access to the courts.  See id. at 979 n.3; see also § 
766.303, Fla. Stat. (Supp. 1998) (providing that “[t]he rights and remedies granted 
by this plan on account of a birth-related neurological injury shall exclude all other 
rights and remedies . . . at common law or otherwise, . . . except . . . where there is 
clear and convincing evidence of bad faith or malicious purpose or willful and 
wanton disregard of human rights, safety, or property”).20  Statutes that limit access 
to the courts “must be narrowly construed in a manner that favors access.”  
Woodham v. Blue Cross & Blue Shield of Fla., Inc., 829 So. 2d 891, 897 (Fla. 
2002).  These dual canons require the Legislature to clearly articulate its intent to 
limit access to the courts or abrogate common law rights.  The Legislature did not 
do so in the version of the statute we are construing in this case.  Although the 
                                          
 
 
20.  For this reason, NICA is not a remedial statute that should be liberally 
construed.  Unlike legislation such as the Wrongful Death Statute and the Whistle-
Blower’s Act, which created remedies unknown at common law and which we 
have stated should be liberally construed, see BellSouth Telecomm. v. Meeks, 863 
So. 2d 287, 290 (Fla. 2003); Irven v. Dep’t of Health & Rehabilitative Servs., 790 
So. 2d 403, 406 (Fla. 2001), NICA mandates an administrative remedy in lieu of a 
common law remedy for most claims arising from birth-related neurological 
injuries.            
 
- 33 -
issue is a narrow one affecting a small number of cases, the principles of strictly 
construing statutes that are in derogation of the common law or that limit access to 
the courts are ones to which we should faithfully adhere.  For these reasons, I 
concur with the dissents.  
LEWIS, C.J., and ANSTEAD, J., concur. 
 
 
Two Cases: 
 
Two Applications for Review of the Decision of the District Court of Appeal - 
Certified Direct Conflict of Decisions 
 
 
Second District - Case Nos. 2D02-1638 and 2D02-285 
 
Wilbur E. Brewton, Kelly B. Plante and Tana D. Storey of Roetzel and Andress, 
L.P.A., Tallahassee, Florida, 
 
 
for Petitioners 
 
C. Howard Hunter and Marie A. Borland of Hill, Ward and Henderson, P.A., 
Tampa, Florida; Steven C. Ruth, Jennifer R. Beltz and Larry D. Beltz of Beltz, 
Ruth, Magazine, Newman and Kohl, P.A., St. Petersburg, Florida; Robert E. 
Biasotti, Sylvia H. Walbolt and Annette M. Lang of Carlton Fields, P.A., St. 
Petersburg, Florida, David H. Gold of Goldfarb, Gold, Gonzalez and Wald, P.A., 
Miami, Florida; and Timothy F. Prugh and Theodore “Ted” E. Karatinos of Prugh, 
Holliday, Deem and Karatinos, P.L., Tampa, Florida, 
 
 
for Respondents 
 
 
- 34 -