Case Name: KELLER KITCHEN CABINETS and Alexis, Inc., Appellants, v. John HOLDER, Appellee
Court: Florida District Court of Appeal
Jurisdiction: Florida
Decision Date: 1991-08-08
Citations: 586 So. 2d 1132
Docket Number: No. 88-3204
Parties: KELLER KITCHEN CABINETS and Alexis, Inc., Appellants, v. John HOLDER, Appellee.
Judges: NIMMONS, J., and WENTWORTH, Senior Judge, concur.
Reporter: Southern Reporter, Second Series
Volume: 586
Pages: 1132–1147

Head Matter:
KELLER KITCHEN CABINETS and Alexis, Inc., Appellants, v. John HOLDER, Appellee.
No. 88-3204.
District Court of Appeal of Florida, First District.
Aug. 8, 1991.
On Motion for Certification and Rehearing Oct. 16, 1991.
Rex A. Hurley and Steven S. Eichenblatt, of Zimmerman, Shuffield, Kiser & Sut-cliffe, P.A., Orlando, for appellants.
Edward H. Hurt, Sr., of Hurt & Parrish, P.A., Orlando, Bill McCabe, of Shepherd, McCabe & Cooley, Longwood, for appellee.

Opinion:
PER CURIAM.
The employer/carrier appeal from an order of the judge of compensation claims which order held that the limitation period under Section 440.28, Florida Statutes (1977), is not applicable to bar the claimant's application for temporary total disability (TTD) benefits. We reverse.
Appellee/claimant suffered a compensa-ble injury to his right knee on March 15, 1979. An order was entered in 1980 which found that appellee had reached maximum medical improvement (MMI) in February 1980 with a 40% permanent partial disability of the right lower extremity. Appellants were directed to pay 80 weeks of permanent partial disability (PPD) benefits and to provide continuing medical care. The order further stated that if in the future appellee should require a total knee replacement, this would be solely for relief of symptoms resulting from the compensa-ble accident. This statement was stricken from the order on appeal. Keller Kitchen Cabinets v. Holder, 397 So.2d 434 (Fla. 1st DCA 1981). A dispute between the parties regarding medical care was resolved by a January 1985 order, which was not appealed and which did not address the issue of disability compensation.
Appellants paid the PPD and have provided continuing medical care up to the time of the hearing in the instant case. In March 1988 a total knee replacement, which the judge found to be necessitated by the 1979 compensable accident, was performed upon appellee. Appellee sought TTD and other benefits relating to the knee replacement and subsequent recuperation.
Appellants took the position that since appellee had previously reached MMI with a permanent partial impairment as found in the 1980 order, he could not obtain TTD benefits in 1988 without seeking modification of the 1980 order pursuant to Section 440.28, which provides in part:
Upon a deputy commissioner's own initiative, or upon the application of any party in interest, on the ground of a change in condition or because of a mistake in a determination of fact, the deputy commissioner may, at any time prior to 2 years after the date of the last payment of compensation pursuant to any compensation order . review a compensation case in accordance with the procedure prescribed in respect of claims in s. 440.25 and, in accordance with such section, issue a new compensation order which may terminate, continue, reinstate, increase, or decrease such compensation or award compensation.
Appellants asserted that since more than two years had passed since the last payment of PPD benefits, the limitation period expressed in Section 440.28 was operative to bar appellee's claim for TTD benefits.
The judge found that appellee was not required to proceed by way of modification and that his claim was therefore governed by Section 440.19(2)(a), Florida Statutes (1979), which provides that a claim for compensation is timely if filed within two years of the last furnishing of compensation or remedial treatment by the employer. As measured by this standard, appellee's claim was found to be timely because it was filed within two years of the last remedial treatment furnished to appellee by the employer.
We agree with appellants that appellee was required to proceed by way of modification on his TTD claim. However, we remand for determination (on this record or additional evidence) of whether facts and circumstances intervening since the original order may prevent application of the statutory bar.
The date of MMI marks the point at which no further recovery or improvement from an injury or disease can reasonably be anticipated. There is no basis for setting a date of MMI while the healing process is still continuing. Hall v. Dade County School Board, 492 So.2d 768 (Fla. 1st DCA 1986). Remedial treatment is available to a claimant who has reached MMI only when the need therefor requires recognition of a change in MMI and reentry of temporary disability status, with or without eligibility for other benefits. Value Construction, Inc. v. Sauer, 465 So.2d 631 (Fla. 1st DCA 1985); Manns Jiffy Food Mart v. O'Neil, 453 So.2d 78 (Fla. 1st. DCA 1984); Lewis v. Town & Country Auto Body Shop, 447 So.2d 403 (Fla. 1st DCA 1984). A claimant may, however, still be entitled to post-MMI palliative treatment for relief of symptoms arising from the compensable injury. Mount Sinai Medical Center v. Cardoso, 527 So.2d 875 (Fla. 1st DCA 1988); Old Cove Condo v. Curry, 511 So.2d 666 (Fla. 1st DCA 1987).
Maximum medical improvement typically marks the end of temporary disability and the beginning of permanent disability. Clyatt Memorial, Inc. v. Scott, 394 So.2d 159 (Fla. 1st DCA 1981). Temporary total disability is generally unavailable for periods after the date of MMI except as above noted upon changed condition. Coca-Cola Bottling Company v. Tunson, 534 So.2d 910 (Fla. 1st DCA 1988); Department of Offender Rehabilitation v. Godwin, 394 So.2d 1091 (Fla. 1st DCA 1981). Except to the extent that Section 440.28 permits modification, compensation orders are governed by the same principles of res judicata and estoppel as are applied to judgments of courts. Wellcraft Marine Corporation v. Turner, 435 So.2d 864 (Fla. 1st DCA 1983). Since the 1980 order established that appellee reached MMI from his knee injury in 1980, the TTD awarded in the instant case would appear to be inconsistent with that order. Accordingly, it is only by a modification of the 1980 award, based upon the statutory grounds, that appellee can claim TTD benefits. General Electric Company v. Spann, 479 So.2d 289, 290 (Fla. 1st DCA 1985); Washington v. Dade County School Board, IRC Order 2-3694 (Feb. 8, 1979); Bishop v. Pinellas Framing & Finishing, 414 So.2d 596 (Fla. 1st DCA 1982). In Robinson v. JDM Country Club, 455 So.2d 1077, 1079 (Fla. 1st DCA 1984), we stated:
Modification is the statutory remedy provided for a claimant whose condition has
changed following entry of a prior order. "The change of condition provision is designed to afford relief to a claimant whose condition either becomes progressively worse when not anticipated by the original diagnosis or is the product of evidentiary factors not known at the time of the initial claim proceeding." General Electric Co. v. Osborne, 394 So.2d 1089, 1090 (Fla. 1st DCA 1981).
Accord, Deneault v. Alachua. County School Board, 555 So.2d 909 (Fla. 1st DCA 1990).
We acknowledge the line of cases holding that a claimant who is hospitalized after MMI due to the compensable injury is entitled to TTD benefits for the period of hospitalization and the period of recuperation which follows. Lopez v. Nabisco Brands, Inc., 516 So.2d 993 (Fla. 1st DCA 1987); Delgado v. LaQuinta Motor Inns, 457 So.2d 572 (Fla. 1st DCA 1984); Atkins v. Greenhut Construction Company, 447 So.2d 268 (Fla. 1st DCA 1983); Smitty's Coffee Shop v. Florida Industrial Commission, 86 So.2d 268 (Fla.1956). See also Palm Beach County Board of County Commissioners v. Roberson, 500 So.2d 180 (Fla. 1st DCA 1986) (TTD benefits properly awarded for time spent in rehabilitation program after MMI); Emergency One, Inc. v. Williams, 431 So.2d 251 (Fla. 1st DCA 1983) (temporary disability benefits properly awarded for period following date that physician set as the date of MMI, where physician released claimant for work without restrictions but subsequently mod ified recommendation to impose restrictions). However, these cases are distinguishable.
In Smitty's Coffee Shop, the earliest Florida decision finding a right to TTD benefits after MMI, and the case which provides the authority for the later cases providing for post-MMI TTD benefits, the claimant proceeded under Section 440.28 in applying for the additional benefits. In Palm Beach County and Atkins, the claimant also proceeded by way of Section 440.28. In Lopez and Delgado the establishment of MMI and the claim for post-MMI TTD benefits were part of one proceeding, so Section 440.28 and the time limitations prescribed therein were not at issue. Furthermore, in Williams we directed that the order be amended to reflect termination of MMI status at the time temporary benefits were reinstated. We also observed: "The circumstances in the present case present no necessity for consideration of when an award of temporary benefits, after final adjudication of MMI, may constitute a modification of the prior order." 431 So.2d at 252, n. 1. None of these cases involved the scenario apparently presented in the instant case, in which (1) a final order has fixed a date of MMI and the parties' consequent rights and responsibilities, including the claimant's entitlement to disability benefits; and (2) after the time for modification has passed, the claimant seeks further benefits which are not contemplated by the original order and are inconsistent with the terms of that order. Accordingly, we hold that a claimant who petitions for application of the exception recognized in Smitty's after he has reached MMI, as found in a previous order, is ordinarily required to proceed by way of Section 440.28.
In the case at bar, notwithstanding the foregoing, the facts and circumstances intervening since the original order may prevent application of the statutory bar. There appears to be no question that remedial care has been provided (by order or otherwise) without interruption. Although provision of such benefits has not been deemed to be payment of "compensation" within the terms of Section 440.28, the award or voluntary payment of remedial (as opposed to palliative) care after adjudication of MMI appears to recognize the claimant's re-entry of a temporary disability status (whether or not TD compensation is paid or payable). The furnishing of remedial care is therefore an implicit modification of a prior MMI and permanency determination based on a change of condition, since remedial care is clearly consistent only with some expectation of potential improvement.
Whether or not those facts would necessarily have any legal or equitable effect in application of the statutory terms, such circumstances should be considered because the statute must be construed consistent with its purpose as a qualification of otherwise applicable res judicata doctrines. The statute is explicit that the prescribed two-year limitations period commences only with the last payment of compensation "pursuant to" a prior order. The character of payments actually made is therefore significant and to be determined by context as well as the label assigned upon payment, although either party may be foreclosed by stipulation or otherwise to raise such issues.
The current order before us resolves the claim on the ground that only the limitations period in Section 440.19 need be applied, which conclusion we now reverse. Unless the judge determines expressly that the parties have waived all factual issues, the judge should determine on remand (1) whether the parties' conduct and intervening proceedings after the original order have effectively accomplished a later legal or equitable modification of the permanency adjudication, or affected the character of compensation payments made, and (2) what effect that would necessarily have on the legal and equitable accrual or waiver of the limitations defense under Section 440.-28.
Although the temporary disability resulting from surgery on which the present claim is based does appear to have been "contemplated" by the original order, it was then necessarily denied as specula tive, not mature, and inconsistent with the commencement of permanent disability benefits at that time. The complex structure of Chapter 440, Florida Statutes, by which temporary and permanent benefits are separately defined, measured, and limited both in duration and amount, must be taken into account in any application of the statutory limitations provisions which qualify res judicata principles.
For the foregoing reasons, the current TTD claim represents a changed condition which is prima facie within the terms of Section 440.28, even though it was a contemplated change. This follows from the unavoidable conclusion that the original order adjudicated and set at rest the fact of claimant's eligibility for permanent disability benefits based on MMI, which under the statutory scheme excludes temporary disability benefits absent modification under Section 440.28.
We reverse and remand for further proceedings consistent with this opinion. Since the award of attorney's fees to appel-lee was based partially upon the award of TTD benefits, we also reverse and remand such fee award for further consistent proceedings.
NIMMONS, J., and WENTWORTH, Senior Judge, concur.
ZEHMER, J., dissents with written opinion.
. This finding is not challenged on appeal and is accepted as correct.
. Only the TTD award is at issue in this appeal.
. At the time of appellee's compensable accident, Section 440.19(l)(a), Florida Statutes (1977), provided:
(l)(a) The right to compensation for disability under this chapter shall be barred unless a claim therefor is filed within 2 years after the time of injury, except that if payment of compensation has been made or remedial treatment has been furnished by the employer without an award on account of such injury a claim may be filed within 2 years after the date of the last payment of compensation or after the date of the last remedial treatment furnished by the employer, (e.s.)
Chapter 79-40, Laws of Florida, which took effect soon after appellee's accident, deleted the qualifying term "without an award" and renumbered Section 440.19(l)(a) as 440.19(2)(a). (Note: the original section number, 440.-19(l)(a), has since been restored.) The judge applied the amended statute under the principle announced in such cases as Garris v. Weller Construction Company, 132 So.2d 553 (Fla.1960), that where a statutory amendment lengthens the limitation period for filing a claim, the amendment applies to claims which are still viable at the time of the amendment. In light of our holding that Section 440.28 provides the applicable limitation period, we need not address the merits of the trial court's application of the amended statute.
. This court has recently observed that this section creates an exception to traditional notions of finality based on res judicata, law of the case, or estoppel by judgment. Massie v. University of Florida, 570 So.2d 963, 973 (Fla. 1st DCA 1990). We would also note that an essential element of res judicata is identity of the thing sued for. Subsequent workers' compensation claims will not be foreclosed on res judicata grounds where this element is absent. Northwest Orient Airlines v. Gonzalez, 500 So.2d 699, 701 (Fla. 1st DCA 1987); Boston v. Budget Luxury Inns, 474 So.2d 355, 357 (Fla. 1st DCA 1985).
. In case law applying the pre-1979 Act, the qualifying term "without an award" found in Section 440.19(l)(a) is cited as a ground for requiring the claimant seeking additional compensation to meet the stricter time limitation requirements of Section 440.28, since benefits furnished pursuant to an earlier order did not act to toll the.time limitations of Section 440.19. University of Florida v. McLarthy, 483 So.2d 723 (Fla. 1st DCA 1985); Bassett's Dairy v. Thomas, 429 So.2d 1356 (Fla. 1st DCA 1983); Jones v. Ludman Corporation, 190 So.2d 760 (Fla.1966). Of course, this distinction does not apply to claims for compensation arising under the Act as amended in 1979. Assuming, without deciding, that the judge properly found appellee entitled to the benefit of the 1979 amendment, the instant TTD claim is still inconsistent with the terms of the 1980 order and must therefore meet the requirements applicable to a claim for modification.
. Cf. a roughly comparable condition, i.e., prosthesis replacement, which may be clearly contemplated but not awardable at the time of initial permanency, or later except pursuant to an express statutory exception. City Investing v. Roe, 566 So.2d 258 (Fla. 1st DCA 1990).