Case Name: ARDMORE FARMS and ESIS, c/o INA, Appellants, v. Joan A. SMITH, Appellee
Court: Florida District Court of Appeal
Jurisdiction: Florida
Decision Date: 1982-08-19
Citations: 423 So. 2d 1039
Docket Number: No. AJ-209
Parties: ARDMORE FARMS and ESIS, c/o INA, Appellants, v. Joan A. SMITH, Appellee.
Judges: MILLS and BOOTH, JJ., concur.
Reporter: Southern Reporter, Second Series
Volume: 423
Pages: 1039–1047

Head Matter:
ARDMORE FARMS and ESIS, c/o INA, Appellants, v. Joan A. SMITH, Appellee.
No. AJ-209.
District Court of Appeal of Florida, First District.
Aug. 19, 1982.
On Rehearing En Banc Dec. 29, 1982.
Donna L. Bergh of Walker, Buckmaster, Miller & Ketcham, Orlando, for appellants.
Edward H. Hurt of Hurt & Parrish, and Bill McCabe of Shepherd, McCabe & Cooley, Orlando, for appellee.

Opinion:
THOMPSON, Judge.
The employer/carrier (E/C) bring this appeal from a compensation order awarding: (1) wage loss benefits for the months of August and September 1981; (2) permanent total disability (PTD) benefits commencing October 1, 1981, and; (3) costs of the proceedings. In the fourth and last paragraph of the decretal portion of the order, the deputy commissioner (deputy) reserved jur isdiction of the cause for the purpose of determining entitlement to attorney's fees. With the exception of the award of wage loss benefits, we reverse these awards and strike that portion of the order reserving jurisdiction on the question of attorney's fees.
On May 18, 1980 claimant, while employed as a truck driver, was exposed to dust thrown into the air by the eruption of the volcano Mount Saint Helens. This exposure resulted in serious and permanent injury to the claimant's lungs. On September 1, 1981, the E/C stipulated and agreed to commence payment of wage loss benefits upon the submission of appropriate wage loss benefit request forms. The E/C paid wage loss benefits for the months of May, June, and July, 1981, but it thereafter refused to pay wage loss benefits for the months of August and September on grounds that the wage loss benefit request forms it received for those months were not properly filled out and executed. The benefit request forms at issue were not signed by either the claimant or her attorney, although they did bear the impression of the attorney's signature stamp. These forms were marked to indicate that claimant was not receiving social security benefits.
Upon the E/C's failure to pay wage loss benefits pursuant to these forms, the claimant applied for a hearing on the matter, which hearing was thereafter scheduled for December 11, 1981. The only issue which was in controversy when the hearing commenced on December 11, 1981 was the claimant's entitlement to wage loss benefits for the months of August and September 1981, plus costs, interest, penalties, and attorney's fees. During the hearing, the claimant submitted revised wage loss benefit request forms for the months of August and September, which were properly signed and which indicated that claimant was receiving certain social security benefits. The deputy thereafter issued the order described hereinabove, without including in her order any reference to the fact that claimant had submitted revised benefit request forms, and without making any finding as to whether the E/C were justified in refusing to honor the unsigned forms.
We agree with the deputy that the E/C are obligated to pay the claimed wage loss benefits for the months of August and September 1981. However, we hold that the benefit request forms originally submitted were not properly executed, and therefore the E/C's obligation to pay the wage loss benefits did not mature until the date of the hearing when the claimant submitted accurate and duly executed forms. This court has held that the self-executing nature of the workers' compensation law requires that mere failure to comply with technical requirements in filing wage loss benefit request forms should not defeat a valid claim for such benefits, Car Stop Unlimited v. Salmon, 404 So.2d 172 (Fla. 1st DCA 1981), and that there is "nothing sacrosanct" about the particular form by which wage loss benefits are requested, Florida Erection Services, Inc. v. McDonald, 395 So.2d 203 (Fla. 1st DCA 1981). However, the claimant's failure to report receipt of social security benefits and her failure to sign a benefit request form, thereby attesting to its accuracy, were not "merely technical" omissions. Without accurate information as to what social security or unemployment compensation benefits claimant is receiving, the E/C cannot determine what wage loss benefits are due the claimant, and without claimant's signature on the request form the E/C are unable to obtain the release of information from the Division of Employment Security. By failing and refusing to submit properly executed forms, the claimant herein deprived the E/C of an opportunity to calculate and ascertain the amount of the benefits due claimant, and to make timely payment thereof.
It is undisputed that the E/C accepted claimant as being PTD and commenced payment of PTD benefits prior to the hearing. There is no contention that the payment of PTD benefits was untimely. Therefore, there was no controversy with respect to the permanent and total nature of claimant's disability, and the deputy erred in adjudicating the issue. Sperry Remington Office Machines v. Stelling, 383 So.2d 1150 (Fla. 1st DCA 1980). Although similar error was held harmless by another panel of this court, see G & S Packing Company v. Driggers, 382 So.2d 446 (Fla. 1st DCA 1980), we think it better to reverse such an award in order to avoid possible future confusion and unnecessary litigation concerning the appropriate basis for an award of attorney's fees. Accordingly, that portion of the deputy's order awarding PTD benefits is stricken.
In view of our reversal of the award of PTD benefits, and of our holding that wage loss benefits for the months of August and September 1981 did not become due and payable until the date of the hearing when claimant submitted properly executed wage loss benefit request forms, we must conclude that the claimant did not "prevail" in the proceedings before the deputy, and that the award of costs of the proceedings was also erroneous. Additionally, the deputy did not, and from this record could not, find that the carrier acted in bad faith in handling this claim. Therefore, the award of costs is reversed, and the portion of the order reserving jurisdiction to determine the issue of attorney's fees is stricken. Claimant's petition for appellate attorney's fees is denied.
REVERSED.
MILLS and BOOTH, JJ., concur.