Locker v. United Pharmaceutical Group, Inc.
46 So. 3d 1126
Fla. Dist. Ct. App.2010Background
- Claimant filed a petition for benefits (PFB) seeking authorization for continued treatment for her right shoulder.
- Dr. Bayliss prescribed treatment that was attached to the PFB.
- Dr. Bayliss had previously been authorized and was not de-authorized by the Employer/Carrier (E/C).
- Employer/Carrier moved to dismiss the PFB based on an EMA opinion from an earlier proceeding in this matter.
- JCC granted the dismissal, relying on extra-record evidence and the EMA finding that the shoulder condition was not ripe for award.
- The reviewing court treats the dismissal as a de novo question of law; the four-corners rule governs whether the PFB states a claim.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| RiPe and entitlement of the PFB | Locker: PFB seeks authorized, ongoing treatment; benefits are ripe, due, and owing. | E/C: relies on prior EMA ruling; issues not challenged previously cannot be relitigated. | Reversed; PFB alleged ripe, due, and owing benefits. |
| Reliance on extra-record evidence | Locker: JCC must decide within the four corners of the PFB and attached medicals. | E/C: prior EMA evidence helps resolve whether benefits are due. | Remanded; trial court erred by considering non-pleaded, extra-record evidence. |
Key Cases Cited
- Gilbreth v. Genesis Eldercare, 821 So.2d 1226 (Fla. 1st DCA 2002) (de novo review for legal conclusions on motions to dismiss)
- Siegle v. Progressive Consumers Ins. Co., 819 So.2d 732 (Fla. 1st DCA 2002) (standard for reviewing dismissal rulings; accept allegations as true)
- Chatham Mfg., Corp. v. Cates, 969 So.2d 515 (Fla. 1st DCA 2007) (four-corners rule; cannot rely on matters outside the complaint)
- Brewer v. Clerk of Circuit Court, Gadsden County, 720 So.2d 602 (Fla. 1st DCA 1998) (motion to dismiss for failure to state a cause of action; de novo review)
- Thomas v. Eckerd Drugs, 987 So.2d 1262 (Fla. 1st DCA 2008) (uses summary-judgment-like framework in absence of governing WC precedent)
