Desir v. Nouveau Associates

969 So. 2d 1089, 2007 WL 3144833
CourtDistrict Court of Appeal of Florida
DecidedOctober 30, 2007
Docket1D06-5943
StatusPublished

This text of 969 So. 2d 1089 (Desir v. Nouveau Associates) is published on Counsel Stack Legal Research, covering District Court of Appeal of Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Desir v. Nouveau Associates, 969 So. 2d 1089, 2007 WL 3144833 (Fla. Ct. App. 2007).

Opinion

969 So.2d 1089 (2007)

Lemil DESIR, Appellant,
v.
NOUVEAU ASSOCIATES and Claims Center, Appellees.

No. 1D06-5943.

District Court of Appeal of Florida, First District.

October 30, 2007.
Rehearing Denied December 7, 2007.

*1090 Mark L. Zientz and Andrea Cox of the Law Offices of Mark L. Zientz, P.A., Miami, for Appellant.

Carlos D. Cabrera and A. Hinda Klein of Conroy, Simberg, Ganon, Krevans, Abel, Lurvey, Morrow & Schefer, P.A., Hollywood, for Appellees.

KAHN, J.

In this workers' compensation case, Lemil Desir, a catastrophically injured worker, sought an award of certain living expenses. The Judge of Compensation Claims (JCC) found that the expenses sought, water and utility bills, were not medically necessary under section 440.13, Florida Statutes, and denied the benefit. We reverse because our case law demonstrates that, under the facts as presented to the JCC, the employer/carrier (E/C) are responsible for paying the difference between what the claimant paid before the accident and post-accident living expenses attributable to the injury.

BACKGROUND

As a result of an industrial injury, admittedly compensable, appellant suffers permanent paralysis from the neck down. Appellees have provided normal medical and indemnity benefits and have, without necessity of a JCC order, purchased and built a home specifically designed to address Desir's unique needs as a quadriplegic. The E/C hold title to the real estate where appellant now lives.

Before the accident, Desir and his family lived in a two-bedroom apartment. He paid a total of $700 per month, which amount included water, sewer, and garbage fees. In addition, Desir paid his electric utilities bill directly. These facts are not in dispute. The E/C have stipulated that Desir's water and sewer bill in the new home averages $161 a month.

Appellant took the position that he is required under workers' compensation law to pay $700 per month toward his present living expenses, and that the $700 he pays necessarily includes water, sewer, and garbage. Desir agreed to pay that portion of the electric utility bill not attributable to the injury, and no dispute exists as to that. The E/C took the position that Desir should pay $700 per month, attributable solely to rent, and should also pay his water, sewer, and garbage, over and above the rent.

The issue, as Desir sees it, is whether the $700 a month includes water, sewer, and garbage bills, or whether that amount should be credited solely to rent, with Desir paying the utility bills. After hearing, *1091 the JCC entered an order finding that claimant's pre-injury "all inclusive rent" would not be dispositive of whether claimant's need for water and sewer has become a medically necessary benefit. As a result, the JCC attributed all of claimant's pre-injury payment of $700 to rent; found that water, sewer, and garbage were not medically necessary under section 440.13; and denied claimant's request for payment of these utilities.

ANALYSIS

On appeal, Desir does not dispute that the utilities at issue are ordinary living expenses. Instead, he argues that when an accident creates a situation rendering a claimant incapable of maintaining his cost of living before the accident, additional expenses should be viewed as uniquely attributable to the accident. Moreover, at the hearing below, Desir's counsel noted in closing argument that the medical necessity of utility service was not the issue before the JCC. The E/C take the position that each benefit under section 440.13 must be viewed individually and determined medically necessary. Because the JCC did not find medical necessity for the water, sewer, and garbage bill, appellees maintain that these items may not be awarded irrespective of the stipulated fact that appellant's pre-injury payment, which he is now willing to replicate, included the disputed utilities.

In the context of this case, the JCC erred by focusing solely on medical necessity, although that principle is more often than not controlling under the express terms of section 440.13. Our resolution of this case will turn on reconciling the medical necessity requirement, which this court thoroughly set out in Polk County Board of Commissioners v. Varnado, 576 So.2d 833 (Fla. 1st DCA 1991), with the equally important principle that, under the very same statute, the E/C must bear responsibility for the difference between the cost of claimant's pre-injury housing and the cost of "an apartment or house fully equipped according to the specifications set out in the JCC's order." Ramada Inn S. Airport v. Lamoureux, 565 So.2d 376, 377 (Fla. 1st DCA 1990).

In Varnado, this court focused upon medical necessity and held, "[a]bsent unique circumstances . . . the carrier is not required to bear the costs of normal living expenses not necessitated by the accident." 576 So.2d at 838. The Varnado court specifically considered the question of utilities, noting that "[u]tilities are generally considered basic necessities in every home in our society, and a claimant will have a difficult time demonstrating that necessity for such items is caused by the compensable accident such that they could be properly awarded as medical benefits." Id. See S. Indus. v. Chumney, 613 So.2d 74 (Fla. 1st DCA 1993).

Fully accepting the holdings of Varnado and similar cases, claimant contends that, because medical necessity is not the issue, he is nonetheless entitled to the payment in question. Claimant relies primarily upon Lamoureux to argue that his previous payment of $700 included water, sewer, and garbage and, accordingly, the provision of such utilities after the accident should be deemed included in his $700 payment. Claimant's position is correct and is further supported by All Clear Locating Services, Inc. v. Shurrum, 855 So.2d 1208 (Fla. 1st DCA 2003). In Shurrum, this court considered, among other things, the E/C's responsibility for an injured worker's post-accident home insurance and a wheelchair-accessible, barrier-free home. Significantly, this court relied upon Varnado and Chumney and observed that "the E/C is only responsible for the cost of the tenants' insurance that exceeds the cost that the claimant would have incurred *1092 in insuring his prior residence." Shurrum, 855 So.2d at 1211. Given Shurrum's reliance upon Varnado and Chumney, we easily conclude that the principles enunciated in these various cases are not irreconcilable.

Here, the question of medical necessity for the home itself is not at issue, as the E/C provided that benefit administratively. Claimant's pre-injury living expenses are also not in controversy, and claimant concedes he must contribute $700 toward his post-injury living expenses. Under Shurrum and Lamoureux, then, the E/C are responsible for the portion of the water and sewer bill necessitated by the new living quarters.

We note that Varnado relied in part for its holding upon this court's decision in Lamoureux. See Varnado, 576 So.2d at 838. The cases fit together, and the JCC's determination must turn on the theories relied upon and the proof presented by the parties at trial. Here, claimant has consistently maintained that his responsibility does not exceed payment of $700 plus electric utilities, exactly the expenses he bore before the accident. Claimant having made that showing, the E/C then had the burden to demonstrate that special circumstances exist so that claimant should be credited with both rent and utilities.

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Related

Southern Industries v. Chumney
613 So. 2d 74 (District Court of Appeal of Florida, 1993)
POLK COUNTY BD. OF COM'RS v. Varnado
576 So. 2d 833 (District Court of Appeal of Florida, 1991)
FLORIDA GAME & FRESH WATER FISH COM'N v. Driggers
65 So. 2d 723 (Supreme Court of Florida, 1953)
Sunshine Towing, Inc. v. Fonseca
933 So. 2d 594 (District Court of Appeal of Florida, 2006)
Ramada Inn South Airport v. Lamoureux
565 So. 2d 376 (District Court of Appeal of Florida, 1990)
Thorkelson v. NY Pizza & Pasta Inc.
956 So. 2d 542 (District Court of Appeal of Florida, 2007)
All Clear Locating Services, Inc. v. Shurrum
855 So. 2d 1208 (District Court of Appeal of Florida, 2003)

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Bluebook (online)
969 So. 2d 1089, 2007 WL 3144833, Counsel Stack Legal Research, https://law.counselstack.com/opinion/desir-v-nouveau-associates-fladistctapp-2007.