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January 1, 2025   Over the past eight years, there has been a steady decrease in workers’ compensation rates and 2025 will be no different. However, the level that rates will be decreased is far lower than in previous years, in part because of changes in how workers’ compensation physicians will be paid.   In November of 2024, the Florida Office of Insurance Regulation announced a 1 percent decrease in workers’ compensation rates as a result of recommendations from the National Council of Compensation Insurance (NCCI). The rate decrease applies to both new and renewal workers’ compensation insurance policies effective in Florida as of Jan. 1, 2025.   “This is the smallest decrease that we’ve seen in years,” said Kyla Murphy, AVP National Healthcare Practice, Risk Strategies. “There was a 15.1 percent decrease in 2024 and an 8.4 percent decrease in 2023; there’s a pretty big difference from 15 to 8 to 1 percent.”   Part of the reason for this minimal decrease is the passing of Florida Senate Bill 362, which determines how worker-treating physicians are reimbursed. The bill increases reimbursement for physicians treating injured workers to 175 percent of Medicare rates from the current rate of 110 percent and increases reimbursement for surgical procedures to 210 percent of Medicare rates from the current rate of 140 percent. These rates will take effect Jan. 1, 2025.   According to the NCCI, the 1 percent decrease in workers’ compensation rates should offset the anticipated impact resulting from the senate bill, which is expected to result in a 5.6 percent increase on overall workers’ compensation system costs. Excluding the impact of this bill from the filing would result in a revised overall rate decrease of 6.4 percent as opposed to the filed 1 percent change.   “This new bill, which aids doctors, is long overdue,” said Tom Murphy, SVP National Healthcare Practice, Risk Strategies, noting that increasing complaints from injured employees and their employers about proper care and lack of access to care helped to propel the bill into law. “In our world, we know when doctors stop treating workers’ compensation patients and there was definitely a lot of frustration out there—especially in the orthopedic community—from doctors who did not feel that they were getting paid enough.”   As a result of doctors’ dissatisfaction, patients were having to deal with not only a shortage of physicians in general, but a limited number of physicians who would take workers’ compensation cases.   “The rate decrease as a result of the bill shows how much the legislature can have an effect on these things, which is why we encourage our physician partners to get involved when it comes to issues that can affect their practices,” said Kyla Murphy.   According to Tom Murphy, workers’ compensation rates have dropped more than 75 percent since 2003, despite the fact that the vast majority of other lines of insurance have increased dramatically over that time, including property and casualty insurance.   “This is one of those things that we’re happy to take to our medical groups and doctors—at least there’s good news when it comes to workers’ compensation,” he said. “However, I do believe that these rates will begin to tick up in the not too distant future since they’ve been going down for so many years.”   Murphy noted that when he first started working as a workers’ compensation agent 20 years ago, the rate for medical practices was $1.05 for every $100 of payroll; it is now 24 cents.   With the increase in workers’ compensation payments, Murphy expects to see more doctors taking these types of cases, including those who had dropped out as a result of lower payments.   “It’s a nice jump from 110 percent of Medicare rates up to 175 percent, and that’s just for primary care physicians; surgeons are making even more,” he said. “With these increases in payment/reimbursement, it’s definitely going to bring in more doctors to treat injured workers.”

December 14, 2024 A Times investigation found twice as many workers have died across the state from heat than officials know.   It felt like 100 degrees on the job site by late afternoon.   “Truly unbearable,” was how Jonathan Baudilio Ramirez Salazar described Florida’s weather when he spoke to his wife on the phone the night before.   He’d worked one day in the thick July heat as a temporary laborer on a Fort Myers landscaping crew for TruScapes Industries Inc.   “Don’t go to work tomorrow,” his wife told him.   “My love, I didn’t come here to rest,” the 31-year-old said from his hotel. “I came here to work — I need to get used to it.”   Ramirez was far from home, a one-bedroom his family of five shared in Guatemala. He missed the chilly breeze descending each evening in Santa Cruz Naranjo.   But in Guatemala, he made about $150 a month. For years, he’d dreamed of working in the U.S. to save for a bigger home and his children’s studies. In 2022, he came to Florida.   On Ramirez’s second day with TruScapes, he worked outside an apartment complex. The weather reached 89 degrees by midmorning.   By 3 p.m., it was 92.   With humidity, it felt like 102.   As the shift wore on, coworkers noticed Ramirez seemed unwell. He skipped lunch but kept working — until he couldn’t any longer.   His coworkers discovered him on his knees in a wooded area behind the complex around 4:40 p.m. He appeared to be seizing. His skin was hot. His heartbeat faint. Vomit lodged in his throat.   When paramedics arrived, his body temperature was above 110 degrees.   Ramirez died of heatstroke, according to medical examiner records. From his exposure on the job.   Workplace regulators, however, didn’t investigate what happened. That’s because TruScapes didn’t tell them he’d died.   Florida banned local governments from providing increased oversight for workers exposed to high temperatures earlier this year, saying businesses and federal regulators alone could keep laborers safe.   But the Tampa Bay Times found far more workers have died from heat across the state than authorities even know.   The missing deaths bring recorded heat fatalities in Florida to at least 37 over the past decade — double the number federal regulators had tallied during the same period.   Employers are supposed to notify the U.S. Occupational Safety and Health Administration, which oversees worker safety, about employee deaths within hours. OSHA has fined six businesses in the state after discovering they didn’t follow the rule when workers died from heat.   The Times identified 19 additional heat-related deaths kept from the agency.   Taken together, the Times found that Florida companies have failed to report the vast majority of heat fatalities as required. Read more

December 5, 2024 Jacksonville, FL — United States District Judge Wendy W. Berger has sentenced Pablo Isila Euceda-Hernandez, a Honduran national illegally present in United States, to 27 months in federal prison for conspiracy to commit wire fraud and conspiracy to commit tax fraud. The court also ordered Euceda-Hernandez to pay restitution to the IRS in the amount of $1,214,508. The court also entered a money judgment against Euceda-Hernandez in the amount of $336,029, representing the proceeds of the wire fraud.   According to court documents, Euceda-Hernandez established a shell company that purported to be involved in the construction industry. Euceda-Hernandez obtained a workers’ compensation insurance policy in the name of the shell company to cover a minimal payroll for a few purported employees. He then “rented” the workers’ compensation insurance to work crews who had obtained subcontracts with construction contractors on projects in various Florida counties as well as contractors in other states. He sent the contractors a certificate as “proof” that the work crews had workers’ compensation insurance, as required by Florida law. By sending the certificate, Euceda-Hernandez falsely represented that the work crews worked for the shell company. Over the course of the scheme, Euceda-Hernandez “rented” the certificates to dozens of work crews, defrauding the worker’s compensation carrier, typically allowing undocumented illegal workers to be employed unlawfully.   As part of the scheme, the contractors issued payroll checks for the workers’ wages to the shell companies and Euceda-Hernandez cashed these checks, then distributed the cash to the work crews after deducting their fee, which was typically about 6% of the payroll. During the scheme, Euceda-Hernandez cashed payroll checks totaling approximately $5 million. Neither the shell company nor the contractors reported to government authorities the wages that were paid to the workers, nor did they pay either the employees’ or the employer’s portion of payroll taxes – including Social Security, Medicare, and federal income tax. According to the IRS, the amount of payroll taxes due on wages collected by Euceda-Hernandez totaled $1,214,508.   The scheme also facilitated the avoidance of the higher cost of obtaining adequate workers’ compensation insurance for the numerous workers on the work crews to whom Euceda-Hernandez “rented” the workers’ compensation insurance. The policy that Euceda-Hernandez purchased and then “rented” out was for an estimated payroll of $169,400 and the insurance company issued a policy for a premium of approximately $11,352. Had a workers’ compensation insurance policy been purchased for the actual payroll totaling approximately $5 million, the policy premium would have totaled approximately $591,978.   “This defendant cheated. He cheated their employees, the U.S. taxpayers, and most importantly the free-market principles which govern our society,” said Ron Loecker, Special Agent in Charge of IRS-Criminal Investigation’s Tampa Field Office. “By breaking the law, Euceda-Hernandez sought an unfair advantage to all their competitors who played by the rules and will now contemplate their actions from prison. We want to ensure a level playing field for the business owners doing things the right way. To those who think they can get away with this type of behavior, no matter what steps you take to cover your tracks, we will find out, and do everything we can to bring you to justice.”   “Under-the-table cash payroll schemes, especially those designed to pay illegal immigrants not authorized to work in the United States, jeopardizes the integrity of the construction industry and undermines the legal framework intended to protect workers and ensure fair business through legal and ethical standards,” said Tim Hemker, Homeland Security Investigations (HSI) Jacksonville assistant special agent in charge. “HSI, through our strong law enforcement partnerships, is committed to uncovering the schemes of criminals and ensuring that justice is served for those who seek to exploit the system.”   This case was investigated by the Internal Revenue Service Criminal Investigation (IRS-CI), Homeland Security Investigations, and the Florida Department of Financial Services. It was prosecuted by Assistant United States Attorney John Cannizzaro.   IRS-CI is the criminal investigative arm of the IRS, responsible for conducting financial crime investigations, including tax fraud, narcotics trafficking, money-laundering, public corruption, healthcare fraud, identity theft and more. IRS-CI special agents are the only federal law enforcement agents with investigative jurisdiction over violations of the Internal Revenue Code, obtaining a more than a 90 percent federal conviction rate. The agency has 20 field offices located across the U.S. and 12 attaché posts abroad.

December 5, 2024   Masci General Contractor, KT Carter Contracting face combined $363K in penalties JACKSONVILLE, FL – In one week, U.S. Department of Labor safety inspectors found two contractors working in Jacksonville and Daytona Beach willfully exposing employees to one of the construction industry’s deadliest hazards: trench and excavation collapses and cave-ins.   On May 28, 2024, inspectors with the department’s Occupational Safety and Health Administration witnessed workers employed by Masci General Contractor Inc. installing a sewer line in a trench 6-feet-deep and 40-feet-long near International Speedway and Atlantic Avenue in Daytona Beach. OSHA inspectors initiated the removal of the employees from the trench and subsequently, the agency issued a citation to the employer for willfully endangering workers by failing to provide essential cave-in protection, such as shoring or trench boxes, while they worked in the excavation.   A few days later, OSHA inspectors encountered workers from K T Carter Contracting Inc. in a 12-foot-deep trench without cave-in protection on Imeson Park Boulevard in Jacksonville. Once again, OSHA inspectors initiated removal of the employees from the trench. As a result of their inspection, OSHA issued a willful violation to the company.   “Exposing workers to unprotected trenches puts their lives at serious risk,” said OSHA Area Director Scott Tisdale in Jacksonville, Florida. “In a matter of seconds, a trench wall can collapse, burying workers under tons of soil, leading to life-altering injuries – incidents that are completely preventable with the right safety measures in place. In these cases, we are fortunate that our inspectors were able to intervene before a tragedy occurred, rather than responding to one afterward.”   OSHA also cited both Jacksonville contractors for serious violations for exposing workers to cave-in and struck-by hazards by not providing a stairway, ramp, ladder or other safe means to enter or exit the trench, as well as for placing spoil piles along the edge of the excavations. Masci General Contractor faces $216,633 in proposed penalties while K T Carter faces $146,803 in proposed penalties for their violations.   OSHA issued the citations, Nov. 13, 2024 to the employers, and they have 15 business days from receipt of the citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.