DI 52120.055 Florida Workers’ Compensation (WC)
Florida is a reverse offset State with the exception of Impairment
benefits, which are offsettable. For Florida’s reverse offset
procedures, see DI 52120.055F in this section.
A. Types of Florida WC payments and payment provisions
1. Temporary Total (TT) and Temporary Partial (TP) benefits
TT and TP benefits are limited to a maximum of 104 weeks. Payments are 66
2/3 percent of the worker’s average weekly wages subject to a State
2. Permanent Total (PT) benefits
PT benefits pay 66 2/3 percent of the worker’s average weekly wages
subject to the State maximum. Payments will be made for the duration of
the disability or until the individual reaches age 75. For State maximum
rates, see DI 52150.045.
3. Permanent Partial (PP) benefits
PP benefits will not pay more than 75 percent of the State maximum. The
number of weeks for which payments will be made is determined based upon
the impairment rating.
The individual will receive:
2 weeks for each percentage point of impairment from 1 percent through 10
3 weeks for each percentage point of impairment from 11 percent through 15
4 weeks for each percentage point of impairment from 16 percent through 20
6 weeks for each percentage point of impairment from 21 percent and up.
If the individual is earning pre-injury wages or more, the benefit period
is reduced by 50 percent.
B. Lump Sum (LS) payments
1. Appeals of initial WC award
Appeals must be filed within 30 days after the mailing of the copies of
the award. Modification of a final compensation order can only be
accomplished by two events:
A “change in condition,” which is defined as a change in the
wage earning capacity of the individual, or
A “mistake in a determination of fact,” which is the absence
of evidence to support a finding of fact. The mistake must be made by the
deputy/industrial commissioner to qualify as a “mistake in a
determination of fact”.
For additional information, see DI 52150.065E Policy on Subsequent Addenda
to Lump Sum Settlements.
2. Award language
The following examples are award language:
“Accepted a Lesser Amount…”
Sometimes a clause is inserted into a Florida WC settlement stating the
individual has accepted a lesser amount in consideration of the receipt of
DIB and also stating SSA is precluded from offset. Such a clause is not
binding on SSA. SSA is entitled to offset for months prior to the
month of adjudication, according to Social Security Ruling 83-29c.
“Representing Any and All…”
Most LS awards will contain closeout language such as "representing any
and all temporary total, temporary partial, permanent impairment, wage
loss, or permanent total disability compensation benefits under the
Florida Workers' Compensation Act to which the employee might be entitled
both now and in the future." This wording does not mean that all these
benefit types are included in the award. The language is meant to closeout
all possible entitlement based on the same injury.
Older Florida lump sum awards were known as ‘washout’
settlements and many of these were life expectancy cases. Washout just
refers to the fact that the claim is closed after the lump sum settlement.
C. Cost-of-Living Adjustments (COLA)
Florida Workers’ Compensation does not provide for a traditional
cost of living increase. However, individuals that are permanently and
totally disabled are potentially eligible for a supplemental yearly
increase of 3 percent. The increase is only payable for individuals under
age 62 that are not subject to offset due to receipt of Social Security
benefits. When the individual attains age 62, if they are eligible for
Social Security benefits they lose entitlement to the supplemental
benefits if the date of injury is on or after July 1, 1990. For injuries
prior to July 1, 1990, the supplemental payments continue.
D. Attorney fees
Attorneys cannot charge fees more than:
20 percent of the first $5,000,
15 percent of the next $5,000,
10 percent on the additional amount received over the first 10 years, and
5 percent on the amount received after 10 years.
E. Retirement insurance benefit (RIB) considerations
Florida WC does not offset for the receipt of RIB. For information on
reverse offset at age 62 and age 65, see DI 52120.055F in this section.
F. Reverse offset
The following chart explains when to apply reverse offset for Florida
cases. Additional information is included after the chart.
When to apply reverse offset
Type of WC Benefit
Apply Reverse Offset?
Permanent Total (PT)
Temporary Total (TT)
Temporary Partial (TP)
1. Determine when to impose offset
Reverse Offset applies to periodic and lump sum (LS) awards. Since
February 1990, reverse offset has not applied to permanent impairment wage
loss or impairment income benefits.
Offset of initial DIB award
Social Security is responsible for imposing offset from the first possible
month of offset up to, but not including, the month of adjudication.
NOTE: For this section, the month of adjudication is determined as
the date the adjudicator takes action on the “DECI” screen,
EF101, or A101.
Offset at age 62
SSA will re-impose offset effective with the month of age 62 attainment.
Florida is responsible for the offset from the month of adjudication, up
to and including, the month prior to the month of attainment of age 62.
Refer to DI 52105.001 for applicable instructions when offset is being
re-imposed at age 62.
It is not necessary to develop for the exact date that Florida
discontinues the offset. However, Florida law concerning age 62 attainment
is different from SSA rules. Take efforts to obtain the amount paid in the
month of age 62 attainment as this amount may vary from your expectations.
The correct amount of WC to use for offset for the age 62 month is the
total amount of WC paid for the full month, which includes the RJ WC paid
Offset at age 65
SSA will impose offset up to but not including the month of age 65
attainment before December 19, 2015. Effective December 19, 2015 or later,
WC offset termination extends from age 65 to full retirement age (FRA).
See 2015 amendment in DI 52101.005.
NOTE: For SSA purposes, an individual attains their age the day
prior to their birthday.
Appeal reverses DIB cessation
Offset does not apply for the retroactive period beginning with the DIB
New period of DIB established
Offset applies for months prior to the month of adjudication of the new
Wage Loss (Permanent Impairment or Temporary Partial) and Impairment
Since February 1990, reverse offset does not apply to permanent impairment
wage loss or impairment income benefits.
NOTE: Most LS awards contain close-out language such as,
“representing any and all temporary total, temporary partial,
permanent impairment, wage loss, or permanent total disability
compensation benefits under the Florida Workers' Compensation Act to which
the employee might be entitled both now and in the future." This
wording does not mean that all of these benefit types are included in the
award. The language is meant to close out all possible entitlement
based on the same injury.
Request proof of verification to resolve any questions about the type of
benefit in an LS award in Florida. See Verification/Proof of
Workers’ Compensation/Public Disability Benefit (WC/PDB) in section
Permanent Impairment Wage Loss on or after 02/1990
Effective with any adjudicative decision on the individual's receipt of
permanent impairment wage loss under section 440.15(3)(B) of Florida law
made in or after 02/90:
Reverse offset rules do not apply to wage loss or impairment benefits;
Wage loss benefits are offsettable whether paid as periodic benefits or
Offset will not be removed; and
Consider a possible return to work, as there is work involved by the
NOTE: Offset will not be imposed on any case where the decision not
to offset wage loss was made prior to February 1990.
Impairment Income Benefits
Effective with injuries occurring on or after 10/1/94, wage loss was
replaced by impairment income benefits. They are subject to offset by SSA.
The maximum number of weeks for these benefits is 401. A diary should be
prepared for removal of offset when payments end.
Temporary Partial Wage Loss
Temporary partial wage loss under Florida law section 440.15(4) falls
2. Determine reverse jurisdiction start and stop dates
The reverse jurisdiction start date is the calendar month of the DIB claim
The reverse jurisdiction stop date, if applicable, is the month before the
NH attains age 62.
For systems inputs see DI 52120.055F.3. in this section and for initial
claims instructions see DI 52120.055F.4. in this section.
NH is awarded DIB with a date of entitlement of February 2007. The claim
is adjudicated October 15, 2007. SSA will offset the NH’s benefit
from February 2007 through September 2007. SSA will pay the NH his or her
full DIB PIA from October 2007 and continuing. The reverse jurisdiction
start date is October 2007.
This same NH turns age 62 on February 12, 2008. SSA will impose offset
again effective with February 2008 and continuing. The reverse
jurisdiction stop date is January 2008.
3. Systems input for reverse jurisdiction start and stop dates
MCS and ICF will allow you to input reverse jurisdiction start and stop
dates. Determine the start and stop dates per instructions above. If
applicable, you can input a future stop date for age 62 attainment. If a
stop date is entered, the system will automatically re-impose offset
effective with the date entered.
CAUTION: Enter a stop date only if it is clear that offset should
be re-imposed. In many cases, development may be needed to determine the
proper amount of offset at age 62.
4. Initial claims taking considerations
When processing a DIB claim involving Florida WC you will need to know the
month of adjudication to accurately process the offset. DO NOT make
an input for Non-Medical Completion (SPORT). You will need to wait until
the claim is allowed so you can enter the correct offset information.
Follow this procedure:
indicate on the WPCL screen that “Y” reverse jurisdiction is
code the start date as 3 months from the filing date;
establish an issue on the DW01 for WC. Set the tickle date equal to the
tickle set for your DDSDEC; and
if the Claim is allowed, change the start date on the WPCL screen to the
month of adjudication, per note below. Complete and send a Form
DFS-F2-DWC-14, Request for Social Security Benefit Information
NOTE: Remember, the month of adjudication is determined as the date
the adjudicator takes action on the “DECI” screen, A101, or
5. Age 62 diaries
Diary 4 months prior to attainment of age 62 for development of:
WC verification, to see if WC continues;
proof of age, if not yet established; and
possible RIB election per DI 52150.030
6. Re-imposition of offset at age 62 – DIB onset March 01, 1981 or later and MOET September 1981 or later
To correctly impose offset at age 62, you must first determine if offset
has been previously considered.
"Offset previously considered" includes situations where benefits are
actually reduced due to offset, as well as situations where a high ACE or
excludable expenses preclude benefit reduction. For Offset Effective
Dates, see DI 52150.020 and for WC/PDB Offset Ending Date, see
The ACE and TFB are computed effective with the first month offset is
considered. The ACE and TFB will only be changed if conditions in
DI 52150.005 - Total Family Benefits - When TFB Can Be Changed or
DI 52150.010 - Average Current Earnings - Changing the ACE) apply.
For complete instructions regarding re-imposition of offset at age
62, see DI 52105.001.
Offset previously considered prior to the reverse offset
If offset was previously considered for at least one month before the
first reverse offset month, SSA benefit increases (due to recomputations,
COLAs, and the combining of maximums) during the reverse offset period are
Reverse offset start date is equal to the DIB MOET
If reverse offset is effective with the DIB MOET (i.e., offset is first
considered at age 62), SSA benefit increases during the reverse offset
period are not protected. The month of age 62 attainment is the first
possible month of offset and the TFB and ACE are computed effective as of
New WC award begins during period of reverse offset
The situation may arise where payments from the first WC award end during
the period of reverse offset. If the individual then becomes entitled to
additional WC payments based on a new WC award (due to a different
injury/illness) during the period of reverse offset, the TFB and ACE are
established as of the month of age 62 attainment, and prior SSA benefit
increases are not protected.
February 2000 - DIB MOET
April 2000 - DIB adjudication date (therefore, 04/00 is reverse offset
February and March 2000 (prior to adjudication) - offset imposed
April 2000 - reverse offset begins
June 2005 - individual attains age 62-offset re-imposed using original ACE
& TFB Increases due 04/00 through 05/05 are protected
May 2000 - DIB MOET and DIB adjudication date (i.e., reverse offset begins
May 2000 and applies for all months of DIB entitlement prior to age 62)
June 2005 - individual attains age 62 - first month offset is considered
and imposed. The TFB is based on the June 2005 monthly benefit amount.
None of the prior benefit increases during the reverse offset period are
7. Form DFS-F2-DWC-14 (Request for Social Security Disability Benefit Information)
The State or the insurance carrier uses the Form DFS-F2-DWC-14 (Request
for Social Security Benefit Information). Go to this website
to request DIB payment data.
When the FO receives the Form DFS-FS-DWC-14:
If the DIB claim is pending, the field office (FO) will:
complete the DWC-14 when the DIB decision is made;
fax a copy to NDRed or eView; and
return the DFS-F2-DWC-14 to the requestor shown in Part IV.
G. Verifying WC
Effective July 2017, the State of Florida discontinued public access to its Workers’ Compensation Claims Database. A limited number of SSA personnel in the Atlanta Region have secure access to the database for the purpose of verifying WC claims information.
After attempting to develop proof of WC directly from the NH or
their attorney per DI 52145.001F, Field Offices can verify FL WC by
sending an e562
(Request for Assistance) to the FO servicing the Florida zip code for the
NH’s employer at the time of the FL WC injury/claim. This
information is found in the Modernized Claims System (MCS) on the
“WPAD” screen, or in information or documentation provided by
the NH or their attorney.
Processing Centers only may contact the Southeastern Program
Service Center (SEPSC) to verify FL WC by sending an email to the mailbox
to SEPSC’s Operations Support Branch (||SEPSC OSB).
Detailed Florida WC claim documentation is available for access without a
password at the
Florida’s Office of the Judges of Compensation Claims. Type all of
the available information on the
Social Security Ruling 83-29c, Reduction of Benefits –
Workmen’s Compensation Benefits Paid Under Florida Law
Social Security Ruling 93-1, Workers’ Compensation Offset –
Offset of Wage Loss Benefits - Florida
PR 02505.011 Worker’s Compensation Offset in Florida
GN 00302.400 Point at Which a Particular Age is Attained
DI 52101.005 Social Security Amendments with Worker’s
Compensation/Public Disability Benefits (WC/PDB) Offset Provisions
DI 52150.045 Chart of States’ Maximum Workers’ Compensation
DI 52150.060 Prorating a WC/PDB Lump Sum Settlement
DI 52150.030 Considering the Retirement Insurance Benefit (RIB) Option
DI 52150.050 Excludable Expenses
DI 52150.065 Complex Lump Sum (LS) Settlement Provisions
DI 52150.065A Life Expectancy Cases