What happened: A Florida appeals court reversed a workers' comp cost ruling because the official affidavit form did not ask for information the statute requires.
Who's involved: Amazon.com Services, Zurich American Insurance Company, and Sedgwick CMS as employer/insurer/TPA
What's at stake: Whether a claimant can be denied cost relief for completing an official form that omits a statutory requirement
Why it matters: The OJCC's financial affidavit form is used statewide, and the court's reasoning could apply beyond this case
Where it stands: Reversed and remanded on October 7, 2026 - not yet final
A Florida workers' comp claimant completed every field on an official court form, as written. Appeals court ruled the form was missing the right questions.
The First District Court of Appeal reversed a judge of compensation claims who denied the claimant's petition for relief from paying appeal costs in a case involving Amazon.com Services, Zurich American Insurance Company, and Sedgwick CMS. The workplace accident dates back to April 18, 2022.
The dispute turned on a gap between what the law requires and what the official form asks. Section 440.25(5)(b), Florida Statutes, requires a financial affidavit to list "all assets and income, including marital assets and income." Florida Rule of Appellate Procedure 9.180(g)(3)(D) echoes that language. Failure to disclose is grounds for denial with prejudice.
But the affidavit form provided by the Office of the Judges of Compensation Claims (OJCC) does not ask for marital income. It asks whether "anyone contributes to your income or helps pay your expenses," then provides three fields: name, relationship, and monthly contribution amount.
The claimant disclosed her spouse's $1,700-a-month contribution to household expenses. On cross-examination, she testified he earns $3,200 per month. The JCC denied her petition, finding she had not met the statute's requirements because full spousal income was not on the affidavit.
The appeals court acknowledged the JCC's "thoughtful nine-page order" but found the analysis too narrow. The JCC had recognized he "must look at the totality of circumstances" yet concluded he was "constrained" by statute. The court disagreed.
That totality included the mismatch between form and statute, the claimant's sworn testimony disclosing full spousal income, her testimony that his income was "wholly inaccessible to her," and the JCC's own finding that benefits would accrue solely to the claimant. The court stated plainly: "The true remedy here is to fix the form."
The decision reversed the order and sent the case back for reconsideration. The panel was unanimous. The ruling is not yet final, subject to any timely motion under Florida Rules of Appellate Procedure 9.330 or 9.331.
Because the OJCC's form is used statewide, the reasoning in this decision could give other claimants grounds to challenge cost-relief denials built on the same affidavit gap.
