Florida Division of Workers’ Compensation Rule Workshop

Oct 21, 2008


Florida Division of Workers’ Compensation Rule Workshop

The Florida Department of Financial Services, Division of Workers’ Compensation, has issued a Notice of Development of Rulemaking regarding the following Rules:

  • 69L-3.0046: Wage Statement: Employer’s and Claims-handling Entity’s Responsibility to Record and Report Wages
    69L-3.025: Forms

The purpose of the proposed Rules is to revise the following forms to comply with the Florida law precluding an agency from requesting an individual’s social security number unless such collection conforms to the specified provisions of that statute. The proposed Rules would revise the following forms:

  • Forms DFS-F2-DWC-1a (Wage Statement) and DFS-F2-DWC-30 (Authorization and Request for Unemployment Compensation Information) would be revised so that collection of a social security number is discontinued
  • Forms DFS-F2-DWC-1 (First Report of Injury or Illness), DFS-F2-DWC-3 (Request for Wage Loss/Temporary Partial Benefits), DFS-F2-DWC-4 (Notice of Action/Change), DFS-F2-DWC-12 (Notice of Denial), DFS-F2-DWC-13 (Claim Cost Report), DFS-F2-DWC-14 (Request for Social Security Disability Benefit Information), DFS-F2-DWC-19 (Employee Earnings Report), DFS-F2-DWC-33 (Permanent Total Off-Set Worksheet), DFS-F2-DWC-35 (Permanent Total Supplemental Worksheet), DFS-F2-DWC-40 (Statement of Quarterly Earnings for Supplemental Income Benefits), and DFS-F2-DWC-49 (Aggregate Claims Administration Change Report) would be revised to include a purpose and use statement regarding collection of the social security number

Clerical revisions also would be made to existing Rules in this Chapter to maintain consistency.

Date: Tuesday, October 21, 2008
Time: 10:00 a.m.
Place: Room 104J of the Hartman Building, 2012 Capital Circle SE, Tallahassee, Florida