Joint Request For Voluntary Mediation | Pdf Fpdf Doc Docx | Florida

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Joint Request For Voluntary Mediation | Pdf Fpdf Doc Docx | Florida

Joint Request For Voluntary Mediation

This is a Florida form that can be used for Workers Comp.

Alternate TextLast updated: 5/7/2012

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Description

OJCC Voluntary Mediation Program The mediators of the OJCC are available to conduct voluntary mediations of workers' compensation matters. When a petition for benefits ("PFB") is filed, mediation is usually mandatory, except for those PFBs set for expedited final hearing. That process is not the same as a voluntary or stipulated mediation. If the parties agree, they may jointly request a mediation with an OJCC mediator using the form below, or its substantial equivalent, whether or not a PFB has been filed. The parties must be in agreement to mediate, as the OJCC in providing this offer of service is not assuming that Judges or the OJCC have the power to order any party to mediate except upon a particular PFB(s). If the case is already assigned to a JCC due to the filing of a prior request for assignment of case number or prior PFB(s), then the Stipulated Request may be e-filed with the assigned Judge. If the case has not been assigned a case number, the parties may file a Request for Assignment of Case Number (RACN) and one will be assigned for the purpose of assigning the case to a mediator. It is not practical for the OJCC Clerk's office to screen each Stipulated Request for special requests. If the parties would like to request a specific mediator (ex. The case is pending in Orlando, but all parties are in Tampa and wish to mediate in Tampa as an expense saving measure), that may be stated in the joint request and the assigned mediator will attempt to accommodate the parties by forwarding the request to the requested mediator or district. This process is strictly voluntary. No parties should ever be asked by a judge or other OJCC personnel to so stipulate. This service is being offered by the OJCC in response to requests by members of the workers' compensation bar. The OJCC specifically recognizes Gus Soto, Esq. for his leadership with this suggestion. American LegalNet, Inc. www.FormsWorkFlow.com STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS OFFICE OF THE JUDGES OF COMPENSATION CLAIMS ________________DISTRICT OFFICE ) ) ) vs. ) ) OJCC Case No. __________________ _________________________, ) Employer/ Carrier/Servicing Agent. ) Accident date: ________________ __________________________________ ) ) Joint Request for Voluntary Mediation The Claimant and Employer/Carrier in this case hereby seek an opportunity to mediate this case. The parties are interested in discussing (Check all that apply): ( ) Specific benefit issues. ( ) Overall settlement. ( ) Both ( ) Attorney's Fees, purely by stipulation, notwithstanding Fla. Stat. §440.25(1) which proscribes mandatory attorney fee mediation, as this is not a mandatory statutory mediation. The parties represent that the mediation will likely require _________ (approximately in minutes). The parties represent the need for this mediation is: ( ) Urgent (next 30 days) ( ) Pressing (next 60 days) ( ) Flexible (next 90 days) The parties stipulate that this mediation will be governed by the Rules of Workers' Compensation Procedure, Chapter 60Q, Florida Administrative Code. The parties likewise agree that if a petition for benefits is filed prior to any voluntary mediation scheduled because of this Joint Request, the voluntary mediation will be cancelled and a mandatory state mediation will be noticed as normal, unless the parties stipulate after that PFB is filed to proceed to the scheduled voluntary mediation on all issues, including the PFB(s) despite the filing of the PFB(s) subsequent to this request. Recognizing that this case is not already assigned to a judge or district, the parties specifically request that the mediation be conducted in District ____________________. ________________, Employee/Claimant, ________________________________ Claimant or Attorney for Claimant _________________________________ Adjuster or Attorney for E/C American LegalNet, Inc. www.FormsWorkFlow.com

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