1/27/2026
Editor: Felicia Wymer, Partner, Pensacola Office
Author: Travis Coleman, Partner, Tampa Office
Author: Katie Valley, Associate, Jacksonville Office
Gerald Kostecka v. North Port Retail Center / Florida Blue and Corvel
JCC Young: Tampa District Order date: 12/05/2025
OJCC Case: 25-004940RLY Date of Accident: 10/14/2024
JCC Order: Click Here
Briefly: Recreational Activities/Course and Scope
Summary: The claimant testified that, on October 14, 2024, he suffered an injury to his shoulder while participating in a Chamber of Commerce endorsed volunteer event. The claimant was distributing cases of bottled water and bags of ice to benefit the people impacted by Hurricane Milton. He estimated that he distributed approximately 400 to 500 of the cases/bags. He testified that his shoulder started to hurt towards the end of the day. The claimant was a retail insurance sales consultant, and his job description included networking in business development and in the community to build awareness. He was directed to volunteer, if possible, by his supervisor. During his deposition, the claimant’s supervisor explained that attending was an option, but that attending was also within the course and scope of his employment, and that the claimant was being sent there “as an employee” to engage in the community event. The claimant’s job description, as well as internal emails from the claimant’s supervisor, provided additional evidence that attending volunteer events, like this one, would “entail demonstrating the knowledge, skills, and competencies of a high performing sales professional through effectively consulting with prospects and existing customers to meet sales targets, performing timely and efficient lead management to drive close rates and retention, etc.” The JCC found that the claimant suffered an “accident” when he developed shoulder pain while volunteering at the Hurricane Milton charity event, and that the injury arose out of, or in the course and scope of, employment. The JCC also found that the recreational/social activity was an expressly required activity of employment for this Employer, that the activity produced a substantial direct benefit to the Employer. However, the JCC ultimately denied the claim, as the claimant did not timely report the injury under 440.185. The Claimant has appealed.
__________________________________________________________________
Laszlo Dosa v. Sunrise Ford and Memic
JCC Hedler: West Palm Beach District Order date: 12/06/2025
OJCC Case: 25-006402TAH Date of Accident: 06/05/2023
JCC Order: Click Here
Briefly: MCC/Misrepresentation
Summary: On June 5, 2023, the claimant was injured in a motor vehicle accident in the course and scope of his employment. He was transported to the hospital, where he remained for five days. The E/C accepted compensability of the accident, and subsequently authorized initial medical care with Dr. Emily Putney, who the claimant first saw on June 23, 2023. The Claimant completed a pain diagram, describing aching pain at the base of the neck/upper back, extending to the shoulders, and stabbing pain in the mid and lower back, as well as the left elbow, and he denied any prior complaints, aside from “intermittent stiffness at times”. The claimant was referred to Dr. Aron Trocchia, an orthopedic doctor, for evaluation of his left elbow, as well as to Dr. Juan Ramos for pain management. He also sought a one-time change from Dr. Putney to Dr. Daniel Husted, who continued the care for the claimant’s spinal complaints. On August 16, 2024, Dr. Husted performed a laminectomy, foraminotomy at L4-5. This resulted in improved back pain, but the claimant continued to complain of pain “radiating up the spine and into the bilateral shoulders and arms.” After obtaining an MRI of the cervical spine that revealed spondylosis between C3-6 and moderate to severe right foraminal stenosis at C4-5 in September 2024, Dr. Husted opined in his report, the Claimant had interscapular and thoracic pain since the accident and that his progressive arm pain was a result of the work injury. He also declared, the Claimant had a possible shoulder component with possible frozen shoulder and that neck and shoulder issues can be concomitant. Dr. Husted assessed the Claimant with adhesive capsulitis of the left shoulder. On December 19, 2024, the claimant returned to Dr. Trocchia, where he stated that he had previously informed the E/C of the shoulder pain, but that it was never addressed. On December 27, 2024, the claimant underwent an MRI of the left shoulder that revealed mild acromioclavicular degenerative changes; suspected tear of the anterior and superior glenoid labrum; and soft tissue fullness of the rotator cuff interval suggestive of adhesive capsulitis. Dr. Trocchia opined that, while it was difficult to conclude that the frozen shoulder was a consequence of the work injury, it was certain that the labral pathology was. Surgery was recommended. The E/C denied the left shoulder, stating that the claimant failed to give timely notice, that the accident was not the MCC of need for shoulder treatment, and that the claimant made false and misleading statements for the purpose of obtained workers’ compensation benefits by falsely claiming to be unable to recall any prior history of pain, injury or treatment to his back to the adjuster, defense counsel, Dr. Putney, and potentially Dr. Husted. The JCC found that the claimant had established compensability and the need for treatment, including the surgery, of his left shoulder, and that the E/C accepted and provided treatment of the condition without invoking the 120-day provision, therefore waiving the denial of compensability of the condition. The JCC further found that the E/C was unable to meet its burden to establish any of cause was the MCC, as the claimant clearly established the work accident was the MCC of the left shoulder condition through the opinions of his authorized treating providers.
__________________________________________________________________
Brandy Muncher v. Publix Super Markets, Inc.
JCC Walker: Pensacola District Order date: 12/08/2025
OJCC Case: 24-028638JW Date of Accident: 12/30/2022
JCC Order: Click Here
Briefly: MCC
Summary: On December 30, 2022, at the end of BOGO watermelon week, the claimant woke up feeling a “crick” in her neck the morning after her final shift. As a produce clerk, she was required to constantly lift watermelons from four-foot-deep bins to be cut and sold. She told a manager at her next shift. In the weeks prior to the work accident, the Claimant denied any neck pain. The E/C defended the claim on the basis that the work accident was not the MCC of the request for treatment nor is such treatment medically necessary. Her initial complaints were well documented in the medical records, where she described “neck pain” that began at work after the date of the accident. The claimant underwent an IME performed by Dr. Buchalter on October 23, 2025. Dr. Buchalter diagnosed the Claimant with C5-7 degenerative disc disease but felt that the 2022 work accident resulted in a permanent aggravation of her preexisting condition. The JCC found Dr. Buchalter’s opinion more favorable than Dr. Erik Nilssen, the E/C’s IME doctor, because while Dr. Nilssen is an orthopedist, he specializes in ankle and foot treatment only and refers any spinal issues to other doctors. The JCC also found the claimant’s testimony to be credible, as she continued to work following her accident, and enjoys her job. Based on the totality of the evidence, the JCC found that the Claimant had a compensable work accident on December 30, 2022. The work accident is the MCC for requested medical treatment, which the JCC found was medically necessary at the time.
__________________________________________________________________
Emma Verdecia v. Aramark/Sedgwick CMS
JCC Jacobs: Miami District Order date: 12/15/2025
OJCC Case: 16-010649JIJ Date of Accident: 3/1/2016
JCC Order: Click Here
Briefly: 120-Day Rule, MCC, Hinderance to Recovery
Summary: The Claimant suffered a compensable low back injury and sought authorization of medications to treat hypertension, hypercholesterolemia, and coronary artery disease, as well as a cardiologist to treat these conditions. Claimant asserts this treatment is needed to continue treatment for her back, the back injury aggravated these conditions, and the E/C waived the right to contest under the 120-day rule. In 2020, the E/C authorized a cardiologist for clearance to undergo a lumbar fusion related to the work accident, but did not invoke the pay-and-investigate provision. Additionally, they paid bills related to hospital visits where the Claimant received treatment for her hypertension. During the course of treatment, the Carrier authorized and paid for three cardiologists, mediations, visits, follow-ups, and required testing. The JCC rejected the hinderance to recovery assertion by the Claimant, as the E/C voluntarily authorized a cardiologist in 2020, 2023, and in 2025. Further, the JCC also placed more weight on the E/C’s IME who made their conclusion based on facts and data whereas the Claimant’s IME relied on personal experience. The JCC also rejected the argument that the compensable back injury aggravated her hypertension and caused the coronary artery disease. The undisputed evidence shows that the Claimant’s hypertension preexisted the accident. Finding that the cause of the hypertension is her genetic predisposition, the diagnosis was attributed to inconsistent treatment rather than pain resulting from the back injury. The JCC ultimately agreed with the Claimant that the E/C waived the ability to deny compensability of the hypertension and related issues as they failed to issue a denial within 120-days following the initial provision of benefits for those conditions. Ultimately, the E/C issued 7 payments to providers treating the Claimants coronary disease without ever notifying the Claimant or providers of any lack of authorization or mistaken payment. The JCC awarded authorization of a cardiologist, medications, as well as penalties and interest on two late indemnity payments.
__________________________________________________________________
Marc Schwarz v. South East Personnel Leasing/Packard Claims and Lion Insurance Co.
JCC Hill: West Palm Beach District Order date: 12/18/2025
OJCC Case: 25-013059KAH Date of Accident: 5/22/2025
JCC Order: Click Here
Briefly: Intoxication Defense
Summary: The Claimant was one of two spike climbers to help with tree trimming and removal. He did not have a certification as a spike climber but testified to 10 years of experience in the role. The Employer was tasked with removing a palm tree. The Claimant was instructed not to climb the tree as the other climber would handle the cutting. As the target tree was, by all accounts, dead, numerous meetings, instructions, and conversations revolved around not climbing the tree as it could be unstable. Several witnesses, including the owners of the company, testified that they were all aware that nobody was to climb the tree and that an A-Frame ladder would be used to remove it. However, the Claimant testified that he was the one designated to climb the tree and that no one told him not to. The JCC rejected the Claimant’s testimony as inconsistent with the other witnesses. Despite warnings, the Claimant proceeded to climb up the tree. As witnesses were walking toward the tree to instruct the Claimant to get down, the Claimant could not maneuver properly and, while the Claimant was attempting to reposition himself, the tree broke from its roots and fell approximately 15 feet. As the claimant was strapped into the tree, he fell along with it, with the tree landing right on top of the Claimant. After the fall, the Claimant testified that he asked his friend to remove drugs and a pipe from his backpack. The Claimant was then airlifted to the hospital where he was diagnosed with significant injuries including fractures, hematomas, and a severe urethral tear. While in the hospital, the Claimant tested positive for THC, as well as other drugs that were administered in the hospital. The Claimant admitted to smoking marijuana twice on the date of accident, once prior to work and once after arriving. In fact, he smoked marijuana with a co-worker daily while at work. Accordingly, there is no dispute that the E/C has met its burden of proving that the presumption of intoxication applies. However, Claimant alleges that the Employe acquiesced to the Claimants presence at the workplace while under the influence of marijuana.
Ultimately, the JCC found no actual acquiescence by the Employer carrying the insurance coverage, Southeast Personnel Leasing. Additionally, the JCC found the testimony of the co-owner of ECO Tree Specialists that he did not allow employees to smoke on the job more credible than the Claimant. No credible evidence was presented that the Claimant was not aware of a no drug policy, as he signed the acknowledgment. The Claimant failed to present any evidence that the marijuana did not contribute to his injuries. To the contrary, all accepted evidence demonstrated that the Claimant should not have climbed the dead tree as it was dangerous, contrary to company safety standards, and in violation of an express directive not to climb the tree. The E/C also raised a misrepresentation defense, specifically based on the Claimant stating that the Employer permitted marijuana smoking while working, and that he smoked with the co-owner, foreman, and others. The statements were directly contradictory to multiple witness statements. Finding that the statements were made during a deposition and at Final Hearing, and that they went directly to the heart of the acquiescence avoidance, the intent behind these statements were to secure workers compensation benefits. The JCC found misrepresentation, and intoxication and denied all of the Claimants requests including compensability of the alleged accident.