8/27/2025
Editor: Felicia Wymer, Partner, Pensacola Office
Author: Travis Coleman, Junior Partner, Tampa Office
Author: Katie Valley, Associate, Jacksonville Office
Kara Weldon v. Astellas US LLC and Sompo America Fire & Marine Insurance Company, Gallagher Bassett Services, Inc.
JCC Pitts: Orlando District Order date: 07/16/2025
OJCC Case: 24-028668 Date of Accident: 02/06/2024
JCC Order: Click Here
Briefly: TPD/Retroactive Work Restrictions
Summary: The claimant sustained compensable cervical spine and right hand/wrist injuries in a February 6, 2024, motor vehicle accident that occurred in the course and scope of employment. The claimant began treating with Dr. Ravi Patel, an orthopedic spine surgeon, for the cervical spine and Dr. Feiner, an orthopedic hand surgeon, for the wrist and hand. The claimant testified that she requested her providers not to assign work restrictions on the alleged basis that she feared losing her job. Dr. Patel both corroborated this and stated that he went as far as to offer work restrictions, but the claimant declined them. Dr. Feiner testified that he placed no work restrictions because he believed her continued work as a sales representative did not require work restrictions. In November 2024, the claimant was terminated as part of a company-wide reorganization that eliminated 140 positions. Upon receiving this notice, the claimant began to look for a new job, which she began on March 10, 2025. As part of her separation, the claimant accepted a severance package which included a lump sum payment of $90,364.00 in consideration of a general release. She was not at MMI. In a petition for benefits, the claimant sought authorization and payment of TPD for January 1, 2025, to February 28, 2025, less earnings, unemployment, compensation, and/or indemnity paid, if any; penalties and or interest; and attorney’s fees and costs. The E/C sought to offset the severance payment against TPD benefits by treating it as a salary continuation, but the JCC found that it failed to meet its burden under section 440.20(14), Fla. Stat. Instead, the JCC held that the lump sum payment only offset otherwise payable TPD benefits in the actual week the lump sum payment was made. The E/C asserted that no medical evidence established entitlement to TPD, as the claimant never received any work restrictions. The JCC referred to Dr. Patel’s April 30, 2025, deposition testimony where he retroactively applied work restrictions during the period the claimant was unemployed and looking for work and opined the Claimant was due TPD for the period at issue.
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Kim K. Bennett v. Enterprise Title Partners of New Tampa, Inc. and Twin City Fire Insurance Company
JCC Arthur: Tampa District Order date: 07/21/2025
OJCC Case: 24-005256 Date of Accident: 03/11//2021
JCC Order: Click Here
Briefly: One-Time Change/Gamesmanship in Request
Summary: On January 31, 2025, the claimant’s attorney emailed a letter to the employer/carrier’s attorney, requesting “Authorization for continued pain management care with Dr. Jay Parekh for her compensable conditions under section 440.13(2)(f).” On February 11, 2025, the claimant filed a Petition for Benefits containing the same language as the January 31, 2025, letter. The attorney for the E/C advised the adjuster to choose the physician to authorize for continued pain management care. On February 26, 2025, the adjuster authorized Dr. Nabil Gerges as the claimant’s change in physician. The adjuster responded to the petition on March 5, 2025, asserting that the request for authorization for continued pain management care with Dr. Parekh obfuscated the claimant’s request for a one-time change, and the employer/carrier was authorizing Dr. Nabil Gerges as the change in physician. The JCC noted that per widely available caselaw, the way to request a change in physician is to do so explicitly. The JCC found that the wording that the claimant’s attorney used had the effect of delaying the delivery of benefits and increasing litigation and expenses. Subsequently, he found the dispute in this case was not the result of inadvertence or ignorance but was the result of obfuscation in making a claim that is, as noted in the language used by the Gonzalez court, an inappropriate sharp practice and gamesmanship. The JCC held that the E/C had the right to select the claimant’s requested change in physician and denied the claim for attorney’s fees and costs.
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Kateryna Gumucio v. Nordstrom, Inc.
JCC Arthur: Tampa District Order date: 8/1/2025
OJCC Case: 24-016520RAA Date of Accident: 11/10/2023
JCC Order: Click Here
Briefly: Authorization of Medical Care Not FDA Approved
Summary: The Claimant filed a Petition for Benefits requesting authorization and scheduling of Lidocaine IV Infusion Therapy. The Carrier denied the request on the basis that the treatment was not FDA approved, stating that the treatment was controversial, experimental, shows no effective relief, not medically necessary, and the doctor refused to perform the treatment at fee schedule. During this compensable claim, the Claimant was diagnosed with CRPS and referred to Dr. Neal Shah to provide pain management treatment. The Claimant failed to respond to numerous treatments, and thus the IV Lidocaine infusion treatments were recommended. The request for the infusions was not responded to until 18 days later, and thus not timely as required by section 440.13(3)(d) & (i), Florida Statutes. These subsections of the statute require the employer to respond to requests for authorization within 3 or 10 days of receipt of the request from the doctor. As they did not respond on time, the plain language of the statute dictates that they have consented to the medical necessity of the treatment. The JCC accepted the testimony of Dr. Shah that IV Lidocaine infusion therapy is not experimental and is in accordance with practice parameters and protocols. Accordingly, the statute requires the employer to furnish to the employee medically necessary remedial treatment, and awarded the infusion therapy.
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Gabriel Arena v. ABF Freight System/ArcBest Corp.
JCC Kerr: Miami District Order date: 8/4/2025
OJCC Case: 25-002667MGK Date of Accident: 10/14/2022
JCC Order: Click Here
Briefly: Voluntary Limitation of Income
Summary: The question posed in this claim is whether a Claimant with restrictions of no driving is justified in refusing suitable light duty work where the employer does not provide transportation to work. The Claimant suffered a compensable workplace accident in which he injured his lower back. The Claimant treated with Dr. Donshik, who assigned restrictions to include no driving. The Employer has an alternate work program with light duty work available. Initially, the E/C could not accommodate the Claimant’s restrictions and TTD was paid from 2/10/2023 to 5/4/2023, when benefits were suspended based upon extension of an offer of non-union, light duty work within Claimant’s restrictions in the AWP program. The Claimant refused the light duty work offer. Claimant argued that his no driving restriction precluded him from returning to work, and requested the Employer to provide him transportation, which was refused. He was released to full duty on 6/27/2023. Section 440.15(6), Florida Statutes (2022), provides, “If an injured employee refuses employment suitable to the capacity thereof, offered to or procured therefor, such employee shall not be entitled to any compensation at any time during the continuance of such refusal unless, at any time in the opinion of the JCC, such refusal is justifiable.” The JCC found that the E/C has carried their burden of proof to show the Claimant limited his income, which shifted the burden to the Claimant to show the refusal was justified. Ultimately, the Claimant did not show that his difficulties in getting to work to be different than an ordinary commuting difficulty faced by millions of employees every day. The JCC found no statutory requirement that the Employer provide transportation. Additionally, the Claimant did not try to arrange transportation with a co-worker or car-pooling. The JCC determined that his refusal was not justified and was not entitled to indemnity benefits from 5/5/2023 to 6/27/2023.
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Daniel Medina v. GEICO/Broadspire Services, Inc.
JCC Arthur: Tampa District Order date: 8/4/2025
OJCC Case: 24-030286RAA Date of Accident: 8/5/2025
JCC Order: Click Here
Briefly: Compensability/Repetitive Trauma
Summary: The Claimant sought authorization of a follow-up with the authorized PCP, compensability, and attorney’s fees and costs. The Employer/Carrier denied for lack of a workplace accident, idiopathic, major contributing cause, not a repetitive trauma, etc. For a claimant to recover under the repetitive trauma theory of accident, he must show 1) prolonged exposure, 2) the cumulative effect of which is injury, and 3) that he has been subjected to a hazard greater than that to which the general public is exposed. Alternatively, he must demonstrate a series of occurrences whose cumulative effect is injury under the Festa standards. For 13.5 years, the Claimant has worked on GEICO’s subrogation review team, with duties mainly involving a computer/typing/using a mouse. There are production quotas in place that require constant keyboarding at a rapid pace. His symptoms of tiredness and soreness in his left shoulder, elbow, and hand, progressed until he sought treatment with Watson Clinic. The JCC found that the keyboarding for 13.5 years was a prolonged exposure. The Claimant sought an IME with Dr. James Shea, who established that his keyboarding resulting in lateral epicondylitis, cubital tunnel syndrome and carpal tunnel syndrome, for all of which the Claimant was at a greater risk than the general public. The JCC rejected the Employer/Carriers IME who opined that the epicondylitis was the result of aging. The JCC found that the diagnoses were related to the job duties of continuous typing. Accordingly, compensability and authorization of a PCP was awarded.
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