7/30/2025
Editor: Felicia Wymer, Partner, Pensacola Office
Author: Travis Coleman, Junior Partner, Tampa Office
Author: Katie Valley, Associate, Jacksonville Office
Lucille Carson v. Mid-Florida Pathology, LLC and Amtrust North America, Inc.
JCC Jacobs: Orlando District Order date: 5/11/2025
OJCC Case: 23-008095 Date of Accident: 3/30/2022
JCC Order: Click Here
Briefly: Major Contributing Cause
Summary: Great job, Elijah! The claimant sustained injuries to her left knee, lower back, and right shoulder in a compensable parking lot trip and fall. The claimant sought authorization for continued medical care for her lower back, left knee, and right shoulder. On August 27, 2024, the claimant presented to Dr. Jeffrey Friedman, the orthopedic surgeon selected as her one-time change. Doctor Friedman opined that while the claimant could continue to seek conservative treatment for her lower back, it should be handled through her private health insurance, given that she had severe scoliosis, arthritis, and significant degenerative changes throughout her lumbar spine. Further, he stated that the major contributing cause and need for any further treatment for her lower back was due to her pre-existing condition. With respect to her left knee, he found end stage arthritis, which had caused the extrusion of the medial meniscus, not the work accident. Regarding her right shoulder, he noted that the claimant had chronic AC joint arthritis and impingement. Doctor Friedman stated within a reasonable degree of medical certainty that the accident was not the MCC of the need for treatment for all of her listed injuries and placed her at MMI with a 0% impairment rating. The JCC found the claimant to lack credibility, particularly with respect to her testimony regarding pre-existing medical history, as well as her testimony regarding her communications with the authorized treating providers and IME providers. Ultimately, the JCC held that the claimant had not met her burden of proof as to entitlement to ongoing or continued care of the compensable body parts. The claim for continued care of the lumbar spine, left knee, and right shoulder was denied.
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Yannie Castillo v. VI at Aventura & CorVel
JCC Kerr: Miami District Order date: 6/19/2025
OJCC Case: 24-020603MGK Date of Accident: 7/25/2024
JCC Order: Click Here
Briefly: Emergency Care
Summary: The Claimant injured her right shoulder while using a vacuum cleaner during her work as a housekeeper. The Employer/Carrier first authorized FastCare for treatment and later, upon a referral, Dr. Mauricio Herrera. The Claimant was diagnosed with impingement syndrome of the right shoulder and treated with PT until she was placed at MMI on November 13, 2024. The Claimant used her one-time change to Dr. Kessler, with whom she treated through February 25, 2025, with MMI likely to occur 4 weeks afterwards. On March 3, 2025, the Claimant testified that she could not lift her arm and had severe pain in her shoulder. Thinking she was having a stroke, she went to an unauthorized Emergency Room. Based on the medical note, the Claimant informed the ER that the pain was present for about a week, and a 6/10 or moderate in intensity. The Claimant informed the ER that she had this pain in the past and thought it was shoulder tendinitis. Afterwards, the Claimant returned to Dr. Kessler and underwent a right shoulder arthroscopy and bursectomy debridement of the bursa. After reviewing the ER records, Dr. Kessler opined that the Claimant could have followed up with his office or the urgent care, but an ER visit was not unreasonable. Although reasonable, medically necessary, and related to the work accident, Dr. Kessler opined that it was not an emergency condition. The JCC found the Claimant failed to produce any evidence that care was undertaken with the intent of determining whether she was suffering a stroke or any other emergency medical condition. Accordingly, the JCC denied compensability of the treatment received at the unauthorized Emergency Room.
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Earl Neuhauser v. Lake County Schools/CCMSI
JCC Grindal: Orlando District Order date: 6/20/2025
OJCC Case: 24-013135EBG Date of Accident: 5/3/2024
JCC Order: Click Here
Briefly: Major Contributing Cause
Summary: The Claimant was injured when he missed a step getting out of the bus to load a wheelchair, feeling a pop in his left knee. Prior medical history includes several left knee surgeries from 1980 to 1981. He had not treated for his left knee at any point within 5 years of the 2024 accident. The Claimant testified to aching in both of his knees that he attributed to peripheral artery disease. The Claimant was diagnosed with arthritis and a septic joint in an ER visit on May 13, 2024. Medical treatment at the hospital from May 13, 2024, to May 23, 2024 was due to the bacterial infection/septic joint in the left knee. The medical reports do not address whether or how the alleged work accident caused the bacterial infection. The Claimant underwent an IME with Dr. Richard Smith on January 14, 2025. Dr. Smith’s report diagnosed the Claimant with an unspecified fracture of the upper end of the left tibia and arthritis of the left knee. The current condition, restrictions, and need for treatment were opined to be the work accident. Additionally, Dr. Smith opined that the work accident resulted in an effusion that became infected. Dr. Smith’s report and deposition also indicated that the Claimant suffered an exacerbation of the pre-existing arthritis.
Dr. Matthew Hurbanis performed an IME for the Employer/Carrier on January 6, 2025. Of note, Dr. Hurbanis found no recurrence of the bacterial infection since May 23, 2024, but the Claimant still had pain and symptoms in the left knee. The JCC agreed with Dr. Hurbanis that the infection was a recurrence of a bacterial infection in the 1980s, and that the Claimant has significant posttraumatic preexisting arthritis in the left knee as a result of the accident in 1980s as well. Ultimately, the JCC found that the only injury sustained in this compensable accident was an exacerbation of the preexisting traumatic left knee arthritis. The Claimant failed to meet his burden establishing MCC of pyrogenic arthritis, streptococcal arthritis, and bacteremia.
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Maurice Hargrove v. ABM Industries, Inc. and Indemnity Insurance Co. of North America, Sedgwick CMS
JCC Newman: Tallahassee District Order date: 07/09/2025
OJCC Case: 22-024894JLN Date of Accident: 9/20/2022
JCC Order: Click Here
Briefly: Fraud
Summary: Awesome win by our very own Felicia Wymer! On September 20, 2022, the claimant felt a “pop” in his lower back when lifting a trash can into a dumpster. The claimant denied a history of chronic back pain and reported no history of having had a similar problem in the past to multiple authorized treating providers, including Dr. Michael Rohan, Jr. of Northwest Florida Spine, Dr. McLoughlin of Ivy Spine and Orthopedics and Dr. Matthew Lee of Tallahassee Orthopedic Clinic. All three providers placed him on some sort of modified duty. On July 18, 2024, after multiple missed depositions and claimant attorney changes, the claimant was deposed by the Employer/Carrier. He either denied any prior accidents or lower back treatment or claimed that he could not remember. However, at the June 2025 hearing, the claimant testified that he sustained a prior work accident while working as a welder in 2001, when he fell off a ladder and injured his low back. He also testified to sustaining and treating for several other injuries to his lower back between 2001 and 2022. Medical records admitted into evidence echoed his newer testimony and established that the claimant had received significant treatment in the past for chronic back pain caused by prior work accidents and MVAs.
Both Drs. McLoughlin and Lee were deposed by the Employer/Carrier. Both providers testified that the claimant denied a history of lower back pain or treatment. Dr. Lee, however, did receive a copy of the claimant’s pre-accident medical records after his initial evaluation of the claimant, and stated that it was clear that the Claimant was experiencing the same symptoms after the work accident as he had been experiencing before the work accident. Subsequently, he opined that the claimant’s work accident was not the major contributing cause of his need of lumbar spine surgery or ongoing treatment. Ultimately, the JCC found that the claimant knowingly made false, fraudulent, and misleading statements regarding his medical history in order to secure benefits. His request for TPD/TTD and continued medical treatment were denied, and it was further concluded that his work accident was not the MCC of his continued need for treatment.
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Ryan C. Pietraszka v. Coffin Marine Services, Inc. and Sedgwick CMS
JCC Jacobs: Miami District Order date: 7/10/2025
OJCC Case: 25-003438JIJ Date of Accident: 9/21/2022
JCC Order: Click Here
Briefly: Motion for Summary Order/Properly Serving PFB
Summary: Wooo, go Ryan! On February 11, 2025, the claimant filed a petition for benefits, which was served on the employer the same day. The uncontroverted record evidence established that the carrier was not served with the petition until June 19, 2025. Section 440.192(1), Florida Statutes, requires a claimant to serve a copy of the petition for benefits on the employer and the employer’s workers compensation insurance carrier. There was no genuine issue of material fact or dispute that the claimant did not serve the carrier with the petition until June 19, 2025. The JCC granted the employer carriers motion for summary final order and the Petition for Benefits filed on February 11, 2025, was dismissed without prejudice.
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