10/28/2025
Editor: Felicia Wymer, Partner, Pensacola Office
Author: Travis Coleman, Partner, Tampa Office
Author: Katie Valley, Associate, Jacksonville Office
Brittney Williams v. Rahco Pensacola, LLC dba Right at Home and Accident Fund Insurance Company of America
JCC Walker: Pensacola District Order date: 09/10/2025
OJCC Case: 23-009953JW Date of Accident: 10/13/2022
JCC Order: Click Here
Briefly: MCC
Summary: A great Quiggins win! The claimant was injured at work while going down the stairs, resulting in shoulder, cervical, and lumbar pain. The claimant treated with Dr. Landry, who performed an authorized cervical surgery in 2023. Claimant also underwent an authorized shoulder surgery on March 4, 2024, performed by Dr. Turnage. Since the surgery, the claimant stated that her neck pain had improved, but that she was constantly experiencing lower back pain. She denied any history of lower back pain. Dr. Landry recommended that the claimant undergo a 3-level lumbar fusion. The E/C obtained an IME from Dr. Barry Lurate, who testified that the claimant had “bad arthritis in her back”. He opined that the MCC of the requested lumbar surgery was the claimant’s “underlying pre-existing disease”, which was becoming symptomatic due to her advanced age. The JCC accepted Dr. Lurate’s opinion over Dr. Landry’s, stating that the claimant’s acute injury in 2022 was now too remote to be considered the primary reason why the lumbar surgery was now required. The claim for the lumbar surgery was denied, as well as claims for attorney’s fees and costs.
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Grenocco Templeton v. Sysco Jacksonville, Inc. and Corvel Enterprise Claims, Inc.
JCC Holley: Jacksonville District Order date: 09/11/2025
OJCC Case: 25-003439 Date of Accident: 09/23/2024
JCC Order: Click Here
Briefly: E/C Costs
Summary: KVP! KVP! On September 23, 2024, the claimant sustained a compensable injury after falling on the ramp of an 18-wheeler. On February 11, 2025, the claimant’s attorney filed a Petition for Benefits seeking authorization of a follow-up appointment with the Claimant’s authorized treating physician, compensability, and PICA. On March 5, 2025, the E/C/SA, through Adjuster Ken Sapp, filed a Response to the PFB, asserting that the Claimant had already been seen by Dr. Christopher Goll at Southeast Orthopedic Specialists on February 5, 2025—six days before the Petition was filed. On April 7, 2025, the E/C took the claimant’s deposition, which incurred an expense of $637.50. On May 19, 2025, a Notice of Resolution was filed, and on June 23, 2025, the E/C filed a Motion to Tax Costs. Section 440.34(3) allows for the prevailing party to recover reasonable costs from the non-prevailing party. The JCC explained that since all of the requested benefits, with the exception of fees and costs, had already been provided prior to the filing of the PFB, the claimant was not the “prevailing party”. Additionally, the filing of the PFB required the E/C to defend against a frivolous request for a benefit that was neither disputed nor outstanding. The E/C is considered to be the “prevailing party” when they successfully defend a PFB, which is what the JCC determined happened in this case. The JCC ordered the claimant to pay $500.00 in costs to the E/C.
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Jorge Alberto Lopez v. Miami Dade County Public Schools/Gallagher Bassett
JCC Havers: Miami District Order date: 9/12/2025
OJCC Case: 24-017928WJH Date of Accident: 10/15/2013
JCC Order: Click Here
Briefly: Authorization of PRP Injections
Summary: The Claimant had worked as a custodian with the school district for about 27 years. In 2013, he injured his knee and back when he fell while carrying a garbage can. Dr. David Keyes diagnosed the Claimant with a left knee medial meniscal tear, cyst, and extensive edema and pain in the cervical, thoracic, and lumbosacral spine. The Claimant refused a surgery to repair the meniscal tear and was placed at non-operative MMI in 2014. The Claimant continued to treat, and his knee continued to get worse. However, in 2023 the Claimant was determined to no longer be a surgical candidate due to developing high blood pressure. The Claimant obtained an IME in December 2024, who agreed with the nonoperative MMI in 2014 and recommended palliative PRP injections to help with inflammation. Dr. Keyes disagreed with the PRP injections, saying that they would not result in long term relief, but could alleviate inflammation in the short term. Dr. Keyes would not give the injections due to the HBP, and would require clearance prior to any injections. The Judge, accepting the uncontroverted opinion of the Claimant’s IME that the MCC of the need for PRP injections is the work accident, and the Claimant’s IME’s opinion that the PRP injections are medically necessary, ordered the Employer/Carrier to authorize the PRP injections.
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Ana Borges v. Ecotec Manufacturing/Harbor America/CCMSI
JCC Hedler: West Palm Beach District Order date: 9/12/2025
OJCC Case: 15-026264BJA, 17-000735BJA Date of Accident: 4/17/2024
JCC Order: Click Here
Briefly: Penalties and Interest on Settlement
Summary: Handled by our very own David Halpern, the Claimant filed a Petition for Benefits requesting payment of the stipulation, settlement funds, and penalties and interest on late payment of same. The Employer/Carrier responded indicating that all monies were paid appropriately. The Employer/Carrier also filed a Motion for Summary Final Order. After mediation, the sole remaining issue was for interest on late payment per 2/21/2025 Order for an E/C paid side fee. The Carrier issued funds pursuant to that Order on 2/27/2025, and again on 3/27/2025 when the original check did not arrive at the Claimant’s Counsels office. After reviewing case law, the Judge determined that the checks were not issued timely, as there is no exception under the law for the untimely re-issuance as it pertains to interest. The Employer/Carrier made an alternative argument, that the Claimant waived entitlement to interest in the settlement agreement and release. After reviewing specific language in the settlement agreement, the Judge determined that the settlement agreement plainly states language that releases claims for interest. Finding that the Claimant waived any claim for interest, the Motion for Summary Final Order was granted.
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Nelson Blanco v. InSource Employer Solutions/Next Level Administration
JCC Case: West Palm Beach District Order date: 10/3/2025
OJCC Case: 24-030728BKC Date of Accident: 4/5/2023
JCC Order: Click Here
Briefly: Misrepresentation/Course and Scope
Summary: The Claimant filed a Petition for Benefits requesting authorization of a PCP, transportation, compensability, and PICA. The Employer/Carrier denied on the basis of Major Contributing Cause, specifically noting the Claimant was involved in a personal altercation that was not related to the workplace. E/C also raised a misrepresentation defense based on the claimant’s initial discussion with the insured in which the claimant advised the altercation resulting in his injuries was personal in nature, then later, in his deposition, reversed his position. For fact purposes, the Claimant was attacked by a co-worker with a machete on April 5, 2023. The Claimant was hired to help remove non-native vegetation from sites around Palm Beach County. To do their job, the Claimant and co-workers were provided equipment, including the machete. On the date of accident, the Claimant was talking with another co-worker when someone yelled for him to watch out. When the Claimant turned around, the attacker started to strike at the Claimant with the machete. The Claimant lifted his left arm to defend himself, and the machete hit with such force that it severed the bone just below the elbow. The Claimant was also hit in the head and tried to run away. The attacker caught up with the Claimant and got on top to continue the attack, at which point other co-workers intervened. The Claimant tried to use his hand to stand up and realized the arm was hanging. He was rushed to the front gate where police and paramedics were waiting. The Claimant was admitted to the hospital for about 4 days, where he underwent surgery on his arm and head. Since the surgery, the Claimant has continued issues with the left arm including swelling, pain, issues grasping, etc. In arguing the misrepresentation defense, the Employer/Carrier stated that the Claimant made statements while in the hospital immediately following the accident to the effect that the accident was personal; that he knew his attacker and there was a conflict not related to work. The Claimant later denied these statements in deposition. The Employer/Carrier relied on testimony from the Owner of the insured, the Claimants former supervisor, and the adjuster. After reviewing all depositions/testimony from the above, the Judge found them inconsistent and unreliable.
Both the owner and adjuster called the Claimant the day after the attack, and the Claimant explained that he did not want to pursue workers’ compensation based on personal choice. The Claimant allegedly told the owner of the insured that he knew his attacker from the neighborhood, but told the adjuster they had just met the day prior. Of note, the alleged, conflicting statements made the day after the attack came when the Claimant was on significant pain medication including fentanyl, oxycodone, and morphine. The Judge accepted the Claimant’s testimony that he did not recall making those statements, and if he did, the Employer/Carrier failed to establish that the Claimant’s subsequent denial of the statements was made knowingly and intentionally to secure workers’ compensation benefits. Accordingly, the misrepresentation defense was rejected. The Employer/Carrier also raised a defense that the accident did not arise out of the Claimant’s employment. There was no question that the Claimant was in the course-and-scope of his employment when the attacked occurred. The question then is whether the attack was due to a risk distinct to the employment, not related to work, or neutral. Based on the facts, the Judge found that the risk is distinct to the employment. The employees were required to use machetes, did not conduct any background checks, and required steel-toed boots due to the dangers of a machete. Based on this, the Judge found the machete attack to be compensable.
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