Editor: Felicia Wymer, Partner, Pensacola Office
Author: Travis Coleman, Partner, Tampa Office
Author: Katie Valley, Associate, Jacksonville Office
Matthew Apanavicius v. Oasis Outsourcing/Harmsco Inc.
JCC Hedler: West Palm Beach District Order date: 02/06/2026
OJCC Case: 24-030216TAH Date of Accident: 6/10/2024
JCC Order: Click Here
Briefly: Repetitive Trauma/Estoppel
Summary: From November 2023 to June 2024, the claimant worked in a modified position as a result of a compensable industrial accident. During this period, he worked on a line assembling paper cartridges. On June 10, 2024, the Claimant reported a repetitive trauma injury from these modified duties. He initially declined medical care. On June 27, 2024, the Carrier issued a Notice of Denial, asserting the claim was denied in its entirety. On July 10, 2024, the employer brought the claimant to Concentra, where the claimant complained of left shoulder and right pinky finger pain “from continuous repetitive motion at work.” On July 24, 2024, the claimant was placed at MMI with a 0% impairment rating and released from care with the report indicating that he was “functionally back to normal”. He underwent an IME of his choice on December 8, 2025, which noted severe tenderness in his bicep, but an otherwise unremarkable MRI and shoulder evaluation. Dr. Cuellar, the IME doctor, diagnosed him with biceps tendonitis, which she attributed to the repetitive motion work. On December 10, 2025, the E/C’s IME doctor, Dr. Butler, opined there was no objective injury to the left shoulder as it pertains to the claimed repetitive trauma.
The claimant sought an order for compensability and authorized medical care for the left shoulder injury. The Employer/Carrier argued there was no compensable accident or injury to the left shoulder attributable to employment. The claimant argued that the E/C accepted compensability by sending him to Concentra for medical care. Both the employer representative and adjuster testified that neither the Employer nor the Carrier paid for the visits to Concentra, and that Concentra was not authorized. There also was no evidence that the claimant actually received any treatment from Concentra, outside of his evaluation. The JCC concluded that the claimant’s argument was associated with estoppel, and that the Carrier would have been estopped from denying authorization because of the Claimant’s reliance upon the Employer taking him to Concentra. However, the Claimant did not raise estoppel (or any affirmative avoidances) in the pretrial stipulation, as required by Rule 60Q6.113(2)(h). Therefore, the JCC concluded that the estoppel argument was waived, and that compensability was not established as a matter of law. Regarding the repetitive trauma claim, the employer representative testified that, despite the labor-intensive nature of the work, the department is comprised of many long-term employees (30+ years), including elderly employees, and he could not recall any other claims upon repetitive trauma. The evidence reflected the repetitive activity was principally movement of a paper product, and that there was no evidence to support the duties were moderate or heavy with regards to weight or strenuous activity. This was further confirmed by the fact this position was provided as accommodated work in lieu of regular welding duties. The JCC found that the claimant was unable to meet his burden to establish compensability of the repetitive trauma resulting in injury to the left shoulder by clear and convincing evidence.
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Amanda Dearman v. PRSM Solutions LLC/Amtrust North America
JCC Johnsen: West Palm Beach District Order date: 02/06/2026
OJCC Case: 25-011640GJJ Date of Accident: 04/01/2025
JCC Order: Click Here
Briefly: Going & Coming
Summary: On April 1, 2025, the claimant was injured in a motor vehicle accident when she struck a deer. At the time, the claimant was on her way to Walgreens to print nursing notes and buy gauze prior to a nursing visit at a patient’s home. She had volunteered to accept the shift as an extra assignment, which was scheduled for 6 AM. The claimant petitioned for compensability of the accident, and the E/C asserted that the claimant was not in the course & scope of her employment because she was on her way to work and not clocked in. The claimant testified that there were several times when she went to Walgreens or CVS before her first appointment of the day in order to print her notes or buy supplies. She also asserted that she had previously been reimbursed mileage when she went to Walgreens or CVS before her first appointment, and that she would often clock in when she got to Walgreens. The employer representative testified that nurses are not required to maintain or carry any supplies with them, and that the Employer provides supplies to the nurses if they are needed. She also testified that there were times when the Employer had reimbursed skilled nurses for out-of-pocket payments for supplies purchased on their own but reported that the Employer has an account with Jupiter Drugs, which will charge the Employer directly for any supplies. She also confirmed that the nurses are not required to print out their notes, as they can submit them via PDF. Although the claimant was considered to be a Traveling Employee, the JCC again found that her status did not include her travel to and from work as provided in 440.092(2). The claimant made several claims that she had requested to be paid mileage for the early visit. However, the Employer testified that the claimant was not offered any kind of incentive to pick up the 6 AM shift, including mileage. The JCC found that the claimant’s testimony surrounding this detail to be inconsistent, and thus not credible. The JCC found that neither the Dual-Purpose exception, nor the Special Errand exception, applied to this case, since the claimant was injured on her way to work, and that her trip to Walgreens did not constitute as a benefit to the Employer. Therefore, her claim for a determination that the Claimant was in the course and scope of her employment at the time of her motor vehicle accident was denied.
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Barbara Hunter v. Polk County School Board/Davies Claims North America, Inc.
JCC Anderson: Orlando District Order date: 01/09/2026
OJCC Case: 97-018337WWA Date of Accident: 08/06/1997
JCC Order: Click Here
Briefly: Medical Necessity of Brand Name Medications
Summary: On December 3, 2025, the claimant filed a Petition for Benefits for authorization and completion of a prescription of Aplenzin 348 mg, plus attorney’s fees and costs. The prior compensation order, currently on appeal, denied a claim for brand name Wellbutrin XL 300 because Claimant failed to prove that a generic version of that drug would have adverse side effects or be less effective than the branded version. In June 2024, the claimant’s authorized treating doctor, Dr. Badiola, discontinued Wellbutrin and began giving the claimant samples of Aplenzin, a brand-name medication with no generic equivalent. Later, Dr. Badiola wrote prescriptions for Aplenzin. The first one was filled and provided by the E/C, but the second one was denied. The E/C contended Aplenzin was not medically necessary because the generic version of Wellbutrin XL 300 is just as effective. Both drugs have the same active ingredient, bupropion. The primary difference is that Wellbutrin and its generic equivalent contain different active salts which affect how the medication is absorbed and how long it remains in the system. Wellbutrin XL 300 contains hydrochloride (HCL), while Aplenzin contains hydrobromide (HBr). Due to this fact, the generic version of Wellbutrin is not medically or legally considered as a generic to Aplenzin. Dr. Badiola testified that he switched the claimant to Aplenzin because she was having hand tremors caused by Wellbutrin. There was no documentation of hand tremors in his medical records, and the claimant did not mention experiencing hand tremors when she testified at the final hearing. Dr. Eric Kaplan, the E/C’s IME psychiatrist, reviewed Dr. Badiola’s records and found no documentation that Claimant developed tremors as a side effect of bupropion. He concluded that Aplenzin was not medically necessary because there were no medical reasons why the claimant required Aplenzin instead of the generic version of Wellbutrin. The claimant testified that she felt better taking the Aplenzin, but she could not articulate what she meant by “better.” Per 440.13(1)(m), medicines are required to be “appropriate to the patient’s diagnosis and status of recovery.” The statute makes no mention to the cost of the drug. The JCC found that the evidence was overwhelming that Aplenzin met this definition. Further, it did not matter that a generic version of bupropion HCL also met the definition of medically necessary because there was no generic equivalent for Aplenzin. Therefore, the JCC ordered the E/C to provide the Aplenzin.
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Robert Lachhonna v. NCR Corp/Chubb Insurance Co & Gallagher Bassett
JCC Jacobs: Orlando District Order date: 2/28/2026
OJCC Case: 23-002270JEJ Date of Accident: 1/28/2021
JCC Order: Click Here
Briefly: One-Time Change
Summary: The Claimant was involved in a compensable workplace accident in which he injured his left shoulder, neck, and lower back. He was authorized to treat with Dr. Christopher Warrell for the shoulder, and Dr. Ravi Patel for the neck and back. On March 7, 2025, the Claimant requested a one-time change to replace Dr. Patel. On March 10, 2025, the E/C responded with Dr. Geoffrey Stewart as their selection of physician. On May 12, 2025, an appointment letter was sent from the E/C to the Claimant, with an appointment date of May 20, 2025. The Claimant did not appear for this visit. The dispute is whether the 63-day delay from request to appointment was reasonable. To further explain the timeline, Dr. Stewart requested medical records from the Claimant’s personal neurosurgeon on March 25, 2025. These were requested via subpoena and forwarded to the doctor on April 16. Dr. Stewart then requested updated records from Dr. Patel, which were forwarded on April 17. The next contact the adjuster had on this claim was on May 12, when Dr. Stewart provided the appointment date. The JCC found that at no time did the adjuster follow-up with Dr. Stewart between March 10 and May 12, and likewise she did not follow-up with the Claimant or his attorney about the status of the appointment. The E/C was found to have taken no action during the initial 15 days that passed between the naming of Dr. Stewart pursuant to F.S. 440.13(2)(f) to the provider’s request for medical records to provide an appointment or name a new doctor. The JCC found this unreasonable and well within the E/C’s control. Accordingly, the JCC ruled in favor of the Claimant in choosing their doctor for the one-time change.
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Andy Agenor v. Broward County water and Wastewater Div./Broward County Risk Mgmt
JCC Lewis: Ft. Lauderdale District Order date: 3/3/2026
OJCC Case: 18-028164DAL Date of Accident: 10/23/2017
JCC Order: Click Here
Briefly: 120-day Pay and Investigate
Summary: This claim deals with an MVA in 2017, resulting in a knee replacement, four-level fusion, treatment for a pulmonary embolism, and surgeries to the elbow and shoulder. The Claimant was accepted as PTD at some point prior to the Final Hearing. The sole issue for this Final Hearing was compensability of the Claimant’s dissecting abdominal aortic aneurysm. The Claimant conceded that there was no evidence establishing a causal relationship between the aneurysm and the workplace accident. However, the Claimant contends that the E/C did not timely deny compensability of the aortic aneurysm within 120-days of the initial provision of benefits and/or, did not provide the 120-day letter to the Claimant. This, according to the Claimant, means that the E/C either waived or is estopped from contesting compensability. The Claimant treated with Dr. Allaf for pulmonary embolism, and during treatment the aneurysm was discovered. Dr. Allaf was never authorized nor provided any treatment for the aneurysm. Dr. Allaf testified that he would defer to the Claimant’s cardiologist for treatment of the aneurysm. The E/C authorized Dr. Perloff to evaluate the aneurysm and determine the major contributing cause of the need for treatment for same. Dr. Perloff evaluated the Claimant on September 24, 2025, during which evaluation he requested additional medical reports in order to formulate an opinion. A second report was completed in October 2025, which included Dr. Perloff’s opinion that the aneurysm was not related to the work accident or its sequela.
The adjuster was deposed three times. During the first, taken in November 2025, she testified that the 120-day letter was issued in October 2025. She also testified that the first she learned of the aneurysm diagnosis was in July 2025. During her second deposition, she testified that she received a referral for cardiothoracic surgeon consultation in June 2025. A PFB for the surgeon was filed on August 12, 2025, with a response being filed on August 22, indicating that Dr. Perloff was authorized to evaluate and determine the MCC of the aneurysm. The aneurysm and treatment for same was denied on December 12, 2025. The E/C then filed their notice of denial on January 15, 2026. The JCC initially found that the initial provision of benefits for the aneurysm was on September 24, 2025, thus the December denial was timely. However, the JCC also found that the August 22 response to PFB was the commencement of payment as required per Fl. Stat. 44.20(2) or section 440.192(8). As the 120-day letter was not sent out until October 2025, 53 days later, it was not sent timely. Accordingly, the claim for compensability of the aneurysm was granted.
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