Editor: Felicia Wymer, Partner, Pensacola Office
Author: Travis Coleman, Partner, Tampa Office
Author: Katie Valley, Associate, Jacksonville Office
James E. Padgett v. State of Florida Department of Transportation/Division of Risk Management
JCC Walker: Pensacola District Order date: 03-12-2026
OJCC Case: 25-000048JW Date of Accident: 08-08-2024
JCC Order: Click Here
Briefly: MCC
Summary: A great win from our amazing Editor, Felicia!!On August 8, 2024, the claimant sustained a work injury when he fell on his knee. After the claimant underwent knee surgery, he began walking with a cane. Due to his reliance on the cane, he testified that he developed right shoulder pain. On February 4, 2025, the claimant made his first request for treatment of the right shoulder. The Carrier agreed to investigate compensability of the right shoulder under the 120-day provision of section 440.20(4) and a 120-day letter was issued on February 5, 2025. Following the medical opinion by Dr. Fox (who also treated him for his knee), the Carrier denied compensability of the right shoulder on April 2, 2025, within the 120-day period allowed by Florida Statute. Dr. Fox diagnosed the claimant with shoulder impingement. The claimant argued that the shoulder injury was a “resulting manifestation” of his original workplace injury. However, Dr. Fox stated that shoulder impingement was usually from overhead use and not from a cane. Dr. Loeb, the E/C’s IME, confirmed Dr. Fox’s opinions, and stated that he had never seen post-surgical cane use cause the shoulder pain that the claimant was describing in his 41 years of practice. The JCC accepted these opinions, which also cited that the claimant’s shoulder pain could be the result of arthritis or diabetes, over that of the Claimant’s IME physician, Dr. Cotton, who suggested that axial loading with the cane resulted in injury. Therefore, the JCC rejected the claimant’s argument that the shoulder pain was a natural result of walking with the cane. The JCC also held that since Dr. Fox had already made a determination regarding MCC, the claimant was not entitled to an evaluation of the shoulder. The claimant’s request for a shoulder evaluation and attorney’s fees and costs was denied.
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Johanna Gomez v. Aventura Finest Carwash and Service/Norguard Insurance Company
JCC Clark: Ft. Myers District Order date: 03-23-2026
OJCC Case: 24-010006FJC Date of Accident: 02-06-2024
JCC Order: Click Here
Briefly: MCC
Summary: On May 30, 2025, the JCC entered the final order denying the claimant’s request for a doctor to treat her back. Dr. Rajadhyaksha, her authorized treating provider, was still authorized to treat her lower back, but was not recommending any additional treatment at that time, as she was previously placed at MMI with no impairment rating and no restrictions. On July 15, 2025, the claimant underwent an IME by Dr. Hodor. Dr. Hodor agreed with Dr. Rajadhyaksha that Claimant’s lumbar MRI did not show any evidence of disc herniations. The only treatment Dr. Hodor had recommended was physical therapy and a trial of aquatic therapy. Dr. Hodor also recommended nerve conduction and EMG studies to determine whether the claimant had sensory abnormalities objectively documented. On December 15, 2025, the claimant returned to Dr. Rajadhyaksha, who reaffirmed MMI And stated that no future treatment was required. The JCC found Dr. Rajadhyaksha’s position to be more credible than Dr. Hodor’s, since Dr. Rajadhyaksha had seen the claimant several times over the past year. Additionally, Dr. Hodor’s recommendation for additional testing to determine if the claimant’s complaints were objective, lent his opinion to coming off as incomplete and unpersuasive. Ultimately, The JCC held that the claimant did not prove that additional back treatment was medically necessary or related to the work accident, especially where the only recommendations were palliative and not supported by objective evidence. The claims for authorization for physical therapy, EMG/NCV, aquatic therapy, and orthopedic follow-up care were denied.
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Marie Mondesir-Achille v. East Florida Premium Medical Care/Travelers
JCC Ring: Ft. Lauderdale District Order date: 4/3/2026
OJCC Case: 25-017572MJR Date of Accident: 6/24/2025
JCC Order: Click Here
Briefly: Employer/Employee Relationship
Summary: Due to a Motion to Bifurcate, the only issue pending for this Final Hearing was whether an employer/employee relationship existed on the date of accident and, therefore, whether this accident was compensable. Claimant alleged that she was injured in a fire on June 24, 2025, the compensability of which the Employer/Carrier denied as the Claimant is an independent contractor. According to the Claimant, she was working on the Employer’s premises when she was informed of the fire. Several minutes later, Fire Rescue arrived and transported her to a hospital with difficulty breathing due to smoke inhalation. As for employment, Claimant testified that she was hired by the Employer in 2019 as a marketing coordinator, a role she held at the time of the accident. Her duties included marketing events both on and off the Employer’s premises using the Employers logo on flyers and other marketing materials. During these events, the Claimant would answer questions and record contact information for prospective patients whom she would later help contact and assist in scheduling the initial appointment. The Employer also requested the Claimant have a set schedule and was paid $2,000 per month with no variation regardless of how many patients she brought in each month. The payment was made to both the Claimant personally, and to a company formed by the Claimant many years prior. Payments were made to this otherwise dormant company at the Employer’s request. No work was performed under this company’s name during the six years the Claimant worked for the Employer. All expenses for marketing purposes were covered by the Employer, and the Claimant was later requested to sign a non-compete agreement drafted by the Employer. Claimant honored that and did not work for any other employer for the six years she worked for the Employer.
Turning to the Independent Contractor analysis, the JCC found that though the Claimant owned her own business, it was essentially dormant on the date of accident. The company did not maintain an office, and had no employees, no equipment, no materials, no expenses, and no vehicles. Further, all materials needed for the Claimant to conduct her work for the Employer were provided by the Employer. Although occasionally receiving money from the Employer to her business account, it was for services that she personally performed for the Employer, not as a representative of any other company. Additionally, that method of payment was requested by the Employer. The Claimant was also requested to sign a non-compete agreement and did not work for any other employers. There was no agreement for specific services for a specific amount of money, the claimant did not incur any expenses while working with the Employer, and the claimant was not paid on a commission or per-job basis. Accordingly, the JCC found that the Employer failed to meet their burden in proving that the Claimant was an Independent Contractor for purposes of this workplace accident. Compensability was granted.
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Aida Madera v. Lee County School District/Davies Claims
JCC Weiss: Ft. Myers District Order date: 3/27/2026
OJCC Case: 23-002040JAW Date of Accident: 1/20/2023, 11/12/2018,
8/21/2023
JCC Order: Click Here
Briefly: Medical Necessity, Major Contributing Cause
Summary: Handled by our very own Mary Frances Nelson! Claimant sought authorization of a lumbar laminectomy and fusion at L4-5, which the Employer/Carrier denied as not medically necessary, and further stating the major contributing cause of the need for surgery was personal and/or preexisting. The Claimant was involved in three accidents during her employment with Lee County School District, one while breaking up a fight resulting in injuries to her knees and back; another while changing a child’s diaper with resulting pain in the shoulder; and then a slip and fall injuring her knees and back. Claimant was accepted as PTD under the 11/12/2018 date of accident. The Claimant was treating with Dr. Franco Vigna for the lower back as of November 2023. An MRI of the lumbar spine was completed, revealing spondylolisthesis as L4-5. Injections could not be offered as the Claimant is diabetic, therefore, the physician requested the above surgery. At that time, the doctor had not reviewed a 2018 MRI of the lumbar spine, which could have impacted his opinion on causality per his deposition testimony. The doctor also testified that he recommended the surgery to treat the spondylolisthesis, which existed before the industrial accident. Claimant also treated with a neurologist, Dr. Wolff. Dr. Wolff opined that the Claimant’s symptoms regarding her LLE giving out were due to her left knee and not radiculopathy or a neurologic cause.
The Employer/Carrier named Dr. Mark Gerber as their IME. After the evaluation, Dr. Gerber opined that the major contributing cause of the spondylolisthesis was degeneration of the facet joints at L4-5 and there was no need to rush into surgery as this could be followed for years. The JCC found that Dr. Gerber and Dr. Wolff’s opinions supported each other that the Claimant does not have a neurologic/radicular problem, but mechanical back pain. The JCC also found that Dr. Vigna’s opinion on major contributing cause was not competent, which was admitted to by the doctor in his deposition based on not reviewing the 2018 MRI. This, along with the spondylolisthesis existing prior to the 2023 industrial accident, led the JCC to deny the requested surgery.
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Sherry Bereziuk v. Dr. Paul Popper/Hartford Underwriters
JCC Clark: Ft. Myers District Order date: 3/31/2026
OJCC Case: 25-013267FJC Date of Accident: 2/18/2025
JCC Order: Click Here
Briefly: Notice, Course and Scope
Summary: After a Motion to Bifurcate, the only issue pending for this Final Hearing was whether Claimant suffered an injury which arose by accident in the course and scope of her employment, and whether the accident/injury was reported timely. The Claimant was injured while painting a wall in the dining room in the home of her Employer, Dr. Paul Popper, and his wife. Claimant was hired approximately 20 years prior to clean the doctor’s residence three days per week. Claimant was paid by check, and employment was solely based on a verbal agreement. At some point, Claimant was placed on the payroll at his medical practice, but she worked almost exclusively in his personal residence. Her role evolved into more of a personal assistant, taking the cars in for service, grocery shopping, catering and cleaning for private parties, cleaning/painting/remodeling rental properties, etc. Claimant also drove the doctor and his wife from the medical office to their home, and vice versa, along with other locations as the doctor is visually impaired.
Testimony was presented showing that the Claimant did not report the accident or injury to the correct person. However, she did text the payroll representative that she may need to file a claim on or around May 7, 2025, but did not explain further. Further, the Claimant informed the doctor’s wife about pain in the shoulder but never reported that it began while painting the home office. As for notice, the JCC found that all of the doctor’s employees knew to report any workplace accidents to one specific person. Despite numerous conversations with the Claimant, no injury or accident was reported. Additionally, no mention of an injury while working was found in the medical reports obtained. Accordingly, the JCC found that the Claimant did not properly put her Employer on notice of the workplace accident or injury.
As for whether the accident occurred while in the course and scope of employment, the Employer/Carrier argued that the Claimant was a domestic servant, excluding her from coverage. Claimant’s only connection to the medical office and practice was transferring records from the office to the house, or an off-site storage facility, and transporting the doctor to the office and back. The totality of the evidence was that the Claimant worked primarily as a personal assistant, not as an employee of the medical practice. Accordingly, she was not working in furtherance of the business conducted at the medical practice and was not engaged in covered employment on the date of accident, thus compensability was denied.
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