FL Case Law Summaries – 10/14/15
JCC Orders
Julie Goddard for Humberto Juarez v. Quality Roofing Inc./FRSA Self-Insurers Fund, Inc.
JCC Lorenzen; Tampa District; Order Date: October 12, 2015
OJCC Case: 14-016962EHL; D/A: 7/24/2014
Claimant’s Counsel: Michael J. Winer
Carrier’s Counsel: Katherine G. Letzter
Briefly: GUARDIAN’S FEE – JCC Lorenzen ordered the Employer/Carrier to pay the guardian’s charges as requested because the compensable injury necessitated appointment of a guardian and all of the activities of the guardian were related to the injured employee’s workers’ compensation claim.
Summary: The JCC noted the state of law regarding guardianship under Chapter 440, particularly 440.17. The JCC held that the Employer/Carrier is obligated to pay for the charges of the guardian if the compensable injury precipitated the need for the appointment to the extent the charges are incurred in handling the employee’s rights, duties, and responsibilities under Chapter 440, including collection of compensation benefits and obtaining medical services. The JCC cited the cases of Southeastern Concrete Floor v. Charlton, 584 So. 2d 574 (Fla. 1st DCA 1991) and Florida Cypress Gardens v. Lavoy, 932 So. 2d 542 (Fla. 1st DCA 2006).
In this case, the Employer/Carrier stipulated claimant’s brain injury was compensable and did not argue that there was no need for appointment of a guardian.
The JCC believed that the Employer/Carrier confused the role of claimant’s guardian and the basis for paying a guardian’s fee with the role of claimant’s attorney and the basis of paying the attorney’s fee, and failed to appreciate the difference between having a workers’ compensation claim and litigating the Petition for Benefits.
Luis Mendez v. American Airlines/Sedgwick CMS
JCC Almeyda; Miami District; Order Date: October 12, 2015
OJCC Case: 14-029616ERA; D/A: 11/16/2014
Claimant’s Counsel: Toni Lynne Villaverde
Carrier’s Counsel: Frank Garcia
Briefly: MEDICAL BILLS – LACK OF JURISDICTION – JCC Almeyda granted the Motion to Dismiss for Lack of Jurisdiction and found jurisdiction over the disputed medical bill lies with AHCA.
Summary: The claimant filed a Petition for Benefits seeking payment of a hospital bill. The Employer/Carrier defended on the grounds that the bill would be paid if “the treatment was related to the industrial accident herein” and when the bill was received in the proper form, without any reservation as to its compensability or necessity.
The JCC found that the carrier was responsible for the bill in question, but also found the matter rests solely within the jurisdiction of AHCA and not with the JCC.
Jesus Rossy v. American Airlines/Sedgwick CMS
JCC Almeyda; Miami District; Order Date: October 12, 2015
OJCC Case: 15-004573ERA; D/A: 12/3/2014
Claimant’s Counsel: Toni Lynne Villaverde
Carrier’s Counsel: Michael A. Hernandez
Briefly: EXPERT MEDICAL ADVISOR – CONFLICT IN INTEREST – JCC Almeyda found the claimant’s suggestion of a conflict of interest between the appointed EMA and a physician who previously examined the claimant was without merit as no evidence was presented to substantiate a conflict in interest.
Summary: The JCC denied claimant’s Motion for Status Conference and notification of a conflict of interest between the EMA, Dr. Hodor, and Dr. Donshik, who previously examined the claimant. The claimant suggested a conflict of interest between the two physicians existed and that both physicians shared the same address.
The JCC noted that Dr. Hodor signed a Notice of No Conflict submitted as a part of the Expert Medical Advisor package. The JCC found there was no evidence presented as to any financial ties between the physicians, any professional ties, or any business relationship. The JCC found there is no evidence presented that the opinion of one physician would be influenced by the other’s opinion.