FL Case Law Summaries – 11/18/15
BY:
1ST DCA ORDERS
Boley Centers, Inc./Comp Options v. William Vines
Appeal of the Order from JCC Stephen Rosen
DCA Order Date: November 16, 2015
Case: 1D14-5869; D/A: 1/8/2014
Appellant’s Counsel: Bill McCabe & John H. Thompson
Appellee’s Counsel: Ben H. Cristal & Gian-Franco Melendez
Briefly: EMERGENCY TREATMENT – The 1st DCA affirmed the JCC’s finding that the claimant suffered a compensable psychiatric injury, but reversed that portion of the order requiring the Employer/Carrier to make payment to emergency medical providers and third party payers for lack of jurisdiction.
Summary: The 1st DCA held that the JCC erred when he ordered the Employer/Carrier to pay the providers and any third party payers for all psychiatric bills incurred with respect to the alleged emergency care treatment. The 1st DCA held that the JCC had no jurisdiction to award payment to the emergency care providers or reimbursement to any third party payer for services. Instead, the JCC could only conclude that the care was for a compensable injury and was medically necessary and therefore not the claimant’s responsibility.
JCC ORDERS
Bette Oramas v. Delad Sucurity, Inc./Travelers Insurance
JCC Almeyda; Miami District; Order Date: November 16, 2015
OJCC Case: 14-025526ERA; D/A: 4/19/2013
Claimant’s Counsel: Mark Touby
Employer/Carrier’s Counsel: Kristina Llerena
Briefly: MAJOR CONTRIBUTING CAUSE – JCC Almeyda denied the claim for medical treatment and found that the claimant’s compensable low back injury was a temporary exacerbation of a pre-existing, longstanding low back syndrome and that the compensable sprain/strain of the low back is no longer the cause of the need for further treatment.
Summary: The JCC found that the claim for referral to an orthopedic physician cannot be supported and noted that two orthopedic physicians, including the Expert Medical Advisor, Dr. Harlan Chiron, concluded that the claimant suffered from a temporary exacerbation of a longstanding low back syndrome and is currently at maximum medical improvement from the exacerbation without impairment. The claimant did not present any medical evidence to the contrary
The JCC noted the claimant requested an evaluation/treatment by an orthopedist in order to rule in/out a condition. The JCC rejected this argument and found that the appropriate orthopedic evaluation/treatment has already been accomplished.
The JCC found that a request for an evaluation by an orthopedic physician is subject to the rule requiring a response within ten days and that the Employer/Carrier failed to do so. However, here the Employer/Carrier did not dispute the medical need for the treatment, but asserted that the “subject accident is not the current need for treatment.”
Although the Employer/Carrier did not deny this claim within 120 days, the JCC noted that F.S. §440.20(4) does not preclude the Employer/Carrier from challenging a claimant’s entitlement to benefits by contending the injuries resulting from the industrial accident were not the major contributing cause of the claimant’s need for future treatment or surgery.
Clyde Coley v. Bromley Pallets, IFCO/Liberty Mutual Insurance
JCC Pitts; Orlando District; Order Date: November 16, 2015
OJCC Case: 02-047025NPP; D/A: 11/6/2000
Claimant’s Counsel: Wendy S. Loquasto & Bradley G. Smith
Employer/Carrier’s Counsel: Todd R. Bohnenstiehl & Edward C. Duncan
Briefly: ATTORNEY’S FEE – JCC Pitts granted the claimant’s Motion to Bar Defenses and found that the Employer/Carrier did not assert a response to a Motion for Attorney’s Fees and Costs detailing matters that are disputed and that the failure to do so requires the acceptance of the allegations in the claimant’s motion as true.
Summary: Claimant’s counsel filed a Verified Petition for Attorney’s Fees. The Employer/Carrier timely filed a response, but the JCC found that the Employer/Carrier’s response failed to comply with the specificity requirements of Rule 60Q-6.124(3)(b) in that the Employer/Carrier did not detail matters that are disputed. The Employer/Carrier did not provide a detailed response to the specific hourly time entries, but instead contested whole categories of time. The JCC found that there were no specific objections raised by the Employer/Carrier or suggestions as to how the time should be reduced and thus the JCC was constrained to award the entire time as requested by the claimant, 32.3 hours.
Hollis Landress v. Publix Distribution Center/Publix Super Markets, Inc./Publix Risk Management
JCC Roesch; Panama City District; Order Date: November 16, 2015
OJCC Case: 12-025879LAR; D/A: 3/12/2012
Claimant’s Counsel: Paul S. Rosenberg
Employer/Carrier’s Counsel: Michael W. Brown
Briefly: ATTORNEY FEE ENTITLEMENT – JCC Roesch denied a claim for entitlement to attorney’s fees and costs and found there was no pleading filed sufficient to invoke the jurisdiction of the OJCC. The JCC found the claimant did not file a Petition for Benefits which the Employer/Carrier was required to respond to within thirty days.
Summary: The JCC noted that a document of some sort appeared to have been faxed to a fax number for Publix. However, the faxed document differs substantially from a Petition for Benefits.