FL Case Law Summaries – 1/6/16
BY:
JCC ORDERS
Nelson Roman v. Lynx Transit Authority/Corvel Corp.
JCC Condry; Orlando District; Order Date: January 5, 2016
OJCC Case: 04-011438WJC; D/A: 8/10/1995
Claimant’s Counsel: Thomas A. Vaughn
Employer/Carrier’s Counsel: Brian B. Bolton
Briefly: ONE-TIME CHANGE IN PHYSICIANS – JCC Condry granted the request for a one-time change in physician from Dr. Marc Gerber to Dr. James Shea and found that the Carrier failed to timely authorize a one-time change in physicians within five days of receipt of the request. The JCC found that by not authorizing a specific doctor, the Employer/Carrier lost control of its selection of a doctor.
Summary: The JCC found that a specifically named doctor arguably agreeable to seeing the claimant was first authorized nine months after the initial request for a change in provider. The JCC found that by not authorizing a specific doctor, the Employer/Carrier lost control of its selection of a doctor and that the claimant was in a position to select a physician of his choosing, and in this case the claimant selected Dr. Shea.
The JCC detailed various facts of the case. The claimant requested a one-time change in his physicians on September 3, 2014, and the Employer/Carrier responded on September 5, 2014, that they would offer Dr. Daniel Frohwein as the claimant’s one-time change and that the Employer/Carrier was in the process of scheduling an office appointment. On September 4, 2014, Dr. Frohwein’s office requested a review of the claimant’s medical records before deciding whether to accept the authorization. This contingency of the doctor was not initially communicated to the claimant or claimant’s counsel. The Employer/Carrier mailed copies of the claimant’s medical records to Dr. Frohwein on September 9, 2014, and after reviewing those medical records, Dr. Frohwein on September 23, 2014, notified the Employer/Carrier that he was declining acceptance of the claimant as a patient.
Six days after Dr. Frohwein told the Employer/Carrier he would not accept the claimant, the Employer/Carrier’s attorney responded to claimant’s counsel on September 29, 2014, and explained the contingency nature of Dr. Frohwein’s initial authorization and that the Carrier would instead authorize Dr. Matthew Imfeld as the claimant’s one-time change in physician. Dr. Imfeld was first contacted on September 30, 2014, and on that same day advised in a telephone call that he was unwilling to accept authorization.
On October 2, 2014, the Employer/Carrier advised the claimant that they would authorize Advance Interventional Pain Clinic for treatment and, notably, no specific doctor within the pain facility was identified to claimant’s counsel or in the authorization letter to Advance International Pain Clinic. Advance International Pain Clinic refused to treat the claimant.
The claimant testified that during this period of time he continued to have symptoms of severe neck pain, shoulder pain and headaches. Because ongoing pain management care was not being furnished, he saw a pain management specialist, Dr. James Shea, on his attorney’s advice.
Timothy Johnson v. Employer #1 GC Development of Lake County, Inc., Employer #2 Chris Lamoureux, Employer #3 W. Lee Humphrey Builders, Inc.
JCC Sculco; Orlando District; Order Date: January 4, 2016
OJCC Case: 14-016288TWS; D/A: 7/2/2014
Claimant’s Counsel: Pro se
Counsel for Employee #1: Joseph Carey
Counsel for Employee #2: Christopher Thorne
Counsel for Employee #3: Joanne M. Prescott
Briefly: EMPLOYER/EMPLOYEE RELATIONSHIP – JCC Sculco found there was no employer/employee relationship between the claimant and either of the alleged Employers in this case and noted that the claimant did not file a claim against a company who potentially employed the claimant at the time of the industrial accident.
Summary: The JCC found that he cannot “pierce the corporate veil” of a corporation for purposes of determining liability of an individual. The JCC found that although Mr. Lamoureux owns a company named “L. Builders” and there is some evidence L. Builders employed the claimant on the date of accident, no claim was filed against L. Builders. The JCC dismissed with prejudice the claims against Mr. Lamoureux as an individual.
Jose Algozain v. Comcast Corporation/Liberty Mutual Insurance Company
JCC Spangler; Miami-Dade District; Order Date: January 5, 2016
OJCC Case: 15-011298EDS; D/A: 3/31/2015
Claimant’s Counsel: Mark Touby
Employer/Carrier’s Counsel: Beth Koller
Briefly: MAJOR CONTRIBUTING CAUSE – JCC Spangler found that the claimant’s neck injury is compensable and causally related to the industrial accident by way of major contributing cause and noted there is no evidence of any other cause for the claimant’s neck complaints other than the compensable accident.
Summary: On March 31, 2015, the claimant sustained a low back injury which was accepted as compensable and associated neck complaints first appeared in the medical reports as early as April 29, 2015. The JCC suggested that the Employer/Carrier should have utilized the procedures provided in F.S. §440.20(4) and invoked the 120-day pay and investigate process instead of simply dismissing the complaints as not being related and being idiopathic or personal in nature.
The JCC found that pursuant to Parodi v. Florida Contracting, Inc., 16 So. 3d 958 (Fla. 1st DCA 2009), Dr. Ray, who became the first medical doctor to evaluate the claimant’s neck complaints, became authorized by law to treat the condition and render opinions regarding the effects of the condition. Again, the JCC noted the Employer/Carrier presented no competent medical evidence of any other cause for these complaints than the compensable accident.
Thomas Colley v. LFI Fort Pierce, Inc./ESIS WC Claims
JCC Dietz; Sebastian-Melbourne District; Order Date: January 5, 2016
OJCC Case: 15-003803RLD; D/A: 2/5/2015
Claimant’s Counsel: Gray Camfield
Employer/Carrier’s Counsel: Thaddeus Harrell
Briefly: TEMPORARY PARTIAL DISABILITY BENEFITS; VOLUNTARY LIMITATION OF INCOME – JCC Dietz found the claimant is entitled to temporary partial disability benefits and that the claimant’s actions were reasonable in not electing the Employer/Carrier’s unknown light-duty job under the circumstances in this case.
Summary: The JCC found the claimant performed a good faith, but unsuccessful, work search and did not voluntarily limit his income. The JCC did not accept the Employer/Carrier’s position that claimant’s work at another job constituted refusal of a light duty offer of employment by the Employer and found that the Employer actually refused the claimant’s subsequent work solicitation.