BY:

Thomas G. Portuallo

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JCC ORDERS

Shane Reed v. Jacksonville Fire & Rescue Dept./City of Jacksonville Risk Management

JCC Holley; Jacksonville District; Order Date: April 29, 2016

OJCC Case: 15-017318WRH; D/A: 11/23/2014

Claimant’s Counsel: John J. Schickel

Employer/Carrier’s Counsel: Gregory Lower

Briefly: PRESUMPTION UNDER F.S. §112.18 – JCC Holley denied the claims for compensability of claimant’s hypertension and stroke and accepted the un-contradicted testimony of Dr. Dietzius that there was no disability, total or temporary, related to the claimant’s hypertension, and that the claimant’s hypertension was caused by non-occupational causes. Further, the JCC found there was no medical opinion to prove the claimant’s stroke was a covered condition or the result of hypertension.

Summary:  The Employer agreed the claimant is a member of a covered class, a firefighter, for purposes of the Presumption under F.S. §112.18, and that there was no evidence of hypertension or heart disease on the pre-employment physical. It was also agreed that the claimant suffers from the covered condition of hypertension.  However, it was disputed that the claimant suffers from the covered condition of stroke. 

The only medical opinion offered as evidence was the Employer’s IME physician, Dr. Dietzius, cardiologist. The JCC found the medical evidence via Dr. Dietzius does not support that the stroke was a result of hypertension.  Instead, Dr. Dietzius testified the claimant’s stroke was the result of thrombus of an unknown origin, but that the thrombus was not related to atherosclerotic disease.  Dr. Dietzius also testified that any disability that occurred was the result of the stroke which was not proven to be a covered condition or related to claimant’s hypertension. 

The JCC also found there were no work restrictions or medical opinions supporting any incapacity that would have been assigned to the hypertension itself. The JCC found that, in the absence of any medical evidence to the contrary, Dr. Dietzius’ testimony is persuasive that the cause of the hypertension is non-work related obesity and sleep apnea.

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Camillus Alfred v. City of Miramar/Gallagher Bassett Services, Inc.

JCC Lewis; Ft. Lauderdale District; Order Date: May 2, 2016

OJCC Case: 04-005200DAL; D/A: 10/21/2003

Claimant’s Counsel: Pro se

Employer/Carrier’s Counsel: Eric L. Stettin

Briefly: EMERGENCY HEARING – JCC Lewis ordered the Employer/Carrier to authorize an evaluation with a cardiologist and found a bona fide emergency existed and that the requested evaluation is reasonably required by the nature of the injury to determine the cause of the claimant’s symptoms, and whether those symptoms are related to the compensable low back condition.

Summary: The claimant is not represented by an attorney and requested an updated evaluation with a cardiologist and treatment if needed. The claimant testified he is experiencing chest pain going into his left arm and pain from his compensable lower back injury, which causes his blood pressure to be elevated. 

The Employer/Carrier raised numerous defenses including that there was no evidence of a bona fide emergency involving the claimant’s health, safety, or welfare, there was no evidence the claimant suffered a heart attack, and that there was no referral by an authorized physician for a cardiologist.

The JCC first determined that a bona fide emergency existed and noted the claimant testified that he experienced chest pain and numbness in his left arm and was transported by ambulance to Memorial Regional Hospital Emergency Room where he was diagnosed with acute chest pain. At the hospital, a stress test and an appointment with a cardiovascular disease specialist was recommended.  The hospital records reflect the claimant should see a cardiologist as soon as possible.  The JCC also noted that a cardiologist who saw the claimant at Memorial Hospital recommended the claimant should see Dr. Horgan and recommended that, since the claimant had seen Dr. Horgan in the past, he should follow up with that doctor.  Under these facts, the JCC found that a bona fide emergency existed involving the claimant’s health, safety, or welfare under F.S. §440.25(4)(f).

The JCC next determined whether the claimant established entitlement to the requested evaluation with a cardiologist and noted that in order to show entitlement to diagnostic testing or evaluations to determine the cause of his symptoms, the claimant must demonstrate only that the evaluation was reasonably required by the nature of the injury. The JCC noted two prior cardiology reports from Dr. Horgan were admitted into evidence which reflect the claimant’s back pain and non-steroidal anti-inflammatory agents can exacerbate hypertension. 

The JCC found the claimant established that the requested cardiological evaluation is reasonably required by the nature of his injury to determine the cause of his symptoms, and whether they are related to the compensable work injury. However, the JCC noted that, absent a showing of medical necessity and causal relationship, cardiological treatment may not be awarded.