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HRMCW Cases
HRMCW lawyers are experts in the field of workers' compensation trial practice and appeals. Please click on the links below to review the firm's most recent victories in each area. To see a particular attorney's chronological list of Orders and Appellate Decisions, please clink on the link under that attorney's bio.

Appellate Opinions
Phares v. School Board of Lee County/Johns Eastern
Jonathan L. Cooley and William H. Rogner
(Fla. 1st DCA 6/21/2017) One Time Change Although the DCA did not write an opinion, they affirmed the JCC’s Order that the adjuster acted absolutely correctly in responding to the one-time change request. The underlying Order below contains all of the facts, surrounding the familiar situation of authorizing doctors, forwarding records, and then waiting on the doctor to accept the E/C’s authorization. In the underlying Order, the JCC read the statute and case law to apply a reasonableness standard in obtaining an appointment, so long as the EC timely responds with the name of a specific physician within five days, even if the appointment ends up with a different physician from the one originally named because the initial doctor selected declines the assignment. Click here to view Opinion

Adams v. Visionquest National, Ltd. and Crum & Forster
Andrew R. Borah and William H. Rogner
Misrepresentation/Burden of Proof(6-7-17) This PCA without written opinion affirmed the Order of the JCC finding misrepresentation. The claimant appealed the Order, and urged the DCA to hold that the E/C’s burden of proof in a Workers’ Compensation hearing should be clear and convincing evidence, versus a preponderance. The DCA declined to accept the claimant’s invitation.

Sansone v. Frank Crum / Frank Winston Crum, Inc.
William H. Rogner and Paul L. Luger
Entitlement to Attorney Fees/Medical Benefits (11/2/2016) In a case litigated by Paul Luger and handled on appeal by Bill Rogner, the First DCA issued a very favorable ruling for E/Cs in relation to attorney fee entitlement where medical benefits are claimed. The claimant fell from a scaffold. The E/C initially denied compensability and the claimant subsequently filed a PFB for indemnity, payment of an outstanding hospital bill and attorney fees. Within 30 days of the filing of the PFB, the E/C accepted compensability, paid indemnity and accepted responsibility for the hospital bill. They paid the bill several weeks later, but more than 30 days after the filing of the PFB. The claimant then filed a Petition for Attorney Fees, arguing that through their efforts, they obtained payment of the hospital bill for their client. The JCC denied entitlement. The DCA noted that entitlement under F.S. s. 440.34(3)(b) does not attach until 30 days have run from the date of the filing of the PFB. They acknowledged prior case law has held that “successful prosecution” requires acceptance and payment, and that “timeliness of payments of benefits occurs when the check is placed in the mail”, but noted those cases concerned only payments made directly to claimants. Where, as in this case, the actual benefit is not payment of the bills, but being relieved from financial responsibility for such payment, the carrier’s acceptance of responsibility for the bills is the “insulation from financial responsibility” being requested. After that point, when and how much is paid becomes a matter between the carrier and health provider. A footnote acknowledged the separate issue, not present in this case, of providers that may not actually even provide billing information to the carrier within 30 days. Finding the carrier accepted responsibility within the 30 day grace period, they affirmed the JCC’s denial of attorney fees.

Hidden v. Day & Zimmerman / Florida Power & Light / Broadspire
Derrick E. Cox and William H. Rogner
Medical Evidence/Admissibility/Self-Help 10-7-16) Claimant alleged neck pain following a work incident where he passed out and was taken to the ER. The E/C denied compensability of the incident or alleged injuries and never provided benefits. The claimant obtained unauthorized treatment with an orthopedist and pain management doctor. Both testified that the alleged neck symptoms were related to the work incident. At trial, the E/C objected to the admission of both doctors’ depositions as neither was an IME, EMA or authorized treating physician pursuant to the evidentiary limitations of F.S. s. 440.13(5)(e). The claimant argued that both doctors became authorized by operation of law under F.S. s. 440.13(2)(c), generally known as the “self-help” provision. The DCA affirmed the JCC’s exclusion of the opinion, noting that although doctors may be authorized under that subsection, pursuant to their 2013 ruling in Miller Electric v. Oursler, the burden remains on the claimant to establish compensability and medical necessity of the care via an admissible source. Attempting to prove compensability and medical necessity soley via a “self-help” physician constitutes impermissible “bootstrapping”. The DCA further rejected the claimant’s arguments that this leaves the claimant without a remedy. They noted that a claimant may designate such a doctor as their IME (despite that subsection’s prohibition on treating doctors becoming IMEs), can obtain another IME doctor, and can seek payment of an advance to pay for that IME. Claimant also appealed the JCC’s failure to address the indemnity claim, which was affirmed without comment.

Evans v. Holland & Knight / Sentry Insurance
William H. Rogner
Compensability/Going and Coming Rule/Exceptions The DCA affirmed the JCC’s denial of compensability under the Going and Coming Rule. Claimant worked at a law firm which offered their employees the option of receiving a parking stipend or receiving an access pass to a garage owned by the City of Tampa. The claimant chose the second option. The law firm never told employees which path to take from the garage to the office. While walking down a ramp used for vehicles, she tripped and fractured her ankle. The DCA affirmed the JCC’s finding that the special hazard exception did not apply. The two part analysis requires the presence of a special hazard at an off premises location and a close association of the access route. Although the metal plate the claimant stepped on created a special hazard, because the garage and office lacked a close association and the hazard was not on a normal route used by the employee as a means of entry to and exit from (her) place of work, both elements could not be met. They also agreed the premises rule did not operate to take the injury out of the Going and Coming rule, as the injury did not occur on the employer’s premises.

O'Connor v. Indian River County Fire Rescue / Johns Eastern
Bill Rogner
The DCA granted the claimant’s Motion for Rehearing, withdrew their May opinion awarding our client appellate fees as a sanction, and issued this opinion. The original case arose out of the claimant’s attempts to have the JCC approve a fee on behalf of the claimant, paid by the employee’s union. The JCC denied that request, the claimant attorney withdrew, the claimant withdrew his PFB and then the JCC awarded our client prevailing party costs. The substituted opinion affirms the JCC’s award of costs in the underlying proceeding. However, they noted that although the claimant’s appellate counsel’s use of the appeal process to essentially challenge the fee order twice was improper, they declined to award appellate fees as a sanction.

Miles v. City of Edgewater Police / Preferred Governmental Claims Solutions / State of Florida
William H. Rogner and George A. Helm, III
Attorney Fees/Criminal Prohibitions/Constitutionality Claimant, a police officer, sought benefits based upon claims of work related exposure. After the E/C denied compensability, she initially obtained counsel who filed PFBs. She withdrew those PFBs and her attorney withdrew. She then obtained new counsel, albeit with retainer agreements that would have the Police Union pay the attorney a $1500 fee and the claimant paying hourly fees over 15 hours. After subsequent PFBs, the claimant attorney asked the JCC to approve the fee agreements, which the JCC could not and did not do as they sought impermissible, non-contingent hourly fees. The claimant attorney then withdrew (citing a conflict of interest and an undue hardship on her ability to practice law) and the claim proceeded to a merit hearing. There the claimant asked again to have the prior fee agreements approved and offered affidavits from other attorneys who said they could not take her case due to the high burden of proof and complexity. The JCC again denied this request, and ultimately denied her claims as they lacked requisite evidence. In a 23 page opinion, the DCA ruled that the prohibitions found in F.S. s. 440.105 (3)(c)(2011) against claimant attorneys receiving anything other than a JCC approved contingency or guideline fee for benefits obtained violated the claimant’s First Amendment guarantees to Free Speech, Freedom of Association and right to petition for redress. The legislature’s ability to restrict these rights is analyzed under strict scrutiny, and the DCA found that the law was (a) not necessary to promote a compelling governmental interest (b) was not narrowly tailored to advance that interest and (c) did not accomplish its goal through the use of least intrusive means. They also found the law violates an individual’s freedom to contract. The appropriate remedy in this situation is to allow injured workers to enter into fee contracts approve by JCCs notwithstanding F.S. s 440/105(3)(c). The JCCs denial of her request for approval of the fee contract as well as the underlying claim was reversed and remanded. With regard to the impact of the decision and the prospect for additional E/C exposure, the opinion notes: “If Claimant prevailed, the E/C still could not be required to pay more in fees that the Legislature allows under section 440.34, Florida Statutes, regardless of Claimant obtaining legal counsel not authorized under chapter 400, as Claimant would pay the excess fee.”

Leiva v. Gems Global Incorporated / Tower Group Companies
William H. Rogner
Bill Rogner obtained a Per Curiam Affirmance (PCA) on a case handled by Kate Albin. The claimant appealed an Order finding that all claims of the claimant were dismissed in 2010, and thus there were no fee or cost claims remaining, as the claimant argued.

Saulnier v. Thrive HR FL, LLC and Guarantee Insurance Company
William H. Rogner
HRMCW obtained a solid PCA decision from the First DCA affirming (without comment) victory at the JCC level. Bill Rogner handled the appellate work on a case tried by Tim Stanton in Miami. The claimant’s misrepresentations arose during the course of the actual merit hearing. The JCC denied all benefits based upon misrepresentation. The claimant asserted a denial of due process because the E/C didn’t raise fraud in the pretrial, which was completed by the parties well before the claimant’s actual misrepresentations.

Pavan v. North Florida Surgical Pavillion / Broadspire
William H. Rogner
(Fla. 1st DCA 11/20/15) P.C.A. – No written opinion. DCA rejects claimant’s argument that failing to identify specific compensable injury “buys” entire cervical spine.

Bedwell v. Stone Container Corporation / Broadspire
William H. Rogner
Compelling IMEs/Element of a Petition for Certiorari: The DCA denied the claimant’s Petition for Certiorari related to the JCC’s Order compelling her to attend the E/C’s IME. Under the controlling law for her 1987 date of accident the JCC has broad discretion to compel such an examination. The court also addressed the claimant’s second point of law asserting the JCC departed from the essential requirements of the law because her entitlement to benefits is (if accepted as true) essentially assured. The opinion notes that the merit of an untried medical issue is irrelevant to the issue of whether the JCC departed from the essential requirements of the law.

Matheny v. Indian River Rescue / Johns Eastern
William H. Rogner
Jurisdiction of DCA/Timeliness of Filing Petition for Certiorari: The DCA dismissed claimant’s Petition for Writ of Certiorari, which was untimely under the Appellate Rules. Rule 9.100(c) requires the petition to be filed within thirty days after the rendition of the order to be reviewed. The court was without jurisdiction as the Petition was filed on the 31st day. The claimant argued that Florida Rule of Judicial Administration 2.514(b) provides an additional 5 days for mailing. However, this rule only applies when another rule, court order or statute requires a party to act within a specified time after service. The Appellate rule governs rendition of the order versus service, and renders the Judicial Administration Rule inapplicable. In addition to dismissing based upon a lack of jurisdiction, the court denied the alternative relief requested to consolidate this case with another similar case.

Babahmetovic v. Scan Design Florida, Inc. / Zenith Insurance
William H. Rogner
Statutory One Time Change: The original 5/1/15 opinion in this case created a very poorly conceived rule that an E/C who provided any benefit prior to issuing a 120 day letter was estopped from denying compensability. Bill Rogner immediately filed a Motion for Rehearing and Rehearing En Banc of that opinion. Thankfully, the DCA granted the Motion and withdrew that opinion in its entirety. The revised ruling omits all discussion of the 120 day rule. It holds merely that the JCC erred in denying the claimant’s request for a one time change where the carrier authorized treatment for his initial injury (lumbar sprain), even though that doctor opined the sprain was less than 50% of the need for treatment, when combined with degenerative conditions.

Gonzalez v. Quinco Electrical, Inc. / The Zenith
William H. Rogner
One Time Change/Effectiveness of Request The claimant attorney filed a PFB, and then three weeks later, filed a Notice of Appearance. On the second page of that Notice, the claimant attorney inserted a request for a one time change. He admitted to the JCC this was done to “take advantage of” his belief that adjusters do not always fully read every document they receive. The E/C authorized their choice of a one time change doctor on the sixth day, which the claimant attorney alleged resulted in a waiver of their ability to select the physician. The JCC found under the circumstances the E/C timely responded to the claimant’s request for a one time change. The DCA affirmed the JCC’s ruling, finding it within his discretion to consider whether an E/C’s failure to respond within five days was because of the form or context of the request. The DCA pulled no punches in finding the claimant attorney’s tactic “had the effect of delaying the delivery of benefits and increasing litigation and expense, directly contrary to the self-executing system intended for workers’ compensation claims.” They continued that “(t)his dispute was not the result of inadvertence or ignorance, but rather was the result of an attorney’s intentional act that we consider inappropriate sharp practice and gamesmanship.” Quoting the Oath of Admission to the Bar and the Bar’s Creed of Professionalism, they noted that “(l)awyers’ adherence to these pledges and duties would eliminate the improper “gotcha” tactics that generate disputes such as this that unfairly and needlessly consume public and private resources while delaying the workers’ compensation process and making it more expensive.” One time changes must be requested in a “readily apparent, unobscured and unambiguous” manner to place the E/C on notice of the request.

Jones v. Broadspire / Stone Container Corporation
William H. Rogner
Effective Date of Causation Standard/Attendant Care Claimant sustained injuries in a workplace explosion in 1981 and has received authorized medical care for orthopedic injuries and psychological care for PTSD since that time. In October of 2013 claimant sought payment of attendant care to his wife, which the E/C denied on the basis the care was (1) needed for an unrelated memory problem and (2) was of the type ordinarily provided by family members (gratuitous services). The JCC awarded 12 hours, the maximum allowed under F.S. s. 440.13(2)(b)(2013). The DCA rejected the E/C’s first point on appeal, finding the JCC did not err in applying the 1981 causation standard. A lengthy analysis of the second issue concluded that the JCC erred in awarding the 12 hours of attendant care. The award was based on the treating doctor’s opinions that such care was medically necessary, but the only specific services so identified were for “daily reminders and the expressions of emotional support” for occasional anxiety attacks. The DCA found these actions were gratuitous, in contrast to the statute’s requirement that such services be “extraordinary” (ie. assistance with bathing, dressing, administering medications and sanitary functions). Further, there was no evidence of safety related concerns to justify on call care. The DCA reversed and remanded the attendant care issue for additional specific findings.

Babahmetovic v. Scan Design Florida Inc. / Zenith Insurance
William H. Rogner
120 day Rule/One Time Change in Physician The DCA reversed the JCC’s denial of a one time change based upon the E/C’s timely denial under the 120 day rule. Claimant received an opinion from his treating physician a month after the accident indicating that the workplace injury (a lumbar strain) was 40% of the cause “regarding the lumbar spine”. Twelve days later, the E/C issued a denial of compensability asserting the IA was not the MCC of the need for treatment. The E/C asserted they properly denied compensability as they did so within 120 days of providing payment or compensation under F.S. 440.20(4)(2013). Claimant then requested a one time change which the E/C denied. The parties asked the JCC to determine whether the IA was the MCC of the injury and need for treatment and whether the claimant was entitled to a one time change if the claim were not compensable. The JCC ruled in favor of the carrier noting that the doctor determined the claimant’s sprain from the accident combined with prior pathology and determined the IA was only 40% responsible for the need for medical care. In reversing, the DCA examined the concepts of MCC and compensability, and noted there was no evidence that anything other than work caused the actual initial injury (the sprain). As such, they determined MCC was inapplicable to determine the compensability of the sprain. The DCA then examined the 120 day issue, reciting the language that upon initial payment, the carrier is to notify the employee it is paying pending further investigation and will notify the claimant within 120 days whether they accept or deny claim. The carrier here did not issue a 120 day letter, which the DCA found precluded a denial based upon that statute/rule. The opinion holds “…an E/C who pays yet does not provide written notice “upon commencement of payment” cannot avail itself of the 120 day rule to deny compensability, because it has elected to “pay” rather than “pay and investigate”. The court distinguished the 2008 Falcon Farms case which denied a one time change, noting in that case there was no evidence of an injury. *The employer/carrier is filing a Motion for Rehearing and Rehearing en banc, based on the fact that the issue of the 120 day rule was not preserved below, or otherwise preserved for appeal. The case appears to conflict with prior case law regarding an employer/carrier’s responsibility under the 120 day rule, and the trigger being if an employer/carrier is “uncertain” of their responsibility. The ruling also imposes a procedural default for any carrier that pays any money prior to filing the 120 day letter, and could encourage carriers to deny claims rather than lose that ability later.

Limith v. Lenox on the Lake DBA FTMI Operator LLC and Castle Point Insurance DBA U.S. Fire Insurance and Crum & Forster
William H. Rogner and Andrew R. Borah
The DCA issued an opinion which clarifies the issue of reserved attorney fee and cost claims as it applies to the statute of limitations. Previously, the E/C asked the JCC to dismiss an outstanding reservation of attorney fees and costs under F.S. s 440.25(4(4)(i). The DCA dismissed the E/C’s certiorari challenge to the JCC’s order denying that request. The E/C argued that had the pending claim been dismissed, the limitations period would have run, barring the claim for a follow up visit that was asserted in a PFB filed after the Order denying the Motion to Dismiss. The DCA agreed that F.S. s. 440.24(4)(i) applies to pending fee claims, rejecting the claimant’s argument that reserving jurisdiction on all but fees and costs means there is no longer a PFB subject to dismissal. The Court indicated the claimant could not have it both ways; i.e. have the fee and costs claims toll the SOL, but then not have that claim be subject to a Motion to Dismiss as it is not a PFB. They further noted that although the statute says the JCC “may” dismiss a PFB for lack of prosecution, this discretion must be considered in the context of “good cause shown”. The JCC did not provide any analysis on that issue, which the DCA found results in a potential indefinite tolling of the statute. The DCA remanded for the JCC to determine whether such good cause exists. This decision provides the employers and carriers with a means to have outstanding fee and cost claims determined in a timely manner, rather than serving as an indefinite tolling mechanism.

Gonzalez v. McDonald's / Amerisure Insurance
William H. Rogner
In a brief, written PCA opinion, the 1st DCA again rejected a claimant's arguments that they were entitled to an hourly fee on a post 9/1/09 date of accident case.

Limith v. FTMI Operator, LLC / U.S. Fire Insurance Company
William H. Rogner and Andrew R. Borah
The First DCA declined to grant the E/C’s Petition for Certiorari review of the JCC’s denial of their motion to dismiss for lack of prosecution. The DCA found the E/C failed to show the required “irreparable harm” in attempting to address what they acknowledged was a “conundrum”. The situation arose from a reservation by the JCC as to attorney fee and costs issues. Cases such as Longley indicate that reserved fee and cost issues may serve to indefinitely toll the Statute of Limitations for the claim. Although an E/C may file a motion under the Q rules to have the JCC order the claimant attorney to file a Petition for Fees and Costs, this rule states only that the JCC, as here, “may” order such. The DCA suggested that prior precedent suggests that the E/C could assert the SOL to any subsequent Petitions filed by the claimant, and seek review upon plenary appeal. As such, there was no irreparable harm. In a lengthy footnote, the DCA indicated that the resolution of this conundrum likely rests with the legislature. Additionally, they indicated that the JCC should exercise its discretionary powers, and only deny E/C motions to compel the filing of a Petition for Fees and

Acosta v. Brevard County School Board / Segwick Claims
William H. Rogner
The JCC reversed the JCC’s order requiring the E/C to authorize surgery for the claimant’s non – compensable left shoulder. The DCA analyzed the hindrance to recovery theory, which requires an E/C to authorize treatment for non compensable conditions that prove a hindrance to treating the compensable condition. The majority noted that in such inquiries, the main question to be answered concerns the purpose of the proposed treatment of the non compensable condition. Although the treating doctor testified that surgery for both shoulders was medically necessary, and that surgery on the non compensable shoulder should be performed to improve the recovery of the compensable shoulder, the JCC did not make findings as to how treatment of the non compensable shoulder would hinder recovery from the claimant’s compensable shoulder injury. The dissent argued that the treating doctor’s testimony showed it was medically necessary to operate on the non compensable left shoulder to improve recovery. The dissent also felt the case should be affirmed based upon the competent substantial evidence doctrine.

Johns Eastern Company & Indian River County BCC v. Bellamy
William H. Rogner and Paul L. Westcott
The DCA affirmed the JCC’s finding that the claimant satisfied the perquisites for occupational presumption afforded firefighters. However, they reversed and remanded for the JCC to clarify the specific standard to determine whether or not the E/C successfully rebutted the occupational causation presumption. The court noted the similarity with Punsky, which identifies the two circumstances/levels of proof to rebut the presumption. Where a claimant relies solely on the statutory presumption, the E/C can rebut with “competent evidence”. When the JCC accepts credible evidence supporting the presumption, the JCC must then find “clear and convincing” evidence to rebut the presumption. In this case, the JCC cited no independent medical evidence supporting the presumption, so the E/C’s burden was competent evidence. However, the JCC referenced both burdens, without specifying either as to the burden required in finding the presumption was not met.

Jose v. Goodwill Industries/Gallagher Bassett
William H. Rogner
The DCA affirmed the JCC’s denial of benefits arising out of a fainting incident at work, noting the claimant failed to prove the existence of any injury due to the fall through requisite medical testimony. Claimant fainted while at work, and was thereafter examined by IMEs for each party. Claimant’s IME diagnosed a host of conditions, and initially related them to the fall based on the claimant’s description of accident. However, this doctor admitted that the only support for these opinions was claimant’s subjective complaints, and that no x-rays or CT scans taken at the hospital showed the presence of any injury. The E/C’s IME testified that some of the claimant’s reported pain was related to the fall, but his testimony did not identify any specific injury. The court noted that the CT scan taken on the date of injury showed a hematoma and some hemorrhaging, but neither doctor was asked or testified whether those findings were causally related to the accident. The DCA noted that F.S.s. 440.09(1)(2001) requires that “[t]he injury, its occupational cause, and any resulting manifestations or disability must be established to a reasonable degree of medical certainty, based on objective relevant medical findings[.]” As claimant failed to provide evidence conforming to this standard, the JCC correctly denied that the claimant suffered any injury as a result of his fall.

Moya v. Trucks & Parts of Tampa, Inc./Ameritrust Insurance Co.
William H. Rogner, Gregory D. White
Summary Final Orders/Res Judicata: On 1/30/99, the JCC entered an order finding that the claimant was at MMI and required no further treatment for alleged shoulder and neck problems as of 10/24/06. The same Order awarded continued treatment for bilateral carpal tunnel syndrome. On 12/27/12, Claimant filed a PFB seeking an MRI of the right shoulder per the authorized carpal tunnel doctor’s prescription. The E/C filed a Motion for Summary Final Order, alleging the JCC’s ’06 Order denying any ongoing treatment for shoulder or neck problems barred the new claim under res judicata. The claimant filed a timely response, but alleged only that the doctor was authorized, they were setting his deposition and the matter was not appropriate for Summary proceedings. Any party may file a motion for summary final order when they assert there are no material factual disputes. The rule directs the opposing party to “file a response to a motion for summary final order together with supporting depositions, affidavits, and/or other documents within 30 days after service of the motion.” Claimant filed no such supporting documents, except the prescription, and the JCC granted the Motion. The DCA found that rule specifically states that res judicata is an appropriate issue for such determinations, and in the absence of any supporting documents, the claimant’s arguments alone were insufficient to establish a material fact that might have supported denying the E/C’s Motion.

Cespedes, Jr. v. Yellow Transportation Inc./Gallagher Bassett
William H. Rogner and Scott B. Miller
Major Contributing Cause/Emergency Treatment/ Admissible Testimony On Rehearing, the First DCA withdrew its original 4/24/13 opinion and reversed and remanded this case to the JCC. The 27 page opinion discusses at length the emergency surgery the claimant had in 2011. Claimant originally sustained a compensable L5-S1 HNP in 2006. After the claimant declined surgery recommended by his authorized physician Dr. Brown, the doctor placed the claimant at MMI with a 6% PIR. The claimant returned to work and treated periodically. In 2010 Dr. Brown again recommended surgery the claimant again declined, but went to Dr. Salaman to obtain lumbar injections. Following a successful first injection, the claimant’s back pain suddenly increased, and on 3/19/11, claimant presented to the emergency room in severe pain. He returned the next day, where Dr. Acebal noted a “massive” HNP on MRI and recommended immediate surgery. He contacted Dr. Brown in this regard as a courtesy, offering to transfer care. Testimony indicated that Dr. Brown thought claimant probably shouldn’t be transferred. On 3/22/11, Dr. Acebal performed emergency surgery, and on 3/23/11, the E/C denied further medical care and de-authorized Dr. Brown. Major Contributing Cause At the Merit Hearing, the JCC considered the claims for TTD/TPD, continued authorization with Dr. Brown and compensability of the surgery. The JCC sustained objections to the testimony of Dr. Acebal, finding he was not an IME, EMA or authorized treater. The JCC denied the compensability of the surgery, which the DCA reversed. The DCA noted that the E/C can only contest MCC of surgery to the previously compensable L5-S1 disc they must do so based on either a pre-existing or subsequent intervening cause. Although medical testimony stated the industrial accident was not the MCC, that testimony did not identify either a significant prior or subsequent cause to break the causal chain. Emergency Services and Care The DCA also rejected the JCC’s finding that the surgery did not constitute “emergency services and care”. The DCA analyzed the definition of emergency services and care in F.S.§440.13(1)(f)(2005) in conjunction with that section’s reference to the definition in F.S.§ 395.002(10)(2005). Essentially, they held the JCC inappropriately focused on the surgery, when the statute considers whether the emergency care was (1) provided by a licensed medical professional; (2) evaluation, screening or examination was conducted by that physician, and (3) whether the care was undertaken to determine if an emergency exists. They noted that ordinarily this can be shown by non-expert testimony, and that although such care may have been provided, that will not suffice to make the care “compensable” under 440. Additionally, the care must be medically necessary and the care must arise as a result of the workplace accident. They also remanded this issue back to the JCC, who in light of the MCC analysis above and the admissibility analysis below, will be hard pressed to find the care was not medically necessary or related to the industrial accident. The DCA further noted that where admissible lay (see above) and medical testimony shows that physician provided compensable emergency services, that doctor’s testimony will become admissible under F.S.§440.13(5)(e). The Surgery The DCA rejected the JCC’s reliance on Dr. Brown’s testimony that the surgery would not have been emergent absent certain medical signs, finding this to be the incorrect test. Instead, they noted Chapter 395 requires that an emergency medical condition may include “severe pain” which, in the absence of immediate medical attention “could reasonably be expected to result” in serious impairment or dysfunction. The court also rejected the JCC’s finding that the surgery was not compensable as the provider did not give the E/C timely notice (by the end of business of the third day after care has been provided). They noted the time requirements do not result in the claimant being responsible for such care, and that any payment dispute between the hospital and the carrier falls under the jurisdiction of AHCA. Conclusion The carrier in this instance was presented with a claimant that had declined surgery for years, had just had a fairly successful injection, and days later presented with a significant worsening of the compensable disc. They did not learn of the surgery until after the fact. This case indicates that identification of a prior or subsequent event/condition is required to break the MCC chain. The DCA’s interpretation of emergency care definitions appears to lower the bar significantly to create E/C responsibility for emergent care obtained for a compensable injury.

Banuchi v. Dept. of Corrections/State of Florida Dept. of Risk Management
Matthew J. Troy and William H. Rogner
The First DCA reversed the JCC’s Order, which treated claimant’s “notice of conflict” as a Motion to Appoint an EMA. Although not noted in the appellate opinion, the pleading was entitled “Notice of Conflict in Medical Opinions and Request for the Court to Appoint an Expert Medical Advisor (EMA).” In the body of the Notice, the claimant used the word “request” three times. The JCC indicated that it was the claimant’s responsibility to pay for such an examination under F.S. s 440.13(9)(f)(“…the party requesting such examination must compensate the advisor for his or her time in accordance with the a schedule adopted by the department”. ) The claimant objected, proceeded to a Merit Hearing without an EMA and was denied benefits. The DCA examined the EMA statute, and characterized claimant’s Notice of Conflict as “not a request to appoint an EMA, but rather a request for a JCC to take notice of his mandatory obligation to appoint an EMA.” The DCA justified this analysis by indicating that parties need to inform the JCC of a conflict given a JCC’s caseload, and the interest in obtaining the EMA early in litigation. However, such conflicts in many situations become apparent at least by the time of a Pre Trial Stipulation. The practical effect of course is that no claimant will ever file a Motion or even a Request to appoint and EMA, when a JCC’s EMA appointment based upon a mere notice of conflict will shift the burden of payment to the E/C. Given the above analysis, the court did not need to address claimant’s constitutional arguments

Pedrez-Martinez v. Yellow Roadway Corporation and Gallagher Bassett
William H. Rogner and Scott B. Miller
Bill Rogner – Per Curiam Affirmance – no written opinion. Scott Miller prevailed at trial on a Statute of Limitations Defense. Claimant appealed, arguing that although the carrier paid IBs timely, the amount was ultimately 20 cents under what it should have been. The DCA affirmed the JCC's determination that carrier’s timely payment was not a dereliction of their duties, but rather an honest and deminimus error that could not excuse claimant’s three year delay in filing a PFB.

Lacaretta Restaurant and Zenith Insurance Company V. Engelds Zepeda
William H. Rogner
The DCA granted HRMCW’s Petition for a Writ of Certiorari, which was filed in response to the JCC’s Order that the E/C produce “Note A” (note in adjuster log re. communication with in-house counsel) and “Note B” (note in adjuster log made by in-house counsel herself). The E/C asserted both were not discoverable, as they were attorney client and work product privileged communications. To invoke certiorari jurisdiction, the court noted there must be “(1) a departure from the essential requirements of the law, (2) resulting in material injury for the remainder of the case (3) that cannot be corrected on post judgment appeal. The court found both Note A and Note B clearly constituted or memorialized communication from the attorney to the E/C made in the rendition of legal services. They further held that ordering the E/C to turn over these communications rose to the level of inherent illegality, which would result in a gross miscarriage of justice were the order to stand, as it would have a chilling effect on communications between attorneys and clients. As the DCA found the communications qualified under attorney/client privilege, they did not analyze the work product nature of the communications. This opinion offers clear guidance to claims handlers in protecting privileged communications with counsel that are memorialized in adjuster note pads and files.

Alexandro Serrano & Roland P. Tan, Jr. V. Del Air & Amerisure
William H. Rogner
The DCA soundly rebuked an additional attempt by the claimant's bar to contest the constitutionality of the 7/1/09 amendments to the Worker's Compensation fee statute. Although the case is a PCA opinion, containing no analysis or discussion of the facts, the court affirmed the JCC's award of a statutory guideline fee on benefits obtained, (which resulted in an hourly fee of $16.62) citing the 2011 Kaufman decision (rejecting equal protection, due process, separation of powers, and access to courts challenges to statutory limitation on award of attorney’s fees).

Manuel Cespedes, Jr. V. Yellow Transportation, Inc./Gallagher Bassett Services, Inc.
Scott Miller and William H. Rogner
In a 23 page opinion (with an accompanying 10 page dissent), the First DCA effectively removes the limitation on admissible medical testimony for “emergency treatment”. Despite the rule that appellate courts are not supposed to retry cases, but rather affirm decisions that rely on competent, substantial evidence, the court essentially retries the case. The opinion also seemingly directly conflicts with the court’s ruling three days prior in Oursler, which reversed the JCC’s appointment of an EMA where the requisite conflict existed only via acceptance of inadmissible, unauthorized treatment. That opinion noted that unauthorized medical opinions are not admissible unless it is “independently established that their treatment was for compensable, medically necessary care”. In this case claimant sustained a compensable injury to L5-S1 in March of 2006. He was placed at MMI in September of 2006, and received sporadic treatment from his authorized doctor until December of 2010, when he agreed to undergo ESIs. Claimant reported improvement after the first injection, but prior to the second injection, appeared at the ER in March of 2011 reporting severe pain. He returned the next day, where an ER neurosurgeon ordered an MRI which showed a “massive” HNP at the same level. The ER doctor contacted the authorized doctor, who declined to have the patient transported to him. The claimant underwent surgery. The E/C denied the surgery, bills and subsequent disability based on defenses including MCC, that the procedure was not authorized nor timely requested. The claimant ultimately sought the requested benefits, but did so without an IME, attempting to rely solely on the testimony of the ER neurosurgeon. The JCC denied the claims, finding that doctor’s testimony inadmissible as he was not an IME, authorized treater or EMA. The DCA engages in lengthy discussion of the E/C’s ability to contest “compensability”, failing to mention the 2006 en banc Checkers holding (establishing an E/C’s right to contest the MCC of treatment of initial compensable injuries and describing the term compensability to mean the existence of an initial injury). The opinion suggests that ongoing MCC is essentially automatic. The opinion rejects the two separate medical opinions the procedure was not emergent by stating that their medical opinions conflict with the statutory definition of emergency medical condition in F.S.§395.002(9)(a). Creative analysis determines that emergency treatment can be established by fact testimony, which then renders the treatment “authorized”, which then renders the emergency treating doctor’s testimony admissible. The shortcomings and internal conflicts of the opinion are discussed at length in the dissent of Judge Marstiller. A motion for rehearing en banc will be filed shortly.

Russ/Winer V. Brooksville HC/PGI
William H. Rogner and Rogers Turner
The claimant attorney took over the case after the claimant, via her prior attorney agreed in writing to settle the case. The E/C filed a motion to find a settlement occurred. The new claimant attorney then asked the JCC to hold a hearing to present evidence on his request that the JCC approve an hourly fee agreement between the claimant and the claimant attorney. The JCC denied the request for hearing and would not approve the fee agreement. The DCA found that the JCC erred in not allowing the claimant and her attorney an opportunity to “build a record”. Although they agreed with the JCC that the Q rules indicate JCC’s should hold hearings only in exceptional circumstances and for good cause shown, they felt the claimant’s desire to have evidence to specifically challenge the constitutionality of the statute prohibiting such fees required such a hearing. The DCA noted that a JCC’s inability to rule on constitutional issues is not a sufficient reason to deny a hearing. The DCA declined to rule on the JCC’s failure to approve the claimant paid fee agreement, or the constitutionality of the statute as premature. Notably, via subsequent Order, the DCA denied the claimant attorney’s request for appellate attorney fees.

Jones v. Royalty Foods, Inc./Gallagher Bassett Services
Gregory D. White & William H. Rogner
Dismissal of PFB for Failure to Pay Costs/Requirement of Willfulness Fla.1st DCA 3/12/2012)Claimant sustained a compensable left shoulder injury. At a Merit Hearing, he then unsuccessfully sought compensability of a right shoulder condition. Following that hearing, an Order awarded the E/C $7,162 in prevailing party costs. The claimant subsequently filed two separate PFBs seeking additional benefits related to the right shoulder. The E/C moved to dismiss those PFBs, pursuant to Fl.St. s. 440.24(4)(2007), which holds a JCC may dismiss pending PFBs where the claimant fails to comply with an order of the JCC 10 days after the order becomes final. At that hearing, the claimant testified he was indigent. The JCC found the claimant specifically was not refusing to comply with the order, but did not have the economic means to comply. The DCA analyzed case law holding that dismissal of a PFB must be accompanied by a finding of willful disregard of a JCC’s authority. The DCA found that even though that language does not appear in 440.24(4), it is error for a JCC to dismiss a PFB under that section absent a finding of willful disregard or failure to comply.

Newick v. Webster Training Center/Zenith Ins. Co.
Andrew Borah – Trial Counsel, Bill Rogner –Appellate Counsel
The First DCA affirmed the JCC’s Order finding the E/C was entitled to apportion 35% of the claimant’s need for shoulder surgery to prior injuries/conditions. Before sustaining her 2010 compensable shoulder injury, the claimant had three shoulder dislocations. Although those injuries occurred while working for herself or others, the injuries were never reported or treated as WC claims, but rather paid through health insurance or out of pocket. The JCC allowed apportionment, based on the EMA opinion that only 65% of the need for surgery was due to the 2010 accident, and that the prior injuries were “never claimed or treated as compensable injuries”, citing Staffmark v. Merrell. Claimant argued Merrell warranted reversal, regardless of whether the prior workplace injury was compensable or not. The DCA rejected this reasoning on multiple grounds. Neither Merrell (nor the prior Proctor or Pearson cases upon which Merrell relied), dealt with workplace injuries that were not claimed through WC. The DCA also held that claimant’s argument would render the apportionment statute meaningless, and noted that the “industry should bear the burden” language of recent cases would not make sense if the prior work related injury were not a WC claim. Perhaps the most encouraging portion of this opinion is Judge Thomas’ written concurrence. While agreeing in the result only, he wrote specially to echo defense arguments; that Merrell and Pearson were incorrectly decided. He noted that those opinions have mistakenly applied the definition of preexisting condition in allocation of benefits (i.e. fights between carriers) to apportionment (i.e. what percentage a carrier may ultimately assign to a claimant’s pre-existing injury). The distinction is critically important, as the concepts are totally different, and there is no statutory exclusion for compensable work related injuries in the apportionment context.

Moya-Perguero v. Trucks and Parts of Tampa, Inc./Ameritrust Insurance Corp.
William H. Rogner and Gregory D. White
The DCA reversed the JCC’s Order dismissing the claimant’s PFB, as the parties appeared for a hearing solely on the issue of Sanctions in the form of Attorney Fees. Parties are entitled to notice of the issues to be determined. The E/C confessed the JCC’s error immediately in a single page answer brief, which foreclosed fees for the claimant’s appellate attorney, who wrote a 40 page brief after the E/C confessed error.

Sentry Insurance Co./Express Scripts Inc. v. Hamlin
William H. Rogner
In August of 2011, the First DCA heard oral argument on two appeals at an “adjuster breakout” during the Workers’ Comp convention. Bill Rogner argued this case. The DCA issued a lengthy, 15 page opinion adopting the E/C arguments that the “arising out of “ element of causation had not been met in this situation, and that a “course and scope” analysis alone is insufficient. The opinion soundly rejected the claimant’s theories, and provides much needed guidance for claims professionals in determining whether or not to accept claims where the risk causing injury is neutral, ie. without an particular employment character or connection. The claimant was injured attempting to retrieve personal property from a car which his lender was repossessing from the employer’s parking lot. The parties agreed the claimant was in the course and scope of employment, but disagreed as to whether the injuries were “arising out of the work performed” pursuant to F.S. s. 440.09(2008). The claimant argued his injury was compensable (1) under the premises rule as he was injured on premises preparing to perform work; (2) because it occurred during a paid break; (3) because he was ministering to personal comfort, or otherwise involved in a momentary deviation and; (4) because retrieving his property was an emergency pursuant to 440.092(3)(2008). The court rejected the premises theory, as the occurrence at the workplace was merely fortuitous and had no connection to the employer’s work or business. They dismissed the personal comfort theory, as it did not meet the traditional elements of (a) being a traditional or routine part of the work place experience (b) the employee’s participation in the activity produced no benefit to the employer and (c) the injury resulted from either a work created or neutral risk. Similarly, the emergency standard was rejected as no objective emergency existed in retrieving the property. The court repeated that “arising out of” means the injury must (1) be causally connected to the employment, (2) have had its origin in some risk incident to or connected to employment, or (3) flow from employment as a natural consequence. As the claimant was on a purely personal mission having no relationship to work, he was unable to demonstrate he suffered an accidental compensable injury arising out a risk of his employment.

Gibson vs. Altman Contractors & North River Insurance Company
William H. Rogner and Teri A. Bussey
The DCA reversed the JCC’s finding that the claimant’s mold exposure was compensable. This decision approves the heightened standard for such cases included in the 2003 amendments to the statute. The DCA noted that the reversal was warranted because no record evidence established the levels of mold to which Claimant was exposed in the workplace, a statutory condition imposed by section 440.02(1), Florida Statutes (2005). See Matrix Employee Leasing v. Pierce, 985 So. 2d 631 (Fla. 1st DCA 2008). They also noted that the JCC erred in substituting the causation standard expressed in Festa v. Teleflex, Inc., 382 So. 2d 122 (Fla. 1st DCA 1980), for the more exacting statutory causation standard for mold exposure claims enacted by the Legislature. See Mangold v. Rainforest Golf Sports Ctr., 675 So. 2d 639, 642 (Fla. 1st DCA 1996). The dissent argued that as the medical testimony agreed that the claimant inhaled Aspergillus mold which caused her injuries, no evidence of the levels to which she was exposed was necessary.

Villa v. Astellas/Tokio Marine Insurance
William H. Rogner and W. Rogers Turner, Jr.
On 1/18/2011, Bill Rogner argued this case before the First District Court of Appeal. W. Rogers Turner, Jr. tried the underlying case. The JCC held that the claimant’s injuries sustained in travel status were not compensable. The claimant ventured miles away from his hotel to ride horses with friends, and was severely injured as he attempted to mount a horse. Three days after the oral argument, the DCA affirmed the JCC’s denial without comment.

Locker v. Utd. Pharm. Group/Zenith
William H. Rogner
Motions to Dismiss/Permissible Analysis by JCC The claimant filed a PFB for continued treatment of her right shoulder, attaching a physician’s note. The E/C moved to dismiss, alleging that the JCC’s prior Order accepting an EMA’s finding of MMI, 0% impairment, and no ongoing MCC of the claimant’s right shoulder meant the claim was not “ripe, due or owing”. The DCA noted that in ruling on a motion to dismiss, the JCC is to accept the allegations in the PFB in the light most favorable to the claimant, and that the JCC may not look beyond the four corners of the pleading. In reversing, the DCA noted the JCC erred in considering evidence outside of those parameters in considering the prior ruling on the MCC of the claimant’s shoulder. The DCA noted that such evidence may indeed be relevant and properly considered at later stages of litigation, but not at the Motion to Dismiss phase. A concurring opinion suggested that JCC’s may not be so tightly constrained to the four corners of the PFB, and where the parties stipulate, a JCC could perhaps decide dispositive matters with extra record evidence.

Braun v. Brevard County
William H. Rogner and Derrick E. Cox
The DCA reversed the JCC’s order denying the claimant’s Petition to require the carrier to pay all medical benefits for a 1993 D/A at 100%. The claimant had compensable accidents with the county in 1993 (C5-6) and 2005 (C4-5). The claimant obtained $15,000 in a subrogation claim related to the later accident, and the parties stipulated the carrier could offset the cost of future remedial care at 25% for the 2005 accident. A physician authorized to treat the claimant for both injuries subsequently testified that each accident was 50% responsible for the claimant’s need for treatment. The E/C then sought to allocate or apportion the two accidents. The claimant asserted he could choose the date of accident under which benefits would be paid. The JCC indicated that practically speaking, he could not see how the doctor was prescribing medications for one cervical level and not the other. He denied the claims, citing 440.42(4)(2005) and Pearson v. Paradise Ford. The DCA summarily reversed and remanded. They found that the claimant’s 1993 medical care could not be apportioned, as the statute did not include medical benefits in the apportionment statute until 2003. They further held Pearson did not apply, and the law in effect required the E/C to provide treatment for the 1993 under the logical cause standard, regardless if the treatment necessarily treated post 2003 conditions or injuries.

Williams v. Aarcher Western Contractors/Gallagher Bassett
William H. Rogner and Matthew W. Bennett
Reversed the JCC’s denial of TPD based upon the recent Toscano decision. The DCA noted “no refusal by Claimant of modified work, nor was Claimant offered modified work; Claimant was not terminated for misconduct; and Claimant did not commence employment elsewhere, followed by termination for misconduct or economic reasons.”

Frank Winston Crum Ins. v. LEANDRO MONTES DE OCA
William H. Rogner and Geoff C. Curreri
The 1st DCA reversed the JCC’s award of TTD from 2/5/09 to 10/7/09, as it was not supported by competent substantial evidence. The only evidence was that the claimant’s authorized surgeon discussed the fact on 2/5/09 that the claimant should return to work.

Carcamo v. Business Representation International/North River Ins Company
William H. Rogner and Robert S. Gluckman
The DCA affirmed the JCC’s denial of TTD, but reversed and remanded the JCC’s denial of TPD. The JCC had ruled the claimant was foreclosed from an award of TPD, accepting a date of MMI in January of 2008. However, the JCC entered into a lengthy analysis of the merits of TPD after that date, and then denied them based on a refusal of suitable employment offered by the employer. The DCA considered the JCC’s analysis of TPD post MMI presupposed the claimant was not actually at MMI, and remanded for clarification of MMI. The DCA also noted that while it was proper for the JCC to determine that the claimant refused an offer of suitable employment, the appropriate analysis would be to determine whether claimant’s refusal of employment continued after October 12, 2008, and whether claimant’s refusal was justifiable. See § 440.15(6), Fla. Stat. (2006). In support, the court cited Moore v. Servicemasters, 19 So. 3d at 1147 (although employer not required to continually reoffer job to avail itself of statutory defenses based on unjustified voluntary limitation of income, employer must establish continued availability of job for each applicable period to obtain continued benefit of defense).

Pruitt v. Southeast Personnel/Packard Claims Administration
William H. Rogner
The claimant had requested a 1x change in their PFB, but did not designate a specific physician. The E/C did not timely respond to the request. At a subsequent mediation, the E/C agreed to provide a 1x change and agreed to attorney fees. The E/C sent a letter to the claimant two days later authorizing a specific doctor. The claimant treated with said doctor until he was again placed at MMI. The claimant then argued that he had a right to select his 1x change as the E/C did not timely respond to the initial request. The DCA held that the claimant acquiesced to the 1x change doctor and that the right to select a physician after 5 days is only an option which may be exercised by the claimant.

Verly v. Orange County/Alternative Service Concepts
William H. Rogner and W. Rogers Turner, Jr.
The claimant appealed the JCC’s denial of her “motion to enforce” an alleged stipulation. The claimant had asked the JCC to rule that an agreement to authorize a doctor on the Pretrial should last until the JCC determined there was no further MCC. The DCA determined that order was non-final, and as such the DCA did not have jurisdiction to rule on the appeal.

Iommelli v. Tuttle Electric/Safeco Insurance
Robert J. Osburn and William H. Rogner
The First DCA issued a PCA without opinion affirming JCC’s denial of the claimant’s claim for payment of medical bills and authorization of a doctor. The E/C “disallowed” a number of medical bills from the authorized physician pursuant to an overutilization review. The Doctor was never de-authorized and continued to see claimant. The E/C asserted the JCC lacked jurisdiction regarding payment of the authorized physician’s medical bills (Florida Department of Financial Services has exclusive jurisdiction regarding overutilization reviews and reimbursement disputes) and that the doctor remained authorized. The JCC denied all pending claims, and the DCA declined to overturn that ruling.

Burgos v. Atlas Paper Mills/Zenith
William H. Rogner
The JCC determined our client was the prevailing party even though the claimant prevailed on some claims and the E/C prevailed on others. The JCC awarded the E/C costs following a merit hearing. The claimant appealed the judge’s finding. Although the First DCA declined to provide a written opinion on the issue, this decision affirms the JCC’s findings in favor of the employer/carrier.

Broadspire/Geico v. Rebecca Rose
Michael S. Waranch
The claimant alleged an onset of repetitive trauma/CTS in 1999. She last saw Dr. Beatty in August of 2007. Over a year later, the claimant filed a PFB seeking the surgery, which the E/C denied. The claimant then filed a PFB alleging a new date of accident for the repetitive trauma, as she still worked with the employer. The only medical testimony of Dr. Beatty indicated it was speculative as to whether or not the surgery was still medically necessary, as she had not seen the claimant since 8/07. The DCA reversed, finding a lack of CSE re. medical causation. In concurring, Judge Benton noted this decision did not preclude the claimant from pursuing future claims or limiting her to “any one time segment”.

Pla v. Point Blank/MDC Products & Sentry Claims
Gregory D. White
At trial, Gregory White successfully prevailed on a denied claim for authorization of a specific doctor, where the claimant alleged failure of the carrier to comply with the one time change statute. The claimant appealed, and William Rogner and Gregory White handled the written appeal. Michael Waranch argued the case at the Appellate level. Although this PCA case does not contain a written opinion, the Opinion affirms the Order of JCC Hogan.

Capps v. Industrial Blowpipe & Broadspire
William H. Rogner
The First DCA affirmed a ruling of JCC Portuallo denying the claimant attorney an appellate fee to be paid by his client. The claimant sustained an accident in 1985. Many years later, the claimant was awarded attendant care at the JCC level. This award was appealed, and reduced significantly. The claimant attorney received a statutory E/C paid fee on the amount of benefits obtained. The claimant then sought JCC approval of a claimant paid appellate fee from the JCC. The JCC found (1) he did not have jurisdiction to approve the fee order (as he felt jurisdiction had not been relinquished by the appellate court), but if he did (2) the fee was unreasonable as the attorney had already been paid based on all of the benefits received. The DCA found the JCC did have jurisdiction to rule on the petition for an employee paid fee, and that competent, substantial evidence supported his finding that the claimant attorney had been compensated for all benefits obtained, and thus no appellate fee was due.

Gallagher Bassett/Delta Health v. Mathis
W.Rogers Turner, Jr. and William H. Rogner for Employer/Carrier
DCA reverses finding of compensability of neck condition, finding JCC erred in basing finding on equivocal statements of neurologist re. causation. Court writes 13 page opinion concerning essentially issue of whether competent, substantial, evidence exists in record to support ruling. Court adds gratuitous language in closing suggesting that treatment for compensable shoulder injury (not appealed issue) might necessarily include treatment for (Now) non-compensable cervical condition.

Interior Custom Cabinets v. Slovak
Zal F. Linder
Decision reversed JCC finding that value of benefits secured by attorney were $478,530.12, resulting in an attorney fee award of $48,603. Claimant had argued that E/C's suspension of PTD benefits (based on claimant's failure to attend vocational evaluation per F.S. § 440.491 placed PTD benefits in jeopardy. E/C asserted suspension was temporary, pending attendance at evaluation). Court found suspension was temporary. Case remanded with instructions to determine attorney fee based on actual value of benefits secured; $5,470.88.

Blue Stone Real Estate v. David Ward, et. al.
Gregory D. White
Professional Employee Organization (PEO) coverage, court finds no evidence that PEO advised employee in writing of termination of employment relationship, which would have cut off coverage

Integrated Administrators v. Valdez
Michael S. Waranch
Permanent Total Disability denied

Begyn v. State Business and Professional Regulations
William H. Rogner
Managed Care Providers

AT&T Wireless Services, Inc. v. Castro
William H. Rogner
Compensation denied for "on call" attendant care

Walt Disney World v. Desselles
William H. Rogner
Change of Condition

Industrial Blowpipe v. Capps
William H. Rogner
Attendant Care Benefits

Tokio Marine Management v. Pizon
William H. Rogner
Major Contributing Cause

Alvarez v. Unicco
William H. Rogner
Compensation denied for period preceeding finding of false or misleading statements

Rice v. Reedy Creek Improvement Dist.
Rex A. Hurley & Andrew R. Borah
Statute of Limitations

 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



 



JCC Merits Orders
Little v. Brentwood Health & Rehab / Gallagher Bassett
Paul T. Terlizzese
JCC Massey (Tampa) (6/19/17) – Denied compensability. Claimant worked as a CNA when he suffered an injury to his right leg. Claimant had a spontaneous “snap” while walking in a normal manner. Claimant admitted, and witness indicated claimant’s leg “gave way.” Claimant suffered from a pre-existing condition in the affected leg (multiple fractures and surgeries), which caused his leg to periodically “give way,” and also caused him to walk with a limp prior to the work accident. JCC found no causal relationship between claimant’s employment and injury; claimant’s fall occurred due to idiopathic condition; claimant’s employment is not MCC of need for treatment; no accident or injury arising out of employment; AWW is correct; no indemnity due; PICA not due.

Willie R. Worlds v. Progressive Employer Managementt Co. / Finish Line Feed / Amtrust North America of Florida and Technology Insurance Company
Andrew R. Borah
JCC Almeyda (Miami) – (6-5-17) Awarded attorney fee of $16,875.00 and costs of $1,590.41. The claimant sought hourly fees and costs in connection with a Final Merits Order awarding six weeks of temporary indemnity benefits. The claimant’s attorney alleged that 91.8 hours were dedicated to securing the awarded benefit and claimed a reasonable hourly rate was in the range of $325.00 to $375.00. The E/C conceded to 32.96 hours and argued a reasonable hourly rate was $250.00 to $300.00. The JCC awarded 67.5 hours at an hourly rate of $250.00. With respect to the hourly rate, the JCC pointed out that of the many benefits claimed at the trial, only one resulted in a positive award; thus, the JCC concluded it was improper to award the attorney a high rate in light of the very limited success during the extensive litigation. The JCC greatly reduced the fee sought by the claimant attorney and awarded $16,875.00 in fees and $1,590.41 in costs.

Gillis v. Head Industries / Amerisure Insurance
William H. Rogner
JCC Forte –Ft. Lauderdale - (4-19-17) – The JCC granted the E/C’s Motion for Protective Order and Quashed Deposition Notices of the prior and current adjuster. The claimant attorney had taken a two day deposition of the prior adjuster in 2014, and no PFBs had been filed since that time. The Deposition notices indicated that the depositions were to last “from day to day” until completed. The JCC found that the depositions had not been noticed for a proper purpose, and were set only to harass, embarrass or annoy the E/C. The JCC specifically rejected the claimant attorney’s stated reasons that the depositions were necessary to (1) conduct discovery on an attendant care issue (“He has not set forth any credible assertion that the Claimant has been prescribed home attendant care by an authorized provider, which the E/C has failed to provide”) or (2) “so that “the prior and current adjusters will need to assist me in doing an accounting for each indemnity draft received for the past couple of years as these instruments are not properly notated in a bi-weekly format so as to properly inform the Claimant of the relevant time period the instruments are intended to cover, precluding an accurate accounting of time period coverages.” The JCC rejected the second stated reason noting that “the request for some assistance by the adjuster to conduct some form of forensic accounting to properly inform the Claimant of the relevant time period the instruments are intended to cover, fails to establish what exactly if anything, would result by this accounting”. The JCC also found the prior adjuster would only be allowed to testify from her personal knowledge, and not as a representative of the carrier with access to the claim file.

Hinzman v. Winter Haven Facility Operations LLC / DBA Consulate Health Care of Winter Haven / Gallagher Bassett Services, Inc.
Paul T. Terlizzese
JCC Spangler (Tampa) (4-17-17) – Denied a specific model spa; awarded a home therapy spa to meet therapeutic requirements of aquatic therapy. The authorized orthopedist recommended home hydrotherapy, and later wrote a prescription for a specific spa based on a brochure provided to him by the claimant, but did not provide a DWC-25 or the prescription to the Carrier for these recommendations. The claimant argued that the Carrier’s failure to respond to the request for a specific spa waived their ability to contest medical necessity per 440.13(3)(d). The JCC found subsection 440.13(3)(i) applied, which required him to address the medical necessity of the specific device. He found that while a home therapy spa was medically necessary, the recommended device, with its “special electronics and entertainment features” was not medically necessary.

Culnan v. Collier County Sheriff's Office / North American Risk Services
Rex A. Hurley and Jonathan L. Cooley
JCC Weiss (Ft. Myers)(3-29-2017) – Denied all benefits under Presumption Statute. The claimant had an aortic aneurysm with resulting surgery. The JCC found the aorta is not part of the cardiovascular system and the condition was not caused by heart disease or hypertension per opinions of both IMEs. The JCC differentiated City of Venice v. Van Dyke, 46 So. 3d 115 (Fla. 1st DCA 2010) due to the testimony supporting the finding an aortic condition was heart disease. The JCC also sustained E/C’s hearsay objection to the pre-employment physical, finding that claimant failed to show he underwent a pre-employment physical showing no evidence of any covered condition.

Alvarado v. Progessive Employer Management Co. / Amtrust North America of Florida
Andrew R. Borah and Vanessa R. Irvin
JCC D’Ambrosio (West Palm Beach)(3-28-17) - Denied all benefits. The claimant alleged she fell while at work. She was subsequently fired a few days after her alleged accident for failing to show up for a shift. The E/C asserted a 30 day notice defense. Her supervisors and other employees testified that she never reported an injury and did not seem injured. The claimant alleged she told supervisors about her fall. Each side obtained IMEs whose opinions conflicted except they agreed that the claimant would have been unable to go an extended period of time without treatment if a fall occurred. The claimant consulted with an attorney and treated within 30 days but never gave a clear accident report to any doctor on how the injury occurred. The JCC found given the medical records, the IMEs’ testimony and employer testimony that the claimant failed to give timely notice.

Wise v. TFR Paving & Grading, Inc. / SUNZ Insurance
Gregory D. White
JCC Winn (Pensacola) - [2-14-17] Denied benefits due to fraud/misrepresentation. The claimant alleged a workplace accident caused a hernia. At deposition, the claimant denied ever having a prior hernia complaint. The employer representative recalled that the claimant complained of a hernia years prior. Medical records also showed prior complaints of hernias and that he was told to follow up with treatment. At the final hearing the claimant denied remembering that he had a hernia previously, but did recall multiple other injuries around the same time. The JCC found the claimant made misrepresentations for the purpose of receiving benefits and denied the petitions.

Johnston v. St. Lucie County Sheriff's Office / North American Risk Services
Rex A. Hurley
JCC Owen (Port St. Lucie)(1-25-17) - Denied all claims under presumption statute. The claimant, a sheriff officer, had chest pain and subsequently had a triple bypass. He then sought compensability of heart disease/CAD under section 112.18, TTD, authorization to treat with PCP, internist or cardiologist. The E/C argued the Claimant did not undergo a pre-employment physical which “failed to reveal any evidence of such a condition” and identified high cholesterol. The JCC determined the claimant met the elements to satisfy use of the presumption because the physical showed high cholesterol and not heart disease. The claimant’s IME opined the cause of CAD was unknown. The E/C’s IME opined that the claimant had high cholesterol on his pre-employment physical and suffered from essential hypertension, hyperlipidemia, and familial cholesterolemia. The claimant argued the E/C must provide clear and convincing evidence of a non-industrial cause, while the E/C argued the competent, substantial evidence standard applied. The claimant’s position, supported by their IME’s testimony, was that the cause can never be determined and therefore the E/C can never rebut the presumption. The JCC rejected the notion that the statute created an irrebutable presumption, and found the E/C satisfied their burden by providing competent, substantial evidence of a non-industrial cause of the heart disease.

Blanco v. Mattress One, and SOS Furniture Co., DBA Mattress One / Amtrust
Andrew R. Borah
JCC Kerr (Miami)(1-26-17) – Denied claimant’s Verified Motion for Attorney Fees. The claimant alleged entitlement to fees for PFBs filed 12/24/14 and 3/18/16. The E/C did not respond to the PFB of 12/24/14 but authorized a physician on 1/6/15 who saw the claimant on 1/23/15. The JCC found the E/C provided the benefit within 30 days. The 3/18/16 PFB requested an increase of the AWW. The E/C adjusted the AWW and paid back indemnity. The claimant then amended the DOA after nearly two years and E/C recalculated AWW and again paid back indemnity due and P&I. The JCC determined that the claimant had the responsibility to use correct DOA and the E/C justifiably relied on it. As predicted in a prior hearing by the JCC, the argument for entitlement was rejected, as no fees were awardable on a retroactive basis due to claimant’s own error.

Ramirez v. Deem, LLC / Amerisure
William H. Rogner
JCC Sojourner (Lakeland)- [12/30/16) Denied authorization of E/C paid second opinion. The claimant sustained a compensable injury and was seen by a surgeon and pain management doctor. The pain management doctor requested a second opinion due to the claimant’s pain. After some confusion over the request, it was clarified that he recommended a comparison of MRIs to determine if a recurrent disc herniation occurred. The E/C authorized another surgeon as the claimant’s one time change. The pain management doctor stated either doctor could give a second opinion by reviewing the MRIs. The JCC found that the claimant timely received the care and treatment recommended by the pain management doctor upon clarification and receipt of the MRIs and nothing more was necessary.

McCarthy v. Florida Institute for Long Term Care dba Pompano Rehab & Nursing Center
Scott B. Miller
JCC Lewis (Ft. Lauderdale) (12-6-2016) - Denied benefits based on Martin v. Carpenter. The claimant was in a motor vehicle accident in May of 2012 where he sustained a low back injury. The claimant underwent surgery in September of 2012 and received a PIR of 9% in November 2012. The claimant was hired by employer in November 2012. A pre-employment questionnaire asked “Do you currently, or have you ever had any of the following…Back pain” which was left unchecked. The claimant injured his low back in 2015. JCC found the claimant knowingly misrepresented his prior condition and “deprived the employer of the opportunity to make an informed decision about whether it would assume the risk of hiring the claimant”.

Lascaibar v. Stack, Fernandez, Anderson & Harris / Castlepoint Florida
Andrew R. Borah
JCC Owens (Port St. Lucie) (11/15/16) - Denied authorization of follow up appointment for compensable cervical and low back pain. Claimant injured back lifting boxes on 11/25/13 and was authorized to treat with an ortho who diagnosed cervical and lumbar strain and anticipated MMI in 6 weeks. Claimant requested a one-time change and saw a new ortho. The new ortho diagnosed cephalagia and lumbago and opined that subjective complaints were not substantiated by objective findings, her cervical changes were chronic, and symptoms did not follow anatomical distribution. He determined further care and treatment was not medically necessary. Claimant’s IME recommended EMG, exams by psychiatry, neurologist, and neurosurgery, pain management, TENS unit, and orthopedic mattress which were all claimed in an earlier petition. EMA, an ortho spine surgeon, was appointed due to the conflict and opined that none of the items recommended by Claimant’s IME were required as a result of the IA. JCC denied claims but subsequent PFB requested follow up for updated evaluation. The E/C denied as not medically necessary. Claimant’s new IME indicated lumbar radiculopathy, bulging annuli causing stenosis and made additional treatment recommendations. The E/C argued Claimant’s pain was personal in nature related to arthritis and existing condition. The Claimant argued that the E/C could not assert MCC as there was no break in causation. The JCC ruled pre-existing condition was considered in MCC analysis and Claimant still has burden to prove medical necessity. The JCC accepted the EMA’s presumptively correct opinions and those of the new ortho and found the treatment was not necessary or related and the conditions from IA had resolved

Willis v. Brevard County Public Schools / Sedgwick CMS
William H. Rogner
JCC Dietz (Sebastian/Melbourne) (11/3/2016) – Awarded appellate attorney fee of $8,910.00 ( $300/hr x 29.7 hours). The parties previously stipulated to the hours, however claimant’s counsel alleged a reasonable hourly rate was $375-$475 per hour. The E/C urged that there was evidence of only one appellate fee award in the district, which was $250/hr. The JCC analyzed the Lee Engineering factors and found in this case $300 presented a reasonable hourly appellate rate for counsel who is board certified in appellate law.

Chilmanski v. Socone Logistics, Inc. / Protective Insurance Company
Scott B. Miller
JCC Beck (Sarasota)- (10/26/16) Denied benefits due to fraud defense. The claimant had prior low back, shoulder, neck and hip injuries from various accidents. The claimant injured his lower back and neck in a compensable accident in 2015. Over several years and several doctors the claimant failed to give consistent medical history, including not reporting prior back problems for the 2015 accident. The claimant had major back injuries starting in 1998 with repeated pain reports for several years. In deposition the claimant attributed many of his accidents to neck and shoulder issues. The claimant denied a 2007 workers’ compensation lawsuit that alleged back pain. The claimant received substantial settlements and indemnity benefits from various claims. At trial, the claimant attributed the inconsistent medical history on his drug addiction, mental history, and forgetfulness. JCC found the claimant not credible. JCC further opined the claimant intended to commit fraud in order to receive workers’ compensation benefits due to the 16 years of history of low back pain and a number of low back complaints and accidents that were not reported.

Chilmanski v. Socone Logistics, Inc. / Protective Insurance Company
Scott B. Miller
JCC Beck (Sarasota)- [10-26-16] Denied benefits due to fraud defense. The claimant had prior low back, shoulder, neck and hip injuries from various accidents. The claimant injured his lower back and neck in a compensable accident in 2015. Over several years and several doctors the claimant failed to give consistent medical history, including not reporting prior back problems for the 2015 accident. The claimant had major back injuries starting in 1998 with repeated pain reports for several years. In deposition the claimant attributed many of his accidents to neck and shoulder issues. The claimant denied a 2007 workers’ compensation lawsuit that alleged back pain. The claimant received substantial settlements and indemnity benefits from various claims. At trial, the claimant attributed the inconsistent medical history on his drug addiction, mental history, and forgetfulness. JCC found the claimant not credible. JCC further opined the claimant intended to commit fraud in order to receive workers’ compensation benefits due to the 16 years of history of low back pain and a number of low back complaints and accidents that were not reported.

Solorzano v. McDonald's / Amerisure Insurance
Andrew R. Borah
JCC Almeyda (Miami)- (10/13/16) Denied TPD from 2013 accident to 8/16/16, return appointment with Dr. Trombly and PTD. Granted return appointment to Dr. Epstein and TPD from 8/17/16 and continuing. The claimant injured her neck, back and head. The claimant underwent extensive treatment for her back, however no medical record evidence was introduced regarding the head injury besides a CT scan. The E/C’s medical records primarily addressed the back injury and doctors found MMI. The claimant’s IME opined she was not at MMI. JCC found claimant’s IME more reliable because the IME reviewed all of the claimant’s injuries for MMI, and granted TPD benefits from 8/17/16 and continuing. JCC also ordered a return visit for Dr. Epstein to clarify need for treatment to neck and headaches. JCC denied TPD benefits prior to 8/17/16 for lack of medical evidence, PTD as it was not ripe, and return visit to Dr. Trombly due to no evidence of medical necessity for further neurosurgical intervention.

Gonzalez v. Southeast Personnel Leasing, Inc.
Anthony M. Amelio
JCC Medina-Shore (Miami)- [10/12/16] Denied all benefits based on misrepresentation. The claimant sustained back and neck injuries while doing roofing work in 2013. The claimant gave a recorded statement and medical history to two doctors, failing to disclose prior injuries to his foot, thoracic spine, lumbar spine, cervical spine, and head two years prior. In deposition, the claimant denied on multiple occasions having any injuries, except an injured jaw and foot, resulting from the prior 2011 motor vehicle accident. The claimant had access to the records as his PIP attorney for the 2011 accident provided those to him. The claimant argued he did not disclose prior back issues due to memory loss issues. He attempted to explain unhelpful facts were due to mistakes made by providers in medical records. He also sought to argue that the fraud was not connected to the new injuries, although authorized doctors testified an accurate history was important to their evaluation, treatment and impairment assessment. In support of her finding of misrepresentation, the JCC cited the recent (2016) Rentals & Sales of Clearwater, Inc. v. Arnold, case - “if the claimant made any misrepresentation for the purpose of obtaining benefits, then he is barred from entitlement...”. JCC found fraud and misrepresentation relying on the IME from the 2011 case and the doctor’s depositions.

Haidy v. Martin County Sheriff's Office / North American Risk Services
Rex A. Hurley
JCC Humphries (Jacksonville) (10-5-16) Denied Presumption claim including indemnity. The JCC determined Claimant did not establish he was disabled as a result of hypertension on the alleged DOA. JCC also found the claim barred as a matter of law as claimant did not report it to the employer in the statutory 90 days period. Claimant reported claim nearly 1 ˝ years after DOA and about 5 months after he became aware of possible presumption claim through his union.

Gardner v. AVT Simulation / Technology Insurance Company / Amtrust North America of Florida
Gregory D. White
JCC Sculco (Orlando) – (9/30/16) – Denied total hip replacement, awarded neurological eval and TPD benefits. The JCC accepted the EMA’s (Murrah) opinion that the MCC of the claimant’s need for a total hip replacement was her pre-existing arthritis (which was “well down the road prior to her accident”). The JCC also rejected claimant’s argument that the hip replacement was necessary as a hindrance to recovery to treat the claimant’s osteophyte from a compensable hip fracture. The JCC found the neurological evaluation not dependent on causation where it is to rule in or rule out a diagnosis, and as she is not at overall MMI and has restrictions, he awarded TPD.

McGhee v. Ace Hardware / York Risk Services Group & ESIS Claims
W. Rogers Turner, Jr.
JCC Spangler –Tampa (9-22-16) Granted Motion to issue Subpoena to Non-Party. The E/C deposed the claimant’s daughter in law and son, who are paid to provide 24 hour attendant care. Both admitted they had both been away from the claimant for a period of several hours, but admitted submitting time records to the E/C, which the claimant signed off on. They denied any other similar periods where they left the claimant alone. The E/C issued a notice of intent to subpoena the daughter in law’s financial records (subsequently limited to only credit card/debit card information), to which the claimant objected. The JCC found the E/C was entitled to seek information which may reasonably lead to discoverable evidence of other periods away from the claimant, that the non-party’s privacy rights did not trump this discoverable issue and that the information sought was relevant.

Guttierez v. The Health Center of Daytona Beach / Premier Group Insurance
W. Rogers Turner, Jr.
JCC Anderson (Daytona Beach) (9-19-16) Denied all claims based on notice defense. Claimant was an LPN who alleged that she injured herself preventing a patient fall. The JCC accepted the E/C representatives’ testimony that the claimant did not notify employer of the 11/5/2015 incident until after 30 days, and found the employer did not have actual knowledge of the injury.

Hanson v. ARC Broward, Inc. / York Risk Services
Derrick E. Cox
JCC Hogan (Ft. Lauderdale) (9-16-16)- Denied request for one time change of PCP to Dr. Suarez and his recommendations for physical therapy, aquatic therapy, outpatient pain management. Claimant suffered a back injury and was released from her doctor in Sept. of 2015. Claimant believed she needed additional treatment and selected Dr. Suarez from a list at her attorney’s office. Claimant’s counsel testified to a fax sent on 10/13/2105 requesting Dr. Suarez as a one-time change. Claimant began seeing Dr. Suarez with the understanding that her attorney requested authorization. E/C adjuster testified that Dr. Jarolem was authorized as one time change on 2/5/2016 via e-mail to Claimant’s attorney and by response to PFB on 2/9/2016 to the claimant’s 2/4/2016 PFB requesting Dr. Suarez. The JCC accepted the E/C’s testimony that they never received the October fax.

Adams v. Vision Quest National / Crum & Forster
Andrew R. Borah
JCC D’Ambrosia (West Palm Beach)- (9-16-16) Denied all benefits based on misrepresentation. Rejected E/C’s misconduct defense as to TPD. The employer terminated the claimant for behavioral issues. The claimant testified he believed his termination was due to his injury, and also denied being counseled for behavior or suspended for a day. JCC considered testimony of employer reps which completely contradicted claimant’s testimony, and found claimant’s statements were knowingly false and made for the purpose of obtaining benefits.

Lopez v. J.A. Croson, LLC / Amerisure
Kate E. Albin
JCC Hogan (Ft. Lauderdale)- 9/9/2016 - Denied advance. The claimant already requested a $2,000 advance and then requested another $2,000 advance. The claimant did not repay first advance. E/C asserted prejudice to the employer and the claimant requested time to find case law. The claimant withdrew the motion for advance and JCC denied as moot.

Abramovitz v. O&C Masonry, Oceanside Masonry; AIG, Zurich and Broadspire
Paul L. Luger
JCC Rosen (West Palm Beach)- (8-16-16) Voided final order striking E/C’s defenses. Employer was under the mistaken fact that its interests were being represented by another party to the action. Employer failed to appear for mediation and a subsequent show cause hearing, after which the JCC struck all defenses. JCC found mistake in fact due to the employer’s belief it was represented through the payroll company and voided the order.

Perez v. Vesa Logistics Corp. / Protective Insurance Company
Vanessa R. Irvin, Scott B. Miller
JCC Almeyda (Miami)(8-4-16) - Granted dismissal of claim for attorney’s fees and costs for lack of prosecution. There was no record of prosecution for over a year. The claimant argued good cause for lack of prosecution because benefits were furnished and there was fee entitlement. The claimant attempted to prove this by providing the court a letter from E/C’s counsel memorializing an agreement, which was executed but never sent back. The JCC found even if the fee entitlement stipulation were fully executed, it “would not be good cause to not dismiss this matter” because the stipulation does not dispose of the attorney’s fees or costs

Irwin Douglas v. Sunryse Construction Services Inc./ Progressive Employer Services, Inc. / Sunz Insurance / North American Risk Services
Anthony M. Amelio
JCC Dietz (Melbourne)- Denied claims based on SOL. The claimant did not file a PFB until four years after the last benefit was provided and three years of the running of the SOL. The JCC found the claimant was properly informed of the SOL. Although the claimant pursued other claims in other venues, there was no evidence to indicate the statute had been tolled.

Thurman v. Sea Level Marine, LLC / AmTrust North America of Florida
Andrew Borah and Kate Albin
JCC Kerr (Miami)– Denied Claimant’s one time change and claims for a L knee MRI, ortho eval, PT and attorneys fees and costs. Claimant requested a one time change with a specific doctor but adjuster notified Claimant of change to alternate doctor within 2 days with a scheduled appointment. Claimant claimed he was in too much pain and appointment was too far away, so within days the adjuster set an appointment with another doctor with a much shorter period until the appointment. The claimant failed to attend that appointment and went to his own doctor. The JCC rejected claimant’s argument that he was entitled to see his own doctor via self help as second doctor was not authorized within 5 days of initial request. The JCC found the one time change occurred timely.

Delgado v. Spherion Staffing, LLC / Sedgwick CMS / ACE USA & ESIS WC Claims
Andrew R. Borah
JCC Medina-Shore (Miami)– Denied further treatment, prescriptions, bills and other medical benefits. The JCC found that the industrial accident was no longer the MCC of the claimant’s back condition. JCC found the causally related back sprain had resolved and/or that the degenerative disk disease was now the MCC.

Stancil v. Right Hand Man / ESIS WC Claims
Derrick E. Cox
JCC Massey (Tampa)– Denied guardian’s attorney fees. The guardian’s attorney testified at the hearing that he could not provide more specific details about his time and that at least some of the time claimed was not related to the pursuit of workers compensation benefits. The JCC rejected the claimant’s arguments that the E/C was responsible for all guardian fees and costs or that estoppel or laches required payment.

Heknter v. Brevard County School Board / Sedgwick CMS
Bill Rogner
JCC Dietz (Sebastian) – Awarded $7,500 (30 @ $250) appellate attorney fee. 1995 d/a. The JCC noted that while the issues were not unusual that “[t]he challenge for the Claimant's attorney in this case [was] not the legal issues, but the knowledge and experience of opposing counsel, who is one of the most respected appellate attorneys in the workers' compensation field.” The JCC accepted the E/C’s position both as to the number of hours and the appropriate hourly rate.

Mojica v. A-Lighting Maintenance Corp. / Amerisure
Andrew Borah and Kate Albin
JCC D’Ambrosio (West Palm Beach) – Awarded $375.00 in sanctions against claimant’s counsel for failure to timely dismiss a claim for fees and costs where the attorney previously agreed to dismiss the claim.

Wable v. Progressive Employer Management Services, Inc. dba J&D Concrete & Masonry, Inc.
Greg White and Tim Stanton
JCC Rosen (St. Petersburg)- Compelled claimant to answer deposition questions. The JCC found the 5th Amendment protections did not apply to workers' compensation.

Lascaibar v. Stack, Fernandez, Anderson & Harris / Castlepoint Florida
Andrew R. Borah
JCC McAliley (VTC Miami)– Awarded $3,072.40 in taxable costs to the E/C including costs for an EMA.

Echevarria v. Southeast Personnel Leasing / Packard
Anthony M. Amelio
JCC Anderson (Daytona Beach)- Awarded $218.60 stat fee. Denied costs. Rejected claimant's hourly fee demand. 2011 d/a.

Garcia v. Randstad / ESIS
Andrew R. Borah
JCC Sturgis (Ft. Myers) - Denied all benefits based upon 440.105. The claimant had testified at a prior advance hearing that she had not worked since 8 weeks before the hearing, however, the claimant had actually been working light duty for the employer in the weeks leading up to the advance hearing. The JCC rejected the claimant’s explanation that she unintentionally provided such misstatements due to her poor understanding of the English language. The JCC also found that the claimant failed to disclose a second bank account at the advance hearing and that the claimant provided false statements at her deposition regarding her physical condition following a subsequent MVA.

Monteagudo v. Payroll Made Easy, Inc. dba Continuum HR / SUNZ Insurance
Gregory D. White
JCC Sculco (Orlando)– Awarded $380 in taxable costs to E/C.

Spofford v. Dixie Metal Products, Inc. / Amerisure
William H. Rogner
JCC Hill (Gainesville)– Denied compensability of lumbar spine. The claimant had a past history of lumbar injury. The JCC found the claimant’s lumbar spine was essentially the same as prior to the work injury and that the accident was not the MCC of the claimant’s lumbar complaints.

Machucha v. Francisco Fuente / JA Drywall, Inc., uninsured subcontractors to Brierhill Homes, Blanton Drywall, Fuentes Construction Services, Inc. / Association Insurance Company / Broadspire
W. Rogers Turner, Jr.
JCC Pitts (Orlando)- Granted summary final order as to the employer. The claimant was injured on a construction site. The JCC found that the first insured subcontractor was responsible for coverage.

Lascaibar v. Stack, Fernandez, Anderson & Harris / Castlepoint Florida
Andrew R. Borah
JCC McAliley (VTC Miami)– Denied various medical benefits. The JCC accepted the opinions of the EMA (Hyde) that the various medical benefits were not medically necessary. The JCC found that he did not reach the claimant’s MCC arguments regarding wavier of MCC as the claimant failed to prove medical necessary.

Hidden v. Day & Zimmerman / Florida Power & Light / Broadspire
Derrick E. Cox
JCC McAliley (Port St. Lucie) - Denied compensability. The JCC found the claimant did not present an IME opinion to support that self-help care was due to an accident and the ER records alone did not establish compensability. Without an expert opinion the JCC found the claimant could not establish compensability.

Antosh v. Setty Enterprises, Inc. / Amtrust North America of Florida
Andrew R. Borah
JCC Punancy (West Palm Beach)– Denied all benefits based upon 440.105. The claimant testified he was bed ridden or wheelchair bound however the JCC accepted the testimony of the claimant’s doctor that he was continuing to work.

Rodriguez v. YRC, Inc. and Sedgwick CMS
Scott B. Miller
JCC Massey (VTC Miami) – Denied therapy, MRI and back brace. The JCC found that the E/C did not prove a break in the causal chain and the E/C could not challenge causal relationship. However the JCC found that the requested therapy, MRI and brace were not medically necessary based upon the EMA (Hyde) opinion.

Perez v. Alson Auto, Inc. / Employers Insurance Company of Nevada
Andrew R. Borah
JCC Hill (Miami) – Denied compensability of elbow, knee and back and penalties. Awarded interest. The JCC found the claimant not credible and found he did not injure his back, elbow or knee in the accident. The JCC found that the adjuster timely reissued an IB check that was not received by the claimant so no penalty was due but that the interest was awardable.

Pierre v. FTS USA, LLC / dba Unitek USA, LLC / Gallagher Bassett Services / Insurance Company of Pennsylvania / Zurich American Insurance Company
Andrew R. Borah
JCC Kerr (Miami) – Denied most benefits. Summary order. The JCC found that most of the claimant raised in the claimant’s petitions had been dismissed previously are were barred by res judicata.

Henry v. Frank Crum / Anthony's Coal Fired Pizza / Frank Winston Crum Insurance
Kate E. Albin
JCC Forte (Ft. Lauderdale)- Denied continued treatment or evaluation. The E/C had authorized three doctors who all opined the claimant was at MMI 0%. The JCC found that despite the continued complaints of pain the claimant presented to evidence of the need for further treatment.

Gomez v. Frank Crum, Inc. / Broadspire
Paul L. Luger, Julie C. Bixler
JCC Lazzara (VTC Ft. Lauderdale)– Denied new law (2012) PTD and TTD/TPD. The JCC found the claimant not credible based upon his statements he was ‘homeless’ while living with his mother. The JCC rejected the claimant’s arguments that Westphal allowed TTD/TPD beyond 104 weeks. The JCC rejected the claimant’s IME opinion that he could not work, found he was full duty for the ankle, had work restrictions for his shoulder but would likely be full duty for his upper extremity injury at MMI, and therefore Westphal and Oswald did not require PTD. The JCC also rejected the claimant’s limited job search and compromised vocational testimony.

O'Neill v. Columbia Staffing / Broadspire
Matthew W. Bennett
JCC Winn (Pensacola) – Granted E/C’s motion to enforce settlement. The JCC found the parties reached a settlement at mediation and the E/C had only agreed to pay specifically enumerated bills. The JCC found the claimant requested to attend the mediation by phone and given authority to his attorney.

Hall v. Florida Highway Patrol / Division of Risk Management
Kate E. Albin
JCC Almeyda (Miami) – Awarded $5,795.48 in taxable costs to E/C.

Gomez v. Frank Crum, Inc./ Broadspire
Paul L. Luger
JCC Lazzara (VTC Ft. Lauderdale) – Denied TTD/TPD and new law (2012) PTD. Abbreviated order. The JCC found that the claimant received all 104 weeks of TTD/TPD. The JCC also found that the claimant did not qualify under Oswald for PTD and did not conduct a job search.

Snowden v. Yellow Freight Systems / Sedgwick CMS
Scott B. Miller
JCC Castiello (Miami) – Denied ongoing trigger point injections. 1994 d/a. The claimant testified at hearing that the injections provided long lasting relief, however the JCC found the claimant not credible based in part on his depo transcript of intense pain two days after an injection. The JCC accepted the EMA (Epstein) opinion that the injections were due to the claimant’s preexisting degenerative changes and skeletal hypostasis.

Gonzalez v. Maewood Food DBA McDonald's / Amerisure
William H. Rogner
JCC Kerr (Miami) – Denied further medical treatment. A prior order found the claimant to be MMI 0%. The JCC found the claimant not credible and accepted the opinions of the EMA (Hodor) that the claimant did not require further care due to the accident. The JCC rejected the claimant’s estoppel argument.

Miles v. Gillette Construction Services / Guarantee Insurance Company
Kate E. Albin
JCC Massey (VTC Miami) - Denied all benefits based upon 440.105. The unrepresented claimant did not appear for hearing however the JCC found the E/C clearly established the claimant’s false statements concerning a lack of prior back pain were made for the purpose of obtaining benefits.

Limith v. Lenox on the Lakes / Crum & Forster Insurance
Andrew R. Borah, Joseph R. Kessler
JCC Forte (Ft. Lauderdale)– Denied future treatment. The claimant argued that since the E/C accepted compensability she was entitled to future medical treatment. The JCC found the claimant failed to present any evidence of medical necessity to entitle her to further treatment.

Green v. Michelle's Cafe and Technology Insurance Company
Joseph R. Kessler
JCC Forte (Ft. Lauderdale) – Dismissed petition for the claimant’s failure to appear.

Rosado v. Howard Leasing / Sunz Insurance
Matthew J. Troy
JCC McAliley (Port St. Lucie)– Denied periods of TPD, awarded increase in AWW. The claimant worked for three weeks prior to the accident. The JCC found the claimant’s AWW should be based upon those three weeks, not a contract of hire, and awarded increased TPD payments prior to MMI. The JCC denied TPD from the claimant’s date of accident until the E/C rescinded their denial, which was based upon late notice. The JCC found no evidence of restrictions prior to the claimant seeing the authorized doctor.

Wheeler v. Coastal Delivery, Inc.
W. Rogers Turner
JCC Sculco (Orlando)– Enforced settlement of claim.

Negron v. Hyatt Regency Orlando / Gallagher Bassett Services, Inc.
Allison M. Twombly
JCC Sculco (Orlando)– Dismissed claimant’s petitions for failure to appear for depositions.

Wynne v. TGIF/ Gallagher Bassett Services, Inc.
Andrew R. Borah
JCC Hogan (Ft. Lauderdale)– Awarded sanctions for not dismissing a frivolous claim for fees on payment of medical bills until the time of the hearing.

Sansone v. Frank Crum / Frank Winston Crum Insurance, Inc.
Paul L. Luger
JCC D’Ambrosio (West Palm Beach)– Denied attorney fees. The claim was initially denied for a drug defense. The E/C rescinded after the PFB was filed and payed the ER bill. The JCC rejected the claimant’s arguments that a fee was due because the E/C responded to the PFB accepting compensability and timely paid the bill within 45 days of receipt.

Rodriguez v. USA Bouquet LLC / AmTrust North America of Florida
Andrew R. Borah and Joseph Kessler
JCC Kerr (Miami)– Denied foot ortho. The JCC accepted the unrebutted opinions of the ER doctor that a podiatrist satisfied the referral for a foot ortho. The JCC found the claimant treated with the podiatrist for months and introduced no evidence that the podiatrist was not appropriate.

Andrade v. CoAdvantage Resources, Inc. / AmTrust North America of Florida
Andrew R. Borah
JCC Weiss (VTC Miami) – Denied all benefits based upon SOL. The JCC rejected the claimant’s testimony that he never received anything from the carrier based upon multiple E/C depos from the claims department establishing that the E/C provided the brochure.

Ricks v. First Coast Tractor and Mower / Sentry Casualty Company / Sentry Select Insurance Company
Robert J. Osburn
JCC Humphries (Jacksonville)– Awarded reimbursement for attendant care from SDTF amounting to $350,740.87. Since 10/01, the E/C paid 24/7 non-skilled attendant care benefits pursuant to a prior Order. During that time, the parties agreed to pay the claimant directly at a rate of $15.04 per hour/$5,054.00 biweekly. The market rate at that time was $36.00 per hour/$12,096.00 biweekly. The claimant was responsible for obtaining and paying for his attendant care. The SDTF denied reimbursement without supporting attendant care logs showing the attendant care was actually provided, arguing they should only be required to reimburse properly documented expenses and not for services that have not been provided. The JCC agreed that the Rule cited by the SDTF was inapplicable because non-skilled attendant care providers are not health care providers. The JCC further agreed with the E/C that this Rule was not applicable because it was not in effect on the date of accident. The JCC also accepted the E/C’s argument the SDTF was estopped from requiring attendant care logs in the instant claim. The evidence showed there had been two prior claims filed with the SDTF seeking reimbursement of attendant care and the SDTF reimbursed those prior submissions without requiring attendant care logs.

Reyes-Garcia v. P.M. Dunn Construction Co., Inc. / Southeast Employee Leasing / Lion Insurance Company / Packard Claims Administration
Anthony M. Amelio
JCC McAliley (Port St. Lucie) – The JCC essentially denied all claims. The claimant sought an increase in his AWW under F.S.§440.14(1)(e) which allows the JCC to take into consideration any expected increases under normal conditions in the AWW of a claimant under age 22. The JCC found the evidence did not warrant such a speculative adjustment given the claimant’s skills and education at the time of the injury. The JCC also denied the claim for provision of a modified wheelchair accessible vehicle (which the E/C stipulated would be provided) as the claimant to date had not completed specific training for operating a vehicle with hand controls. No evidence existed to support claims for transportation for “all of claimant’s needs” or an FES bike.

Matheny v. Indian River Fire Rescue / Johns Eastern Company
Mark E. Hill
JCC Dietz (Sebastian)- Awarded $2,677.96 in taxable costs. Denied cost for air quality testing regarding 70 exposure claims.

O'Connor v. Indian River County BCC / Johns Eastern Company
Mark E. Hill
JCC Dietz (Sebastian)– Awarded $538.20 in taxable costs. Denied cost for air quality testing regarding 70 exposure claims.

Ruffalo v. Ocala Regional Medical Center / Broadspire
Matthew W. Bennett
JCC Hill (Gainesville)– Denied TPD. The JCC found the E/C continually offered 53 hours per week of light duty work within the claimant’s restrictions to meet the 80/80 formula and that any loss of income was due to the claimant’s choice not to work the hours available.

Seligman v. IMC Healthcare, Inc. and Zenith Insurance Company
Matthew J. Troy
JCC Anderson (Daytona Beach) – Compelled claimant to attend IME. The JCC found that as the E/C had not authorized the requested procedure within 14 days of the PFB being filed there was a pending dispute.

Castillo v. Casselberry Meat Market / Tower Companies
Matthew J. Troy
JCC Condry (Orlando) – Granted E/C’s motion to enforce settlement.

Castillo v. Casselberry Meat Market / Tower Companies
Matthew J. Troy
JCC Condry (Orlando) – Granted E/C’s motion to enforce settlement.

Coombes v. Howard Leasing
Matthew J. Troy
JCC Lewis (Ft. Lauderdale) - Taxed $1,122.42 against the claimant.

Santana v. Hubbell Enterprises, Inc. / Protective Insurance Co.
Scott B. Miller
JCC Forte (Ft. Lauderdale) – Denied claimant’s motion for summary final order on 440.105. The JCC rejected the claimant’s argument that the JCC must enter an order denying benefits before the E/C may unilaterally suspend benefits.

Lavan v. N. Florida Surgical Pavillion / Broadspire
Matthew M. Bennett
JCC Hill (Gainesville)– Denied claimant’s motion for protective order for IME. The JCC found the motion, filed 24 hours before the appointment, to be untimely.

Peters v. Miami Palm Restaurant / Crum & Forster
Andrew R. Borah
JCC Almeyda (Miami) - Denied authorization of an alternate physiatrist. 1997 d/a. The claimant sought an IME and physiatrist treatment. The claims assistant mistakenly set up the evaluation as an IME which was corrected. The JCC found the mistake was timely corrected and that the physiatrist could remain the authorized doctor. The JCC previously awarded the IME in a prior hearing.

Myers v. Pestsure Association (Massey) / Sedgwick CMS
Derrick E. Cox
JCC Lazzara (Tallahassee) – Taxed $2,062.24 in costs against the claimant.

Mohammed v. Integrated Regional Laboratory and Broadspire
Andrew R. Borah
JCC Forte (Ft. Lauderdale)– Granted E/C’s motion to dismiss for lack of prosecution where claimant reserved on fees and costs in 2013 and no record activity had taken place for one year

Peters v. Miami Palm Restaurant, Inc. / Crum & Forster
Scott Glick
JCC Medina-Shore (Miami) – Dismissed claim for home assessment and DME due to claimant’s failure to attach referrals. 1997 d/a.

Jean-Pierre v. Eli Witt Company / United States Fire Insurance Company / Crum & Forster
Andrew R. Borah
JCC Almeyda (Miami)– Denied follow up with second opinion. 1996 d/a. The E/C via a stipulation agreed to provide a second opinion in 2012. The JCC found that authorization was limited to an evaluation only and found the authorized treating doctor did not refer the claimant back to the second opinion.

Vidal-Casimiro v. Howard Leasing / NARS / Sunz Insurance
Matthew J. Troy
JCC Punancy (West Palm Beach) – Denied all benefits based upon 440.105. The JCC found the claimant provided a false SSN to the adjuster in a recorded statement and found the claimant’s explanations not credible.

Valdez v. Soil Tech
Andrew R. Borah
JCC Rosen (VTC Miami) – Denied compensability. Bifurcated hearing. The JCC found the that the claimant was an owner-operator and independent contractor not subject to WC coverage and in fact there was a separate accident insurance policy which paid the claimant benefits.

Nieblas v. Four Points by Sheraton / The Simplex / Guarantee Insurance Company
Andrew R. Borah
JCC Massey (Miami)- JCC assessed sanctions against claimant’s attorney pursuant to Fla. Stat. 440.32(3) for filing claims for compensability and an E/C paid IME that were not well grounded in fact and law. JCC further held that E/C was not required to provide claimant’s attorney with 21 days notice before filing Motion for Sanctions as 21 day safe harbor provision in Rule 60Q-6.125 does not apply to sanctions provisions in Fla. Stat. 440.32.

Linares v. La Mia Supermarket / Packard Claims
Anthony M. Amelio and Julie Bixler
JCC Hill (VTC Miami) – Dismissed claim for fees and cost. A prior order had compelled the claimant’s attorney to file a VFP within 30 days. The attorney did not file the petition until the 213th day. The JCC found the VFP was not timely and there was no good cause shown.

Olivencia v. Florida Keys Wild Bird Center / Castlepoint
Andrew R. Borah
JCC McAliley (Port St. Lucie)– Awarded $2,307.55 in costs to E/C.

Ellis v. Florida Institute of Technology / PMA / York Risk Services Group
Gregory D. White
JCC Dietz (Sebastian) - Denied Vax-D and hip MRI. The JCC accepted the opinions of the EMA (Rojas) that neither was necessary or related to the claimant’s SI joint issue.

Limith v. Lenox on the Lakes / Crum & Forster
Andrew R. Borah
JCC Forte (Ft. Lauderdale) – Denied fee entitlement. The JCC found that the E/C timely responded to two PFBs and continued to authorize medical care.

Colindres-Banegas v. DCHC Inc., Markel Services / Winter Park Construction / Amerisure
William H. Rogner
JCC Sculco – Denied reimbursement to E/C1. E/C1 and E/C2 both denied compensability. E/C1 settled the claim on a controverted basis but agreed to pay medical bills. E/C2 separately settled on a controverted basis for a nominal amount. E/C1 sought reimbursement from E/C2. The JCC found that as the claims were settled on a controverted basis he was without jurisdiction under 440.42(4). The JCC accepted E/C2’s construction of the statute.

Matheny v. Indian River Fire Rescue / Johns Eastern Company
Mark E. Hill
JCC Dietz (Sebastian) – Denied fee approval. The claimant sought to have his union pay his attorney an hourly fee for representing him in a mold claim.

Wallace v. Indian River BCC-Fire Rescue / Johns Eastern Company
Anthony M. Amelio
JCC Dietz (Sebastian) – Denied hourly fee agreement and retainer for firefighter.

Sams v. Decision HR, USA, Inc. / Chartis
Matthew W. Bennett
JCC Roesch (Panama City): Judge denied mileage to claimant. Claimant relocated from Tennessee where he had authorized care to Wyoming and then to New Jersey without notifying the Employer/Carrier. As he liked his physician in Tennessee, he took trips back to Tennessee to treat. The Judge found it unreasonable to require carrier to pay for trips and found Claimant failed to provide the carrier with an opportunity to determine the means of transportation.

Maqueira v. Frank Crum / Frank Winston Crum Insurance
Andrew R. Borah
JCC Almeyda (Miami) – Granted E/C’s motion for summary final order on authorized medical bills.

Kirkland v. DSI Management / Amerisure Insurance
William H. Rogner
JCC Dietz (Sebastian)– Denied TPD. The claimant enrolled in an LPN program after the injury. The JCC found the employer documented its numerous efforts to accommodate her restrictions and changes to her schedule but the claimant failed to show up for the work provided.

Hernandez v. Southeast Personnel Leasing, Inc. / Packard Claims Administration
Anthony M. Amelio
JCC Massey (VTC Miami)– Denied compensability. The claimant attempted to introduce medical records from a clinic that had been initially authorized based upon a motion to admit which had been filed in 2013. The JCC found that the granting of a motion to admit is hearing, or at least proceeding, specific. The JCC also found the claimant did not timely file their pre-trial. Finally the JCC found the claimant not credible and found the claimant did not report the injury within 30 days.

Santiago v. Florida Highway Patrol / Division of Risk Management
Andrew R. Borah
JCC Massey (VTC Miami) – Denied compensability of HTN. Presumption claim. Claimant left the employer in 2008. The claimant alleged a HTN from 2004 when he was treated. No NOI was created at that time and no brochure was sent out. The JCC rejected the E/C’s SOL and notice defenses. The JCC also rejected the E/C’s 440.105 defense based upon medical records which mentioned prior treatment for HTN. However the JCC found the amendment to 112.18 limiting claims to within 180 days of retirement was procedural and that the claim was not timely.

Eugene v. American Airlines / TLC Retirement / Sedgwick CMS & Broadspire
W. Rogers Turner
JCC Sojourner (Lakeland) -- Awarded $88.00 stat fee to prior counsel. The prior attorney did not appear for the hearing and the JCC accepted the E/C’s position that all but $440 in TTD/TPD had been properly paid.

Saulnier v. Thrive HR FL 1 LLC / Guarantee Insurance
Tim Stanton
JCC Massey (VTC Miami)– Denied all benefits based upon 440.105. At hearing the claimant testified that he had been paid for consulting work which he denied multiple times during his deposition. The JCC found the claimant violated 440.105. The JCC also would have denied all benefits sought.

Vidal v. NIC EX / Protective Insurance Company
Scott Miller
JCC Beck (Sarasota)– Denied all benefits based upon 440.105. The claimant denied prior back complaints which were documented in his PCP records. The JCC found the claimant’s misrepresentations were made with the intent of helping or supporting his workers’ compensation claim, and that his demeanor while testifying did not support the trustworthiness of his statements.

Battaglino v. State of Florida Department of Corrections / Division of Risk Management
Matthew J. Troy
JCC Anderson (Daytona) – Denied periods of TPD and scooter. Awarded TTD/TPD, sleep study and videostroboscopy. The JCC found the E/C offered the claimant a job within her restrictions which she refused but found the refusal only lasted until the claimant was terminated. The JCC found the E/C did not prove the continued existence of that job. The JCC also found the claimant could rely upon an off work status from her first doctor as the 1x change did not address work status. Finally the JCC found a scooter was not medically necessary but a sleep study and videostroboscopy were.

Etienne v. Randstad North America and ESIS / Ace American Insurance Company
Andrew R. Borah
JCC Forte (Ft. Lauderdale) – Denied TT/TPD. Denied E/C’s misconduct defense. The claimant alleged injury after a van in which she was traveling with 10 other people rolled over. In considering the misconduct defense, the JCC found the claimant’s use of a cell phone and confrontation with supervisors insufficient, as the employer had no prior documented instances of prohibited cell phone use. However, the JCC accepted the EMA’s (Jarolem) opinion that the claimant’s lumbar herniations were due to pre-existing conditions, while her neck and shoulder showed no objective signs of injury. In accepting the EMA’s opinions, the JCC noted that he was the only doctor to have reviewed the actual MRI films. The lumbar films actually showed disc pathology a year post accident that did not appear in scans taken closer in time after the accident.

Wheeler v. Coastal Delivery, Inc.
Rogers Turner
JCC Sculco (Orlando)– Awarded $300 sanction against the claimant for refusal to answer deposition questions.

Whitt v. Satellite Unlimited / Amerisure Insurance
Matthew W. Bennett
JCC Roesch (Panama City)- Denied compensability. The claimant’s injury occurred while driving to his supervisor’s home to begin his work day. The JCC found the claimant was not in the course and scope of employment based upon the going and coming rule.

Vice v. La Place du Soleil, LLP / Tower Group Companies
Andre R. Borah
JCC Forte (Ft. Lauderdale)– Denied compensability of back and benefits for knee. Amended order. The JCC found the claimant sustained a resolved laceration of her knee and any further treatment was unrelated.

Ginyard v. Southeast Personnel Leasing, Inc./ Lion Insurance Co. / Packard Claims
Kate E. Albin
JCC Massey (VTC Miami) – Denied advance.

Jones v.Unitek Global Services / Gallager Bassett Services
Derrick E. Cox
JCC Spangler (Ft. Myers) – Awarded $710.88 in taxable costs to E/C.

Vice v. La Place du Soleil, LLP / Tower Companies
Andrew R. Borah
JCC Forte (Ft. Lauderdale)- Denied compensability of claimant’s alleged back condition and benefits. The claimant sustained a knee injury. The JCC rejected the claimant’s arguments that the authorized doctor’s opinions did not meet the Daubert standard. The JCC found the claimant reached MMI with no need for further treatment regarding the knee and did not injure her back.

Carrazana v. Renovations Property Management, LLC / Castlepoint Florida
Andrew R. Borah
JCC Hill (VTC Miami) - Denied surgery. The EMA (Gilbert) opined that the accident was not the MCC of the need for cubital tunnel surgery. The JCC rejected the claimant’s Daubert challenge to that opinion and also the doctor’s qualifications.

Higgs v. WFF Facility Services / Bethune Cookman University / Gallagher Bassett
Rex A. Hurley
JCC Anderson (Daytona Beach)– Denied all benefits. The JCC found the claimant failed to give notice of his accident and presented no medical evidence. The claimant admitted he had only informed a non supervisory co-worker.

Bishop v. Orlando Predators Sports Group, LLC
Scott B. Miller
JCC Sculco (Orlando)– Denied compensability of claim against Arena Football team for one date of accident. The claimant was a football player who alleged he was hired onto the practice squad of an arena league team. The JCC found the claimant was not employed by the team and was not an employee of anyone on the first day. The JCC found the claimant was a league employee on the second day and appointed an EMA.

Bateman v. McDonald's / Amerisure Insurance
William H. Rogner
JCC Dietz (Sebastian)– Denied TTD/TPD. Denied E/C’s 440.105 defense. The JCC found the claimant obtained new employment multiple times post accident making more until she was let go for other reasons each time. The JCC rejected the E/C’s misrepresentation defense finding a photo of the claimant going to a strip club without a neck brace did not prove her statements about using a neck brace 24/7 were false or for the purpose of obtaining benefits.

Pirintchieva v. Jane E. Bistline MD PA / Technology Insurance Company
Andrew R. Borah
JCC Punancy (West Palm Beach)– Awarded $1,653.46 in taxable costs to E/C.

Schaub v. Quality TV Sales & Service / Progressive Employer Management Co. / FWCIGA / CorVel Corp.
Gregory D. White
JCC Beck (Sarasota) – Denied future benefits. Claimant initially alleged three accident dates, later agreeing one of them did not happen. The JCC found the claimant’s first accident was prior to coverage from a PEO and then found that the accident did not occur. The JCC accepted the EMA (Davis) opinion the second alleged accident was only 30% of the need for treatment and denied based upon MCC.

Alfonso v. Maintenance Tech Management, LLC / Castlepoint Florida
Kate E. Albin
JCC Almeyda (Miami)- Awarded $1,975.25 in taxable costs to Employer/Carrier.

Appiah v. Hungry Howie's Pizza / Chartis Insurance
Matthew M. Bennett
JCC Winn (Pensacola)– Awarded $424.22 in taxable costs to Employer/Carrier.

Geffrard v. Columbia JFK Hospital / Broadspire
Paul L. Luger
JCC Punancy (West Palm Beach)– Denied follow up with an unauthorized doctor. The claimant was dissatisfied with the opinions from her one time change and treated with an unauthorized doctor whom she claimed helped. The JCC found no basis to award treatment with an unauthorized doctor, where the claimant presented no admissible medical evidence and where the claimant was offered care with the one time change.

Lamb v. Stephenson Septic Tank Service, Inc. / Sunz
Greg White
JCC Hill (Gainesville)– Awarded $689.31 stat fee and $5.01 in costs. 2012 d/a.

Lore v. Milo Enterprises, dba McDonald's / Amerisure
Kate Albin
JCC Almeyda (Miami) – Denied attorney fees. The claimant requested a follow up appointment and the E/C responded that the doctor remained authorized on the 30th day. Within 10 days of that response an appointment was set. The JCC found the E/C never denied care.

Wallace vs. Indian River County BCC / Johns Eastern Company
Paul L. Westcott
JCC Dietz (Sebastian) – Denied attorney fee. Seeking to expand upon Jacobsen, the claimant sought the JCC’s approval of the local IAFF union’s agreement to pay a $1500 fee, and $150 hourly fee going forward to claimant’s attorney. However, the JCC found that Jacobson clearly limited a claimant paid fee to cost proceedings, noted he had no statutory authority to approve a claimant fee paid by a non-party, and found the request contravened the intent of the statute.

Almenares v. Demetech Corporation / Guarantee Insurance Company
Kate E. Albin
JCC Almeyda (Miami) - Awarded $2,855.75 in taxable costs to E/C.

Jimenez v. FrankCrum, Inc. / Crum Services / Broadspire
Kate E. Albin
JCC Almeyda (Miami) – Denied compensability of low back and ulnar variance. The JCC found that if the claimant did have an ulnar variance it was not related to the compensable wrist injury and was an incidental finding. The JCC accepted the EMA (Chiron) opinion that the claimant did not currently have a back condition. Click here to view Order

Hyppolite v.Coastal Delivery, and Orlando Estate Auction
W. Rogers Turner
JCC Pitts (Orlando)– Granted employer’s motion to enforce settlement/found that the parties entered into a valid settlement agreement.

Tuero vs. Miami Iron & Metal / Tower Group
Andrew R. Borah
JCC Hill (Miami) – Awarded $970 in taxable costs to E/C.

Taylor vs. Sodexo / Gallagher Bassett Services
Matthew W. Bennett
JCC Roesch (Panama City)– Denied TTD/TPD and gap PTD. Awarded increased PTD. The JCC found the claimant was eligible for PTD at the expiration of 104 weeks but did not present any medical evidence. The JCC found the E/C was not properly paying Supps.

Brownie vs. Charlotte County Sheriff's Office / North American Risk Services
Rex A. Hurley
JCC Spangler (Ft. Myers) - Denied additional TPD and P&I. The claimant was initially placed at MMI and the E/C began IBs. Subsequently the claimant received additional treatment and the E/C reinstated TTD, reclassified the IBs and paid the difference with P&I. The JCC rejected the claimant’s argument that the TPD must be paid in full with a 20% recoupment of the IBs.

Farias vs. BAM Delivery / Protective Insurance Company
Jonathan Cooley
JCC Spangler (Ft. Myers)– Denied compensability. The claimant alleged a slip and fall after missing a time-sensitive delivery. The JCC rejected the claimant’s testimony and found no medical evidence to support compensability.

Gonzalez vs. McDonalds / Amerisure
Zal Linder
JCC Kerr (Miami)– Denied hourly fee for 75 hours. Awarded $196.40 stat attorney fee. 2011 d/a.

Phedor vs. Cracker Barrel Old Country Store / Safety National Casualty Corp / CCMSI
Andrew R. Borah
JCC Dietz (VTC Miami)- Denied TPD and medical benefits. The JCC accepted the EMA (Fischer) opinions and found no further care was necessary. The JCC found the claimant had been offered work and refused to even attempt to return to work.

Meijia-Gaspar vs. New China Buffet / Technology Insurance Company
Kate E. Albin
JCC Winn (VTC Ft. Lauderdale)– Awarded $1,877.37 in taxable costs.

Brownie vs. Charlotte County Sheriff's Office / North American Risk Services
Rex Hurley
JCC Spangler (Ft. Myers)– Denied additional TPD and P&I. Abbreviated order. The claimant was initially placed at MMI and the E/C began IBs. Subsequently the claimant received additional treatment and the E/C reinstated TTD, reclassified the IBs and paid the difference with P&I. The JCC rejected the claimant’s argument that the TPD must be paid in full with a 20% recoupment of the IBs.

Alvarez vs. On-Site Services, Inc. / 02 HR / Thrive HR / Sunz Insurance
Gregory D. White
JCC Sojourner (Lakeland) - $2,473.00 in taxable costs to E/C.

Higgs vs. WFF Facility Services / Bethune Cookman University / Gallagher Bassett Services, Inc.
Rex A. Hurley
JCC Anderson (Daytona) – Denied advance. The JCC found the claimant did not prove a need for the advance with a nexus to the accident.

Wienckowski v, Manor at Blue Water Bay/Premier Insurance Group
C. Bowen Robinson
JCC Winn (Pensacola)– Denied claimant’s motion for summary final order. The claimant alleged the E/C was estopped from raising an SOL defense for failure to obtain MMI and PIR. However the JCC found the claimant introduced no evidence.

Rivera v. Howard Leasing/Sunz Insurance/Corvel Corporation
Matthew J. Troy
JCC Condry (Orlando)- Denied compensability of back. The claimant sustained a foot injury but alleged a concurrent back injury. The JCC rejected the claimant's testimony and found the employer more credible.

Almenares v. Demetech Corporation and Demetech Corporation/Guarantee Insurance Company
Andrew R. Borah
JCC Almeyda (Miami)- Denied TTD/TPD and benefits. Determined AWW. The JCC accepted the opinions of the EMA (Cummings) that the claimant had preexisting congenital ulnar carpal impaction syndrome and that any aggravation had resolved without further treatment. The JCC rejected the claimant's 120 day argument and found the E/C was not bound by prior adjuster testimony as to the AWW.

Limith v. F.T.M.I.Operator/DBA Lenox on the Lake/United States Fire Insurance Co.
Andrew R. Borah
JCC Forte (Miami) – Denied follow up. The claimant alleged she had been in continuous 8/10 pain, however the JCC found that for three months post MMI the claimant was pain free. The JCC found the claimant had fully recovered with no residual impairment and the E/C proved the accident was no longer the MCC.

Banuchi v. Department of Corrections/Indian River Correctional Institute/Division of Risk Management
Matthew J. Troy
JCC Lazzara (Tallahassee) – Denied claimant’s advance. The claimant sought a $900 advance to travel from her current home in Puerto Rico to Florida to attend her EMA. The JCC found the claimant did not have a notary present to swear her in and the JCC sustained the E/C’s objection to the claimant’s financial affidavit, so the claimant was without evidence. Also the JCC found no connection between the claimant’s current financial status and the accident.

Guzman v. Infante Zumpano, et al/Guarantee
Andrew R. Borah
JCC Humphries (VTC Miami)- 2011 d/a. Denied claim for attorney’s fees pursuant to Fla. Stat. 440.30 for attending a claimant’s deposition when there was no claim pending. The claimant’s attorney indicated on the record at the onset of the claimant’s deposition that there were no outstanding issues aside from attorney’s fees and costs, but acknowledged that he had yet to dismiss the pending petition. The JCC found that the claimant’s attorney did not definitively dismiss the pending claims at the onset of the deposition and denied the claim for Fla. Stat. 440.30 fees and costs.

Rodriguez v. Dana Construction/Association Insurance, Inc./JLSC Services/AmTrust North America/Lennar Homes/Broadspire Services, Inc.
Allison M Twombley
JCC Sculco (Orlando)- Awarded $150 in sanctions ($50 each) to three employers for claimant's failure to attend mediation.

Torres v. Infrasource / Gallagher Bassett
Andrew R. Borah
JCC Pitts (Orlando) - Denied claimant's motion to strike opinions of authorized doctor. The E/C provided surveillance to the authorized doctor. The claimant argued this was an inappropriate mini trial under Holiday Inn v. Re. The JCC rejected this argument and found the 2003 amendments overruled Holiday Inn v. Re.

Lopez v. Southeast Personnel Inc./Packard Claims Administration
Anthony M. Amelio
JCC McAliley (Port St. Lucie) ) – Denied advance. The JCC found the claimant did not present evidence of the purpose of the advance or support for a $2,000 advance.

Hunt v. Rivergold Citrus / Amerisure Mutual
Anthony M. Amelio
JCC McAliley (Port St. Lucie)– Denied advance.

Saulnier v. Anchor Aluminum/Guarantee Insurance Company
Kate E. Albin
JCC Massey (Miami) – Claimant withdrew PFB’s for a smoking cessation program at trial. Although the treating doctor repeatedly told the claimant not to smoke, there was no specific prescription for the E/C to authorize such a program. The claimant, nevertheless, filed a PFB for authorization of a smoking cessation program. Although the PFB was filed in November of 2013, the claimant never sought to depose the treating doctor. The E/C set his deposition, which took place 22 days before trial. In May of 2014 the doctor confirmed that he did not write, nor does he write prescriptions for such programs. Having no competing evidence, the claimant filed for a continuance the day before trial. The JCC denied this rejecting claimant’s position that she was “surprised” by the doctor’s opinion, finding this was certainly something that should have been taken into account and not outside of claimant’s control. Additionally, the motion the day prior to trial was untimely.

Mendoza v. All Trades Construction, LLC/Frank Winston Crum Insurance
Jonathan L. Cooley
JCC Sturgis (Ft. Myers) (Jonathan Cooley) – Denied compensability. A co-worker tickled the claimant with a blade of grass while in a van. After the employees arrived at the job site, the co-worker attempted to apologize but the claimant refused and began to insult the co-worker. The co-worker then said ‘hit me.’ The claimant swung and missed and was punched back. The JCC found the claimant was the aggressor. The JCC also found the claimant made false statements denying headaches from a 2009 WC claim.

Collado v. 50 Eggs, Inc./AmTrust North America
Andrew R. Borah
JCC Hill (Miami) - Awarded $1,500 sanction against claimant's attorney and dismissal of PFB. The claimant's attorney admitted he did not contact his client before filing a PFB for a neurologist evaluation which the E/C already provided. He further testified that he has clients sign blank fraud statements without reviewing the actual PFB. He testified he filed the PFB after finding the referral on his desk, which could have been there "for several weeks". After receiving the PFB, the E/C, per the Q rules, sent the claimant attorney a draft copy of the Motion for Sanctions, and the letter informing the claimant attorney that his client had attended the requested evaluation prior to the PFB being filed. The letter gave the claimant attorney 21 days to withdraw the PFB. When the claimant attorney failed to respond to the letter or withdraw the PFB, the E/C filed the Motion.

Ramirez v. Xanitos, Inc./North River Insurance Company
Julie Bixler
JCC Punancy (West Palm Beach)– Awarded $3,268.69 in taxable costs to E/C.

Bishop v. Orlando Predators Sports/The Hartford/Arena Football One, LLC
Teri A. Bussey and Scott B. Miller for E/C 1
JCC Sculco (Orlando) - Granted E/C 1’s motion to Consolidate regarding notice of controversy. Ruled that a self-insured is a carrier under Florida 440 with regard to notice of controversy. JCC also denied ER2 motion to intervene as a party to the claim, which ER2 had sought without having a PFB filed against them.

Ramirez v. Xanitos, Inc. / North River Insurance Company
Julie C. Bixler
JCC Punancy (West Palm Beach)– Awarded $3,268.69 in taxable costs to E/C.

Stutzman v. Howard Leasing / CorVel
Matthew J. Troy
JCC McAliley (Port St. Lucie)– Denied advance. The JCC found the claimant did not present medical evidence to prove impairment and questioned if the stated purpose of the advance, to pay for an IME, was permissible.

Lascaibar v. Stack, Fernandez, Anderson & Harris / Castlepoint Florida
Andrew R. Borah
JCC McAliley (VTC Miami) – Granted E/C’s Motion for Summary Final Order and denied claimant’s Motion for Summary Final Order on the claimant’s request for a one time change. Claimant was treating with an orthopedist, but requested a 1x change to a neurosurgeon. The E/C timely authorized an orthopedist as claimant’s one time change. The JCC found nothing required the E/C to authorize a doctor in the specialty requested by the claimant.

Tamargo v. Frank Crum / Frank Winston Crum Insurance
Andrew R. Borah
JCC Lewis (Ft. Lauderdale)– Denied claimant’s requests for payment of an unauthorized pain management bill and authorization of that pain management physician. The JCC found that the self-help provision did not apply as the care sought was not “initial.” The JCC also found the report and bill were not properly placed in evidence. Finally the JCC found the claimant already had an authorized pain management physician. The JCC did award a natural supplement sleep aid pursuant to the opinion of a different doctor whose opinions were previously accepted.

Byrd vs, Yellow Freight System, Inc./Gallagher Bassett
Kate E. Albin
JCC Almeyda (Miami)– Awarded $464.85 in taxable costs to E/C.

Pompa vs. FrankCrum/Labor Advantage/Broadspire
Matthew J. Troy
JCC Medina-Shore (Miami)– Granted E/C’s motion for Summary Final Order. The E/C did not timely respond to the claimant’s request for a 1x change and agreed the claimant could choose any orthopedic in the Naples area where the claimant now lived. The claimant argued that since the accident occurred in Miami the claimant could choose a 1x change in Miami. The JCC found that the choice of 1x change was unreasonable and inappropriate.

Wessells vs. Southeast Personnel / Packard Claims
William H. Rogner
JCC Condry (Orlando)– Denied compensability and all benefits. Bifurcated hearing. The JCC found the client company did not submit the employee to the PEO before his accident and was not therefore an employee. The JCC rejected the claimant’s estoppel argument. The JCC found the E/C did not comply with all drug testing rules and rejected the E/C drug test defense.

McNiven v. YRC/Gallagher Bassett Services
Scott B. Miller
JCC Hogan (Ft. Lauderdale) – Denied all benefits based upon SOL. The JCC found that while mistakes may have been made in claims handling, the E/C did not misrepresent any facts to the claimant.

Leiva v. Gems Global, Inc./Tower Group
Andrew R. Borah
JCC Almeyda (Miami) – Amended 3/4/14 Order partially denying benefits. Following the filing of a Motion for Rehearing by the E/C, the JCC found that the EMA’s (Lozman) opinions were correct, and denied entitlement to further ankle surgery or evaluation by an orthopedic surgeon. The JCC rejected the claimant’s arguments that a surgical evaluation should be awarded due to the E/C’s failure to respond within 10 days, as the E/C’s position denying the evaluation was clear at the time, and to award an evaluation contrary to the EMA’s opinions would be futile.

Neel v. Anderson Media Corporation / Crum & Forster
Bowen Robinson
JCC Winn (Pensacola) – Denied TTD/TPD and medical benefits. Denied E/C’s 440.105 defense. The JCC found the claimant’s pre-existing symptomatic arthritis was the MCC of her injury and need for treatment. The JCC found that minor inconsistencies in the claimant’s history did not support the 440.105 defense.

McIntosh v. City of Kissimmee and PGCS
Teri A. Bussey
JCC Sculco (Orlando) – Denied P&I. The parties resolved TPD via a joint stip. The JCC found no statutory basis for P&I. The JCC then found that the payment was timely based upon the agreement of the parties.

Bonner v. Nissan Melbourne / FFVA Mutual Insurance Company
Anthony M. Amelio
JCC Remsnyder (Sebastian) – Denied compensability. The claimant alleged injuring his knee in a slip at work. The JCC found the claimant not credible. The JCC found that the alleged witnesses all denied the accident and testified that the claimant danced at a holiday party only days after the alleged injury.

Leiva v. Gems Global Incorporated / Tower Group Companies
Andrew R. Borah
JCC Almeyda (Miami) – Denied surgery. Awarded ortho. The JCC found that the prior EMA’s (Lozman) denial of the same surgery was still binding. However the JCC found the claimant’s new pain complaints resulted in a referral to an ortho from the authorized doctor. Despite the E/C’s denial of the benefits the last time they were requested, the JCC found the E/C did not respond within 10 days of this specific request and had waived arguments against an eval.

Perez v. Boulevard Tire Center and Zenith
Andrew R. Borah
JCC Spangler (VTC Miami) – Denied all benefits based upon SOL. The claimant alleged estoppel due to not being paid on the date of his Sept. 21, 2010 accident. The JCC found it irreconcilable that the claimant could not remember the date of his accident, but could specifically not remember being paid

Centeno v. MCJ Auto Sales/Castlepoint Florida
Matthew J. Troy
JCC Condry (Orlando)– Denied $4,000 advance. Awarded $2,000 advance. The JCC found the claimant did not prove an advance over $2,000 would not prejudice the employer.

Maza v. Central Florida Behavioral Hospital/Sedgwick CMS
Scott B. Miller
JCC Pitts (Orlando)- Denied all benefits based upon 440.105. The claimant was an RN who denied prior significant injury. The JCC found the claimant had a prior NY WC claim as well as several MVAs with documented injuries. These accidents were not remote in time, nor did they involve sporadic or minimal treatment. The prior accidents also resulted in injuries to the same body parts involved in the instant accident. The JCC found that due to his medical knowledge the claimant was aware of the importance of an accurate medical history, and it was inconceivable that he could have forgotten about them or misunderstood inquiries regarding past accidents or injuries. Click here to view Order

Martinez v. Keys Armored Express/Sunz Insurance
Mattew J. Troy
JCC Almeyda (Miami) - Denied advance. The JCC found that although the claimant may be in financial need, he failed to demonstrate such need arose from the injury as he continued to work post accident and obtained a new similar job after his termination. Click here to view Order

Hernandez v. Self Industries, Inc./Florida Tool/Tokio Marine
W. Rogers Turner, Jr.
JCC Sojourner (Lakeland) - Denied all benefits based upon misrepresentation. Claimant obtained employment after presenting a false green card and social security card. After reporting a low back strain, the claimant used the false # in obtaining medical care, and provided the number to the E/C during the claim. The carrier provided medical and indemnity benefits for a year until they learned the claimant used false identification. The JCC found the claimant had the requisite intent based in part on her concurrent use of an ID issued by the Mexican Consulate, which the claimant recently renewed because it had expired. Claimant testified she was required to provide a current non-expired Mexican Consulate ID card to obtain medical care at the Public Health Clinic. The JCC found this testimony evidenced claimant’s intent to use the false Social Security # to obtain W/C benefits.

Gomez V. Southeast Personnel/Packard Claims
Anthony Amelio
JCC Almeyda (Miami) – Denied all benefits based upon 440.105. The claimant provided a false SSN to a clinic to obtain treatment. The JCC accepted the employer’s testimony that the claimant himself completed the portion of the intake forms regarding his personal information.

Alfonso v. Maintenance Tech Management, LLC / Castlepoint Florida
Andrew R. Borah and Kate E. Albin
JCC Kerr (Miami) – Denied compensability. The claimant alleged a specific accident resulting in a hernia in the Petition, however that hernia accident occurred two months prior to the date of accident listed on the petition when the employer had no coverage. The claimant argued at trial that he was alleging a repetitive trauma injury, but the JCC found the claimant never alleged or pled a repetitive trauma injury.

Delgado v. Westree Financial Inc., dba Westree Marina / Gallagher Bassett Services, Inc.
Andrew R. Borah
JCC Sturgis (VTC Miami) – Awarded $2,134.50 in taxable costs to E/C.

Dyke v. The National Deaf Academy & Sedgwick Insurance
Scott B. Miller
JCC Sculco (Orlando) – Denied all benefits based upon 440.105. The claimant’s doctor noted that the claimant had been in a car accident, which the claimant denied. The JCC rejected the claimant’s attempts to explain why that history appeared in the doctor’s notes.

Anestal v. List Industries, Inc./Amerisure Insurance
Zal Linder
JCC Lazzara (VTC Ft. Lauderdale) – Denied compensability. Bifurcated hearing. The claimant alleged a repetitive trauma injury from using a foot pedal. He testified that he first thought it was work related in Sept. 2012. Despite his supervisors asking if the pain was work related the claimant denied that it was until Nov. 2012. The JCC found that the claimant did not timely report the injury.

Sierra v. Nature's Flowers/Florists' Insurance Company/Florists' Mutual Insurance Company
Rex A. Hurley and Kate E. Albin
JCC Kerr (Miami) – Denied physiatrist. The EMA (Dr. Chiron) recommended the claimant see a physiatrist for a conditioning program. The authorized neurosurgeon referred the claimant for physical therapy which included core strengthening and the EMA opined that this satisfied the physiatrist recommendation and withdrew it.

Torres v. YRC/Roadway Express, Inc. and Gallagher Bassett Services
Scott B. Miller
JCC Medina-Shore (Miami) – Granted E/C’s motion for EMA. The JCC rejected the claimant’s argument that the motion was untimely as the dispute did not become apparent until the parties obtained medical testimony prior to trial.

Rivera v. F.C.S. Building Services, LLC and CastlePoint Florida Insurance Company
Gina M. Jacobs
JCC Condry (Orlando) – Awarded $1,047.43 in taxable costs to E/C.

Burgess v. Buckhead Beef Florida/Royalty Foods/Sentry Casualty Company
Tim Stanton and Gregory White
JCC Remsnyder (VTC Lakeland) – Awarded $50,075 (200 @ $225 (Board Cert.), 29 @ $175 (Non Board Cert.) attorney fee and $14,001.12 in costs. 2006 d/a. The claimant attorney requested to be paid over $160,000 for 393.30 hours of attorney time ($325/Board Cert. Attorney – Non Board Cert $250) and 339.53 hours of paralegal time. The JCC denied all paralegal time, noting a failure to include qualifications or background for any paralegal. Additionally, the JCC noted that every paralegal entry contained a concurrent attorney entry instructing the paralegal to perform the task, almost all of which were secretarial in nature. The claimant sought almost $21,000 in costs. The JCC awarded only $557.12 over the E/C’s calculation of taxable costs. The JCC specifically accepted the E/C argument that costs of a vocational expert were not taxable, as they pertained to a separate proceeding.

Vixamar v. Solstas Labs/Oracle Diagnostics/Amerisure Insurance
Anthony M. Amelio
JCC McAliley (Port St. Lucie) – Denied compensability. The pro se claimant alleged exposure to polluted moldy air. The JCC found no evidence was presented by the claimant to support the exposure and she contradicted herself at trial.

Guido v. Bimbo Bakeries d/b/a Sara Lee Bakeries/York Risk
Matthew J. Troy and Rex A. Hurley
JCC Rosen (St. Petersburg) – Denied claimant’s motion to appoint EMA. Granted E/C’s motion in limine. The JCC found no conflict between the opinions of two psych IMEs because the claimant’s IME provided opinions on the claimant’s physical complaints outside his specialization and therefore did not meet the Daubert standard. Further the IME had not review the opinions of the physical EMA and did not have the most recent DSM-V.

Acevedo v. Southeast Personel Leasing Group/Packard Claims Administration
Matthew J. Troy and William H. Rogner
JCC Pitts (Orlando) – Denied prior attorney lien. The JCC found the prior attorney voluntarily withdrew and was not entitled to a lien. The claimant was unhappy with the prior firm because they were not local and attended all events by phone.

Rucker v. Furniture Your Way/Tower Group Companies
Matthew W. Bennett
JCC Roesch (Panama City)– Denied all benefits against non appearing pro se claimant.

Savilus v. Riverbell Inc./Sunz Insurance
Gregory D. White
JCC McAliley (Port St. Lucie) – Denied compensability of death claim. The claimant died while picking fruit. The JCC found the claimant did not prove MCC. The JCC also found Victor Wine did not apply but if it did, the E/C proved the claimant’s death was due to pre-existing heart disease.

William Nunes v. Trojan Battery Company / Crum & Forster Insurance Company
William H. Rogner
JCC Jenkins (Tampa) – Denied compensability of low back. The claimant told the authorized doctor he did not have pre-existing back pain. The EMA (Fiore) found that the claimant had back pain with treatment in the years before the accident and that the MRIs showed no appreciable difference. The EMA conceded there may have been a temporary exacerbation of the pre-existing condition but did not find any objective findings to substantiate that opinion.

James Quesada v. Miami Dade Ambulance Service/Frank Winston Crum Insurance, Inc./Broadspire
Kate Albin
JCC Medina-Shore (Miami) – Dismissed pending petitions for fees and costs. The claimant had filed multiple dismissals reserving on fees and costs. The JCC found no record activity on these pending claims for fees and costs and no stipulation had been entered.

Monte Parker v. PR Employer DBA ABC Fence / Tower
Matthew W. Bennett
JCC Roesch (Panama City) - Denied post-104 TTD/TPD. The JCC found no authority to pay TTD/TPD beyond 104 weeks.

Lourdes Muro v. Alphastaff, Inc./AmTrust North America
Andrew R. Borah
JCC Remsnyder (Sebastian) – Denied all benefits based upon 440.105. The claimant denied prior history of back pain and headaches. Medical records showed she went to a doctor two months before her accident complaining of headaches that were four months in duration, which she was referred to a neurologist for. The claimant also gave that doctor a history of back and neck pain. The JCC found the claimant intentionally withheld this information from her authorized doctors and the E/C.

Whitehouse v. Paramedics Plus / Crum & Forster
Teri A. Bussey
JCC Rosen (St. Petersburg) – Denied claimant’s motion for EMA. The JCC found the claimant’s IME report was unauthenticated hearsay.

Borrego v. J&K Boring and Welding Services, Inc./Tower Group Companies
Andrew R. Borah
JCC Rosen (VTC Miami) Granted E/C’s motion for protective order and compelled claimant’s deposition. The JCC again granted the E/C’s motion to prohibit the claimant from forcing the adjuster to appear live for a deposition 250 miles from her office.

Pagano vs. Allen Green Construction/Safeco Insurance Company
Robert J. Osburn
JCC Anderson (Daytona Beach)– Denied attendant care. Awarded surgery. 1989 d/a. The doctor recommending a 2 level lumbar fusion also required the claimant to stop smoking before surgery. The claimant stated at final hearing that he had stopped smoking. The JCC found that as the claimant stated he had stopped smoking the surgery was ripe but a claim for post surgery attendant care was not.

Lakatos vs. Coastal Steel, Inc./Summit
Paul L. Westcott
JCC Remsnyder (Sebastian) – Awarded limited surgery for removal of loose bodies rather than the more extensive surgery sought by the claimant.

Devero-Lynn vs. Bay Center & Gallagher Bassett Services
Matthew Bennett
Panama City) – Granted E/C’s motion to enforce settlement.

Sierra vs. Nature's Flowers/Florists' Insurance Company/Florists' Mutual Insurance Company
Matthew Troy
JCC Kerr (Miami) – Awarded $1,458.92 in taxable costs to E/C.

Russ vs. Brooksville Health Care Center/Premier Group Insurance
Rogers Turner
JCC McAliley (VTC Tampa) – Approved fee agreement between claimant and her attorney to pay $200 per hour to defend against E/C’s motion to enforce settlement. A continuation of claimant attacks on constitutionality of fee statute following Jacobson opinion allows for claimant paid fee in proceedings related to motion to tax costs.

Sierra vs. Nature's Flowers/Hortica
Rex Hurley and Matt Troy
JCC Kerr (Miami) – Granted E/C’s motion for protective order. The claimant subpoenaed a former attorney of the firm to appear live for a hearing with all billing records. The subpoena was served less than 5 days before hearing. The JCC found the subpoena was improperly served and overbroad and granted the E/C’s motion for protective order.

Hernandez vs. MGS & Mario Concrete Service/Bridgefield Employers Insurance Company
Gregory White & Tim Stanton
JCC McAliley (Port St. Lucie) – Denied CPAP machine. 2002 d/a. The claimant was diagnosed with depression causing aggravation of hypersomnolence for which the E/C had provided medication. The VA had provided a CPAP machine. The JCC found that as the claimant already had a functioning CPAP machine the E/C was not required to provide another.

Villagran vs. Southeast Personnell Leasing, Inc./Packard Claims
Anthony Amelio
JCC Hill (Miami) – Denied all benefits based upon 440.105. The claimant admitted to providing a false SSN in a recorded statement and to the clinic to get medical care. The JCC rejected the claimant’s argument that he thought he would not get medical care without a SSN.

Gordon vs. Vehicare/Montgomery Insurance/First National Insurance
Gina M. Jacobs
JCC Sojourner (Lakeland) - Denied claim for unauthorized pharmacy bills. Claimant alleged that unauthorized psychiatric was authorized by operation of law. Claimant provided evidence of a written request to the E/C for a psychiatric evaluation on 12/10/07. Two days later the E/C sent an appointment letter to O/C, authorizing an alternate psych for an evaluation. On 12/16/07 Claimant demanded that the appointment be canceled and asked for a list of physicians. The adjuster testified in 2008 that this case was not Managed Care. The claimant went on his own to Dr. Walker on 2/8/08, and continued seeing him regularly through 2010 without authorization. The claimant was eventually evaluated by the alternate doctor on 6/3/08 and again 6/9/10. That doctor opined that the accident was not the MCC of the claimant’s condition and need for treatment. The JCC accepted E/C arguments that they complied with their duty to provide treatment within a reasonable time (2 days). The JCC rejected claimant's argument that because the alternate did not offer treatment, claimant was forced to treat on his own with his doctor. The JCC noted that claimant's remedy was either a one-time change if available or an IME. Claimant's self-help argument failed, as Sec. 440.13(2)(c) “operates only in the limited circumstances where the E/C wrongfully denies medical care.” Even if the E/C were responsible for paying the pharmacy bills, Claimant failed to authenticate those documents or establish a hearsay exception.

Lichauco V. Cornerstone Hospice/Amerisure Insurance
William H. Rogner
JCC Pitts (Orlando) – Awarded $1,304.30 in taxable costs to E/C.

Miranda V. Frank Crum/Broadspire
Zal Linder
JCC McAliley (VTC Miami) – Awarded $2,085.75 in taxable costs to E/C.

Gooding V. HCH2, LLC / WorkLife Financial / Tower Companies
Matthew Bennett
JCC Lazzara (Tallahassee) – Denied $2,000 advance. The claimant moved to Kentucky with his wife where their income doubled. The claimant had no outstanding debts. The JCC found an advance to pay down debt did not have a “plausible nexus” to the W/C claim, citing liberally from the HRMCW opinion in Kuhn v. Delta Air Lines, Inc. Although having permanently relocated to Kentucky, the claimant drove to Tallahassee, FL, to appear live at the advance hearing.

Zepeda V. La Carreta Restaurant / Zenith Insurance
Andrew Borah
JCC Castiello (Miami) – Awarded $1,500 medical only fee. The claimant sought $30,600 in fees for time spent proving entitlement to the medical only fee or as a sanction against the E/C. The JCC found no basis for an hourly fee for proving entitlement to a stat fee. The JCC also found the E/C’s defense against entitlement was in good faith and denied 57.105 fees.

Benniefield V. City of Lakeland /Retail First Insurance Company
Rogers Turner (as expert witness)
JCC Sojourner (Lakeland) – Awarded $21,793.75 (73.25 @ $275, 30 @ $55) appellate attorney fee and $300 in costs. The JCC accepted the E/C’s attorney’s and expert’s (W. Rogers Turner, Jr. as E/C Fee Expert) opinion of $275 as the prevailing rate for a board certified appellate attorney, rejecting a higher “state wide” rate argued by claimant’s appellate attorney and her expert. The JCC further noted the claimant’s appellate attorney based her asserted higher hourly fee on many stipulated fee orders, versus the E/C’s evidence of fees awarded by JCC’s.

Briones V. SOI / CCMSI
Gina M. Jacobs
JCC Sculco (Orlando) - Awarded $4,636.88 in taxable costs to E/C.

Eliezier Andino V. Hy-Tech Recovery & Towing, LLC
Matthew J. Troy
JCC Pitts (Orlando)– Granted employer’s motion to enforce settlement. The JCC found the claimant’s attorney had clear unequivocal authority to settle the claimant’s workers compensation claim against the uninsured employer.

Taylor V. Alphastaff, Inc./Tower Group
Julie Bixler
JCC Remsnyder (Sebastian) – Awarded $5,319.03 in taxable costs to the E/C.

Doran V. Florida Power & Light/Broadspire
Derrick Cox
JCC McAliley (Port St. Lucie) – Awarded $1,680.72 in taxable costs to E/C.

Espinosa V. Larson Dairy, Inc./Zenith Insurance Company
Paul Westcott
JCC Remsnyder (Sebastian)- Denied claimant’s motion for advance. Claimant was awarded a prior advance in December of 2012. Claimant was subsequently placed at MMI with a 0% rating. The JCC found the claimant did not prove he met the statutory criteria for an advance, as he presented no medical evidence whatsoever.

Gattorno V. Alpha Staff Group, Inc., Alphastaff Group/Tower Group Companies & SUA Insurance
Andrew R. Borah
JCC Castiello (Miami) – Denied TTD/TPD and compensability of cervical spine. The JCC found the claimant had been terminated from post-injury employment for a scheme to purchase tires wholesale and then sell them on the side. The JCC also found the claimant made numerous inconsistent statements about his complaints and abilities.

Morales V. Frank Crum/Frank Winston Crum Insurance
Matthew J. Troy and Sandra Wilkerson
JCC Punancy (West Palm Beach) – Awarded 15 day extension and $100 per hour sanction for the claimant’s failure to timely file a motion for fees and costs.

Abel De La Cruz V. Pacific Tomato Growers/U.S. Fire Insurance Company
Jonathan L. Cooley
JCC Beck (Sarasota)– Partially granted E/C’s Motion for Summary Final Order. The claimant claimed TTD and PTD. During a significant portion of the period claimed, the claimant was receiving unemployment. The JCC found the claimant was barred from receiving TTD or PTD during the periods he received unemployment.

Maria Delgado V. Westree Financial, Inc. d/b/a Westree Marina/Gallagher Bassett Services, Inc.
Andrew Borah
JCC Sturgis (Ft. Myers)– Denied TPD and chiro. The JCC found the claimant’s chiro IME did not have any medical records, an accurate history or diagnostic studies and that such treatment was not medically necessary. The JCC also denied temporary partial, finding that the claimant was terminated for misconduct due to her multiple instances of absenteeism.

Oswaldo Sauri V. Record Aircraft Parts/CastlePoint (Tower Group Companies), and Tower Group Companies
Andrew R. Borah
JCC Remsnyder (VTC Miami) - Denied all benefits based upon SOL and 440.105. The JCC found the E/C timely provided the brochure and rejected the claimant’s arguments that he did not receive it or that it should have been sent in Spanish. The claimant also was involved in an intervening motor vehicle accident which he denied in deposition and at trial despite his wife testifying that the claimant was involved in an accident.

Jose D. Romero V. Thrive HR FL 1, LLC/Sunz Ins. Co./Corvel
Gregory D. White
JCC Beck (Sarasota) – Denied all benefits based upon 440.105. The EMA (Dr. Gilberto Eli Vega) reviewed the E/C’s surveillance which contradicted the claimant’s presentation during examination. The JCC found the claimant was untruthful about his prior back problems and back injury in 2007, usage of a cane, ability to squat, and other areas.

Robert D. O'Connor V. United Launch Alliance/Broadspire
Derrick E. Cox
JCC Remsnyder (Sebastian)– Denied TTD/TPD, further medical care and reimbursement to health insurance. The JCC found the pro se claimant was at MMI and the MCC of the need for further treatment was pre-existing arthritis. Further the JCC found the claimant had no standing to seek reimbursement to his health insurance.

Bandariz Garcia V. Cargo Force, Inc. Frank Winston Crum Insurance
Sandra D. Wilkerson
JCC Castiello (Miami) – Awarded $145.68 (34.4 hrs) stat attorney fee and $132 in costs. 11/2009 d/a. The claimant alleged entitlement to both a stat fee and a $1500 med-only fee. The JCC accepted the E/C’s argument that a claim for indemnity remained outstanding at the time the claimant filed the medical claims.

Miranda V. Frank Crum/Broadspire
Zal Linder
JCC McAliley (VTC Miami) – Denied compensability. The JCC found the claimant’s description of a shoulder injury not credible and also that the claimant did not timely report the claim. Notably the claimant denied prior WC claims in deposition, despite the fact that her attorney represented her for all three claims.

Moya-Perguero v. Trucks & Parts of Tampa, Inc./Ameritrust Ins. Corp.
Gregory D. White
JCC Jenkins (Tampa)- Granted E/C’s motion for summary final order. The claimant filed a PFB for a shoulder MRI from an authorized physician. A 2009 final order denied further treatment for the shoulder. The JCC found the claim barred by res judicata.

Taylor v. Alphastaff, Inc./Tower Group Companies
Paul Luger & Julie Bixler
JCC Remsnyder (Sebastian) – Denied compensability of neck. The E/C accepted a back and leg injury. The claimant alleged injury to her neck although she did not complain of neck pain until 51 days afterwards. The JCC found the claimant had a pre-existing osteophyte and that the claimant did not prove the IA was the MCC of her neck complaints.

Luna-Martinez v Frank Crum/Broadspire
Andrew Borah
JCC Harnage (Miami) – Denied medical only fee and awarded reduced $3,202.45 stat attorney fee and costs. 7/2009 d/a. The E/C stipulated to costs and to a $3,029 fee on past benefits. The claimant also sought a $1,500 medical only fee for an MRI and EMG. The JCC agreed with the E/C that as there was a pending claim for indemnity, he could not award the MO fee. Finally the JCC accepted the E/C’s argument that future medical benefits awarded must be reduced to fee schedule and rejected the claimant’s estimate of $120,000 for future benefits.

Martinez v. Devcon Security Services Corp./Crum & Forster
Zal Linder
JCC Basquill (West Palm Beach) – Denied a period of TPD when the claimant chose FMLA leave rather than light duty offered. Awarded TPD, although the claimant refused medical care from authorized doctors and treated on his own. The JCC accepted an IME’s restrictions following surgery to award TPD.

Gilmore v. Roadway Express, Inc./Gallagher Bassett Services
Scott Miller
JCC Condry (Orlando) – Denied continued medical care. A prior order found the E/C was required to provide reasonable and necessary care for the claimant’s shoulder. The E/C authorized the claimant to return to the prior ortho, who subsequently testified that no further care was necessary. The JCC found no authority to award surgery the EMA previously suggested might be needed and that the current authorized physician did not recommend any further care.

Burgess v. Buckhead Beef Florida/Royalty Foods/Sentry Insurance
Greg White
JCC Remsnyder (VTC Sebastian) – Awarded 40% apportionment of new law (2006) PTD benefits. A prior order awarded 40/60 apportionment, found light duty restrictions per the EMA (Dr. Goll), but rejected a bipolar condition as unrelated. The JCC found that totality of the physical and unrelated psychological restrictions rendered the claimant PTD and accepted the claimant’s voc. expert over the E/C’s. The JCC agreed with the E/C’s argument that 40% apportionment applied to PTD benefits.

Quintero v. FrankCrum and Broadspire
Kate Albin
JCC Kuker (Miami) – Denied all benefits. The JCC found no evidence a compensable accident occurred on the date claimed by the claimant.

Christiansen v. NPC International, Inc./Gallagher Bassett Services
Jonathan Cooley
JCC Beck (Sarasota) – Denied TTD/TPD, awarded medical benefits. The claimant settled prior 2008 and 2010 WC claims and a 1998 MVA and also had age appropriate degenerative changes. The JCC found MCC did not apply or that the 2011 accident caused the symptomatology that necessitated surgery. The claimant testified that he could perform his pre-injury employment with adjustments.

Devariste v. Columbia HCA JFK Medical Center 5301/Broadspire, a Crawford Company
Paul Luger
JCC Basquill (West Palm Beach) – Denied advance. The JCC found under this firm’s recent Kuhn decision that as there were no pending petitions, the employee was not a proper claimant.

Doran v. Florida Power & Light/Broadspire
Derrick Cox
JCC McAliley (Port St. Lucie) – Denied TT/TPD and medical benefits. The JCC found the claimant was “hoisted on his own petard” by waiting five years after his treatment began (outside the WC system). Those doctors attributed his disability to non-industrial causes when he applied for disability insurance.

Krouth v. CEVA Logistics/Gallagher Bassett Services, Inc.
William Rogner
JCC Sculco (Orlando) - Denied new law (2009) PTD. EMA (Dr. Ziegler) opined the claimant (60 year old truck driver with no GED) was MMI with 10 lb restrictions. The claimant's voc. expert (Stuart Cody) found appropriate positions for the claimant. The JCC accepted the E/C's voc. expert (Richard DiBacco). Finally the JCC rejected the claimant's job search as the jobs were outside his restrictions or qualifications, such as security guard jobs he applied for without having the requisite certifications.

Alvarez v. Thrive HR FL1, LLC/Sunz Insurance Co.
Greg White
JCC Sojourner (Lakeland) – Denied TTD/TPD. Awarded compensability and medical treatment. The claimant filed multiple PFBs listing both the correct and incorrect E/C. The JCC found that at least one of the petitions named the correct E/C and remained pending, tolling the SOL. The JCC also found that the claimant timely reported the accident upon the manifestation of problems. The claimant was struck in the eye by a box with immediate pain but did not believe there was an injury. Finally the JCC denied TTD/TPD as the claimant was able to continue working until the end of picking season. Click here to view Order

Fernald v. State of Florida Department of Corrections/State of Florida/Division of Risk Management
Rob Osburn
JCC Humphries (VTC Daytona Beach) – Denied compensability of heart disease. The E/C stipulated that the presumption applied. The claimant had a 20-25 year history of smoking and medically treated high cholesterol. The EMA (Dr. Tee) opined that smoking and high cholesterol was the MCC of the claimant’s heart attack. The JCC found the EMA’s opinion was either competent substantial or clear and convincing evidence to rebut the presumption, and further found the claimant did not present evidence to rebut the presumption in favor of the EMA. Click here to view Order

Gauthier v. Walt Disney World/Liberty Mutual Insurance Co.
Derrick Cox
JCC Sculco (Orlando) – Awarded partial mileage and guardian expenses, but denied guardianship attorney fees. 2002 d/a. The JCC found mileage which had previously been awarded in a 2010 order either had been paid or was due, however the JCC found mileage incurred before the prior hearing but not claimed at that time barred by res judicata. The JCC denied guardianship attorney fees noting no evidence existed that her efforts involved obtaining benefits under 440. The JCC did award expenses claimed by the worker’s guardian/father.

Jones v. Indian River County Fire Rescue/Johns Eastern Company, Inc.
Paul Westcott
JCC Remsnyder (Sebastian) – Denied compensability of heart disease. Presumption claim. The JCC found the E/C rebutted the presumption with evidence the claimant’s heart disease was caused by smoking. The claimant’s IME disagreed with both the US Surgeon General and the American College of Cardiology that smoking causes heart disease.

Pedrez-Martinez v. Gallagher Bassett Services - Nashville
Scott Miller
JCC Harnage (Miami) – Denied all benefits based upon SOL. The JCC rejected the claimant’s argument that a back brace that he wore on-and-off under his shirt without the E/C’s knowledge tolled the SOL. The JCC found a .10 alleged difference in the AWW did not defeat the SOL defense.

Redding v. The Health Center of Orlando, Inc./Premier Group Insurance
W. Rogers Turner
JCC Condry (Orlando) - Denied all benefits based on misrepresentation. The claimant underwent a minor outpatient foot procedure in September of 2010. The claimant reported severe pain and limitation to the treating podiatrist, physical therapist and trainer for a period of five months. The podiatrist relied on her reports and continued her on an off work status and continued to recommend more treatment. The carrier obtained 16 separate days of surveillance over a 5 month period, which showed the claimant's capabilities to be far in excess of what she reported to health care providers. The treating doctor felt he had been "duped" after reviewing the surveillance, with the therapist and trainer providing similar testimony. The JCC also noted an ALJ reviewed the surveillance in a DOAH hearing on her denial of voc retraining and pronounced her not credible. The JCC also awarded $9,828.07 in costs in a separate order related to numerous previously dismissed PFBs. The claimant did not appear for trial despite receiving actual notice.

Trujillo v. Baker Concrete Construction, Inc./Gallagher Bassett Services
Scott Miller
JCC D'Ambrosio (West Palm Beach) - Denied advance, finding that the advance would not be in the claimant's best interest. The claimant obtained a wrongful termination settlement prior to completing his financial affidavit, but failed to list the funds as an asset. Similarly, the claimant listed a rent obligation of $650 per month on his affidavit, but testified at hearing he only pays half that amount. Prior to the advance hearing, the carrier filed a misrepresentation defense. Although the JCC did not consider the fraud defense, she specifically found the claimant misled the E/C and the court. The Order also found that "If defense counsel had not been diligent in his investigation, this information would not have been voluntarily revealed by the Claimant, at least during the evidentiary hearing."

Aldridge v. Escambia County Sherift's Department/North American Risk Services, Inc.
Rex Hurley
JCC Winn (Pensacola) – Denied all benefits. The JCC found that the claimant’s continued smoking and drinking against medical evidence satisfied the heart/lung law reverse presumption and that the claimant’s two separate accidents for hypertension and bypass surgery were not compensable.

Evans v. Gray Communications/Columbia Insurance Group
Matthew Bennett, Bowen Robinson
JCC Lazzara (Tallahassee) – HRMCW obtained a complete denial of all benefits, based upon the JCC’s finding that the claimant made numerous misrepresentations for the purpose of obtaining benefits. The carrier had accepted the claimant as permanently and totally disabled. Thereafter, the carrier obtained multiple days of surveillance. This video showed the claimant alternately using a non prescribed cane to limp into doctor appointments, and subsequently moving about without the cane. In addition, the claimant was filmed constructing two different wooden decks for hours over several days. Deposition testimony was obtained where the claimant represented himself as severely limited and disabled. The JCC examined all of the video, as well as his deposition testimony and statements to authorized doctors. The JCC determined that these statements of disability and limitation were in stark contrast to his actual abilities on video, and that the claimant made these misrepresentations to obtain W/C benefits.

Cabrera v. National Molding, LLC/North River Insurance Company
Zal Linder
JCC Spangler (VTC Miami) – The JCC relied upon opinion of authorized ortho who opined that 75% of the claimant’s conditions and need for joint replacement surgeries to the hip and shoulder are pre-existing, but then in unexplainable result, awarded compensability of both procedures, and ordered that E/C can apportion 75% of the costs.

Aldridge v. Escambia County Sherift's Department/North American Risk Services, Inc.
Rex Hurley
JCC Winn (Pensacola) – Denied TTD/TPD. Presumption claim. The JCC found the claimant satisfied the presumption, with a prior order awarding compensability of a different accident date, but that the claimant’s continued smoking and drinking against medical evidence satisfied the reverse presumption.

Guardado v. Pallet Consultants Enterprises and Crum & Forster
Andrew Borah
JCC Pecko (Ft. Lauderdale) – Awarded a period of TPD. Denied new law (2008) PTD and IBs. Abbreviated order. Denied E/C’s 440.105 defense.

Jones v. Royalty Foods, Inc./Gallagher Bassett Services,Inc.
Greg White
JCC Pitts (Orlando) – Denied pain mgmt and psych. The claimant sustained a compensable left shoulder injury. A prior order accepted the EMA (Dr. Murrah) opinion that the right shoulder was not compensable. The JCC accepted the opinions of the EMA that the claimant did not need further care to the left shoulder due to the IA and found that the claimant’s psych issues were related to a fear of surgery, thus the claimant did not require further psych care.

Lantigua v. Frank Crum / Hanna v. Robinson Tractor/Gallagher Bassett
Andy Borah / Bill Rogner
The firm prevailed in two separate PCA decisions this week. The DCA affirmed the JCC’s denial of temporary benefits in Lantigua v. Frank Crum (Andy Borah (trial attorney) and Bill Rogner (appellate attorney)) and affirmed the JCC’s approval of the E/C’s 25% reduction in benefits for failure to wear a seatbelt in a compensable auto accident (Bill Rogner Trial & Appeal) in Hanna v. Robinson Tractor/Gallagher Bassett.

Burgess v. Buckhead Beef Florida/Royalty Foods, and Sentry Insurance
Gregory D. White/Timothy F. Stanton
JCC Rosen (Melbourne) – Awarded $5,241.30 in taxable costs to E/C.

Amritt v. Northwest Medical Center/Broadspire
Paul L. Luger
JCC McAliley (Port St. Lucie) – Found an enforceable settlement agreement had been reached. The JCC rejected claimant’s position that discussions between counsel and himself were attorney client privileged. The JCC noted that he did not have the power to “enforce” the agreement. Rather, he could find the parties reached a valid agreement, and that if the motion for fees were presented to him, with or without the claimant’s signature, he would approve the fees for the washout (and additional side fees) and the claimant’s entitlement to further benefits would end. The JCC further found he did not have the authority to compel the claimant to sign washout documents, but suggested the E/C could seek this via subsection (1) of the Rule Nisi statute. This subsection, however, deals only with employers or carriers failing to comply with valid orders.

Alston v. Lakeview Center Inc./Crum&Forster
C. Bowen Robinson
JCC Winn (Pensacola) – Awarded $904.80 in taxable costs to E/C.

Bridgewater v. Southeast Personnel Leasing, Inc., Moment's Notice/Packard Claims Administration, Inc.
Anthony M. Amelio
JCC Lazzara (Ft. Lauderdale) – Denied compensability. The JCC found the pro se claimant presented no medical evidence to establish compensability of a bilateral knee injury.

Jones v. Royalty Foods, Inc./Gallagher Bassett Services, Inc.
William Rogner/Greg White
JCC Pitts (Orlando) – Awarded $15,000 (60 @ $250) appellate attorney fee and $268.46 in taxable costs. The JCC rejected hours spent on a petition for writ of cert based upon the E/C’s argument.

Rose v. AlphaStaff/Tower Group Insurance Company
Timothy F. Stanton
JCC Sojourner (Lakeland) – Denied compensability of low back and treatment. The JCC found the claimant did not timely secure an IME before trial because they were attempting to avoid the expense in case of settlement.

Banuchi v. Department of Corrections/State of Florida Division of Risk Management
Matthew J. Troy
JCC Lazzara (VTC Melbourne) – Denied TPD. The JCC rejected the claimant’s IME opinion that the claimant was not at MMI. Additionally the JCC rejected the claimant’s argument that the E/C should be forced to pay for a claimant requested EMA when the claimant could not afford the evaluation, accepting the E/C’s argument that the Florida Bar rules permitted the claimant’s attorney to advance costs for medical examinations.

Thomas v. Team Staffing Services/Broadspire
William H. Rogner
JCC Pitts (Orlando) – Denied medical care. Awarded TPD. Denied E/C’s intoxication, 440.105 and misconduct defenses. The JCC found insufficient proof that the claimant had submitted a urine sample, which he denied providing. The JCC accepted the claimant’s IME as to restrictions, but found no further medical treatment was necessary for a bruise.

Pernaci v. Winn-Dixie/Sedgwick Claims Management Services, Inc.
Derrick E. Cox
JCC Portuallo (Daytona)– Denied compensability of neck. The E/C had accepted compensability of a low back injury from unloading a truck. The JCC found that the claimant did not complain of neck pain until 3-4 months after his accident and found the claimant’s IME changed his opinions during cross exam by the E/C’s counsel.

McLeish v. AlphaStaff Group, Inc./Zurich American Insurance Company
Andrew R. Borah
Awarded 49% apportionment of the neurosurgeon evaluation. Awarded psych and neurosurgeon evaluations. The JCC rejected the E/C's argument that MCC applied to the psych evaluation and found the IA was the MCC of the neurosurgeon eval. The JCC denied the E/C's motion for EMA.

Mercier v. Walt Disney Parks & Resorts, U.S., Inc./Walt Disney World Co./WC
William H. Rogner
JCC Sculco (Orlando) – Awarded $630 (2.8 @ $225) appellate attorney fee and denied costs. The claimant attorney had another attorney actually handle the appeal. The claimant attorney’s Petition for Appellate fees sought 40 hours at $300 per hour. The JCC denied a large amount of time allegedly spent on redacting certain personal information from the DOAH website, finding it was not related to the appeal itself. The JCC accepted William Rogner’s expert testimony on the reasonable fee and number of hours.

Snowden v. YRC, Inc./Gallagher Bassett Services
Scott B. Miller/Matthew J. Troy
JCC Castiello (Miami) - Awarded $748.59 in taxable costs to E/C.

Gattorno v. Alpha Staff Group, Inc./Tower Group Company
Andrew R. Borah/Matthew J. Troy
JCC Castiello (Miami) (Andrew Borah/Matthew Troy) - Awarded 992.15 in taxable costs to the E/C.

Altman Contractors/North River Ins. Co. v. Gibson
William H. Rogner/Teri A. Bussey
On February 2, 2012, the Florida Supreme Court denied certiorari review of the 4/29/2011 1st DCA opinion in Altman Contractors/North River Ins. Co. v. Gibson. (Teri Bussey litigated the case at trial and Bill Rogner handled the appeal). The original DCA opinion reversed the JCC’s finding that the claimant’s lung condition due to mold inhalation was compensable. The DCA noted that no record evidence existed showing to what levels the claimant had been exposed, as the statute requires. They also held that the JCC erred in substituting the causation standard expressed in Festa v. Teleflex, Inc., 382 So.2d 122 (Fla. 1st DCA 1980), for the more exacting statutory causation standard for mold exposure claims enacted by the Legislature. The Supreme Court’s denial of certiorari establishes that the current exposure causation standard under F.S. § 440.02 (2005) is the proper and exclusive method to analyze post 10/1/03 exposure claims.

Ogeris v. Delaney Park Health & Rehabilitation/Gallagher Bassett Services, Inc.
Scott B. Miller
JCC Pitts (Orlando) – Awarded $4,180.47 in taxable costs to E/C.

Bridgewater v. Southeast Personnel Leasing, Inc., Moment's Notice /Packard Claims Administration, Inc.
Anthony M. Amelio
JCC Lazzara (VTC Ft. Lauderdale) – Denied all benefits. The JCC found the claimant had a pre-existing bilateral knee condition and rejected the claimant’s repetitive trauma injury.

Chase v. The Health Center of Plant City/Premier Group Insurance Co.
W. Rogers Turner, Jr.
JCC Lorenzen (Tampa) – Denied an increase in the AWW, awarded brief period of TPD and determined MMI based upon E/C’s earlier asserted date. The JCC found the E/C correctly calculated the claimant's AWW and rejected the claimant's argument that he worked less than 75% of his customary hours, or that he could prove the value of fringe benefits based upon claimant’s recollection of amounts indicated in COBRA letter. The JCC reviewed multiple dates of surveillance, noting that the claimant appeared to move fluidly and without difficulty. Finally, she determined that the claimant should be repaid a 10$ co-pay he paid after his first MMI date was rescinded.

Hulbert v. Southeast Personnel Leasing, Inc./Lion Ins. Co.
Anthony M. Amelio
JCC Basquill (West Palm Beach)- Denied advance to claimant.

Smith v. Martin County Sherrif's Department/North American Risk Services
Matthew J. Troy/Rex A. Hurley
JCC McAliley (Port St. Lucie) - Denied total knee replacement. The claimant was a Sheriff’s Deputy with 4 prior knee injuries at work. While patrolling near the beach the claimant alleged he heard a pop and felt immediate knee pain. A total knee replacement was recommended. The JCC found the claimant sustained an accident but no additional injury. The JCC accepted EMA (Dr. Penner) opinion.

Lantiqua v. FrankCrum/Broadspire, a Crawford Company
Andrew R. Borah
JCC Pecko (Ft. Lauderdale)– Denied TPD. The JCC found that the claimant remained at overall MMI despite sloppy and inaccurate DWC-25s from the claimant’s authorized physicians that indicated otherwise.

Rodriguez v. FrankCrum/Broadspire, a Crawford Company
Andrew R. Borah
JCC Medina-Shore (Miami) – Awarded $677.50 in taxable costs to the E/C.

Baker v. Alpha Staff Group, Inc./Zurich American Insurance Company
Andrew R. Borah
JCC Basquill (West Palm Beach) – Denied claimant’s choice of 1x change. The claimant was referred to pain mgmt and the E/C authorized an anesthesiologist. The claimant refused to treat with the anesthesiologist and requested a 1x change to a physiatrist. The E/C authorized another anesthesiologist. The JCC found no medical necessity for a change to a physiatrist.

Villalta v. YRC, Inc./Gallagher Bassett Services
Scott B. Miller
JCC Kuker (Miami) – Awarded $5,465.20 in taxable costs to E/C.

Seaton v. Florida Power & Light Co./Broadspire
Derrick E. Cox
JCC Pecko (Ft. Lauderdale) (Derrick Cox) – Awarded $912.38 in costs to E/C.

Cespedes v. Yellow Transportation, Inc./Gallagher Bassett Services, Inc.
Scott B. Miller
JCC Portuallo (VTC Miami) – Denied past surgery, TTD/TPD and increase in AWW. The claimant allegedly obtained emergency back surgery on his own at a hospital. The JCC found that the E/C had authorized an ortho to treat the claimant, and that the surgery the claimant obtained on an unauthorized basis was not an emergency nor shown to be related. However the JCC found that the claimant remained entitled to care related to the IA.

Hanna v. Robinson's Tractor Service/Gallagher Basset Services, Inc.
William H. Rogner
JCC Condry (Orlando) - Denied full payment of TTD. The JCC found the E/C was entitled to the 25% reduction for the claimant's failure to use a seat belt and that the E/C was entitled to recoup past benefits paid at the full rate

Noguera v. FrankCrum/Broadspire
Andrew R. Borah
JCC Jenkins – Denied TPD and medical benefits. EMA (Dr. Kenneth Fischer) opined that the claimant was at MMI and did not need any treatment.

Rodriguez v. FrankCrum, Inc./Broadspire
Andrew R. Borah
JCC Rosen – Denied TT/TPD and increased IBs. The JCC found the requested benefits were barred by res judicata and the two dismissal rule. The JCC also found a claim for P&I was barred by the language of a prior mediation agreement resolving all issues

Sanchez v. Daily Bread Food Bank/Selective Insurance Company
Andrew R. Borah
JCC Lazzara (VTC Ft. Lauderdale) – Denied medical benefits from the claimant’s unauthorized doctor. The claimant injured his low back with the same employer but different carrier. The E/C previously agreed to authorize the doctor as the claimant’s late 1x change. The JCC found that the doctor was not retroactively authorized and that the care requested was not reasonable, medically necessary, or causally related to the IA.

Rodriguez v. Frank Crum, Inc. and Broadspire
Andrew R. Borah
JCC Medina-Shore (Miami) - Granted E/C's motion for summary final order. The parties previously entered into a joint stip resolving all issues which the claimant's attorney argued had not resolved indemnity and the AWW. The JCC found the stipulation resolved the issue and that the claimant's position was 'tantamount to fraud on [the] tribunal.'

George v. Imperial Health Care Center/Premier Group Insurance
Jonathan L. Cooley
JCC Spangler (Ft. Myers) – Denied TTD/TPD, finding the claimant failed to sustain her burden to prove entitlement to lost wage benefits.

Caswell v. Gulf Coast Electric/United Self Insured Services
Matthew W. Bennett
JCC Roesch (Panama City)- Denied Osteo Bi-Flex. Awarded authorization of the claimant’s choice of pharmacy. 1992 d/a. The E/C asked the claimant to change pharmacies as the mail order pharmacy was double billing the E/C. The JCC found the claimant had a statutory absolute right to choice of pharmacies. The JCC however found Osteo Bi-Flex was not related to the IA

Juliano v. Phiris Corporation/Protective Insurance Company
Scott B. Miller
JCC Portuallo (Daytona Beach)– Denied further TTD/TPD and medical benefits. The JCC found the IA was not the MCC of the claimant’s complaints and need for treatment. The claimant had a prior work related back injury and a significant prior MVA with multiple fusions. The JCC also found the claimant worked full time until a separate knee injury at work

Robinson v. Economy Air Condition Heating/Amerisure Mutual Insurance Company
William H. Rogner
JCC Roesch (Panama City)– Denied additional TTD and IBs for psych benefits. The JCC found that since the claimant had been paid IBs, the 6 month limit on TTD began on the date of physical MMI, distinguishing Roe v. Razo-Guevara. The JCC also found the claimant was limited per the statute to 1% PIR for the psych injury.

Bradshaw v. Custom Architectural Metals, Inc./Travelers Property and Casualty Corporation
Michael S. Waranch
JCC Portuallo (Daytona Beach) – Denied full payment of old law (1989/1991) PTD. A 1994 order denied PTD and allocated payment of benefits between two E/Cs (75/25). The claimant was later accepted as PTD by both E/Cs. The JCC found that the claimant did not present medical or vocational evidence to support PTD for any specific injury or date of accident and erroneously attempted to argue res judicata or law of the case.

Chestnut v. C & C Pool Services, LLC/Amerisure
Robert J. Osburn, Jr.
JCC Condry (Orlando) - Denied weight reduction, aquatic therapy, traction and injections. Awarded TPD. The JCC found that the claimant sustained an aggravation of preexisting spondylolisthesis. The JCC also accepted a revised MMI date and retroactive restrictions.

Ledesma v. Castle Point Florida Insurance Company
Matthew J. Troy
JCC D’Ambrosio (West Palm Beach) - Denied all benefits based upon 440.105. The JCC found that the claimant made false statements denying prior car accidents, including a cervical x-ray two days prior to the IA.

Turner v. O2HR/Providence Property & Casualty
Zal Linder
JCC Hogan (Ft. Lauderdale)Awarded $65,487.50 (201.5 @ $325) attorney fee and $4,064.61 in costs. Claimant attorney asserted $80,600 was a reasonable fee.

Ford v. Watson's Towing/Providence Property and Casualty
Gregory D. White
JCC Hill (Gainesville)– Awarded $5,502 (26.2 @ $210) attorney fee and denied costs. The claimant alleged 33.2 hours were reasonable, and that those hours should be reimbursed at $250.00 per hour ($8,300). The JCC accepted the E/C position on both the hourly rate and objections to costs claimed.

Jesus Garza Rodriguez vs. ATG Holding Company/U.S. Fire Insurance Co. & Crum and Forster Ins.
Jonathan L. Cooley
JCC Sturgis (Ft. Myers) – Denied further medical benefits.

Moya-Perguero vs Trucks & Parts of Tampa, Inc./Ameritrust Ins. Corp.
Gregory D. White
JCC Jenkins (Tampa) – Granted E/C’s motion for summary final order. The JCC found that the claimant’s petition for re-employment services was barred by res judicata and lack of jurisdiction.

Rose vs. GEICO Corporation/Broadspire
Michael S. Waranch
JCC Sojourner – Denied treatment for carpal tunnel. The claimant had a prior compensable repetitive trauma with a recommendation for bilateral surgery which she did not undergo. The JCC found the claimant’s condition was essentially unchanged from her prior injury and that the claimant did not prove a new accident or injury.

Everly vs. Florida Wildlife Conservation Commission/Dvision of Risk Management
William H. Rogner
JCC Condry (Orlando) – Requests for payment of advances are on the rise. By now most people are familiar with the First DCA’s 2010 decision in Lopez v. Allied Aerofoam. Lopez reversed a JCC’s denial of an advance in a totally controverted case. The DCA ruled the legislature’s failure to exclude controverted cases impliedly meant that advances could be awarded in such cases. . Here, the JCC was asked to award a $2,000 advance to the claimant, a volunteer instructor for the State of Florida. F.S. s. 440.0(15)(d)(6)(2002) allows state volunteers to receive medical benefits, but as they receive no income, they are not entitled to any compensation. The JCC analyzed the advance statute, and found it required at least some potential prospect of entitlement to compensation. The JCC accepted the E/C position that as the claimant will never be entitled to compensation, an advance was improper and denied the claimant’s request.

Martinez vs. Southeast Personnel Leasing, Inc./Packard Claims Administration, Inc.
Zal F. Linder
JCC Castiello (Miami) – Granted E/C’s motion to dismiss for the claimant’s failure to pay costs previously awarded.

Sena vs. Parkway Health & Rehabilitation/Premier Group Ins.
Matthew J. Troy
JCC McAliley (Port St. Lucie) – Denied medical benefits. The JCC found that the pro se claimant did not present any admissible medical evidence to support entitlement to further medical benefits. The JCC found insufficient evidence to support the E/C’s 440.105 defense.

Duby vs. Wuestoff Health Systems/United Self Insured Services
Derrick E. Cox
JCC Terlizzese (Melbourne) – Awarded costs to employer/carrier in the amount of $4,771.49.

Latson vs. Medical Revenue Service/Crum & Forster
Andrew R. Borah & Matthew J. Troy
JCC Terlizzese (Melbourne) – Awarded $1,412.45 in taxable costs to E/C.

Portales vs. YRC, Inc./Gallagher Bassett Services-Nashville Carrier
Scott B. Miller
JCC Murphy (Tampa) – Denied compensability of shoulder injury. The claimant alleged injuring shoulder during physical therapy for the wrist. The JCC rejected claimant’s testimony which was not consistent with therapy records or history given to treating physician.

Bienes vs. Brevard County Parks and Recreation/PGCS
Derrick E. Cox
JCC Terlizzese (Melbourne) – Awarded $5,573.03 in taxable costs to E/C.

Fuentes vs. Stafflink Outsourcing IV, Inc. vs. SUA Insurance Company
Zal Linder
JCC Basquill (West Palm Beach) – Granted E/C’s motion to dismiss the claimant’s PFB for failure to pay costs awarded.

Kelly vs. Brevard County Board of Commissioners/Preferred Governmental Claim Solutions
Derrick E. Cox
JCC Terlizzese (Melbourne) – Granted E/C’s motion to enforce settlement.

Fuentes vs. Frank Crum/Frank Winston Crum Ins.
Andrew R. Borah & Matthew J. Troy
JCC Harnage (Miami) – Denied compensability. The JCC rejected the claimant’s description of an accident and found the claimant not credible. The JCC also found it suspect that the claimant waited three years to obtain medical treatment despite constant pain.

Jackson vs. YRC, Inc./Gallagher Bassett Services, Inc.
Scott B. Miller
JCC Pitts (Orlando) – Awarded $7,023.81 in taxable costs to E/C.

Kash vs. Global Employment Solution PEO
Andrew R. Borah & Kimberly De Arcangelis
JCC Sculco (Orlando) – Awarded $3,150.14 in taxable costs to E/C.

Seaton vs. Florida Power & Light Co. and Broadspire
Derrick E. Cox
JCC Pecko (Ft. Lauderdale) – Denied payment of spousal death benefits. The decedent had a legal wife in Wisconsin, a wife and children in Jamaica and a girlfriend in Florida. The JCC found that the claimant’s legal wife was neither dependent upon the claimant nor living apart from him for just cause.

Santoyo vs. The Hill Group, Inc./FFVA Claims
Anthony M. Amelio
JCC Terlizzese (Melbourne) – Granted E/C’s motion to enforce settlement.

Lesniak vs. Service Management Systems, Inc./Gallagher Bassett Service, Inc.
Scott B. Miller
JCC Sculco (Orlando) – Awarded 25% safety device reduction. The claimant fell while using a 3 wheel electric vehicle as a security guard. The JCC found that the claimant (a supervisor) knew of the requirement to wear a helmet correctly, was wearing it incorrectly, and that it caused his catastrophic injury. The JCC rejected the claimant’s estoppel argument that management was aware of the failure to correctly wear helmets and did nothing about it.

Stewart vs. Service Construction Supply, Inc./Sentry Insurance
Matthew Bennett
JCC Roesch – Denied new law (2006) PTD and pain mgmt. The JCC found that the claimant sustained a lumbar strain with no permanent restrictions. The JCC found that the claimants preexisting arachnoiditis was the cause of any need for treatment. The JCC rejected the claimant’s voc. expert.

Duby vs. Wuesthoff Health Systems/USIS, Inc.
Derrick E. Cox
JCC Terlizzese (Melbourne) – Denied all benefits based upon 440.105. The JCC found that the claimant made false statements about the type of shoes she had been able to wear following her ankle injury. Alternatively the JCC found that the IA was no longer the MCC of any disability or need for treatment.

Moros vs. Brevard County Board of Commissioners/Preferred Governmental Claim Solutions
Derrick E. Cox
JCC Terlizzese (Melbourne) – Denied compensability of presumption claim. The JCC found that the claimant’s pre-employment physical showed borderline HTN, sinus tachycardia, atrial enlargement and borderline ECG, and therefore found the presumption did not apply. The JCC rejected the argument that since the claimant was cleared for work the PEP did not show heart disease. Alternatively the JCC found that the E/C rebutted the presumption with the claimant’s family history and low HDL history. Notably the claimant sustained his heart attack while elk hunting in Colorado.

Lesniak vs. Valor Security Services/Gallagher Bassett
Gina M. Jacobs
JCC Sculco (Orlando) – Opposing counsel sought $24,922 in fees plus costs for securing $15,000 in attendant care benefits. JCC awarded $15,025 (55 @ $250, 3 @ $225, 10 @ $60) attorney’s fee and $47 in costs. 1/10/2009 d/a. Abbreviated order.

King vs. Osceola County Sheriff's Office/Florida Sheriff's WC Self-Ins. Fund/North Am. Risk Services
Kimberly De Arcangelis
JCC Sculco (Orlando) – Awarded $1,240.74 in taxable costs to E/C.

Salomon vs. Source Broadband Services, LLC/Crum & Forster/U.S. Fire Insurance Company
Zal F. Linder
JCC D’Ambrosio (West Palm Beach) – Granted E/C’s motion to enforce settlement. The JCC found that the E/C had agreed to fund any shortfall in an MSA and that all contingencies were met.

Neil vs. Thrive HR FL 1 LLC and SUNZ Insurance and USIS
Gregory D. White
JCC Langham (VTC Melbourne) – Granted E/C’s motion to enforce settlement. The JCC found that the claimant’s former counsel had authority to and did settle the workers compensation claim.

Newick vs. Webster Training Center/Zenith
Andrew R. Borah
JCC Hill (Gainesville) – Denied full payment of compensation and surgery. The claimant sustained a number of prior injuries, allegedly while at work for her own company. She did not file any notices of injury or seek benefits for these prior injuries. The E/C had already agreed to provide indemnity and surgery with a 65/35% apportionment per the EMA. The JCC found that these injuries were pre-existing conditions and accepted the EMA’s opinion on apportionment.

Turner vs. Frank Crum/Frank Winston Crum Ins./Broadspire
Paul L. Luger and Matthew J. Troy
JCC Spangler (VTC Miami) - Denied TTD/TPD, increase in AWW, and surgery. Awarded compensability of aggravation of pre-existing arthritis and conservative care. The claimant sustained a finger fracture when a crane fell on his hand. He also alleged an injury to the CMC joint of his hand. The JCC accepted the claimant’s IME and found that the claimant sustained an aggravation of his pre-existing arthritis and awarded conservative care. The JCC rejected proposed surgery. The JCC found that the claimant’s AWW should not be increased based upon the health insurance which started on the claimant’s d/a. Finally the JCC found that the claimant returned to his pre-injury employment and that any loss of earnings was unrelated to the IA.

Martinez vs. Southeast Personnel Leasing/Lion Ins. Co. serviced by Packard Claims
Matthew J. Troy
JCC Castiello (Miami) – Dismissed claimant’s PFB for failure to pay costs. A prior order had awarded costs to the E/C. The claimant failed to pay those costs. The JCC dismissed the claimant’s pending petition.

Salado vs. The Simplex Group, Inc./USIS, Inc.
Andrew R. Borah
JCC Medina-Shore (Miami) – Awarded $1,757.17 in costs to the E/C. The JCC noted a prior order awarding costs to the E/C.

Isajiw vs. Fank Crum/Frank Winston Crum Ins./Broadspire Carrier/Servicing Agent
Jonathan L. Cooley
JCC Spangler (Ft. Myers) – Denied work conditioning program. The JCC found that no evidence was presented that a program was recommended by the doctor.

Hayes vs. Graham Brothers Construction/Gallagher Bassett Services
Matthew Bennett
JCC Roesch (Panama City) – Denied TPD. The JCC found that the claimant remained at MMI until he underwent surgery and that all treatment since MMI had been palliative.

Jones vs. Royalty Foods, Inc./Gallagher Bassett Services, Inc.
Gregory D. White
JCC Pitts (Orlando) – Granted E/C’s motion to dismiss PFB for failure to pay costs awarded. The language in the statute indicates the JCC “may” dismiss the PFB for failure to copy with a cost order. Several JCCs have recently dismissed pending claims as a sanction for failure to pay costs.

Correa vs. MC Professional Window Cleaning, Inc./Frank Crum Insurance, Inc./Broadspire
Zal F. Linder
JCC Portuallo (VTC Miami) – Awarded $3,529.74 in taxable costs to E/C.

Hale vs. Gulf Coast Enterprises d/b/a Lakeview Center, Inc./U.S. Fire Insurance Company
Julie C. Bixler
JCC Winn (Pensacola) – Awarded $265.51 in taxable costs to E/C for securing medical records.

Fuentes vs. StaffLink Outsourcing, Inc./SUA Insurance Company
Zalman F. Linder
JCC Basquill (West Palm Beach) – Awarded $829.50 in taxable costs to E/C.

Segady vs. JFK Hospital and Broadspire
Sandra D. Wilkerson
JCC Basquill (West Palm Beach) – Denied PT, pain mgmt, and medical bills. Awarded replacement neurologist. 2001 d/a. The claimant had an initial compensable injury followed by a MVA. The JCC found that since the claimant sustained a permanent impairment rating from the IA, she was entitled to ongoing care, with a replacement neurologist. The JCC denied all specific medical benefits sought.

Kash vs. Global Employment Solutions PEO/SUA Insurance Company
Andrew R. Borah & Kimberly C. De Arcangelis
JCC Sculco (Orlando) - Denied all benefits based up on 440.105. The claimant alleged an inhalation injury and denied any similar prior problems. Medical records showed the claimant was diagnosed with asthma and treated for breathing problems before the accident. The claimant called her prior physician and asked him to lie about her records.

Rogers vs. 02HR, LLC/Providence Property and Casulty Insurance, and Imperial Casualty & Indemnity Company
Gregory D. White & Michelle A. Bayhi
JCC Sojourner (Lakeland) - Denied TTD/TPD, increase in AWW, medical care, and pain mgmt. EMA Dr. Cutler opined that the claimant’s complaints were due to unrelated degenerative disk disease, that the claimant was at MMI 0%, and no further treatment was necessary. The JCC also rejected the claimant’s arguments regarding the value of employer provided housing.

Martinez-Cardenas vs. Drawdy Brothers Construction/Amerisure Ins. Co.
Anthony M. Amelio
JCC McAliley (Port St. Lucie) – Amended order. Denied lumbar injury, reinstatement of a doctor and TTD/TPD. The E/C de-authorized that claimant’s doctor who recommended a stretching procedure which would suck a herniated disk back into place. Kenneth C. Fisher, EMA, rejected the procedure and opined that no further care was necessary. Despite allegations of memory problems, the JCC noted the unflagging memory of the claimant at trial.

Norvell-Murphy vs. Place At Vero Beach/Cambridge Integrated Services, Inc.
Anthony M. Amelio
JCC McAliley (Port St. Lucie) – Determined a settlement agreement was reached and the E/C had provided all settlement proceeds. The parties agreed to a settlement at mediation and the E/C subsequently provided all funds to the claimant’s former counsel. During that time, claimant’s former counsel was being investigated for misappropriation of funds. The Florida Bar suspended the attorney’s license and criminal charges are currently pending. The claimant argued that no settlement was reached or that the E/C should be required to pay the funds a second time to the claimant. The JCC found an agreement was reached and that the E/C had satisfied their duty by providing the funds to the claimant’s former counsel to hold in trust.

Jackson vs. YRC/Gallagher Bassett Services, Inc.
Scott B. Miller
JCC Pitts (Orlando) - Denied all benefits based upon claimant's violation of 440.105. Bifurcated hearing. The JCC found that the claimant made numerous false statements regarding prior injuries to the claimed body parts during the initial investigation of the claim and later to medical doctors. He rejected the notion these were “honest mistakes”, finding the numerous inconsistencies showed either a pattern of deceit or at best unacceptable indifference to integrity and truthfulness. At trial the claimant admitted to prior low back and bi-lateral shoulder pain.

Appleton vs. Arrmaz Custom Chemicals/Crum & Forster
Teri A. Bussey
JCC Sojourner (Lakeland) – Denied compensability. The E/C agreed that an accident had occurred but denied any injury as a result. The claimant had previously indicated during a statement and his deposition that he had only a stiff neck, not pain. The JCC rejected both claimant and his wife’s description of ongoing neck pain as a result of the fall.

Moya-Perguero vs. Trucks & Parts of Tampa, Inc. and Ameritrust Insurance Corp.
Gregory D. White
JCC Jenkins (Tampa) – Granted E/C’s motion for summary final order. The claimant filed a PFB seeking reemployment services. The JCC found jurisdiction was with the Department of Education.

Martinez-Cardenas vs. Drawdy Brothers Construction/Amerisure Ins. Co.
Anthony M. Amelio
JCC McAliley (Port St. Lucie) – Denied lumbar injury, reinstatement of Dr. Gary Weiss for neurological treatment for head injury, Vax D for an alleged neck and lumbar injury, and TTD/TPD. EMA rejected the procedures and opined that no further care was necessary. Despite allegations of memory problems, the JCC noted the unflagging memory of the claimant at trial.

Chilomer vs. Unitek USA/Broadspire
Derrick E. Cox
JCC Basquill (West Palm Beach) – Denied compensability. EMA opined that repetitive job duties were not the cause of claimant’s low back complaints.

Gauthier vs. Walt Disney World/Liberty Mutual Insurance, Inc.
Derrick E. Cox
JCC Sculco (Orlando) – The JCC denied mileage for the claimant’s representative to drive to pick the employee up for medical appointments but awarded other mileage claimed. A guardianship was established for an injured employee. Her representative claimed mileage to take the employee to her guardian attorney, mileage to and from appointments and to the representative’s house for ‘therapy.’

Crane vs. Fleetwood Homes of Florida, Inc./Broadspire
Derrick E. Cox
JCC Sojourner (Lakeland) – Denied E/C’s motion to tax costs. A prior order had denied most benefits, however the JCC found the claimant was entitled to fees and costs. The JCC found the issue controlled by res judicata, even though the current JCC would have awarded costs.

Redding vs. Heathcenter of Windermere/Premier Group Insurance
W. Rogers Turner, Jr.
JCC Condry (Orlando) – The claimant attorney sought $46,365 in fees for obtaining authorization of a podiatrist and foot surgery. The JCC considered that the fee affidavit contained numerous entries for items unrelated to the benefits secured. Awarded $11,182.50 (49.7 @ $225) attorney fee and $2,177.20 in costs. 2007 d/a..

Davis vs. Staffing Concepts, Inc./North American Risk Services
Teri A. Bussey
JCC Lazzara (VTC Gainesville) – Denied all benefits. Following numerous appeals to both the 1st DCA and the Supreme Court, the JCC found that no evidence was presented that the claimant’s complaints were causally related to her 2003 slip and fall.

Iglesias vs. Michaels Stores/Gallagher Bassett Services
Andrew R. Borah & Matthew J. Troy
JCC Medina-Shore (Miami) – Awarded $1,580.90 in taxable costs to E/C.

Blackwell vs. Wave Construction, Inc./First Commercial insurance Company, and Unisource Administrators, Inc.
Julie C. Bixler
JCC Roesch (Panama City) - Awarded $334 in taxable costs to E/C.

Crane vs. Fleetwood Homes of Florida, Inc./Broadspire
Derrick E. Cox
JCC Sojourner (Lakeland) - Awarded $9,625 (55 @ $175) attorney fee and $3,119.60 in costs. 2005 d/a. The claimant’s fee affidavit sought a fee of $73,664.25, alleging all submitted hours were related to the benefits obtained (two weeks of temporary indemnity and an MRI of the right shoulder). The JCC noted that a majority of the time was spent on benefits that were denied. The JCC further noted that legal assistant time listed was generally clerical in nature, duplicative or vague.

Norvell-Murphy vs. Place at Vero Beach/Cambridge Integrated Services, Inc.
Anthony M. Amelio
JCC McAliley – (Port St. Lucie) – The JCC ordered the parties to attend a status conference. The E/C sought to enforce a settlement where the claimant attorney absconded with the settlement proceeds. The JCC analyzed in detail the privileges attached to the mediation process, and then ordered the parties to confer on facts prior to another hearing.

Jones vs. Royalty Foods, Inc./Gallagher Bassett Services
Timothy F. Stanton & Greg D. White
JCC Lazzara (VTC Orlando) - Awarded $7,162.21 in taxable costs to E/C. The JCC rejected the claimant's arguments that costs should not be awarded because he would not be able to pay them.

De La Pena vs. East Coast Metal Decks, Inc./Frank Winston Crum Services
Sandra D. Wilkerson
JCC Punancy (West Palm Beach)- Denied PTD and attendant care based upon violation of 440.105. The claimant was seen on surveillance lifting furniture and welding, both of which he denied during deposition. The JCC rejected the claimant’s arguments that his attorney instructed him to lie.

Salado vs. The Simplex Group, Inc.
Andrew R. Borah & Matthew J. Troy
JCC Medina-Shore (Miami) – Awarded $1,679.40 in taxable costs to the E/C. Denied claimant’s arguments that she did not provide prior counsel with authority to dismiss her PFB and that 440.30 did not permit the taxation of deposition costs.

Bradshaw v. Brevard County Board of Commissioners
Derrick E. Cox
JCC Terlizzese (Melbourne) - Awarded $2,536.31 in taxable costs to E/C.

Adams vs. State of Florida – Highway Patrol and Division
Teri A. Bussey
JCC Langham (Orlando) – Denied TTD/TPD, increase in AWW, and compensability of a 2008 D/A. Awarded psych eval. Presumption claim. The claimant had a compensable heart attack in 2002 with a period of disability and reached MMI in 2002. He claimed a new D/A on the day he announced his retirement. The JCC found that the claimant did not have a new cardiac event and that there was no evidence of progression of his compensable coronary artery disease and his restrictions had not changed since the 2002 MMI.

Green vs. Irby Construction/Gallagher Bassett Services
Gregory S. Raub
JCC Rosen (VTC Lakeland)– Determined jurisdiction was in Florida in a bifurcated hearing. The claimant was injured while in North Dakota. The JCC determined that the claimant’s contract for hire was completed in Florida.

Williams v. Gulf Coast Enterprises d/b/a Lakeview Center, Inc./United States Fire Insurance Company
Julie C. Bixler
JCC Winn (Pensacola) Awarded $344.24 in taxable costs to E/C and $500 for half of IME’s no show fee.

Garcia v. American Reprographics/U.S. Fire Insurance Company
Andrew R. Borah
JCC Kuker (Miami) – Awarded $1,430.60 in taxable costs to E/C. The JCC rejected the claimant’s argument that 440.30 prohibits the taxation of deposition costs.

Wilcox v. East Coast Fire Protection/United States Fire Insurance Company
Andrew R. Borah & Kimberly De Arcangelis
JCC Condry (Orlando) – Denied compensability of bi-lateral foot conditions, indemnity and ortho. The JCC rejected the claimant’s description of the accident. The JCC also stated he believed that the claimant withdrew his claim for compensability of his back based upon a probable violation of 440.105 and that the withdrawal did not change the misrepresentations.

Bruton v. Orange County Convention Center/Alternative Service Concepts
Kimberly De Arcangelis
JCC Pitts (Orlando) Awarded $3,336.27 in taxable costs to E/C.

McCollum v. Alternative Service Concepts
Kimberly De Arcangelis
JCC Sculco (Orlando) - Awarded $2,811.86 in taxable costs to E/C. The JCC rejected the claimant's argument that 440.30 prohibited the award of deposition costs to the E/C.

Wasef v. Mitsubishi Electric America/Tokio Marine
W. Rogers Turner, Jr.
JCC Pitts (Orlando)(2/2008 d/a) -- Awarded $10,000.00 appellate fee based on $250.00 per hour. Claimant had requested 67 hours at $300.00 per hour.

Correa v. MC Professional Window Cleaning/Broadspire
Zal F. Linder
JCC Portuallo (Daytona Beach) Denied TTD/TPD. The JCC found no evidence to support indemnity, no causal relationship, that the claimant was at MMI and that the claimant voluntarily limited his income. All authorized physicians released the claimant with a 0% PIR.

Chirino-Diaz v. Southeast Personnel Leasing, Inc.
Anthony M. Amelio
JCC Medina-Shore (Miami) Denied TPD. Awarded P&I on IBs. The JCC determined that the claimant quit the employer to work a different job and was subsequently fired from the new job for theft. All restrictions would have permitted the claimant to work in his pre injury job as a valet and the JCC granted the E/C’s voluntary limitation of income defense. The JCC awarded P&I based upon late payment of IBs, despite the confusion in the doctor’s notes.

Jones v. Royalty Foods/Gallagher Bassett Services
Gregory D. White
JCC Lazzara (Gregory D. White) Denied compensability of right shoulder and pain management. The claimant sustained a left shoulder injury and now sought compensability of his right shoulder. The JCC completely rejected the claimant’s testimony. EMA Dr. Robert Murrah opined that the right shoulder was unrelated to the IA and no further care was needed.

Villa v. Astellas US Holdings, Inc./Tokio Marine
W. Rogers Turner, Jr.
JCC Hill (Gainesville)Denied compensability. Claimant was a pharmaceutical rep who lived in S. Florida. Every other week he would spend several days in Orlando, calling on doctors in Orange and Lake Counties. After seeing the last doctor in Lake County, instead of returning to his hotel in Orlando, the claimant drove approximately 20 miles north of Ocala to go horseback riding and have a BBQ. Sadly, seconds after attempting to mount the horse, the claimant fell and sustained permanent brain damage. The parties bifurcated the issue of compensability, specifically whether the claimant’s accident was compensable under the “personal comfort” theory of the traveling employee rule. The JCC denied compensability, holding that while it was reasonable for the claimant to have dinner, and perhaps even do so miles away from his hotel, compensability could not be found where the claimant engaged in an inherently dangerous activity (per F.S. s. 733) which was not reasonably related to his employment, nor foreseen or acquiesced to by the employer.

Emilsaint v. Frank Crum /Frank William Crum Ins.
Sandra D. Wilkerson
JCC Rosen (VTC Miami) Denied all benefits. The JCC found the claimant injured himself at home and denied compensability of the accident. The JCC also found the claimant did not establish any evidence to support the claims were compensable.

Lago v. Lee County Sheriff's Department/North American Risk Services
Kim De Arcangelis
JCC Spangler (Ft. Myers) Granted E/C’s motion for Summary Final Order. The JCC found the claimant was an inmate trustee at the time of injury and therefore statutorily excluded from “employment.”

Mobius v. Brevard County Board of Commissioners/PGCS
Derrick E. Cox
JCC Terlizzese (Melbourne)– Awarded $481.97 in taxable costs to E/C. Dismissed portions of PFB seeking full pay status per 440.15(11) and reimbursement of leave.

Cheryl Pugsley v. Highlands County Sheriff's Department/North American Risk
Kim De Arcangelis
JCC Hofstad (Lakeland) – Awarded E/C taxable costs of $248.01.

Maria Iglesias v. Michael's Stores/Gallagher Bassett
Andrew R. Borah
JCC Medina-Shore (Miami) Denied treatment for cervical strain, MRI, and PT. The claimant was placed at MMI following a cervical strain which had resolved without pain. Approximately one year later, and one month after resigning, the claimant complained of neck pain. The JCC rejected all the claimant’s arguments, finding that the IA was not the MCC of any need for treatment or diagnostic studies.

Juan Mercado v. Drawdy Brothers Construction, Inc./Amerisure
Anthony M. Amelio
JCC Terlizzese (Melbourne) Denial of benefits. The JCC reserved jurisdiction as to E/C’s 440.105 defenses.

Marie Paraison v. Vacation Resorts International/Safeco
Dominic C. Locigno
JCC Pecko (Ft. Lauderdale)Granted E/C’s motion to enforce settlement, finding the parties reached an enforceable agreement.

Markel Chirino-Diaz v. Southeast Personnel/Packard Claims
Anthony M. Amelio & Matthew J. Troy
JCC Medina-Shore (Miami) Awarded $1,358.80 in taxable costs to E/C. The JCC rejected the claimant’s argument that E/C’s are not permitted to recover deposition fees.

Starr v. Brevard County Board County Comissioners/PGCS
Derrick E. Cox
JCC Terlizzese (Melbourne) Denied request for an authorized ortho to treat claimant’s back. The claimant was referred to an ortho for his shoulder and neck, but not his low back. His PCP continued to treat his low back. The JCC denied a request for the authorized ortho to be authorized to treat his low back.

Wilkinson v. Work Impex Trading Corp/Sentry Insurance
Timothy F. Stanton
JCC Pitts (Jacksonville)1998 d/a. Denied increase in attendant care benefits. Awarded additional hours of attendant care at federal minimum wage. The parties had previously stipulated to paying attendant care at a set rate. A doctor subsequently determined that the claimant needed additional non professional attendant care. The JCC awarded the same, but at the minimum wage, not the previously agreed upon rate.

Mott v. FrankCrum/Frank Winston Crum Insurance
Paul L. Luger
JCC Lewis (Ft. Lauderdale) Denied TPD. The JCC found the claimant did not present medical evidence that the IA remained the MCC of any disability or need for treatment. The claimant attempted to admit medical records at trial pursuant to 440.29(4), however the records were not provided 30 days prior to the hearing and the JCC denied the motion. The JCC did not rule on the E/C’s numerous other defenses.

Garcia v. American Reporgraphics/U.S. Fire Insurance Company
Dominic C. Locigno
JCC Kuker (Miami) Denied all benefits, based upon E/C’s SOL defense. Previously, all pending PFBs had been dismissed by the JCC’s order for failure to appear for mediations. Following dismissal, the claimant filed a new PFB, which the E/C denied based upon SOL. The claimant testified that he had not received any information about the SOL, despite returning forms accompanying the initial claim packet and brochure. The JCC found the PFB to be barred by the SOL and denied all benefits.

Keller v. Family Dollar/Risk Enterprise Management
Jonathan L. Cooley
JCC Sturgis (Ft. Myers) On rehearing, enters an Order accepting the carrier’s positions that the issue of entitlement to a one time change was not ripe for hearing.

Cruz v. HCA Health Services of Fla/Broadspire
Robert S. Gluckman
JCC Basquill (West Palm Beach)Denied PCP and discectomy. Awarded neurosurgeon. The JCC determined that the E/C had waived MCC by accepting compensability of the claimant’s lumbar injury. The JCC however determined that the claimant did not present a case for the PCP and that the surgery was one of many options available to the claimant.

Teran v. Goodwill Industries/United States Fire Ins. Co.
Sandra D. Wilkerson
JCC Rosen (video conference in Miami)– The Judge denied all benefits, accepting the Carrier’s statute of limitations defense. The Judge specifically found that the carrier proved the brochure had been provided, rejecting the Claimant’s assertion that she did not receive it. Additionally, the Judge found that the Claimant had not met her burden of proving entitlement to benefits.

Bruton v. Orange County Convention Center/Alternative Service Concepts
Rex A. Hurley
JCC Farrell (Orlando) Denied PTD on 2005 date of accident. All but one physician placed the Claimant at MMI without restriction. One physician provided restrictions of no lifting greater than 30 or 35 pounds. The Claimant had continued to work post accident, until being terminated from a subsequent job for yelling at a customer. The Claimant had only looked at several places for work with those searches being done in the days immediately before the hearing. The carrier introduced rebuttal testimony establishing the Claimant had not looked where he said he had.

Simmons V. Orange County/Alternative Service Concepts
Rex A. Hurley and Kim De Arcangelis
JCC Condry (Orlando) Denied temporary indemnity and authorization of an alternative orthopedic surgeon, but awarded a neurosurgeon. The Judge accepted the Carrier’s position that the claim for temporary indemnity benefits, which was predicated on claim for an average weekly wage adjustment based on concurrent employment, was barred by res judicata as the Claimant had previously claimed an adjustment to the average weekly wage and entered into a mediation agreement indicating the issue was resolved. Furthermore, the Claimant failed to include an AWW issue on the pretrial stipulation or PFB and furthermore failed to introduce evidence in support of the claim. The Judge resolved medical conflicts in awarding a neurosurgeon. However, the Judge awarded an evaluation only to determine whether further neurosurgical care, including potential surgery, was necessary and related.

McCollum v. Orange County/Alternative Service Concepts
Rex A. Hurley and Kim De Arcangelis
JCC Sculco (Orlando) Denied temporary indemnity benefits, increased impairment income benefits, and compensability of injury to back. In denying the back, the Judge found the Claimant had pre-existing degenerative changes and had failed to establish the industrial accident as the major contributing cause of the need for treatment. Prior to the industrial accident, the employer had made multiple accommodations for the Claimant due to pre-existing personal conditions. The Judge found the Claimant’s restrictions due to work related injuries would not preclude her from engaging in her pre-injury employment. The Claimant further failed to demonstrate that the industrial accident was the major contributing cause of “sit down” restrictions that did preclude her from working.

Braun v. Brevard County/PGCS
Derrick E. Cox
JCC Terlizzese (Melbourne) Allocated 50% of claimant’s treatment to second date of accident per 440.42(4). The claimant had previously stipulated to a WC lien for the second date of accident and attempted to pursue care under the first date of accident to avoid the out-of-pocket costs.

Travieso v. Miner Florida/Tokio Marine Management
Scott B. Miller
JCC Sculco (Orlando) Denied all benefits based upon claimant’s violation of 440.105. JCC found claimant incredible as he could clearly recall prior accident in 2000 but failed to remember 2 accidents in 2006 which led to 3 visits to ER. Claimant presented no evidence to substantiate what the JCC called an “unusual manifestation of memory problems”.

Watson v. Gulf Coast Enterprises/United States Fire Ins. Co.
Julie C. Bixler
JCC Winn (Pensacola)The Judge of Compensation Claims denied permanent total disability benefits to a 44 year old with a seventh grade education, who had been hired under a disability program due to a pre existing mental disability. The employer testified that any work restrictions could be accommodated. The claimant had exhausted the 104 weeks of temporary indemnity, but was not at medical maximum medical improvement. The Claimant attempted to utilize Emmanuel to establish PTD from the date of “statutory” MMI. The Judge distinguished the case from Emmanuel, noting the Claimant in Emmanuel had been at physical MMI, while the Claimant in this matter was not at physical MMI and was expected to make substantial improvement. There was no evidence to support an award under Oswald.

Menchaca v. Creative Ins. Concepts/SUA Insurance
Robert S. Gluckman and Dominic C. Locigno
JCC Medina-Shore (Miami) Awarded E/C taxable costs of $3,976.10 for defense of the below PFB through a merits hearing.

Menchaca v. Creative Ins. Concepts/SUA Claims
Robert S. Gluckman and Dominic C. Locigno
JCC Medina-Shore (Miami) Granted E/C’s motion for sanctions. A prior order found the E/C timely authorized a walk-in clinic. The claimant then filed a PFB seeking medical care with the walk-in clinic. The claimant then requested that the E/C set an appointment for the claimant. The E/C timely responded that the clinic was authorized and that no appointment was needed nor could one be set. No evidence was presented that the claimant ever actually went to the clinic nor that he was ever turned away by the clinic for lack of an appointment. The JCC also found that the claimant did not make a good faith effort prior to filling the PFB. The JCC deemed the PFB frivolous.

Rivera v. Southeast Personnel Leasing/Packard Claims
Robert S. Gluckman
JCC Medina-Shore denied all benefits. The claimant sustained a documented accident and compensable treatment at a hospital. He then refused further medical care and a drug test. The claimant returned to work 2 days after the accident and was later terminated. The JCC found the IA was not the MCC of any disability or need for treatment. The JCC denied the 1x change in PCP, finding the claimant treated at a hospital, which is a health care provider, not a physician, and therefore no 1x change was applicable. Finally the JCC found the claimant had a prior accident which he did not reveal to his IME, negating his opinions.

Davis v. Gainesville Healthcare Center/Providence Property & Casualty
Teri A. Bussey
JCC Lazzara granted motion for summary final order. The JCC found there was no employee/employer relationship and dismissed all petitions referencing the employer.

Barrera v. Stafflink Outsourcing/SUA Claims
Robert S. Gluckman
JCC Harnage granted Motion for Summary Final Order dismissing PEO E/C. The JCC considered numerous affidavits filed by the PEO that they possessed no application paperwork, wage information or other documentation of any kind that the claimant was their employee. The claimant argued that discovery was ongoing, but the JCC felt the documentation provided was sufficient to rule on the Motion in a summary manner.

Becerra v. Frank Winston Crum Ins./Broadspire
Geoffrey C. Curreri
JCC Pecko denied all benefits, based on SOL. Medical care and indemnity was last paid in 2007. The carrier’s file contained the documents sent to the claimant at the outset of the claim, including warnings about the SOL. The claimant testified he had only not received mail twice in the 16 years he had lived at the same address. The JCC found the claimant had received the SOL documentation.

Gordon v. Vehicare Corporation/Montgomery Ins.
Scott B. Miller
JCC Hofstad awarded taxable costs of $1,242.36 to the E/C.

Chirino-Diaz v. Southeast Personnel/Packard Claims
Robert S. Gluckman
JCC Medina Shore denied claimant’s request for one time change in physicians. The carrier timely authorized Dr. Berkowitz when first requested. Claimant filed new PFB’s which were dismissed for lack of specificity seeking change in physician. Carrier maintained Dr. Berkowitz still authorized. Claimant replies via fax not acceptable. Claimant files specific PFB asking for change in orthopedic, Dr. Berkowitz fed up with the games won’t see the claimant, carrier still authorizes Dr. Donshik timely. JCC holds original authorization timely and the claimant and claimant attorney the reason for the unwarranted delay in medical care.

Carpenter v. Florida Power & Light/Broadspire
Robert S. Gluckman
JCC Castiello denied all benefits. Found violation of 440.09 and 440.105. The Claimant denied any history of prior back injury to authorized physicians despite evidence of the same. He also denied working following the accident, which surveillance showed to be untrue. He alleged the work shown on surveillance was actually just assisting fellow AA (Alcoholics Anonymous) members. The JCC found the claimant incredible. Additionally the JCC found the accident was not the MCC of the need for treatment.

Socorro v. Southeast Personnel/Packard Claims
Jonathan L. Cooley
JCC Spangler amended order denying all benefits. The JCC found that the Claimant’s evidence did not present a change from a previous Merit Order, that there was no MCC for a neurological referral, and that the Claimant had not demonstrated entitlement to TT/TPD.

Chirino-Diaz v. Southeast Personnel/Packard Claims
Robert S. Gluckman
JCC Medina-Shore denied claim for change in physicians. The E/C timely authorized a 1x change following a PFB. Counsel for the Claimant rejected the offered doctor and the Claimant never went. The JCC found that the 1x change remained authorized and that the Claimant may avail himself of that treatment. Finally the JCC notes that the WC legal system should not be used as a “personal ‘playground’.”

Sweet v. Brevard County/PGCS
Derrick E. Cox
JCC Terlizzese awarded podiatric and psychological evaluations. Rejected E/C MCC defense. Claimant suffered a back injury in 1997 with surgery. He subsequently moved to Chicago and had been undergoing authorized care. The JCC awarded podiatric and psychological evaluations as claimant’s complaints remained the same since the accident.

McMath v. Winn Dixie/Sedgwick Claims Management
Derrick E. Cox
JCC Sculco granted E/C’s motion to enforce settlement, rejecting claimant’s argument he felt forced to settle at mediation. The JCC found the claimant was bound by the settlement agreement.

Soto v. U.S. Security Assoc./Gallagher Bassett
Zalman F. Linder
JCC Castiello entered an Order to Show Cause and to Strike “Claimant’s Motion to Compel Updated Carrier File”. The JCC noted the claimant routinely files such motion before the Court, and had filed 41 identical motions in separate cases in a month period. The JCC noted that filing the motion was premature and groundless, as there was no outstanding Request to Produce for which the court could compel compliance. The Court noted the Motion also failed to observe any applicable procedural rule regarding personally conferring with the carrier attorney, or otherwise trying to resolve the matter without judicial intervention. The JCC gave the claimant attorney ten days from the date of the Order to show cause why he should not be sanctioned, and why the motion to compel was not a sham pleading.

Mondragon v. Southeast Personnel/Packard Claims
Robert S. Gluckman
JCC Kuker granted the Employer/Carrier’s Motion to Dismiss Petition for Benefits seeking penalty on untimely payment of settlement. The Order on the Settlement had been filed by the court under the wrong date of accident, so that the Employer/Carrier’s counsel did not receive it timely. Upon the Employer/Carrier’s receipt, payment was promptly issued. The Judge found that any delay in payment was not willful.

Kringel v. Modern Business Assoc./Insurance Company of America
Timothy F. Stanton
JCC Sculco denied Employer/Carrier’s Petition to Modify prior award of 24 hours per day attendant care from an LPN. The Claimant’s mother did not want an attendant in the house when she was there, so the parties agreed that the mother would provide 12 hours per day when she got home. The physician’s testimony confirming this would be appropriate did not give rise to a change of circumstances, however the parties were free to enter into agreements as they saw fit.

Hayden v. Brevard County/PGCS
Derrick E. Cox
JCC Terlizzese denied a claim for reimbursement to the claimant of co-pays to an unauthorized physician and for an MRI. The Judge found the carrier had, at all times, provided appropriate care for the Claimant and that the Claimant did not request the care from the carrier prior to obtaining care. Therefore the claimant could not rely upon the self help features of s. 440.13.

Black v. Traffic Control Devices/Amerisure
William H. Rogner
JCC Sculco denied claim based on misrepresentation. Employer witnesses testified to the claimant’s statements re: monetary problems and his intent to fake a WC injury. The claimant gave conflicting descriptions of his injury at different stages, and surveillance showed the claimant to be much better off than he presented at trial.

Socorro v. Southeast Personnel/Packard Claims
Jonathan L. Cooley
JCC Spangler denied TT/TPD, awards neuro. Relying on prior order, JCC denies indemnity claims and finds the claimant did not prove entitlement to a new different period. Parties had previously stipped to 1x change on eve of prior trial. JCC finds 1x change recommended neuro and does not address E/C MCC arguments.

Leon v. Leath Furniture/United States Fire Insurance Company
Robert S. Gluckman
JCC Kuker denied claimant PTD and found the claimant violated section 440.105 and 440.09. The claimant’s prior attorney withdrew from the case after the E/C sent surveillance of the claimant working. The claimant denied working post accident and completed DWC 19's denying income. He then filed an apology letter with the JCC asking for forgiveness, as he had child support payments to make. He also said he was fired from the job because he could not work up to par. The Owner of the business where he worked post accident testified he paid the claimant cash and produced receipts. He also said he thought he was a good employee and wanted to put him on the books but the claimant asked for all copies of documents he provided to the subsequent employer apparently in an effort to conceal his work.

Martin v. Fleetwood Homes/Broadspire
Derrick E. Cox
JCC Hofstatd denied request for lumbar injections for 88’ DOA. After EMA Eichberg denied medical necessity from ’06 PFB, the claimant proceeded on an ’09 PFB with a renewed Rx for the same injections. The JCC noted no additional medical testimony to counter prior EMA opinion.

Moya v. Trucks and Parts of Tampa/Ameritrust
Gregory D. White
JCC Jenkins denied new law PTD. The JCC rejected the claimant’s vocational expert, noting numerous assumptions that were not borne out by record evidence. The expert based many restrictions on an alleged psychiatric condition that had been denied in a previous order, and referred to a job search that the JCC rejected as not being “in good faith” as most jobs exceeded the claimant’s restrictions. The JCC also rejected the assumption that the claimant lacked English skills.

Burgess v. Buckhead Beef Florida/Sentry Insurance
Gregory D. White
JCC Terlizesse denied all medical and indemnity benefits except for authorization of ongoing palliative care. In addition to denying multiple claimed benefits, the JCC determined that the carrier was entitled to apportion 40% of ongoing expense. The JCC also expressly limited any fees to only the issue of obtaining ongoing palliative care.

Wilkinson v. World Impex Trading Corp/Sentry Ins.
Gregory D. White
JCC Pitts awarded a $14,750.00 fee based on $250.00 per hour. The Judge rejected entitlement to a fee for obtaining payment of a supplemental benefit. The failure to pay was an oversight and the carrier corrected within 30 days of the filing of the Petition for Benefits. Likewise, the Judge rejected the Claimant’s counsel’s argument that the Claimant should pay a fee based upon the full value of the 5% supplemental until 62 noting it was an issue promptly corrected and that the carrier had previously paid a fee on permanent total disability which would have included the supplemental. A claimant paid statutory fee was awarded on the amount of the underpayment.

Robert Bend v. Shamrock Services/Zenith
Rex A. Hurley
JCC Terlizzese denied benefits to the Claimant, finding the insurance contract between the Zenith and the Employer was void based upon employer fraud. The Employer completed an application stating they had a lawn maintenance business and that no travel beyond sixty miles would occur. In actuality, the Employer ran a statewide commercial painting company. The Judge accepted the carrier testimony that they do not write coverage for high risk jobs such as commercial painting and would not have written the coverage. Alternatively, the JCC found the Claimant was not an employee of the Employer engaged in lawn maintenance but was employed, if anything, in a separate statewide painting company.

Steedly v. Volusia County School Board/USIS
William H. Rogner - As Expert Fee Witness
JCC Portuallo awarded an appellate fee of $23,540 (85.6 hours @ $275 an hour). The JCC awarded only 4.65 hours to the trial counsel for his appellate involvement @ $250 and hour, finding much of his time duplicative. The JCC rejected the claimant’s appellate attorney’s argument that he should be awarded between $300 and $500, as he was a Miami attorney and should be awarded Miami rates. The JCC accepted Bill Rogner’s opinions on most issues, and noted his research into hourly rates both in the locality and across the state was more extensive than that of the claimant’s fee expert. He denied the claimant’s objections that Bill’s opinions were inadmissible.

Williams v. Archer Western Contractors/Gallagher Bassett
Matthew W. Bennett
JCC Lazarra denied over nine months of requested temporary partial benefits, based on the Claimant’s failure to job search. The JCC awarded payment of medical bills and authorization of physician as claimant’s one time change. The Judge held that the physician was statutorily authorized due to carrier’s failure to timely authorize a replacement. The Judge found it was unnecessary for the carrier to have a specific request for a one time change in writing once the carrier had actual knowledge of the request for a one time change that had previously been requested by email. The Judge denied transportation as premature as no claim for mileage had been submitted.

McLean V. McLane Grocery/Sedgwick CMS
Michael S. Waranch
JCC Sculco approved E/C motion to enforce settlement. Claimant had been initially represented. The claimant signed letter from that attorney regarding terms of settlement. Claimant then retained a second attorney to try and get out of settlement. The JCC rejected the claimant’s arguments that the letter did not evidence the E/C’s assent to settlement, and that the documents operated to amend the agreement of the parties.

Garcia v. Crum Services/Broadspire/Crum & Forster
Geoff Curreri
Complete denial of benefits. The claimant alleged multiple injuries from an assault at work. The JCC had to resolve the testimony of two employer reps vs. the claimant. The JCC was clearly unimpressed with the employer reps, and noted he doubted the legitimacy of the alleged reasons for terminating the claimant. However, the JCC similarly rejected the claimant’s rendition of injuries from a fight. He carefully examined the evidence, including the claimant’s prior WC fight related claim, and found there was no evidence to substantiate his WC claim.

Davila v. Osceola County Sheriff/Unisource
Rex A. Hurley
In a lengthy order, JCC denies compensability of two accidents that claimant sought to relate to hypertension. The claimant, a corrections officer who had been transferred to a different role when the jail closed, suffered a couple of syncopal episodes. None of the physicians definitively related the syncopal episodes to the Claimant’s high blood pressure. The syncopal episodes were the cause of the claimant’s disability, not the hypertension. Therefore, the Judge denied compensability.

Floyd v. Gulf Coast Enterprises/U.S. Fire Insurance
Julie C. Bixler
JCC Winn denied approximately 10 months of TPD, finding the claimant failed to prove the MCC of her wage loss was the industrial accident. The claimant worked for a federal contractor who was required to have at least 70% of their workforce be disabled. After a fall, the claimant was given restrictions. The employer testified they accommodated every restriction. The Judge accepted that testimony, coupled with the testimony that the claimant terminated her work due to an unwillingness to perform modified jobs. The Judge also noted the claimant had not looked for work during the claimed period and rejected the argument that applying with the State for assistance in obtaining employment satisfied her burden.

Correa v. Finishing Systems of Florida/Amerisure
William H. Rogner
JCC Langham denied compensability of alleged accident and injury. The claimant alleged all the way up until trial that his accident and resulting injuries occurred on April 5th. At trial the claimant sought to amend the accident date to March 29th. The JCC agreed to allow the amendment, and allow the E/C 90 days to conduct further discovery. The E/C withdrew their objection and proceeded to try the case. The JCC found the claimant's "evolving" story regarding the accident and resulting events incredible, and accepted the testimony of four live employer witnesses.

DeOliveira v. Progressive Employer Service/USIS
Robert S. Gluckman
JCC D’Ambrosio. All benefits denied to unrepresented claimant.

Vasquez v. Southeast Personnel/Packard Claims
Robert S. Gluckman
JCC Kuker denied all pending claims. The claimant was a delivery driver injured in a compensable MVA. After the accident, the claimant had restrictions. The E/C offered work within those restrictions, which the claimant refused. The JCC further accepted the testimony of authorized doctors that the claimant had no current work restrictions. The Judge denied the claim for a one time change, finding the carrier timely authorized the claimant’s change following a written request.

Duke v. Select PEO/Providence Property & Casualty
Gregory D. White
JCC Hofstad granted E/C motion to enforce settlement agreement. The Judge found the claimant knowingly entered into a settlement, and no contingencies existed to excuse enforcement.

James v. ELS/EastGuard Insurance/Americhase
Gregory D. White
JCC Portuallo denied compensability based on no employer/employee relationship. Alternatively, the Judge found the claimant was not due any benefits due to misrepresentations regarding his prior drug use. The E/C also proved the claimant was not due benefits per a failed drug test, without a presumption. The carrier was not afforded the presumption, under F.S. §440.09(7), because the drug test was not forensic, but rather for medical purposes. The E/C established chain of custody, and the Judge found the E/C established their burden that the accident was occasioned primarily by the intoxication of the employee.

Hidalgo v. The Simplex Group/USIS
Robert S. Gluckman
JCC Lewis denied compensability of claimant’s right shoulder condition. The E/C had accepted the neck and left shoulder. The JCC also awarded payment of an MRI of the left shoulder that had been initially authorized, but deauthorized after it was performed. The JCC also awarded neurological and psychiatric evaluations based on the claimant’s compensable conditions.

Newton v. 1st Fire & Security/Providence Property & Casualty
Paul L. Westcott
JCC McAliley dismisses Petitions for lack of prosecution. The Judge found that prior voluntary dismissals were a nullity since all issues were not dismissed. The Judge undertakes an analysis of the evolution of the case law, statutes and rules regarding voluntary dismissals but ultimately decides that no action was taken in a year and the claimant’s counsel was not mislead in any way that would have prevented him from pursuing prosecution of the Petitions or issues. The Judge notes that the impact on the claim for attorney’s fees remained to be determined.

Cortez v. Fern Park/Crum & Forster
Andrew R. Borah
JCC Farrell (Orlando) – denied claims for TP/TT. The judge found no requisite causal connection for alleged wage loss. The claimant looked for one job in one year, and applied for SSD based upon an unrelated back condition.

Martinez v. Southeast Personnel/Packard Claims
Robert S. Gluckman
JCC Castiello (Miami)– total denial of all claims. The claimant had a compensable accident with multiple alleged body parts. During the course of treatment, complaints migrated from the left side to the right side. The Judge noted multiple inconsistencies with the claimant’s testimony, found all his complaints had resolved and no interpretation of the evidence supported any of his multiple claims.

Roncero v. Bulk Express/Providence Property & Causalty
Zal Linder
JCC Medina-Shore (Miami)denied all requested indemnity to claimant. The claimant treated with numerous doctors. The JCC found that although the claimant disagreed with his full duty status, there was no admissible medical testimony to support an award of indemnity.

Menchaca v. Creative Insurance/SUA Claims
Robert S. Gluckman
JCC Medina Shore (Miami) denied all benefits sought. The JCC denied the claimant’s attempt to introduce an IME report, sustaining the E/C authenticity argument. The JCC accepted testimony that there was no ongoing MCC for any alleged complaints, but noted that as the E/C had timely authorized a 1x change, the claimant could still go to that Dr.

Garcia v. Frank Crum
Dominic C. Locigno
JCC Hill (Miami) denies compensability based on lack of notice, accepting the testimony of supervisors and co-workers over that of Claimant regarding whether the claimant ever reported the injury.

Villamil v. O2HR/Providence Property & Casualty
Paul L. Westcott
JCC Punancy. Total denial of benefits.

Parkes v. Covenant Transport/Gallagher Bassett
Scott B. Miller
JCC Hofstad awards E/C costs of $823.

Carcamo v. Business Representation International/North River Insurance
Robert S. Gluckman
JCC Harnage denied temporary indemnity benefits and an adjustment of the average weekly wage. The Judge found the claimant resigned his employment after being suspended for abandoning his duties. The Judge rejected the Claimant’s testimony that he had performed a job search.

Ford v. Placita Supermarket /USIS
Michael S. Waranch
JCC Portuallo denied benefits to the claimant, finding the Claimant failed to provide notice of the accident. The Judge further found there was no accident in the course and scope of employment. The Judge found the claimant’s testimony lacking credibility, noting conflicts with the testimony of the physicians as to her complaints and limitations. Her testimony also conflicted with co-workers and supervisors. The Judge engaged in a moderately entertaining analysis of why the Claimant, a convicted felon, was less credible than one of the other witnesses, also a convicted felon.

Capps v. Enterprise Rent A Car/Frank Gates
W. Rogers Turner, Jr.
JCC Remsnyder awarded $200 an hour fee related to PTD award. The judge accepted evidence of prior JCC orders in that district awarding $200 an hour, with the most recent order from 2006.

Pruitt v. Southeast Personnel/Packard Claims
Robert S. Gluckman
JCC Medina-Shore denied an adjustment to the average weekly wage and change in primary care physicians. The Judge rejected the Claimant’s assertion that the average weekly wage should be based upon the contract of hire, finding the claimant worked 75% of the usual and customary hours during the 13 weeks preceding the industrial accident. In denying the change of PCP’s, the Judge noted a mediation agreement wherein the carrier agreed to authorize a change. Although this was not done within five days of request, the agreement did not specify the claimant would select and the claimant never did select. The carrier authorized a provider. The Judge awarded a five day period of temporary partial benefits, although there appears to be an absence of medical evidence to support the award. The Judge rejected a misrepresentation defense, finding the claimant’s statements regarding the time periods he worked after the accident were not intentionally false.

Alcazar v. National Employer Services/Southeast Services
Timothy F. Stanton
JCC Spangler denied all temporary benefits sought. The JCC found that the claimant's combination of Unemployment Benefits and TPD exceeded what he was owed, and the claimant has been overpaid $1600.

Escobar v. Frank Crum
Paul L. Luger
Obtained a total denial of benefits.

Iommelli v. Tuttle Electric/Safeco
Robert J. Osburn, Jr.
JCC Beck denied payment of multiple medical bills claimed. The Judge found that the carrier had not denied the medical necessity of the treatment, but instead the issue involved utilization review. Therefore, the issue should be handled through the utilization review procedures and not through workers’ compensation. Of note, the physician in this claim had actually purchased the claimant a one month YMCA membership and purchased $16,000.00 worth of laser therapy equipment in an attempt to benefit the patient. The case does an excellent job spelling out how to set up utilization review as compared to denied care.

Green v. Modern Business Associates/ICA
Gregory D. White
JCC Hofstad awarded hand therapy based on the EMA opinions, finding no clear and convincing evidence to the contrary. However, the Judge denied all requested indemnity. The claimant was incarcerated post accident and secured employment immediately upon release. On that application he asserted he could lift whatever the job required. He worked that job for two months, quit without notice and did not work thereafter. The JCC agreed that there was no causal connection between the accident and any loss of income.

Van Der Borg v. Duamex/Hortica
Rex A. Hurley
JCC Medina-Shore issued a total denial of claims for compensability, temporary and PTD benefits and medical benefits including attendant care. The JCC agreed that the owner/officer of the corporation was not covered under the employer’s WC policy. She agreed the carrier did not collect premium on the claimant’s alleged wages, nor did they know of the sale of the company, as the claimant alleged alternatively he was performing work for the successor company as an employee. The JCC rejected the claimant’s testimony as incredible re: prior injuries, reporting to the ER and initial treating doctors about his current injury, and other aspects of the claim, noting his story changed depending on the benefits he was seeking.

Calvay v. Frank Crum
Dominic Locigno
JCC Lewis denied bifurcated compensability issue. The JCC weighed testimony of the employer and the claimant regarding alleged notice of the case. The E/C also sent the claimant to an IME, who reviewed pre and post date of accident medical records, and testified the claimant’s reports of onset of symptoms to him conflicted with the medical records.

Baranovic v. Employee Leasing Solutions/Americhase
Gregory D. White
JCC Harris denied all benefits to claimant whom she determined was not credible. The judge determined the claimant’s prior cervical surgery and significant ongoing treatment was at odds with his statements to doctors and in deposition. Additionally, she noted the claimant’s presentation on surveillance exceeded his reports of his capabilities to physicians. She did not rule on the E/C fraud defense, despite apparent ample evidence.

Alcazar v. Southeast Personnel/Packard Claims
Anthony M. Amelio
JCC Lewis awarded fees to be paid to the carrier by the claimant attorney of over $4300, as a sanction for maintaining a frivolous action. The JCC considered several other prior fee sanction orders against the same claimant attorney, noting the sanction was necessary to deter further similar conduct.

Gordillo v. Frank Crum & Frank Winston Crum Ins.
Dominic C. Locigno
JCC Pecko granted employer/carrier’s Motion to Enforce and dismissed all Petitions for Benefits with prejudice against Claimant. The Judge accepted the testimony of Claimant’s prior counsel that he had informed the Claimant of the specific terms of the settlement. This testimony was supported by written documentation advising the Claimant what he would receive. The Judge rejected the Claimant’s deposition testimony that he never authorized a settlement and was unsure of the terms of the agreement, noting that the Claimant’s testimony was inconsistent. The Judge discharged a Show Cause Order entered against the Claimant for failing to attend the hearing, after receiving a letter stating the Claimant had overslept because he had been up all night because of pain, but mildly scolds the claimant in a footnote for not making arrangements to make sure he woke up for an evidentiary hearing.

Edmond v. Oslo Citrus Growers/FFVA Mutual Insurance
Anthony M. Amelio
JCC Terlizesse denied all claims to unrepresented claimant. The Judge found the claimant made material misrepresentations regarding her past medical condition and history.

LeCount v. Employee Leasing Solutions/East Guard Insurance Group
Gregory D. White
JCC Portuallo denied all benefits to claimant based on misrepresentation. The JCC excerpts several passages from the claimant deposition that effectively committed the claimant to his testimony that he never had prior low back or hip problems. The prior medical records clearly indicated otherwise, and the Judge rejected assertions by the claimant that such inconsistencies were the result of mistake or forgetfulness.

Wimberly v. Winn Dixie/Sedgwick CMS
Derrick E. Cox
JCC Hofstad denied authorization of all medical care requested by the claimant as it was barred by the doctrine of res judicata. However, the Judge did find the carrier responsible for provision of a splint which the carrier had already paid for, prior to the filing of the Petition for Benefits. The Judge rejected the carrier’s argument that the splint was paid for in error and barred by the statute of limitations, noting that initially the splint was denied and then paid for.

Jones v. Burger King/Sedgwick CMS
William H. Rogner
JCC Terlizzese found the claimant did not sustain an injury by accident in the course and scope of employment. The Judge ordered the claimant to pay for an EMA with Dr. Stolzer, following the claimant’s “notice” or suggestion of conflict. The EMA found no injury, disability or impairment. The Judge further rejected the claimant’s contention that the ER records following the slip and fall contained objective medical findings, holding they contained only subjective complaints and treatment plans.

Lamarre v. Lake Bennett Health & Rehab/Premier Group Insurance
W. Rogers Turner, Jr.
JCC Farrell awards minimal period of TP. The judge awarded approximately $536 in TP during a partial period where the claimant remained employed at the employer, but with restrictions. The judge accepted her testimony that her reduced hours were due to the work injury over the employer’s testimony that the claimant could have worked as many hours as she wanted. The judge rejected the E/C defense that the claimant’s termination was for “misconduct”, finding her merely a poor employee. The judge did, however, accept the E/C voluntary limitation of income defense, finding that the MCC of her wage loss post termination was not the restrictions from the accident. The claimant admitted some work within her restrictions that actually paid more after termination, and she testified no doctor had instructed her not to continue to do that job.

Knight v. Employee Leasing Solutions/Americhase
Gregory D. White
JCC Lorenzen denied temporary indemnity benefits to claimant, finding that he remained at MMI until he could undergo a recommended surgery. The Claimant had surgery to foot with hardware. He was placed at MMI after the surgery. He saw other physicians and another surgery was recommended. There was a dispute with the hospital refusing to accept fee schedule to perform the surgery, so other physicians were authorized. The Claimant was to quit smoking for a month before the surgery would be performed. The Claimant had only quit for two weeks at the time of the trial. As the Claimant was not improving, and would not be until the surgery, the Judge found the Claimant remained at MMI until the surgery actually took place.

Martinez v. Conco, Inc./Amerisure
Anthony M. Amelio
JCC McAliley judge denied the claim based on a lack of medical evidence. Previously, the judge had also ruled that while the claimant was not compelled to answer questions about an allegedly false SS#, such refusal created a rebuttable presumption that the SS# was used to obtain benefits.

Baranovic v. Employee Leasing Solutions/The Guard/Americhase
Gregory D. White
JCC Harris denied claims for TP and authorization of a neurosurgeon in an abbreviated order.

Socorro v. Southeast Personnel/Packard Claims
Jonathan L. Cooley
JCC Spangler denied approximately eleven months of temporary benefits to claimant. Following the accident, the claimant continued to work for a period of time until terminated. The circumstances of her termination were disputed, but the judge accepted the employer’s version of events. The judge found the loss of income post termination was not related to the industrial accident

Bray v. City of Coconut Creek/Employer's Mutual Inc.
Geoffrey Curreri
Total denial of compensability JCC Lewis found the claimant to be incredible, noting multiple inconsistencies. The judge rejected the claimant explanations for deposition testimony contrary to his trial testimony (that the E/C attorney was trying to “confuse his mind”). The judge also noted that the E/C attorney reminded the claimant that he was under oath and was subject to the penalties of perjury. Based upon the denial of compensability, the judge found it unnecessary to rule on the fraud defense.

Whitmore v. FPL/Helmsman Management Services, Inc.
Allison M. Twombly
JCC Sturgis reduced attorney’s claimed hours, and accepted E/C’s evidence of $200 per hour for appellate fee, versus the $300 per hour sought by the claimant attorney.

Moya v. Trucks & Parts of Tampa, Inc./Ameritrust
Gregory D. White
Judge Jenkins denied authorization of psychiatric care. In doing so, the Judge rejected the employer/carrier’s res judicata defense, but found the industrial accident was not the major contributing cause of the Claimant’s psychiatric condition. The Judge accepted the opinion of the Carrier’s IME over that of the Claimant’s IME, as the Claimant’s IME only relied on records of an unauthorized provider (which were not admitted into evidence) and rendered no real opinion of his own.

Vences v. Employer Leasing Solutions/Americhase Services
Gregory D. White
JCC Portuallo denied benefits based on false SS#. Claimant gave a false SS# to authorized medical providers. The JCC discussed the claimant’s responsibility to be truthful, and found the E/C proved he did so to obtain WC benefits.

Wimberly v. Winn Dixie/Sedgwick Claims
Derrick E. Cox
JCC Hofstad awarded carrier costs as the carrier was the prevailing party, but struck the cost of the EMA finding the statute governing payment of the cost of EMA is more specific and controls over the more generic prevailing party costs provisions.

Baxley v. Apalachee Correctional Inst./Division of Risk Management
Julie C. Bixler
JCC Lazzara denied electrodiagnostic studies as well as a physical therapy, a walker and a shower chair. The Judge found that the accident from over five years ago was not the major contributing cause of the claimant’s current need for treatment. Additionally, in denying the electrodiagnostic studies, the Judge found that while they might show whether the claimant had nerve involvement, they would not be able to demonstrate a causal relationship. The case outlines how “medical necessity” based upon the carrier’s failure to timely respond does not eliminate Claimant’s burden on major contributing cause.

Kuchta v. Tradesmen International/Specialty Risk Services
Paul L. Westcott
JCC MacAliley denied all benefits to the claimant. The claimant offered multiple versions of how his elbow problems began, and offered multiple dates as to when it might have happened. The claimant also alleged repetitive trauma. Referring to the claimant’s relation of events to a doctor several days after and alleged event as an “epiphany”, the JCC found the versions of events incredible, and noted the claimant had failed to sustain his burden to prove entitlement to any benefits.

Alcazar v. Southeast Personnel/Packard Claims Administration
Anthony M. Amelio
JCC Lewis awarded fees and costs (amount to be determined later) against the claimant attorney. The JCC had previously denied compensability following a merit hearing in November of ’07, The claimant then filed a new PFB in January of ‘08, seeking a determination of compensability. This was denied as well in May of 2008, and the claimant appealed that ruling. That appeal was denied by the First DCA. The judge awarded fees and costs as a sanction under F.S. §440.32(1), finding the PFB was filed without reasonable grounds. The JCC rejected the claimant’s arguments that the PFB was not barred by res judicata (the basis of the May ’08 denial of the PFB). The judge also rejected the claimant’s arguments that second attempt to litigate the compensability, (allegedly based upon “new medical evidence), was not proper.

Peavy v. Zenith
Robert J. Osburn
JCC Murphy denied all benefits based on misrepresentation defense. Claimant made multiple, significant misrepresentations including denying complaints nearly identical to those allegedly related to comp claim, despite having treatment only weeks prior to the accident.

Clark v. Southeast Personnel/Packard Claims
Jonathan Cooley
Judge denied authorization of cervical disc replacement surgery and/or fusion finding same not medically necessary but awarded temporary indemnity from d/a forward. The Judge does not really address the major contributing cause argument as it related to the surgery, but in awarding temporary indemnity noted it is inconsistent that the carrier has continued to provide some benefits but defends others on the grounds of major contributing cause. JCC rejects apportionment defense.

Pla v. Point Blank/MDC Products & Sentry Claims
Gregory D. White
JCC denies request for continued authorization of Dr. Roberts and the request for an alternative doctor raised for the first time at trial. Claimant, via PFB requests continued authorization of Dr. Roberts, the pcp. Dr. Roberts had retired. At first, Claimant is advised to go to clinic that purchased Dr. Robert’s practice. However, it appears as though the Claimant had previously treated with the physician of that clinic before using her one time change to Dr. Roberts. A different clinic is authorized several months later. Claimant argues since E/C did not provide new physician within five days of learning Dr. Roberts retired, they should get to choose. JCC rejects argument as Claimant had already had one time change and no evidence of a written request for an alternative was admitted.

Koifman v. Ameritech/Providence Property Casualty
Zalman Linder
JCC denies temporary partial disability benefits finding claimant failed to establish with medical evidence that loss of earnings was caused by the industrial accident. JCC further finds that Claimant was terminated for misconduct, specifically failing to perform at least three jobs to code and when confronting his employer about payroll concerns, threatening to “shoot up the place.” Claimant also didn’t return DWC-19’s. Claimant’s last minute efforts to obtain continuance was denied. Had claimant timely tried to line up an IME, they would have realized that the one they chose, Dr. Stone wanted a total of more than $1,800 dollars and could have timely lined up an alternative.

McNatt V. Brevard County/PGCS
Derrick E. Cox
JCC awards costs in the amount of $3,231.44 to E/C based on prior order denying compensability. Rejects Claimant’s counsel’s argument that deposition costs are not awardable to E/C per s. 440.30.

Linares v. Southeast Personnel/Packard Claims
Robert S. Gluckman
Total denial of benefits; JCC finds claimant refused to take drug test; further finds claimant made false and misleading statement re. his prior drug use, which was made for the purpose of obtaining benefits

Ruiz v. Camayen Cattle Company and Crum & Forster
Anthony M. Amelio
JCC McAliley – Total denial of compensability for injuries allegedly caused by repetitive trauma of riding a tractor; claimant fails to sustain burden; JCC accepts medical opinions that claimant’s post polio syndrome explains all of conditions

Mulgrew v. Labor Finders and The Hartford
Anthony M. Amelio
JCC McAliley - Case denying compensability of alleged foot injury from same accident as compensable wrist injury; JCC notes numerous inconsistencies in claimant’s testimony, calling his recollection of events “untrustworthy, even puzzling”

McNatt v. Brevard County & Preferred Governmental Claims
Derrick E. Cox
JCC Terlizesse – Total denial of presumption case; finds no occupational cause; accepts opinions of Kakaar over Mathias; finds Mathias opinion lacked sufficient foundation and was not based on all the facts

Thompson v. First Financial Employee Leasing/Unisource
Gregory D. White
JCC Condry – GDW total winner; rejects claimant’s testimony, considering multiple inconsistencies re: actual DOA, alleged reporting and other issues.

Monroy v. ASP Framing/Usis & GM Group Const./FCIC
Rex Hurley
JCC Sculco - Obtains ruling that GM/FCIC not the claimant's employer, July 15, 2008

Campos v. S.E. Personnel Leasing/Lion Insurance/Packard Claims
Anthony M. Amelio
JCC Harnage - Total denial of benefits based upon evidence of claimant's multiple misrepresentations regarding prior lumbar injuries to authorized physicians and in deposition

Harrison v. Coronet Industries/U.S. Fire and Casualty
William H. Rogner
JCC Jenkins - Total denial of compensability for alleged cardio-pulmonary disease and cervical injuries.

Jackson v. VNA of Treasure Coast/FCCI
Anthony M. Amelio
JCC denies claim for compensability of low back injury and associated medical treatment; finds claimant failed to sustain her burden to prove causal relationship

Chamness v. Cargill/SRS
Michael S. Waranch
JCC Sculco - total denial based on misrepresentation; claimant questioned extensively in depo re. gym membership and working out; claimant denied; requested errata sheet which initially did not correspond to correct page numbers; two months later changed some but not all answers concerning gym memberships and working out; JCC finds errata sheet does not make initial answers disappear; rejects claimant explanations that he did not understand questions and that Vicodin clouded his mind;

Paulding v. Brooksville Healthcare/Premier Group Ins.
W. Rogers Turner, Jr.
JCC Murphy – total denial of benefits; JCC finds claimant misrepresented her prior condition and medical history for the purpose of obtaining benefits.

Burgess v. Buckhead Beef/Sentry Ins. Co.
Gregory D. White
JCC Terlizzise – total denial of ongoing benefits; JCC denies claimant's attempts to have doctors testify by phone; denies attempts to offer unauthenticated records into evidence; rejects claimant’s lack of recall re. pre-injury permanent restrictions assigned by Dr. Martinez; Martinez emphatically testified those restrictions were personally communicated to claimant

Lewis v. Employee Leasing Solutions / ICA
Gregory D. White
JCC Thurman – denies all futher benefits based on claimant’s adamant denial of prior low back pain or problems, which was false, fraudulent and misleading in light of evidence to the contrary.

Wimberly v. Winn Dixie
Derrick E. Cox
Petition for Benefits dismissed and denied for compensability of subsequent alleged accident, repetitive trauma, and medical treatment.

Alcazar v. Southeast Personnel Leasing, Inc.
Anthony M. Amelio
Claimant failed to present competent substantial evidence proving causal connection between claimant's employment to alleged injuries.

Auman v. Spectrum HR
Gregory D. White
Claimant had separate IA’s to separate body parts and sought 104 weeks for each injury, although disabilities ran concurrently. JCC awarded disability in addition to 104 weeks, but declined to rule that each injury resulted in additional potential 104 weeks.

Richards v. One Eleven Grill Inc/Zenith Insurance
Matthew W. Bennett
JCC found, based upon medical testimony that Major Contributing Cause of claimant's back condition was pre-existing, denied further benefits

Braun, Mark v Brevard County Board of Commissioners
Derrick Cox
Judge Terlizzese denied treatment, bills, mileage and further treatment for claimant’s back condition

Pearson v. Gevity HR
Robert S. Gluckman, Esq.
JCC denies compensability of treatment for knee condition finding Major Contributing Cause of need for treatment to be underlying, unrelated avascular necrosis; denies temporary benefits, attorney fees and costs.

Brown v. Velda Farms, Inc.
W. Rogers Turner, Jr. & Matthew W. Bennett
Employer/Carrier awarded full amount of net tort recovery from third party lien

Cooper v. Discount Auto Parts, Inc.
Andrew R. Borah
Denial of Psychiatric Care

Hernandez v. First Financial Employee Leasing
Andrew R. Borah
Motion to stay workers' compensation proceedings denied

Meija v. Prince General Contractor
William H. Rogner
Claim denied based upon false or misleading statements

Rosemary Furek v. Bayonet Point Health and Rehab/Premier Group Insurance
W. Rogers Turner, Jr.
Accident not in the course and scope of employment/ Claim denied based upon false or misleading statements

Annie Bews v. Eckerds/AIG
W. Rogers Turner, Jr.
Permanent total disability benefits denied

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