| JCC Merits Orders |
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.
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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”.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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Gordon v. Vehicare Corporation/Montgomery Ins.
Scott B. Miller
JCC Hofstad awarded taxable costs of $1,242.36 to the E/C.
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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.
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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.
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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.
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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’.”
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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DeOliveira v. Progressive Employer Service/USIS
Robert S. Gluckman
JCC D’Ambrosio. All benefits denied to unrepresented claimant.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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Villamil v. O2HR/Providence Property & Casualty
Paul L. Westcott
JCC Punancy. Total denial of benefits.
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Parkes v. Covenant Transport/Gallagher Bassett
Scott B. Miller
JCC Hofstad awards E/C costs of $823.
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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.
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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.
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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.
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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.
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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.
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Escobar v. Frank Crum
Paul L. Luger
Obtained a total denial of benefits.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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
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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”
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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
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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.
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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
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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
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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.
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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
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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;
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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.
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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
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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.
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Wimberly v. Winn Dixie
Derrick E. Cox
Petition for Benefits dismissed and denied for compensability of subsequent alleged accident, repetitive trauma, and medical treatment.
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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.
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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.
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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
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Braun, Mark v Brevard County Board of Commissioners
Derrick Cox
Judge Terlizzese denied treatment, bills, mileage and further treatment for claimant’s back condition
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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.
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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
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Cooper v. Discount Auto Parts, Inc.
Andrew R. Borah
Denial of Psychiatric Care
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Hernandez v. First Financial Employee Leasing
Andrew R. Borah
Motion to stay workers' compensation proceedings denied
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Meija v. Prince General Contractor
William H. Rogner
Claim denied based upon false or misleading statements
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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
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Annie Bews v. Eckerds/AIG
W. Rogers Turner, Jr.
Permanent total disability benefits denied
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