Case Law Update December 2021
Updated 1-3-21
| Ranger Construction/Travelers v. Brand, (Fla. 1st DCA 12/1/2021) Final Orders/Competent, Substantial Evidence The DCA made short work of the E/C appeal alleging the JCC erred in finding a compensable injury occurred. Noting “formidable evidence” of an injury by accident, the appellant pointed only to inconsistencies in that proof. The DCA noted that numerous decisions provide the standard of review in WC cases of “the existence of competent, substantial evidence supporting the decision.” Citing contradictory record evidence is simply insufficient. The DCA repeated they would not substitute their judgment at the appellate level on the JCC’s judgment of factual evidence supported by CSE. Appeals requesting such review are “baseless,” and this appeal lacked merit. Click here to view Opinion Tejeda v. City of Hialeah/Sedgwick, ___So.3d ___ (Fla.1st DCA 12/29/21) Jurisdiction of JCC/Medical Disputes/Interpretation of Prior Agreements The DCA affirmed the JCC’s jurisdictional decisionas well as the JCC’s interpretation of a prior agreement between the parties. The E/C initially provided authorized back treatment including surgeries with Dr. Brusovanik. In 2017, Dr. Vanni was authorized and Dr. Brusovanik was de-authorized. The parties stipulated “If Dr. Vanni opines that Claimant does require further surgical invention, the Employer/Servicing Agent will authorize same, and the Claimant will decide whether he wants to undergo such procedure.” The claimant subsequently obtained an unauthorized fusion from Dr. Brusovanik, with no opinion from Dr. Vanni. The claimant then filed a PFB seeking payment of the surgery and co-pays. Although the JCC’s Order found the surgery medically necessary, he denied reimbursement based upon the prior agreement. The DCA rejected the claimant’s argument (despite filing a PFB on the issue) that DFS, and not the JCC had jurisdiction over the reimbursement dispute. The DCA found that the issue did not meet the statutory definition of reimbursement dispute as the claimant was not a health care facility or provider. Additionally, the DCA found no error in the JCC’s interpretation of the parties’ prior agreement. Click here to view Opinion |