Gil v. Penguin Hotel Management, LLC / Associated Industries Insurance Company and AmTrust North America
JCC Havers (Miami) – (Andrew Borah) (6-9-25) – JCC denied claims for compensability and treatment for left shoulder due to being barred by res judicata. The claimant was a 75-year-old housekeeper who slipped and fell on her back. The claimant received emergency treatment for a T-12 fracture and then subsequently complained of left-shoulder pain, however, E/C only accepted compensability of T-12 fracture and provided authorized treatment for such. After providing years of treatment, E/C issued a denial for all further treatment due to the accident. After the denial, the claimant filed a PFB requesting authorization of a follow-up visit to the authorized doctor. That claim proceeded to a final hearing on 2/15/23 without the claimant seeking compensability or treatment of the left shoulder. The JCC denied the claim for a follow up visit to the authorized doctor and then the claimant filed a PFB seeking compensability and treatment for the left shoulder. The E/C argued that this claim was ripe, due and owing at the 2/15/23 final hearing and since the claim was not litigated then, the claim is barred by the doctrine of res judicata. The JCC agreed and held the claims for compensability and treatment for left shoulder are barred by the doctrine of res judicata. Click here to view Order