Glazier v. KRK Enterprises / AYS Employee Leasing / AmTrust North America of Florida

HR Law Cases

JCC Dietz (Sebastian) (Paul Terlizzese)(12-29-21) – Denied Medical Benefits. The claimant sought authorization of lumbar facet injections as recommended by his IME Dr. Krost as well as a lumbar fusion as recommended by authorized physician, Dr. Popp.  The E/C asserted a number of defenses including medical necessity, major contributing cause and apportionment.  EMA Dr. Lenard opined that there was no objective sign of any lumbar injury related to the work accident, that no more lumbar injections were reasonable, medically necessary or related to the work accident and that no more care was needed for the lumbar spine due to the work injury.  The claimant raised a 120-day/estoppel argument which the JCC held did not apply as compensability of the accident was never denied and there was no evidence that the E/C ever accepted or authorized care for the claimant’s pre-existing lumbar conditions other than to treat an exacerbation/aggravation.  Dr. Popp also testified that the lumbar fusion was needed due to pre-existing conditions and that that 60% of the need for care was related to pre-existing conditions and 40% to the work accident.  Claimant’s counsel timely raised Daubert objections to this apportionment testimony which the JCC sustained, finding Dr. Popp’s opinions regarding apportionment were based on pure opinion.  The JCC denied the injections and surgery accepting the opinions of the EMA, but awarded fees to claimant’s counsel for overcoming the affirmative apportionment defense raised by E/C.       Click here to view Order