United States Fires Ins. Co./Oxford Shops of S. FL v. Hackett

HR Law Cases

Bill Rogner


The claimant’s injury occurred in 1985. Per a 1999 Final Order she received 24 hour a day attendant care from her husband and *daughter in law*, whom the E/C each paid over $31,000 a year. The claimant stopped seeing her doctor in 2012, but continued signing off on the timesheets. Thereafter, the E/C obtained surveillance which clearly showed the daughter in law was not providing the care attested to on time sheets. The E/C sought to file a Petition to Modify, alleging a change in the claimant’s underlying condition. They also sought to compel the claimant to attend an IME, so they could obtain admissible medical testimony to support their Petition. After an evidentiary hearing, the JCC found the evidence clearly showed deceit by the claimant and her family, but denied the E/C’s Petition, due to a lack of medical evidence. The DCA reversed the JCC’s ruling that the E/C cannot file a Petition to Modify for medical benefits only, and they reversed her ruling that she could not compel the claimant to attend an IME. Although a PFB is generally seen as the “dispute” which triggers the ability of the E/C to compel a claimant to attend an IME, the DCA found a Petition to Modify clearly encompasses the formal dispute requirement, and that to deny the E/C the right to obtain requisite medical evidence to sustain their burden of proof to show a change in the claimant’s underlying medical condition runs afoul of the statute’s intent to decide issues quickly on their merits.
*(erroneously identified in the DCA opinion as the daughter)*
Click Here to View Opinion