Steier v. Winn-Dixie Stores, Inc. / Sedgwick CMS
JCC Grindal (Sarasota) (Jonathan Cooley)(6-6-22) – Denied authorization of orthopedic evaluation. The claimant’s compensable accident involved falling forward onto her outstretched arms, resulting in injuries to her chest, right knee, left knee and lip. Nineteen days later, the claimant complained of right shoulder pain. She admitted to a prior injury to the right arm in 2011 which had since resolved. The parties agreed to admit the records from the treating physician who requested authorization to treat the right shoulder but did not opine as to whether those complaints were causally related to the accident. The parties also admitted records from the authorized orthopedist who treated the claimant for six months and who did not reference any right shoulder complaints or the need for an evaluation of the right shoulder. The parties submitted no medical testimony. The claimant argued that since she was only seeking an evaluation, then there was no need for evidence of causation or medical necessity. The JCC ruled that the claimant’s argument only applies when there is medical evidence that an evaluation is necessary to determine if the condition is causally related to the accident. Since there was no such evidence, and no evidence of causation or medical necessity, the request for authorization of a physician to treat the right shoulder was denied. Click here to view Order