Ugarte v. Vintro Hotel South Beach / Technology Insurance Company / AmTrust North America of Florida

HR Law Cases

Andrew R. Borah


JCC Medina-Shore (1-11-18) – Denied compensability. The claimant alleged a repetitive trauma injury to the right wrist working as a housekeeper for about 2 months with Employer. The E/C denied all benefits asserting MCC. The claimant argued the E/C was estopped from raising the defense as they failed to comply with the 120 day pay and investigate provision of 440.20(4). The E/C’s Response to the first PFB accepted compensability of the accident under the 120 rule and agreed to authorize Dr. Cummings for care. The claimant saw Dr. Cummings first on 5/24/17 and the JCC asserted the 120 day clock started at that time. The doctor’s notes relate the claimant’s condition to the IA. The E/C spoke with the doctor thereafter providing additional facts of the claimant’s work history and he opined that the MCC of the claimant’s condition and need for care was not the IA. The E/C denied all benefits requested on 6/14/17. The JCC held that the E/C was not estopped from asserting an MCC defense in this case even though they did not pay the claimant indemnity after her 5/24/17 visit when she was assigned restrictions because there was no evidence that the claimant’s wage loss was related to the accident as Dr. Cummings testimony was unrefuted.
View JCC Merits Order