Blanco v. Duke Energy / Sedgwick CMS
JCC Young (St. Petersburg) (Scott Miller for the E/C) (4-12-21) – Denied claimant’s request for authorization of gastrointestinal specialist and omeprazole, compensability of gastrointestinal condition, attorney’s fees and costs. The claimant was treating with Dr. Craig Bennet for cervical and shoulder complaints. After being placed at MMI, the claimant continued to have increased pain with movement and lifting. Dr. Bennett prescribed Mobic and two months later, the claimant returned with complaints of swelling in her feet, legs and her abdomen, digestive issues, and weight gain. She was advised by MedExpress that the Mobic medication could be the cause of her symptoms. The claimant subsequently filed a PFB seeking compensability of a gastrointestinal condition and authorization of gastrointestinal specialist. Dr. Bennet discontinued the Mobic Mediation and advised the claimant that if her symptoms continued, she should consult a gastroenterologist as it would not be related to her workers’ compensation injuries. The Claimant filed a claim for authorization of a gastrointestinal specialist, compensability of her gastrointestinal condition and authorization of Omeprazole on May 16, 2019. When the Claimant returned to Dr. Bennett on October 2, 2019, he documented no complaints of continuing abdominal pain or swelling. The claimant obtained an IME with Dr. Jawahar Taunk, who opined the Mobic “could” be the MCC of her GI issues, but testified it “could” have also been caused by the claimant’s unrelated dysphasia, GERD, and Irritable bowel syndrome. The JCC determined that the claimant failed to present competent or substantial evidence that the major contributing cause of a gastrointestinal condition, claim for gastrointestinal specialist or claim for Omeprazole was the industrial accident. https://www.jcc.state.fl.us/Finals/16028649_229_04122021_04475317_i.pdf |