Case Law Update June 2024
Updated 6-28-24
Ongoing Compensability
Palm Beach Cty. School Brd./Sedgwick v. Josaphat, ___So.3d___(Fla. 1st DCA 6/12/24)
Claimant received initial treatment for a 1/21 compensable right-wrist sprain for several months. A year after the last treatment, the E/C denied a request for additional orthopedic and PCP treatment. The E/C asserted that no further treatment was warranted and ultimately the JCC awarded the requested treatment. The DCA reversed, analyzing the medical necessity, MCC and the claimant’s burden of proof. They held the claimant did not establish MCC, and that all three doctors testified the claimant reached MMI and required no further treatment. The DCA specifically disagreed with the JCC’s finding that the E/C was prohibited from denying the cases under the 120-Day Rule, noting the E/C can argue the injury is no longer the MCC of a need for treatment and other benefits. They also addressed the JCC’s reliance on a subsequently corrected medical opinion regarding the claimant’s MMI status. Click here to view Opinion