Gil v. Penguin Hotel Management / Associated Industries Insurance Company / Amtrust

JCC Medina-Shore (Miami-Dade) (Andy Borah) (2-21-23) – Denied follow-up appointment. Dr. Rajadhyaksha treated the claimant for a compression fracture of the T12 level. After the fracture healed, he opined the industrial injury was no longer the MCC of her complaints and need for continued treatment and told her to follow up with her personal physician for her degenerative spinal arthritic condition. Dr. Langone, the claimant’s IME, opined that the support mechanism of the thoracic cage was altered and the claimant would need lifelong treatment for her thoracic spine. Dr. Rajadhyaksha testified he solely treated the claimant’s T12 compression fracture and did not treat her spondylosis and degenerative disc disease. The adjuster testified that only the T12 compression fracture was accepted as compensable.  The JCC found the claimant’s pre-existing spondylosis and degenerative disc disease are the MCC of her back pain and need for further medical treatment and the E/C satisfied their burden of proof of a “break in the causal chain” between the industrial injury and claimant’s pain complaints and need for medical treatment. Click here to view Order