Hector v. Latin Cafe Restaurant / AmTrust North America of Florida

Andrew R. Borah

JCC Medina-Shore – Miami (4-10-19) – Granted authorization of PCP for lumbar spine; granted entitlement to fees; dismissed PFBs with prejudice. While working as a waitress for the insured, Claimant slipped and fell, injuring the back of her head, right shoulder, elbow, low back and finger. Although a NOI was filled out that day, Claimant did not seek medical care until three months after the accident based on her dislike of doctors and hope that her pain would improve over time. E/C authorized Rite Care Clinic, followed by an ortho, Dr. Steiner, to treat Claimant’s compensable right shoulder, elbow and low back pain. Dr. Steiner referred Claimant to, and E/C authorized, Dr. Baylis, a shoulder specialist, who subsequently performed shoulder surgery, and Claimant reported improvement to her shoulder but not to her low back. The JCC rejected the employer rep’s testimony that the Claimant did not report her lower back, and accepted the Claimant’s testimony that she reported the entire side of her body. He further found that Claimant reported her low back pain to Dr. Steiner and Dr. Baylis, and that the work accident was the MCC of Claimant’s need for care. Claimant’s IME, Dr. Suite, examined Claimant’s lumbar spine, opining that Claimant suffered an aggravation of a PEC, and opined that the work accident was the MCC for Claimant’s need for care.
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