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AT&T Communications and Sedgwick CMS v. Rosso

Florida Court of Appeals, First District

May 2, 2017



          Date of Accident: February 10, 1989.

         An appeal from an order of Judge of Compensation Claims. Geraldine B. Hogan, Judge.

          Thaddeus A. Harrell of Hinshaw & Culbertson LLP, Fort Lauderdale, for Appellants.

          Barbara B. Wagner of Wagenheim & Wagner, P.A., Fort Lauderdale, and Richard B. Berman of Richard B. Berman, P.A., Lauderhill, for Appellee.

          PER CURIAM.

         The Employer/Carrier (E/C) in this workers' compensation case challenges the Judge of Compensation Claims' (JCC's) award of claims for authorization of lawn care, home renovations, attendant care for at least four hours per day, and an evaluation and treatment by a podiatrist together with the authorization of a custom AFO brace and an evaluation of the need for specialized shoes. We affirm the award for lawn care because competent, substantial evidence (CSE) supports the JCC's finding that such care will improve Claimant's compensable conditions of depression and anxiety. See Delong v. 3015 W. Corp., 558 So.2d 108 (Fla. 1st DCA 1990) (affirming JCC's finding of no medical necessity for lawn care where physician admitted that such care would not improve claimant's condition or aid in his recovery). We also affirm the awards for attendant care, a podiatrist, an AFO brace, and evaluation of the need for specialized shoes because the E/C have shown no error in the JCC's determination that the E/C forfeited the right to contest medical necessity for these items by failing to timely respond to a written request by an authorized health care provider. See § 440.13(3)(d), Fla. Stat. (2016). But we reverse the award for home renovations for the reasons that follow.

         In workers' compensation, the E/C may be responsible for providing an accessible living environment under the statutory requirement for the furnishing of "medically necessary apparatus." See Timothy Bowser Constr. Co. v. Kowalski, 605 So.2d 885, 888 (Fla. 1st DCA 1992) (citing § 440.13(2)(a), Fla. Stat. (Supp. 1988); Diamond R. Fertilizer v. Davis, 567 So.2d 451, 455 (Fla. 1st DCA 1990); Aino's Custom Slip Covers v. DeLucia, 533 So.2d 862 (Fla. 1st DCA 1988)). Thus, the issue here is whether the record contains CSE to support a finding of medical necessity for the specific home renovations that were awarded by the JCC.

         Claimant, who was seventy-three years of age at the time of the final hearing, sustained a workplace injury to her low back on February 10, 1989. Following authorized spinal fusion surgery in 2014, Claimant developed a dropped foot. She currently uses a cane to ambulate and reports problems with balance and frequent falls. Claimant subsequently hired Ms. Litwin, a registered nurse with rehabilitation experience and training, to prepare a home assessment. In the home assessment report that followed, Ms. Litwin made numerous recommendations for home renovations including ramp access, outdoor motion sensor lighting, door widening, smooth flooring, and kitchen/bathroom modifications. In the order on appeal, the JCC awarded all the home renovations recommended by Ms. Litwin.

         In support of her finding of medical necessity for the renovations, the JCC stated she relied on certain evidence from the treating psychologist and pain management physician as well as testimony from an unauthorized orthopedic surgeon. But the evidence identified by the JCC does not constitute CSE of the medical necessity for the numerous home renovations awarded here. For example, the cited report from the authorized psychologist contains a recommendation identified only as "per home study, " which imparts no information whatsoever about the medical necessity of any particular home renovation. The JCC also improperly relied on the testimony from the orthopedic surgeon who only stated that he agreed with some of the suggestions in the home assessment report, but never identified which ones.

         Furthermore, the JCC misplaced her reliance on the pain management physician's apparent deference to the opinions of Ms. Litwin. Ms. Litwin's opinion testimony, while arguably sufficient to show how a properly accessible environment may be provided, is insufficient to establish the medical necessity for the specific accommodation or assistance because she is not a physician. In this way, this case is analogous to DeLucia. In DeLucia, the JCC placed Lawrence Forman & Associates, a rehabilitation company, in charge of the claimant's rehabilitation, home modification, vehicle purchase, and further medical care. 533 So.2d at 864. The only supporting evidence for the award was the testimony of Lawrence Forman himself. This Court reversed the sweeping scope of award, for all but the award of rehabilitative oversight, based on the finding that "although Forman was apparently competent to testify concerning his rehabilitation services, his testimony was not sufficiently substantial to provide the sole support for such a far ranging award. . . ." Id. at 863-84.

         Even assuming that the authorized pain management physician here could properly defer to Ms. Litwin regarding the medical necessity of any home renovations, it is not entirely clear that he did so. He was never really questioned about the specific home renovations, and when asked generally about Ms. Litwin's recommendations, he responded that he believed a re-evaluation was indicated with the approval of the authorized orthopedic surgeon who performed Claimant's surgery. The JCC, however, did not attempt to reconcile this testimony with her finding that the pain management physician deferred to the existing recommendations from Ms. Litwin.

         Finally, we note that the JCC originally found insufficient evidence of medical necessity for the home renovations, but upon rehearing reversed her finding based on Claimant's argument that a liberal construction in her favor should apply to this 1989 date of accident.[*] A liberal construction, however, does not mean the JCC must give a claimant the "benefit of the doubt" in weighing conflicting evidence or ignore evidence indicating a claimant is not entitled to benefits. See Uniweld Prods., Inc. v. Lopez, 511 So.2d 758 (Fla. 1st DCA 1987). Here, the JCC's explanation for changing her original ruling certainly suggests that she reconsidered the evidence with the assumption that Claimant should be given the "benefit of the doubt." It is unnecessary ...

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