PREMIER COMMUNITY HEALTHCARE GROUP, AmTrust North America of Florida and Associated Industries Insurance Company, Appellants,
Ana RIVERA, Appellee.
Accident: June 9, 2017.
appeal from an order of the Judge of Compensation Claims.
Stephen L. Rosen, Judge.
H. Taylor of Hall Booth Smith, P.C., Atlanta, for Appellants.
J. Winer of Law Office of Michael J. Winer, P.A., Tampa, for
C.J., and Wolf, J., concur; B.L. Thomas, J., dissents with
Thomas, J., dissenting.
this workers compensation case, Claimant had the burden of
proving her workplace injury is the major contributing cause
of the need for requested medical care; this was the sole
issue for determination by the Judge of Compensation Claims
(JCC). On appeal, the Employer/Carrier challenge the JCCs
determination in Claimants favor based on the evidence.
Because I agree the record lacks competent substantial
evidence in support of the MCC determination, I would reverse
the order below.
a dental assistant, was injured while trying to stop a
patient from falling. The E/C initially accepted
compensability of Claimants injuries to the low back and
neck (cervical spine), but later denied claims for cervical
injections and physical therapy when Claimants medical
history revealed that she had a prior motor vehicle accident
and previous neck symptoms. Dr. Schulak, an orthopedic
surgeon authorized to treat the workplace injuries, testified
that Claimant never mentioned any neck or cervical
complaints to him. Dr. Davis, another orthopedic surgeon and
the E/Cs independent medical examiner, testified Claimant
has objective findings of preexisting degenerative disc
disease. Ultimately, both doctors opined that the workplace
injury is not the major contributing cause of Claimants
current need for medical treatment of the cervical spine.
Claimant relied on the medical records maintained by Dr.
Tolli, another authorized treating physician. In the appealed
order, the JCC found that the compilation of Dr. Tollis
records sufficiently established that Claimant suffered
injury to her neck in the workplace accident. In particular,
the JCC emphasized both Dr. Tollis notation that the
requested treatment for the cervical spine was on hold
awaiting authorization from the workers compensation carrier
and the fact that Dr. Tolli did not relate the need for
medical care to any other cause. Although the JCC
acknowledged the contrary opinions from Drs. Schulak and
Davis, he concluded Dr. Tollis opinions should be given
greater weight "based on the claimants credible
testimony and Dr. Tollis continuous treatment and
examination of the claimant."
the statute, the accidental compensable injury must be the
MCC of any resulting injuries. § 440.09(1), Fla. Stat.
(2016). "Major contributing cause" is defined in
the statute as "the cause which is more than 50 percent
responsible for the injury as compared to all other causes
combined for which treatment or benefits are sought."
MCC "must be demonstrated by medical evidence
Section 440.09(1)(b) further provides that when a
work-related injury combines with a preexisting disease or
condition to cause or prolong disability of the need for
treatment, benefits are due "only to the extent that the
injury arising out of and in the course of employment is and
remains more than 50 percent responsible for the injury as
compared to all other causes combined and thereafter remains
the [MCC] of the disability or need for treatment
." (emphasis added). In the instant case, however, the
JCC did not make any findings concerning any ...