Charlene D. Kinley v. Sunrise Community Inc. and PMA Management Corporation

In Charlene D. Kinley v. Sunrise Community Inc. and PMA Management Corporation Claimant sought authorization for shoulder surgery recommended by the authorized provider. The E/C denied the surgery, claiming the claimant’s work accident was not the major contributing cause of the need for the surgery. Claimant argued she was entitled to authorization of shoulder surgery because the E/C previously accepted compensability of her shoulder injury and there was no break in the causal chain that would allow the E/C to deny treatment. Here, the E/C had the burden of proving there had been a break in the causal connection between the compensable injury and the requested treatment, such as the occurrence of a new accident or the treatment being related to a condition unrelated to the accepted compensable injury. The JCC determined the E/C failed to present sufficient medical evidence of a break in the causal connection, and as a result the claim for surgery was GRANTED.

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