Michelle C. Carter v. American Airlines and Sedgwick CMS

In Michelle C. Carter v. American Airlines and Sedgwick CMS the Claimant filed for SI joint injection which was denied by the E/C. The E/C argues that the major contributing cause of the need for any further care is no longer the industrial accident and the major contributing cause of the need for an SI joint infection is not the industrial accident. The JCC looked to the 120-day rule and found that the E/C did provide benefits for claimant’s SI condition and did not deny compensability within the 120-pay period. Also, the Claimant was not required to establish medically necessity in light of the E/C failure to response to the authorized request within 10 days. The JCC GRANTED the claim for SI joint injection.

Leave a Reply