In Su-ann Belle Zilnicki v. Steward Sebastian River Medical Center and Sedgwick CMS, Twin City Fire Insurance Company the E/C denied the claim asserting claimant should be barred from benefits due to her alleged misrepresentation of her prior medical history. Claimant denied a prior accident with a different employer. When confronted with the documents pertaining to that claim, claimant denied having any knowledge of the same. The JCC found claimant to be a credible witness, particularly where none of the documents had been signed by her and the medical records all reflected her clear and repeated disclosure of her pre-existing rheumatoid arthritis. Upon the record presented, the JCC found the E/C failed to establish claimant had knowingly made misrepresentations with the intent of securing benefits. Fraud defense DENIED. After addressing the merits of the benefit claims asserted, the JCC GRANTED TTD as well as shoulder and neck treatment.
