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#onetimechangeofphysician

Miguel Lorenzo v. Kiewit Corp. d/b/a Kiewit Infrastructure South Co and Old Republic Insurance Company, Sedgwick CMS

In Miguel Lorenzo v. Kiewit Corp. d/b/a Kiewit Infrastructure South Co and Old Republic Insurance Company, Sedgwick CMS Claimant filed for a One Time Change and the E/C claimed they had properly and timely provided claimant with a one-time change of physician. To the contrary, claimant prosecuted his claim for a OTC provider of his …

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Miguel Perez Ortiz v. YRC, Inc. d/b/a YRC Freight and Sedgwick CMS

In Miguel Perez Ortiz v, YRC, Inc, d/b/a YRC Freight and Sedgwick CMS Claimant requested a OTC. The current issue is which party had the right of selection. The adjuster testified that she did not receive the email alleged to have been sent requesting the OTC. She further testified she timely provided a OTC provider …

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JCC – Compensation Orders Fernada Hurst v. L.R.G. Transportation & Storage, Inc., America’s Back Office, Inc., Amergo Enterprises, Inc. and Service American Indemnity Company OJCC# 21-025694, Tampa District, JCC Anthony Claimant Counsel: Yuli Kotler; E/C Counsel: Steven Hovsepian Primary Issue: Notice D/A: 08-12-2021 Decision Date: 08-05-2022 Summary: The JCC observed many discrepancies in the deposition and final hearing testimonies of claimant, but the E/C had not raised a misrepresentation defense. Instead, the E/C asserted a lack of timely notice and that claimant was an independent contractor. Judging claimant’s credibility, the JCC did not accept the representation that claimant reported his injuries and as such failed to meet the notice requirements in F.S. Sec. 440.185. Concluding the claims were not compensable due to lack of timely notice, the JCC found it unnecessary to address the employer-employee dispute. All petitions DENIED and DISMISSED. Alfredo Morono Perez v. Florida Service Painting, Inc. and Sedgwick CMS OJCC# 20-024051, Sarasota District, JCC Grindal Claimant Counsel: Eric M. Christiansen; E/C Counsel: David Hamilton Roos Primary Issues: Surgery, Major Contributing Cause, Rehearing D/A: 08-28-2020 Decision Date: 08-05-2022 Summary: Amended Order (On E/C motion for rehearing. No change in decree.) – Cervical surgery was denied by the E/C on the assertion that the industrial accident was not the MCC of the need for the procedure. The authorized treating physician testified claimant had asymptomatic degenerative changes which were aggravated by the accident. The doctor testified as to apportionment percentages, but admitted the same were arbitrary and not scientifically supported. Accepting the MCC opinion favorable to claimant, the JCC determined the surgery was compensable. However, apportionment was rejected. In any case, the JCC found the E/C had failed to timely respond to the doctor’s written request for authorization of the procedure. Authorization of surgery GRANTED. Almon J. Potter v. City of St. Petersburg and Commercial Risk Management, Inc., City of St. Petersburg – W/C Office OJCC# 05-000429, Panama City Beach District, JCC Moneyham Claimant Counsel: John Sharpless; E/C Counsel: Kimberly Diane Proano Primary Issues: Temporary Partial Disability, Voluntary Limitation of Income D/A: 07-23-2004 Decision Date: 08-05-2022 Summary: In 2009, claimant was terminated by the employer. He testified he had not been offered any employment by the employer since that time and remained retired, receiving social security and retirement benefits from the employer. On the evidence presented, the JCC found claimant had been terminated from his position due to his inability to perform the job. He remained on light duty restrictions and had not yet reached MMI following a 2021 surgery. Accordingly, the JCC concluded claimant established a prima facie case of TPD entitlement. Here, there was no proof that claimant had been offered a light duty position since the surgery or even since the termination. As such, the E/C voluntary limitation of income defense was DENIED and TPD benefits were GRANTED, together with penalties and interest. Bryon William Hunter v. Autozone, Inc. and Gallagher Bassett Services, Inc.

In Bryon William Hunter v. Autozone, Inc, and Gallagher Bassett Services, Inc. Counsel for claimant submitted a One time change request to the adjuster but named his client as “Hunter B. William” instead of “Bryon William Hunter”. No petitions were pending and the adjuster never received the request due to the name discrepancy. A petition …

JCC – Compensation Orders Fernada Hurst v. L.R.G. Transportation & Storage, Inc., America’s Back Office, Inc., Amergo Enterprises, Inc. and Service American Indemnity Company OJCC# 21-025694, Tampa District, JCC Anthony Claimant Counsel: Yuli Kotler; E/C Counsel: Steven Hovsepian Primary Issue: Notice D/A: 08-12-2021 Decision Date: 08-05-2022 Summary: The JCC observed many discrepancies in the deposition and final hearing testimonies of claimant, but the E/C had not raised a misrepresentation defense. Instead, the E/C asserted a lack of timely notice and that claimant was an independent contractor. Judging claimant’s credibility, the JCC did not accept the representation that claimant reported his injuries and as such failed to meet the notice requirements in F.S. Sec. 440.185. Concluding the claims were not compensable due to lack of timely notice, the JCC found it unnecessary to address the employer-employee dispute. All petitions DENIED and DISMISSED. Alfredo Morono Perez v. Florida Service Painting, Inc. and Sedgwick CMS OJCC# 20-024051, Sarasota District, JCC Grindal Claimant Counsel: Eric M. Christiansen; E/C Counsel: David Hamilton Roos Primary Issues: Surgery, Major Contributing Cause, Rehearing D/A: 08-28-2020 Decision Date: 08-05-2022 Summary: Amended Order (On E/C motion for rehearing. No change in decree.) – Cervical surgery was denied by the E/C on the assertion that the industrial accident was not the MCC of the need for the procedure. The authorized treating physician testified claimant had asymptomatic degenerative changes which were aggravated by the accident. The doctor testified as to apportionment percentages, but admitted the same were arbitrary and not scientifically supported. Accepting the MCC opinion favorable to claimant, the JCC determined the surgery was compensable. However, apportionment was rejected. In any case, the JCC found the E/C had failed to timely respond to the doctor’s written request for authorization of the procedure. Authorization of surgery GRANTED. Almon J. Potter v. City of St. Petersburg and Commercial Risk Management, Inc., City of St. Petersburg – W/C Office OJCC# 05-000429, Panama City Beach District, JCC Moneyham Claimant Counsel: John Sharpless; E/C Counsel: Kimberly Diane Proano Primary Issues: Temporary Partial Disability, Voluntary Limitation of Income D/A: 07-23-2004 Decision Date: 08-05-2022 Summary: In 2009, claimant was terminated by the employer. He testified he had not been offered any employment by the employer since that time and remained retired, receiving social security and retirement benefits from the employer. On the evidence presented, the JCC found claimant had been terminated from his position due to his inability to perform the job. He remained on light duty restrictions and had not yet reached MMI following a 2021 surgery. Accordingly, the JCC concluded claimant established a prima facie case of TPD entitlement. Here, there was no proof that claimant had been offered a light duty position since the surgery or even since the termination. As such, the E/C voluntary limitation of income defense was DENIED and TPD benefits were GRANTED, together with penalties and interest. Bryon William Hunter v. Autozone, Inc. and Gallagher Bassett Services, Inc. Read More »

Tomas Ortega v. Amerit Fleet Solutions Inc and Corvel Corporation

In Tomas Ortega v. Amerit Fleet Solutions Inc and Corvel Corporation the Claimant requests a one-time change in his treating physicians for his back injury. The E/C argues that Claimant is not entitled to a change in physicians per his continued non-compliance with the court’s order on costs and his sworn testimony to pay same. …

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Bernard Smalls v. Comcast Corporation and Helmsman Mgmt Services, Liberty Mutual Insurance

In Bernard Smalls v. Comcast Corporation and Helmsman Mgmt Services, Liberty Mutual Insurance the issue is the identity of the one-time change provider. The request for a one time change was made on 9/3/20 the issue is when the request was received. The E/C argues that it was not received until 9/9/20. The five-day mail …

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Maria Ayala v. Skampa Painting & Renovating Inc and CCMSI

In Maria Ayala v. Skampa Painting & Renovating Inc and CCMSI the Claimant is seeking an orthodontic night guard designed to produce her with some relief of jaw pain cause by her compensable injury. The E/C authorized an orthodontist and a night guard but didn’t actually provide the night guard because there was an issue …

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Norman Evans v. Vets USA II, Inc. and Amtrust North America of Florida, Technology Insurance Company

In Norman Evans v. Vets USA II, Inc. and Amtrust North America of Florida, Technology Insurance Company the Claimant is requesting a follow up appointment with an authorized provider and payment of a medical bill. The E/C defends the issues on the defense of major contributing cause, failure to provide timely notice of alleged accident, …

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Yeimy Mora Abreu v. B&A Gourmet Foods, LLC and Hartford Casualty Insurance Company

In Yeimy Mora Abreu v. B&A Gourmet Foods, LLC and Hartford Casualty Insurance Company the Claimant submitted a request for a one time change of physician. The E/C authorized the one time change and provided a doctor who was board certified in orthopedic surgery with a certificate of added qualification in hand surgery. Claimant argued …

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Benigno Landero v. Tri-Choice Services, Inc. and Federated Mutual Insurance

In Benigno Landero v. Tri-Choice Services, Inc. and Federated Mutual Insurance the claimant suffered a compensable injury while working for the employer. The claimant was not satisfied with the care received and requested a change in physician from E/C. Claimant was then advised that he must request a one-time change in writing. The employer prepared …

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Mary Kathleen Lynn v. American Airlines Group and Sedgwick CMS

In Mary Kathleen Lynn v. American Airlines Group and Sedgwick CMS Claimant petitioned for authorization of an orthopedic surgeon as an alternate physician. Claimant contends the carrier unreasonably delayed the provision of an alternate physician and therefore has the right to select the orthopedic surgeon. E/C argues that they timely offered a one-time change of …

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