Cases / Verdicts / Settlements

Claimant v. Agency for Healthcare Administration and Division of Risk Management

St. Petersburg District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Joseph A. Bayliss

Primary Issue: One Time Change of Physician

D/A: 11-06-2017

Decision Date: 05-22-2019

Summary: Workers Compensation Claimant made a request for an alternate treating workers Comp doctor, to which the E/C promptly responded. At issue was the specific date the request was received by the E/C, thereby commencing the statutory 5 day response time. Claimant attorney posited the received date was 7/19/2018 based on the fax transmission confirmation, while the workers comp insurance company contended the date stamp of their mailroom on 7/25/2019 established their receipt. The JCC accepted the best workers compensation attorney arguments as those of the injured workers attorney, and further accepted the evidence favorable to injured worker and established the one time change doctor request date was 7/19/2018. Because the one time change doctor was not provided until six days later, the JCC concluded injured worker was entitled to select his one time change doctor. Petition GRANTED.

Claimant v. BMP USA, Inc. and Ascendant Claims Services

Tampa District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Daniel O. Gonzalez

Primary Issues: Average Weekly Wage, Temporary Partial Disability, Voluntary Limitation of Income

D/A: 08-16-2018

Decision Date: 03-20-2019

Summary: A quarterly bonus of $550.00 was paid to injured worker within the 13 week pre- work accident period. Injured worker petitioned for an increase in Average Weekly Wage (AWW) to include the full bonus amount, while the E/C posited the bonus should be prorated over the period it was intended to cover. Notwithstanding the label “quarterly bonus”, the JCC agreed with the claimant’s attorney arguments, and found the bonus vested on the date it was received and thus the full amount should be included in the workers compensation claimant’s Average Weekly Wage (AWW) calculation. Increase in AWW GRANTED.

Claimant v. Broward County School Board and Optacomp

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Michael M. Riedhammer

Primary Issues: Abbreviated Order, Average Weekly Wage, Temporary Partial Disability

D/A: 11-04-2011

Decision Date: 11-28-2018

Summary: In this abbreviated workers comp order the JCC advised of his conclusions, accepting the best Workers compensation attorney arguments favorable to the injured worker regarding the correct AWW with and without fringe benefits, and AWARDED TPD benefits.

Claimant v. Miami-Dade County Transit and Miami Dade County Risk Management

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Daron S. Fitch

Primary Issues: Authorization of Medical Care, Major Contributing Cause, 120 Day Pay & Investigate

D/A: 09-03-2011

Decision Date: 09-24-2018

Summary: The workers comp orthopedic surgeon opined claimant’s bilateral knee complaints were due to preexisting arthritis. The injured worker’s IME agreed that injured worker suffered from preexisting osteoarthritis, but concluded the work accident caused medical tears, and the two combined diagnoses were the major contributing cause of injured worker’s knee pain. The E/C accepted compensability under the 120 day rule. Based on the evidence presented, the JCC concluded the E/C had not denied the original bilateral knee injuries, but rather argued the accident was not the Major contributing cause of the need for workers comp treatment. Because the Worker’s comp carrier failed to make a proper showing of a break in the causation chain, the JCC found the workers comp treatment of claimant’s workers comp knee injury remained the E/C responsibility. Claim for authorization of physician GRANTED.

Claimant v. W Ft. Lauderdale Hotel and PMA Insurance Company

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Sal Richardson

Primary Issue: Claimant Trial Fees

D/A: 05-25-2015

Decision Date: 08-10-2018

Summary: The injured worker argued that she should be entitled to payment from the workers Compensation insurance company for any attorney fees and costs because she was forced to hire A workers comp attorney to get the temporary indemnity benefits and determination of the proper Average weekly wage which she sought. The JCC agreed with the best workers compensation attorney Arguments presented by claimants attorney, and awarded attorney fees and costs to the injured worker.

Claimant v. UCP of South Florida and FARA, a York Risk Services Company

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Shannon Arsenault

Primary Issue: E/C Costs

D/A: 01-12-2016

Decision Date: 06-14-2018

Summary: By virtue of the order granting the E/C unchallenged motion for summary final order, the JCC found the E/C was the prevailing party and was entitled to taxable cost recovery. However, workers comp claimant’s hearsay objection to the ‘client ledger’ relied upon by the workers compensation insurance company to establish the costs was sustained. Counsel who attended on behalf of the E/C had no personal and/or actual knowledge of the costs incurred. E/C motion to tax costs DENIED.

Claimant v. Amazon.com and Sedgwick CMS

Tampa District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Michael R. Beane

Primary Issues: Major Contributing Cause, Temporary Total Disability

D/A: 12-04-2016

Decision Date: 06-06-2018

Summary: The workers comp insurance company denied temporary indemnity benefits to the injured Worker, arguing that the injured worker was not taken out of work by the workers comp doctor. The Claimant’s attorney argued that the evidence established that the claimant had physical work restrictions. Which prevented the injured worker from performing her pre workers comp accident job. The JCC found the best workers compensation attorney arguments made were those of the injured workers attorney, and granted TTD benefits. 

Claimant v. West Broward Care Center and Normandy Insurance Company

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Andrew R. Borah

Primary Issue: Claimant Trial Fees

D/A: 06-26-2017

Decision Date: 06-05-2018

Summary: The injured workers attorney argued that the workers compensation insurance company should pay any attorney fees and costs incurred because the workers comp insurance company did not timely provide medical care, and the injured worker had to have his attorney fight for said workers comp benefits. The JCC agreed, and awarded fees and costs to the workers compensation claimant in this case.

Claimant v. West Kendall Toyota and Summit

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Omar Perez

Primary Issues: Temporary Total Disability, Temporary Partial Disability, Average Weekly Wage D/A: 04-02-2017

Decision Date: 06-01-2018

Summary: The JCC considered the injured worker’s claim for AWW adjustment and found the 13 week wage statement aptly supported the average weekly wage. The JCC then considered workers compensation claims and defenses concerning temporary disability benefits. The JCC accepted the best workers compensation attorney’s arguments presented, and rejected the Workers Comp insurance company’s termination for cause and voluntary limitation of income defenses. The insurance company also argued that the injured worker failed to return completed DWC-19 forms. However, based upon the evidence presented, the JCC GRANTED temporary disability benefits.

Claimant v. Memorial Healthcare Systems and Preferred Government Claims Solutions/PGCS

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher; E/C Counsel: Michael M. Riedhammer

Primary Issues: Major Contributing Cause, One Time Change of Physician, Medical Bills D/A: 11-25-2016

Decision Date: 05-11-2018

Summary: The E/C authorized Worker’s compensation claimant for a one time change of physician as requested. However, they later denied the bill of the One time change physician on the grounds the evaluation was not causally related to the work injuries. The disputed charge was for $225.00. The JCC found that to allow the E/C to avoid payment responsibility for the one time change evaluation would eviscerate the statutory scheme allowing for one time changes. Payment of the $225 medical bill GRANTED.

Claimant v. MCV Contracting, Inc. and Bridgefield Employers Insurance Company, Summit

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS

 D/A: 04-01-2017 Decision Date: 02-20-2018

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Omar Perez

Primary Issue: Temporary Partial Disability D/A: 04-01-2017

Decision Date: 02-20-2018

Summary: The Workers Compensation claimant was placed on restrictions by North Shore Medical Center, Physicians Health Center and Jackson Memorial Hospital. The Workers Compensation Claimant’s attorney petitioned for Temporary Partial Disability benefits (TPD), asserting his income dropped below the threshold 80% of AWW level thereby entitling him to benefits. The E/C defended the loss of earning was unrelated to injured worker’s work restrictions or limitations. Based upon the best workers compensation attorney arguments and evidence presented, the JCC held the compensable work accident had created work restrictions on his physical activity and contributed to the partial wage loss sustained. Temporary Partial Disability benefits (TPD) GRANTED, together with penalties and interest.

Claimant v. Decktight Roofing Services, Inc and Summit D/A: 05-01-2017

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC) Decision Date: 02-16-2018Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Gil Godfrey

Primary Issue: Drug Free Workplace D/A: 05-01-2017

Decision Date: 02-16-2018

Summary: While there was no dispute that the Worker’s comp claimant had sustained work injuries from a fall from a ladder at work, the workers compensation insurance company denied all workers comp benefits, relying on a drug free workplace defense. Evidence at trial covered all aspects of the E/C defense, but the Judge of Compensation Claims (JCC) found the threshold issue of notice was determinative of the dispute. Accepting the evidence favorable to the injured worker that the E/C had not provided injured worker with proper notice of the drug free workplace program as is required by Florida Workers Compensation law, the JCC concluded the denial of workers comp benefits based on that defense was impermissible. The JCC accepted the best workers comp attorney arguments and evidence, and the Drug free workplace defense DENIED; Compensability, medical and indemnity benefits GRANTED.

Claimant v. Tower Group Companies and Travelers Insurance

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Jason T. Selwood

Primary Issue: Workers Compensation claimant Trial Fees D/A: 06-24-2013

Decision Date: 01-16-2018

Summary: The claimant requested that the insurance company pay any attorneys fees of the claimant’s attorney related to the subject workers compensation claim. The workers comp insurance company refused said request. The fee entitlement at issue related to petition for benefits requests. The claimant had been under the care of Dr. Brad Chayet, but had not been treated for the work injury to the right foot. Judge of Compensation Claims concluded treatment for a right foot work injury was not provided within 30 days of the request and Workers Compensation claimant was entitled to attorney fees.

Ines Rivera v. Target Corporation and Sedgwick CMS

OJCC# 13-018206, Jacksonville District, JUDGE OF COMPENSATION CLAIMS (JCC)Humphries

Workers Compensation claimant Counsel: Kevin Gallagher, Martha D. Fornaris;

E/C Counsel: David S. Gold

Primary Issues: Summary Final Order, Attorney Fee Lien D/A: 01-02-2013

Decision Date: 01-08-2018

Summary: The Judge of Compensation Claims (JCC) ordered former counsel for Workers Compensation claimant to submit a verified fee petition, and when no pleading was timely served the workers compensation insurance company moved for SFO on the fee entitlement issue. Notably, the motion did not address fee entitlement, but rather was an attempt to dispose of the substantive matter based upon a lack of procedural compliance by Workers Compensation claimant’s former counsel. Concluding there remained genuine issues of disputed material fact, the Judge of Compensation Claims (JCC) DENIED the E/C motion for SFO.

Claimant v. Marlin James and Summit

Tampa District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: David K. Beach

Primary Issues: Drug Free Workplace, Intoxication/Willful Intent to Injure D/A: 03-29-2017

Decision Date: 12-12-2017

Summary: Following the initial acceptance of compensability of the work accident, Workers Compensation claimant was ultimately denied benefits and terminated from employment due to drug testing which returned positive for marijuana and cocaine. Although the employer contended a drug free workplace was in effect, the Judge of Compensation Claims (JCC) held Workers Compensation claimant was never informed that presenting to work drug free was a condition of employment and thus the requirements of Chapter 440 were not met. Additionally, the Judge of Compensation Claims (JCC) noted that even if a drug free workplace was in effect, the workers compensation insurance company failed to make a proper showing of the levels of drugs detected. The E/C alternatively attempted to raise an intoxication defense, but the JCC accepted the best workers comp attorney arguments and evidence, and the insurance company’s intoxication defense was rejected by the Judge of Compensation Claims (JCC) on due process grounds as the defense had not been separately and timely plead. Compensability and indemnity benefits of the claimant’s work accident and work injury GRANTED.

Claimant v. CHP Management Services LLC and Employers

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)Hogan

Workers Compensation claimant Counsel: Kevin Gallagher, Lizbeth Ruiz;

E/C Counsel: Jessika X. Lorie

Primary Issue: Attorney Fee Lien D/A: 03-24-2016

Decision Date: 11-30-2017

Summary: Counsels for Workers Compensation claimant sought payment of attorney fee liens following settlement of the underlying workers compensation claim. After hearing argument and testimony from the interested parties, the Judge of Compensation Claims (JCC) determined attorney fees were approved and payable from settlement – which amount was to be paid by the workers compensation insurance company. 

Claimant v. CHP Management Services LLC and Employers

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)Hogan

Workers Compensation claimant Counsel: Kevin Gallagher, Lizbeth Ruiz; E/C Counsel: Jessika X. Lorie

Primary Issues: Motion to Enforce, Unrepresented Workers Compensation claimant D/A: 03-24-2016

Decision Date: 11-30-2017

Summary: The Judge of Compensation Claims (JCC) was tasked with determining whether a valid settlement agreement had been made. Finding the parties reached a binding and enforceable workers compensation settlement agreement, the Judge of Compensation Claims (JCC) GRANTED the motion to enforce settlement agreement.

Claimant v. Falcon Farms, Inc. and Continental Indemnity Company

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A. ,Suzanne Gorowitz; E/C Counsel: Barbara K. Case;

Primary Issue: Attorney Fee Lien D/A: 05-13-2016

Decision Date: 11-29-2017

Summary: Workers Compensation claimant and Workers Compensation claimant’s current and former counsels amicably agreed to a resolution of former counsel’s fee lien. Counsel also sought a quantum meruit fee from the workers compensation insurance company for past workers comp benefits obtained. Upon consideration of the best workers compensation attorney argument and evidence, the attorney fee lien was AWARDED, and the workers compensation insurance company was ordered to pay same. 

Claimant v. Embassy Suits by Hilton and Sedgwick CMS

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Beth T. Koller

Primary Issues: Major Contributing Cause, Average Weekly Wage, Temporary Partial Disability D/A: 12-15-2016

Decision Date: 11-27-2017

Summary: Medical care was provided by the workers compensation insurance company for a compensable work accident, and accompanying foot/ankle work injury. The injured worker and claimant’s attorney did not believe that the insurance company were using a fair average weekly wage (AWW) upon which to calculate the claimant’s workers compensation indemnity benefits. The Judge of Compensation Claims (JCC) accepted the best workers compensation attorney arguments and evidence, and resolved the AWW dispute, the result of Workers Compensation claimant’s 8 weeks of employment, by using only those full time wages for weeks where Workers Compensation claimant worked full time hours. Upward AWW adjustment, TPD benefits and penalties and interest GRANTED.

Claimant v. City Concrete Systems, Inc and FCCI Insurance Group

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Diane B. Hernandez

Primary Issues: Workers Compensation claimant Trial Fees, Order on Remand D/A: 04-23-2014

Decision Date: 11-08-2017

Summary: The insurance company agreed that it would accept responsibility for paying the attorneys fees of the claimant’s attorney in regard to this workers compensation claim, and that the claimant would not be responsible for same. The predecessor Judge of Compensation Claims (JCC)’s, John. J. Lazzara, denial of approval of a stipulated attorney fee was reversed by the District Court of Appeal. In this order on remand, the Judge of Compensation Claims (JCC) found the stipulated workers compensation insurance company paid attorney fee for obtaining past workers comp benefits was properly supported by the evidence, and the insurance company’s payment of the attorney’s fees was APPROVED.

Claimant v. City of Miami Beach and Corvel Corporation

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Luis F. Estrada

Primary Issue: Workers Compensation claimant Trial Fees D/A: 12-12-2011

Decision Date: 11-07-2017

Summary: The workers compensation insurance company denied the claimant’s request that the insurance company pay any attorneys fees of claimant’s attorney. Finding Workers Compensation claimant’s counsel was entitled to attorney fees for securing reimbursement of expenses to the claimant, and that the workers compensation insurance company failed to itemize their objections, the Judge of Compensation Claims (JCC) accepted the best workers compensation attorney procedural arguments, and awarded the entirety of requested attorney’s hours to be paid by the workers compensation insurance company.

Claimant v. United Health Group and Sedgwick CMS

Tampa District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Brian C. Dowling

Primary Issue: One Time Change of Physician D/A: 02-27-2017

Decision Date: 10-05-2017

Summary: A fax requesting a one time change of physician was delivered by Workers Compensation claimant’s lawyer to a number assigned by the workers compensation insurance company. However, the number was to a document service company which converted the fax into electronic form and then forwarded the message to the workers comp adjuster. In the instant workers comp case, the forwarded message was received by the adjuster more than five days after the fax was sent. The adjuster authorized a one time change doctor within five days of her receipt of the request. The foregoing facts were not in question and the Judge of Compensation Claims (JCC) was called upon to determine whether the workers comp insurance company response was timely under Florida Workers Compensation laws. The Judge of Compensation Claims (JCC) rejected the insurance company’s attempt to escape liability based upon the defective fax delivery system since it was clear Workers Compensation claimant utilized a correct fax number provided by the workers comp insurance company. Accordingly, the Judge of Compensation Claims (JCC) concluded the E/C response was untimely and Workers Compensation claimant was entitled to select his choice of one time change provider.

Claimant v. American Airlines and Sedgwick CMS

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher; E/C Counsel: Frank Garcia

Primary Issue: Motion for Advance D/A: 11-09-2016

Decision Date: 08-30-2017

Summary: The workers comp insurance company denied the claimant’s request for a workers compensation advance, and argued that the claimant was not entitled to same as his need for an advance was not related to his work injuries or work accident. The Judge of Compensation Claims (JCC) accepted the best workers comp attorney arguments, and agreed with the claimant attorney that the must meet only (1) of (3) criteria under the Florida Workers Compensation law to establish eligibility to a workers compensation advance. Thus, the JCC determined that the claimant met the entitlement and eligibility requirements for an advance, and GRANTED Workers Compensation claimant an advance of $1,000.00 based upon the financial information provided.

Claimant v. Buy Buy Baby and Corvel

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: D. Robert Swanson, Christopher Thorne

Primary Issue: Major Contributing Cause D/A: 04-05-2016

Decision Date: 08-01-2017

Summary: The work accident was accepted as compensable by the workers compensation insurance company as were the work injuries to Workers Compensation claimant’s head and neck. Workers Compensation claimant’s headaches were also accepted as compensable. The instant matter concerned the narrow issue of compensability of a cerebral spinal fluid (CSF) leak, which the workers comp insurance company denied as not causally related to the work accident. The Judge of Compensation Claims (JCC) determined the best workers compensation attorney arguments to be those of the claimant’s attorney, and denied the insurance company’s request for appointment of an expert medical advisor (EMA), specifically finding the medical opinions on major contributing cause (MCC) of the CSF leak were consistent with each other and did not require EMA appointment. Accordingly, the Judge of Compensation Claims (JCC) concluded the work accident was the MCC of the CSF leak. Having established the condition as compensable, the Judge of Compensation Claims (JCC) GRANTED workers compensation medical and indemnity benefits related thereto.

Claimant v. Fontainebleau Miami JV and Bridgefield Casualty Insurance

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Rangel Cruz

Primary Issue: Workers Compensation claimant Trial Fees D/A: 07-30-2012

Decision Date: 06-30-2017

Summary: The claimant’s attorney had already been successful in obtaining workers compensation benefits for the injured worker. The sole issue presented concerned Workers Compensation claimant’s entitlement to have the workers comp insurance company pay his attorney fees for securing a follow-up medical appointment. Workers compensation insurance company posited the workers comp doctor was authorized and the underlying petition for benefits had been dismissed for lack of jurisdiction as Workers Compensation claimant had not exhausted the grievance procedures of the workers compensation managed care program. Workers Compensation claimant attorney argued that the injured worker was unable to schedule his own appointment with the workers comp doctor and ultimately had to wait four months before finally receiving workers comp treatment. The Judge of Compensation Claims (JCC) found the verified petition could stand on its own notwithstanding the dismissal of the petition for benefits. Further, the Judge of Compensation Claims (JCC) accepted the best workers compensation attorney arguments, and agreed with Workers Compensation claimant that the insurance company suggestion that the workers comp doctor was authorized did not actually satisfy the request for an appointment under Florida Workers Compensation laws. Entitlement to attorney fees payable by the insurance company GRANTED.

Claimant v. Imburgia Construction Services and Bridgefield Employers Insurance/Summit

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Omar Perez

Primary Issues: Authorization of Medical Care, Major Contributing Cause D/A: 11-20-2015

Decision Date: 04-18-2017

Summary: Compensability of a right knee work injury was at issue having been denied by the workers compensation insurance company based upon a major contributing cause (MCC) defense. The work accident and resulting foot injury at work had been accepted. Workers Compensation claimant had fallen from a roof at work, was diagnosed with an acute left foot fracture, and later underwent surgery under workers comp. The medical records were consistent with Workers Compensation claimant’s trial testimony that he had continued to experience and complain of knee pain to the authorized physician since the work accident. As trier of fact, the Judge of Compensation Claims (JCC) accepted the best workers comp attorney arguments, resolved the conflicts in the medical opinions in favor of Workers Compensation claimant and concluded Workers Compensation claimant injured his knee in the work accident. Compensability of the knee injury and a knee specialist evaluation GRANTED.

Claimant v. Progressive Employer Management and AmTrust North America

OJCC# 15-025523, Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Andrew Borah

Primary Issues: Temporary Partial Disability, Voluntary Limitation of Income D/A: 09-04-2015

Decision Date: 12-28-2016

Summary: Following this work accident in Miami, the workers compensation insurance company denied workers comp checks to the claimant, arguing that the claimant was fired from work, and voluntarily limited his own income. At the outset of his analysis, the Judge of Compensation Claims (JCC) denied the workers compensation insurance company objection to an unauthorized physician whose opinions Workers Compensation claimant relied upon in support of his medical and indemnity claims. While the E/C had denied authorization, they paid the doctor shortly thereafter and the Judge of Compensation Claims (JCC) found no evidence was presented establishing the payment was made in error. The Judge of Compensation Claims (JCC) accepted the best workers comp attorney arguments, considered the medical evidence, and ultimately AWARDED Temporary Partial Disability benefits (TPD) to the claimant. 

Claimant v. Jackson Memorial Hospital and CCMSI

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Darin Fitch

Primary Issue: One Time Change of Physician D/A: 04-14-2014

Decision Date: 12-14-2016

Summary: Workers Compensation claimant’s one time change request was served on the workers compensation insurance company via a three page facsimile addressed to the grievance coordinator and sent to a phone number in Illinois. The handling workers comp adjuster received the request eleven days later and responded to the request for a one time change doctor within two days of receipt. Selection of the provider was litigated based upon the aforementioned time frames. The Judge of Compensation Claims (JCC) rejected each of the workers compensation insurance company defenses suggesting impropriety in the service of the request, as the fax number used was the only number provided on the company website. Concluding the workers compensation insurance company did not provide a timely response to Workers Compensation claimant’s OTC request, and that the best workers compensation attorney efforts were utilized by the claimant’s attorney, the Judge of Compensation Claims GRANTED Workers Compensation claimant’s selection of one time change doctor. 

Claimant v. G.L. Staffing Services and Amerisure Insurance

OJCC# 15-028599, Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)Lewis

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Desi Morales

Primary Issue: One Time Change of Physician D/A: 04-17-2015

Decision Date: 11-15-2016

Summary: One day after the Workers Compensation claimant’s facsimile request for one time change of physician, the workers comp insurance company offered a one time change physician. However, the adjuster was not successful in authorizing the originally selected workers comp doctor, so he scheduled an appointment with another workers comp doctor within the same group. Workers Compensation claimant refused to attend that appointment and selected his own physician for the one time change. The Judge of Compensation Claims accepted the best workers compensation attorney arguments from the claimant’s lawyer, rejected all of the workers compensation insurance company’s arguments against Workers Compensation claimant’s choice of physician, finding they had not timely complied with the statutory requirements and Workers Compensation claimant was entitled to select his doctor. Workers Compensation claimant’s choice of one time change physician GRANTED.

Claimant v. Truly Nolen and Crawford & Company

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Janet Greene

Primary Issue: Authorization of Medical Care D/A: 03-26-2010

Decision Date: 10-17-2016

Summary: The workers comp insurance company denied the workers compensation claim on the basis that the claimant had not treated with an authorized workers comp doctor within a year, and that the Statute of Limitations had barred any entitlement to continuing workers compensation benefits and treatment. After receiving a notice of denial of workers comp case based upon a statute of limitations defense, and following the best workers compensation attorney practices, the Workers Compensation claimant secured treatment from his own physician. Subsequently, the workers comp insurance company rescinded that denial. However, they did not authorize or pay Workers Compensation claimant’s physician. Workers Compensation claimant prosecuted the instant claim for authorization of his physician and the medications prescribed. Workers Compensation claimant’s properly designated workers comp indempendent medical examiner (IME) established the unauthorized care obtained was causally related to the work accident, reasonable and necessary. Authorization of Workers Compensation claimant’s selected physician and prescribed medications GRANTED. E/C appealed, but the workers compensation appeal was voluntarily dismissed prior to court rendition.

Claimant v. Doyle Electric Services and ESIS WC Claims

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Isabel Alcocer

Primary Issue: One Time Change of Physician D/A: 10-08-2015

Decision Date: 07-29-2016

Summary: While the workers compensation insurance company agreed their untimely response to the Workers Compensation claimant’s one time change of physician request entitled Workers Compensation claimant to choose the one time change doctor, they nonetheless argued Workers Compensation claimant was constrained to select a one time change doctor within the same specialty because there was no indication that a specialist was medically necessary. As there were no factual disputes, Workers Compensation claimant moved for SFO. The Judge of Compensation Claims found there was no verbiage in the subject statute that limited Workers Compensation claimant to a one time change physician in the same specialty as the current physician. Accordingly, the Judge of Compensation Claims accepted the workers compensation claimant’s attorney arguments, and Workers Compensation claimant’s motion for SFO was GRANTED and his choice of one time change physician without limitation as to specialty was AWARDED.

Claimant v. Advance Auto Parts and Sedgwick CMS

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Robert Swanson

Primary Issue: Overpayment D/A: 12-13-2010

Decision Date: 06-29-2015

Summary: Amended order – The workers comp insurance company reduced the claimants indemnity benefits based on an alleged overpayment of previously paid indemnity benefits. This matter concerned two separate workers comp accidents and two separate work injuries. After the workers comp insurance company overpaid income impairment benefits (IIB’s) on the earlier date of accident, they attempted to recover from Workers Compensation claimant’s indemnity benefits in the later workers comp case. It was undisputed that an overpayment had occurred. At issue was the propriety of overpayment recovery from an unrelated workers comp case. The Judge of Compensation Claims found the E/C was entitled to recover the overpayment in a court of competent jurisdiction, but was not legally entitled to deduct said amounts from benefits due under a second unrelated work accident. Accordingly, the Judge of Compensation Claims ORDERED the workers compensation insurance company to reimburse Workers Compensation claimant for all prior 20% reduction amounts, together with penalties and interest.

Claimant v. The Berkley Group and Zurich American Insurance

Pensacola District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Gonzalo Rodriguez

Primary Issues: Authorization of Medical Care, Major Contributing Cause D/A: 04-20-2013

Decision Date: 02-26-2015

Summary: The workers comp insurance company denied the claimant’s request for pain management treatment under the accepted workers comp claim. Resolving the medical conflicts, the workers compensation expert medical advisor (EMA) opined Workers Compensation claimant did not suffer from RSD and the Judge of Compensation Claims afforded such opinion the presumption of correctness. On the issue of pain management referral, the Judge of Compensation Claims observed the distinction between challenges to medical necessity and challenges to major contributing cause (MCC). Here, the workers comp insurance company could not defend based upon lack of medical necessity because their untimely response to the referral resulted in waived of that defense. However, the E/C MCC defense that the treatment was not related to the work accident remained viable. However, the Judge of Compensation Claims accepted arguments of the workers compensation claimant’s attorney and the medical evidence favorable to Workers Compensation claimant and GRANTED authorization of the referral for pain management.

Claimant v. Ryder and Old Republic Insurance

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Robert Strunin

Primary Issue: Temporary Partial Disability D/A: 09-30-2008

Decision Date: 10-28-2014

Summary: While Workers Compensation claimant had been placed at Maximum Medical Improvement (MMI) as per the Florida Worker’s Compensation laws for his original work injury, he later sustained an aggravation of that work injury and was placed on a restricted work duty status. Workers Compensation claimant petitioned for temporary indemnity benefits which the workers compensation insurance company denied on the basis MMI had been reached. The Judge of Compensation Claims accepted the best workers compensation attorney arguments and evidence that Workers Compensation claimant had not been returned to MMI following the aggravation of the work injury nor had the imposed workers comp work restrictions been lifted. Temporary Partial Disability benefits (TPD) GRANTED.

Claimant v. Advance Auto Parts and Sedgwick CMS

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Robert Swanson, Christopher Thorne

Primary Issues: Major Contributing Cause, Surgery, Temporary Partial Disability D/A: 12-13-2010

Decision Date: 06-06-2014

Summary: An workers compensation expert medical advisor (EMA) was previously appointed to resolve the medical causation issue pertaining to a low back work injury alleged by Workers Compensation claimant and denied by the workers comp insurance company. The trial before the Judge of Compensation Claims concerned three dates of work accident which were not consolidated, but the parties agreed the issues should be resolved simultaneously. The EMA found no objective evidence that Workers Compensation claimant sustained a lumbar work injury in either of his first two accidents, but did find positive exam findings in the medical records related to the third work accident. The Judge of Compensation Claims accepted the EMA opinions, GRANTED compensability of the back injury related to the third work accident. On an issue of shoulder surgery, the Judge of Compensation Claims found the medical evidence presented was unrefuted that the recommended surgery was medical necessary. Shoulder surgery and Temporary partial disability benefits (TPD) GRANTED.

Claimant v. Tuesday Morning and Broadspire

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Susan Arrick

Primary Issues: Temporary Partial Disability, Temporary Total Disability D/A: 03-13-2012

Decision Date: 03-13-2014

Summary: Amended order (Altering decree to extend TPD benefits through the date of MMI) – At the onset of hearing the parties stipulated to the average weekly wages (AWW) making the claim for such workers comp benefit moot. The Judge of Compensation Claims addressed the remaining issues of temporary disability, dividing the disputed benefits into three logical payment periods. Based upon the evidence presented, the Judge of Compensation Claims accepted the claimant’s attorney’s arguments over that of the insurance company’s attorney, and GRANTED Temporary Total Disability benefits (TTD) / Temporary partial Disability benefits (TPD) for two of the three periods.

Claimant v. Hyatt Hotel and Gallagher Bassett Services

Jacksonville District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Judith Blinderman

Primary Issue: Dismissal D/A: 11-16-2009

Decision Date: 02-04-2014

Summary: On the grounds of lack of prosecution, the workers compensation insurance company moved to dismiss Workers Compensation claimant’s pending claims. The insurance company argued that the claimant was not entitled to continuing workers comp treatment and benefits some 4 years after her worker’s comp accident. After the Workers Compensation claimant submitted a Notice of Resolution of the Worker’s compensation claim issues, the Judge of Compensation Claims administratively closed the file, reserving jurisdiction on attorney fees and costs. Upon review of the facts, the Judge of Compensation Claims suggested the matter was a ‘close decision’, but ultimately concluded the statute squarely placed dismissal within the realm of the Judge of Compensation Claims’ discretion. Considering the best workers comp attorney practices, the Judge of Compensation Claims held the facts did not justify dismissal in this Workers Comp case where Workers Compensation claimant had allegedly submitted a grievance to the E/C and the E/C did not attempt to force the outstanding attorney fee issue by way of motion to compel a verified fee petition. Workers compensation insurance company motion DENIED.

Claimant v. T-Mobile USA and Sedgwick CMS

Jacksonville District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Nicole Florentino

Primary Issue: Temporary Partial Disability D/A: 06-15-2011

Decision Date: 01-27-2014

Summary: In this Workers Compensation claim for temporary disability benefits, the workers comp insurance company denied workers comp benefits to the claimant. The Judge of Compensation Claims found the medical evidence did not demonstrate any restricted duty assignment for periods in 2011 but did support entitlement to Temporary Partial Disability benefits for certain periods in 2013. TTD benefits GRANTED in part.

Claimant v. Tuesday Morning and Safety National Casualty

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Susan Arrick

Primary Issues: Major Contributing Cause, One Time Change of Physician D/A: 03-13-2012

Decision Date: 08-26-2013

Summary: At issue were Workers Compensation claimant’s request for one time change of physician and compensability of a neck injury at work. The Judge of Compensation Claims accepted the Workers Compensation claimant’s testimony and the medical evidence which supported her position that the work accident was the MCC of the work-related neck condition. Furthermore, the Judge of Compensation Claims found Workers Compensation claimant’s selection of a physician was proper in light of the workers compensation insurance company’s failure to timely provide a one time change upon request. Compensability of neck injury and one time change of physician request GRANTED.

Claimant v. Flack’s Painting and Waterproofing and None

Tallahassee District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: E#1 Jonathan Gunn, E/C#2 Mark Ingram

Primary Issue: EE/ER relationship D/A: 06-05-2012

Decision Date: 03-14-2013

Summary: No employer/insurance company accepted responsibility for the claimant’s work accident. The Judge of Compensation Claims previously entered an order bifurcating the issue as to which named defendant was responsible for worker’s compensation coverage in this matter. Workers Compensation claimant had been injured at work prior to the principal employer’s submission of paperwork regarding the work accident to the personnel leasing company. Based upon the testimony from the principal employer, the Judge of Compensation Claims concluded she was aware that her contract with the leasing company required certain enrollment procedures be completed before an employee would be covered, and in this case those Worker’s comp procedures were not satisfied. Employer #1 determined to be the proper party to provide coverage for Workers Compensation claimant’s alleged work accident.

Claimant v. Pioneer Roofing and Summit Claims Management

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Stephanie Robinson

Primary Issues: Dismissal, Managed Care D/A: 03-21-2012

Decision Date: 01-08-2013

Summary: Asserting Workers Compensation claimant failed to exhaust the managed care grievance procedures, the workers compensation insurance company moved to dismiss Workers Compensation claimant’s petition seeking medical care and treatment. Workers Compensation claimant responded that there was no evidence a proper managed care arrangement was in effect. The Judge of Compensation Claims determined that the E/C motion was not the proper vehicle for jurisdictional challenges such as the one before him. Here, the E/C did not contend the petition failed to meet the specificity requirements and the lack of jurisdiction defense required the Judge of Compensation Claims to look beyond the four corners of the petition. The Judge of Compensation Claims instructed the best workers comp attorney practices and proper method to assert the instant challenge was a motion for summary final order, and in this case the motion did not comply with the applicable procedural requirements for SFO. Workers compensation insurance company’s Motion to dismiss DENIED.

Claimant v. American Airlines and Chartis

Jacksonville District, JUDGE OF COMPENSATION CLAIMS (JCC

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Frank Garcia

Primary Issue: Misc. Motion D/A: 03-16-2012

Decision Date: 08-28-2012

Summary: The Judge of Compensation Claims noted the purpose of the functional capacity evaluation (FCE) in workers comp, to which the workers compensation insurance company sought to compel Workers Compensation claimant’s attendance, was to determine the credibility of Workers Compensation claimant and/or as assistance to the doctor to assign restrictions. The Judge of Compensation Claims concluded he had no statutory authority to order compliance with an FCE. Notwithstanding, there was no evidence of medical necessity which would support such an award. Insurance company’s Motion to compel attendance at FCE DENIED.

Claimant v. City of Fort Lauderdale Housing Authority and Florida League of Cities

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: David Schweiger

Primary Issues: Motion to Enforce, Jurisdiction D/A: 10-19-2009

Decision Date: 07-18-2012

Summary: The Workers Compensation claimant’s personal health insurer asserted a lien against Workers Compensation claimant’s settlement proceeds. The issue presented was whether the Judge of Compensation Claims had jurisdiction to consider the workers comp insurance company request for an order allowing the insurance company to issue a settlement check that included the health insurer as payee. The Judge of Compensation Claims concluded he was without authority to consider the asserted lien. Workers Compensation claimant’s motion to enforce settlement GRANTED.

Claimant v. Reliance Steel & Aluminium and ACE USA/ESIS

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Katie Kaplan

Primary Issues: Summary Final Order, One Time Change of Physician D/A: 12-07-2010

Decision Date: 04-20-2012

Summary: The workers compensation insurance company moved for final summary judgment asserting they timely authorized a one time change of physician. Workers Compensation claimant argued that, under the best workers comp attorney practices, authorization was not timely. The Judge of Compensation Claims found the authorization issue was a genuine issue of material fact and, even if it were not, there remained other issues raised by the petition. Workers compensation insurance company’s motion for SFO DENIED.

Claimant v. West Boca Medical Center and Specialty Risk Services

West Palm Beach District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Debrah Antell

Primary Issue: One Time Change of Physician D/A: 09-10-2010

Decision Date: 03-01-2012

Summary: Workers Compensation claimant forwarded a 1x change of physician request to the workers comp insurance company on February 23. No action was taken. On March 24, the workers comp insurance company received a petition for benefits and immediately scheduled an appointment for a 1x change of physicians. The Judge of Compensation Claims found the E/C did not timely respond to the original request for 1x change of physicians within the statutory 5 days, allowing Workers Compensation claimant to select his own one time change doctor. In this case Workers Compensation claimant utilized the best workers compensation attorney practices, and availed himself of that right, and the Judge of Compensation Claims GRANTED Workers Compensation claimant’s request for authorization of his chosen 1x change physician.

Claimant v. Radstad North America and REM Risk Enterprise Management

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Jeffrey Marks

Primary Issue: Surgery D/A: 01-27-2011

Decision Date: 03-01-2012

Summary: In light of competing medical opinions as to the MCC and the medical necessity of a work related shoulder surgery, the Judge of Compensation Claims was called upon to resolve the parties’ dispute. In that regard, the Judge of Compensation Claims accepted the opinions of the authorized workers comp physician who opined the MCC and need for surgery were the work accident and work injuries. An eleventh hour fraud assertion by the workers comp insurance company was DENIED as untimely. Petition for benefits for surgery GRANTED. Workers compensation insurance company appealed, but voluntarily DISMISSED the appeal due to settlement of the workers comp case.

Claimant v. Cayman National Manufacturing and Amerisure

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)Lewis

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Roberto Mendez

Primary Issue: Dismissal D/A: 08-20-2010

Decision Date: 08-17-2011

Summary: Workers compensation insurance company moved to dismiss Workers Compensation claimant’s petition for benefits for lack of specificity. The Judge of Compensation Claims found in determining whether a petition for benefits should be dismissed, the Judge of Compensation Claims may not look beyond the four corners of the petition for benefits. In this workers comp case, the E/C allegations required factual determinations that went beyond the information contained in the petition for benefits (ie. whether the work accident date was correct or the named party was correct). Consequently, the workers compensation insurance company motion to dismiss was DENIED.

Claimant v. Starwood Hotels & Resorts and Gallagher Bassett Services

, Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Stephanie Robinson

Primary Issues: Repetitive Trauma, Major Contributing Cause D/A: 05-20-2010

Decision Date: 05-13-2011

Summary: The medical evidence suggested Workers Compensation claimant suffered from a ganglion cyst in his wrist, most likely caused by repetitive duties as a busboy. Workers Compensation claimant worked two similar busboy positions with different companies leading up to the reported work injury. Notwithstanding, because any percentage of the sustained work injury related to the other employer would also be work related, MCC was not a consideration. Compensability of the work injuries and authorization of medical care GRANTED. Authorization of an independent Medical examination (IME) hand specialist and an interpreter for authorized workers compensation medical appointments DENIED. (However, IME was a recoverable taxable cost against the E/C.)

Claimant v. Miami Dade County and Miami Dade County Risk Management

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Daron Fitch D/A: 10-08-2009

Decision Date: 01-21-2011

Summary: The parties disputed who controlled the choice of one time change of physician requested by Workers Compensation claimant. Workers Compensation Workers Compensation claimant also moved for a $2,000 advance. After the accident Workers Compensation claimant was provided initial care with a clinic physician who referred care to an orthopedic specialist. The ortho recommended a ‘different specialist’. Workers Compensation claimant contacted the carrier and the request was denied on the basis that a change of physician had already been exercised from the the clinic doctor to the ortho. Workers Compensation claimant proceeded to treat with her own doctor. The E/C then changed its position and authorized a new doctor and Workers Compensation claimant accepted the care. The Judge of Compensation Claimsfound this change was not timely authorized and therefore past bills from Workers Compensation claimant’s unauthorized doctor were the responsibility of the E/C. However, since Workers Compensation claimant acquiesced to the E/C change, the E/C choice became the one time change physician. The JUDGE OF COMPENSATION CLAIMS (JCC)GRANTED the motion for advance.

Claimant v. Penn Dutch Food Center and Gallagher Bassett Services

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Chris Fisher, Clmt Former Counsel: Mario Perez D/A: 06-12-2010

Decision Date: 12-08-2010

Summary: On E/C Motion to Enforce Settlement Agreement – The disputed issue was whether Workers Compensation claimant’s former counsel had authority to enter into a settlement agreement on behalf of Workers Compensation claimant. The JUDGE OF COMPENSATION CLAIMS (JCC)noted enforcement was appropriate only if the attorney had been given ‘clear and unequivocal’ authority to settle the claim. Here, the JUDGE OF COMPENSATION CLAIMS (JCC)found the attorney thought in good faith he had authority to resolve the case, but given the accepted testimony of the Workers Compensation claimant such was not actually the case. E/C motion to enforce DENIED.

Claimant v. Frank Crum and Frank Winston Crum Services

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Sandra Wilkerson D/A: 06-05-2009

Decision Date: 11-19-2010

Summary: On E/C Motion to Enforce Workers Comp Settlement – The workers compensation Workers Compensation claimant did not appear at the evidentiary hearing before the Judge of Compensation Claims. Workers Compensation claimant’s prior workers compensation attorney testified that the injured worker had provided him the authority to enter a workers compensation settlement on the injured worker’s behalf. The prior workers compensation attorney had forwarded the workers comp settlement documents to Workers Compensation claimant, but received only a termination letter in response. The paperwork provided that the workers comp settlement was voidable until such time as the Judge of Compensation Claimsentered the appropriate attorney fee/child support allocation order. Here, the papers had not been signed by the Workers comp Workers Compensation claimant nor had the requisite order been entered. Pursuant to McLean v. McLane Grocery, (Fla. 1st DCA 2010), the JUDGE OF COMPENSATION CLAIMS (JCC)found the language operated to defeat the concept of an enforceable agreement, and DENIED the E/C motion.

Claimant v. Jim Threlkel Florist and AequiCap Insurance

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Jeffrey Breslow D/A: 12-15-2008

Decision Date: 07-30-2010

Summary: Amended Order following E/C motion for rehearing (No change in decree) – Workers Compensation claimant alleged a right arm and neck injuries as a result of lifting a heavy tree at work. E/C denied the claim on the bases that no accident occurred and/or Workers Compensation claimant did not give timely notice. E/C conceded that benefits would be due if the Judge of Compensation Claims (JCC) found in favor of Workers Compensation claimant on the compensability/notice issues. The Judge of Compensation Claims (JCC) rejected Workers Compensation claimant’s attempt to appoint his treating physician as his IME. The E/C had not agreed to the same and the statute therefore did not permit Workers Compensation claimant’s improper assignment. However, the doctor’s deposition was admitted for fact purposes. As to compensability and notice, the Judge of Compensation Claims (JCC)accepted Workers Compensation claimant’s uncontroverted testimony that he sustained an accident and that he notified his employer the next day. Compensability and medical benefits AWARDED.

Claimant v. Jim Threlkel Florist and AequiCap Insurance

Ft. Lauderdale District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Jeffrey Breslow D/A: 12-15-2008

Decision Date: 07-09-2010

Summary: Workers Compensation claimant alleged a right arm and neck injuries as a result of lifting a heavy tree at work. E/C denied the claim on the bases that no accident occurred and/or Workers Compensation claimant did not give timely notice. E/C conceded that benefits would be due if the Judge of Compensation Claims (JCC)found in favor of Workers Compensation claimant on the compensability/notice issues. The Judge of Compensation Claims (JCC) rejected Workers Compensation claimant’s attempt to appoint his treating physician as his IME. The E/C had not agreed to the same and the statute therefore did not permit Workers Compensation claimant’s improper assignment. However, the doctor’s deposition was admitted for fact purposes. As to compensability and notice, the Judge of Compensation Claims (JCC)accepted Workers Compensation claimant’s uncontroverted testimony that he sustained an accident and that he notified his employer the next day. Compensability and medical benefits AWARDED.

Claimant v. Pepsi Americas and Gallagher Bassett Services

JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Beth Koller D/A: 10-03-2005

Decision Date: 12-29-2008

Summary: The injured worker was a truck driver and was injured at work on 6/2/2008. He injured his back while lifting a bay door. The Workers Compensation claimant had received authorized care with Dr. McCarthy, clinic physician, Dr. Christopher Brown, orthopedic surgeon, and Dr. Lance Lehman, pain management physician. The outstanding claim for trial was authorization of an alternative primary care physician – specifically Dr. Marquez, Neurologist. The workers comp insurance carrier defended that the injured worker had two pain management physicians and already exercised his one-time change and that the Workers Compensation claimant never treated with a neurologist, so a one-time change would be improper. The workers comp insurance carrier objected to Workers Compensation claimant’s amendment to the pretrial stipulation, wherein the Workers Compensation claimant noticed its IME selection, on the basis that same was untimely. Dr. Kenneth Jarolem served as the independent medical examiner in this case. The Judge of Compensation Claims found that the amendment was due on a Saturday and, per the best Florida workers compensation attorney practices, the amendment filed on the following Monday was timely. Upon testimony of the adjuster, the adjuster was unable to establish that the Workers Compensation claimant had actually exhausted his one-time change of doctor. Authorization of the injured worker’s choice of one-time change doctor GRANTED.

Claimant v. Miami Drywall and AIG Claims

JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Jeffrey Golovin D/A: 08-24-2007

Decision Date: 12-04-2008

Summary: The Employer and their workers compensation insurance carrier denied that the Workers Compensation claimant was hurt at work, and denied compensability of the Workers Compensation claimant’s work injuries, as well as all temporary indemnity benefits claimed as the result of same. The injured worker had treated at Port of Miami Medical Clinic, and orthopedics U.S.A. The Judge of Compensation Claims found the medical evidence supported the Workers Compensation claimant’s position that the back condition was related to the work accident. The best Worker’s compensation attorney practice was to present argument supported medical expert opinion that is admissible per Florida Worker’s Compensation statutes. Based on same, the Judge of Compensation Claims (JCC)found the injured worker was due indemnity benefits for all periods that he remained out of work. Compensability of the back injury and temporary indemnity benefits GRANTED. 

Claimant v. Eagle Security & Patrol Agency and None

JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: None D/A: 05-16-2004

Decision Date: 10-24-2008

Summary: The Worker’s comp insurance company denied compensability of the Workers Compensation claimant’s work injuries. The Judge of Compensation Claims accepted the evidence presented by the Workers Compensation claimant’s attorney, and determined that the injured worker suffered a compensable work accident. As there was no evidence as to the Workers Compensation claimant’s post accident earnings presented by the Worker’s comp carrier, the Judge of Compensation Claims (JCC)also determined that the injured worker was entitled to the maximum allowable period of temporary indemnity benefits of 5/16/04 through 6/15/06. The Judge of Compensation Claims (JCC)further found that the injured worker was entitled to payment/reimbursement of all medical bills presented for the Worker’s Compensation Final Hearing. Compensability of the work accident, authorization of treatment, payment/ reimbursement of medical bills, and payment of temporary indemnity benefits, as well as payment by the carrier of Worker’s compensation fees and costs GRANTED. 

Claimant v. United States Sugar Corporation and Gallagher Bassett Services

JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Heather Hatch D/A: 09-26-2006

Decision Date: 10-16-2008

Summary: The injured worker was authorized to treat at Palm Glades Rural Health Associates, and with Dr. Chang, orthopedic surgeon. The injured worker obtained additional treatment due to increased pain levels, which treatment the Worker’s compensation carrier initially denied. The injured worker’s attorney and the Workers Compensation insurance carrier stipulated at trial that the Employer/ carrier was responsible for payment of all medical bills of Hendry County EMS and Berner ER Services Partnership for Hendry Regional Medical Center at fee schedule. 

Claimant v. Blue Ridge Plumbing and None

JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A. D/A: 07-20-2007

Decision Date: 09-09-2008

Summary: The injured worker obtained an order from the Judge of Compensation Claims striking all defenses of the employer. At trial, the Workers Compensation claimant’s attorney and employer then stipulated to payment of all medical bills related to the work accident, as well as payment of the Worker’s compensation attorney fees. 

Claimant v. Master Restaurant Developers and Technology Ins. Co.

JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Stephen Wilson D/A: 07-29-2007

Decision Date: 03-17-2008

Summary: The injured worker initially received medical treatment at the Physician’s Health Center, and then pursued a request for a 1x change doctor. The Workers Compensation claimant’s attorney secured the Workers Compensation claimant’s choice of doctor, and the Workers Compensation claimant treated with said physiatrist. The physiatrist made a referral to a neurosurgeon. Upon authorizing the neurosurgeon, the Worker’s compensation insurance carrier deauthorized the physiatrist. The injured worker’s attorney argued that the unilateral deauthorization of the authorized treating physiatrist was illegal, and the Judge of Compensation Claims agreed. The Judge of Compensation Claims awarded continued authorization of the physiatrist, as well as the ultrasound and electrical stimulator recommended by said physiatrist. 

Claimant v. McDonald’s, Inc.

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Louis Caputo D/A: 05-04-2005

Decision Date: 05-01-2007

Summary: While the Employer/Carrier accepted the work accident as compensable, they accepted only the work injuries to the elbow and wrist, but denied that the Workers Compensation claimant injured her back also. The injured worker obtained treatment for the back on her own with a chiropractor. The Workers Compensation claimant pursued claims for authorization and payment of the “self-help” medical treatment with the chiropractor, and also authorization of a neurologist, physiatrist, doctor of osteopathic medicine specializing in orthopaedic hand and arm rehab for evaluation and treatment, physical therapy, and an MRI of the cervical spine, as well as payment of mileage and Temporary Partial Disability Benefits from 5/4/2005 to present. The Judge of Compensation Claims GRANTED all benefits requested. The Employer/Carrier appealed the order. The First District Court of Appeal limited the reimburseable chiropractic treatment to 24 visits, and affirmed the Judge of Compensation Claims decision as to all remaining benefits.

Claimant v. Publix Super Markets, Inc.

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Benjamin D. Levy D/A: 9/7/2002

Decision Date: 05-14-2007

Summary: Prior to the work accident, the Workers Compensation claimant was working not only for the employer, but also with a concurrent employer, International House of Pancakes, part time. The Worker’s Compensation insurance Carrier refused to include the earnings from the concurrent employer in the Workers Compensation claimant’s Average Weekly Wage. The Workers Compensation claimant argued that the concurrent earnings were properly includable in the AWW, and that the injured worker should be paid additional Temporary Disability Benefits for all past, relevant periods based on the increased AWW. The Judge of Compensation Claims agreed, and awarded an upward adjustment to the Average Weekly Wage (AWW), and ordered the Employer/Carrier to pay past due indemnity benefits from the date of her work injury through 12/31/2002.

Claimant v. United Parcel Services & Liberty Mutual

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC

Workers Compensation claimant Counsel: Kevin Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Michael R. Gilmartin D/A: 02-26-2006

Decision Date: 10-02-2007

Summary: The Workers Compensation claimant suffered from pain to the wrists, hands, arms, neck, and shoulders during the course of her 20 years of employment with the employer as a data processor. The Workers Compensation claimant attributed the injuries to the repetitive motions of leaning over a desk and typing at her keyboard. The Worker’s Compensation insurance company denied the entire claim on the basis that there was no accident in the course of employment, and that there was not sufficient evidence to establish that the Workers Compensation claimant’s injuries were caused by her work activity. The Workers Compensation claimant’s attorney argued that it was the Employer/Carrier’s burden to prove that the Workers Compensation claimant’s work injuries were caused by some other specific trauma or source once the Workers Compensation claimant established through competent medical evidence that the work activities did cause the work injuries. The Judge of Compensation Claims agreed with the Workers Compensation claimant’s attorney in his recitation of the applicable legal standard, and GRANTED compensability the accident and resulting work injuries to include the Carpel Tunnel Syndrome. The Worker’s Comp carrier was ordered to authorize and pay the bills of Dr. Paul Bates, Dr. Bruce Zaret, Dr. Kevin Stone, Dr. Nicholas Suite, Dr. Phillip Cummings, Dr. Guillermo Pasarin, and Dr. Alan Siegal. The JUDGE OF COMPENSATION CLAIMS (JCC)further ordered that the Worker’s Compensation insurance company was to pay the Workers Compensation claimant Temporary Total Disability Benefits from the date of the work accident and continuing.

Claimant v. Mediterranean Roof Tiles and First Commercial Group Companies

Miami District, JUDGE OF COMPENSATION CLAIMS (JCC)

Workers Compensation claimant Counsel: Kevin R. Gallagher / The Gallagher Law Group, P.A.; E/C Counsel: Amy Perl D/A: 11-11-2003

Decision Date: 01-23-2007

Summary: The Workers Compensation claimant suffered compensable work accidents with the employer. He was sent by the Worker’s compensation insurance company to Dr. Villegas at Physician’s Health Center. However, the injured worker did not believe that he was receiving adequate treatment from the Worker’s comp doctor that had been authorized and provided by employer/ Carrier. The Workers Compensation claimant began treating with a doctor whom he was directed by his attorney, and refused to return to the previously authorized doctor. The Carrier suspended the Workers Compensation claimant’s indemnity benefits for his “failure to comply with medical treatment”. The Workers Compensation claimant continued to treat with the doctor of his choice for over 2 years. While the workers compensation carrier objected to the treatment with the Workers Compensation claimant’s choice of doctor, the carrier made several payments to said doctor. The Workers Compensation claimant’s attorney argued that the payment of the Workers Compensation claimant’s doctor resulted in ‘aquiescence’ by the carrier, and implied authorization of the doctor. The Judge of Compensation Claims granted authorization of the Workers Compensation claimant’s choice of doctor, Temporary Total Disability benefits from 12/3/2003 through 11/18/2005 with penalties and interest, payment of Impairment Income Benefits (IIB’s) based on a 6% permanent impairment rating, and evaluation and treatment with a neurosurgeon.