Compensability


I was going to write that this case is the “big one.”  But, they all seem like big ones these days ( TPD, IME’s).  However, I do not want to diminish this importance of this recent decision as it will have a significant impact on defending claims as well as provide ample ammunition to the Claimant’s attorneys bar’s argument that the 2003 amendments are unconstitutional.

With that little pre-amble out of the way, lets dive into Staffmark v. Merrell. (more…)

This issue came up recently and I thought I would share it with you:

Claimant has a desk job in a large corporation.  In the office, during normal working hours, walking between a conference room and her desk, her ankle suddenly gives out and she falls to the carpeted floor.  Her injuries are serious as she fractured the ankle and suffered a possible torn shoulder labrum when her arm braced the fall. 

The question left to me was: is this an accident?  Your answer after the jump. (more…)

Last week I wrote about the Parodi decision which reinforces the self help section of chapter 440.  [see s. 440.13(2)(c)]   The main thrust of my post was that the stakes are now considerably raised with such a decision.

In that case the First DCA found that should Claimant receive unauthorized treatment on his own, and prove that the treatment was compensable and medically necessary, then the doctors providing said treatment could testify in Claimant’s case in chief. 

After talking with a mediator about the Parodi case, he declared that Claimant’s no longer need to use their IME anymore.  They can just go and find a doctor to provide treatment under a letter of protection (LOP).  While I see his point, I don’t think the situation is as dire as that for Employers and Carriers. (more…)

I’ve written about the 3-day rule and the 5-day rule located in section 440.13, but there is also the self help provision that Employer/Carriers must worry about.  Now the First DCA just reinforced  s. 440.13(2)(c), otherwise known as the self help provision, which allows Claimant to seek medical treatment on her own, if said treatment is later found to be compensable and medically necessary.

What this means is to deny a claim or deny medical benefits carries higher risks. (more…)

I can understand the facts of Morrow v. Sam’s Club and why the First DCA ruled the way they did for that specific case.  But, I am worried that the decision can open up a can of worms for a host of issues outside of just a recommendation for a specialist. (more…)