City of Fort Pierce/Florida Municipal Insurance Trust v. Spence
155 So. 3d 1197
| Fla. Dist. Ct. App. | 2014Background
- Claimant injured in a work-related motor vehicle accident on October 21, 2012; Employer/Carrier (E/C) conceded compensability.
- Authorized pain management physician (Dr. Slobasky) recommended bilateral cervical facet medial branch blocks; attributed 70% of need to preexisting degenerative cervical disease.
- Claimant’s primary care physician had documented degenerative spine changes predating the accident and characterized them as age-appropriate for a 44-year-old.
- Judge of Compensation Claims (JCC) accepted Dr. Slobasky’s percentage attribution but discounted the weight because he viewed the degeneration as "normal, aging," and nonetheless awarded the facet injections.
- Claimant sought authorization for an orthopedic surgeon and C5-6 diskectomy and fusion based on Dr. Roush’s opinion; the JCC excluded Dr. Roush’s testimony under section 440.13(5)(e) but also alternatively rejected Dr. Roush’s opinion on the merits in favor of Dr. Slobasky’s view that the facet joints, not the discs, were the primary pain generator.
- E/C appealed the facet-injection award; Claimant cross-appealed exclusion of Dr. Roush’s testimony and denial of surgical authorization.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether facet injections are compensable given preexisting degenerative disease | Preexisting degeneration is age-appropriate and does not bar treatment; injections are needed for work injury | Degeneration is the major contributing cause; majority of need non-work-related (70%) so injections not compensable | Reversed: JCC erred in awarding facet injections because medical evidence showed preexisting degeneration was the major contributing cause of need |
| Whether JCC erred excluding Dr. Roush’s testimony and denying C5-6 diskectomy/fusion | Dr. Roush’s opinion that surgery is needed is admissible and supports authorization | JCC excluded Dr. Roush under §440.13(5)(e); alternatively, JCC rejected his opinion in favor of Dr. Slobasky’s opinion that facets are primary pain source | Affirmed in part: Exclusion under §440.13(5)(e) was error, but harmless because JCC permissibly rejected Dr. Roush’s opinion on evidentiary grounds in favor of Dr. Slobasky |
Key Cases Cited
- Bysczynski v. United Parcel Servs., Inc., 53 So.3d 328 (Fla. 1st DCA 2010) (preexisting degeneration that did not independently require treatment distinguished from degeneration that is major contributing cause)
- Osceola Cnty. Sch. Bd. v. Pabellon-Nieves, 152 So.3d 733 (Fla. 1st DCA 2014) (major contributing cause, not age-appropriateness, controls compensability of treatment)
- Romano v. Trinity Sch. for Children, 43 So.3d 928 (Fla. 1st DCA 2010) (admissibility of medical opinions under §440.13(5)(e))
- Miller Elec. Co. v. Oursler, 113 So.3d 1004 (Fla. 1st DCA 2013) (context for expert testimony admissibility under workers’ compensation rules)
- Parodi v. Fla. Contracting Co., Inc., 16 So.3d 958 (Fla. 1st DCA 2009) (same)
- Vadala v. Polk Cnty. Sch. Bd., 822 So.2d 582 (Fla. 1st DCA 2002) (JCC may reject unrefuted opinion if a stated reason exists)
- Trejo-Perez v. Arry’s Roofing, 141 So.3d 220 (Fla. 1st DCA 2014) (record-supported reasons can provide a reasonable evidentiary basis for rejecting testimony)
- Wald v. Grainger, 64 So.3d 1201 (Fla. 2011) (standard for appellate review of evidentiary determinations)