148 So. 3d 827
Fla. Dist. Ct. App.2014Background
- Claimant suffered a dislocated shoulder in an on-the-job May 19, 2011 accident caused by an assault by a bicyclist.
- Emergency treatment occurred the day of the accident at Brandon Regional Hospital; follow-up care was advised.
- Supervisor knew of the injury; no injury notice was completed at the time.
- Claimant received follow-up care at a VA facility about eleven days after the incident and a subsequent attempted surgery about two months later; employer–employee relationship continued.
- Carrier did not receive notice of the injury until September 2012, approximately sixteen months after the accident, and denied compensability.
- JCC found claimant was in the course and scope of employment and ordered reimbursement for emergency treatment and future care, but denied follow-up reimbursement for lack of a request; court reversed and remanded for reimbursement of follow-up care, mileage, and co-payments.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether claimant is entitled to reimbursement for follow-up medical treatment | Fortune argues the exception in 440.13(2)(c) requires reimbursement. | Gulf Coast Tree Care asserts no entitlement due to failure to request follow-up care. | Yes; reversal and remand for follow-up reimbursement. |
| Whether mileage and co-payments are reimbursable | Claimant seeks reimbursement as part of medical expenses. | Carrier/Employer contested non-emergency cost reimbursements absent proper request. | Yes; reversal and remand for mileage and co-payments. |
| Whether the JCC erred in applying the 440.13(2)(c) exception and in status of employer notice | Employer neglected to provide initial care; exception applies and shifts costs to employer. | JCC properly limited reimbursement due to lack of timely request and employer notification failure. | Yes; statutory exception applied and JCC erred by not enforcing it. |
Key Cases Cited
- Airey v. Wal-Mart, 24 So. 3d 1264 (Fla. 1st DCA 2009) (undisputed facts yield purely legal issue on review)
- Lombardi, Inc. v. Smithfield, 11 A.3d 1180 (Del. 1989) (statutory interpretation and governing text guidance)
- Parodi v. Fla. Contracting Co., 16 So. 3d 958 (Fla. 1st DCA 2009) (employer abandonment of care affects employee control of treatment)