Florida worker’s compensation claims can involve some complex issues. Nationally, 60% of all first-time workers’ compensation claims are rejected. Upon appeal, a substantial number of claims are allowed.
However, sometimes worker’s comp claims go down a long road, ending up in court. This is just what occurred with Brevard County School Board v. Acosta. A recent decision by the Florida First District Court of Appeal concerning this workers’ comp case offers insights into how complex such claims can be.
Brevard County School Board v. Acosta
In Brevard County School Board v. Acosta, there has been a judgment made in relationship to the “hindrance to recovery” doctrine. Ms. Acosta’s case centered on her need to have surgery on her right shoulder due to an injury that was covered by workers’ compensation. Ms. Acosta’s lawyer argued at the original trial that she also required surgery on her left shoulder, and that although this was unrelated to her workers’ comp claim, that the surgery on her left shoulder needed to be performed first and by doing so that the “result from the right shoulder repair will be better.”
Thus, if this were the situation, under “hindrance to recovery,” workers’ comp would have to pay for both surgeries. A medical expert testified in overall agreement, but also added that the “ultimate result from the right shoulder surgery would be unaffected by the order.”
Ms. Acosta won the day, as the trial judge deemed that putting off the left shoulder surgery in lieu of performing the right shoulder procedure was a hindrance to the recovery of the work injury. Thus, for the right shoulder to properly recover, the left shoulder had to be done first. The judge ordered that the employer pay for the left shoulder surgery first and then the subsequent right shoulder surgery.
Florida First District Court of Appeal Ruling
The Florida First District Court of Appeal (DCA) ruling reversed the original judgment. Why was this? They noted that there was no hindrance to recovery regarding the issues related to the surgeries.
In reviewing the medical evidence, the DCA observed that the information confirmed only that Ms. Acosta’s left shoulder would benefit from that surgery being performed; that the procedure would help to prevent further injury to her left shoulder, but that it would not benefit her right shoulder or the recovery from the injuries to that right shoulder. Thus, worker’s compensation should only pay for her right shoulder procedure.
The DCA noted, “unless the purpose is to remove a hindrance to treating the compensable right shoulder injury, the doctrine does not apply.” In order for both surgeries to be covered, the result from the right shoulder repair would have to have been affected by the left shoulder surgery being performed first.
Do You Need a Lawyer?
Workers’ compensation benefits can be difficult to get. The system is rife with fraud, employers are hesitant to pay for injuries that they feel are either nonexistent or over exaggerated, and the need to be exacting and specific in your claim can challenge even the most organized and detail oriented person. No lawyer is need for one to file a Florida workers’ compensation claim; however, an attorney who focuses in this area can help ensure that when your claim is submitted it is as convincing as possible.
Contact Florida Workers’ Compensation Attorney
To discuss your Florida workers’ compensation claim or appeal contact Scott J. Sternberg and Associates, P.A., in Boca Raton and West Palm Beach at 561-687-5660. We will be happy to discuss your case with you and to ensure that you have every opportunity to receive the benefits that you deserve.