Babahmetovic v. Scan Design Fla. Inc., No. 1D14–2986.

CourtCourt of Appeal of Florida (US)
Writing for the CourtPER CURIAM.
Citation176 So.3d 1006
PartiesEsad BABAHMETOVIC, Appellant, v. SCAN DESIGN FLORIDA INC./Zenith Insurance Company, Appellees.
Decision Date08 October 2015
Docket NumberNo. 1D14–2986.

176 So.3d 1006

Esad BABAHMETOVIC, Appellant,
v.
SCAN DESIGN FLORIDA INC./Zenith Insurance Company, Appellees.

No. 1D14–2986.

District Court of Appeal of Florida, First District.

Oct. 8, 2015.


176 So.3d 1007

Michael J. Winerof the Law Office of Michael J. Winer, P.A., Tampa, for Appellant.

William H. Rognerof Hurley, Rogner, Miller, Cox, Waranch & Westcott, P.A., Winter Park, for Appellees.

ON MOTION FOR REHEARING

PER CURIAM.

This cause is before us on Appellees' motion for rehearing and rehearing en banc. We grant the motion for rehearing, withdraw our prior opinion issued May 1, 2015, and substitute this opinion in its place. We deny the motion for rehearing en banc.

In this workers' compensation case, Claimant appeals an order of the Judge of Compensation Claims (JCC) denying him a one-time change in authorized treating physician, as permitted by section 440.13(2)(f), Florida Statutes (2013). For the reasons set forth herein, we reverse the ruling.

Background

Claimant lifted a heavy box at work on October 9, 2013. His low back hurt, so the Employer/Carrier (E/C) sent him to Fast Track Urgent Care and authorized Fast Track to treat him. The provider at Fast Track diagnosed radiculitisand checked the boxes on a Uniform Medical Treatment Status Reporting Form (Form DWC–25) that indicated the “injury/illness for which treatment is sought” was “work-related.” Fast Track also referred Claimant to Dr. Delgado, who first saw Claimant on November 15, 2013. Dr. Delgado concluded Claimant had both a resolving lumbar muscle sprainand, as a condition preexisting the date of the work accident, degenerative disk disease. Dr. Delgado checked the same “work-related” boxes on his DWC–25, but the same day he sent a letter to the E/C indicating the cause “regarding the lumbar spine” was 60% the preexisting condition and only 40% the “workplace injury.”

On November 27, 2013, the E/C issued a Notice of Denial (Form DWC–12) stating, under the heading “denied benefits,” “total claim denied,” and, under the heading “reason for denial of benefits,” that the “industrial accident” is not the major contributing cause (MCC) of the need for treatment. Both parties agree that this form was intended to be a denial of compensability—that is, a statement that there was never a compensable injury here.

The instant claim

Despite the Notice of Denial, Claimant asked for a one-time change in authorized treating physician. The E/C denied the one-time change, giving the same reasoning given in the Notice of Denial: that the industrial accident was not the MCC of the need for treatment. When the matter came before the JCC, the parties asked the JCC to consider whether the work accident was the MCC of not only the need for treatment, but also the “injury”—in other words, to determine compensability. They also asked the JCC to consider whether Claimant was entitled to the one-time change despite the E/C's denial of compensability—in other words, whether a claimant can receive a one-time change where there was never a compensable injury.

The JCC drew several conclusions. The JCC stated, “[t]here must first be a compensable accident and injury before an employee is entitled to any benefit allowed in Chapter 440”—thus rejecting Claimant's argument that he is entitled to a one-time change without first having to prove he had suffered a compensable injury of any sort. The JCC found that “Dr. Delgado identified an injury from the accident (a

176 So.3d 1008

sprain) as well as a pre-existing condition (degenerative disc disease) which combinedto produce the potential need for medical care,” and that Dr. Delgado opined the sprain was less than half of the cause of the “injury and need for care.” (Emphasis added). The JCC then found both that “the accident was not the [MCC] of the injury” and that “the accident was not the [MCC] of claimant's need for medical care.” Based on all of this, the JCC denied the one-time change.

Analysis

The JCC is correct that “[t]here must...

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3 practice notes
  • Rueda v. Utah Labor Comm'n, No. 20140043
    • United States
    • Supreme Court of Utah
    • 31 Agosto 2017
    ..."injury by accident" by Fenton v. Thorley & Co. , [1903] A.C. 433 (HL)); see also Babahmetovic v. Scan Design Fla. Inc. , 176 So.3d 1006, 1008 (Fla. Dist. Ct. App. 2015) ("[I]t requires the presence of certain elements described ... by terms of art such as accident, injur......
  • Gil v. Tenet Healthsystem N. Shore, Inc., No. 4D15–3216.
    • United States
    • Court of Appeal of Florida (US)
    • 16 Noviembre 2016
    ...injury is not the major contributing cause for the employee's "need for treatment." See Babahmetovic v. Scan Design Fla. Inc., 176 So.3d 1006, 1008 (Fla. 1st DCA 2015).In the present case, if the hospital merely intended to allege the medical causation defense, it did not do so cl......
  • Levy Cnty. Transit/Gallagher Bassett Servs. v. Kokenzie, CASE NO. 1D16–4817
    • United States
    • Court of Appeal of Florida (US)
    • 14 Junio 2017
    ...workplace injury is the major contributing cause for the need for the requested benefits. See Babahmetovic v. Scan Design Fla., Inc. , 176 So.3d 1006, 1008 (Fla. 1st DCA 2015) ; Checkers Restaurant v. Wiethoff , 925 So.2d 348, 350 (Fla. 1st DCA 2006). In accordance with the statute, a major......
3 cases
  • Rueda v. Utah Labor Comm'n, No. 20140043
    • United States
    • Supreme Court of Utah
    • 31 Agosto 2017
    ..."injury by accident" by Fenton v. Thorley & Co. , [1903] A.C. 433 (HL)); see also Babahmetovic v. Scan Design Fla. Inc. , 176 So.3d 1006, 1008 (Fla. Dist. Ct. App. 2015) ("[I]t requires the presence of certain elements described ... by terms of art such as accident, injur......
  • Gil v. Tenet Healthsystem N. Shore, Inc., No. 4D15–3216.
    • United States
    • Court of Appeal of Florida (US)
    • 16 Noviembre 2016
    ...injury is not the major contributing cause for the employee's "need for treatment." See Babahmetovic v. Scan Design Fla. Inc., 176 So.3d 1006, 1008 (Fla. 1st DCA 2015).In the present case, if the hospital merely intended to allege the medical causation defense, it did not do so cl......
  • Levy Cnty. Transit/Gallagher Bassett Servs. v. Kokenzie, CASE NO. 1D16–4817
    • United States
    • Court of Appeal of Florida (US)
    • 14 Junio 2017
    ...workplace injury is the major contributing cause for the need for the requested benefits. See Babahmetovic v. Scan Design Fla., Inc. , 176 So.3d 1006, 1008 (Fla. 1st DCA 2015) ; Checkers Restaurant v. Wiethoff , 925 So.2d 348, 350 (Fla. 1st DCA 2006). In accordance with the statute, a major......

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