Northwest Orient Airlines v. Gonzalez

• Decision Date: 06 January 1987
• Docket Number: No. BK-422,BK-422
• Citation: 12 Fla. L. Weekly 241,500 So.2d 699
• Parties: 12 Fla. L. Weekly 241 NORTHWEST ORIENT AIRLINES and Underwriters Adjusting Company, Appellants, v. Hugo GONZALEZ, Appellee.
• Court: Florida District Court of Appeals

Page 699

500 So.2d 699

12 Fla. L. Weekly 241

NORTHWEST ORIENT AIRLINES and Underwriters Adjusting Company, Appellants, v. Hugo GONZALEZ, Appellee.

No. BK-422.

District Court of Appeal of Florida First District.

Jan. 6, 1987.

Cesar A. Armstrong of Lanza, Sevier & O'Connor, Coral Gables, for appellants.

Irving J. Whitman of Whitman, Wolfe, Gross & Schaffel, P.A., Miami, for appellee.

MILLS, Judge.

Northwest Orient Airlines and Underwriters Adjusting Co. (E/C) appeal from an order of the deputy commissioner requiring it to pay certain medical bills incurred in the treatment of Gonzalez' knees, and awarding temporary total disability benefits during the hospitalization and recovery period related to that treatment. We affirm in part, reverse in part and remand for further proceedings.

Gonzalez, employed by the E/C as a baggage handler, suffered injuries to his neck and right shoulder and arm in industrial accidents occurring in 1972 and 1975. A claim for benefits relating to both accidents was heard in 1977 and, in an order dated 20 April 1978, the D/C held that the injuries had left Gonzalez 40% permanently partially disabled and awarded him 140 weeks of compensation.

In December 1984, Gonzalez filed a claim for benefits relating to a third injury to his shoulder. In April 1985, that claim was consolidated for hearing with the claim involved herein; namely, for payment of medical bills relating to December 1983 knee surgery and for TTD benefits for the period of hospitalization and recovery therefor, 13 December 1983 to 10 February 1984. It was Gonzalez' contention that his knee condition, torn medial menisci, had occurred at the time of the 1975 injury. The E/C countered first that the 1978 order was res judicata as to any injuries occurring in the 1975 accident. It also alleged that, not only was the treatment of the knee unauthorized, the condition was not causally related to the 1975 accident.

The consolidated claims were considered at several hearings between May and November 1985. With regard to the knee injury, Gonzalez testified that it had occurred in the course of the 1975 accident, but could recall neither reporting knee problems at that time nor exactly when he was first treated for those problems. Dr. Lopez, Gonzalez' authorized and treating physician since the 1972 accident, testified in one deposition that he "seemed to remember" that the knee problem stemmed from a fall at work in 1977. However, in a report placed in Gonzalez' file in 1984, he wrote that the trouble began in the work-related accident in 1975 and that it was "the most important injury" with regard to the knees.

In 1980, Dr. Lopez referred Gonzalez to Dr. Kalbac for evaluation of the knee problems, to determine whether there was something organically wrong or whether the pain was emanating from a back injury. The referral and evaluation was authorized by the E/C, but when Kalbac recommended the performance of an arthrogram, the E/C refused to authorize it. Despite Dr. Lopez' repeated requests for the procedure, at no time did the E/C authorize treatment for the knees.

On 13 December 1983, Gonzalez was admitted to the hospital by Dr. Rothman for an abdominal problem related to pain medication prescribed for his shoulder injury; the compensability of this condition is not contested. While in the hospital, however, Gonzalez continued to complain of knee pain. Dr. Lopez was called in and referred Gonzalez to Dr. Levitt, an orthopedic surgeon. After an examination, during which Gonzalez related the origin of his knee pain to sometime in 1981, Levitt diagnosed him as suffering from tears of the medial menisci. He recommended arthroscopic surgery, and performed it during this same admission on 27 December 1983. Gonzalez was discharged on 13 January 1984 and returned to work on 10 February 1984.

In his December 1985 order, the D/C found that, based on Dr. Lopez' medical reports and testimony, Gonzalez sustained knee injuries in the 1975 accident. He did not address the E/C's contention that the 1978 order precluded such a finding. The order proceeded to require the E/C to pay Dr. Levitt's bill for treatment of the knee condition in that the referral to Dr. Levitt was made by Gonzalez' authorized physician, Dr. Lopez. The D/C also awarded TTD benefits from 13 December 1983 to 10 February 1984, based on Gonzalez' testimony that he was hospitalized for thirty days and out of work an additional 29 days.

We reject the E/C's contention that the D/C was barred by the 1978 order from considering the compensability of the knee condition. While compensation orders are governed by the same principles of res judicata as are judgments of a court, Wellcraft Marine Corp. v. Turner, 435 So.2d 864, 865 (Fla. 1st DCA 1983), an essential element of that doctrine is the identity of the thing sued for. Boston v. Budget Luxury Inns, 474 So.2d 355, 357 (Fla. 1st DCA 1985). In 1977, Gonzalez sought permanent partial benefits for injuries to his right arm and shoulder incurred in 1972 and 1975; the instant claim seeks the payment of medical bills and TTD benefits relating to a knee injury allegedly caused by that same accident.

The E/C's argument would be more well taken had it presented evidence that a claim for the knee was mature at the time of the earlier proceeding, but that Gonzalez had failed to present evidence thereon. See Green Thumb Corp. v. Britten, 393 So.2d 613 (Fla. 1st DCA 1981). However, the E/C presented no such evidence. In fact, the record shows that the knee condition did not concern the treating physician sufficiently to request an evaluation until 1980, two years after the earlier order, which evaluation was authorized by the E/C. Therefore, we decline to reverse on grounds of res judicata.

The award of medical benefits must nevertheless be reversed, in that we find no competent substantial evidence that the knee condition was causally related to a compensable accident. The E/C does not dispute, and we acknowledge, the presence in the record of a medical report stating that Gonzalez' knee problems began with the 1975 accident. However, it is well settled that the conclusion of an expert based on facts not supported by the evidence has no evidential value. Arkin Construction Co. v. Simpkins, 99 So.2d 557 (Fla.1957), accord Braddock v. School Board of Nassau County, 455 So.2d 394 (Fla. 1st DCA 1984), Joanos, J., concurring.

Here, Lopez stated in the 1984 medical report that "based on a review of his records,"...