Tejeda v. City of Hialeah, 1D21-704

CourtCourt of Appeal of Florida (US)
Writing for the CourtPER CURIAM.
Docket Number1D21-704
PartiesCarlos Tejeda, Appellant, v. City of Hialeah/Sedgwick Claims Management Services, Inc., Appellees.
Decision Date29 December 2021

Carlos Tejeda, Appellant,

City of Hialeah/Sedgwick Claims Management Services, Inc., Appellees.

No. 1D21-704

Florida Court of Appeals, First District

December 29, 2021

Not final until disposition of any timely and authorized motion under Fla. R. App. P. 9.330 or 9.331.

Date of Accident: December 28, 2013.

On appeal from an order of the Office of the Judges of Compensation Claims. Walter J. Havers, Judge.

Richard A. Sicking and Mark A. Touby of Touby, Chait &Sicking, P.L, Coral Gables, for Appellant.

Eduardo E. Neret of Law Offices of Eduardo E. Neret, P.A., Miami, for Appellees.


Claimant appeals the denial of his petitions for benefits. Claimant contends that the Judge of Compensation Claims (JCC) did not have jurisdiction to adjudicate the issue of Claimant's entitlement to reimbursement for the expenses from spinal fusion surgery because it was a "reimbursement dispute." The Claimant therefore contends that the Department of Financial Services (DFS) had sole jurisdiction. Claimant also contends that JCC erred by construing the meaning of the stipulation between the


parties. We reject both arguments as explained below, and all other issues raised by Claimant in this appeal.

Claimant was involved in a motor vehicle crash while on the job as a firefighter. He injured his back in the crash, and the Employer/Carrier (E/C) accepted the injuries as compensable. Before the petition for benefits at issue, Claimant underwent various procedures for his back, including surgeries with Dr. Brusovanik. In 2017, Dr. Vanni was designated as the new authorized physician, and Dr. Brusovanik was deauthorized. The parties stipulated, "If Dr. Vanni opines that Claimant does require further surgical invention, the Employer/Servicing Agent will authorize same, and the Claimant will decide whether he wants to undergo such procedure."

In June 2020, despite Dr. Brusovanik being deauthorized as a treating physician, and without an opinion from Dr. Vanni, Claimant underwent spinal fusion surgery with Dr. Brusovanik. Claimant filed a petition for benefits seeking payment of the surgery bill and copayments as medically necessary. After a contested hearing, the JCC determined that the surgery was medically necessary. But the JCC also determined that the 2017 stipulation was binding on Claimant and denied reimbursement.

On appeal, Claimant contends that although he petitioned for benefits seeking reimbursement for the...

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