BILL SPRAGUE, APPELLANT,
v.
SARASOTA PALMS HOSPITAL, CRAWFORD AND COMPANY, APPELLEES

Fla. 1st DCA | 1989-08-31
No. 88-1766
SHIVERS, C.J. and WENTWORTH, J., concur.
550 So. 2d 58 Florida District Court of Appeal, First District (1989) Positive Treatment
Cited by 2 cases

AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.

Synopsis

A workers' compensation claimant appealed a deputy's order finding maximum medical improvement (MMI) with no permanent impairment and denying further medical care and temporary total disability benefits following a 1987 industrial accident. The court reversed, finding that the neurosurgeon's report lacked sufficient clarity to constitute competent substantial evidence of MMI and that the claimant's disability benefits claim should be reconsidered using the average weekly wage figure asserted by the employer.


Holding

The court reversed the finding of MMI with no permanent impairment and the resulting denial of further treatment because the medical report lacked a clear statement regarding MMI status and failed to address whether a CT scan review was performed. The court also reversed the denial of disability benefits and directed the deputy to reconsider the claim using the average weekly wage amount ($241.44) asserted by the employer/carrier in the pre-trial stipulation.


Headnotes

[1] A medical report is not competent substantial evidence to support a finding of maximum medical improvement with no permanent impairment if it does not contain a clear sta…

[2] A medical report that fails to mention the review of diagnostic tests or whether such review was performed is insufficient to support a finding of maximum medical improve…

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Key Quotes

“This report contains no clear statement of whether appellant has reached MMI without permanent impairment, and is therefore not competent substantial evidence in support of the finding.”

The court's basis for finding that the neurosurgeon's report was insufficient to support the MMI determination.

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Facts & Procedural History

Sprague suffered an industrial accident on March 4, 1987, and was treated by several physicians. In October 1987, he came under the care of neurologis…

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Opinion of the Court
NIMMONS, Judge.

NIMMONS, Judge.

The claimant in this workers’ compensation case appeals the deputy’s order finding maximum medical improvement (MMI) with no permanent impairment, denying further medical care, and denying temporary total disability benefits.

This case arose out of a March 4, 1987 industrial accident. Appellant was treated by several physicians and in October 1987 came under the care of neurologist Dr. Aung-Din, who prescribed physical therapy. In the instant case, appellant sought further treatment with Dr. Aung-Din, which the E/C maintained was unnecessary because appellant had reached MMI with no permanent impairment. Dr. Aung-Din felt that appellant was in need of further remedial treatment.

Appellant underwent an independent medical examination by Dr. Padar, a neurosurgeon, in January 1988. After the examination, Dr. Padar stated in a report that he intended to review a CT scan of appellant’s neck, and suggested that appellant may require surgery.1 A subsequent report by Dr. Padar, relied upon by the deputy to establish MMI with no permanent impairment, stated:

This is to certify that I have reviewed Mr. Sprague’s MRI scan of the cervical spine. There is no evidence of cervical disc rupture.

This man has a cervical sprain. He does not have a permanent disability and does not need to return here.

This report contains no clear statement of whether appellant has reached MMI without permanent impairment, and is therefore not competent substantial evidence in support of the finding. See Johnson v. United Parcel Service, 513 So. 2d 1336 (Fla. 1st DCA 1987) (statement in medical report that “I do not see, at this point, any limitation of his activities ...” cannot be reasonably interpreted as stating that the claimant has reached MMI); Walker v. Allied Septic Tanks, 522 So. 2d 456 (Fla. 1st DCA 1988) (medical records which were both stale and less than explicit regarding claimant’s need for further care could not support denial of claim for medical care). Moreover, the report makes no reference to the results of the review of appellant’s CT scan, or even whether such a review was performed.

We therefore reverse the finding of MMI with no permanent impairment and resulting denial of further treatment, and remand for further consideration upon the existing record or such additional evidence as may be deemed necessary.2 .

Regarding appellant’s claim for disability benefits, the deputy correctly stated that “[n]o evidence is presented as to the average weekly wage issue ...” Under the circumstances of this case, however, the lack of such evidence does not justify denial of the requested benefits. In the pre-trial stipulation entered into between the parties, appellant stated that AWW is in issue, but appellees asserted that the correct amount is $241.44. Where the E/C has asserted a specific amount as the correct AWW and the claimant presents no evidence to the contrary and no alternative amount, we see no reason why the claim should not be judged on its merits utilizing the figure asserted by the E/C in the stipulation. We therefore direct that the deputy reconsider appellant’s entitlement to disability benefits. The deputy is authorized to take further evidence.

REVERSED and REMANDED for further proceedings consistent with this opinion.

SHIVERS, C.J. and WENTWORTH, J., concur. . Dr. Padar did not testify either via deposition or at the hearing before the deputy.

. We note that the record contains evidence which would permit the deputy to go either way on this issue.


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Citator

Cited By

  • Gillich v. Park Ave. Night Club & Emp'rs of Wausau, 569 So. 2d 930 (Fla. 1st DCA 1990)
    …ould ordinarily be based upon a clear, explicit expression of that fact set forth in medical records or medical opinion testimony. Scott v. Container Corporation of America, 559 So. 2d 399, 400 (Fla. 1st DCA 1990); Sprague v. Sarasota Palm Hospital, 550 So. 2d 58, 59 (Fla. 1st DCA 1989); Walker v. Allied Septic Tanks, 522 So. 2d 456 (Fla. 1st DCA 1988); Johnson v. United Parcel Service, 513 So. 2d 1336, 1337 (Fla. 1st DCA 1987). A maximum medical improvement determination should not be confused with a findin…

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