RICHARD R. TAYLOR, APPELLANT,
v.
TGI FRIDAY'S, INC. AND GALLAGHER BASSETT SERVICES, INC., APPELLEES

Fla. 1st DCA | 2013-02-22
No. 1D11-6356
VAN NORTWICK, LEWIS, and SWANSON, JJ., concur.
108 So. 3d 698 Florida District Court of Appeal, First District (2013) Positive Treatment
Cited by 2 cases

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Synopsis

In this workers' compensation appeal, the court reversed the Judge of Compensation Claims' denial of medical bill payments, finding that the expert medical advisor's uncontradicted opinion—that the compensable injury was the major contributing cause of the symptoms requiring hospital treatment—was presumed correct and could not be rejected without clear and convincing evidence.


Holding

Yes. The court reversed because the EMA's opinion that the compensable injury was the major contributing cause of the collection of symptoms requiring hospital treatment was presumed correct under Florida law, and the JCC failed to articulate clear and convincing evidence to reject that opinion. Taylor is entitled to payment for all reasonable and medically necessary services related to the symptoms presented on March 11th.


Headnotes

[1] An expert medical advisor's opinion in a workers' compensation case is presumed correct and has nearly conclusive effect.

[2] A Judge of Compensation Claims must cite clear and convincing evidence to reject the presumed correctness of an expert medical advisor's opinion.

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Key Quotes

“An EMA's opinion has nearly conclusive effect, Pierre v. Handi Van. Inc., 717 So.2d 1115 (Fla. 1st DCA 1998), and is presumed to be correct unless the JCC finds and articulates clear and convincing evidence to the contrary.”

Establishes the high deference afforded to expert medical advisor opinions in workers' compensation cases

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Facts & Procedural History

Richard Taylor sustained a compensable workplace injury. He later presented to Memorial Hospital West with a collection of symptoms requiring treatmen…

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Opinion of the Court
PER CURIAM.

PER CURIAM.

In this workers’ compensation appeal, Richard Taylor, Claimant, argues that the Judge of Compensation Claims (JCC) erred by denying Claimant’s claim for payment of medical bills related to the symptoms Claimant demonstrated when he presented to the hospital for treatment. Because the expert medical advisor (EMA) testified that the compensable injury was the major contributing cause (MCC) of the collection of symptoms that led to the treatment provided to Claimant, and because the JCC failed to cite clear and convincing evidence sufficient to reject the presumed correctness of the EMA’s opinion, we REVERSE.

An EMA’s opinion has nearly conclusive effect, Pierre v. Handi Van. Inc., 717 So.2d 1115 (Fla. 1st DCA 1998), and is presumed to be correct unless the JCC finds and articulates clear and convincing evidence to the contrary. See § 440.13(3)(c), Fla. Stat. (2006); see also Amos v. Gartner, Inc., 17 So.3d 829 (Fla. 1st DCA 2009). Although the JCC states that she relied upon the EMA’s medical *699opinions regarding the nature of Claimant’s condition and need for treatment, the JCC miseharacterized the EMA’s deposition testimony relative to the MCC of the collection of symptoms that led to the treatment provided at Memorial Hospital West. Even though the EMA opined that Claimant’s compensable injury was not the MCC requiring the installation of a permanent pacemaker in Claimant, the EMA testified that Claimant’s compensable injury was the MCC of the collection of symptoms that led to treatment provided at Memorial Hospital West. Absent clear and convincing evidence to reject same, the JCC erred in finding that Claimant’s com-pensable accident was not the MCC of the collection of symptoms that led to the treatment provided at the hospital. Accordingly, Claimant is entitled to payment for all reasonable and medically necessary services related to the collection of symptoms Claimant presented with on March 11th, based on the testimony from the EMA. Accordingly, the order on review is reversed and remanded for entry of an order consistent with this opinion.

REVERSED and REMANDED.

VAN NORTWICK, LEWIS, and SWANSON, JJ., concur.


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