TRAVELERS INSURANCE AND ANN TAYLOR, APPELLANTS,
v.
CAROL ARMSTRONG, APPELLEE
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In this workers' compensation appeal, the Florida First District Court of Appeal reversed the Judge of Compensation Claims' (JCC) award of surgery and attorney's fees, holding that the JCC failed to articulate clear and convincing reasons for rejecting the expert medical advisor's opinion as required by law.
The JCC erred in rejecting the EMA's opinion because it failed to articulate clear and convincing reasons for the rejection. The JCC's stated reasons were insufficient: noting the EMA's failure to directly answer one question contradicted the record showing the EMA did state he would not recommend surgery; citing the E/C's selection of a different doctor without explaining how this undermined the EMA's trustworthiness; and finding the treating physician's opinions were 'most logical' without articulating how or why. Consequently, the JCC also erred in awarding surgery and attorney's fees.
[1] A Judge of Compensation Claims must articulate clear and convincing reasons to reject an expert medical advisor's opinion.
[2] A Judge of Compensation Claims must explain how the selection of a doctor whose opinion differs from an expert medical advisor's opinion undermines the trustworthiness of…
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Join FLexlaw to unlock all legal intelligence“When the JCC rejects the opinion of an EMA, this Court reviews the record for competent, substantial evidence to support the JCC's determination that clear and convincing evidence existed to contradict the EMA's opinion.”
Establishes the standard of review for JCC rejection of expert medical advisor opinions in workers' compensation cases.
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Join FLexlaw to unlock all legal intelligenceCarol Armstrong (Claimant) sought workers' compensation benefits including authorization for surgery. The expert medical advisor (EMA) opined against …
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In this workers’ compensation appeal, the Employer/Carrier (E/C) argues that the Judge of Compensation Claims (JCC) erred in disregarding the expert medical advisor’s (EMA’s) opinion because the JCC failed to articulate clear and convincing reasons in support of his rejection of the opinion. The E/C also argues that the JCC erred in determining that Carol Armstrong (Claimant) was entitled to attorney’s fees and costs. For the following reasons, we reverse both issues.
When the JCC rejects the opinion of an EMA, this Court reviews the record for competent, substantial evidence to support the JCC’s determination that clear and convincing evidence existed to contradict the EMA’s opinion. Amau v. Winn Dixie Stores, 105 So.3d 669, 671 (Fla. 1st DCA 2013). Here, the JCC rejected the EMA’s opinion in part because the JCC found that it was “notable” that the EMA avoided answering a question about whether Claimant was a surgical candidate. However, the record shows that the EMA stated in his report that he would not recommend surgery for Claimant and he reaffirmed this statement during his deposition. The next reason given by the JCC for rejecting the EMA’s opinion was that the E/C selected one of the doctors whose opinion differed from the EMA’s opinion, but the JCC failed to explain how the E/C’s selection of one of the doctors who opined that Claimant should undergo surgery undermined the trustworthiness of the EMA’s opinion. Finally, the JCC found that the opinions of the authorized treating physician were “the most logical and comport most closely with reason,” but the JCC failed to articulate how or why he reached this conclusion. Mobile Med. Indus. v. Quinn, 985 So.2d 33, 36 (Fla. 1st DCA 2008) (holding that the JCC is required to find and articulate the reasons for rejecting an EMA’s opinion).
Because the JCC failed to articulate clear and convincing reasons for rejecting the EMA’s opinion testimony, the JCC erred in awarding the requested sur*867gery. Likewise, the JCC erred in awarding attorney’s fees and costs. § 440.34(2), Fla. Stat. (2010). Accordingly, the order is REVERSED, and the matter REMANDED, for entry of an order consistent with this opinion.
LEWIS, C.J., ROBERTS, and ROWE, JJ., concur.
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Certistaff v. Owen, 181 So. 3d 1218 (Fla. 1st DCA 2015)…s not enough for the JCC to find “that the opinions of the authorized treating physician were ‘the most logical, and comport most closely with reason,’” the JCC must “articulate how or why [she] reached this conclusion.” Travelers Ins. v. Armstrong, 118 So. 3d 865, 866 (Fla. 1st DCA 2013). When a claimant has a pre-existing condition not related to an earlier workplace injury, it is appropriate to consider whether the workplace injury at issue is the MCC of the need for the treatment. See § 440.09(1)(b), Fla…
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Collins v. Mosaic Fertilizer, LLC, 121 So. 3d 1119 (Fla. 1st DCA 2013)…hen the JCC rejects the opinion of an EMA, this Court reviews the record for competent, substantial evidence to support the JCC’s determination that clear and convincing evidence existed to contradict the EMA’s opinion.” Travelers Ins. v. Armstrong, 118 So. 3d 865, 2013 WL 3441529 (Fla. 1st DCA Jul.9, 2013) (citing Arnau v. Winn Dixie Stores, 105 So. 3d 669, 671 (Fla. 1st DCA 2013)). The record here supports the JCC’s findings of fact regarding the MRI results, the doctors’ opinions that the MRI should have r…
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Ascension Benefits & Ins. Solutions OF Fla. & City of Orlando v. Robinson, 232 So. 3d 1178 (Fla. 1st DCA 2017)…onded that he did not recommend further upper extremity surgeries. His acknowledgement that another physician might perform such a surgery is not clear and convincing evidence so as to call his opinion into question. See Travelers Ins. v. Armstrong, 118 So. 3d 865, 866 (Fla. 1st DCA 2013) (reversing JCC’s rejection of EMA’s opinion for failure to articulate clear and convincing reasons for doing so where. one reason given was that “JCC found that it was ‘notable’ that the EMA avoided answering a question abou…
Authorities Cited
- Mobile Med. Indus. & Associated Indus. Ins. Co., Inc. v. Quinn, 985 So. 2d 33 (Fla. 1st DCA 2008)
- Arnau v. Winn Dixie Stores & Sedgwick CMS, 105 So. 3d 669 (Fla. 1st DCA 2013)