News & Events

Jacqueline M. Gregory, Partner, Hollywood office, obtained a favorable ruling for the Employer/Carrier on a workers’ compensation case. 

Claimant sought retroactive authorization for continued care and treatment by an unauthorized spine surgeon, including lumbar surgery performed.  Claims were also made for medical supplies and post-surgical follow up care with a hematologist and vascular surgeon due to post-surgery complications. 

The Employer/Carrier denied the medical necessity of the lumbar discectomy, and asserted that the treatment did not rise to the level of an emergency, under Section 440.13(3)(b).

The Judge of Compensation Claims also analyzed whether the emergency room case and surgery could be classified as self-help, pursuant to Section 440.13(2)(c).  He found that no prior authorization was requested by Claimant, therefore the Employer/Carrier did not have the opportunity to provide the requested care.  The emergency room treatment, surgery and sequelae were denied as not rising to the level of an emergency,  and not meeting the self-help statutory requirements.