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First DCA reaffirms ban on “bootstrapping” inadmissible medical opinions in self-help cases in favor of the employer.

April 1, 2019
Hansen and Adkins Auto Transport/Gallagher Bassett Services v. James Martin, No. 1D17-3339, (Fla. 1st DCA 2018)

After the employer denied surgery recommended by the authorized provider, the claimant underwent a less invasive surgery with an unauthorized provider. The judge of compensation claims found that the surgery performed was sufficiently similar to the procedure recommended and was medically necessary to treat a compensable work injury. The First District Court of Appeals found that the judge correctly found that the employer wrongfully denied the initial surgery, but erred in finding that the actual surgery performed was medically necessary. The authorized provider testified that he could not state that the surgery actually performed was medically necessary. No other admissible evidence was provided to meet the claimant’s burden under the self-help provision of 440.13(2)(c). The First DCA ruled that inadmissible opinions of the self-help provider cannot be “bootstrapped” into evidence in the absence of other admissible evidence establishing care as compensable and medically necessary. 

 

Case Law Alerts, 2nd Quarter, April 2019

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