Sylvestre v. Coca Cola and Travelers Ins, Sedgwick, OJCC# 16-003534, Ft. Lauderdale District, JCC Lewis

Second opinion referral granted even though workers’ compensation law does not provide for same.

This case involved a claimant with a severe crush injury to his left foot and ankle. The claimant made a claim for authorization for a second opinion with a plastic surgeon. His authorized treating orthopedic surgeon thought he may be a candidate for a transfer or transplantation of muscle or tissue to his heel pad to provide additional cushion. The authorized plastic surgeon opined that this procedure would not alleviate his pain and he did not believe that any additional surgery should be performed. Therefore, the plastic surgeon had nothing more to offer in the way of treatment/care. The employer argued that there is no second opinion provision in the statute (440.13(2)(f)) and that the claimant could use his one time change. The judge of compensation claims held that case law demonstrates that a claimant may obtain a second opinion but has the burden of proof to show that same is reasonable and medically necessary. In this case, the judge did find that the claimant met his burden, and he granted the second opinion.


Case Law Alerts, 3rd Quarter, July 2019

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