MBM Corporation/Sedgwick Claims Management Services, Inc., v. Wilson
41 FLW D358
To the extent resolution of an appeal requires statutory interpretation, the appeals is subject to de novo review. Whether the JCC utilized the correct legal standard is also reviewed de novo.
Claimant sought a diagnostic medical evaluation to determine whether a potential neck or head condition was related to a compensable workplace accident. The claimant alleged that since the date of accident, he had complained of neck and head pain. Only a right shoulder injury had been originally diagnosed and treated by an authorized doctor. The employer/carrier had denied the request for the diagnostic evaluation on grounds that the head or neck condition had not been accepted as compensable and that the compensable accident was not the major contributing cause of any neck or head condition. On appeal, the JCC's order awarding an evaluation to determine the causal relationship of the neck and head injury was reversed.
JCC erred in ordering a diagnostic evaluation to determine if the claimant's subjective complaints of pain in his neck and head were related to the compensable accident. It is the claimant's burden to prove causal relationship between a medical condition and a workplace accident in the first instance and the claimant's failure to do so in this situation resulted in an error by the JCC to order the diagnostic care. Claimant's subjective complaints, standing alone, were insufficient to prove the claimant's injury and its occupational cause within a reasonable degree of medical certainty based on objective relevant medical findings.