Cases

Court determined that the 120-day rule for denying the compensability of the claim applied in this case and any denial of compensability after the 120-day period was ineffective.  The JCC basically had determined that there were material facts relevant to the issue of compensability that the employer/carrier could not have discovered through reasonable investigation within the 120-day period and therefore, the failure to deny compensability within this period of time would not preclude a subsequent denial of compensability.  Court found that the JCC could not have reached such a conclusion in the absence of a finding as to when the investigation should have begun. When the 120-day period begins to run is a factual determination.  The statute does not require that certainty exists before the investigation period begins to run. 

In this case, the claimant had a preexisting arthritic back condition. The surgical notes of the treating physician on a particular date should have reasonably been brought to the carrier's attention the fact that the claimant's personal condition preexisted the industrya accident thereby alerting to the necessity of beginning an investigation.  Yet, the employer/carrier failed to take any action within 120 days from such notice.  The court on remand mandated that the JCC determine when the employer/carrier had material facts relevant to the issue of causation that calls into question their obligations to the claimant to provide treatment, thus triggering the duty to immediately and in good faith commence an investigation of the employee's entitlement to benefits.

Certain medical evidence from a doctor that treated the claimant prior to the compensable accident was excluded from testimony concerning the compensability of this case.  The JCC's exclusion of evidence is reviewed for an abuse of discretion.  

Although medical opinion testimony admissible before the JCC can only be given by Expert Medical Advisors, Independent Medical Examiners, and authorized treating physicians, other medical testimony can be received as a factual report of the information contained in a doctor's office records regarding the claimant. That testimony can include a claimant's complaints, the doctor's diagnosis, and the prescribed treatment. In this case, a court determined that the JCC erred in denying the admissibility of evidence from physician as to the claimant's preexisting medical condition.  Dissenting opinion.