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  • Florida Appellate Court Addresses Definition of “Compensable Injury” in Workers’ Comp Claims

Florida Appellate Court Addresses Definition of “Compensable Injury” in Workers’ Comp Claims

In the recent case of Babametovic v. Scan Design Florida, Inc., a Florida Court of Appeal had a chance to clarify the meaning of “compensable injury” under Florida’s Workers’ Compensation Law.

In October 2013, the plaintiff suffered injuries to his back while lifting a series of boxes. The worker reported the injury to his employer, who authorized the worker to seek medical treatment at a local urgent care center. While there, a doctor diagnosed the worker as having suffered radiculitis stemming from his work-related accident. The doctor referred the worker to another physician for a more extensive treatment plan. 

Approximately one month later, the worker saw the referral doctor, who elaborated on the diagnosis. According to the second doctor, the worker had suffered a lumbar muscle sprain and a preexisting degenerative disc condition. During the appointment, the doctor stated that the injuries stemmed from the workers’ employment, but he later sent a letter to the employer stating that only 40 percent of the injury was work-related. According to the second physician, the remaining 60 percent of the conditions were attributable to a preexisting condition.

Based on this, the employer’s workers’ compensation insurance company denied the man’s claim for benefits, finding that the accident was not the major cause of the reason he sought treatment. The way the employer saw it, the worker had never sustained any workplace injuries. Following the denial, the employee requested a one-time change of his authorized treating physician, but the employer denied the request.

A Judge of Compensation Claims (JCC) next reviewed the dispute, first noting that a worker cannot obtain benefits pursuant to Chapter 440 unless a compensable workplace injury happened. The JCC next concluded that the worker’s physician concluded that the back injury was less than half of the total injury. Finally, the JCC held that the work-related injury was not the major contributing cause (MCC) of the worker’s injury, and as a result the worker’s need for medical care was not the result of the workplace injury.

The worker appealed the JCC’s denial of benefits to the First District Court of Appeals. The court first noted that the JCC correctly noted that a compensable injury must take place before an injured employee can be granted workers’ compensation benefits. Based on the record, the appellate court held that the JCC erred in concluding that no compensable injury had occurred in this case, stating that compensability deals with the harm that occurred as a result of work performed during the scope of the injured employee’s employment. The appellate court surmised that the JCC conflated the existence and cause of the actual injury with the existence and cause of the worker’s need to receive medical care.

The appellate court also concluded that since nothing in the record suggested that something other than the work-related accident caused the worker’s back injury, the JCC should have concluded that he suffered a compensable injury.

If you have been injured on the job, you may be entitled to compensation. At The Hoffman Firm, we have helped many injured workers throughout Florida seek the benefits they deserve from their employers. We know just how tricky the workers’ compensation system can be and will guide you through every step of the process and ensure that your rights are asserted aggressively along the way. Call us now at (800) 223-1866 or contact us online to set up your free consultation now.

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Evan A. Hoffman

Evan A. Hoffman

Mr. Hoffman’s philosophy is "our knowledge and experience is your best defense." He has been a featured author on criminal law issues such as driving under the influence, domestic violence and illegal searches.

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