Prada USA Corp/Travelers Insurance Company of America v. Charles Young ( 2019 )


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  •          FIRST DISTRICT COURT OF APPEAL
    STATE OF FLORIDA
    _____________________________
    No. 1D18-1267
    _____________________________
    PRADA USA CORP/TRAVELERS
    INSURANCE COMPANY OF
    AMERICA,
    Appellants,
    v.
    CHARLES YOUNG,
    Appellee.
    _____________________________
    On appeal from an order of the Judge of Compensation Claims.
    Walter J. Havers, Judge.
    Date of Accident: April 30, 2003.
    May 2, 2019
    PER CURIAM.
    The Employer/Carrier appeal an order holding that res
    judicata did not bar Claimant from seeking benefits in 2017
    similar to benefits he had sought, but withdrawn before hearing,
    in 2015. Claimant had injured his lumbar spine, among other
    things including his knee, in the industrial accident; and the E/C
    provided treatment and other benefits related to the lower back
    injury from 2003 through 2014. In December of 2014, Claimant
    filed a new petition for benefits seeking Lidoderm patches and
    lumbar physical therapy as recommended by his authorized
    neurologist. By that time several of Claimant’s healthcare
    providers had concluded that Claimant’s condition was
    attributable to pre-existing degenerative conditions rather than to
    the industrial accident. Shortly before the scheduled hearing on
    the 2014 PFB, Claimant’s authorized neurologist opined in his
    deposition that the ongoing symptoms were not related to the work
    accident, and the recommended Lidoderm patches and lumbar
    physical therapy were not medically necessary due to the work
    accident. Claimant withdrew the lower-back claim before the PFB
    went to hearing on other benefits involving Claimant’s knee injury.
    Beginning in the fall of 2015, less than three months after he
    withdrew his PFB for lumbar spine treatment, Claimant began
    seeing a physician for persistent lumbar spinal pain. After six
    months, that physician recommended that future treatment be
    provided by a spine doctor or neurosurgeon. Almost a full year
    later, on March 24, 2017, Claimant filed a new PFB requesting
    follow-up with that physician, but the E/C authorized treatment
    solely for the left shoulder. In September of 2017, Claimant again
    filed a PFB requesting evaluation and treatment for his lumbar
    spine.
    For the hearing on the 2017 PFB, the E/C asserted that
    Claimant’s requests for spinal treatment were barred by res
    judicata because the same treatment had been requested and
    withdrawn prior to the 2015 hearing. The JCC rejected the res
    judicata argument on the grounds that the 2015 PFB had narrowly
    requested Lidoderm patches and lumbar physical therapy,
    whereas the 2017 request more broadly sought lumbar evaluation
    and any treatment deemed necessary as a result of that
    evaluation. The JCC found that this distinction was sufficient to
    destroy the “identity of the thing sued for” element of res judicata,
    citing Caron v. Systematic Air Servs., 
    576 So. 2d 372
    , 375 (Fla. 1st
    DCA 1991). The JCC also accepted Claimant’s argument that
    under the 120-day rule, the E/C waived any right to deny
    compensability of the lumbar spine after stipulating to
    compensability in 2005 and providing treatment for more than a
    decade.
    We observe that while the doctrine of res judicata may have
    its place in the workers compensation arena, it is a difficult concept
    to apply to physical conditions that can and do change over time
    2
    and often involve complex multi-factorial considerations. However,
    we find it unnecessary to reach the res judicata issue here, because
    we conclude that the JCC correctly invoked the 120-day rule as
    precluding the E/C’s argument against industrial causation of the
    lumbar spine injury. We note that the E/C can raise an MCC
    defense whenever the evidence supports it, and raised it below; but
    did not argue that issue on appeal.
    AFFIRMED.
    ROBERTS, KELSEY, and WINSOR, JJ., concur.
    _____________________________
    Not final until disposition of any timely and
    authorized motion under Fla. R. App. P. 9.330 or
    9.331.
    _____________________________
    Kurt J. Wirsing of Miller, Kagan, Rodriguez & Silver, P.L., Coral
    Gables, and Steven H. Preston of Hicks, Porter, Ebenfeld & Stein,
    P.A., Miami, for Appellants.
    William F. Souza of Law Offices of William F. Souza, P.A., North
    Miami Beach, for Appellee.
    3
    

Document Info

Docket Number: 18-1267

Filed Date: 5/2/2019

Precedential Status: Precedential

Modified Date: 5/2/2019