Broward County Workers' Compensation Judge Finds No Fraud on Injured Worker's Part and Awards Additional Hours of Attendant Care Benefits

July 3, 2013

A workers' compensation Judge of Compensation Claims for Lauderdale Lakes, Broward County, Florida, ruled that an injured worker caught on video surveillance walking in front of his house did not intentionally make any false or misleading statements for the purpose of securing workers' compensation benefits.

A Palm Bay, Florida resident was working in Broward County as a water removal expert when, on January 1, 2003, A wall unit he was moving fell causing pain in his back. His claim was accepted by workers' compensation and he was provided medical care for his low back injury and psychiatric care for depression. He was subsequently accepted as permanently and totally disabled and awarded 12 hours of attendant care per day.

At issue in the trial was provision of additional aid and attendant care services. The Judge found the psychiatrist who treated the injured worker for nine years was more credible than the insurance company's expert who saw the injured worker once. The Judge awarded the injured worker three additional hours of daily professional care to help with morning activities of daily living including assistance with getting to and from the bathroom, bathing, dressing, getting to the table for breakfast, grooming, shaving and brushing his teeth.

The insurance company accused the injured worker of making false and misleading statements regarding his ability to perform certain activities to his doctors and during his deposition. They then raised a misrepresentation defense which, if the Judge agreed, would allow the insurance carrier to deny all benefits, recover all monies paid by the workers' compensation insurance company from the injured worker and report the injured worker to the Florida Department of Financial Services for criminal or civil action.

The video surveillance upon which the insurance company relied showed the injured worker walking a short distance without assistance and no apparent difficulty; driving a vehicle, exiting a vehicle and walking with obvious difficulty but without an assistive device; pushing a wicker chair into the back of his vehicle; and using both hands to lift each leg into the vehicle. The authorized medical provider testified that the video did not change his opinion that the injured worker would have good days and bad days and that on good days he can walk and get around better. Another workers' compensation doctor testified medically there was nothing preventing the injured worker from driving and the injured worker never stated he could not walk or drive.

The Judge noted that the injured worker did not intentionally provide any false or misleading information for the purposes of obtaining workers' compensation benefits. The Judge then denied the misrepresentation defense and awarded continued care as well as additional aid and attendant care services.

If you or a loved one have suffered a workplace injury or accident, or have had your medical care denied due to allegations of fraud or misrepresentation, contact one of our experienced workers' compensation attorney's today. Call 1-(877) WE-CAN-HELP (1-877-932-2643) or contact us online to speak with one of the dedicated workers' compensation attorneys at the Law Offices of Franks, Koenig & Neuwelt today.



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