JCC Rejects Paddle-Boarding Misrepresentation Defense but Limits Benefits

In Gisela Acevedo v. Southwest Airlines/Sedgwick CMS and Starr Specialty Insurance Company, Judge Jack A. Weiss considered claims arising from an October 7, 2025 right shoulder and neck injury suffered while the claimant worked as a material specialist lifting an engine mount crate.

The employer/carrier raised misrepresentation and misconduct defenses after the claimant went paddle boarding for about two hours while on right-shoulder restrictions. The JCC rejected those defenses, finding the activity was consistent with Concentra's industrial-athlete instructions and that the short video and photographs did not prove an intentional false statement made to secure benefits.

The order denied temporary partial disability benefits after accepting Dr. Baldwin's opinion that the claimant was full duty as of December 23, 2025, and also denied authorization of a primary care physician because the record did not show further PCP evaluation was medically necessary.

The JCC granted authorization for the orthopedic surgeon, finding the employer/carrier did not prove a break in causation from the accepted accident and that Dr. Baldwin had recommended physical therapy and at least needed to address MMI and permanent impairment. Attorney fees and costs were awarded for obtaining that benefit, with jurisdiction reserved on amount. OJCC Case No. 26-003929JAW.

Source: Compensation Order