JCC Orders Surgery After Carrier Fails to Timely Respond

In Estimond v. Florida Institute for Long Term Care d/b/a Boca Raton Rehabilitation / Amerisure Insurance Company, OJCC Case No. 23-026582BKC, Judge Barbara K. Case considered whether the employer/carrier had to authorize surgical fusion of the claimant's left calcaneocuboid joint.

The authorized podiatrist recommended surgery on June 19, 2025. The employer/carrier did not respond within the statutory ten-day period for surgical requests and first authorized the procedure months later, after the petition was filed. The carrier then argued the claim was premature because a consulting surgeon had not issued his own medical-necessity opinion.

The JCC rejected that defense, finding the carrier forfeited its right to contest medical necessity under section 440.13(3), Florida Statutes. The surgery was ordered, and the claimant was awarded entitlement to attorney's fees and costs.

Source: Final Compensation Order