JCC Denies Follow-Up Care After Ankle Surgery Without Current Medical Necessity

In Ryan Ben Khader v. Baycare Health System - Morton Plant Hospital/Commercial Risk Management, Inc., OJCC Case No. 24-028942JPM, the claimant tripped over a computer wire at work, underwent surgery for a left ankle fracture, and later sought continued authorization of medical care, including a follow-up appointment with the authorized physician.

Judge John P. Moneyham denied the claim after finding the claimant did not prove that additional medical care was medically necessary at this time. The order credited E/C IME Dr. Adam Jester over claimant IME Dr. Walton, emphasizing that Dr. Walton described possible future care in indefinite terms while Dr. Jester gave a definite opinion that no further evaluation, follow-up, or treatment was indicated for the work injury.

The ruling underscores that once compensability is established, the claimant still must prove the requested treatment is connected to the industrial accident and medically necessary now. Possible future symptoms, subjective numbness without objective support, and speculative recommendations were not enough to secure continued care, costs, or attorney fees.

Source: Compensation Order