Dee­Ward­Hock,­founder­of­Visa­International,­once­said,­“An­organization,­nomatter­how­well­designed,­is­only­as­good­as­the­people­who­live­and­work­in­it.”Here­at­Johns­Eastern­we­could­not­agree­more!­As­we­celebrate­71­years­inbusiness,­we­are­grateful­for­our­dedicated­and­capable­staff.­Thank­you!

Meet­Simone­Logan,­Johns­Eastern’s­Georgia­Account­Manager!­Simone­has­more­than­20­yearsof­experience­in­workers’­compensation.­She­is­a­licensed­adjuster­and­mediator­in­Georgia­andhas­ achieved­ her­ Certified­ Workers’­ Compensation­ Professional­ designation.­ Simone­ hasmanaged­teams­of­adjusters­since­2003­and­has­considerable­experience­as­a­dedicated­adjusterhanding­claims­for­governmental­entities.

She­has­been­responsible­for­the­workers’­compensation­needs­of­large­national­accounts­and­hasmanaged­ all­ aspects­ of­ complex­ claims,­ including­ investigation,­ reserves,­ coordination­ of­ file

reviews­with­clients­and­brokers,­and­discovery/litigation­strategy­with­legal­counsel.

Simone­grew­up­in­St.­Louis,­Missouri­and­attended­the­University­of­Kansas.­She­is­married­and­has­two­sons:Austin­who­studies­at­Full­Sail­University­in­Orlando­and­Aric­who­attends­the­University­of­Alabama.

In­addition­to­being­a­devoted­St.­Louis­Cardinals­baseball­fan,­Simone­loves­to­travel,­read,­snorkel­and­work­out.

This­spring,­the­Florida­FirstDistrict­Court­of­Appeal(DCA)­issued­severaldecisions­addressing­theEmployer/Servicing­Agent’sobligations­when­it­comes­torebutting­the­statutorypresumption­found­in­section112.18(1)­of­the­FloridaStatutes.­One­such­case,City of Jacksonville/City ofJacksonville RiskManagement v. Ratliff 1,­isnow­being­presented­to­andconstrued­by­judges­ofcompensation­claimsthroughout­the­state.

In­this­case,­the­claimantsuffered­a­heart­attack­whileat­work.­On­that­date,­hehad­attended­a­meeting­inwhich­a­disagreement­aroseas­to­building­coderequirements.­The­claimantbegan­to­experiencediscomfort­and­chest­painduring­the­“extremelystressful”­meeting.­Shortlythereafter,­the­claimant­wasadmitted­to­the­hospitalwhere­he­was­diagnosedwith­coronary­artery­disease(CAD)­and­an­acute­anterior

wall­myocardial­infarction,­orheart­attack.­The­employerconducted­a­120-dayinvestigation,­after­which­adenial­was­issued.­This­waspremised­on­their­expert’sdecision­relating­heartdisease­to­the­claimant’shistory­of­diabetes,­highcholesterol,­prior­history­ofsmoking,­and­family­history.

The­claimant­challenged­thedenial­and­at­the­finalhearing,­medical­testimonywas­introduced­on­behalf­ofboth­parties.­Both­testifyingexperts­noted­the­claimant’smultiple­risk/causativefactors.­The­testimony­alsoestablished­that­the­claimantsuffered­from­blockedarteries­caused­by­the­buildup­of­plaque,­and­that­themyocardial­infarctionresulted­from­the­build-up­ofplaque.­The­physician­whocompleted­the­employer’sIndependent­MedicalExamination­(IME)­“admittedthere­was­no­medical­test­todetermine­the­‘trigger’­orcause­of­the­plaque­rupture”;however,­possible­triggersinclude­high­blood­pressure,stress,­or­other­non­work-related­factors.­TheIME­expert­for­Ratliff­testifiedthat­stress­or­increase­in

blood­pressure­from­thebusiness­meeting­could­havebeen­the­“trigger”­of­theplaque­rupture,­but­agreedthe­cause­or­“trigger”­wasunknown.

The­Judge­of­CompensationClaims­(JCC)­rejected­theopinion­of­the­employer’sIME­expert,­noting­he­did­notfind­the­doctor’s­testimony­tobe­“persuasive­or­sufficientas­competent­evidence­orclear­and­convincingevidence­by­which­toestablish­a­rebuttal­of­theLegal­Presumption…[nor­didit]­meet­the­standard­set­toconstitute­major­contributingcause.”­The­appellate­courtfound­such­“catch-all”language­to­be­in­error,confirming­that­their­priordecisions­as­to­theemployer’s­burden­did­notrequire­a­satisfaction­of­the“major­contributing­cause”standard.­­

JOHNS EASTERN COMPANYIntegrity. Experience. Results.

Publisher Beverly Adkins

Editor-In-Chief Alice Wells

Graphic Designer Deirdre Harris

Contributors:● Bernadette Anthon, Johns Eastern

● Kristen Magana, Esq.Broussard & Cullen, P.A.

● Healthesystems Clinical Services Team

● John Powers, Johns Eastern● Rose Rome, Johns Eastern● Sniffen & Spellman, P.A.

PO Box 110259Lakewood Ranch, FL 34211-0004

Phone: 941-907-3100Toll Free: 877-326-JECO

Fax: 813-402-7913

www.johnseastern.com

JOHNS EASTERN

6

COURT OFFERS NEW INSIGHT ON TRIGGERS

What does the JCCdecision in Ratliffmean to your program?

Third Quarter 2017

IN THE SPOTLIGHT

UPCOMINGCEU SEMINAR­September 2017September­811:30am­-­2:00pm

“Pain ManagementInjections” Presented­by:­Dr.­Satinderpaul­S.Satia,­with­Kennedy-White­OrthopaedicCenter­and­Eraclides,Gelman,­Hall,­Indek,Goodman­&­Waters,P.A.

This­course­willprovide­attendeeswith­2­hours­ofoptional­CEU­credit.­

Location:­Holiday­InnLakewood­Ranch6231­Lake­Osprey­Dr.

For more details,contact: Rose­Rome­atrrome@johnseastern.com

Page 2Reducing PhysicianDispensing

Page 5Medical Marijuana &Workplace Policies

Page 3Court: New Attorney Fee Guidelines

JOHNS EASTERN CELEBRATES 71 YEARS

Continued on page 4

Q3­2017­Newsletter_Working_newsletter­­8/30/2017­­10:00­AM­­Page­1

2 5

MEDICAL MARIJUANA BILL RAISES WORKPLACE ISSUES

CONFERENCE CONNECTION

Typically,­doctors­write­prescriptions­that­their­patientsthen­take­to­have­filled­at­a­retail­pharmacy.­However,­inworkers’­compensation,­a­number­of­physicians­chooseto­dispense­prescription­medications­directly­from­theiroffices.­This­is­an­ongoing­concern­that­can­negativelyimpact­an­injured­worker’s­safety,­as­well­as­claimduration­and­cost.

Patient SafetyPhysician­dispensing­removes­the­safeguard­of­havinglicensed­pharmacists­act­as­the­clinical­expert­to­identifypatient­safety­concerns­such­as:•­Drug-drug­and­drug-disease­interactions•­Therapeutic­duplication•­Inappropriate­therapy­or­dosing

Pharmacy­dispensing­is­an­important­tool­for­ensuringsafe­use­of­medications­because­it­provides­a­completepicture­of­the­injured­worker’s­treatment­regimen,including­medications­that­are­unrelated­to­their­workers’compensation­claim.­­

Claim Duration and Cost The­increased­safety­concernspresented­by­physiciandispensing­can­often­lead­to­adelay­in­recovery.­Whencompared­to­claims­that­fillprescriptions­in­theHealthesystems’­pharmacynetwork,­claims­that­containphysician-dispensed

medications­are­associated­with­extended­claimduration,­by­up­to­six­months.1

From­a­cost­perspective,­physician-dispensedmedications­are­often­much­more­expensive­than­thesame­medications­dispensed­by­a­retail­pharmacy.When­compared­to­claims­that­fill­prescriptions­in­theHealthesystems’­pharmacy­network,­physiciandispensing­results­in­up­to­2-3­times­the­cost­per­claim.­

Reducing Physician DispensingBy­limiting­physician-dispensed­medications­anddirecting­injured­workers­toretail­pharmacies,­we­can­helpexpedite­the­injured­workers’safe­recovery,­as­well­asreduce­the­cost­and­duration­of­their­claims.­­

Johns­Eastern­has­beenconsistently­working­to­educate­and­inform­prescribersand­patients­of­physician­dispensing­concerns,­withgreat­success.­In­the­first­quarter­of­2017,­92%­of­claimsdid­not­utilize­any­physician­dispensers!­This­representsa­significant­decrease­over­the­last­12­months.

Furthermore,­over­the­past­year,­the­spend­and­count­oftotal­physician-dispensed­medications­has­significantlydecreased­as­a­result­of­this­effort.­

Compared­to­the­firstquarter­of­2016,­JohnsEastern­has:•­Reduced­physiciandispensed­spend­by­8%­

•­Reduced­physiciandispensed­transactions­by­5%­

This­is­a­laudableaccomplishment­that

not­many­TPAs­are­able­to­achieve.­Improving­patientsafety­while­reducing­costs­continues­to­set­JohnsEastern­apart­from­the­rest.­1­Healthesystems­data,­2014-2017­

Vendor Partner: Clinical Services Team,Healthesystems

MAKING AN IMPACT ON PHYSICIAN DISPENSING

North Carolina Public Risk ManagementAssociation (PRIMA) Educational ConferenceSeptember­10­-­13­• Wrightsville­Beach,­NC

Risk Management Society (RIMS) Southeastern Educational ConferenceSeptember­20­-­22­• Charleston,­SC

Florida Public Risk Management Association(PRIMA) Annual ConferenceOctober­30­-­November­1• Orlando,­FL

Georgia Association of School Business Officials(GASBO) ConferenceNovember­7­-­10­•Augusta,­GA

Plan­now­to­meet­Johns­Eastern­representatives­at­an­upcoming­conference:

Florida­Governor­Rick­Scott­recently­signed­into­law­amedical­marijuana­bill­which­amended­the­FloridaConstitution­to­provide­certain­patients­the­limited­rightto­use­marijuana­for­medical­purposes.­The­law­limitsthe­right­to­use­medical­marijuana­to­patients­withdebilitating­medical­conditions.­However,­the­law­doesnot­define­the­parameters­of­“debilitating­medicalconditions.”

Furthermore,­the­law­specifically­states­that­employersare­not­required­to­accommodate­medical­marijuanause­in­any­respect­and­that­no­new­cause­of­action­forindividuals­who­are­disciplined­for­testing­positive­foruse­of­marijuana­exists.­Critics­of­the­law­have­alreadyasserted­that­this­type­of­legalization­is­meaninglessbecause­employers­maintain­the­ability­to­disciplineemployees­for­using­marijuana,­even­if­they­do­so­witha­medical­marijuana­prescription.

As­a­result­of­this­tension,­there­is­a­likelihood­we­willsee­a­flood­of­litigation­in­this­area­as­both­employeesand­employers­test­the­water­of­the­new­law.­

Employers­need­to­prepare­themselves­now­forquestions­regarding­their­policies­for­marijuana­usageinside­and­outside­of­the­workplace.

Sniffen & Spellman, P.A.

For­companies­required­to­keep­track­of­workplaceinjuries­and­illnesses­and­to­report­the­information­tothe­Occupational­Safety­and­Health­Administration(OSHA),­life­just­got­a­little­easier.­

As­of­August­1,­2017,­OSHA­­announced­that­its­InjuryTracking­Application­(ITA)­is­accessible­from­its­webpage.­Through­the­ITA,­companies­will­be­able­toprovide­their­2016­OSHA­Form­300A­information.

See­https://www.osha.gov/injuryreporting/index.html­formore­information.

The­US­Citizenship­and­Immigration­Services­(USCIS)published­the­latest­Form­I-9,­Employment­EligibilityVerification,­on­July­17.­Employers­may­use­thisrevised­version,­or­continue­using­the­previous­Form­I-9­(revised­on­November­14,­2016)­throughSeptember­17,­2017.­Form­I-9’s­must­be­completed­forall­newly­hired­employees­to­verify­their­identity­andauthorization­to­work­in­the­United­States.

HAVE YOU CONNECTED WITH JOHNS EASTERN?

Join us today on:

OSHA Launches New Injury TrackingSystem Online

USCIS Publishes Latest I-9 Form

8%Reduction

5%Reduction

Employment Law Update

National Workers’ Compensation and Disability Conference & ExpoDecember­5­-­7­• Las­Vegas,­NV

Q3­2017­Newsletter_Working_newsletter­­8/30/2017­­10:00­AM­­Page­2

The Florida SupremeCourt recently issued adecision in GEICO v.Macedo, an automobile liability casethat resulted in an award to theplaintiff, Macedo, of $243,954. Duringthe pre-trial stages of litigation,Macedo served Geico’s insured with aProposal for Settlement (PFS) of$50,000 that was not accepted.Geico’s insured had Bodily Injurypolicy limits of $100,000 per person,

$300,000 per occurrence.

The PFS statute, FS 768.79, states: “If a plaintiff files ademand for judgment which is not accepted by thedefendant within 30 days, and the plaintiff recovers ajudgment in an amount at least 25% greater than theoffer, she or he shall be entitled to recover reasonablecosts and attorney’s fees incurred from the date of thefiling of the demand.” Judgment is defined as the netamount after offsets or reductions are due.

In the Macedo case, the judgment had to be at least$62,500. Meeting that threshold gave Macedo the rightto recover reasonable costs and attorney’s feesincurred after the date the PFS was filed. After the

verdict, Macedo attached Geico to themotion for taxable fees and costs. The courtagreed and made Geico responsible for

half the fees and costs, a decision which Geicoappealed. In reviewing Geico’s appeal, the court noted“costs” was a term undefined in the policy, and insteadof looking to popular definition, it abruptly andambiguously decided in favor of the insured. Theadditional payments clause in the Geico policyincluded all reasonable costs incurred by the insurer’srequest. The court found Geico responsible because itcontrolled litigation, in part because of the ability tosettle the case within the policy limits, and therebycreated the incurrence of cost. The Florida courtscontinue to be very favorable to insureds with respectto any issue even remotely resembling bad faith.

In cases where property is damaged or employees areinjured due to a third party’s negligence, this precedentcan work in favor of a plaintiff. Many defendants arejudgment-proof and therefore the recovery of costs canbe unlikely. Being able to tie an insurer to an award forfees and costs could provide a better chance of somerecovery. It should at least make insurance carriersand their legal teams much more aware of thepotential for adverse action if a PFS is not takenseriously.

Case LawUpdate

FL SUPREME COURT UPHOLDS ATTORNEY FEES DECISION

In the second quarter of 2017, JohnsEastern employees elected to supportthe HumaneSociety atLakewood Ranch(HSLWR). HSLWRserves thecommunity byrescuing andsheltering at-risk

animals until they are placed in aloving home.

Our goal was to donate $500 to help with shelter andmedical costs, as well as supplies. Thanks to thegenerosity of JE employees, we surpassed our goal

and raised a total $1,879. With an additional $1,500 inJohns Eastern matching funds, our donation to HSLWR

totaled $3,379!

This quarter we are supporting anew organization, the Alzheimer’sAssociation–Florida Gulf CoastChapter. The aim of the Alzheimer’sAssociation is to advance researchto fight Alzheimer’s, while enhancingcare and support for those living withthe disease. Our goal is to raise$2,500, increase Alzheimer’s and

brain issue awareness, and rally a team to support thelocal Walk to End Alzheimer's to support those copingwith the disease.

Rose RomeExecutive Assistant

JE EXCEEDS GOAL FOR HUMANE SOCIETY DONATION

John PowersTPA Liability Quality Assurance Manager

3

It’s that time of year when school bussafety becomes a high priority.Although standard school buses arestatistically the safest mode oftransportation according to theNational Safety Council, there are stilla number of safety precautionseveryone should be aware of when itcomes to school transit.

1. Arrive at the Bus Stop EarlyRemind kids to put everything they need for the schoolday in their backpack the night before. This should helpcut down on last-minute rushing around in the morning.

2. Walk Young Children to the Bus StopEncourage parents or guardians to walk young children

to the bus stop and,when possible, haveolder children walk ingroups. There is safetyin numbers becausegroups are easier fordrivers to see. Also, remind children to stop and lookboth ways before crossing the street to the bus stop.

3. Getting On and Off the BusRemind children to ALWAYS cross in front of the busand never behind it. Once they have entered the bus,they also need to be certain not to stand up or walkaround while the bus is in motion.

These are a few simple rules children can follow to staysafe on the way to and from school.

3 TIPS TO KEEP KIDS SAFE ON THE WAY TO SCHOOL

HAVE YOU CONNECTED WITH JOHNS EASTERN?

Join us today on:

4

Ultimately, the panel concluded that the employer didsatisfy its burden of rebutting the statutory presumptionwith respect to the coronary artery disease.

In regard to the “triggering event” analysis, the Courtconfirmed that the employer must establish that the“trigger” of a congenital/non work-related condition wasalso non-occupational. In this case, the employer failedto satisfy its rebuttal burden with respect to this secondtier, the heart attack, as both experts testified it was notpossible to determine the cause of the “trigger,” i.e.,rupture of the plaque. Therefore, the JCC’s conclusionsthat the employer failed to satisfy both tiers of therebuttal were affirmed without need for remand.

This decision is of particular concern as it renders evenmore challenging an already difficult standard (i.e.,

establishing the cause of heart disease). Now, it seems,it is not enough to assert that various risk factorscaused heart disease which, in turn, caused a heartattack; rather, the employer must introduce medicaltestimony establishing the cause of plaque rupture. Inthe Ratliff decision, neither testifying expert could citethe cause of the heart attack, and it is difficult to say atthis time whether most cardiologists could. Obviously,this is another element that must be addressed in detailin heart disease cases, particularly those involvingmyocardial infarctions.

As always, we will keep you updated on the impact ofthese decisions and their significance to your program.1 City of Jacksonville v. Ratliff, 217 So. 3d 183 (Fla. 1st DCA 2017).

Kristen Magana, Esq.Broussard & Cullen, P.A.

COURT OFFERS NEW INTERPRETATION OF TRIGGERSContinued from page 1...

Bernadette AnthonTPA Liability Supervisor

2 5

MEDICAL MARIJUANA BILL RAISES WORKPLACE ISSUES

CONFERENCE CONNECTION

Typically,­doctors­write­prescriptions­that­their­patientsthen­take­to­have­filled­at­a­retail­pharmacy.­However,­inworkers’­compensation,­a­number­of­physicians­chooseto­dispense­prescription­medications­directly­from­theiroffices.­This­is­an­ongoing­concern­that­can­negativelyimpact­an­injured­worker’s­safety,­as­well­as­claimduration­and­cost.

Patient SafetyPhysician­dispensing­removes­the­safeguard­of­havinglicensed­pharmacists­act­as­the­clinical­expert­to­identifypatient­safety­concerns­such­as:•­Drug-drug­and­drug-disease­interactions•­Therapeutic­duplication•­Inappropriate­therapy­or­dosing

Pharmacy­dispensing­is­an­important­tool­for­ensuringsafe­use­of­medications­because­it­provides­a­completepicture­of­the­injured­worker’s­treatment­regimen,including­medications­that­are­unrelated­to­their­workers’compensation­claim.­­

Claim Duration and Cost The­increased­safety­concernspresented­by­physiciandispensing­can­often­lead­to­adelay­in­recovery.­Whencompared­to­claims­that­fillprescriptions­in­theHealthesystems’­pharmacynetwork,­claims­that­containphysician-dispensed

medications­are­associated­with­extended­claimduration,­by­up­to­six­months.1

From­a­cost­perspective,­physician-dispensedmedications­are­often­much­more­expensive­than­thesame­medications­dispensed­by­a­retail­pharmacy.When­compared­to­claims­that­fill­prescriptions­in­theHealthesystems’­pharmacy­network,­physiciandispensing­results­in­up­to­2-3­times­the­cost­per­claim.­

Reducing Physician DispensingBy­limiting­physician-dispensed­medications­anddirecting­injured­workers­toretail­pharmacies,­we­can­helpexpedite­the­injured­workers’safe­recovery,­as­well­asreduce­the­cost­and­duration­of­their­claims.­­

Johns­Eastern­has­beenconsistently­working­to­educate­and­inform­prescribersand­patients­of­physician­dispensing­concerns,­withgreat­success.­In­the­first­quarter­of­2017,­92%­of­claimsdid­not­utilize­any­physician­dispensers!­This­representsa­significant­decrease­over­the­last­12­months.

Furthermore,­over­the­past­year,­the­spend­and­count­oftotal­physician-dispensed­medications­has­significantlydecreased­as­a­result­of­this­effort.­

Compared­to­the­firstquarter­of­2016,­JohnsEastern­has:•­Reduced­physiciandispensed­spend­by­8%­

•­Reduced­physiciandispensed­transactions­by­5%­

This­is­a­laudableaccomplishment­that

not­many­TPAs­are­able­to­achieve.­Improving­patientsafety­while­reducing­costs­continues­to­set­JohnsEastern­apart­from­the­rest.­1­Healthesystems­data,­2014-2017­

Vendor Partner: Clinical Services Team,Healthesystems

MAKING AN IMPACT ON PHYSICIAN DISPENSING

North Carolina Public Risk ManagementAssociation (PRIMA) Educational ConferenceSeptember­10­-­13­• Wrightsville­Beach,­NC

Risk Management Society (RIMS) Southeastern Educational ConferenceSeptember­20­-­22­• Charleston,­SC

Florida Public Risk Management Association(PRIMA) Annual ConferenceOctober­30­-­November­1• Orlando,­FL

Georgia Association of School Business Officials(GASBO) ConferenceNovember­7­-­10­•Augusta,­GA

Plan­now­to­meet­Johns­Eastern­representatives­at­an­upcoming­conference:

Florida­Governor­Rick­Scott­recently­signed­into­law­amedical­marijuana­bill­which­amended­the­FloridaConstitution­to­provide­certain­patients­the­limited­rightto­use­marijuana­for­medical­purposes.­The­law­limitsthe­right­to­use­medical­marijuana­to­patients­withdebilitating­medical­conditions.­However,­the­law­doesnot­define­the­parameters­of­“debilitating­medicalconditions.”

Furthermore,­the­law­specifically­states­that­employersare­not­required­to­accommodate­medical­marijuanause­in­any­respect­and­that­no­new­cause­of­action­forindividuals­who­are­disciplined­for­testing­positive­foruse­of­marijuana­exists.­Critics­of­the­law­have­alreadyasserted­that­this­type­of­legalization­is­meaninglessbecause­employers­maintain­the­ability­to­disciplineemployees­for­using­marijuana,­even­if­they­do­so­witha­medical­marijuana­prescription.

As­a­result­of­this­tension,­there­is­a­likelihood­we­willsee­a­flood­of­litigation­in­this­area­as­both­employeesand­employers­test­the­water­of­the­new­law.­

Employers­need­to­prepare­themselves­now­forquestions­regarding­their­policies­for­marijuana­usageinside­and­outside­of­the­workplace.

Sniffen & Spellman, P.A.

For­companies­required­to­keep­track­of­workplaceinjuries­and­illnesses­and­to­report­the­information­tothe­Occupational­Safety­and­Health­Administration(OSHA),­life­just­got­a­little­easier.­

As­of­August­1,­2017,­OSHA­­announced­that­its­InjuryTracking­Application­(ITA)­is­accessible­from­its­webpage.­Through­the­ITA,­companies­will­be­able­toprovide­their­2016­OSHA­Form­300A­information.

See­https://www.osha.gov/injuryreporting/index.html­formore­information.

The­US­Citizenship­and­Immigration­Services­(USCIS)published­the­latest­Form­I-9,­Employment­EligibilityVerification,­on­July­17.­Employers­may­use­thisrevised­version,­or­continue­using­the­previous­Form­I-9­(revised­on­November­14,­2016)­throughSeptember­17,­2017.­Form­I-9’s­must­be­completed­forall­newly­hired­employees­to­verify­their­identity­andauthorization­to­work­in­the­United­States.

HAVE YOU CONNECTED WITH JOHNS EASTERN?

Join us today on:

OSHA Launches New Injury TrackingSystem Online

USCIS Publishes Latest I-9 Form

8%Reduction

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Employment Law Update

National Workers’ Compensation and Disability Conference & ExpoDecember­5­-­7­• Las­Vegas,­NV

Q3­2017­Newsletter_Working_newsletter­­8/30/2017­­10:00­AM­­Page­2

Dee­Ward­Hock,­founder­of­Visa­International,­once­said,­“An­organization,­nomatter­how­well­designed,­is­only­as­good­as­the­people­who­live­and­work­in­it.”Here­at­Johns­Eastern­we­could­not­agree­more!­As­we­celebrate­71­years­inbusiness,­we­are­grateful­for­our­dedicated­and­capable­staff.­Thank­you!

Meet­Simone­Logan,­Johns­Eastern’s­Georgia­Account­Manager!­Simone­has­more­than­20­yearsof­experience­in­workers’­compensation.­She­is­a­licensed­adjuster­and­mediator­in­Georgia­andhas­ achieved­ her­ Certified­ Workers’­ Compensation­ Professional­ designation.­ Simone­ hasmanaged­teams­of­adjusters­since­2003­and­has­considerable­experience­as­a­dedicated­adjusterhanding­claims­for­governmental­entities.

She­has­been­responsible­for­the­workers’­compensation­needs­of­large­national­accounts­and­hasmanaged­ all­ aspects­ of­ complex­ claims,­ including­ investigation,­ reserves,­ coordination­ of­ file

reviews­with­clients­and­brokers,­and­discovery/litigation­strategy­with­legal­counsel.

Simone­grew­up­in­St.­Louis,­Missouri­and­attended­the­University­of­Kansas.­She­is­married­and­has­two­sons:Austin­who­studies­at­Full­Sail­University­in­Orlando­and­Aric­who­attends­the­University­of­Alabama.

In­addition­to­being­a­devoted­St.­Louis­Cardinals­baseball­fan,­Simone­loves­to­travel,­read,­snorkel­and­work­out.

This­spring,­the­Florida­FirstDistrict­Court­of­Appeal(DCA)­issued­severaldecisions­addressing­theEmployer/Servicing­Agent’sobligations­when­it­comes­torebutting­the­statutorypresumption­found­in­section112.18(1)­of­the­FloridaStatutes.­One­such­case,City of Jacksonville/City ofJacksonville RiskManagement v. Ratliff 1,­isnow­being­presented­to­andconstrued­by­judges­ofcompensation­claimsthroughout­the­state.

In­this­case,­the­claimantsuffered­a­heart­attack­whileat­work.­On­that­date,­hehad­attended­a­meeting­inwhich­a­disagreement­aroseas­to­building­coderequirements.­The­claimantbegan­to­experiencediscomfort­and­chest­painduring­the­“extremelystressful”­meeting.­Shortlythereafter,­the­claimant­wasadmitted­to­the­hospitalwhere­he­was­diagnosedwith­coronary­artery­disease(CAD)­and­an­acute­anterior

wall­myocardial­infarction,­orheart­attack.­The­employerconducted­a­120-dayinvestigation,­after­which­adenial­was­issued.­This­waspremised­on­their­expert’sdecision­relating­heartdisease­to­the­claimant’shistory­of­diabetes,­highcholesterol,­prior­history­ofsmoking,­and­family­history.

The­claimant­challenged­thedenial­and­at­the­finalhearing,­medical­testimonywas­introduced­on­behalf­ofboth­parties.­Both­testifyingexperts­noted­the­claimant’smultiple­risk/causativefactors.­The­testimony­alsoestablished­that­the­claimantsuffered­from­blockedarteries­caused­by­the­buildup­of­plaque,­and­that­themyocardial­infarctionresulted­from­the­build-up­ofplaque.­The­physician­whocompleted­the­employer’sIndependent­MedicalExamination­(IME)­“admittedthere­was­no­medical­test­todetermine­the­‘trigger’­orcause­of­the­plaque­rupture”;however,­possible­triggersinclude­high­blood­pressure,stress,­or­other­non­work-related­factors.­TheIME­expert­for­Ratliff­testifiedthat­stress­or­increase­in

blood­pressure­from­thebusiness­meeting­could­havebeen­the­“trigger”­of­theplaque­rupture,­but­agreedthe­cause­or­“trigger”­wasunknown.

The­Judge­of­CompensationClaims­(JCC)­rejected­theopinion­of­the­employer’sIME­expert,­noting­he­did­notfind­the­doctor’s­testimony­tobe­“persuasive­or­sufficientas­competent­evidence­orclear­and­convincingevidence­by­which­toestablish­a­rebuttal­of­theLegal­Presumption…[nor­didit]­meet­the­standard­set­toconstitute­major­contributingcause.”­The­appellate­courtfound­such­“catch-all”language­to­be­in­error,confirming­that­their­priordecisions­as­to­theemployer’s­burden­did­notrequire­a­satisfaction­of­the“major­contributing­cause”standard.­­

JOHNS EASTERN COMPANYIntegrity. Experience. Results.

Publisher Beverly Adkins

Editor-In-Chief Alice Wells

Graphic Designer Deirdre Harris

Contributors:● Bernadette Anthon, Johns Eastern

● Kristen Magana, Esq.Broussard & Cullen, P.A.

● Healthesystems Clinical Services Team

● John Powers, Johns Eastern● Rose Rome, Johns Eastern● Sniffen & Spellman, P.A.

PO Box 110259Lakewood Ranch, FL 34211-0004

Phone: 941-907-3100Toll Free: 877-326-JECO

Fax: 813-402-7913

www.johnseastern.com

JOHNS EASTERN

6

COURT OFFERS NEW INSIGHT ON TRIGGERS

What does the JCCdecision in Ratliffmean to your program?

Third Quarter 2017

IN THE SPOTLIGHT

UPCOMINGCEU SEMINAR­September 2017September­811:30am­-­2:00pm

“Pain ManagementInjections” Presented­by:­Dr.­Satinderpaul­S.Satia,­with­Kennedy-White­OrthopaedicCenter­and­Eraclides,Gelman,­Hall,­Indek,Goodman­&­Waters,P.A.

This­course­willprovide­attendeeswith­2­hours­ofoptional­CEU­credit.­

Location:­Holiday­InnLakewood­Ranch6231­Lake­Osprey­Dr.

For more details,contact: Rose­Rome­atrrome@johnseastern.com

Page 2Reducing PhysicianDispensing

Page 5Medical Marijuana &Workplace Policies

Page 3Court: New Attorney Fee Guidelines

JOHNS EASTERN CELEBRATES 71 YEARS

Continued on page 4

Q3­2017­Newsletter_Working_newsletter­­8/30/2017­­10:00­AM­­Page­1