JCC Denies Cervical Fusion Request After Rejecting IME Causation Opinion

In Smythe v. Apex Service Partners / Liberty Mutual Insurance, OJCC Case No. 24-025944IF, Judge Iliana Forte denied and dismissed with prejudice a petition for benefits seeking authorization and payment for a multi-level cervical surgery.

The litigated claim sought maximal discectomy with arthrodesis at C4–C7 based on the IME recommendation. The claimant argued waiver/estoppel and “120-day” defenses. The JCC rejected those arguments and found the employer/carrier was not barred from contesting the medical necessity and work-relatedness of the requested surgery.

On the medical merits, the JCC rejected the IME’s major contributing cause opinion after the doctor acknowledged preexisting degenerative disease contributing to the need for surgery. The JCC accepted Concentra’s opinions that the claimant reached MMI with a 0% impairment rating and that further cervical treatment was not work-related or medically necessary.

Source: Final Compensation Order