The readers of this blog should be well aware of the litigation-intensive nature of our society and the importance of appropriate, adequate insurance to cover personal and commercial risk. We generally update you on insurance-related issues affecting the workers’ compensation industry, but this column relates more to personal risk coverage. We all have automobile insurance…

The US Department of Justice is investigating potential health care fraud related to compounded pain relief creams. Preliminary estimates suggest this fraud could exceed half a billion dollars. In addition to overbilling and inappropriate automatic refills, the clinical efficacy of these medications is being questioned, according to a report from the Wall Street Journal. The…

Like other forms of civil litigation, the majority of workers’ compensation claims settle short of trial. Even claims that have been tried and appealed on multiple occasions tend to settle via lump sum at some point. Settlement of a claim is comprised of 2 major elements: settlement of future wage loss/indemnity benefits and settlement of…

The First District Court of Appeal has suggested that in order to deny benefits pursuant to a Major Contributing Cause (MCC) analysis, the employer/carrier may need to issue a 120 day pay and investigate letter in every case. Babahmetovic v. Scan Design Florida, Inc./Zenith Ins. Co. (Fla. 1st DCA, Oct 8, 2015). The dispute in…

Vecchio, Carrier, Feldman & Johannessen is pleased to announce that our Senior Partner, Thomas P. Vecchio, has received the Chartered Property Casualty Underwriter designation conferred by the Insurance Institute of America. The CPCU designation is the insurance industry’s premier accreditation awarded to insurance professionals. Mr. Vecchio’s concentration was in commercial insurance. The CPCU designation is…

The First District Court of Appeal (DCA) issued an opinion holding that a claimant’s request for a one-time change in his treating physician must be set forth in a direct and obvious way, and that a request for a one-time change that is intentionally hidden does not compel an employer/carrier to act. The First DCA…

One method where the claimant’s attorney can control authorization of physicians is through the five-day rule under 440.13(2)(f). This statute states that where the claimant sets forth his request for his one-time change in treating physician, the employer/carrier must offer an alternative physician within 5 days. If the employer/carrier does not offer an alternative physician…

The First DCA recently rejected an appeal where the claimant argued that service of a Petition for Benefits on an EC compelled the employer/carrier to act, even though the PFB was not filed with DOAH until much later. Elms v. Castle Construction, (Fla. 1st DCA, Oct. 10, 2014). This author tried the case before Judge…

Lawsuits under the Family Medical Leave Act (FMLA) are on the rise, as recently reported in the Wall Street Journal. The FMLA law is a federal statute which allows employees to take up to 12 weeks of unpaid leave per year for medical and family reasons. An employer is prohibited from taking any adverse employment…

With the Thanksgiving holiday approaching, beware of claimant lawyers using the Hinzman case to secure authorization of undesirable physicians. In February 2013, the First DCA issued its opinion in Hinzman v. Winter Haven Facility Operations. This case holds that the 5 day rule pertaining to the claimant’s one-time change in treating physicians is 5 consecutive…

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