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…

Effective July 1, 2014, Chapter 440 now allows for calculation of the compensation rate as EITHER 66 2/3% OR 66.67%. This is the legislative response to Escambia County School District Board v. Vickery-Orso, which found the proper method for determining the compensation is not by multiplying the average weekly wage by .6667 or .66667, but…

Every adjuster has received that e-mail or fax from a claimant’s attorney with a whopping emergency room bill. Had the claimant waited a few more days and simply gone to their authorized provider, the carrier would only be on the hook for a simple follow-up visit, as opposed to the hospital bill which often multiplies…

The problematic request for a one-time change in treating physician can severely impact a case if not handled properly. As new case law continues to modify the acceptable manner of appropriately and timely responding to these requests, adjusters have greater burdens in appropriately responding. Below are some tips to help preserve the EC’s right to…

Changes in the Florida Workers’ Compensation Law implemented in 1994 provide employer/carriers with a powerful investigative tool. Section 440.13(4)(c), Florida Statutes, was amended as follows: [U]pon the request of the employer, the carrier, an authorized qualified rehabilitation provider, or the attorney for the employer or carrier, the medical records, reports, and information of an injured…

TTD @ 104 WEEKS – CLAIMANT DEEMED TO BE AT STATUTORY MMI & ELIGIBLE TO FILE FOR PTD 440.15, Fla. Stat: (2) TEMPORARY TOTAL DISABILITY.- …….. in case of disability total in character but temporary in quality, 66 2/3 percent of the average weekly wages shall be paid to the employee during the continuance thereof,…

The First DCA entered an opinion on October 16, 2013 that will likely result in appointment of Expert Medical Advisors (EMAs) in many more claims. Banuchi v. Dep’t. of Corrections, (Fla. 1st DCA, Oct. 16, 2013). Prior to Final Hearing, the claimant filed her “Notice of Conflict” wherein she pointed out a conflict in the…

In a recent court decision in the case of Bustamante v. Amber Construction Co. and American Interstate Insurance Co., the First DCA held that mere authorization of a change in physician is not enough to avoid the claimant partaking in the self-help nature of Florida Statute 440.13. Specifically, in this case, the claimant requested a…

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