McConnaughhay, Coonrod, Pope, Weaver, Stern & Thomas, P.A.

Workers' Compensation

Sun Bank/South Florida v. Baker

632 So.2d 669

Whenever the purpose of a diagnostic test is to determine the cause of a claimant's symptoms and which symptoms may be related to a compensable accident, the cost ofthe diagnostic test is compensable, even if it should later be determined that the claimant suffered from both compensable and non-compensable conditions. The diagnostic testing which is recommended by an authorized physician is implicitly authorized. Once an injured employee establishes a satisfactory physician-patient relationship with an authorized physician, the employer/carrier may not deauthorize that physician without the employee's prior agreement or without the approval of the JCC. When the employer/carrier deauthorizes claimant's first treating physician without authorizing alternative medical care, even when a claimant requests such care, claimant is justified in seeking medical care from a physician of her own choice. In this case, the employer/carrier deauthorized treating doctor Claimant injured in work related accident and sued third party tortfeasor, recovering a settlement. Medical care was provided and the employer/carrier, pursuant to theworkers' compensation statute, paid the provider's bill based upon the maximum reimbursement allowance as provided for in the workers' compensation statute. Provider sought to recover the difference between the total bill and the amount allowed under the reimbursement schedule from the claimant or from the proceeds received in the third party settlement. Court determined that the health care provider may not recover a fee in excess of the statutory maximum reimbursement allowance from the employee or from his settlement proceeds.

Cases

Workers' Compensation

Sun Bank/South Florida v. Baker