Cases

Claimant's treating doctor recommended the claimant be evaluated by a Spanish speaking neuropsychologist.  The employer/carrier provided a neuropsychologist but authorized a translator to accompany the claimant to this appointment rather than scheduling a Spanish speaking neuropsychologist.  The basis of a referral to a Spanish speaking psychiatrist in neuropsychologist was the possibility that the referral doctor would get the wrong information without adequately communicating with the claimant.  The JCC found that the referral based solely on the possibility that one could get the wrong information did not equate to medical necessity for such a referral and accordingly denied the specific request for the Spanish speaking physician or psychologist.

A determination of reasonable medical certainty depends on the substance of the evidence rather than the use of "reasonable medical certainty" terminology or on any other so called magic words by a medical witness.  This is a factual issue that remains within the adjudicatory function of the JCC based on the substance of the evidence presented.  Court on appeal determined that there was sufficient evidence of record sustaining the JCC's determination of a lack of medical evidence concerning the necessity for treatment.  It may have been preferable for a Spanish speaking physician to treat the claimant but Section 440.13(2)(a), Florida Statutes, requires that recommended treatment be medically necessary if the employer is to pay for it.  Court determined that the JCC did not err in rejecting the testimony of the authorized doctor that a Spanish speaking physician was necessary to provide care for the claimant.

Unrebutted medical testimony can be rejected by the JCC so long as there is a reasonable evidentiary basis for doing so.  A reasonable basis for the JCC to reject medical testimony can include conflicting medical evidence; evidence that impeaches the expert's testimony or calls such testimony into question, such as a failure of the claimant to give the medical expert an accurate or complete medical history; or conflicting lay testimony or evidence that disputes the claim. 

Concurring opinion concluding that the provision of a qualified psychiatrist, coupled with an interpreter, met prevailing standards of care related to medical necessity of treatment as provided for in Section 440.13(k), Florida Statutes (2014).  Dissenting opinion opined that this case of first impression incorrectly denied a Spanish speaking claimant a medically necessary evaluation by a Spanish speaking psychiatrist, a treatment which the claimant's authorized doctor recommended that the claimant receive.