In what could be a first-of-its-kind decision in Florida, an appeals court Monday ruled against an injured worker who sought a change in physicians under the workers’ compensation insurance system.
The ruling by a three-judge panel of the 1st District Court of Appeal was rooted in part of state law that allows workers to request a one-time change in physicians while being treated for workplace accidents.
Worker Brenton Davis requested such a change, but insurer Retailfirst Insurance Co. and his employer didn’t respond in a timely way to the request, according to the ruling.
Because of the lack of a response, Davis sought to change his doctor from a family practice physician to an orthopedist. A judge of compensation claims said Davis was entitled to select a physician of his choice, but the 1st District Court of Appeal said he could only change to a physician of the type originally approved for workers’ compensation treatment.
“In essence, Davis’ reading would allow a claimant to add a new physician, rather than change from the originally authorized one,” said the four-page ruling, written by Judge Scott Makar of Jacksonville and joined by judges James Wolf and Stephanie Ray.
“And it would allow a claimant, at least in theory, to select a specialist who is wholly unsuitable for the ‘course of treatment’ that has been authorized. As such, we read that statute as a whole to reflect a legislative intent of allowing only a one-for-one exchange of physicians within the same specialty under these circumstances,” the ruling continued.
“Procedures exist for claimants to seek authorization for physicians beyond the specialties originally established for their workplace accidents. But (a section of state law) cannot be read to allow that result simply because an employer/carrier has not timely responded to a one-time change of physician,” the ruling said.
It does not give details about Davis’ employment or injuries, but appealing with Retailfirst Insurance Co. was Servpro of Southeast Tampa.
The ruling said it was a “case of first impression” — indicating the first time the appeals court has dealt with the issue.
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