WILLIS JONES, APPELLANT,
v.
PLANTATION FOODS, FIDELITY AND CASUALTY COMPANY OF NEW YORK AND TRAVELERS INSURANCE COMPANY, APPELLEES
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Willis Jones appealed a workers' compensation decision challenging both the degree of impairment rating and the denial of payment for medical bills. The court affirmed the 5% impairment rating but reversed the denial of payment for evaluation services performed by a referred physician, remanding for consideration of prejudice from untimely report filing.
The court affirmed the 5% impairment rating as it was supported by both medical evidence and the judge's direct observations of the claimant's physical functioning during the hearing. The court reversed the denial of payment for Dr. Sternberg's evaluation services, finding he was authorized through referral by the authorized physician, but remanded for the trial judge to determine whether prejudice to the employer-carrier resulted from the failure to timely file required reports.
[1] A judge may consider the claimant's physical use of their body during hearings as evidence when determining impairment ratings, even if medical reports were admitted for…
[2] A judge is not bound to accept medical testimony regarding impairment ratings and may rely on lay testimony or demonstrative evidence.
Previewing 2 of 5 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.
Join FLexlaw to unlock all legal intelligence“it is within the judge's discretion to reject the medical testimony and rely instead on lay testimony or demonstrative evidence”
Establishes that the trial judge properly relied on his observations of the claimant's physical functioning during the hearing as a basis for the impairment rating alongside medical evidence.
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Join FLexlaw to unlock all legal intelligenceWillis Jones was injured in a workplace accident and referred by the employer to Dr. Teitelbaum, who in turn referred him to Dr. Sternberg for evaluat…
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MILLS, Chief Judge.
The claimant, Willis Jones, appeals from an order of the Judge of Industrial Claims, challenging the determination of the degree of impairment resulting from one accident and the failure of the judge to order the payment of medical bills for services performed at the request of an authorized physician.
Regarding the first issue, it appears from the record and order that the judge considered the substance of some medical reports in arriving at his impairment rating even though those reports were admitted only for the purposes of proving knowledge on the part of the insurance company of assignment of impairment and for purposes of attorney’s fee.
In the part of the order establishing the impairment rate, the judge stated that Dr. Abel (a report not contested) set a rate of 3%, Dr. Silverman (contested) a rate of 3 to 4%, Dr. Unger (contested) contradicted himself, and Dr. Russell (contested) set a rate of 5%. In accepting the 5% rating, he stated, “Dr. Russell believed five percent and is adopted because [it is] consistent with the employee’s use of his body sitting and standing during the hearing.”
Even though the judge considered medical reports not in evidence for that purpose in establishing the impairment rating, we affirm the five percent rating because it was not based solely on the medical reports. It was also based on the judge’s observations of Jones’ use of his body during the hearings. Under Magic City Bottle & Supply Co. v. Robinson, 116 So. 2d 24 (Fla.1959), it is within the judge’s discretion to reject the medical testimony and rely instead on lay testimony or demonstrative evidence.
The second issue involves the judge’s rejection of a claim for payment of a bill from Dr. Sternberg. The record reveals that the employer referred Jones to Dr. Teitelbaum and Dr. Teitelbaum referred him to Dr. Sternberg for evaluation. Dr. Sternberg saw Jones eleven times,- some of those visits were for testing and evaluation and others were for treatment. Dr. Stern-berg was authorized by virtue of the referral to him by the authorized physician, Dr. Teitelbaum. McKinney v. McKinney Farms, 380 So. 2d 469 (Fla. 1st DCA 1980). The authorization extended, however, only to the evaluation and not to the treatments.
We would order the payment of Dr. Sternberg’s bills based on the above holding if it were not for the fact that he failed to timely submit the reports required by Section 440.13, Florida Statutes (1975). The judge’s order made note of this failure, but he made no finding concerning whether there was prejudice to the employer-carrier or whether good cause was shown. Accordingly, we reverse the denial of payment of Dr. Sternberg’s bills related to evaluation and remand for consideration of the question of prejudice caused by the failure to file timely reports. AFFIRMED in part; REVERSED in part; remanded for further consideration in light of this opinion.
McCORD, J., concurs.
WENTWORTH, J., specially concurs.
WENTWORTH, Judge,
concurring.
I agree with the court’s opinion but would affirm the permanency rating for the August 1976 accident only because no issue was raised as to applicability of § 440.-25(3)(b), Florida Statutes, as amended in 1978 to alter Magic City v. Robinson, 116 So. 2d 24 (Fla. 1959). The amendment on standard of proof might have been properly invoked in this hearing conducted after its effective date in accordance with decisions applying statutes on remedies, including standard of proof, as amended at time of trial. Summerlin v. Tramill, 290 So. 2d 53 (Fla. 1974). Section 25 of Chapter 78-300, Laws of Florida, limiting the act to subsequent injuries, would in my opinion relate to substantive changes. Cf., Myers v. Carr Construction, 387 So. 2d 417 (Fla. 1st DCA 1980).
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Atkins v. Greenhut Constr. Co., 447 So. 2d 268 (Fla. 1st DCA 1983)…er, we suggest that the authorized physician contact the carrier and secure authorization before subjecting it to financial responsibility for such treatment and hospitalization. 380 So. 2d at 470. We subsequently held in Jones v. Plantation Foods, 388 So. 2d 590 (Fla. 1st DCA 1980), that the implied authorization which results when an authorized physician refers a claimant to another doctor extends to evaluation and not treatment. When the insurance carrier was notified that additional surgery on Atkins’ ha…
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Nw. Orient Airlines & Underwriters Adjusting Co. v. Gonzalez, 500 So. 2d 699 (Fla. 1st DCA 1987)…e suggest that the authorized physician contact the carrier and secure authorization before [*702] subjecting it to financial responsibility for such treatment and hospitalization. McKinney at 470. We subsequently held in Jones v. Plantation Foods, 388 So. 2d 590 (Fla. 1st DCA 1980), that the implied authorization which results when an authorized physician refers a claimant to another doctor extends to evaluation and not to treatment. Jones at 591 (emphasis supplied). In Atkins v. Greenhut Construction Co.,…
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Bradford A. Prince v. Prince Ins. Servs. & Lumbermans Mut. Ins., 556 So. 2d 1195 (Fla. 1st DCA 1990)…Toppers of Florida, Inc., 382 So. 2d 441, 442 (Fla. 1st DCA 1980). Diagnostic testing which is recommended by an authorized physician is itself implicitly authorized. Green v. Chromal-loy-Turbocumbustor, 540 So. 2d at 876; Jones v. Plantation Foods, 388 So. 2d 590, 591 (Fla. 1st DCA 1980). The record in this case reflects that the contested diagnostic test was requested by an authorized treating physician. The record further reflects, as the judge found, that when Dr. Fulton recommended the sonogram, he did…
Previewing 3 of 12 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Myers v. Carr Constr. Co. & Mich. Mut. Ins. Co., 387 So. 2d 417 (Fla. 1st DCA 1980)
- McKINNEY v. McKINNEY Farms & Fla. Farm Bureau, 380 So. 2d 469 (Fla. 1st DCA 1980)
- Summerlin v. Tramill, 290 So. 2d 53 (Fla. 1973)