MICHAEL C. BOYKIN, APPELLANT,
v.
AMERICAN MARINE PRODUCTS, INC. ET AL., APPELLEES
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In a workers' compensation appeal, the court affirmed the denial of temporary total disability benefits but reversed portions of the award regarding medical expenses for an uncompensated heart condition and treatment authorization by an unauthorized cardiologist. The court held that diagnostic procedures necessitated by combined symptoms remain compensable even if they later reveal multiple conditions, but treatment specifically for the non-compensable condition is not reimbursable.
Temporary total disability benefits were properly denied because claimant's condition did not result in loss of wage earning capacity. Medical bills for diagnostic procedures performed to determine the cause of combined symptoms are compensable despite later revealing multiple conditions, but treatment specifically for the uncompensable pericarditis after its diagnosis is not reimbursable. The authorization for Dr. Barratta to treat claimant was improper and is amended to authorize only Dr. Flores to continue treatment for the small airways disease.
[1] A deputy errs in denying temporary benefits if the stated reason for denial is legally erroneous, even if the deputy's actual basis for denial is supported by competent s…
[2] Diagnostic procedures are compensable when a claimant's combined symptoms, regardless of their independent causes, necessitate the diagnostic process.
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“The after-the-fact determination of causation does not affect the compensability of such diagnostic procedures.”
Establishes that diagnostic procedures undertaken for combined symptoms remain compensable even when they reveal multiple conditions, one of which is uncompensable.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceClaimant Boykin suffered from small airways disease, a compensable occupational condition. During initial treatment and hospitalization for combined s…
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PER CURIAM.
Claimant urges the deputy erred by denying all temporary benefits. Although the reason in the order for denying such benefits may at first appear erroneous as a matter of law, the deputy clearly indicates in the transcript that he denied temporary benefits because claimant’s condition did not result in a loss of wage earning capacity. In turn, this determination is supported by competent substantial evidence.
The issues raised on cross appeal are without merit except for Point III which needs clarification. The employer and carrier challenge the payment of medical bills, including a hospital bill, for an uncompensable heart condition, pericarditis, which independently accompanied the compensable small airways disease. We find that before the diagnosis of the separate diseases, claimant’s combined symptoms caused his initial treatment, his hospitalization, and the need for diagnosis by Dr. Flores. The purpose of the diagnostic process was to determine the cause for the combined and even overlapping symptoms. The after-the-fact determination of causation does not affect the compensability of such diagnostic procedures. See generally, Barris v. Toppers of Florida, Inc., 382 So. 2d 441 (Fla. 1st DCA 1980). However, to the extent that Dr. Hoe and Dr. Flores treated claimant’s pericarditis after its diagnosis by Dr. Flores, the medical bills related to this treatment are not reimbursable. If the parties cannot agree to the uncompensable amount, the deputy may take further evidence to make this determination.
The employer and carrier also complain the deputy improperly ordered further treatment by Dr. Barratta, a cardiologist. The record suggests that Dr. Barratta practices with Dr. Flores. However, there’s no evidence that Dr. Barratta treated claimant, that he is qualified to treat claimant’s lung disease, or that claimant requested a change in physicians. We amend this portion of the order to authorize Dr. Flores to further treat claimant for the small airways disease.
Affirmed in part, reversed in part and remanded for further proceedings consistent with this opinion.
McCORD, SHIVERS and JOANOS, JJ., concur.
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Lanoris Nealy v. City OF W. Palm Beach & Crawford & Co., 491 So. 2d 585 (Fla. 1st DCA 1986)…dents. Whenever the purpose of the diagnostic test is to determine the cause of a claimant’s symptoms, which symptoms may be related to a compensable accident, the cost of the diagnostic test is compensable. Boykin v. American Marine Products, Inc., 395 So. 2d 1163 (Fla. 1st DCA 1981). This is true even though it should later be determined that the claimant suffered from both compensable and noncompensable conditions. Barris v. Toppers of Florida, Inc., 382 So. 2d 441 (Fla. 1st DCA 1980). We hold that Boykin…
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Perry v. Ridgecrest Int'l & CNA Ins., 548 So. 2d 826 (Fla. 1st DCA 1989)…ant suffered from both compensable and noncom-pensable conditions. Sanchez v. Security Sales Company, 522 So. 2d 435 (Fla. 1st DCA 1988); Nealy v. City of West Palm Beach, 491 So. 2d 585 (Fla. 1st DCA 1986); Boykin v. American Marine Products, Inc., 395 So. 2d 1163 (Fla. 1st DCA 1981). The deputy also denied payment for past medical treatment relating to appellant’s noncompensable cardiovascular problems. We therefore remand with directions that the deputy deny payment for past remedial treatment only to the…
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Bradford A. Prince v. Prince Ins. Servs. & Lumbermans Mut. Ins., 556 So. 2d 1195 (Fla. 1st DCA 1990)…rpose or reason for the test, i.e., whether the test is necessary to determine the precise causal etiology of claimant’s symptoms. Abbott v. Price Plumbing, Inc., 500 So. 2d 698 (Fla. 1st DCA 1987). See also Boykin v. American Marine Products, Inc., 395 So. 2d 1163 (Fla. 1st DCA 1981); Barris v. 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…
Authorities Cited
- Barris v. Toppers OF Fla., Inc., 382 So. 2d 441 (Fla. 1st DCA 1980)