WALT DISNEY WORLD COMPANY, APPELLANT,
v.
SANDRA SCHIEBEL, APPELLEE

Fla. 1st DCA | 1982-05-28
No. AE-327
LARRY G. SMITH and THOMPSON, JJ., concur.
414 So. 2d 602 Florida District Court of Appeal, First District (1982) Caution
Cited by 16 cases

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Synopsis

Walt Disney World Company appeals a workers' compensation order excusing a chiropractor's failure to timely file medical reports as required by Florida law. The court reverses, holding that an employer's refusal to pay bills and the fact that a claim is contested do not constitute good cause for failing to file required medical reports.

Holding

An employer's refusal to provide or pay for medical services and the fact that a claim is being contested do not constitute good cause excusing the failure to timely submit required medical reports. Good cause exists only in limited circumstances such as when the employer waives the reporting requirements with actual knowledge or where a confused legal situation or particularly complex facts exist.

Headnotes

[1] An employer's refusal to provide medical services does not constitute good cause to excuse the failure to timely submit required medical reports in a workers' compensatio…

[2] The fact that a workers' compensation claim is being contested does not, in itself, constitute good cause for the failure to timely file medical reports.

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Key Quotes

“an employer's refusal to provide medical services is not good cause which excuses the failure to timely submit the required reports, ... nor does the fact that a claim is being contested constitute such good cause”

Establishes the core holding that employer refusal to pay and claim contestation are not valid bases for excusing failure to file required reports

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Facts & Procedural History

Sandra Schiebel injured herself and received authorized care at Disney's medical facility. On July 18, 1979, she unilaterally sought treatment from Dr…

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Topics
Notice Of Controversy Waiver Of Statutory Requirements Worker'S Compensation

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Opinion of the Court
BOOTH, Judge.

BOOTH, Judge.

The employer appeals a workers’ compensation order excusing the failure of the claimant and of her chiropractor, Dr. Bartlett, to file timely medical reports as required by Florida Statutes, Section 440.-13(1).

In Walt Disney World Company v. Schiebel, 397 So. 2d 1004 (Fla. 1st DCA 1981), this court previously reversed the award of payment of the unauthorized and unreported medical bills, holding that the notice of controversy did not in itself excuse the failure to file reports.1 See St. Francis Hospital, Inc. v. Feinberg, 192 So. 2d 753 (Fla.1966); Hood’s Dairy v. Severino, 178 So. 2d 588 (Fla.1965).

The cause was remanded for a specific finding as to whether good cause existed for the failure to comply with Section 440.13(1).

On remand, without taking additional evidence or hearing argument of counsel, the Deputy Commissioner found that “Dr. Bartlett did have good cause to be excused from timely filing his medical reports under Workmen’s Compensation inasmuch as the claimant, Sandra Schiebel, informed him that Walt Disney World Workmen’s Compensation would not pay his bill ... and also that they had controverted the case in its entirety.”

We agree with the employer that such a finding is clearly insufficient, as “an employer’s refusal to provide medical services is not good cause which excuses the failure to timely submit the required reports, ... nor does the fact that a claim is being contested constitute such good cause.” Broward Industrial Plating, Inc. v. Weiby, 394 So. 2d 1117, 1120 (Fla. 1st DCA 1981). The rationale for requiring reports under such circumstances is that the employer’s receipt of prompt and accurate medical information is necessary to avoid the risk of inflated medical bills and dupli-cative treatment, as well as to facilitate any decision by the employer to rescind a previous denial of benefits. Torres v. Eden Roc Hotel, 238 So. 2d 639, 643 (Fla.1970).

Therefore, untimely medical reports have been excused for good cause only where, for example, the employer waives the requirements of Section 440.13(1) with actual knowledge, see Torres v. Eden Roc Hotel, supra at 642, or where a confused legal situation or particularly complex facts exist. E.g., Exxon Company, U.S.A. v. Rodriquez, 410 So. 2d 571 (Fla. 1st DCA 1982); Joy Footwear Corporation v. Folgueral, 409 So. 2d 188 (Fla. 1st DCA 1982). Since no such legally sufficient good cause was found here, the award of Dr. Bartlett’s medical bills is REVERSED.

LARRY G. SMITH and THOMPSON, JJ., concur. . Claimant had been receiving authorized care at the employer’s medical facility since the date of the accident. However, she unilaterally chose to seek treatment by Dr. Bartlett on July 18, 1979, without notifying the employer. Dr. Bartlett filed no workers’ compensation medical reports within the statutory ten-day period. The record in fact does not reveal that such reports were ever filed. Although Dr. Bartlett did send a private insurance form to claimant’s personal group carrier on August 4, 1979, this form indicated that claimant’s condition was not related to her employment.

Cases With Similar Vibessemantic neighbors from the corpus

Citator

Cited By

  • Fuchs Baking Co. & Emp'r's Serv. Corp. v. Est. of Francis Szlosek, 466 So. 2d 415 (Fla. 1st DCA 1985)
    …t of prompt and accurate medical information was necessary to avoid the risk of inflated medical bills and duplicative treatment, as well as to facilitate any decision ... to rescind a previous denial of benefits.” Walt Disney World Co. v. Schiebel, 414 So. 2d 602 (Fla. 1st DCA 1982). Instead, the evidence seems to me to be well within the principle applied in recent decisions holding that a failure to honor reporting requirements may be excusable upon evidence “that the employer [carrier] has conducted itsel…
  • Worthy Watson v. Freeman Decorating Co. & Hartford Ins. Grp., 455 So. 2d 1097 (Fla. 1st DCA 1984)
    …eason advanced by the health care provider is the most relevant evidence in reaching a decision as to whether or not good cause applies. See, e.g., Jack Eckerd Corp. v. Coker, 411 So. 2d 1026, 1028 (Fla. 1st DCA 1982); Walt Disney World v. Schiebel, 414 So. 2d 602, 603 (Fla. 1st DCA 1982); Cedars of Lebanon Health Care v. Summerset, 409 So. 2d 185 (Fla. 1st DCA 1982); Vannice Construction Co. v. Silverman, 419 So. 2d 369 (Fla. 1st DCA 1982). Other cases, however, consider the conduct of the employer as the mo…
  • Fla. SOD Co. v. Myers, 432 So. 2d 645 (Fla. 1st DCA 1983)
    …rida Statutes (1979). The dep [*646] uty’s omission of that finding and the failure of claimant’s attorney to call that oversight to the deputy’s attention thus jeopardizes payment of these medical bills. E.g., Walt Disney World Company v. Schiebel, 414 So. 2d 602 (Fla. 1st DCA 1982); Jack Eckerd Corporation v. Coker, 411 So. 2d 1026 (Fla. 1st DCA 1982). Nevertheless, the deputy’s remarks during the transcribed hearing indicate that the deputy considered there to be good cause excusing the physicians’ failure…

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