DOUGLAS C. STUCKEY, APPELLANT,
v.
EAGLE PEST CONTROL CO., INC., AND OLD REPUBLIC INSURANCE COMPANY, APPELLEES
AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.
An employer/carrier cannot unilaterally deauthorize a claimant's treating physician without employee agreement or deputy commissioner approval, and must show good cause for the change.
[1] An employer or carrier seeking to change an authorized treating physician must obtain an order from a deputy commissioner or risk a ruling against good cause for the chan…
[2] Once an injured employee establishes a satisfactory physician-patient relationship with an authorized physician, the employer or carrier may not deauthorize that physicia…
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 intelligenceFollowing a compensable accident, an employer/carrier deauthorized the claimant's treating chiropractor after six months. The claimant continued treat…
The full statement of facts, procedural history, and disposition for this case are member content.
Join FLexlaw to unlock all legal intelligence© FLexlaw, Inc. — AI-generated enrichments are proprietary. All rights reserved.
Explore caselaw by topic → Browse Physician-Patient Relationship cases and more on FLexlaw
BARFIELD, Judge.
Appellant seeks review of a deputy commissioner’s order denying reimbursement for chiropractic bills, on the premise that the employer/carrier had properly deau-thorized the chiropractor.
We find the deputy’s order insufficient in the finding that good cause was shown by the employer/carrier (e/c) in deauthorizing the chiropractor. Following a compensable accident, appellant received authorized chiropractic treatment from Dr. Schwartz for an injury to his neck and upper back. After six months of such treatment, the e/c informed both appellant and the chiropractor that Dr. Schwartz would no longer be authorized to provide treatment. The e/c offered appellant alternate care from any one of three named chiropractors. Appellant continued to see Dr. Schwartz as he felt Dr. Schwartz was helping him and as he did not want another doctor. Within three weeks of the e/c’s deauthorization, appellant filed a claim for continued authorization of Dr. Schwartz.
Appellant then sought to have the e/c pay the unpaid chiropractic bills and to have Dr. Schwartz authorized to provide continuing care.
At the hearing, the e/c’s claims adjustor testified Dr. Schwartz was deauthorized after six months of treatment, when appellant had reached MMI, and the doctor still continued to treat him. The e/c felt there was a need for a second opinion of whether the treatment was necessary and as to how long it should continue. In denying the claim for unpaid bills and for authorization of future treatment with Dr. Schwartz, the deputy found that appellant had been properly advised of the deauthorization and offered alternative care to which appellant did not object. The e/c was found to be entitled to deauthorize the chiropractor as they desired both a second opinion and a second treating physician.
Under section 440.13(2)(a), Florida Statutes (1985), “once the claimant and employer or carrier agree on a treating physician and a satisfactory physician-patient relationship is established, when a change in the authorized treating physician is requested by the employer or carrier and the claimant disputes the change, the employer or carrier, being the party seeking to change the status quo, should obtain an order from the DC or incur the risk of a ruling against good cause for the change.” Cal Kovens Construction v. Lott, 473 So. 2d 249, 253 (Fla. 1st DCA 1985).
Thus, once an injured employee establishes a satisfactory physician-patient relationship with an authorized physician, the e/c may not deauthorize that physician without the employee’s prior agreement or without approval of a deputy commissioner. Where the e/c attempts to deauthorize a physician without the employee’s or deputy’s prior approval, the e/c must then show good cause for such action. In this situation the focus should be on the question of why an authorized physician should no longer provide care, thereby severing an established physician-patient relationship.
We find that the two reasons given by the deputy as demonstrating good cause are insufficient as a matter of law to sanction such unilateral deauthorization. The desire for a second opinion and a desire to provide a second chiropractor are insufficient for they ignore the issue of why Dr. Schwartz should no longer render care or why Dr. Schwartz’s care is inappropriate or unnecessary. The e/c made no effort to seek a second opinion before terminating authorized care by Dr. Schwartz and has shown no reason why such care should be ended while a second opinion was sought. Without such reasons relating to terminating existing care, the deputy’s order is incomplete.
The instant case is distinguishable from Crenshaw v. Florida Farm Bureau, 489 So. 2d 186 (Fla. 1st DCA 1986), which was relied on by the deputy in her order. In that case, the claimant voiced no objection for two years after the e/c deauthorized a treating physician and instead availed herself of the alternative physicians provided by the e/c. In the instant case, the filing of the claim within three weeks of the notice of deauthorization demonstrated to the e/c that appellant disputed this change, triggering the e/c’s duty to obtain a ruling from the deputy. Crenshaw, 489 So. 2d at 187.
There may well be justifiable reasons to make such a change, supportable by this record. But that is a matter for the deputy’s fact-finding responsibilities and not one for this Court to undertake. We therefore REVERSE and REMAND the case for further proceedings consistent with this opinion.
WENTWORTH and ZEHMER, JJ., concur.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Cited By
-
Wolk v. Jaylen Homes, Inc., 593 So. 2d 1058 (Fla. 1st DCA 1992)…hout the claimant’s prior agreement or without approval of a judge of compensation claims. Should the employer/carrier attempt to' deauthorize without prior approval, good cause must be shown for such action. Stuckey v. Eagle Pest Control Co., Inc., 531 So. 2d 350, 351 (Fla. 1st DCA 1988); Cal Kovens Construction v. Lott, 473 So. 2d 249, 253 (Fla. 1st DCA 1985). The issue presented by claimant in this case requires a determination by the judge of compensation claims regarding whether deauthorization is in th…
-
City OF Bartow & Commercial Risk Mgmt. v. Brewer, 896 So. 2d 931 (Fla. 1st DCA 2005)…r “deauthorizing” Dr. Simon as the treating physician for Ms. Brewer’s knee injury. Dr. Simon never treated Ms. Brewer for her knee injury, only for the shoulder injury she sustained in a separate accident. Compare Stuckey v. Eagle Pest Control Co., 531 So. 2d 350, 351 (Fla. 1st DCA 1988) (“[OJnce an injured employee [*934] establishes a satisfactory- physician-patient relationship with an authorized physician, the. e/c may not deauthorize that physician without the employee’s prior agreement or without appro…
-
Scott v. Bisanti Servs., Inc., 634 So. 2d 292 (Fla. 1st DCA 1994)…satisfactory physician-patient relationship with an autho [*295] rized physician, the employer/carrier may not deauthorize that physician -without the employee’s prior agreement or without the approval of the JCC. Stuckey v. Eagle Pest Control Co., 531 So. 2d 350 (Fla. 1st DCA 1988). When the employer/carrier deauthor-izes claimant’s first treating physician without authorizing alternative medical care, even when a claimant requests such care, claimant is justified in seeking medical care from a physician of…
Previewing 3 of 8 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- CAL Kovens Constr. & United States Fid. & Guar. Co. v. Lott, 473 So. 2d 249 (Fla. 1st DCA 1985)
- Crenshaw v. Fla. Farm Bureau & Fla. Farm Bureau Cas. Ins. Co., 489 So. 2d 186 (Fla. 1st DCA 1986)