GUILLERMO FUENTES, APPELLANT,
v.
CARIBBEAN ELECTRIC AND FIRST ALLIANCE INSURANCE, APPELLEES
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Claimant appealed an order denying workers' compensation benefits after a work-related back injury and subsequent reinjury. The court reversed, finding that the employer/carrier improperly deauthorized claimant's treating chiropractor without good cause and that the judge failed to adequately explain rejection of the treating physician's unrebutted testimony regarding disability.
The court reversed, holding that the employer/carrier improperly deauthorized Dr. Silverman without good cause because Dr. Dranoff's MMI opinion predated the second accident and did not address claimant's condition following that injury. The court also held that the judge could not reject Dr. Silverman's unrebutted testimony regarding claimant's inability to work without providing adequate explanation.
[1] An employer/carrier may not unilaterally deauthorize a physician who has an established physician-patient relationship with an injured employee without the employee's pri…
[2] Where an employer/carrier attempts to deauthorize a physician without employee or deputy commissioner approval, the employer/carrier must demonstrate good cause for the a…
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Join FLexlaw to unlock all legal intelligence“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.”
Establishes the legal standard for deauthorization of treating physicians under Florida workers' compensation law
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Join FLexlaw to unlock all legal intelligenceClaimant injured his back on October 29, 1987, in a work-related accident and began treatment with Dr. Silverman, an authorized chiropractor. On March…
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PER CURIAM.
This cause is before us on appeal from an order denying workers’ compensation benefits. Claimant asserts errors in the denial of claims for reimbursement of medical expenses and temporary total disability (TTD) benefits.
On October 29, 1987, claimant injured his back in a work-related accident. Claimant began seeing Dr. Silverman, an authorized chiropractor, and returned to work shortly thereafter. On March 16, 1988, Dr. Dranoff, a chiropractor, examined claimant and determined that he had reached maximum medical improvement (MMI) with no permanent physical impairment. Thereafter, the E/C deau-thorized Dr. Silverman.
On March 31, 1988, claimant fell from a ladder, twisted his knee, and reinjured his back. Claimant attempted to see Dr. Sil-verman but learned that the E/C had deau-thorized chiropractic care. Dr. Silverman agreed to treat claimant and placed claimant on light-duty status. Dr. Silverman testified that claimant had not reached MMI.
The JCC accepted Dr. Dranoff’s opinion that claimant reached MMI without any permanent impairment and denied the claims for temporary benefits, wage-loss benefits, and permanent benefits.
In Stuckey v. Eagle Pest Control Co., Inc., 531 So. 2d 350 (Fla. 1st DCA 1988), this court held that:
Under section 440.13(2)(a), Florida Statutes (1985), ... once an injured employee establishes a satisfactory physi cian-patient relationship with an authorized physician, the e/c may not deau-thorize 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.
In the instant case, claimant established a satisfactory physician-patient relationship with Dr. Silverman, an authorized chiropractor. The E/C deauthorized Dr. Silverman as a result of Dr. Dranoff’s opinion that claimant had reached MMI with no permanent impairment. However, Dr. Dra-noff’s opinion was made prior to claimant’s second accident. The E/C have failed to show that Dr. Dranoff’s opinion related to claimant’s condition following the second accident. Therefore, Dr. Silverman was unilaterally deauthorized without “good cause.” We must reverse the order denying reimbursement of Dr. Silverman’s medical expenses.
Furthermore, Dr. Silverman’s unre-butted testimony reveals that claimant could not work following the second accident. The JCC rejected Dr. Silverman’s testimony without providing adequate explanation for its rejection. Therefore, we must reverse and remand for further findings concerning the second accident and the period of wage-loss benefits. See Philpot v. City of Miami, 541 So. 2d 680 (Fla. 1st DCA 1989) (JCC may not reject unre-butted medical testimony without a reasonable explanation).
Accordingly, the order is reversed and remanded for proceedings consistent herewith.
BOOTH, SHIVERS and MINER, JJ., concur.
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Joal Wiederhold v. Wiederhold, 696 So. 2d 923 (Fla. 4th DCA 1997)…o accept the testimony of such an expert. Gordon, 615 So. 2d at 844 (citation omitted). Nevertheless, while the trial court can reject unrebutted expert testimony, it must offer a reasonable explanation for doing so. See Fuentes v. Caribbean Elec., 596 So. 2d 1228 (Fla. 1st DCA 1992). In other words, the trial court as fact-finder cannot arbitrarily reject unrebutted expert testimony. See, e.g., The Fla. Bar v. Clement, 662 So. 2d 690, 696 (Fla.1995), cert. denied, — U.S. -, 116 S.Ct. 1829, 134 L.Ed.2d 933 (1…
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Benson v. Okeechobee Cnty. Sheriff's Dep't & Isac, 632 So. 2d 100 (Fla. 1st DCA 1994)…ida Statutes (1987). We have held repeatedly that a physician may not be deauthorized without either the claimant’s prior agreement or approval by the judge of compensation claims, neither of which occurred here. E.g., Fuentes v. Caribbean Electric, 596 So. 2d 1228 (Fla. 1st DCA 1992); Wolk v. Jaylen Homes, Inc., 593 So. 2d 1058 (Fla. 1st DCA 1992); Stuckey v. Eagle Pest Control Co., 531 So. 2d 350 (Fla. 1st DCA 1988). The March 1989 treatment by Dr. Stephens occurred less than two years after the November 198…
Authorities Cited
- Philpot v. City OF Miami, 541 So. 2d 680 (Fla. 1st DCA 1989)
- Abdul Rashid v. Newberry Fed. Sav. & Loan Ass'n, 531 So. 2d 350 (Fla. 3d DCA 1988)
- Stuckey v. Eagle Pest Control Co., Inc., 531 So. 2d 350 (Fla. 1st DCA 1988)