WINN DIXIE STORES, INC. AND CRAWFORD & COMPANY, APPELLANTS,
v.
KAREN FRANK, APPELLEE
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.
Winn Dixie Stores and its workers' compensation carrier appealed an emergency order awarding 24-hour attendant care to injured employee Karen Frank. The court reversed, holding that the claimant failed to meet the statutory burden of providing physician testimony establishing medical necessity for such care.
The court held that the claimant did not meet her burden of proving medical necessity for attendant care because she failed to provide competent substantial evidence through physician testimony as required by section 440.13(2)(g). The JCC erred in awarding emergency attendant care before the claimant provided such evidence.
[1] A claimant seeking attendant care benefits bears the burden of proving that such care is medically necessary.
[2] A claimant cannot meet the burden of proving medical necessity for attendant care benefits without a physician's statement that the care is medically necessary.
Previewing 2 of 4 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 claimant had the burden of proving that she was entitled to the care because it was medically necessary”
Establishes the claimant's burden of proof in attendant care claims
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceKaren Frank, an injured claimant, petitioned for emergency attendant care benefits. At the hearing, the only physician witness testified that although…
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 Attendant Care Benefits cases and more on FLexlaw
DAVIS, Judge.
In this case Winn Dixie Stores and Crawford & Company, employer and carrier respectively, appeal an emergency order awarding Karen Frank, the claimant, 24-hour a day attendant care. As the JCC’s order acknowledges, and the claimant argues, her emergency petition for an award of attendant care benefits was a new claim based upon her current need. See Caron v. Systematic Air Services, 576 So. 2d 372 (Fla. 1st DCA 1991).
Therefore, the claimant had the burden of proving that she was entitled to the care because it was medically necessary. See Jackson Manor Nursing Home v. Ortiz, 606 So. 2d 422 (Fla. 1st DCA 1992).
Under section 440.13(2)(g), Florida Statutes (1993), the claimant cannot meet that burden of proof without a statement by a physician that such care is medically necessary. See also Attitudes & Trends v. Arsuaga, 616 So. 2d 1103, 1103 n. 1 (Fla. 1st DCA 1993) (section 440.13(2)(f) (Supp.1990) is a procedural burden of proof enactment). The only witness to testify in the hearing below was a doctor who stated that, though claimant is still wearing a brace to support her injured knee, attendant care was not necessary.
We note, however, that the JCC interrupted the proceedings and prevented the taking of additional evidence in support of the claim for attendant care, by ruling that the claimant was entitled to attendant care on an emergency basis. That was error because the claimant had not yet provided competent substantial evidence (by means of a physician’s testimony as required by section 440.13(2)(g)) of the medical necessity for such benefits.
Accordingly, we REVERSE and REMAND for further proceedings, in which the parties shall be given a full and fair opportunity to prove the claimant’s medical need for the benefits requested.
ALLEN, J., and SMITH, Senior Judge, concur.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Cited By
-
Frank v. Crawford & Co., 670 So. 2d 117 (Fla. 4th DCA 1996)
-
Adams Bldg. Materials, Inc. v. Brooks, 892 So. 2d 527 (Fla. 1st DCA 2004)…ndicate attendant care services are medically necessary. See § 440.13(2)(b), Fla. Stat. (2001)-(2002) (providing that employer must provide attendant care performed only at the direction and control of a physician); Winn-Dixie Stores, Inc. v. Frank, 665 So. 2d 271, 272 (Fla. 1st DCA 1995) (noting statutory standard that physician issue statement indicating attendant care is medically necessary). The statute and our case law interpreting the statute require that a physician prescribe all attendant care. See §…
-
Dep't OF Revenue v. M.J.M. and A.M.R., 217 So. 3d 1148 (Fla. 2d DCA 2017)…M.J.M. was denied that opportunity by the manner in which the trial court conducted the hearings on his petition. As the decisions cited in the text demonstrate, remand is the correct remedy in such cases. See also Winn Dixie Stores, Inc. v. Frank, 665 So. 2d 271, 272 (Fla. 1st DCA 1995) (remanding for a "full and fair” opportunity for the claimant to present her case where the trier of fact "interrupted the proceedings and prevented the taking of additional evidence”). The dissent also argues that M.J.M. wi…
Authorities Cited
- Caron v. Systematic AIR Servs. & State Farm Ins., 576 So. 2d 372 (Fla. 1st DCA 1991)
- Thurston McCLAIN v. State, 576 So. 2d 372 (Fla. 2d DCA 1991)
- Attitudes & Trends & Aetna Life & Cas. Co. v. Arsuaga, 616 So. 2d 1103 (Fla. 1st DCA 1993)
- Jackson Manor Nursing Home & Fireman's Fund Ins. v. Ortiz, 606 So. 2d 422 (Fla. 1st DCA 1992)