ABC LIQUORS, INC., AND UNITED SELF-INSURED SERVICES, PETITIONERS,
v.
JULIO FLORES, RESPONDENT
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The court held that a dispute over a requested psychiatric independent medical examination constitutes a dispute over a medical benefit, authorizing the claimant to select an examiner.
A claimant injured at work requested a psychiatric independent medical examination due to depression. The employer and insurance carrier denied the re…
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ERVIN, Judge.
We deny the petition for writ of certiorari filed by the employer and insurance carrier, ABC Liquors, Inc., and United Self-Insured Services (respectively the E/C), asking this court to quash an order granting Julio Flores’ motion for a psychiatric independent medical examination (IME). We conclude that the correspondence from Flores, the claimant, to the E/C demonstrates the existence of a dispute over a requested medical benefit under section 440.13(5), Florida Statutes (1995), which gave Flores the authority to select an independent medical examiner. Flores was injured at work on April 16, 1996, and thereafter received treatment for a herniated disc. He sent a letter to the E/C asking for an IME with a psychiatrist, because he had become increasingly depressed about his condition and progress. When the E/C declined, Flores filed a motion pursuant to section 440.13(5), which provides, in part: “In any dispute concerning overutilization, medical benefits, compensability, or disability under this chapter, the carrier or the employee may select an independent medical examiner.” The E/C contends that the judge of compensation claims (JCC) erred in granting the motion, because the dispute between the parties did not fall within any of the four categories of this provision. We disagree.
Flores’ request for an IME was essentially a request for authorization of a psychiatrist under section 440.13(2) to evaluate his symptoms and determine his need for treatment. The E/C’s denial of such request created a dispute over a medical benefit under section 440.13(5); therefore, the JCC properly granted Flores’ motion for IME.
PETITION FOR WRIT OF CERTIORA-RI DENIED.
BARFIELD, C.J., and BENTON, J., concur.
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Cortina v. State of Florida-Dept. OF HRS & Div. of Risk Mgmt., 901 So. 2d 273 (Fla. 1st DCA 2005)…sability, or disability under this chapter, the carrier or the employee may select an independent medical examiner. Under section 440.13(5)(a), the only condition required for a party to request an IME is a dispute. See ABC Liquors, Inc. v. Flores, 700 So. 2d 102 (Fla. 1st DCA 1997); Union Camp Corp. v. Hurst, 696 So. 2d 873, 875 (Fla. 1st DCA 1997). Under relevant case law, there are two ways to create a section 440.13(5)(a) dispute. First, when an employer denies a claim for benefits, the employer is clea…
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Lehoullier v. Gevity/Fire Equip. Servs. & AIG Claim Servs., Inc., 43 So. 3d 834 (Fla. 1st DCA 2010)…Cortina, 901 So. 2d at 274 (holding that a section 440.13(5)(a) “dispute” is created when an employer denies a claim for benefits or when a claimant disagrees with the diagnosis of an E/C-authorized treating physician); ABC Liquors, Inc. v. Flores, 700 So. 2d 102 (Fla. 1st DCA 1997) (holding that a claimant’s request for IME amounted to a request for authorization of medical care and, therefore, that the E/C’s denial of that request created a dispute over medical benefits, warranting authorization of IME).…
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Velasquez v. Malaja Constr., Inc., 720 So. 2d 302 (Fla. 1st DCA 1998)…treatment have been authorized may itself be viewed as a request for medical benefits. Denying such a request may therefore create a dispute of the kind contemplated by section 440.13(5)(a), Florida Statutes (1995). See ABC Liquors, Inc. v. Flores, 700 So. 2d 102, 102 (Fla. 1st DCA 1997). Differences over future medical benefits may also arise after medical benefits have been furnished, when one party disagrees with the diagnosis of a treating physician, or of the other party’s independent medical examiner.…
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