VERNON ROLLE, APPELLANT,
v.
CITY OF RIVIERA BEACH/GALLAGHER BASSETT SERVICE, APPELLEE
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Vernon Rolle appealed the denial of workers' compensation benefits for diagnostic cardiac testing he underwent following a work-related injury. The court reversed, holding that an authorized treating physician's referral for medical evaluation implicitly authorizes the evaluation as compensable medical expenses, even if no causal connection to the original injury is proven.
The court held that when an authorized physician refers a claimant for medical evaluation in the exercise of independent medical judgment—not merely at the claimant's request—the evaluation is compensable as workers' compensation benefits, even absent a proven causal relationship to the original injury. The physician's referral implicitly authorizes the evaluation under Florida Statute § 440.13(2)(a), and the evaluation is part of the normal progression of authorized treatment.
[1] An authorized physician's referral for an evaluation is compensable under workers' compensation law if the referral is made in the physician's professional judgment and n…
[2] A referral by an authorized physician to another doctor for an evaluation is implicitly authorized and compensable, but this authorization does not extend to treatment.
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“an authorized physician's referral for an evaluation authorized the evaluation as effectively as if the employer itself had explicitly and directly granted authorization”
Establishes the key holding that referrals by treating physicians implicitly authorize evaluations
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Join FLexlaw to unlock all legal intelligenceRolle was injured in an industrial accident on June 13, 1988, while employed by the City of Riviera Beach. On August 26, 1999, while undergoing author…
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PER CURIAM.
On appeal, Vernon Rolle contends that medical expenses he incurred in undergoing diagnostic testing are the responsibility of his former employer, the City of Riviera Beach, and its servicing agent, Gallagher Bassett. We agree and reverse on the authority of Green v. Chromalloy-Turbocumbustor, 540 So. 2d 874 (Fla. 1st DCA 1989), and McKinney v. McKinney Farms, 380 So. 2d 469 (Fla. 1st DCA 1980).
While employed by the City of Riviera Beach, Mr. Rolle was injured in an industrial accident on June 13, 1988, on account of which he was undergoing physical therapy on August 26, 1999. At the conclusion of this therapy, he reported chest pains. Dr. Lichtblau, the authorized treating physician who was supervising his physical therapy, referred him to an emergency room for an immediate cardiac evaluation. Testimony that Mr. Rolle would not have been allowed to continue physical therapy without receiving cardiac clearance was uncontroverted.
Under the statute in force at the time of the industrial accident, see § 440.13(2)(a), Fla. Stat. (1987), an authorized physician’s referral for an evaluation authorized the evaluation as effectively as if the employer itself had explicitly and directly granted authorization.
[T]he referral of a claimant by an authorized physician to another physician, is compensable if the referral was made in the exercise of the treating physician’s own judgment, and not just at the request of the claimant. Northwest Orient Airlines v. Gonzalez, 500 So. 2d 699, 701 (Fla. 1st DCA 1987); Shafer & Miller, Inc. v. Moore, 499 So. 2d 871, 873 (Fla. 1st DCA 1986); Sloan v. Concrete Sciences, 382 So. 2d 411 (Fla. 1st DCA 1980). This implied authorization which results when an authorized physician refers a claimant to another doctor for an evaluation extends only to the evaluation, and does not encompass treatment. Jones v. Plantation Foods, 388 So. 2d 590 (Fla. 1st DCA 1980). See also Northwest Orient Airlines v. Gonzalez, 500 So. 2d at 702.
Green v. Chromalloy-Turbocumbustor, 540 So. 2d 874, 876 (Fla. 1st DCA 1989); see Carpet Shop v. Vance, 542 So. 2d 1039, 1040 (Fla. 1st DCA 1989); Wynn v. Hogan Baptist Church, 483 So. 2d 551, 553 (Fla. 1st DCA 1986); McKinney, 380 So. 2d at 470; see also Prince v. Prince Ins. Servs., 556 So. 2d 1195, 1197 (Fla. 1st DCA 1990) (“Since the diagnostic test recommended by [the authorized physician] was designed to reveal the precise causal etiology of claimant’s symptoms so that an appropriate treatment decision could be made, the claimant should have been awarded payment of the bills incurred for the diagnostic testing.”).
The judge of compensation claims found that, “as indicated by Dr. Chait [the independent medical examiner], Dr. Licht-blau’s action[ ] in sending claimant to the emergency room was appropriate, reasonable, and medically necessary based on the exigent circumstances.” While it is true that, as the judge of compensation claims also found, “no evidence was presented that a connection existed between the claimant’s symptoms on August 26, 1999 and the work injury sustained on June 13, 1988,” the evaluation was “in the normal progression of authorized treatment.” McKinney, 380 So. 2d at 470.
REVERSED and REMANDED.
MINER, BENTON, and LEWIS, JJ„ CONCUR.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Authorities Cited
- Jones v. Plantation Foods, 388 So. 2d 590 (Fla. 1st DCA 1980)
- McKINNEY v. McKINNEY Farms & Fla. Farm Bureau, 380 So. 2d 469 (Fla. 1st DCA 1980)
- Jewel May Daophin v. State, 540 So. 2d 874 (Fla. 4th DCA 1989)
- Nw. Orient Airlines & Underwriters Adjusting Co. v. Gonzalez, 500 So. 2d 699 (Fla. 1st DCA 1987)
- Buford Sloan v. Concrete Scis. & Liberty Mut. Ins. Co., 382 So. 2d 411 (Fla. 1st DCA 1980)
- Bradford A. Prince v. Prince Ins. Servs. & Lumbermans Mut. Ins., 556 So. 2d 1195 (Fla. 1st DCA 1990)
- J.W. Wynn v. Hogan Baptist Church & Preferred Risk Mut. Ins. Co., 483 So. 2d 551 (Fla. 1st DCA 1986)
- Shafer & Miller, Inc. v. Mose Moore and the Division of Workers' Compensation, 499 So. 2d 871 (Fla. 1st DCA 1986)
- Milton v. State, 542 So. 2d 1039 (Fla. 1st DCA 1989)
- The Carpet Shop & Se. Administrators v. Vance, 542 So. 2d 1039 (Fla. 1st DCA 1989)