Florida Injury Attorneys Blog

Are ex parte communications between a nurse case manager and a physician permissible?  The answer to this question truly depends on whether the nurse case manager is a qualified rehabilitative provider performing a reemployment assessment or if the nurse case manager is solely retained to perform medical care coordination services.  If the nurse case manager is a “qualified rehabilitation provider” and retained to perform a re-employment assessment,  then ex parte communications are appropriate and allowable pursuant to Florida Statue 440.13(4)(c).    Conversely, if the nurse case manager is retained by the employer or the carrier for the sole purpose of medical care coordination, ex parte communications are impermissible and a violation of the statute.  It is important to note that just because the nurse case manger is deemed a “qualified rehabilitation provider” that does not, in and of itself, permit ex parte communications between she and the physician.

While Florida Statute 440.13 (4)(c), allows the employer and or the carrier to have ex parte communications with the physicians, this statute does not extend to third parties or a qualified rehabilitation provider who is not performing a reemployment assessment.

If you have been assigned a nurse case manager, it is important to understand her role.  If you are unsure, please do not hesitate to contact our office as we would be more than happy to speak with you.

On 4-28-16, the Florida Supreme Court in the case of Castellanos v Next Door Company SC 13-2082 declared Florida Statute 440.34 unconstitutional because it violated the Constitutional due process right to the courts for the injured workers. The constitutional violation was based on the failure of that statute to allow claimants’ attorneys to obtain a reasonable attorney fee for litigating and obtaining benefits under the Florida Workers Compensation Act.  This is a victory for the injured workers as their attorneys can now receive reasonable compensation for obtaining needed benefits for the injured workers.

This firm has always been dedicated to protect the rights of the injured person. Angel Kirkconnell at this firm has litigated tirelessly to help the injured worker.  Now with the advent the ability of attorneys to get paid, this firm can give meaningful help to achieve benefits for those injured in the line of work.

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As we know, the law requires that a medical benefit which includes, but is not limited to, the treatment, a device or an aid be medically necessary.  In order to award that benefit, the test is whether it is medically necessary.  A Judge of Compensation Claims may award only those medical benefits that are medically necessary.  It is important to understand the distinction between a medically necessary benefit and those that are merely pleasant or convenient.  Simple convenience will not suffice nor would a benefit that would neither improve nor aid in recovery be considered medically necessary. Continue reading →

The answer to this question is – NO.  The 1^st District Court of Appeals recently addressed this question and issued an opinion which can be found in Boley Centers, Inc./Comp Options v. William Vines, Case No. 1D14-5869 (November 16, 2015). Continue reading →

According to Fla. Stat. 440.13(2)(f), “Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during his course of treatment for any one accident. Upon granting of a change of physician, the originally authorized physician in the same specialty as the changed physician shall become de‑authorized upon written notification by the employer or carrier.  The carrier shall authorize an alternative physician who shall not be professionally affiliated with the previous physician within five (5) days after receipt of the request.  If the carrier fails to provide a change of physician as requested by the employee, the employee may select the physician and such physician shall be considered authorized if the treatment being provided is compensable and medically necessary.

As of late, there has been some controversy as to whether the physician must be in the same specialty as that of the treating physician. As you will note from the Statute, same does not contain any requirement whatsoever that the one-time change must be in the same specialty.  In fact, said issue was recently addressed in Edwards v. Miami-Dade County Public Schools, OJCC #15‑009693CMH.  In Edwards, Judge Hill ruled that Fla. Stat. 440.13(2)(f), does not require the Claimant to first prove as a condition precedent to the operation of this subsection, that all the proposed treatment be within the same medical specialty.

As you will note, in the most recent case, it is evident that the Statute is devoid with regard to specific language pertaining to whether the one-time change must be within the same specialty. As such, it is our position that once a one-time change has been made, the Claimant may be free to choose any specialty and may not compelled to change to the same specialty.