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Florida Statute 440.13 - Full Text and Legal Analysis
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The 2025 Florida Statutes

Title XXXI
LABOR
Chapter 440
WORKERS' COMPENSATION
View Entire Chapter
440.13 Medical services and supplies; penalty for violations; limitations.
(1) DEFINITIONS.As used in this section, the term:
(a) “Alternate medical care” means a change in treatment or health care provider.
(b) “Attendant care” means care rendered by trained professional attendants which is beyond the scope of household duties. Family members may provide nonprofessional attendant care, but may not be compensated under this chapter for care that falls within the scope of household duties and other services normally and gratuitously provided by family members. “Family member” means a spouse, father, mother, brother, sister, child, grandchild, father-in-law, mother-in-law, aunt, or uncle.
(c) “Carrier” means, for purposes of this section, insurance carrier, self-insurance fund or individually self-insured employer, or assessable mutual insurer.
(d) “Compensable” means a determination by a carrier or judge of compensation claims that a condition suffered by an employee results from an injury arising out of and in the course of employment.
(e) “Emergency services and care” means emergency services and care as defined in s. 395.002.
(f) “Health care facility” means any hospital licensed under chapter 395 and any health care institution licensed under chapter 400 or chapter 429.
(g) “Health care provider” means a physician or any recognized practitioner licensed to provide skilled services pursuant to a prescription or under the supervision or direction of a physician. The term “health care provider” includes a health care facility.
(h) “Independent medical examiner” means a physician selected by either an employee or a carrier to render one or more independent medical examinations in connection with a dispute arising under this chapter.
(i) “Independent medical examination” means an objective evaluation of the injured employee’s medical condition, including, but not limited to, impairment or work status, performed by a physician or an expert medical advisor at the request of a party, a judge of compensation claims, or the department to assist in the resolution of a dispute arising under this chapter.
(j) “Instance of overutilization” means a specific inappropriate service or level of service provided to an injured employee that includes the provision of treatment in excess of established practice parameters and protocols of treatment established in accordance with this chapter.
(k) “Medically necessary” or “medical necessity” means any medical service or medical supply which is used to identify or treat an illness or injury, is appropriate to the patient’s diagnosis and status of recovery, and is consistent with the location of service, the level of care provided, and applicable practice parameters. The service should be widely accepted among practicing health care providers, based on scientific criteria, and determined to be reasonably safe. The service must not be of an experimental, investigative, or research nature.
(l) “Medicine” means a drug prescribed by an authorized health care provider and includes only generic drugs or single-source patented drugs for which there is no generic equivalent, unless the authorized health care provider writes or states that the brand-name drug as defined in s. 465.025 is medically necessary, or is a drug appearing on the schedule of drugs created pursuant to s. 465.025(6), or is available at a cost lower than its generic equivalent.
(m) “Palliative care” means noncurative medical services that mitigate the conditions, effects, or pain of an injury.
(n) “Pattern or practice of overutilization” means repetition of instances of overutilization within a specific medical case or multiple cases by a single health care provider.
(o) “Peer review” means an evaluation by two or more physicians licensed under the same authority and with the same or similar specialty as the physician under review, of the appropriateness, quality, and cost of health care and health services provided to a patient, based on medically accepted standards.
(p) “Physician” or “doctor” means a physician licensed under chapter 458, an osteopathic physician licensed under chapter 459, a chiropractic physician licensed under chapter 460, a podiatric physician licensed under chapter 461, an optometrist licensed under chapter 463, or a dentist licensed under chapter 466.
(q) “Reimbursement dispute” means any disagreement between a health care provider or health care facility and carrier concerning payment for medical treatment.
(r) “Utilization control” means a systematic process of implementing measures that assure overall management and cost containment of services delivered, including compliance with practice parameters and protocols of treatment as provided for in this chapter.
(s) “Utilization review” means the evaluation of the appropriateness of both the level and the quality of health care and health services provided to a patient, including, but not limited to, evaluation of the appropriateness of treatment, hospitalization, or office visits based on medically accepted standards. Such evaluation must be accomplished by means of a system that identifies the utilization of medical services based on practice parameters and protocols of treatment as provided for in this chapter.
(2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.
(a) Subject to the limitations specified elsewhere in this chapter, the employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require, which is in accordance with established practice parameters and protocols of treatment as provided for in this chapter, including medicines, medical supplies, durable medical equipment, orthoses, prostheses, and other medically necessary apparatus. Remedial treatment, care, and attendance, including work-hardening programs or pain-management programs accredited by an accrediting organization whose standards incorporate comparable regulations required by this state or pain-management programs affiliated with medical schools, shall be considered covered treatment only when such care is given based on a referral by a physician as defined in this chapter. Medically necessary treatment, care, and attendance does not include chiropractic services in excess of 24 treatments or rendered 12 weeks beyond the date of the initial chiropractic treatment, whichever comes first, unless the carrier authorizes additional treatment or the employee is catastrophically injured.
(b)1. The employer shall provide appropriate professional or nonprofessional attendant care performed only at the direction and control of a physician when such care is medically necessary. The physician shall prescribe such care in writing. The employer or carrier shall not be responsible for such care until the prescription for attendant care is received by the employer and carrier, which shall specify the time periods for such care, the level of care required, and the type of assistance required. A prescription for attendant care shall not prescribe such care retroactively. The value of nonprofessional attendant care provided by a family member must be determined as follows:
a. If the family member is not employed or if the family member is employed and is providing attendant care services during hours that he or she is not engaged in employment, the per-hour value equals the federal minimum hourly wage.
b. If the family member is employed and elects to leave that employment to provide attendant or custodial care, the per-hour value of that care equals the per-hour value of the family member’s former employment, not to exceed the per-hour value of such care available in the community at large. A family member or a combination of family members providing nonprofessional attendant care under this paragraph may not be compensated for more than a total of 12 hours per day.
c. If the family member remains employed while providing attendant or custodial care, the per-hour value of that care equals the per-hour value of the family member’s employment, not to exceed the per-hour value of such care available in the community at large.
2. The employer or carrier may use a nurse registry licensed pursuant to s. 400.506 for the placement of authorized compensable attendant care services.
(c) If the employer fails to provide initial treatment or care required by this section after request by the injured employee, the employee may obtain such initial treatment at the expense of the employer, if the initial treatment or care is compensable and medically necessary and is in accordance with established practice parameters and protocols of treatment as provided for in this chapter. There must be a specific request for the initial treatment or care, and the employer or carrier must be given a reasonable time period within which to provide the initial treatment or care. However, the employee is not entitled to recover any amount personally expended for the initial treatment or care unless he or she has requested the employer to furnish that initial treatment or service and the employer has failed, refused, or neglected to do so within a reasonable time or unless the nature of the injury requires such initial treatment, nursing, and services and the employer or his or her superintendent or foreman, having knowledge of the injury, has neglected to provide the initial treatment or care.
(d) The carrier has the right to transfer the care of an injured employee from the attending health care provider if an independent medical examination determines that the employee is not making appropriate progress in recuperation.
(e) Except in emergency situations and for treatment rendered by a managed care arrangement, after any initial examination and diagnosis by a physician providing remedial treatment, care, and attendance, and before a proposed course of medical treatment begins, each insurer shall review, in accordance with the requirements of this chapter, the proposed course of treatment, to determine whether such treatment would be recognized as reasonably prudent. The review must be in accordance with all applicable workers’ compensation practice parameters and protocols of treatment established in accordance with this chapter. The insurer must accept any such proposed course of treatment unless the insurer notifies the physician of its specific objections to the proposed course of treatment by the close of the tenth business day after notification by the physician, or a supervised designee of the physician, of the proposed course of treatment.
(f) Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident. Upon the granting of a change of physician, the originally authorized physician in the same specialty as the changed physician shall become deauthorized 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 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.

Failure of the carrier to timely comply with this subsection shall be a violation of this chapter and the carrier shall be subject to penalties as provided for in s. 440.525.

(3) PROVIDER ELIGIBILITY; AUTHORIZATION.
(a) As a condition to eligibility for payment under this chapter, a health care provider who renders services must receive authorization from the carrier before providing treatment. This paragraph does not apply to emergency care.
(b) A health care provider who renders emergency care must notify the carrier by the close of the third business day after it has rendered such care. If the emergency care results in admission of the employee to a health care facility, the health care provider must notify the carrier by telephone within 24 hours after initial treatment. Emergency care is not compensable under this chapter unless the injury requiring emergency care arose as a result of a work-related accident. Pursuant to chapter 395, all licensed physicians and health care providers in this state shall be required to make their services available for emergency treatment of any employee eligible for workers’ compensation benefits. To refuse to make such treatment available is cause for revocation of a license.
(c) A health care provider may not refer the employee to another health care provider, diagnostic facility, therapy center, or other facility without prior authorization from the carrier, except when emergency care is rendered. Any referral must be to a health care provider, unless the referral is for emergency treatment, and must be made in accordance with practice parameters and protocols of treatment as provided for in this chapter.
(d) A carrier must respond, by telephone or in writing, to a request for authorization from an authorized health care provider by the close of the third business day after receipt of the request. A carrier who fails to respond to a written request for authorization for referral for medical treatment by the close of the third business day after receipt of the request consents to the medical necessity for such treatment. All such requests must be made to the carrier. Notice to the carrier does not include notice to the employer.
(e) Carriers shall adopt procedures for receiving, reviewing, documenting, and responding to requests for authorization.
(f) By accepting payment under this chapter for treatment rendered to an injured employee, a health care provider consents to the jurisdiction of the department as set forth in subsection (11) and to the submission of all records and other information concerning such treatment to the department in connection with a reimbursement dispute, audit, or review as provided by this section. The health care provider must further agree to comply with any decision of the department rendered under this section.
(g) The employee is not liable for payment for medical treatment or services provided pursuant to this section except as otherwise provided in this section.
(h) The provisions of s. 456.053 are applicable to referrals among health care providers, as defined in subsection (1), treating injured workers.
(i) Notwithstanding paragraph (d), a claim for specialist consultations, surgical operations, physiotherapeutic or occupational therapy procedures, X-ray examinations, or special diagnostic laboratory tests that cost more than $1,000 and other specialty services that the department identifies by rule is not valid and reimbursable unless the services have been expressly authorized by the carrier, unless the carrier has failed to respond within 10 days to a written request for authorization, or unless emergency care is required. The insurer shall authorize such consultation or procedure unless the health care provider or facility is not authorized, unless such treatment is not in accordance with practice parameters and protocols of treatment established in this chapter, or unless a judge of compensation claims has determined that the consultation or procedure is not medically necessary, not in accordance with the practice parameters and protocols of treatment established in this chapter, or otherwise not compensable under this chapter. Authorization of a treatment plan does not constitute express authorization for purposes of this section, except to the extent the carrier provides otherwise in its authorization procedures. This paragraph does not limit the carrier’s obligation to identify and disallow overutilization or billing errors.
(j) Notwithstanding anything in this chapter to the contrary, a sick or injured employee shall be entitled, at all times, to free, full, and absolute choice in the selection of the pharmacy or pharmacist dispensing and filling prescriptions for medicines required under this chapter. It is expressly forbidden for the department, an employer, or a carrier, or any agent or representative of the department, an employer, or a carrier, to select the pharmacy or pharmacist which the sick or injured employee must use; condition coverage or payment on the basis of the pharmacy or pharmacist utilized; or to otherwise interfere in the selection by the sick or injured employee of a pharmacy or pharmacist.
(k) Reimbursement shall not be made for oral vitamins, nutrient preparations, or dietary supplements. Reimbursement shall not be made for medical food, as defined in 21 U.S.C. s. 360ee(b)(3), unless the self-insured employer or the carrier in its sole discretion authorizes the provision of such food. Such authorization may be limited by frequency, type, dosage, and reimbursement amount of such food as part of a proposed written course of medical treatment.
(4) NOTICE OF TREATMENT TO CARRIER; FILING WITH DEPARTMENT.
(a) Any health care provider providing necessary remedial treatment, care, or attendance to any injured worker shall submit treatment reports to the carrier in a format prescribed by the department. A claim for medical or surgical treatment is not valid or enforceable against such employer or employee, unless, by the close of the third business day following the first treatment, the physician providing the treatment furnishes to the employer or carrier a preliminary notice of the injury and treatment in a format prescribed by the department and, within 15 days thereafter, furnishes to the employer or carrier a complete report, and subsequent thereto furnishes progress reports, if requested by the employer or insurance carrier, at intervals of not less than 3 weeks apart or at less frequent intervals if requested in a format prescribed by the department.
(b) Upon the request of the department, each medical report or bill obtained or received by the employer, the carrier, or the injured employee, or the attorney for the employer, carrier, or injured employee, with respect to the remedial treatment, care, and attendance of the injured employee, including any report of an examination, diagnosis, or disability evaluation, must be produced by the health care provider to the department pursuant to rules adopted by the department. The health care provider shall also furnish to the injured employee or his or her attorney and the employer or carrier or its attorney, on demand, a copy of his or her office chart, records, and reports, and may charge the injured employee no more than 50 cents per page for copying the records and the actual direct cost to the health care provider or health care facility for X rays, microfilm, or other nonpaper records. Each such health care provider shall provide to the department information about the remedial treatment, care, and attendance which the department reasonably requests.
(c) It is the policy for the administration of the workers’ compensation system that there shall be reasonable access to medical information by all parties to facilitate the self-executing features of the law. An employee who reports an injury or illness alleged to be work-related waives any physician-patient privilege with respect to any condition or complaint reasonably related to the condition for which the employee claims compensation. Notwithstanding the limitations in s. 456.057 and subject to the limitations in s. 381.004, upon the request of the employer, the carrier, an authorized qualified rehabilitation provider, or the attorney for the employer or carrier, the medical records, reports, and information of an injured employee relevant to the particular injury or illness for which compensation is sought must be furnished to those persons and the medical condition of the injured employee must be discussed with those persons, if the records and the discussions are restricted to conditions relating to the workplace injury. Release of medical information by the health care provider or other physician does not require the authorization of the injured employee. If medical records, reports, and information of an injured employee are sought from health care providers who are not subject to the jurisdiction of the state, the injured employee shall sign an authorization allowing for the employer or carrier to obtain the medical records, reports, or information. Any such discussions or release of information may be held before or after the filing of a claim or petition for benefits without the knowledge, consent, or presence of any other party or his or her agent or representative. A health care provider who willfully refuses to provide medical records or to discuss the medical condition of the injured employee, after a reasonable request is made for such information pursuant to this subsection, shall be subject by the department to one or more of the penalties set forth in paragraph (8)(b). The department may adopt rules to carry out this subsection.
(5) INDEPENDENT MEDICAL EXAMINATIONS.
(a) In any dispute concerning overutilization, medical benefits, compensability, or disability under this chapter, the carrier or the employee may select an independent medical examiner. If the parties agree, the examiner may be a health care provider treating or providing other care to the employee. An independent medical examiner may not render an opinion outside his or her area of expertise, as demonstrated by licensure and applicable practice parameters. The employer and employee shall be entitled to only one independent medical examination per accident and not one independent medical examination per medical specialty. The party requesting and selecting the independent medical examination shall be responsible for all expenses associated with said examination, including, but not limited to, medically necessary diagnostic testing performed and physician or medical care provider fees for the evaluation. The party selecting the independent medical examination shall identify the choice of the independent medical examiner to all other parties within 15 days after the date the independent medical examination is to take place. Failure to timely provide such notification shall preclude the requesting party from submitting the findings of such independent medical examiner in a proceeding before a judge of compensation claims. The independent medical examiner may not provide followup care if such recommendation for care is found to be medically necessary. If the employee prevails in a medical dispute as determined in an order by a judge of compensation claims or if benefits are paid or treatment provided after the employee has obtained an independent medical examination based upon the examiner’s findings, the costs of such examination shall be paid by the employer or carrier.
(b) Each party is bound by his or her selection of an independent medical examiner, including the selection of the independent medical examiner in accordance with s. 440.134 and the opinions of such independent medical examiner. Each party is entitled to an alternate examiner only if:
1. The examiner is not qualified to render an opinion upon an aspect of the employee’s illness or injury which is material to the claim or petition for benefits;
2. The examiner ceases to practice in the specialty relevant to the employee’s condition;
3. The examiner is unavailable due to injury, death, or relocation outside a reasonably accessible geographic area; or
4. The parties agree to an alternate examiner.
(c) The carrier may, at its election, contact the claimant directly to schedule a reasonable time for an independent medical examination. The carrier must confirm the scheduling agreement in writing with the claimant and the claimant’s counsel, if any, at least 7 days before the date upon which the independent medical examination is scheduled to occur. An attorney representing a claimant is not authorized to schedule the self-insured employer’s or carrier’s independent medical evaluations under this subsection. Neither the self-insured employer nor the carrier shall be responsible for scheduling any independent medical examination other than an employer or carrier independent medical examination.
(d) If the employee fails to appear for the independent medical examination scheduled by the employer or carrier without good cause and fails to advise the physician at least 24 hours before the scheduled date for the examination that he or she cannot appear, the employee is barred from recovering compensation for any period during which he or she has refused to submit to such examination. Further, the employee shall reimburse the employer or carrier 50 percent of the physician’s cancellation or no-show fee unless the employer or carrier that schedules the examination fails to timely provide to the employee a written confirmation of the date of the examination pursuant to paragraph (c) which includes an explanation of why he or she failed to appear. The employee may appeal to a judge of compensation claims for reimbursement when the employer or carrier withholds payment in excess of the authority granted by this section.
(e) No medical opinion other than the opinion of a medical advisor appointed by the judge of compensation claims or the department, an independent medical examiner, or an authorized treating provider is admissible in proceedings before the judges of compensation claims.
(f) Attorney’s fees incurred by an injured employee in connection with delay of or opposition to an independent medical examination, including, but not limited to, motions for protective orders, are not recoverable under this chapter.
(g) When a medical dispute arises, the parties may mutually agree to refer the employee to a licensed physician specializing in the diagnosis and treatment of the medical condition at issue for an independent medical examination and report. Such medical examination shall be referred to as a “consensus independent medical examination.” The findings and conclusions of such mutually agreed upon consensus independent medical examination shall be binding on the parties and shall constitute resolution of the medical dispute addressed in the independent consensus medical examination and in any proceeding. Agreement by the parties to a consensus independent medical examination shall not affect the employer’s, carrier’s, or employee’s entitlement to one independent medical examination per accident as provided for in this subsection.
(6) UTILIZATION REVIEW.Carriers shall review all bills, invoices, and other claims for payment submitted by health care providers in order to identify overutilization and billing errors, including compliance with practice parameters and protocols of treatment established in accordance with this chapter, and may hire peer review consultants or conduct independent medical evaluations. Such consultants, including peer review organizations, are immune from liability in the execution of their functions under this subsection to the extent provided in s. 766.101. If a carrier finds that overutilization of medical services or a billing error has occurred, or there is a violation of the practice parameters and protocols of treatment established in accordance with this chapter, it must disallow or adjust payment for such services or error without order of a judge of compensation claims or the department, if the carrier, in making its determination, has complied with this section and rules adopted by the department.
(7) UTILIZATION AND REIMBURSEMENT DISPUTES.
(a) Any health care provider who elects to contest the disallowance or adjustment of payment by a carrier under subsection (6) must, within 45 days after receipt of notice of disallowance or adjustment of payment, petition the department to resolve the dispute. The petitioner must serve a copy of the petition on the carrier and on all affected parties by certified mail. The petition must be accompanied by all documents and records that support the allegations contained in the petition. Failure of a petitioner to submit such documentation to the department results in dismissal of the petition.
(b) The carrier must submit to the department within 30 days after receipt of the petition all documentation substantiating the carrier’s disallowance or adjustment. Failure of the carrier to timely submit such documentation to the department within 30 days constitutes a waiver of all objections to the petition.
(c) Within 120 days after receipt of all documentation, the department must provide to the petitioner, the carrier, and the affected parties a written determination of whether the carrier properly adjusted or disallowed payment. The department must be guided by standards and policies set forth in this chapter, including all applicable reimbursement schedules, practice parameters, and protocols of treatment, in rendering its determination.
(d) If the department finds an improper disallowance or improper adjustment of payment by an insurer, the insurer shall reimburse the health care provider, facility, insurer, or employer within 30 days, subject to the penalties provided in this subsection.
(e) The department shall adopt rules to carry out this subsection. The rules may include provisions for consolidating petitions filed by a petitioner and expanding the timetable for rendering a determination upon a consolidated petition.
(f) Any carrier that engages in a pattern or practice of arbitrarily or unreasonably disallowing or reducing payments to health care providers may be subject to one or more of the following penalties imposed by the department:
1. Repayment of the appropriate amount to the health care provider.
2. An administrative fine assessed by the department in an amount not to exceed $5,000 per instance of improperly disallowing or reducing payments.
3. Award of the health care provider’s costs, including a reasonable attorney fee, for prosecuting the petition.
(8) PATTERN OR PRACTICE OF OVERUTILIZATION.
(a) Carriers must report to the department all instances of overutilization including, but not limited to, all instances in which the carrier disallows or adjusts payment or a determination has been made that the provided or recommended treatment is in excess of the practice parameters and protocols of treatment established in this chapter. The department shall determine whether a pattern or practice of overutilization exists.
(b) If the department determines that a health care provider has engaged in a pattern or practice of overutilization or a violation of this chapter or rules adopted by the department, including a pattern or practice of providing treatment in excess of the practice parameters or protocols of treatment, it may impose one or more of the following penalties:
1. An order barring the provider from payment under this chapter;
2. Deauthorization of care under review;
3. Denial of payment for care rendered in the future;
4. An administrative fine of $5,000; and
5. Notification of and review by the appropriate licensing authority pursuant to s. 440.106(3).
(9) EXPERT MEDICAL ADVISORS.
(a) The department shall certify expert medical advisors in each specialty to assist the department within the advisor’s area of expertise as provided in this section. The department shall, in a manner prescribed by rule, in certifying, recertifying, or decertifying an expert medical advisor, consider the qualifications, training, impartiality, and commitment of the health care provider to the provision of quality medical care at a reasonable cost. As a prerequisite for certification or recertification, the department shall require, at a minimum, that an expert medical advisor have specialized workers’ compensation training or experience under the workers’ compensation system of this state and board certification or board eligibility.
(b) The department shall contract with one or more entities that employ, contract with, or otherwise secure expert medical advisors to provide peer review or expert medical consultation, opinions, and testimony to the department or to a judge of compensation claims in connection with resolving disputes relating to reimbursement, differing opinions of health care providers, and health care and physician services rendered under this chapter, including utilization issues. The department shall by rule establish the qualifications of expert medical advisors, including training and experience in the workers’ compensation system in the state and the expert medical advisor’s knowledge of and commitment to the standards of care, practice parameters, and protocols established pursuant to this chapter. Expert medical advisors contracting with the department shall, as a term of such contract, agree to provide consultation or services in accordance with the timetables set forth in this chapter and to abide by rules adopted by the department, including, but not limited to, rules pertaining to procedures for review of the services rendered by health care providers and preparation of reports and testimony or recommendations for submission to the department or the judge of compensation claims.
(c) If there is disagreement in the opinions of the health care providers, if two health care providers disagree on medical evidence supporting the employee’s complaints or the need for additional medical treatment, or if two health care providers disagree that the employee is able to return to work, the department may, and the judge of compensation claims may, upon his or her own motion or within 15 days after receipt of a written request by either the injured employee, the employer, or the carrier, order the injured employee to be evaluated by an expert medical advisor. The injured employee and the employer or carrier may agree on the health care provider to serve as an expert medical advisor. If the parties do not agree, the judge of compensation claims shall select an expert medical advisor from the department’s list of certified expert medical advisors. If a certified medical advisor within the relevant medical specialty is unavailable, the judge of compensation claims shall appoint any otherwise qualified health care provider to serve as an expert medical advisor without obtaining the department’s certification. The opinion of the expert medical advisor is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the judge of compensation claims. The expert medical advisor appointed to conduct the evaluation shall have free and complete access to the medical records of the employee. An employee who fails to report to and cooperate with such evaluation forfeits entitlement to compensation during the period of failure to report or cooperate.
(d) The expert medical advisor must complete his or her evaluation and issue his or her report to the department or to the judge of compensation claims within 15 days after receipt of all medical records. The expert medical advisor must furnish a copy of the report to the carrier and to the employee.
(e) An expert medical advisor is not liable under any theory of recovery for evaluations performed under this section without a showing of fraud or malice. The protections of s. 766.101 apply to any officer, employee, or agent of the department and to any officer, employee, or agent of any entity with which the department has contracted under this subsection.
(f) If the department or a judge of compensation claims orders the services of an expert medical advisor to resolve a dispute under this section, the party requesting such examination must compensate the advisor for his or her time in accordance with a schedule adopted by the department. If the employee prevails in a dispute as determined in an order by a judge of compensation claims based upon the expert medical advisor’s findings, the employer or carrier shall pay for the costs of such expert medical advisor. If a judge of compensation claims, upon his or her motion, finds that an expert medical advisor is needed to resolve the dispute, the carrier must compensate the advisor for his or her time in accordance with a schedule adopted by the department. The department may assess a penalty not to exceed $500 against any carrier that fails to timely compensate an advisor in accordance with this section.
(10) WITNESS FEES.Any health care provider who gives a deposition shall be allowed a witness fee. The amount charged by the witness may not exceed $300 per hour. An expert witness who has never provided direct professional services to a party but has merely reviewed medical records and provided an expert opinion or has provided only direct professional services that were unrelated to the workers’ compensation case may not be allowed a witness fee in excess of $300 per day.
(11) INVESTIGATION; MONITORING; JURISDICTION.
(a) The department may investigate health care providers to determine whether providers are complying with this chapter and with rules adopted by the department, whether the providers are engaging in overutilization, whether providers are engaging in improper billing practices, and whether providers are adhering to practice parameters and protocols established in accordance with this chapter. If the department finds that a health care provider has improperly billed, overutilized, or failed to comply with department rules or the requirements of this chapter, including, but not limited to, practice parameters and protocols established in accordance with this chapter, it must notify the provider of its findings and may determine that the health care provider may not receive payment from the carrier or may impose penalties as set forth in subsection (8) or other sections of this chapter. If the health care provider has received payment from a carrier for services that were improperly billed, that constitute overutilization, or that were outside practice parameters or protocols established in accordance with this chapter, it must return those payments to the carrier. The department may assess a penalty not to exceed $500 for each overpayment that is not refunded within 30 days after notification of overpayment by the department or carrier.
(b) The department shall monitor carriers as provided in this chapter.
(c) The department has exclusive jurisdiction to decide any matters concerning reimbursement, to resolve any overutilization dispute under subsection (7), and to decide any question concerning overutilization under subsection (8), which question or dispute arises after January 1, 1994.
(d) The following department actions do not constitute agency action subject to review under ss. 120.569 and 120.57 and do not constitute actions subject to s. 120.56: referral by the entity responsible for utilization review; a decision by the department to refer a matter to a peer review committee; establishment by a health care provider or entity of procedures by which a peer review committee reviews the rendering of health care services; and the review proceedings, report, and recommendation of the peer review committee.
(12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM REIMBURSEMENT ALLOWANCES.
(a) A three-member panel is created, consisting of the Chief Financial Officer, or the Chief Financial Officer’s designee, and two members to be appointed by the Governor, subject to confirmation by the Senate, one member who, on account of present or previous vocation, employment, or affiliation, shall be classified as a representative of employers, the other member who, on account of previous vocation, employment, or affiliation, shall be classified as a representative of employees. The panel shall determine statewide schedules of maximum reimbursement allowances for medically necessary treatment, care, and attendance provided by hospitals and ambulatory surgical centers. The maximum reimbursement allowances for inpatient hospital care shall be based on a schedule of per diem rates, to be approved by the three-member panel no later than March 1, 1994, to be used in conjunction with a precertification manual as determined by the department, including maximum hours in which an outpatient may remain in observation status, which shall not exceed 23 hours. All compensable charges for hospital outpatient care shall be reimbursed at 75 percent of usual and customary charges, except as otherwise provided by this subsection. Annually, the three-member panel shall adopt schedules of maximum reimbursement allowances for hospital inpatient care, hospital outpatient care, and ambulatory surgical centers. A hospital or an ambulatory surgical center shall be reimbursed either the agreed-upon contract price or the maximum reimbursement allowance in the appropriate schedule.
(b) Payments for outpatient physical, occupational, and speech therapy provided by hospitals shall be the schedule of maximum reimbursement allowances for these services which applies to nonhospital providers.
(c) Payments for scheduled outpatient nonemergency radiological and clinical laboratory services that are not provided in conjunction with a surgical procedure shall be the schedule of maximum reimbursement allowances for these services which applies to nonhospital providers.
1(d)1. Outpatient reimbursement for scheduled surgeries shall be 60 percent of charges.
2. Reimbursement for emergency services and care as defined in s. 395.002 which have not been assigned a maximum reimbursement allowance must be 250 percent of Medicare, unless there is a contract, in which case the contract governs reimbursement. Upon this subparagraph taking effect, the department shall engage with an actuarial services firm to begin development of maximum reimbursement allowances for services subject to the reimbursement provisions of this subparagraph. Until the three-member panel adopts a schedule of maximum reimbursement allowances, reimbursement for emergency services and care that have not been assigned a maximum reimbursement allowance and for which there is no Medicare billing code must be 75 percent of usual and customary charges, unless there is a contract, in which case the contract governs reimbursement. This subparagraph expires June 30, 2026.
(e)1. By July 1 of each year, the department shall notify carriers and self-insurers of the physician and nonhospital services schedule of maximum reimbursement allowances. The notice must include publication of this schedule of maximum reimbursement allowances on the division’s website. This schedule is not subject to approval by the three-member panel and does not include reimbursement for prescription medication.
2. Subparagraph 1. shall take effect January 1, following the July 1, 2024, notice of the physician and nonhospital services schedule of maximum reimbursement allowances that the department provides to carriers and self-insurers.
(f) Maximum reimbursement for a physician licensed under chapter 458 or chapter 459 shall be 175 percent of the reimbursement allowed by Medicare, using appropriate codes and modifiers or the medical reimbursement level adopted by the three-member panel as of January 1, 2003, whichever is greater.
(g) Maximum reimbursement for surgical procedures shall be 210 percent of the reimbursement allowed by Medicare or the medical reimbursement level adopted by the three-member panel as of January 1, 2003, whichever is greater.
(h) As to reimbursement for a prescription medication, the reimbursement amount for a prescription shall be the average wholesale price plus $4.18 for the dispensing fee. For repackaged or relabeled prescription medications dispensed by a dispensing practitioner as provided in s. 465.0276, the fee schedule for reimbursement shall be 112.5 percent of the average wholesale price, plus $8.00 for the dispensing fee. For purposes of this subsection, the average wholesale price shall be calculated by multiplying the number of units dispensed times the per-unit average wholesale price set by the original manufacturer of the underlying drug dispensed by the practitioner, based upon the published manufacturer’s average wholesale price published in the Medi-Span Master Drug Database as of the date of dispensing. All pharmaceutical claims submitted for repackaged or relabeled prescription medications must include the National Drug Code of the original manufacturer. Fees for pharmaceuticals and pharmaceutical services shall be reimbursable at the applicable fee schedule amount except where the employer or carrier, or a service company, third party administrator, or any entity acting on behalf of the employer or carrier directly contracts with the provider seeking reimbursement for a lower amount.
(i) Reimbursement for all fees and other charges for such treatment, care, and attendance, including treatment, care, and attendance provided by any hospital or other health care provider, ambulatory surgical center, work-hardening program, or pain program, must not exceed the amounts provided by the uniform schedule of maximum reimbursement allowances as determined by the panel or as otherwise provided in this section. This subsection also applies to independent medical examinations performed by health care providers under this chapter. In determining the uniform schedule, the panel shall first approve the data which it finds representative of prevailing charges in the state for similar treatment, care, and attendance of injured persons. Each health care provider, health care facility, ambulatory surgical center, work-hardening program, or pain program receiving workers’ compensation payments shall maintain records verifying their usual charges. In establishing the uniform schedule of maximum reimbursement allowances, the panel must consider:
1. The levels of reimbursement for similar treatment, care, and attendance made by other health care programs or third-party providers;
2. The impact upon cost to employers for providing a level of reimbursement for treatment, care, and attendance which will ensure the availability of treatment, care, and attendance required by injured workers; and
3. The financial impact of the reimbursement allowances upon health care providers and health care facilities, including trauma centers as defined in s. 395.4001, and its effect upon their ability to make available to injured workers such medically necessary remedial treatment, care, and attendance. The uniform schedule of maximum reimbursement allowances must be reasonable, must promote health care cost containment and efficiency with respect to the workers’ compensation health care delivery system, and must be sufficient to ensure availability of such medically necessary remedial treatment, care, and attendance to injured workers.
(j) In addition to establishing the uniform schedule of maximum reimbursement allowances, the panel shall:
1. Take testimony, receive records, and collect data to evaluate the adequacy of the workers’ compensation fee schedule, nationally recognized fee schedules and alternative methods of reimbursement to health care providers and health care facilities for inpatient and outpatient treatment and care.
2. Survey health care providers and health care facilities to determine the availability and accessibility of workers’ compensation health care delivery systems for injured workers.
3. Survey carriers to determine the estimated impact on carrier costs and workers’ compensation premium rates by implementing changes to the carrier reimbursement schedule or implementing alternative reimbursement methods.
4. Submit recommendations on or before January 15, 2017, and biennially thereafter, to the President of the Senate and the Speaker of the House of Representatives on methods to improve the workers’ compensation health care delivery system.

The department, as requested, shall provide data to the panel, including, but not limited to, utilization trends in the workers’ compensation health care delivery system. The department shall provide the panel with an annual report regarding the resolution of medical reimbursement disputes and any actions pursuant to subsection (8). The department shall provide administrative support and service to the panel to the extent requested by the panel. The department may adopt rules pursuant to ss. 120.536(1) and 120.54 to implement this subsection. For prescription medication purchased under the requirements of this subsection, a dispensing practitioner shall not possess such medication unless payment has been made by the practitioner, the practitioner’s professional practice, or the practitioner’s practice management company or employer to the supplying manufacturer, wholesaler, distributor, or drug repackager within 60 days of the dispensing practitioner taking possession of that medication.

(13) PAYMENT OF MEDICAL FEES.
(a) Except for emergency care treatment, fees for medical services are payable only to a health care provider authorized to render remedial treatment, care, or attendance under this chapter. Carriers shall pay, disallow, or deny payment to health care providers in the manner and at times set forth in this chapter. A health care provider may not collect or receive a fee from an injured employee within this state, except as otherwise provided by this chapter. Such providers have recourse against the employer or carrier for payment for services rendered in accordance with this chapter. Payment to health care providers or physicians shall be subject to the medical fee schedule and applicable practice parameters and protocols, regardless of whether the health care provider or claimant is asserting that the payment should be made.
(b) Fees charged for remedial treatment, care, and attendance, except for independent medical examinations and consensus independent medical examinations, may not exceed the applicable fee schedules adopted under this chapter and department rule. Notwithstanding any other provision in this chapter, if a physician or health care provider specifically agrees in writing to follow identified procedures aimed at providing quality medical care to injured workers at reasonable costs, deviations from established fee schedules shall be permitted. Written agreements warranting deviations may include, but are not limited to, the timely scheduling of appointments for injured workers, participating in return-to-work programs with injured workers’ employers, expediting the reporting of treatments provided to injured workers, and agreeing to continuing education, utilization review, quality assurance, precertification, and case management systems that are designed to provide needed treatment for injured workers.
(c) Notwithstanding any other provision of this chapter, following overall maximum medical improvement from an injury compensable under this chapter, the employee is obligated to pay a copayment of $10 per visit for medical services. The copayment shall not apply to emergency care provided to the employee.
(14) STANDARDS OF CARE.The following standards of care shall be followed in providing medical care under this chapter:
(a) Abnormal anatomical findings alone, in the absence of objective relevant medical findings, shall not be an indicator of injury or illness, a justification for the provision of remedial medical care or the assignment of restrictions, or a foundation for limitations.
(b) At all times during evaluation and treatment, the provider shall act on the premise that returning to work is an integral part of the treatment plan. The goal of removing all restrictions and limitations as early as appropriate shall be part of the treatment plan on a continuous basis. The assignment of restrictions and limitations shall be reviewed with each patient exam and upon receipt of new information, such as progress reports from physical therapists and other providers. Consideration shall be given to upgrading or removing the restrictions and limitations with each patient exam, based upon the presence or absence of objective relevant medical findings.
(c) Reasonable necessary medical care of injured employees shall in all situations:
1. Utilize a high intensity, short duration treatment approach that focuses on early activation and restoration of function whenever possible.
2. Include reassessment of the treatment plans, regimes, therapies, prescriptions, and functional limitations or restrictions prescribed by the provider every 30 days.
3. Be focused on treatment of the individual employee’s specific clinical dysfunction or status and shall not be based upon nondescript diagnostic labels.

All treatment shall be inherently scientifically logical, and the evaluation or treatment procedure must match the documented physiologic and clinical problem. Treatment shall match the type, intensity, and duration of service required by the problem identified.

(15) Failure to comply with this section shall be considered a violation of this chapter and is subject to penalties as provided for in s. 440.525.
History.s. 13, ch. 17481, 1935; CGL 1936 Supp. 5966(13); s. 6, ch. 18413, 1937; CGL 1940 Supp. 8135(14-a); s. 2, ch. 20672, 1941; s. 2, ch. 21824, 1943; s. 1, ch. 22814, 1945; s. 1, ch. 25244, 1949; s. 1, ch. 28241, 1953; s. 2, ch. 57-225; ss. 1, 2, ch. 63-91; ss. 17, 35, ch. 69-106; s. 363, ch. 71-136; s. 5, ch. 75-209; s. 3, ch. 77-290; ss. 4, 23, ch. 78-300; s. 16, ch. 79-7; ss. 8, 124, ch. 79-40; ss. 7, 21, ch. 79-312; s. 4, ch. 80-236; s. 1, ch. 82-46; s. 1, ch. 83-45; s. 1, ch. 83-303; s. 4, ch. 83-305; s. 1, ch. 86-171; s. 1, ch. 87-111; s. 2, ch. 87-330; s. 2, ch. 88-203; s. 1, ch. 88-372; ss. 10, 43, ch. 89-289; ss. 18, 56, ch. 90-201; ss. 16, 52, ch. 91-1; s. 3, ch. 91-269; s. 101, ch. 92-33; s. 81, ch. 92-289; s. 17, ch. 93-415; s. 199, ch. 96-410; s. 1051, ch. 97-103; s. 45, ch. 97-264; s. 36, ch. 98-89; ss. 33, 188, 259, ch. 98-166; s. 22, ch. 2000-160; s. 9, ch. 2000-189; s. 12, ch. 2001-91; s. 25, ch. 2002-194; s. 9, ch. 2002-236; s. 477, ch. 2003-261; s. 15, ch. 2003-412; s. 91, ch. 2006-197; s. 2, ch. 2008-133; s. 10, ch. 2013-93; s. 1, ch. 2013-131; s. 6, ch. 2013-141; s. 1, ch. 2014-131; s. 2, ch. 2015-42; s. 4, ch. 2016-56; s. 1, ch. 2020-101; s. 5, ch. 2023-144; s. 6, ch. 2024-140; s. 1, ch. 2024-241; ss. 122, 123, ch. 2025-199.
1Note.

A. Section 122, ch. 2025-199, amended paragraph (12)(d) “[i]n order to implement Specific Appropriations 2295 through 2308A of the 2025-2026 General Appropriations Act.”

B. Section 123, ch. 2025-199, provides that “[t]he amendment to s. 440.13(12)(d), Florida Statutes, made by this act expires July 1, 2026, and the text of that paragraph shall revert to that in existence on June 30, 2025, except that any amendments to such text enacted other than by this act shall be preserved and continue to operate to the extent that such amendments are not dependent upon the portions of text which expire pursuant to this section.” Effective July 1, 2026, paragraph (12)(d), as amended by s. 123, ch. 2025-199, will read:

(d)1. Outpatient reimbursement for scheduled surgeries shall be 60 percent of charges.

2. Reimbursement for emergency services and care as defined in s. 395.002 which does not include a maximum reimbursement allowance must be 250 percent of Medicare, unless there is a contract, in which case the contract governs reimbursement. Upon this subparagraph taking effect, the department shall engage with an actuarial services firm to begin development of maximum reimbursement allowances for services subject to the reimbursement provisions of this subparagraph. This subparagraph expires June 30, 2026.

F.S. 440.13 on Google Scholar

F.S. 440.13 on CourtListener

Amendments to 440.13


Annotations, Discussions, Cases:

Arrestable Offenses / Crimes under Fla. Stat. 440.13
Level: Degree
Misdemeanor/Felony: First/Second/Third

S440.13 - PUBLIC ORDER CRIMES - REMOVED - M: S

Cases Citing Statute 440.13

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Acosta v. Richter, 671 So. 2d 149 (Fla. 1996).

Cited 68 times | Published | Supreme Court of Florida | 1996 WL 15522

...ralluzzo. In 1988, however, the legislature amended section 455.241(2), ch. 88-208, § 2, Laws *151 of Fla., to provide for a physician-patient privilege of confidentiality by adding the following emphasized language: Except as otherwise provided in s. 440.13(2), such [medical] records may not be furnished to, and the medical condition of a patient may not be discussed with, any person other than the patient or the patient's legal representative or other health care providers involved in the car...
...United States, 508 U.S. 223, 233, 113 S.Ct. 2050, 2056, 124 L.Ed.2d 138 (1993) ("Just as a single word cannot be read in isolation, nor can a single provision of a statute.") The first sentence of section 455.241(2) states: Except as otherwise provided in s. 440.13(2), such records[ [4] ] may not be furnished to, and the medical condition of a patient may not be discussed with, any person other than the patient or the patient's legal representative or other health care providers involved in the care and treatment of the patient, except upon written authorization of the patient....
...We did not specifically discuss section 455.241(2). [4] The reference to "such records" relates back to section 455.241(1) which discusses the records relating to a physical or mental examination or treatment made by a licensed health care practitioner. [5] Initially, section 440.13(2) is excepted from the scope of section 455.241 because that statutory provision already creates an exception to patient records confidentiality in workers' compensation cases. Section 440.13(2)(f) states in relevant part: Notwithstanding the limitations in s....
...ituations where the employer or carrier has reason to believe there is a probable basis for filing a claim against the Special Disability Trust Fund as a result of such injury and the employee or his attorney has been furnished a copy of such claim. § 440.13(2)(f), Fla.Stat. (1993) (footnote omitted). This provision is no longer found in section 440.13(2). In fact, the language has been somewhat altered. See Ch. 93-415, § 17, Laws of Fla. (codified at section 440.13(4)(c), Florida Statutes (1995))....
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Sasso v. Ram Prop. Mgmt., 431 So. 2d 204 (Fla. 1st DCA 1983).

Cited 40 times | Published | Florida 1st District Court of Appeal

...Section 440.15(3) does not bar a claimant who is either permanently, totally disabled or temporarily, totally impaired from such benefits. Nor does it bar one who is permanently, partially impaired from remedial medical treatment, as authorized under section 440.13(1), Florida Statutes....
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Palm Springs Gen. Hosp. v. Cabrera, 698 So. 2d 1352 (Fla. 1st DCA 1997).

Cited 33 times | Published | Florida 1st District Court of Appeal | 1997 WL 570467

...Concluding that the judge of compensation claims had a statutory duty to order evaluation by an expert medical advisor before ruling on the merits of the petition for benefits, we reverse the final order and remand for the designation of an expert medical advisor, as contemplated by section 440.13(9)(c), Florida Statutes (1995), and Florida Administrative Code Rule 38F-54.005, and for such further proceedings before a judge of compensation claims as may be required....
...His psychiatric condition had become the only basis on which he might qualify for permanent total disability benefits when, a week before the final hearing began, his employer filed a motion for appointment of an expert medical (psychiatric) advisor, on the authority of section 440.13(9)(c), Florida Statutes (1995)....
...on. The concern for timeliness the final order manifests is unquestionably legitimate. It is for the judge of compensation claims—not for the parties—to set hearings, to continue them, if need be, and generally to control the docket. To the extent section 440.13(9)(c), Florida Statutes (1995), permits a party to insist in effect on a continuance—even after an evidentiary hearing on the merits has begun—it carries with it possibilities for unwarranted disruption and delay....
...Farm Stores, Inc. v. Fletcher, 621 So.2d 706, 708 (Fla. 1st DCA 1993)(holding employer lost statutory right to independent examination where it "waited more than a year to attempt to schedule the independent dental examination"). On the other hand, sections 440.13(9)(c) and 440.25(4)(d), Florida Statutes (1995), contemplate resort to an expert medical advisor, even if disagreement between medical providers becomes apparent only after the merits hearing has begun. At such hearing, the claimant and employer may each present evidence in respect of such claim.... When there is a conflict in the medical evidence submitted at the hearing, the provisions of s. 440.13 shall apply....
...Comp. P. 4.045. Even without a party's requesting it, the judge of compensation claims "shall" appoint an expert medical advisor, if the requisite disagreement in the opinions of health care providers is apparent at the time of the pretrial hearing. § 440.13(9)(c), Fla....
...pursuit of any discovery designed to reveal conflict in the medical evidence. Fla. R. Work. Comp. P. 4.045(m) and 4.055. Material Disagreement The final order denied the employer's motion for appointment of an expert medical advisor, characterizing section 440.13(9)(c) Florida Statutes (1995), as "directive in nature permitting [but not requiring] a judge to invoke additional assistance in decision-making in some settings," and awarded permanent total disability benefits....
...he judge of compensation claims necessarily accepted only one of these opposing views. Reaching the merits of appellants' motion, the judge of compensation claims declined to "order the injured employee to be evaluated by an expert medical advisor," § 440.13(9)(c), Fla....
..."[P]rocedure within administrative agencies is subject to statutory regulation." Life Care Ctrs. of Am., Inc. v. Sawgrass Care Ctr., Inc., 683 So.2d 609, 612 (Fla. 1st DCA 1996)(quoting Gator Freightways, Inc. v. Mayo, 328 So.2d 444, 446 (Fla.1976)). Section 440.13(9)(c), Florida Statutes (1995), provides: If there is disagreement in the opinions of the health care providers, if two health care providers disagree on medical evidence supporting the employee's complaints or the need for additional...
...ee to be evaluated by an expert medical advisor. The opinion of the expert medical advisor is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the judge of compensation claims. The requirements of section 440.13(9)(c), Florida Statutes (1995), are mandatory and binding on the judge of compensation claims....
...In our view, the statute leaves intact the distinction between witnesses and adjudicators, virtual or otherwise. In any event, such arguments should be addressed to the Legislature, and are a wholly insufficient basis for a judge of compensation claims to disregard the clear expression of legislative policy that section 440.13(9)(c), Florida Statutes (1995), embodies....
...I find that this motion initially filed by the Employer/Carrier [sic] was untimely and late-filed. Although I heard argument on the motion and held the motion in abeyance without prejudice to renew consideration.... [2] The judge of compensation claims has fifteen days in which to act on a party's written request. § 440.13(9)(c), Fla. Stat. (1995). "[T]he Division shall, within 10 days, assign an expert medical advisor." Fla. Admin. Code R. 38F-54.005(2). Section 440.13(9)(d), Florida Statutes (1995), provides: The expert medical advisor must complete his evaluation and issue his report to the division or to the judge of compensation claims within 45 days after receipt of all medical records....
...Once an appointment is scheduled, however, a claimant who is receiving benefits has an important incentive to show up: "An employee who fails to report to and cooperate with such evaluation forfeits entitlement to compensation during the period of failure to report or cooperate." § 440.13(9)(c), Fla....
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US Sugar Corp. v. Henson, 823 So. 2d 104 (Fla. 2002).

Cited 31 times | Published | Supreme Court of Florida | 27 Fla. L. Weekly Supp. 551, 2002 Fla. LEXIS 1159, 2002 WL 1208720

...cal reports of authorized treating health care providers relating to the claimant and subject accident shall be received into evidence by the [JCC]." Finally, Henson submits that Frye testing is unnecessary to assure evidentiary reliability, because section 440.13(9)(c) provides for the appointment of expert medical advisors to assist the JCC with issues of medical causation and requires that the EMA [expert medical advisor] opinion "is presumed to be correct unless there is clear and convincing evidence to the contrary." Henson, 787 So.2d at 10....
...This statutory provision only ensures the admission into evidence of the written records of the claimant's treating physicians, and does not address the content of expert opinion testimony. See § 440.29(4), Fla. Stat. (2001). Thus, section 440.29 has no bearing on the question before us. Section 440.13(9), Florida Statutes (2001), defines the role and appointment of expert medical advisors (EMA's) in workers' compensation proceedings. While the statutory framework certainly allows the JCC to rely upon an EMA's expert opinion, see § 440.13(9)(c) ("The opinion of the [EMA] is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the [JCC]."), none of the provisions of chapter 440 preclude or conflict with use of the Frye criteria to test and ensure the reliability of novel scientific methods utilized by any expert witness. See § 440.13(9), Fla....
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Fitzgerald v. Osceola Cnty. Sch. Bd., 974 So. 2d 1161 (Fla. 1st DCA 2008).

Cited 30 times | Published | Florida 1st District Court of Appeal | 2008 WL 420027

...penses." Claimant has taken this appeal and argues that the JCC misinterpreted the EMA's testimony in this case. ANALYSIS An EMA's opinion is presumptively correct unless the JCC finds and articulates "clear and convincing evidence to the contrary." § 440.13(9)(c), Fla....
...s automatically in a victory for the claimant is not correct. Instead, remand is appropriate. The EMA, as envisaged by the Legislature, is tasked "to assist the agency and the judge [ ] of compensation claims within the advisor's area of expertise." § 440.13(9)(a), Fla....
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Rucker v. City of Ocala, 684 So. 2d 836 (Fla. 1st DCA 1996).

Cited 30 times | Published | Florida 1st District Court of Appeal | 1996 WL 708614

...December 5, 1996. Rehearing Denied January 10, 1997. *837 Barbara L. Richard, Ocala, for appellant. Betty D. Marion, Ocala, for appellees. KAHN, Judge. In this workers' compensation appeal, the claimant, Benjamin Rucker, challenges the constitutionality of section 440.13(5)(e), Florida Statutes (Supp.1994)....
...This case turns on whether Dr. Bennett, who treated Rucker but was never authorized by the E/SA, should have been allowed to testify on Rucker's behalf. II Proceedings Before the JCC Before the merits hearing, the E/SA sought an order excluding Dr. Bennett's testimony. Citing section 440.13(5)(e), Florida Statutes (Supp.1994), [1] the E/SA argued that *839 because they had never authorized Dr. Bennett, his testimony was prohibited. In response, Rucker filed a Motion to Designate Dr. Bennett as Medical Advisor. In this motion, Rucker argued that the E/SA had not authorized Dr. Bennett, nor had he performed an IME; therefore, pursuant to section 440.13(5)(e), Dr....
...Rucker further asserted that refusal to admit Dr. Bennett's testimony into evidence would amount to a denial of his right to a fair hearing and due process of law. The JCC granted the E/SA's request to exclude Dr. Bennett's testimony. The JCC also denied Rucker's Motion to Designate, citing section 440.13(4) and Florida Administrative Code Rule 38F-54.002(10)....
...to agree that the Claimant could return to work, provided he did not have to lift over 50 pounds." Rucker has appealed and raises four points. Specifically, Rucker asserts that the JCC erred in interpreting the term "authorized treating provider" in section 440.13(5)(e) to mean treating providers authorized by the E/SA, thereby rendering the statute unconstitutional. Rucker also asserts that the JCC erred in applying section 440.13(5)(e) to exclude Dr....
...on of equal protection as guaranteed by article I, section 2 of the Florida Constitution. III "Authorized Treating Provider" As to the first point on appeal, we find that the JCC did not err in interpreting the term "authorized treating provider" in section 440.13(5)(e) to mean treating providers authorized by the E/SA....
...94), provides in pertinent part: "All medical reports of authorized treating health care providers relating to the claimant and subject accident shall be received into evidence by the judge of compensation claims upon proper motion...." In addition, section 440.13(3)(a) provides in pertinent part: (3) PROVIDER ELIGIBILITY; AUTHORIZATION.— (a) As a condition to eligibility for payment under this chapter, a health care provider who renders services must be a certified health care provider and must receive authorization from the carrier before providing treatment. This paragraph does not apply to emergency care.... See also § 440.13(14)(a), Fla.Stat. (Supp. 1994) (payment of medical fees). Further, section 440.13(3)(c) prohibits a health care provider from referring an employee without prior authorization from the carrier, except when emergency care is rendered....
...Finally, Rule 38F-7.516(2), Florida Administrative Code, defines "authorization" as "[a]pproval from the carrier to render or order the provision of health care services." Read in conjunction with the foregoing provisions, the term "authorized treating provider" in section 440.13(5)(e) means a treating provider authorized by the E/SA, as determined by the JCC in this case. IV Procedural Due Process Next, appellant challenges section 440.13(5)(e) as an unconstitutional denial of procedural due process in violation of article I, section 9 of the Florida Constitution. [2] Section 440.13(5)(e), Florida Statutes (Supp....
...In addition, the JCC denied Rucker's Motion to Designate Dr. Bennett as Medical Advisor. Accordingly, pursuant to the statute, the JCC determined that Dr. Bennett's opinions were not admissible. Appellant asserts that Dr. Bennett's testimony was essential to his claim and that its exclusion, pursuant to section 440.13(5)(e), constituted a denial of a full and fair opportunity to be heard....
...of the courts.' The judicial model of an evidentiary hearing is neither a required, nor even the most effective, method of decisionmaking in all circumstances." (citation omitted)). No procedural due process violation occurred by the application of section 440.13(5)(e) in this case....
...alternative methods of obtaining and introducing medical opinions under the statute and case law. [4] For example, Rucker could have selected Dr. Bennett, or another chiropractor, as an IME physician rather than Dr. Jones, an orthopedic surgeon. See § 440.13(5), Fla....
...Further, Dr. Jones, as an orthopedic surgeon, could have been questioned regarding Rucker's need for chiropractic care if he had the requisite knowledge and qualifications. See Clair v. Glades County Bd. of Comm'rs, 649 So.2d 224, 225 (Fla.1995) ("[S]ection 440.13, Florida Statutes (1983), does not preclude physicians licensed under one statute from testifying regarding reasonableness and necessity of treatment by a physician licensed under another statute, provided the testifying physician is, based on...
...actic care Rucker received or his qualifications to render such an opinion. Moreover, if Dr. Jones could not qualify to render an opinion concerning chiropractic care, Rucker could have requested appointment of an alternate IME physician pursuant to section 440.13(5)(b), Florida Statutes (Supp.1994)....
...by article I, section 21 of the Florida Constitution. [5] He argues that although the exclusive remedy provided by the workers' compensation system itself has been found to be a reasonable alternative to an injured worker's common law tort remedies, section 440.13(5)(e), Florida Statutes (Supp.1994), as applied within that system, is an unreasonable burden on the employee's constitutional right of access to courts....
...ously recognized cause of action and, as such, does not offend article I, Section 21, of the Florida Constitution." (citations omitted; emphasis added)), decision approved, 440 So.2d 1285 (Fla.1983). VI Equal Protection Finally, Rucker contends that section 440.13(5)(e) is unconstitutional as a violation of his equal protection rights guaranteed by article I, section 2 of the Florida Constitution....
...498, 83 L.Ed.2d 391 (1984). Therefore, this argument must fail. See Peoples Bank, 395 So.2d at 524 (statute is presumed constitutional and party challenging statute has burden of establishing its invalidity). VII Conclusion The limitation on testimony contained in section 440.13(5)(e) does not in and of itself frustrate the claimant seeking to introduce helpful medical testimony....
...We do not, therefore, preclude a future challenge to the statute as applied. See Agency for Health Care Admin. v. Associated Indus. of Fla., 678 So.2d 1239 (Fla. 1996); Martinez v. Scanlan, 582 So.2d 1167, 1176 (Fla.1991). AFFIRMED. BARFIELD, C.J., and ERVIN, J., concur. NOTES [1] Section 440.13(5), Florida Statutes (Supp....
...be deprived of life, liberty or property without due process of law, or be twice put in jeopardy for the same offense, or be compelled in any criminal matter to be a witness against himself." [3] In Southern Bakeries v. Cooper, this court held that section 440.13(5)(e), Florida Statutes (Supp....
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Aino's Custom Slip Covers v. DeLucia, 533 So. 2d 862 (Fla. 1st DCA 1988).

Cited 23 times | Published | Florida 1st District Court of Appeal | 1988 WL 112286

...Empire Drilling Co. v. Dunaway, IRC Order 2-3453 (June 6, 1978). Although the E/C can be ordered to furnish or provide a vehicle, the Workers' Compensation Act does not authorize a deputy to order that title to such vehicle vest in the claimant. Id. Section 440.13(2), Fla....
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Caldwell v. Wal-Mart Stores, Inc., 980 So. 2d 1226 (Fla. 1st DCA 2008).

Cited 22 times | Published | Florida 1st District Court of Appeal | 2008 Fla. App. LEXIS 6948, 2008 WL 1930139

...She asserts Chapter 440, Florida Statutes, permits the employer and insurance carrier one IME, and thus, given Dr. Ciano's evaluation, respondents are no longer entitled to have petitioner examined by Dr. Brown. In contrast, respondents argue Dr. Ciano's evaluation is a "peer review," pursuant to section 440.13, Florida Statutes, and not an IME....
...Sherwin, 829 So.2d 961 (Fla. 4th DCA 2002) (same). Petitioner argues that an IME had already been performed by Dr. Ciano and an IME by Dr. Brown would be the second IME. A second IME may only be ordered under more stringent circumstances than the first. See § 440.13(5)(b), Fla....
...1st DCA 1993). Therefore, the JCC's second order authorizing the IME was a material change from the first, contrary to the majority's opinion. Turning to the merits, I agree with petitioner that the JCC erred in finding Dr. Ciano performed a peer review. Section 440.13(1), Florida Statutes, defines a "peer review" as "an evaluation by two or more physicians licensed under the same authority and with the same or similar specialty as the physician under review, of the appropriateness, quality, and cost of health care and health services provided to a patient, based on medically accepted standards." § 440.13(1)(q), Fla....
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Florida Birth-Related Neurological Injury Comp. Ass'n v. Dep't of Admin. Hearings, 29 So. 3d 992 (Fla. 2010).

Cited 19 times | Published | Supreme Court of Florida | 35 Fla. L. Weekly Supp. 40, 2010 Fla. LEXIS 43, 2010 WL 114510

...Accordingly, we held that section 766.316 requires that health care providers give patients pre-delivery notice of their participation in NICA as a condition precedent to invoking NICA immunity. Id. Notably, the term "health care provider" includes a health care facility. See § 440.13(1)(i), Fla. Stat. (1997); § 766.202(4), Fla. Stat. (2009). And "health care facility" includes a hospital. See §§ 408.032(7), 440.13(1)(h), Fla....
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Stand. Blasting & Coating v. Hayman, 476 So. 2d 1385 (Fla. 1st DCA 1985).

Cited 18 times | Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 2420

...She testified that he sleeps approximately 6 hours per night. Earlier cases stand for the proposition that ordinary household chores which would have been provided anyway are not compensable. See, e.g., City of Leesburg v. Balliet, 413 So.2d 860 (Fla. 1st DCA 1982). The 1983 legislature amended Fla. Stat. § 440.13(2)(d) to make clear that this is its legislative intent....
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Lombardi v. S. Wine & Spirits, 890 So. 2d 1128 (Fla. 1st DCA 2004).

Cited 17 times | Published | Florida 1st District Court of Appeal | 2004 Fla. App. LEXIS 18089, 2004 WL 2723616

...Rehearing Denied January 14, 2005. David Rickey, Orlando and Bill McCabe, Longwood, for Appellant. Doreen E. Lasch of Conroy, Simberg, Ganon, Krevans & Abel, P.A., Hollywood, for Appellees. KAHN, J. May a claimant entitled to workers' compensation benefits under section 440.13, Florida Statutes (2001), receive a second medical opinion at the expense of the employer/carrier (E/C)? We hold that such an opinion may be required, contingent, however, upon an evidentiary showing that such is both reasonable and medically necessary....
...In response, the E/C filed a motion for summary order asserting that claimant was not entitled to a second opinion at the E/C's expense because the E/C *1129 did not participate in a managed care arrangement at the time of claimant's accident. The E/C argued a second opinion is authorized only under section 440.134, Florida Statutes, which governs the provision of benefits under a managed care arrangement. The E/C sought dismissal because section 440.13, Florida Statutes, which controls medical benefits outside managed care arrangements, authorizes only the provision of an independent medical examination (IME). The JCC agreed with the E/C's argument and dismissed claimant's petition concluding, as a matter of law, that a claimant can never obtain a second opinion at E/C expense under section 440.13....
...The question presented is one of statutory interpretation. Thus, we apply the de novo standard of review. See Socolow v. Flanigans Enters., 877 So.2d 742, 743 (Fla. 1st DCA 2004). We reject the E/C's contention that a claimant seeking a second medical opinion is limited to obtaining an IME under section 440.13(5), Florida Statutes. We reach this conclusion because we cannot categorically rule out instances where a second medical opinion would constitute "medically necessary remedial treatment, care, and attendance" under section 440.13(2)(a)....
...inion. We have long recognized that an IME is a means of obtaining expert medical testimony. See, e.g., Reed v. Reed, 643 So.2d 1180, 1182 (Fla. 1st DCA 1994) ("By granting the party seeking the IME the choice of selecting the examining physicians, [section 440.13] effectively recognizes that such physicians are essentially expert witnesses of the party requesting the examinations."); Adelman Steel Corp....
...t witness for the party requesting the examination."). Although an IME may ultimately assist a claimant in securing necessary medical treatment, it is not, in and of itself, a form of medical treatment. Our conclusion is bolstered by the language of section 440.13(5)(a), Florida Statutes (2001), which authorizes the selection of an independent medical examiner to assist in the resolution of "any dispute concerning overutilization, medical benefits, compensability, or disability." Thus, while an IME is useful in resolving disputes, it does not fall under the "medically necessary remedial treatment, care, and attendance" that an E/C must furnish under section 440.13(2)(a). On the other hand, occasions may arise where the "nature of the injury or the process of recovery" renders a second medical opinion medically necessary as contemplated by section 440.13(2)(a). Section 440.13(1)(m) defines "medically necessary" as: [A]ny medical service or medical supply which is used to identify or treat an illness or injury, is appropriate to the patient's diagnosis and status of recovery, and is consistent with the location of service, the level of care provided, and applicable practice parameters. We do not read section 440.13 as evincing a legislative intent to deny a claimant the opportunity to demonstrate the medical necessity of a second opinion....
...We are unable to define in advance the universe of possible situations where a second opinion would be medically necessary. We do, however, conclude that the claimant's request for a second opinion presents a question of fact, similar to any other request under section 440.13(2)(a), Florida Statutes....
...1st DCA 1993) (finding that it is "incumbent upon claimant to establish" the medical necessity of treatment denied by the E/C); Polk County Bd. of Comm'rs v. Varnado, 576 So.2d 833, 837 (Fla. 1st DCA 1991) ("The initial inquiry in determining the validity of an award of benefits pursuant to section 440.13(2)(a), Florida Statutes, is the employee's medical need for the benefit.")....
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Warwick v. Hudson Pulp & Paper Co. Inc., 303 So. 2d 701 (Fla. 1st DCA 1974).

Cited 17 times | Published | Florida 1st District Court of Appeal | 1974 Fla. App. LEXIS 8375

...The exclusiveness of remedy provided by the Florida Workmen's Compensation Act is the quid pro quo accruing to the employer for his assumption of liability without fault. [6] The judgment appealed is affirmed. JOHNSON and McCORD, JJ., concur. NOTES [1] Florida Statute 440.13 which states in part: "......
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Exxon Co. v. Alexis, 370 So. 2d 1128 (Fla. 1978).

Cited 17 times | Published | Supreme Court of Florida

...a was not causally related to the accident of May 8, 1974; (3) claimant had not sustained permanent physical impairment or a loss of wage-earning capacity as a result of the accident; (4) the outstanding medical bills were not authorized pursuant to Section 440.13, Florida Statutes (1973)....
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Polk Cnty. Bd. of Com'rs v. Varnado, 576 So. 2d 833 (Fla. 1st DCA 1991).

Cited 16 times | Published | Florida 1st District Court of Appeal | 1991 WL 35440

...That finding was not appealed. The order appealed herein was entered on December 13, 1990, and addressed, inter alia, Varnadoe's claims for benefits and attendant care. The first issues raised by the appellant in this appeal involve benefits awarded pursuant to section 440.13(2)(a), *837 Florida Statutes....
...." We will examine the propriety of the award of each benefit individually, following a brief discussion of the general state of the law concerning medical benefits. The initial inquiry in determining the validity of an award of benefits pursuant to section 440.13(2)(a), Florida Statutes, is the employee's medical need for the benefit....
...ith relieving the effect of the injury. While we sympathize with the plight of the appellee, we feel that the evidence does not support the award of an interior decorator or home furnishings. The final dispute concerning benefits awarded pursuant to section 440.13(2)(a) involves the award of one-half of the gasoline for the handicap-equipped van. [4] The JCC stated that the E/C should provide one-half of the gasoline, but expresses no justification or reason for making such an award. Section 440.13(5), Florida Statutes (1988), outlines the responsibility of the E/C for transportation costs. [5] While case law interpreting section 440.13(5) indicates that the E/C may be held responsible for insurance and major maintenance which directly relate to the availability of the vehicle itself, there is no *841 showing that one-half of the gasoline is being used for medically n...
...nt to be able to personally select the person to provide his attendant care in the event that such care could not be provided by his wife. In Robinson v. Howard Hall Co., 219 So.2d 688 (Fla. 1969), the Florida Supreme Court dealt with a provision of section 440.13, Florida Statutes, which requires an employer to furnish to an employee "such remedial treatment, care, and attendant care under the direction and supervision of a qualified physician or surgeon ......
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Grice v. Suwannee Lumber Mfg. Co., 113 So. 2d 742 (Fla. 1st DCA 1959).

Cited 16 times | Published | Florida 1st District Court of Appeal | 1959 Fla. App. LEXIS 2655

...rcentage of disability is of three hundred fifty weeks." [7] F.S. § 440.02(9), F.S.A. [8] Ball v. Mann, Fla. 1954, 75 So.2d 758; Rosier v. Roofing & Sheet Metal Supply Co., see note 2. [9] Allen v. Maxwell Co., 152 Fla. 340, 11 So.2d 572. [10] F.S. § 440.13, F.S.A....
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Lollie v. Gen. Am. Tank Storage Terminals, 34 So. 2d 306 (Fla. 1948).

Cited 16 times | Published | Supreme Court of Florida | 160 Fla. 208, 1948 Fla. LEXIS 643

...We are convinced that Section 440.54 must be read in connection with section 440.20, Florida Statutes 1941, which provides that the “total compensation payable under this Chapter for disability and death shall in no event exceed the sum of $5000.00 in addition to any benefits under Section 440.13 for medical services and treatment, and under subsection (1) of Section 440.16, for funeral expenses.” *212 The total award by the Industrial Commission in this case was $10,000.00, plus funeral expenses, medical treatment and attorn...
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Kirkland v. Harold Pratt Paving, Inc, 518 So. 2d 1320 (Fla. 1st DCA 1987).

Cited 16 times | Published | Florida 1st District Court of Appeal | 1987 WL 3196

...Frey's bills from December 19, 1985, through August 20, 1986. It is well-established that the employer and carrier are responsible for unauthorized medical care in those instances where the claimant has requested a specific type of medical treatment by one of the types of physicians described in section 440.13(1)(f), if it appears that such treatment is reasonably and medically necessary, and the employer and carrier have *1325 refused to authorize that type of treatment. Section 440.13(2), Florida Statutes (1985); Fuchs Baking Co....
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Pierre v. Handi Van, Inc., 717 So. 2d 1115 (Fla. 1st DCA 1998).

Cited 15 times | Published | Florida 1st District Court of Appeal | 1998 WL 658293

...nc., and carrier, Humana Workers' Compensation Services (respectively, the E/C), to schedule an ex parte conference with an expert medical advisor (EMA). We have jurisdiction. Adelman Steel Corp. v. Winter, 610 So.2d 494 (Fla. 1st DCA 1992). Because section 440.13(4)(c), Florida Statutes (Supp.1994), authorizes ex parte conferences with health care providers and not with EMAs, we grant the petition and quash the order. This is a case of first impression. Section 440.13(4)(c) provides: It is the policy for the administration of the workers' compensation system that there be reasonable access to medical information by all parties to facilitate the self-executing features of the law....
...ction, shall be subject by the division to one or more of the penalties set forth in paragraph (8)(b). (Emphasis added) (footnotes added). The JCC concluded that Dr. Robert Butler, an EMA appointed by the JCC, was a "health care provider" subject to section 440.13(4)(c), and granted the E/C's request for an ex parte conference. This was error. In reaching our decision, we note that the language in subsection (4)(c), permitting ex parte discussions between health care providers and the respective parties, was but one of several subsections added to section 440.13 at the special session of the 1993 Florida Legislature. See Ch. 93-415, § 17, at 98-111, Laws of Fla. In addition to the above subsection, the legislature amended section 440.13 by including within it subsections (5),(6),(7), (8) and (9), all of which in should be read in pari materia....
...See § 1.04, Fla. Stat. (1993). In applying this rule to the amended statute, we conclude that the legislature intended the added subsections to address chronologically the progression of a worker's injury from its initial occurrence through subsequent disputes. Section 440.13, as amended, addresses the roles of three separate categories of physicians or practitioners placed within the amended act: health care providers, independent medical examiners (IMEs), and EMAs....
...s injuries in the event of disagreement between health care providers on the medical evidence, the claimant's need for additional treatment, or the claimant's ability to return to work. A presumption of correctness attaches to the EMA's opinion. See § 440.13(9)(c)....
...e requires that the EMA selected not only be qualified to render the opinion, but also be impartial, a fact alluded to by this court's recent decision in Johns Eastern Co. v. Matta, 23 Fla. L. Weekly D1846, 717 So.2d 91 (Fla. 1st DCA 1998). See also § 440.13(9)(a)....
...olution of medical disputes, and the experts so chosen should not be subject to even the "appearance of impropriety," which would result from private meetings with either party. As we earlier observed, the disputed language at issue is found only in section 440.13(4)(c), generally pertaining to the requirement that health care providers inform E/Cs of treatment furnished to injured employees on forms furnished by the division. Such language was not repeated in any other subsection of section 440.13....
...[2] Chapter 381 governs public health, and section 381.004 addresses HIV testing and the confidentiality thereof. [3] We do not mean to suggest by the above enumeration that IMEs and EMAs do not fall within the general definition of health care providers. Clearly they do. See § 440.13(1)(i). It is rather our position, for the reasons stated infra, that the pertinent language of 440.13(4)(c) was not intended to extend to health care providers who are also selected as EMAs. [4] This presumption was carried over from section 440.13(2)(j)3 a, Florida Statutes (1993)....
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Mobley v. Jack & Son Plumbing, 170 So. 2d 41 (Fla. 1964).

Cited 15 times | Published | Supreme Court of Florida

...e record. We go then to the next question presented by the claimant. Claimant was treated by three doctors. The last to treat him, Dr. Reinherz, was not authorized by the employer-carrier to treat claimant, and failed to file the reports required by Section 440.13(1), F.S.A....
...Reinherz for his services. The Full Commission reversed this portion of the deputy's order on the double ground that (1) the services were not authorized by the employer-carrier, and (2) the doctor failed to submit the reports required by the statute. Section 440.13(1), F.S.A....
...Reinherz $146.50 on account, nor explains why this payment should not constitute an acceptance of the doctors services and a waiver of the reports required to be made under the statute. In Foster v. Cooper, supra, this Court stated that one of the purposes of the medical reports required by Section 440.13 (1) is protection of the employer from liability on unfounded or fraudulent claims....
...sation orders require their payment. It is true, as contended by cross-petitioners, that Chapter 440 does not specifically require or authorize payment of travel expenses incurred in obtaining medical treatment. Nevertheless, we are of the view that Section 440.13, which requires the employer to furnish to the employee "such remedial treatment, care and attendance" as the injury shall require, must be interpreted to include reasonable travel expenses incurred by the employee in presenting himself at the place where such treatment and care is provided....
...Other jurisdictions have reached the same conclusion. Huhn v. Foley Bros., 221 Minn. 279, 22 N.W.2d 3 (1946); Newberry v. Youngs, 163 Neb. 397, 80 N.W.2d 165 (1956); Scruggs Bros. & Bill Garage v. State Industrial Commission, 94 Okla. 187, 221 P. 470 (1923). Under this interpretation of Section 440.13, the part of said Rule 18, that requires the payment of the "reasonable actual cost" of travel expenses by the employer-carrier merely tracks the statute....
...mmission so as to make it invalid. We have greater difficulty, however, upholding the portion of the rule that establishes seven and one-half cents per mile as the sum to be paid for travel by private automobile. We have considered the provisions of Section 440.13(3) (a), which authorize the Commission to adopt a schedule of charges for medical treatment and services, but have concluded that the wording of the subsection authorizes the adoption of a schedule only for medical service and treatment rendered claimants by others....
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Broward Indus. Plating, Inc. v. Weiby, 394 So. 2d 1117 (Fla. 1st DCA 1981).

Cited 15 times | Published | Florida 1st District Court of Appeal

...by the claimant nor reported by various doctors and hospitals. In this respect, the Deputy found that this medical treatment was "reasonable and necessary," and he ordered that the appellants pay for such treatment. This ruling was erroneous. Under § 440.13(1), Fla....
...ment. See Atlantic Cold Storage v. Hernandez, IRC Order 2-3071 (Nov. 22, 1976). We remand this matter to the Deputy for appropriate findings as to whether there was a legally acceptable excuse for the claimant's failure to request medical treatment. Section 440.13(1), Fla....
...imely submit the required reports, id., nor does the fact that a claim is being contested constitute such good cause. See Hood's Dairy v. Severino, 178 So.2d 588, 591 (Fla. 1965). Here, the record does not indicate that the reporting requirements of § 440.13(1), Fla....
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Miller v. Brewer Co. of Florida, Inc., 122 So. 2d 565 (Fla. 1960).

Cited 15 times | Published | Supreme Court of Florida

...Speh and Burnis T. Coleman, Tallahassee, for respondents. ROBERTS, Justice. Petitioner-claimant has applied for review on certiorari of an order of the Florida Industrial Commission denying his claim for additional remedial treatment under the provisions of § 440.13, Fla....
...reatment furnished in 1957. The Commission held, however, that the claimant's right to additional remedial treatment had been barred since 1955 (two years after the date of the last compensation payment) under the provisions of Subsection (3) (b) of § 440.13, supra, providing that the right to remedial treatment "shall be barred unless claim therefor is filed * * * within two years after the date of the last remedial treatment furnished by the employer, or after the date of the last payment of...
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Adelman Steel Corp. v. Winter, 610 So. 2d 494 (Fla. 1st DCA 1992).

Cited 15 times | Published | Florida 1st District Court of Appeal | 1992 WL 332753

...[1] We deny the petitions for certiorari in cases number 91-2306 and 91-2773, and we grant the petition for certiorari and quash the order in case number 91-2713. I. The issues presented are governed by the interrelated provisions in sections 455.241 and 440.13, Florida Statutes....
...cal records, reports, and information given by that person in connection with medical treatment or examination, and prohibits the disclosure thereof by the health care practitioner or entity providing such services other than as provided therein. Subsection 440.13(2) provides for limited disclosure of medical information in workers' compensation matters under specifically defined exceptions to the restrictions set forth in section 455.241, and thereby facilitates the self-executing concept for providing benefits under the Workers' Compensation Law....
...or treatment, including X rays and insurance information (emphasis added), with certain exceptions relating to psychotherapeutic records not involved in these cases. Subsection 455.241(2) reads in pertinent part: (2) Except as otherwise provided in s. 440.13(2), such records may not be furnished to, and the medical condition of the patient may not be discussed with, any person other than the patient or his legal representative or other health care providers involved in the care or treatment of the patient, except upon written authorization of the patient....
...the medical examination or treatment was procured or furnished by the requesting party with the patient's consent, (3) such disclosure is sought by an authorized court subpoena with appropriate notice, or (4) disclosure is otherwise provided for in section 440.13(2)(c). We now discuss this last exception. B. Section 455.241 explicitly limits disclosure of a person's medical records and information in all contexts, including workers' compensation proceedings, "except as otherwise provided in s. 440.13(2)(c)." [2] This latter phrase, being an exception to a general rule, must be strictly construed, e.g., Samara Development Corp. v. Marlow, 556 So.2d 1097, 1100 (Fla. 1990), in determining when it suspends or supersedes the provisions of section 455.241 in workers' compensation cases. Section 440.13(2)(f) provides in pertinent part: (f) Notwithstanding the limitations in s....
...loyee or his attorney has been furnished a copy of such claim." (Emphasis added.) The emphasized language refers to records and information pertaining only to the employee's medical condition causally related to the workplace injury. No provision in section 440.13 or any other section of chapter 440 indicates that "discussions" by the employer and carrier's attorney or rehabilitation provider, as stated in subsection 440.13(2)(f), may be held ex parte without first giving notice and affording counsel for the opposing party an opportunity to be present at such discussions. Perez v. Eastern Airlines, 569 So.2d 1290 (Fla. 1st DCA 1990), rev. denied, 581 So.2d 1307 (Fla. 1991). In Perez *502 this court addressed whether subsection 440.13(2)(c), Florida Statutes (1989), which contains substantially the same language as the present subsection 440.13(2)(f), authorizes an employer and carrier's attorney to have ex parte communications with a claimant's treating physician in respect to medical information relating to the employee's injury....
...no objection to a deposition or a conference with the claimant's treating internist, provided the claimant's attorney could be present. Nevertheless, the employer attempted to have a private discussion with the claimant's internist and relied on subsection 440.13(2)(c), Florida Statutes (1989), as authority to do so. When the claimant's attorney objected to such ex parte communication as a violation of subsection 455.241(2), Florida Statutes (1989), the employer brought the issue before the judge of compensation claims. The judge ruled that section 440.13(2)(c) provided authority for the employer to conduct ex parte communications with the claimant's physician....
...s case, the judge's order allowing ex parte communications to take place between Eastern's counsel and Perez's physician was a departure from the essential requirements of law." Id. at 1291. Acknowledging that the judge had correctly recognized that section 440.13(2)(c) is an exception to the confidentiality constraints of section 455.241 and allows the employer to discuss the claimant's medical condition with the claimant's physician, we explained: However, nothing in Section 440.13(2)(c) requires that such discussion be had in the absence of Perez's counsel....
...n reaching a decision, thereby clearly indicating that this fact, i.e., whether the physician was authorized or not, was deliberately held to be immaterial to the court's decision in that case. Hence, that decision must be read as holding that while section 440.13(2)(f) authorizes discussions with the claimant's treating physician, it does not authorize ex parte discussions by the employer and carrier's attorney with a claimant's treating physician, regardless of whether that physician was authorized. C. Reading subsections 455.241 and 440.13(2)(f) in pari materia, as construed and applied in the cited decisions, we discern the following principles for application in workers' compensation cases in respect to disclosure of medical information by health care providers....
...e that section 455.241 prohibits disclosure of medical information by a health care provider other than in the manner and scope authorized therein, and that additional limited disclosure may occur in workers' compensation cases only as authorized by section 440.13(2)(f)....
...This conclusion is based on the express provisions in subsection 455.241(2) that such records "may not be furnished to, and the medical condition of a patient may not be discussed with, any person other than the patient or his legal representative " (emphasis added), and is also explicitly required in part by subsection 440.13(2)(e)....
...are practitioner will be permissible only with the consent of the claimant or claimant's attorney, or after the latter have been provided with notice and an opportunity to be present at such discussion. This conclusion is required by the language of section 440.13(2)(f) as construed and applied in Perez....
...ed" to the workplace injury as required by the statute cannot be effectively enforced if such discussions are ex parte. Of course, the employer and carrier remain entitled to request and receive written reports of injury and treatment required by subsection 440.13(2)(d) to be made on forms prescribed by the Division. Fifth, a physician performing an independent medical examination (IME) in workers' compensation cases pursuant to subsection 440.13(2)(b) is essentially an expert witness for the party requesting the examination....
...yer and servicing agent's representatives and attorneys from having any ex parte communication with authorized health care providers without making prior arrangement for claimant's counsel to be present. Nothing *506 in the self-executing concept of section 440.13, and particularly subsection 440.13(2)(c), Florida Statutes (1989) [now § 440.13(2)(d)-(f), Fla....
...This can be by requesting a report in writing, and by telephoning the medical provider to ask for a report or an updated report on the claimant's condition. Claimant's petition seeks to quash the provisions in paragraph 4 of this order, urging that these conditions violate subsections 455.241(2) and 440.13(2) and our decisions in Perez and Pic N' Save v....
...Petitioner contends that the order departs from the essential requirements of law because the limiting condition requiring that the attorney for the employer and carrier may be present during conversations between Claimant's attorney and Claimant's treating physicians is neither required by Perez nor section 440.13(2)(c) [now 440.13(2)(d)-(f)]....
...This provision precludes Petitioner's attorney from communicating with the claimant's physicians unless the employer and servicing agent's attorneys are notified and allowed to be present. This restriction is contrary to the spirit and intent of sections 455.241(2) and 440.13(2) to permit free disclosure and communication of medical information by the physician to the treated person and that person's attorney....
...Setting forth the Division's policy regarding such ex parte communications, that letter recited in pertinent part: The case that you cited Perez v. Eastern Airlines involved ex-parte communication between Eastern counsel and Perez's physician. This is a departure from the requirements of the law. However, pursuant to both Section 440.13(e) [sic], F.S....
...ied with regards to ex parte communications between anyone on behalf of the employer/carrier, attorney and rehabilitation provider and treating physicians and providers as defined by F.S. § 455.241(2). It is agreed that communications pursuant to F.S. 440.13(2)(c) do not apply to IME Physicians....
...uld be appropriate under that rule, we have elected to accord review by certiorari because the case was perfected under rule 9.100(c), Florida Rules of Appellate Procedure, prior to the effective date of rule 4.160(b)(5). [2] This reference is to subsection 440.13(2)(c), Florida Statutes (1989). The relevant provisions in that subsection have been moved to subsection 440.13(2)(f), Florida Statutes (1991), and we refer to the latter citation hereafter in this opinion....
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US Sugar Corp. v. Henson, 787 So. 2d 3 (Fla. 1st DCA 2001).

Cited 15 times | Published | Florida 1st District Court of Appeal | 2001 Fla. App. LEXIS 5255, 2000 WL 1880340

...cal reports of authorized treating health care providers relating to the claimant and subject accident shall be received into evidence by the [JCC]." Finally, Henson submits that Frye testing is unnecessary to assure evidentiary reliability, because section 440.13(9)(c) provides for the appointment of expert medical advisors to assist the JCC with issues of medical causation and requires that the EMA opinion "is presumed to be correct unless there is clear and convincing evidence to the contrary...
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Sears, Roebuck & Co. v. Viera, 440 So. 2d 49 (Fla. 1st DCA 1983).

Cited 14 times | Published | Florida 1st District Court of Appeal

...deputy when it objected to his request for chiropractic care. The deputy commissioner agreed and held that once claimant objected to the services rendered by the authorized physicians and requested alternative care, it was the employer's duty, under section 440.13(2), Florida Statutes (1981), to either select a physician to provide such care to the claimant or to seek a ruling from the deputy commissioner that such change in medical attendance would not be in the best interest of the claimant. Failing in same the employer must pay for the requested treatment subject only to the reasonableness and necessity of same. The deputy's conclusion properly coordinates the legislative mandate contained in subsections (1) and (2) of section 440.13, [1] and is not inconsistent with our holdings in Commercial Carriers, Inc....
...Flanders . In Porter, the claimant was not seeking alternative treatment as such, but merely additional care. Therefore, he was first required to seek prior approval from the deputy commissioner for the unauthorized care, demonstrating good cause therefor. Section 440.13(2); see also Mt....
...In the instant case, the employer utterly failed in its duty by totally disregarding claimant's request, neither providing the alternative care nor seeking a deputy commissioner's determination that "a change in medical attendance is not for the best interests of the injured employee... ." Section 440.13(2)....
...e weekly wage to include the tips. The deputy's order in that regard is therefore affirmed. AFFIRMED in part, REVERSED in part, and remanded for further proceedings consistent with this opinion. ROBERT P. SMITH, Jr. and BOOTH, JJ., concur. NOTES [1] Section 440.13 provides in relevant part: (1) ..., the employer shall furnish to the employee such remedial treatment, care, and attendance under the direction and supervision of a qualified physician or surgeon or other recognized practitioner, nurs...
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Palma v. State Farm Fire & Cas. Co., 489 So. 2d 147 (Fla. 4th DCA 1986).

Cited 13 times | Published | Florida 4th District Court of Appeal | 11 Fla. L. Weekly 1221

...The insurance policy provided only that the insurer would pay eighty percent of the "reasonable charges incurred for necessary... medical services." Since neither the statute nor the policy defines the term "necessary medical services," the trial court looked to the Workers Compensation Act, section 440.13, Florida Statutes (1983) and adopted three parts of the definition contained therein....
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Pan Am. World Airways, Inc. v. Weaver, 226 So. 2d 801 (Fla. 1969).

Cited 13 times | Published | Supreme Court of Florida

...Respondent was involved in an admittedly compensable accident which left him permanently and totally disabled. He now employs an unlicensed practical nurse full-time in the dual capacity of nurse and housekeeper. The sole issue in dispute is whether or not respondent's employer is required, under F.S. § 440.13(1), F.S.A., to assume the full cost of the attendant's services....
...The majority held, in pertinent part, as follows: "We believe the Judge of Industrial Claims erred in this respect and that he should have ordered the Carrier to pay the total amount of $40.00; with no part of the amount to be paid by the Claimant. The Claimant is permanently and totally disabled and cannot care for himself. Section 440.13(1), Florida Statutes, provides that the Employee shall be furnished with such remedial treatment, care, and attendance as the nature of the injury or process of recovery may require....
...The attendant also performs the functions usually carried out by a practical nurse, such as administering medicine to respondent when he is unable, and assisting with his bathing. In the Chizauskas case, this Court discussed the services that are compensable under F.S. § 440.13(1) and plainly stated the rule which is applicable in the instant case: "Housekeeping and related services are not required to be furnished." 172 So.2d at 444....
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Franklin v. Nationwide Mut. Fire Ins. Co., 566 So. 2d 529 (Fla. 1st DCA 1990).

Cited 13 times | Published | Florida 1st District Court of Appeal | 1990 WL 107756

...and discovery provisions in the Florida Rules of Civil Procedure therein discussed are applicable both to civil cases and to workers' compensation cases. We stated in pertinent part in that case: There is no issue as to compliance with this statute [section 440.13(2)(b)] in the present case, and there is no other provision in chapter 440 by which employer/carrier's desired oral communication might be compelled....
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Mylock v. Champion Intern., 906 So. 2d 363 (Fla. 1st DCA 2005).

Cited 13 times | Published | Florida 1st District Court of Appeal | 2005 WL 1660710

...ee for services performed in achieving the re-authorization of claimant's physician. While claimant was being treated for his work-related injury, the E/C, on October 10, 2003, forwarded a letter to claimant's counsel informing him that, pursuant to section 440.13(2)(d), Florida Statutes (2003), it was transferring the care of claimant from his authorized physician, Dr....
...Thereafter, on October 31, 2003, the E/C replied by letter that it did not intend to de-authorize Dr. Mangieri, who remained claimant's physician. Four days thereafter, the carrier filed a formal reply to the petition, again referring to its rights under section 440.13(2)(d), to transfer the care of an injured employee to a health-care provider, if the IME confirmed that the employee was not making adequate progress....
...ent it involved an interpretation of law, our standard is that of de novo. We cannot agree that the Pardo holding affects the outcome of the present case. The facts in Pardo, involving an injured employee's request for medical care, as authorized by section 440.13(2)(a), are far different from those at bar, involving, under section 440.13(2)(d), a carrier's attempt to transfer care from an attending health-care provider with whom the employee had expressed no dissatisfaction....
...ning the worker's life. In contrast, the transfer of care from an existing health-care provider to another at the carrier's direction is not ordinarily attended by the same dire consequences. We find nothing expressly stated or reasonably implied in section 440.13(2)(d) to require that the de-authorization of an attending physician shall occur simultaneously with the carrier's communication....
...o transfer care, regardless of the timing of the de-authorization. For example, in State Attorney v. Johnson, 770 So.2d 187 (Fla. 1st DCA 2000), this court affirmed a JCC's refusal to approve an E/C's unilateral transfer of medical care, pursuant to section 440.13(2)(d), wherein the carrier advised claimant "that it intended to transfer her care from the authorized doctor with whom she had been receiving treatment." Id....
...REVERSED and REMANDED. PADOVANO and THOMAS, JJ., concur. NOTES [1] Section 440.34(3)(a), Florida Statutes, authorizes an award of fees to claimant if he or she prevails on a claim for medical benefits. [2] The language in the letter generally tracked that in section 440.13(2)(d), which provides: "The carrier has the right to transfer the care of an injured employee from the attending health care provider if an independent medical examination determines that the employee is not making appropriate progress...
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Turner v. Keller Kitchen Cabinets, S., Inc., 247 So. 2d 35 (Fla. 1971).

Cited 13 times | Published | Supreme Court of Florida

...The Commission did not hear from claimant or his wife again until December 3, 1969, when it received a claim filed by claimant's second attorney. This claim came on for hearing on January 9, 1970. The paramount issue was whether the statute of limitations provided by Fla. Stat. § 440.19(1) (a), F.S.A. and Fla. Stat. § 440.13(3) (b), F.S.A....
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Mr. C's Tv Rental v. Murray, 559 So. 2d 452 (Fla. 1st DCA 1990).

Cited 13 times | Published | Florida 1st District Court of Appeal | 1990 WL 43136

...David Parrish of Hurt & Parrish, P.A., Orlando, and Bill McCabe of Shepherd, McCabe & Cooley, Longwood, for appellee. BOOTH, Judge. This cause is before us on appeal from an order awarding claimant 24-hour-per-day attendant care benefits to be paid for care provided by claimant's wife. We reverse based on Section 440.13(2)(e)2, Florida Statutes (1989). Section 440.13(2)(e)2 provides: 440.13 Medical services and supplies; penalty for violations; limitations....
...fective October 1, 1989, after the entry of the order (July 3, 1989) in this case. Ch. 89-289, §§ 10 and 45, Laws of Fla. In Williams v. Amax Chemical Corporation, 543 So.2d 277 (Fla. 1st DCA 1989), this court applied the earlier 1988 amendment of Section 440.13(2)(e)2, Florida Statutes, to benefits awarded prior to, but paid after, the effective date of the amendment, holding: After October 1, 1988, payment for the wife's services must be governed by section 440.13(2)(e), Florida Statutes (Supp....
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S. Bakeries v. Cooper, 659 So. 2d 339 (Fla. 1st DCA 1995).

Cited 13 times | Published | Florida 1st District Court of Appeal | 1995 WL 155374

...pellants. Dean Burnetti of Smith & Burnetti, P.A., Lakeland, and Bill McCabe of Shepherd, McCabe & Cooley, Longwood, for appellee. ALLEN, Judge. The employer/carrier appeal a workers' compensation order, contending that the judge should have applied section 440.13(5)(e), Florida Statutes (Supp. 1994), so as to exclude certain medical testimony. We conclude that the application of this enactment depends on a new independent medical examination process under section 440.13(5), which alters the parties' substantive rights. Section 440.13(5)(e) therefore does not apply in this case, where the claimant was injured prior to the effective date of the new statute....
...The employer/carrier sent the claimant to a doctor whom they chose for a medical evaluation. The claimant was also seen by several doctors whom he chose for medical evaluations. A merits hearing was scheduled, and these doctors were identified in a pretrial list of witnesses. Section 440.13(5), Florida Statutes (Supp....
...1994), subsequently became effective, creating a new independent medical examination process. Under this statute the carrier and the employee may each select an independent medical examiner, but they are then generally bound by their selection. See § 440.13(5)(a) and (b). Other rights and obligations pertaining to the independent medical examination process are also addressed, and section 440.13(5)(e) provides that: *340 No medical opinion other than the opinion of a medical advisor appointed by the judge of compensation claims or division, an independent medical examiner or an authorized treating provider is admissible in proceedings before the judges of compensation claims. After these new provisions became effective the claimant saw another doctor whom he chose for a further medical evaluation, and the case proceeded to a hearing. The employer/carrier invoked section 440.13(5)(e), and thereby sought to exclude the testimony of all of the claimant's chosen doctors....
...Lucie County Sheriff's Department, 599 So.2d 1353 (Fla. 1st DCA), rev. denied, 613 So.2d 6 (Fla. 1992), cert. denied, ___ U.S. ___, 113 S.Ct. 2350, 124 L.Ed.2d 258 (1993). Although procedural amendments which merely affect the method of proof are not similarly constrained, e.g., Litvin, and section 440.13(5)(e) would appear to have such limited procedural import if read solely unto itself, this enactment does not apply in isolation. Rather, it depends on other statutory processes relating to medical advisors, authorized treating providers, and independent medical examiners. And while the independent medical examination process under section 440.13(5) may have some procedural aspects, it also effects a change in the parties' substantive rights. When the claimant was injured section 440.13(2)(b), Florida Statutes (1991), allowed the employer/carrier to schedule an independent medical examination with a health care provider of their choice....
...uthority was somewhat altered with regard to the consequences of a conflict in the medical evidence. See § 440.25(4)(d), Fla. Stat. (Supp. 1994). [1] Carriers could conduct independent medical evaluations in connection with utilization review under section 440.13(6), Florida Statutes (Supp. 1994), and an independent medical examination process was adopted for maximum medical improvement and permanent impairment disputes. Section 440.1925, Fla. Stat. (Supp. 1994). A new process was also created at section 440.13(5), broadly addressing the parties' general rights to independent medical examinations. Like the prior law, section 440.13(5)(c) allows the carrier to schedule an independent medical examination. But while the claimant may also select an independent medical examiner, the claimant's attorney may not schedule such a medical evaluation. [2] Section 440.13(5)(c). Should the claimant fail to appear for an independent medical examination, section 440.13(5)(d), Florida Statutes (Supp. 1994), specifies the circumstances in which *341 the claimant may be required to reimburse the carrier for a portion of the doctor's cancellation fee. Section 440.13(5) does not otherwise address the source of payment for independent medical examinations, but section 440.13(3)(g), Florida Statutes (Supp. 1994), indicates that in the absence of an express statutory provision the claimant is not obligated to pay for medical services under this section. See also § 440.13(14)(a), Fla....
...ependent medical examination of his own choice without being obligated for the cost of the examination. In giving the claimant the right to select an independent medical examiner and obtain such an examination without having to pay for this service, section 440.13(5) departs from the prior law under which the claimant could not always avoid such costs....
...the source of payment therefor, as a matter of substance. See Clay Hyder Trucking v. Atherton, 450 So.2d 318 (Fla. 1st DCA 1984); Webb v. Hills Van Service, 414 So.2d 262 (Fla. 1st DCA 1982); Ship Shape v. Taylor, 397 So.2d 1199 (Fla. 1st DCA 1981). Section 440.13(5) is likewise properly viewed as effecting a substantive change in the law, insofar as it alters the parties' obligation to pay for the claimant's independent medical examination. Section 440.13(5) thus does not apply in the present case, as the claimant was injured before this statute became effective. See, e.g., Sullivan. Because section 440.13(5)(e) depends on this statutory process in restricting the medical testimony, this enactment also does not apply in the present case, as it would necessitate an underlying alteration of the parties' substantive rights. The appealed order is affirmed. DAVIS, J., and WENTWORTH, Senior Judge, concur. NOTES [1] See also § 440.13(9)(c), Fla. Stat. (Supp. 1994); § 440.13(2)(j)3.a, Fla. Stat. (1991). [2] Independent medical examinations are defined with reference to objective evaluations of the injured employee's medical condition. Section 440.13(1)(k), Fla....
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Curtis v. Fla. Corr. Inst., 509 So. 2d 1192 (Fla. 1st DCA 1987).

Cited 12 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 1569

...eviate. The claimant became increasingly depressed and discouraged under the care of *1195 her authorized doctors, feeling more comfortable with her own physician. Upon consulting Dr. Hynick, she was hospitalized and given immediate attention. Under Section 440.13(3), Florida Statutes, a deputy may, at any time, for good cause shown, order a change in the claimant's remedial attention, care, or attendance....
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Daniel v. Holmes Lumber Co., 490 So. 2d 1252 (Fla. 1986).

Cited 12 times | Published | Supreme Court of Florida | 11 Fla. L. Weekly 278, 1986 Fla. LEXIS 2297

...In June 1983 Daniel filed an amended claim for disability benefits and medical treatment, naming both Fidelity and American as parties. The deputy commissioner found that the 1982 volleyball injury would *1254 not have occurred except for the 1978 injury, but that the statute of limitations contained in sections 440.13(3)(b) and 440.19(1)(a), Florida Statutes (1977), barred any claim against Fidelity....
...h injury a claim may be filed within 2 years after the date of the last payment of compensation or after the date of the last remedial treatment furnished by the employer. Just as section 440.19(1)(a) deals with the right to disability compensation, section 440.13(3)(b) provides a parallel provision with the identical exceptions for recovery for remedial attention. [1] The parties agree that, under the express language of sections 440.13(3)(b) and 440.19(1)(a), a claim filed within two years of a compensation payment voluntarily made without an award would normally be timely....
...1978 and that once the two-year limitation period expired no subsequent payments or remedial attention could revive the period for filing a claim related to that injury. On the other hand, Daniel maintains that under the plain terms of both sections 440.13(3)(b) and 440.19(1)(a) the occurrence of a two-year time gap in compensation payments is irrelevant....
...Both the conflicting case law which the parties cite and the six-to-six vote in the district court reflect the judicial confusion as to the precise effect of voluntary compensation payments upon the two-year limitations period contained in sections 440.13(3)(b) and 440.19(1)(a)....
...As this Court held in Miller v. Brewer Co., 122 So.2d 565 (Fla. 1960), the fact an insurance carrier voluntarily complied with a claimant's request for subsequent remedial treatment once two years had passed did not revive the right of the claimant to remedial treatment under section 440.13(3)(b). In what may have been a response to the denial of relief in Miller, however, the Florida legislature in 1963 amended section 440.13(3)(b) and created the two-year extended statute of limitations, triggered by voluntary remedial treatment or compensation, that existed in 440.13(3)(b) at the time relevant to the case at bar. Watson v. Delta Airlines, Inc., 288 So.2d 193, 194 (Fla. 1973). Ten years after this amendment, we reconsidered the application of sections 440.13(3)(b) and 440.19(1)(a) to compensation claims....
...fore the claim was filed" and that the voluntary payment of benefits did not reactivate the filing period. 288 So.2d at 194. The Industrial Relations Commission (IRC) affirmed. In quashing the IRC order we observed that, due to the 1963 amendment to section 440.13(3)(b), Miller no longer applied....
...State Road Department, 171 So.2d 523 (Fla. 1965), also lends support to this position. As to Hodges, however, we find that it focused more on res judicata than the issue presently before us and we decline to read a binding pronouncement into Hodges when that opinion mentioned neither section 440.13(3)(b) nor 440.19(1)(a)....
...Petersburg Kennel Club, 396 So.2d 161 (Fla. 1981); Farrens Tree Surgeons v. Winkles, 334 So.2d 569 (Fla. 1976); Thomas Smith Farms v. Alday, 182 So.2d 405 (Fla. 1966); Topeka Inn Management v. Pate, 414 So.2d 1184 (Fla. 1st DCA 1982). Yet in the case of sections 440.13(3)(b) and 440.19(1)(a) no ambiguities exist. These statutes unequivocally state that so long as an employee files a claim within two years of the last voluntary compensation payment or dispensation of remedial treatment made without an award the claim is timely. §§ 440.13(3)(b) & 440.19(1)(a), Fla....
...Sanford-Orlando Kennel Club, Inc., 434 So.2d 879 (Fla. 1983); Carson v. Miller, 370 So.2d 10 (Fla. 1979); Heredia v. Allstate Insurance Co., 358 So.2d 1353 (Fla. 1978); Phil's Yellow Taxi Co. v. Carter, 134 So.2d 230 (Fla. 1961). Therefore, given the unambiguous language of sections 440.19(1)(a) and 440.13(3)(b), it would be inappropriate for us to read into the statutes more obstacles for claimants than these provisions otherwise require....
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Aguilera v. Inservices, Inc., 905 So. 2d 84 (Fla. 2005).

Cited 12 times | Published | Supreme Court of Florida | 2005 WL 1403993

...Further, section 440.192, Florida Statutes (2000), provides a procedure for resolving any benefit disputes between a carrier and a claimant and sets strict deadlines for dispute resolution. A carrier is entitled to request an independent medical examination concerning compensability or medical benefits. See § 440.13, Fla....
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Cal Kovens Const. v. Lott, 473 So. 2d 249 (Fla. 1st DCA 1985).

Cited 12 times | Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 1752

...Rech for treatment after April 4, 1983, to the date of the order "because there was no determination by the Deputy Commissioner that a change in medical provider was in the claimant's best interest, particularly since the other technical requirements of § 440.13(2), Fla....
...rentially, that claimant could not be coerced by the employer and carrier to change from his authorized treating physician to new physicians unacceptable to him absent a showing of good cause sufficient to require a change in medical treatment under section 440.13(2)....
...agree among themselves as to a suitable physician to provide medical treatment to the claimant closer to his home in the future. Failing that, the parties are free to request a change of physician and apply for a hearing in a manner provided for in § 440.13(2), Fla....
...st. The deputy commissioner's ruling follows the proper procedure for accomplishing disputed changes in treating physicians, Bradley Construction v. White, 457 So.2d 547 (Fla. 1st DCA 1984), and is perfectly consistent with previous constructions of section 440.13(2) by this court and the Industrial Relations Commission....
...ropractic care. The deputy commissioner agreed with claimant's position and, as the court noted, held that once claimant objected to the services rendered by the authorized physicians and requested alternative care, it was the employer's duty, under section 440.13(2), Florida Statutes (1981), "to either select a physician to provide such care to the claimant or to seek a ruling from the deputy commissioner that such change in medical attendance would not be in the best interest of the claimant....
...Failing in same the employer must pay for the requested treatment subject only to the reasonableness and necessity of same." 440 So.2d at 51. The court concluded that the deputy's holding properly coordinated the legislative mandate contained in sub-sections (1) and (2) of section 440.13....
...yer or carrier and the claimant disputes the change, the employer or carrier, being the party seeking to change the status quo, should obtain an order from the deputy commissioner or incur the risk of a ruling against good cause for the change under section 440.13....
...Those cases stand for the proposition that a claimant cannot be awarded payment of medical fees for treatment by an unauthorized physician unless that claimant shows good cause for the selection of that physician in lieu of the selection of physicians made by the employer and carrier. In Walling, it was stated: Section 440.13 reserves to the claimant the right to dispute the carrier's selection of a treating physician for good cause....
...il the question which doctor shall perform the treatment has been resolved by the Judge. 384 So.2d at 253 (emphasis supplied). In Robinson v. Howard Hall Co., 219 So.2d 688 *254 (Fla. 1969), the Supreme Court first construed the relevant language of section 440.13 to require that a claimant show good cause for not accepting a physician selected by the employer and obtaining unauthorized treatment in lieu of requesting new authorization, and explained its holding with the following comments: The...
...Industrial Claims. We analogize this limited right of a claimant as to the initial selection of a physician to be essentially similar to a situation where a claimant desires a change in medical attention already provided him. In the latter situation Section 440.13 provides: `The commission may at any time, for good cause, shown in its discretion order a change * * *.' We recognize that in certain instances it may be found to be in the best interest of an injured claimant to have the satisfaction of being treated by a physician of his own choosing....
...v. Howard Hall Co., 219 So.2d 688. In the former case claimant's right to veto the carrier's selection and compel the carrier to tender another physician is absolute and requires no good cause; otherwise, the guarantee against coercion contained in section 440.13(2) is made a mere sham....
...nized in his order that it would be in "the claimant's best interest in the future that he have medical care available to him, which is closer to his residence." The deputy, in ruling against the employer/carrier's deauthorization of Dr. Rech, found Section 440.13(2), Florida Statutes (1982 Supp.), controlling: (2) If an injured employee objects to the medical attendance furnished by the employer, it shall be the duty of the employer to select another physician to treat the injured employee unle...
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Fid. & Cas. Co. of NY v. Cooper, 382 So. 2d 1331 (Fla. 1st DCA 1980).

Cited 12 times | Published | Florida 1st District Court of Appeal

...The claimant paid for such modifications, and the judge of industrial claims ordered the employer/carrier to reimburse the claimant for these costs. We hold that such modifications were properly awarded as "other apparatus" which "the nature of the injury ... may require ..." § 440.13(1), Florida Statutes....
...Where an industrial injury necessitates the modification or substitution of an automobile in order to accommodate a wheelchair or artificial member and to restore in part a claimant's former ambulatory ability, such costs may be awarded as "other apparatus" pursuant to § 440.13(1). Walt Disney World v. Morgan, IRC Order 2-3818 (May 22, 1979). In Jordan v. Florida Industrial Commission, 183 So.2d 529 (Fla. 1966), the Court stated, in applying § 440.13(1), that "the employer should bear the cost of returning the employee to an employable status... ." While a § 440.13(1) award will usually require medical evidence as to necessity, see e.g., Goldsmith v....
...We conclude that the present case is controlled by the same considerations as those involved in Walt Disney World v. Morgan, supra, and that the modifications necessitated by the loss of claimant's left hand are "other apparatus" as that term is used in § 440.13(1)....
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Williams v. Amax Chem. Corp., 543 So. 2d 277 (Fla. 1st DCA 1989).

Cited 12 times | Published | Florida 1st District Court of Appeal | 1989 WL 36156

...With regard to future attendant care, testimony from Drs. Gonzalez and Malzone would support an award of $7.50 per hour for outside care which figure was provided by nurse Weiss for such companion care. After October 1, 1988, payment for the wife's services must be governed by section 440.13(2)(e), Florida Statutes, (Supp. 1988) She may wish to quit her job and receive her present hourly wage to the extent that it does not exceed "the per hour value of such care available in the community *281 at large." § 440.13(2)(e)(2), Fla....
...n outright denial or as an award of only 4 hours per day. Competent, substantial evidence requires that claimant be provided companion care on an around-the-clock basis. In entering an order consistent with this opinion, the dc is instructed to take section 440.13(2)(e) into account....
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Reynolds v. Neisner Bros., Inc., 436 So. 2d 1070 (Fla. 1st DCA 1983).

Cited 11 times | Published | Florida 1st District Court of Appeal

...e reached MMI on December 11, 1981, with a return to her pre-injury status. The order awarded her TTD benefits from October 27 through December 11, 1981, based on an AWW of $100.65, but found she was neither entitled to medical expenses, pursuant to section 440.13(1), Florida Statutes, nor to permanent and total disability....
...Rather, we remand for further proceedings, and direct the deputy to clarify his findings, upon which Reynolds' entitlement to benefits can be determined in accordance with the evidence, including claimant's age, education and physical limitations. We affirm the deputy's denial of future medical benefits pursuant to section 440.13(1), Florida Statutes, as it is supported by the evidence....
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Wiggins v. B & L Servs., Inc., 701 So. 2d 570 (Fla. 1st DCA 1997).

Cited 11 times | Published | Florida 1st District Court of Appeal | 1997 WL 564212

...The E/C argued that the claimant was not entitled to receive IMEs outside the managed care plan, and that the JCC did not have jurisdiction over the matter until the claimant had exhausted the grievance process. The JCC ruled that when a managed care plan is in place, provision of medical services is governed by section 440.134....
...l witnesses (i.e., whether the JCC erred in her interpretation of the relevant statutes as limiting a claimant's choice of an IME physician to those within the carrier's managed care provider network). She argues that the exclusivity provision of subsection 440.134(16) is limited by its own terms to benefits provided under subsections 440.13(2)(a) and (b), necessarily excluding from the scope of managed care IMEs performed pursuant to subsection 440.13(5). The E/C argue that the managed care grievance provisions of 440.134(15) exclusively govern the provision of medical care and services....
...titutional safeguards. A straightforward reading of the statutes at issue indicates that the managed care provisions were intended to govern only the E/C's provision of "medically necessary remedial treatment, care, and attendance" under subsections 440.13(2)(a) and (b), and were not intended to govern the selection and use, in a dispute arising from the industrial accident, of medical expert witnesses pursuant to subsection 440.13(5). Under our interpretation of the statutes, if the claimant was requesting the IMEs to resolve a dispute regarding the medical treatment she was receiving for her work-related injury, the JCC's denial of her request was proper because section 440.134 and rule 4.028(5)(d) require the claimant, where medical treatment is at issue, to first exhaust the procedures provided in the carrier's managed care plan of operation....
...The petition is therefore DENIED, without prejudice to the claimant's right to renew her motion for an IME before *573 the JCC for purposes authorized by the statutes. The claimant's motion for appellate attorney fees is also DENIED. KAHN and DAVIS, JJ., and SMITH, LARRY G., Senior Judge, concur. NOTES [1] Section 440.134, Florida Statutes (1995), sets out the provisions regarding "managed care arrangements." Subsection 440.134(15) requires grievance procedures for complaints from injured workers. Subsection 440.134(16) provides: When a carrier enters into a managed care arrangement pursuant to this section the employees who are covered by the provisions of such arrangement shall be deemed to have received all the benefits to which they are entitled pursuant to s. 440.13(2)(a) and (b). In addition, the employer shall be deemed to have complied completely with the requirements of such provisions. The provisions governing managed care arrangements shall govern exclusively unless specifically stated otherwise in this section. Subsection 440.134(17) provides: Notwithstanding any other provisions of this chapter, when a carrier provides medical care through a workers' compensation managed care arrangement, pursuant to this section, those workers who are subject to the arrangem...
...Treatment received outside the workers' compensation managed care arrangement is not compensable unless authorized by the carrier prior to the treatment date. When medical treatment is provided through managed care and the petition for benefits includes a claim for medical care under subsections 440.13(2)(a) and (b), Florida Workers' Compensation Rule of Procedure 4.028(5)(d) requires the petition to include a certificate that the grievance procedures required by 440.134(15) were exhausted before the petition was filed under 440.192(3). [2] Subsection 440.13(5), Florida Statutes (1995), provides that "[i]n any dispute concerning overutilization, medical benefits, compensability, or disability under this chapter, the carrier or the employee may select an independent medical examiner" to render an expert medical opinion upon an aspect of the employee's illness or injury which is material to the claim or petition for benefits and that this IME physician "may be a health care provider treating or providing other care to the employee." Subsection 440.13(1)(j) defines "independent medical examiner" as "a physician selected by either an employee or a carrier to render one or more independent medical examinations in connection with a dispute arising under this chapter." Subsection 440.13(1)(k) defines "independent medical examination" as "an objective evaluation of the injured employee's medical condition, including, but not limited to, impairment or work status, performed by a physician or an expert medical advisor at the request of a party, a judge of compensation claims, or the division to assist in the resolution of a dispute arising under this chapter." Subsection 440.13(5)(e) limits admissible medical opinions to those of the treating physician(s), the independent medical examiner(s), and a medical advisor appointed by the JCC....
...[4] Section 440.1925 provides a procedure for resolving maximum medical improvement (MMI) or permanent impairment (PI) disputes, and authorizes the employee or carrier to obtain one IME opinion on the issue of permanent impairment, notwithstanding the limitations on carrier IMEs in section 440.13. It also provides that a dispute as to MMI or PI "which is not subject to dispute resolution according to rules promulgated pursuant to s. 440.134 shall be resolved according to the procedures set out in this section." [5] Under subsection 440.134(10)(c), the claimant may request an alternate chiropractor and orthopedist from the carrier's medical care coordinator, who would refer her to alternate physicians in each specialty within the plan's provider network. She may also obtain a second opinion in each specialty within the provider network, see subsection 440.134(6)(c)9. In either case, if she is not satisfied with the medical treatment provided by the E/C after she has exhausted the grievance process, she may then file a petition for medical benefits. At that point she may, under subsection 440.13(5), seek IMEs by physicians outside the managed care provider network, for the purpose of resolving the dispute regarding her medical treatment.
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Thomas v. Salvation Army, 562 So. 2d 746 (Fla. 1st DCA 1990).

Cited 11 times | Published | Florida 1st District Court of Appeal | 1990 WL 61926

...iling fee of $100.00 (now $250.00). The letter from the EC in response to the request for the authorization of Dr. Preste, which was introduced into evidence by the claimant's attorney, clearly shows that the EC fully complied with the provisions of § 440.13, Fla....
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Square G. Const. Co. v. Grace, 412 So. 2d 397 (Fla. 1st DCA 1982).

Cited 11 times | Published | Florida 1st District Court of Appeal

...The hearing before the deputy followed shortly after the carrier controverted payment of the prescription. Under the circumstances presented we are unable to reverse the deputy's conclusion that the treatment was of such emergency character as not to violate the provisions of Section 440.13 with respect to authorization....
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Caron v. Systematic Air Servs., 576 So. 2d 372 (Fla. 1st DCA 1991).

Cited 11 times | Published | Florida 1st District Court of Appeal | 1991 WL 30425

...ppellant's request for attorney's fees. In all other respects, the order will be affirmed. Because appellant's parents were not employed, upon remand the judge should award payment for attendant care services from January 6, 1989, in accordance with Section 440.13(2)(e)(1), Florida Statutes....
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Sun Bank/South Florida, NA v. Baker, 632 So. 2d 669 (Fla. 4th DCA 1994).

Cited 11 times | Published | Florida 4th District Court of Appeal | 1994 WL 51861

...nd deposited it into his trust account. When he refused to release the funds, CNS filed suit, with counts for breach of contract, open account and quantum meruit. The trial court granted Baker's motion to dismiss. CNS contends that language added to section 440.13(3) in 1983 permits it to enforce its contract with Baker and carve its "usual and customary" fee out of his settlement....
...delivery of disability and medical benefits to an injured worker at a reasonable cost to the employer." § 440.015, Fla. Stat. (1993). To achieve that end, the statute provides for a schedule of maximum reimbursement allowances for medical services. § 440.13(4)(a), Fla. Stat. (1993). A health care provider or physician is to be reimbursed the lesser of either (a) the usual and customary charge for the service or (b) the maximum reimbursement allowance in the schedule. §§ 440.13(4)(a) and (f), Fla. Stat. *671 (1993). [4] By implementing a fee schedule ceiling on charges, the statute seeks to "promote health care cost containment and efficiency with respect to the workers' compensation health care delivery system." § 440.13(4)(f), Fla....
...er fees for their services. See, e.g., Easter Elevator Co. v. Hedman, 290 So.2d 56, 58 (Fla. 1974). [5] In this case, having received the maximum reimbursement allowance for the services provided, CNS may not recover any fee exceeding that amount. §§ 440.13(4)(a) and (f), Fla....
...In addition to the limitation on charges, the workers' compensation law makes the employer and insurance carrier legally responsible for paying medical bills, while the employee is insulated from liability. See Long Grove Builders, Inc. v. Haun, 508 So.2d 476, 477 (Fla. 1st DCA 1987); §§ 440.10(1)(a) and 440.13(3), Fla....
...he position of shopping for a reasonable fee, anticipating potential liability for an amount exceeding fee schedule limits. For this reason, too, CNS is precluded from recovering additional fees from Baker. In 1983, the legislature added language to section 440.13(3): The health care provider or health care facility providing services pursuant to this section shall be paid for the services solely by the employer or its insurance carrier, except for payments from third parties who have been determined to be liable for such payment. § 440.13(3), Fla....
...83-305, § 4, at 1783, Laws of Fla. It is this amendment, CNS argues, which authorizes its lawsuit against Baker. However, such an expansive reading does not harmonize with the purposes of the Act and is not supported by the legislative history and development of section 440.13(3)....
...[7] No reliable indicator of legislative purpose demonstrates an intent to abandon fee schedule limits or to impose liability on employees for chapter 440 medical treatment. The Florida senate staff analysis of chapter 83-305, Laws of Florida, describes the amendment to section 440.13(3) as "[p]roviding an express limitation that health care providers shall be paid solely by the employer/carrier." Staff of Fla.S.Comm....
...of Archives, ser. 18, carton 1283, Tallahassee, Fla.). Although not determinative of legislative intent, staff analyses are one touchstone of the collective legislative will. See In re Forfeiture of $7,750, 546 So.2d 1128, 1130 (Fla. 2d DCA 1989). In 1987, section 440.13(3) was amended to clearly express the intent that the subsection not be read to impose liability on an employee except under limited circumstances....
...services provided pursuant to this section. Ch. 87-330, § 2, at 2136, Laws of Fla. Because it was intended to clarify the legislature's intention, the 1987 amendment may properly be considered in gauging the correct meaning of the 1983 amendment to section 440.13(3)....
...edule, then 80 percent of the usual and customary charge. Apparently some health care providers have been billing injured employees for the difference between what is normally charged and the amount allowed in the statute. This bill would clarify subsection 440.13(3), F.S., by reiterating the fact that the injured employee is not responsible for paying for authorized medical treatment and services. Staff of Fla.S.Comm. on Commerce, PCS/SB 821, Staff Analysis 2 (April 24, 1987) (available at Fla. Dep't of State, Div. of Archives, ser. 18, carton 1283, Tallahassee, Fla.) (emphasis supplied). Finally, the 1993 amendment to chapter 440 rewrote section 440.13 to eliminate the equivocal 1983 language. Ch. 93-415, § 17, at 2374-84, Laws of Fla. Section 440.13(3)(g) confirms that the employee "is not liable for payment for medical treatment or services provided pursuant to this section except as otherwise provided in this section." Id. at 2378. Most importantly, section 440.13(14), entitled "Payment of medical fees," now provides: (a) ......
...Such providers have recourse against the employer or carrier for payment for services rendered in accordance with this chapter. (b) Fees charged for remedial treatment, care, and attendance may not exceed the applicable fee schedules adopted under this chapter. Id. at 2383-84. Given the evolution of section 440.13(3) in the context of the system established by chapter 440, CNS was barred from suing Baker in this case....
...prompt, reasonable payment for services on behalf of many patients who could not otherwise afford them. Tipping the statutory balance to allow a health care provider to pursue a larger fee requires a clearer legislative expression than is evident in section 440.13(3)....
...A health care provider may not accept payments under the Act and also seek to avoid the statutory limits by contracting for a higher fee with the worker. To the extent that it sought compensation in excess of the fee schedule, CNS's contract contravened section 440.13 and was void....
...The issue to be decided by the fact-finder is the reasonableness of the fee schedule charge. Garrett v. Morris Kirschman & Co., 336 So.2d 566 (Fla. 1976); Irwin v. Blake, 589 So.2d 973 (Fla. 4th DCA 1991). [9] Absent a different pronouncement from the legislature, we believe that section 440.13(3) should be narrowly construed....
...act implied at law, or any other legal theory. Accordingly, the judgment is affirmed. GLICKSTEIN and KLEIN, JJ., concur. NOTES [1] Appellant Sun Bank/South Florida, N.A., now holds CNS's accounts receivable as a result of a foreclosure judgment. [2] § 440.13(4)(a), Fla....
...(1985). [3] For example, the fee schedule permitted a $2,020 charge for a combined discogram and chemonucleolysis. CNS's charge to Baker for this procedure was $5,200. [4] Under the 1993 amendment to chapter 440, these limitations are now contained in section 440.13(12)(a) and (c), Florida Statutes....
...1992), contains language indicating that a medical provider may accept workers' compensation benefits and still pursue the employee for that portion of a reasonable fee which exceeds the compensation payment. That case failed to consider the explicit language of section 440.13(3), Florida Statutes (1987). Moreover, it relied on Charter Oak Fire Insurance Co. v. Regalado, 339 So.2d 277 (Fla. 3d DCA 1976), which was decided before the enactment of the limiting language similar to sections 440.13(4)(a) and (f) and 440.13(3), Florida Statutes (1993). See § 440.13(3)(a), Fla. Stat. (1979); Ch. 79-40, § 8, at 226, Laws of Fla; Ch. 93-415, § 17, at 2377, Laws of Fla. We therefore decline to follow Figueroa. [7] We note that even under CNS's reading of section 440.13(3), it was not entitled to bring suit, because there was no determination of liability or fixing of a reasonable fee by a judge or jury....
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Butler v. Bay Ctr./Chubb Ins. Co., 947 So. 2d 570 (Fla. 1st DCA 2006).

Cited 11 times | Published | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 21785, 2006 WL 3813782

...There were two procedural issues before the JCC in this case: (1) Whether the E/C's authorization of Claimant's pain management physician was timely; (2) and if timely, whether Claimant may refuse treatment and immediately request a one-time change in her treating physician. See § 440.13(2)(c), (f), Fla....
...Jacobs, 782 So.2d 404, 405 (Fla. 1st DCA 2001). Whereas parties have vested rights in the substantive law, they do not have vested rights in the procedure. See id. As such, procedural or remedial changes to law apply without regard to the date of a claimant's accident. See id. Section 440.13, Florida Statutes (2005), establishes an E/C's duty to ensure an injured claimant receives medical treatment, and it prescribes the procedure for authorizing medical providers. See St. Augustine Marine Canvas & Upholstery, Inc. v. Lunsford, 917 So.2d 280, 283 (Fla. 1st DCA 2005). Accordingly, the 2005 version of section 440.13, controls in this case. Under section 440.13, the E/C has the initial right and duty to authorize the physician who will treat the injured claimant....
...ysician of his or her choosing at the expense of the E/C, this procedural right attaches only after the E/C fails to provide initial treatment or care within a reasonable time after the claimant's specific request has been made known to the E/C. See § 440.13(2)(c), Fla....
...Here, the record contains competent, substantial evidence to support the JCC's finding of timeliness. Since the E/C timely offered medical care in response to Claimant's PFB, the JCC could not award the specific physician sought by Claimant. City Of Bartow v. Brewer, 896 So.2d 931, 933 (Fla. 1st DCA 2005)("Section 440.13(2)(c), Florida Statutes, does not authorize the JCC to order treatment with a specific physician, where the E/C promptly offers qualified alternatives.")....
...Because the treatment was timely authorized, the JCC was required to determine whether Claimant could request a one-time change in her treating physician without first being treated by the authorized physician. A claimant may request "one change of physician during the course *573 of treatment for any one accident." § 440.13(2)(f), Fla....
...However, even if a claimant had received treatment, a claimant would only be entitled to see the physician of her choice if the E/C failed to provide another physician within five days of receiving her request for another authorized physician. See § 440.13(2)(f), Fla....
...For the reasons stated above, the Judge of Compensation Claims' order, denying Claimant's Petition for Benefits, is AFFIRMED. THOMAS, J., concurs. KAHN, J., dissents with opinion. KAHN, J., dissenting. I do not quarrel with the majority's construction of section 440.13(2)(f), Florida Statutes (2005)....
...I dissent, however, because I conclude that the statute in effect at the time of the injury controls the present issue. I would reverse. Interestingly, the parties, as well as the Judge of Compensation Claims (JCC) below, assumed that the 1985 version of section 440.13 would control this case....
...It is unlawful for any employer or representative of any insurance company or insurer to coerce or attempt to coerce a sick or injured employee in the selection of a physician, surgeon, or other attendant or remedial treatment, nursing or hospital care, or any other service that the sick or injured employee may require . . . § 440.13(3), Fla....
...lso Cal Kovens Constr. v. Lott, 473 So.2d 249, 254 (Fla. 1st DCA 1985) (noting claimant's right to veto E/C's selection of treating physician, and explaining claimant's right to veto E/C's selection vindicates guarantee against coercion contained in section 440.13(2), Florida Statutes)....
...ontrols. The specific issue in this case is, of course, whether the right to veto the E/C's choice of a physician is a substantive right or a procedural right. The majority finds the right procedural because, in their view, the applicable portion of section 440.13 merely "prescribes the procedure for authorizing medical providers." Op....
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Firestone Tire & Rubber Co. v. Vaughn, 381 So. 2d 740 (Fla. 1st DCA 1980).

Cited 11 times | Published | Florida 1st District Court of Appeal

...*741 Billy L. Rose, of Harrison, Greene, Mann, Rowe, Stanton & Mastry, St. Petersburg, for appellants. Edwin J. Bradley, of Lloyd & Henninger, P.A., St. Petersburg, for appellee. PER CURIAM. This case involves an unusual award of palliative care under § 440.13(1), Florida Statutes (1977)....
...conditional mandate for "vesting of title" under the statutory requirement to "furnish ... other apparatus." Thus, the vesting of title is not per se prohibited. The test is whether the furnishing of the apparatus, i.e., the pool, was required under § 440.13(1)....
...Appellants urge that the pool increases the value of the residence and is a monetary advantage to appellee to the detriment of appellants. On the other hand, Vaughn urges that there is no statutory authority to apportion the costs of furnishing apparatus under § 440.13(1) between the employer/carrier and employee....
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Travelers Ins. Co. v. Sitko, 496 So. 2d 920 (Fla. 1st DCA 1986).

Cited 10 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 2260

...1st DCA 1981), petition for review denied, 417 So.2d 328 (Fla. 1982); U.S. Home Corp. v. Parker, 404 So.2d 170 (Fla. 1st DCA 1981). The deputy did, however, have jurisdiction to advise Feuer to pay the $78,759.82 to the unpaid medical care providers. Section 440.13(3) provides that "[t]he health care provider or health care facility providing services pursuant to this section shall be paid for the services solely by the employer or its insurance carrier." This section directs FIGA to pay the unpaid medical care providers directly....
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Brown v. Winn-Dixie Montgomery, Inc., 469 So. 2d 155 (Fla. 1st DCA 1985).

Cited 10 times | Published | Florida 1st District Court of Appeal | 50 Fair Empl. Prac. Cas. (BNA) 458, 10 Fla. L. Weekly 1129, 1985 Fla. App. LEXIS 13817

...loyee, ... and anyone otherwise entitled to recover damages ... on account of such injury or death... ." (e.s.) Section 440.10 places on the employer the responsibility for furnishing compensation benefits to the employee, as provided under sections 440.13, 440.15 and 440.16 of the act. Section 440.13 generally describes the employer's liability for medical services to the injured employee, section 440.15, disability benefits, including permanent total, temporary total and wage-loss, while section 440.16 provides death compensation benefits to designated survivors....
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Socolow v. Flanigans Enter., 877 So. 2d 742 (Fla. 1st DCA 2004).

Cited 10 times | Published | Florida 1st District Court of Appeal | 2004 WL 1091155

...See, e.g., Montgomery Ward v. Lovell, 652 So.2d 509, 511 (Fla. 1st DCA 1995); Marlowe v. Dogs Only Grooming, 589 So.2d 990 (Fla. 1st DCA 1991); Sealey Mattress Co. v. Gause, 466 So.2d 399 (Fla. 1st DCA 1985). Care is compensable only if it is "medically necessary." § 440.13(2)(b), Fla....
...fore she married his son. The applicable statute for awarding compensation for attendant care is the statute in effect at the time the compensable care was given. Walt Disney World Co. v. McCrea, 754 So.2d 196, 197 n. 2 (Fla. 1st DCA 2000). In 1988, section 440.13 specified that family members could not be compensated for attendant care services that would normally be provided by family members gratuitously. § 440.13(2)(d), Fla. Stat. (Supp.1988). Kelli became Appellant's family member, as defined by section 440.13, only after her marriage to Sam. See § 440.13(2)(e), Fla....
...Thus, the JCC did not err in limiting the award to compensation for 61 hours per week of care since January 18, 2002, and we affirm that determination. Appellant also argues that the compensation awarded should not have been limited to the federal minimum wage. However, this was not error. In 2002, the relevant portion of section 440.13 required that compensation be paid to family members at this wage if the family member is not employed. § 440.13(2)(b), Fla....
...ed, and chooses to leave that employment to provide attendant care, will be entitled to compensation at "the per-hour value of the family member's former employment, not to exceed the per-hour value of such care available in the community at large." § 440.13(2)(b), Fla....
...Collier had prescribed an electric wheelchair or electric cart, and that the carrier was willing to provide one when Appellant made his selection. Then, Appellee's counsel affirmatively agreed to that statement on the record. Finally, Appellant argues that the JCC erred either in citing section 440.13(3)(d) in the order, or in failing to implement the provisions of that section. We disagree, as the reference to section 440.13(3)(d) is a typographical error. The JCC stated that "the statutory provision as set forth in F.S. 440.13(3)(d) must be followed to determine what qualifies as compensable attendant or custodial care," and recited case law to support the proposition that "[h]ousekeeping services, such as making the bed, cleaning the home, washing clothes, and shopping, are not the responsibility of the Employer/Carrier." The context of the citation indicates that the reference is to the statutes in effect at the times care was given. The relevant statute in 1988 is section 440.13(2)(d), Fla....
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Lewis v. Town & Country Auto Body Shop, 447 So. 2d 403 (Fla. 1st DCA 1984).

Cited 10 times | Published | Florida 1st District Court of Appeal

...Claimant is entitled as a matter of right, in the absence of a specific finding that he has reached maximum medical improvement, to have medical care provided by the employer. And if the authorized physician declines to see him further, claimant is entitled to have another physician authorized to provide such medical care. § 440.13, Fla....
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Willard Kaufman Co. v. Rawlings, 414 So. 2d 641 (Fla. 1st DCA 1982).

Cited 10 times | Published | Florida 1st District Court of Appeal

...1st DCA 1981); Lake Highland Nursing Home v. Everett, 397 So.2d 380 (Fla. 1st DCA 1981). We also affirm the portion of the award requiring the employer/carrier to pay the medical bills of Florida Hospital and Dr. Robert Boswell, even though no timely medical reports were filed pursuant to Section 440.13(1), Florida Statutes....
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Wal-Mart Stores, Inc. v. Liggon, 668 So. 2d 259 (Fla. 1st DCA 1996).

Cited 10 times | Published | Florida 1st District Court of Appeal | 1996 Fla. App. LEXIS 1150, 1996 WL 63251

...E/C's request for a second IME. Specifically, the JCC improperly relied on Roberts v. Ben Hill Griffin, Inc., 629 So.2d 236 (Fla. 1st DCA 1993), for the proposition that the Legislature restricted the scope of an IME to the four situations listed in section 440.13(2)(b), Florida Statutes (1991)....
...ground and does not contain *264 any facts regarding the reasonableness of the request. Id.; see Reed v. Reed, 643 So.2d 1180, 1182 (Fla. 1st DCA 1994). Further, this court has previously determined that the right to an IME is not without limits and section 440.13(2)(b) "seems to impose a `reasonableness' requirement subject to the scrutiny of the JCC." Farm Stores, Inc....
...ons for accepting opinion of IME physician over that of claimant's treating physician), review denied, 598 So.2d 79 (Fla. 1992). The JCC improperly denied the E/C's request for a second IME based on his erroneous construction of the Roberts case and section 440.13(2)(b)....
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Budget Luxury Inns, Inc. v. Boston, 407 So. 2d 997 (Fla. 1st DCA 1981).

Cited 10 times | Published | Florida 1st District Court of Appeal

...limitation period in Section 440.28. See also Dean v. McLeod, 270 So.2d 726 (Fla. 1972). Mansell recognizes that only a claimant's last receipt of medical benefits within two years before the filing of a claim tolls the limitation period provided in Section 440.13(3)(b), stating that a claim may be filed within two years after the last remedial attention furnished by the e/c. Here, the claimant's petition to modify, as it relates to a requested change in compensation benefits, was governed by the provisions of Section 440.28 — not by Section 440.13(3)(b), Florida Statutes (1975)....
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Haverty Furniture Co. v. McKesson & Robbins, Inc., 19 So. 2d 59 (Fla. 1944).

Cited 10 times | Published | Supreme Court of Florida | 154 Fla. 772, 1944 Fla. LEXIS 815

...m any amount recovered by or *776 paid to the employer, by compromise or otherwise, on the strength of such assignment, the employer may deduct or retain the expense of the proceedings, the cost of all benefits furnished by him to the employee under Section 440.13, F.S....
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Hunter v. Allstate Ins. Co., 498 So. 2d 514 (Fla. 5th DCA 1986).

Cited 9 times | Published | Florida 5th District Court of Appeal | 11 Fla. L. Weekly 2376, 1986 Fla. App. LEXIS 10560

...his religious beliefs. (Emphasis added.) No Florida appellate court has ruled on the issue of whether the term "reasonable expenses for necessary medical services" includes the cost of transportation to obtain those services. Both parties urge that section 440.13(5), Florida Statutes (1985), [1] dealing with workers compensation law, applies to the instant case....
...Therefore, the question certified by the county court is answered in the affirmative, the judgment entered below reversed, and the cause remanded for entry of judgment for appellant Hunter. REVERSED and REMANDED. UPCHURCH, C.J., and LEE, R.E., Associate Judge, concur. NOTES [1] Section 440.13(5), Florida Statutes (1985), provides: (5) An injured employee is entitled, as a part of his remedial treatment, care, and attendance, to reasonable actual cost of transportation to and from the doctor's office, hospital, or other plac...
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Sealey Mattress Co. v. Gause, 466 So. 2d 399 (Fla. 1st DCA 1985).

Cited 9 times | Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 801

...ry functions. Mrs. Gause performed all these services. Further, the number of hours she expended in providing attendance was conservatively estimated by the deputy, thereby eliminating the normal time spent by a spouse rendering gratuitous services. Section 440.13(2)(b), Florida Statutes (1983), provides that an employee shall not be entitled to recover any amount personally expended for remedial treatment, care or attendance unless the employee requested the employer to provide such treatment o...
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Paulk v. Sch. Bd. of Palm Beach Cnty., 615 So. 2d 260 (Fla. 1st DCA 1993).

Cited 9 times | Published | Florida 1st District Court of Appeal | 1993 WL 64493

...March 10, 1993. *261 Jason J. Goldstone of Goodmark & Goodmark, P.A., West Palm Beach, for appellant. Richard H. Gaunt, Jr. of Gaunt, Pratt & Radford, P.A., West Palm Beach, for appellees. ALLEN, Judge. The claimant appeals a workers' compensation order by which section 440.13(2)(k), Florida Statutes (Supp....
...a substantive right and may apply to services rendered after the effective date of the statutory limitation. See Mr. C's TV Rental v. Murray, 559 So.2d 452 (Fla. 1st DCA 1990); accord, Williams v. Amax Chem. Corp., 543 So.2d 277 (Fla. 1st DCA 1989). Section 440.13(2)(k), Florida Statutes (Supp....
...s entitlement to such testimony. By limiting the amount which the health care provider may charge, the statute imposes no greater burden of payment than that which previously pertained. The claimant's substantive rights were thus not diminished, and section 440.13(2)(k), Florida Statutes (Supp....
...1986), which involved a different attorney's fee provision outside the ambit of the Workers' Compensation Law. The enactment addressed in L. Ross had a potential impact on the affected parties' concomitant burden which differed significantly from the impact of section 440.13(2)(k), Florida Statutes (Supp....
...Ross in the context of a workers' compensation attorney's fee, we find no basis to extend those decisions to the context of the present case, insofar as the claimant's burden and entitlement with regard to the witness' services remained unaffected by section 440.13(2)(k), Florida Statutes (Supp. 1990). We also find no impermissible conflict between section 440.13(2)(k), Florida Statutes (Supp. 1990), and section 440.30, Florida Statutes, or section 440.31, Florida Statutes. While the latter enactments contain general provisions relating to the use of depositions and certain witness fees, section *262 440.13(2)(k), Florida Statutes (Supp. 1990), is a more specific enactment relating to the narrower circumstances which the statute identifies. Section 440.13(2)(k), Florida Statutes (Supp....
...1990), was therefore properly applied upon the occurrence of these circumstances, without regard to the more general provisions in section 440.30 and section 440.31. See generally, DeConingh v. City of Daytona Beach, 103 So.2d 233 (Fla. 1st DCA 1958). We further find that section 440.13(2)(k), Florida Statutes (Supp....
...nt that such rules conflict with the provisions of this chapter." The due process and access to the courts issues which the claimant raises are likewise without merit, and we reject these constitutional challenges without further discussion. Because section 440.13(2)(k), Florida Statutes (Supp....
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Florida Distillers v. Rudd, 751 So. 2d 754 (Fla. 1st DCA 2000).

Cited 9 times | Published | Florida 1st District Court of Appeal | 2000 WL 228617

...Florida Statutes. Application of Managed Care System The employer/carrier argue that Rudd's petition for worker's compensation benefits was required to be dismissed because the employer/carrier had entered into a managed care arrangement pursuant to section 440.134, Florida Statutes (1994), and Rudd failed to file a grievance under the managed care system. See § 440.134(15), Fla....
...tition for benefits, as sought by the employer/carrier, would not be appropriate. The existence of a managed care arrangement would be relevant to the claim for medical treatment, but would not be dispositive of the claim for indemnity benefits. See § 440.134(16), Fla. Stat. (Supp.1994)(when a carrier enters into a managed care system, employees covered by such an arrangement are deemed to have received all benefits to which they are entitled pursuant to section 440.13(2)(a) and (b), which pertains to medical treatment and authorized providers), see also Wiggins v....
...The employer/carrier authorized an independent medical evaluation (IME) by an neurologist, William Malzone, M.D., which was conducted on November 21, 1995, but treatment by a neurologist was never authorized. Rudd is entitled, therefore, to seek treatment and recover the costs of that treatment, section 440.13(2)(c), and the JCC was not obliged to exclude the records and opinions of Dr....
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Alford v. G. Pierce Woods Mem'l Hosp., 621 So. 2d 1380 (Fla. 1st DCA 1993).

Cited 9 times | Published | Florida 1st District Court of Appeal | 1993 WL 247134

...Kessler, an orthopedic surgeon, was not qualified to render opinions on the subject of the appropriateness of chiropractic treatment; therefore, Dr. Kirschner's testimony that chiropractic treatment was appropriate was uncontroverted. We are unable to accept claimant's argument. Section 440.13(2)(a), Florida Statutes (1991), requires the employer to "furnish to the employee such medically necessary remedial treatment, care, and attendance by a health care provider and for such period as the nature of the injury or the process of recovery may require ..." (emphasis added). Section 440.13(1)(d), Florida Statutes (1991), defines "medically necessary," in relevant part, as follows: "Medically necessary" means any service or supply used to identify or treat an illness or injury which is appropriate to the patient's diagnosis, consistent with the location of service and with the level of care provided....
...I would reverse the order denying appellant's claim seeking authorization of chiropractic treatment for the reason that the only evidence supporting the denial was the opinion testimony of Dr. Kessler, an orthopedic physician, which, in my judgment, is incompetent because of the unique provisions of Section 440.13, Florida Statutes (1987)....
...rted by competent, substantial evidence. The threshold question requiring *1384 decision, however, is whether Dr. Kessler, a physician not licensed within the practicing peer group whose care claimant requested, was qualified under the provisions of section 440.13 to express the opinion that chiropractic treatment was not reasonable and necessary. In our interpretations of section 440.13(3) pertaining to a claimant's specific request for chiropractic care, we have held that an employer's provision of an orthopedist did not satisfy the employer's statutory obligation, and that the employer was therefore required to pay...
...In no previous opinion, however, have we expressly decided whether a physician, not licensed within the same school of practice as that requested by an employee, is qualified to express an opinion as to the reasonableness and necessity of the practitioners' care, pursuant to the provisions of section 440.13, notwithstanding that the witness may satisfy the qualifications of an expert, as provided in Section 90.702, Florida Statutes, by reason of his knowledge and education. I am of the view that Dr. Kessler is not qualified by virtue of section 440.13 to give any such opinion, and it is therefore immaterial, for the reasons stated infra, that he may otherwise be qualified as an expert under section 90.702. In reaching this conclusion, I refer to section 440.13(1)(c), which defines "medically necessary" as any service or supply used to identify or treat an illness or injury which is appropriate to the patient's diagnosis, consistent with the location of service and with the level of care provided....
...mplation that physicians of one school of practice would be considered qualified to give opinions regarding the appropriateness of requested treatment by physicians of another licensed school or community of practice. Although peer is not defined in section 440.13, the dictionary defines it as "a person or thing of the same rank, value, quality, ability, etc." Webster's New World Dictionary 1048 (2d college ed. 1980). When comparing the statutory term, "practicing peer group," with the term "peer review committee," used in other portions of section 440.13, I think it reasonably clear, given the definition of peer, that the former term means simply the same licensed school of practice. In so saying, I note that section 440.13(1)(e) defines "peer review committee" to mean "a committee composed of physicians licensed under the same authority as the physician who rendered the services being reviewed." (Emphasis added.) While the term "peer review committee" is not used in regard to that portion of section 440.13(3) relating to a requested change in the health care provided an employee, but rather is specifically applied to review of overutilization of services rendered by health care providers, I consider that the manner in which the term is o...
...Akins, 547 So.2d 1001, 1002 (Fla. 1st DCA 1989) (to determine whether chiropractic physician over utilized services he rendered to the injured employee, the physician's records were submitted to the Chiropractic Peer Review Committee). My interpretation of section 440.13 is consistent with the general rule recognizing that physicians of one school are incompetent to testify in malpractice actions against physicians of other schools regarding whether such physicians' treatment conformed with the requisi...
...1st DCA 1983), as stating that the Evidence Code applies to the Workers' Compensation Law. Those cases hold only that the portion of the Evidence Code which precludes the admission of hearsay evidence applies to workers' compensation proceedings. Neither opinion supports the majority's conclusion that section 440.13 permits a physician outside the practicing peer group of another physician to testify that the requested treatment of a member of the different group is not reasonable or necessary. And I find nothing in section 440.13 evincing any legislative intent to incorporate the provisions of section 90.702 therein....
...Indeed, Section 90.103(1), Florida Statutes (1987), states that the Evidence Code applies to the same proceedings to which the general law of evidence applied before the effective date of the code, "[u]nless otherwise provided by statute." (Emphasis added.) It is axiomatic that a more specific statute (here section 440.13) dealing with a particular subject is controlling over a statute that covers the same subject more generally....
...not abuse his discretion in deciding that Dr. Kessler, an orthopedic surgeon, possesses the necessary knowledge, education, etc., to opine that chiropractic care was not reasonable and necessary. Because, however, the provisions of the more specific section 440.13 restrict such testimony to the same practicing peer group or discipline as that from which the treatment is sought, the opinion testimony of a physician from a different practicing peer group must be considered incompetent as to the reasonableness and necessity of such solicited care....
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City of Fort Lauderdale v. Flanders, 416 So. 2d 1234 (Fla. 1st DCA 1982).

Cited 9 times | Published | Florida 1st District Court of Appeal | 1982 Fla. App. LEXIS 20576

...After the hearing, the deputy commissioner accepted Dr. Centrone's opinion that the *1235 surgery was reasonable and necessary and thereupon found that appellant, having failed to provide necessary treatment despite numerous requests by appellee, is responsible for the medical bills incurred. Section 440.13(2), Florida Statutes, provides: If an injured employee objects to the medical attendance furnished by the employer, it shall be the duty of the employer to select another physician to treat the injured employee [as was done in this cas...
...s not for the best interests of the injured employee; however, a deputy commissioner may at any time, for good cause shown, in the deputy commissioner's discretion, order a change in such remedial attention, care, or attendance. (Emphasis supplied.) Section 440.13(1) provides: If the employer fails to provide [medical treatment] after request by the injured employee, such injured employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by a deputy commissioner....
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Watkins Engineers & Constructors v. Wise, 698 So. 2d 294 (Fla. 1st DCA 1997).

Cited 9 times | Published | Florida 1st District Court of Appeal | 1997 WL 394896

...on of a pre-existing condition, no apportionment may be made"). The JCC also properly denied the E/C's motion for an IME by Dr. Witorsch, because Dr. McGregor had already performed an IME of Wise for the E/C. At issue is the proper interpretation of section 440.13(5)(b)(1), Florida Statutes (Supp.1994), which provides: (b) Each party is bound by his selection of an independent medical examiner and is entitled to an alternate examiner only if: 1....
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Lake Cnty. Com'rs v. Walburn, 409 So. 2d 153 (Fla. 1st DCA 1982).

Cited 9 times | Published | Florida 1st District Court of Appeal

...provide the claimant with further medical treatment by a different physician. I am aware of no law holding that a deputy commissioner must appoint a physician recommended by the employer/carrier over one sought by the claimant. As a matter of fact, Section 440.13(2), Florida Statutes (1979), authorizes a deputy commissioner at any time, for good cause shown in the deputy's discretion, to order a change in remedial attention, care, or attendance....
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Usher v. Cothron, 445 So. 2d 387 (Fla. 1st DCA 1984).

Cited 9 times | Published | Florida 1st District Court of Appeal

...Except in an emergency, a claimant who has been offered alternative medical care is not entitled to unilaterally obtain treatment from an unauthorized physician of his choice and then obtain reimbursement from the E/C. City of Fort Lauderdale v. Flanders, 416 So.2d 1234 (Fla. 1st DCA 1982); § 440.13, Fla....
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Inservices, Inc. v. Aguilera, 837 So. 2d 464 (Fla. 3d DCA 2002).

Cited 9 times | Published | Florida 3rd District Court of Appeal | 2002 WL 31870185

...Further, section 440.192, Florida Statutes (2000), provides a procedure for resolving any benefit disputes between a carrier and a claimant and sets strict deadlines for dispute resolution. A carrier is entitled to request an independent medical examination concerning compensibility or medical benefits. See § 440.13, Fla....
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Diamond R. Fertilizer v. Davis, 567 So. 2d 451 (Fla. 1st DCA 1990).

Cited 9 times | Published | Florida 1st District Court of Appeal | 1990 WL 126325

...ting physician or primary care physician. The award of benefits in Ms. Bell's life care plan are also unsupported. By adopting Ms. Bell's plan as a whole, the judge abdicated his responsibility for determining which benefits are medically necessary. Section 440.13(2), Florida Statutes, provides that an E/C must provide "medically necessary" benefits....
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Sam's Club v. Bair, 678 So. 2d 902 (Fla. 1st DCA 1996).

Cited 9 times | Published | Florida 1st District Court of Appeal | 1996 WL 476878

...In this appeal and cross-appeal of an order of the judge of compensation claims (JCC) awarding temporary total disability benefits to claimant, Annette Bair, we affirm, in the main appeal, those portions of the order finding Bair's back injury compensable and awarding costs of transportation for medical treatment under section 440.13(2)(a), Florida Statutes (Supp.1994)....
...bstantial evidence supporting the JCC's finding that claimant's compensable accident was the major contributing cause of her need for treatment for her back injury. We affirm as well the award of medical mileage. In 1964, the supreme court held that section 440.13, Florida Statutes, which requires the employer to furnish the claimant with "remedial treatment, care, and attendance" for as long as the injury requires, included costs of transportation for medical treatment....
...s provided by the Act are an incident of medical care and treatment. Therefore, the employer-carrier must either furnish such transportation or pay claimant the reasonable actual cost thereof. Id. at 47. In 1977, the legislature added a provision to section 440.13 expressly authorizing such medical mileage. Ch. 77-290, § 3, at 1287, Laws of Fla. When the legislature amended section 440.13 in 1993, it deleted this provision. [1] Ch. 93-415, § 17, at 98-111, Laws of Fla. We conclude that this omission did not abrogate the judicial construction in Mobley and its progeny that section 440.13(2)(a) implicitly authorizes such costs....
...construction of this language in Mobley to permit reimbursement of medical transportation. In the case at bar, there is no actual conflict between the amendment omitting the express authorization of transportation costs, and the retained language of section 440.13(2)(a) requiring remedial treatment, care, and attendance, and therefore the legislative acts can be harmonized....
...part of a claimant's remedial treatment, care, and attendance, as held in Mobley, else it would have stated the contrary. It was reasonable for the JCC to conclude that mere omission of subsection (6) did not abrogate prior judicial construction of section 440.13(2)(a)....
...AFFIRMED IN PART, REVERSED IN PART, and REMANDED with directions to the JCC to determine whether the treatment Dr. Dumbadse provided after the E/C refused to authorize treatment for back pain was reasonable and necessary. KAHN and DAVIS, JJ., concur. NOTES [1] The provision was first codified at section 440.13(4). When omitted in 1993, it was codified at section 440.13(6).
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Amos v. Gartner, Inc., 17 So. 3d 829 (Fla. 1st DCA 2009).

Cited 9 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 12742, 2009 WL 2602304

...e date of MMI and the degree of the permanent work restrictions. The JCC concluded that, because the EMA failed to render definitive opinions on these two issues, none of the EMA's opinions were afforded the presumption of correctness as provided in section 440.13(9)(c), Florida Statutes (2004)....
...In making his findings, and analyzing the evidence, the JCC relied on statements contained in the unauthenticated FCE report. This appeal followed. Rejection of the EMA's Opinions If there is a disagreement in the opinions of health care providers, the legislature has mandated that the JCC shall appoint an EMA. See § 440.13(9)(c), Fla....
...Further, the report or testimony of the EMA shall be admitted into evidence, see section 440.25(4)(e), Florida *832 Statutes (2004), and the opinion of the EMA is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the JCC. See § 440.13(9)(c), Fla....
...f an EMA's unequivocal opinions relative to issues upon which the EMA's assistance was sought, without the JCC first making a finding as to the existence of clear and convincing evidence which contradicts the presumed correctness of the opinion. See § 440.13(9)(c), Fla....
...materially inconsistent in rendering his opinions. The JCC found the evidence opposing the EMA's opinion unclear, equivocal, and unreliable. Nevertheless, the JCC, instead of following the procedure for resolution of medical disputes as required by section 440.13(9)(a)-(f), disregarded the EMA's opinion (and the presumptive correctness attached thereto) based on an unwarranted expansion of this court's holding in Fitzgerald....
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Fuchs Baking Co. v. Est. of Szlosek, 466 So. 2d 415 (Fla. 1st DCA 1985).

Cited 9 times | Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 836

...We also find no error in the commissioner's finding that claimant's treatment by Drs. Stillman and Berntson was reasonable and necessary. However, we find an absence of a finding of "good cause" to excuse the failure to file timely medical reports as required by Section 440.13(2), Florida Statutes (1983)....
...commissioner's finding of orthopedic TTD. Appellants next assert that the commissioner erred in ordering the E/C to pay the medical bills of Drs. Stillman and Berntson. The E/C deny that psychiatric services were not provided by them, and claim that Section 440.13(2)(b), Florida Statutes (1983) and City of Ft....
...1st DCA 1982) dictate that claimant should have sought authorization of Dr. Stillman prior to beginning treatment by him. Further, the E/C argue that claimant's failure to submit timely medical reports from Drs. Stillman and Berntson renders the claim for medical care invalid. We disagree with appellants' argument. Section 440.13(2)(b) provides in pertinent part: (b) If the employer fails to provide such treatment, care, and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by a deputy commissioner....
...This court has made it clear that a claimant may seek unauthorized medical treatment where authorization has been requested and refused by the E/C. Cedars of Lebanon Health Care Center, Inc. v. Summerset, 409 So.2d 185 (Fla. 1st DCA 1982); Mayberry v. Sunland Training Center, 404 So.2d 810 (Fla. 1st DCA 1981). Section 440.13(2)(b) further provides: Nor shall any claim for medical, surgical, or other remedial treatment be valid and enforceable unless, within 10 days following the first treatment ......
...d prescribed... . Although we find that claimant was justified in seeking treatment from Drs. Stillman and Berntson, we also note the absence of any consideration of "good cause" to excuse the failure to furnish timely medical reports as required by section 440.13(2)(b)....
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Dawson v. Clerk of Circuit Ct.-hillsborough Cty., 991 So. 2d 407 (Fla. 1st DCA 2008).

Cited 8 times | Published | Florida 1st District Court of Appeal | 2008 WL 4298565

...In this workers' compensation appeal, Appellant (Claimant) challenges the Judge *409 of Compensation Claims' (JCC) denial of her request for a one-time change of physician, the appointment of an expert medical advisor, and the constitutionality of section 440.13(2)(f), Florida Statutes (2003)....
...Appellee/Employer-Carrier (E/C) denied this request. The JCC found that because Claimant presented no evidence to rebut Dr. Raterman's opinion as to the major contributing cause of her need for treatment, she was not entitled to the one-time change of physician provided in section 440.13(2)(f), Florida Statutes....
...r the sole purpose of establishing a causal connection between a compensable injury and the continued need for treatment. The JCC concluded that, in such circumstances, the proper procedure is to obtain an independent medical examination pursuant to section 440.13(5), Florida Statutes. We find that the JCC misapprehended the provisions of section 440.13(2)(f). Section 440.13(2)(f), Florida Statutes (2003), provides in relevant part: Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident.......
...s compensable and medically necessary. (Emphasis added). In construing a statute, courts must look to its plain language. See Fla. Dep't of Educ. v. Cooper, 858 So.2d 394, 395 (Fla. 1st DCA 2003). The use of the word "shall" in the quoted portion of section 440.13(2)(f) means that this one-time change is mandatory, regardless of the e/c's position as to either the change of physician or the new physician's treatment....
...If the e/c are of the opinion that the treatment recommended or provided is unnecessary or unrelated to the industrial accident, they can risk denying authorization for the treatment, pending resolution of the issue by the JCC. In interpreting a prior, but similar, version of section 440.13(2)(f), this court stated that after an employer has authorized a medical provider to evaluate and treat a claimant, "the employee may request a one-time change of physician. In that case, the employer must offer the employee a choice of at least three alternative physicians." See St. Augustine Marine *410 Canvas & Upholstery, Inc. v. Lunsford, 917 So.2d 280, 283 (Fla. 1st DCA 2005) (emphasis added). While section 440.13(2)(f) no longer requires the employer to offer a list of three alternative physicians, it does require the employer to offer an alternative physician upon the claimant's request....
...ulder. The JCC appointed an expert medical advisor, who eventually opined there was no causal connection between Claimant's shoulder condition and her compensable injury. Consequently, the JCC denied Claimant's request for treatment of her shoulder. Section 440.13(9)(c), Florida Statutes (2004), provides, in relevant part: If there is disagreement in the opinions of the health care providers, if two health care providers disagree on medical evidence supporting the employee's complaints or the need for additional medical treatment, or if two health care providers disagree that the employee is able to return to work, ... the [JCC] shall ... order the injured employee to be evaluated by an expert medical advisor. Section 440.13(5)(e), Florida Statutes (2004), provides that "[n]o medical opinion other than the opinion of a medical advisor appointed by the [JCC] ......
...tion claims." The JCC found Dr. Greene's testimony regarding the causal relationship *411 between Claimant's industrial accident and her shoulder condition was admissible because Dr. Greene was her authorized treating physician. We agree. Nothing in section 440.13(9)(c) requires that for an opinion to be admissible, the doctor giving the opinion must be authorized to evaluate or treat a specific condition or body part; it only requires that the doctor be authorized to treat the claimant....
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Providence Prop. & Cas. v. Wilson, 990 So. 2d 1224 (Fla. 1st DCA 2008).

Cited 8 times | Published | Florida 1st District Court of Appeal | 2008 WL 4298546

...Rogner of Hurley, Rogner, Miller, Cox & Waranch, P.A., Winter Park, for Appellants. Basil A. Valdivia, Orlando, and Bill McCabe, Longwood, for Appellee. PER CURIAM. In this workers' compensation appeal, we address the issue of a claimant's entitlement to a one-time change in physician, which pursuant to section 440.13(2)(f), Florida Statutes (2005), must be sought during the course of treatment....
...to obtain additional treatment at the clinic approximately one year later, he was told that his case had been closed, and he was no longer entitled to care under workers' compensation. Claimant then sought a one-time change in physician pursuant to section 440.13(2)(f), Florida Statutes....
...Grant's office note, the compensable accident was no longer the major contributing cause (MCC) of Claimant's need for treatment of his back; and 2) Claimant was no longer in the "course of treatment" at the time he made his request, and thus failed to satisfy this statutory requirement. Ultimately, the JCC interpreted section 440.13(2)(f), Florida Statutes, as permitting a claimant an absolute right to a one-time change in treating physician, if the claimant's written request was made during the course of treatment. We agree. Analysis Section 440.13(2)(f), in relevant part, provides: Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident.......
...s compensable and medically necessary. (Emphasis added). In construing a statute, courts must look to its plain language. See Fla. Dep't of Educ. v. Cooper, 858 So.2d 394, 395 (Fla. 1st DCA 2003). The use of the word "shall" in the quoted portion of section 440.13(2)(f) means that this one-time change is mandatory, regardless of whether the initial authorized doctor opines that a compensable accident is no longer the MCC of a claimant's need for treatment....
...at the treatment recommended or provided is unnecessary, or is unrelated to the industrial accident, the E/C can deny authorization for such treatment pending resolution of the issue by the JCC. *1226 In interpreting a prior, but similar, version of section 440.13(2)(f), this court stated that, after an employer has authorized a medical provider to evaluate and treat a claimant, "the employee may request a one-time change of physician....
...ation, and rendered a diagnosis. This was sufficient to constitute "treatment," and because the neurosurgeon evaluated the claimant "during the course of treatment," the claimant was entitled, "as a matter of law," to the one-time change provided by section 440.13(2)(f)....
...Similarly, in the instant case, Claimant began treatment with an authorized physician, and that physician evaluated Claimant and rendered a diagnosis during the course of that treatment. Consequently, as a matter of law, Claimant was entitled to a one-time change in physician *1227 pursuant to section 440.13(2)(f)....
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Fid. Const. Co. v. Arthur J. Collins & Son, Inc., 130 So. 2d 612 (Fla. 1961).

Cited 8 times | Published | Supreme Court of Florida

...Both decisions involve a dispute as to liability for workmen's compensation under Section 440.10(1), Florida Statutes, F.S.A., reading as follows: "Every employer coming within the provisions of this chapter * * * shall be liable for and shall secure the payment to his employees of the compensation payable under § 440.13 * * *....
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Delong v. 3015 West Corp., 558 So. 2d 108 (Fla. 1st DCA 1990).

Cited 8 times | Published | Florida 1st District Court of Appeal | 1990 WL 19950

...s a medical benefit in the circumstances of this case. However, I do not agree with the apparent recited standard that such benefit may not be awarded where it "would not improve claimant's condition or aid his recovery," by treatment of his injury. Section 440.13(2)(a), Florida Statutes, authorizes the award of such medically necessary services "as the nature of the injury or the process of recovery may require......
...recovery, or meet the medical need standards for treatment. But because the record in the present case establishes none of these criteria with regard to the requested law care service, the claim for this benefit was properly denied. NOTES [1] See §§ 440.13(1)(c), 440.13(2)(a), Fla....
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City of Bartow v. Brewer, 896 So. 2d 931 (Fla. 1st DCA 2005).

Cited 8 times | Published | Florida 1st District Court of Appeal | 2005 WL 491299

...sicians. Despite the E/C's responses to her requests, Ms. Brewer contended in the pre-trial stipulation that she was entitled to treat with the orthopedist of her choice, Dr. Simon, who did not appear on the lists the E/C provided to Ms. Brewer. [3] Section 440.13(2)(c), Florida Statutes, does not authorize the JCC to order treatment with a specific physician, where the E/C promptly offers qualified alternatives. See § 440.13(2)(c), Fla....
...within the 120-day period. § 440.20(4), Fla. Stat. (2000). [3] Ms. Brewer's knee injury occurred on May 13, 1998, and her requests for a change of physician were made between July 2002 and February 2003. At the time Ms. Brewer's requests were made section 440.13(2)(f), Florida Statutes (2002), provided that "the carrier shall give the employee the opportunity for one change of physician ... for any one accident. The employee shall be entitled to select ... from ... not fewer than three carrier-authorized physicians...." See ch.2001-91, § 12, at 773, Laws of Fla. (creating right to one-time change of physician by adopting section 440.13(2)(f), Florida Statutes). No statute granting a right to a one-time change of physician existed at the time Ms. Brewer injured her knee at work. Although section 440.13(2)(f) became effective prior to her change-of-physician requests, even under the 2002 statute, the E/C's responses to Ms....
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Doctors Hosp., Lake Worth v. Robinson, 411 So. 2d 958 (Fla. 1st DCA 1982).

Cited 8 times | Published | Florida 1st District Court of Appeal

...Robinson, West Palm Beach, for appellants. J.J. Goodmark of Goodmark & Goodmark, West Palm Beach, for appellee. McCORD, Judge. This is an appeal from a workers' compensation order awarding to claimant Faye Robinson reimbursement for child care expenses. § 440.13, Fla....
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Malu v. Sec. Nat. Ins. Co., 898 So. 2d 69 (Fla. 2005).

Cited 8 times | Published | Supreme Court of Florida | 2005 WL 549933

...atutory language. As examples, the Malu panel cited to the statutory scheme that provided benefits for birth-related neurological injuries, section 766.31(1)(a), Florida Statutes (2002), and a workers' compensation statute that was repealed in 1993, section 440.13(6), Florida Statutes (1993)....
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Union Camp Corp. v. Hurst, 696 So. 2d 873 (Fla. 1st DCA 1997).

Cited 8 times | Published | Florida 1st District Court of Appeal | 1997 WL 287557

...claimant's treating physicians, Dr. Barclay and Dr. Gonzalez. The JCC reasoned that because e/c knew of claimant's need for medical care and treatment and failed to provide the care, the JCC was entitled to admit the medical opinion testimony under section 440.13(5)(e), Florida Statutes (Supp.1994)....
...le medical opinions. The medical opinions admissible in a proceeding before a JCC are limited to the opinions of (1) a medical advisor appointed by the JCC or division; (2) an independent medical examiner; or (3) an authorized treating provider. See § 440.13(5)(e). In the present case, Drs. Gonzalez and Barclay did not fall into any of those categories. The claimant was under an affirmative obligation to request an IME under section 440.13(5)(a), Florida Statutes (Supp.1994), by the physician of his choice, if he objected to the e/c's decision to controvert his request for benefits based upon the opinions rendered in the independent medical evaluations obtained by e/c....
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Deinema v. Pierpoint Condos., 415 So. 2d 811 (Fla. 1st DCA 1982).

Cited 8 times | Published | Florida 1st District Court of Appeal

...In response to this request, the e/c reauthorized Dr. Fraraccio. The claimant, ignoring the e/c's action, went to Dr. DiBartolo. The e/c's reauthorization of Dr. Fraraccio was not, under the circumstances, in compliance with the express provisions of Section 440.13(2), Florida Statutes (1979), requiring the e/c "to select another physician to treat the injured employee" if the claimant objects to the medical treatment provided....
...ideration by the deputy commissioner as is accorded other medical evidence submitted in the proceeding; and all costs incurred in connection with such examination and testimony may be assessed as costs in the proceeding, subject to the provisions of s. 440.13(3)(a).
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Ryder Truck Rental, Inc. v. Perez, 715 So. 2d 289 (Fla. 3d DCA 1998).

Cited 8 times | Published | Florida 3rd District Court of Appeal | 1998 Fla. App. LEXIS 6584, 1998 WL 299388

...I am aware that the law, unfortunately, does not recognize such an unqualified privilege. See Coralluzzo v. Fass, 435 So.2d 262, 263 (Fla. 3d DCA 1983) (Jorgenson, J., dissenting), approved, 450 So.2d 858 (Fla. 1984), superseded in part by statute, section 440.13(2), Florida Statutes (1988); see also Acosta v....
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Torres v. Eden Roc Hotel, 238 So. 2d 639 (Fla. 1970).

Cited 8 times | Published | Supreme Court of Florida

...enefits. The attorneys' fee established by the Judge of Industrial Claims is inadequate, and should be increased upon remand. It is contended that the Industrial Claims Judge erred in failing to grant payment of medical bills of claimant. Fla. Stat. § 440.13(1), F.S.A., provides that an injured claimant may under certain circumstances, in essence not prejudicial to the employer, seek his own medical assistance....
...failure of the physician or other recognized practitioner to furnish any report within the period prescribed and may order the payment to him of such remuneration for treatment or service rendered as the *643 commission finds equitable." Fla. Stat. § 440.13(1), F.S.A....
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City of Orlando v. Blackburn, 519 So. 2d 1017 (Fla. 1st DCA 1987).

Cited 8 times | Published | Florida 1st District Court of Appeal | 1987 WL 2631

...clusion of treatment which is not curative but which nevertheless mitigates the conditions or effects of the injury. Such a construction would be contrary to the interpretation given to the phrase "remedial treatment, care and attendance" as used in section 440.13, Florida Statutes (1981), and also would be contrary to the intent of chapter 440, which is to provide an injured worker with appropriate benefits which undisputedly are necessary....
...ry to treat a compensable injury or to mitigate its effects or conditions. For example, in Professional Administrators v. Macias, 448 So.2d 1159 (Fla. 1st DCA 1984), the court construed the phrase "remedial treatment, care and attendance" as used in section 440.13(1) in a general, as opposed to an exclusive, sense to include not only strictly curative care, but also palliative treatment which merely mitigates the conditions or effects of the injury....
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Fuster v. E. Airlines, Inc., 545 So. 2d 268 (Fla. 1st DCA 1988).

Cited 8 times | Published | Florida 1st District Court of Appeal | 1988 WL 131135

...Captain Stacey testified that claimant was his copilot and he saw claimant wearing the back brace, but that claimant appeared not to be disabled, and flew the plane well. Also, Dr. Millett, who was *274 the head physician at the Eastern Airline Medical Clinic, knew claimant was flying with a brace, for he prescribed it. Section 440.13(2)(a) Florida Statutes, provides that an employer shall furnish to the employee such medically necessary remedial treatment ......
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Di Giorgio Fruit Corp. v. Pittman, 49 So. 2d 600 (Fla. 1950).

Cited 8 times | Published | Supreme Court of Florida | 1950 Fla. LEXIS 1676

...receded sums expended by him in connection with his injury for medical assistance and medication from the 18th day of November, 1948, up until the day of this order." The Appellants correctly suggest that this proceeding involves the construction of Section 440.13, Florida Statutes 1941, as amended by Chapter 21824, Laws of Florida 1943, F.S.A., which took effect the day of the accident....
...ch-making business, so as to keep him off his feet as much as possible, which trade Claimant now follows, the Insurance Carrier ceased medical payments on Claimant's behalf and refused to be responsible for any further medical payments, relying upon Section 440.13, Florida Statutes 1941, as amended by Chapter 21824, Laws of Florida 1943, F.S.A., as authority for its position....
...On the other hand, counsel for appellees contend that there was no error in the findings or order made by the Deputy Commissioner and that the full Commission and the Circuit Judge were correct in entering their orders of affirmance. It is necessary for us to construe that portion of section 440.13, supra, which reads as follows: "(3) (a) All fees and other charges for such treatment or service shall be limited to such charges as prevail in the same community for similar treatment of injured persons of like standard of living, an...
...ounsel for appellant appears to us to be controlling; nor indeed are we persuaded by any or all of them to the view that the Carrier should not be responsible for further medical expenses in this case. It will be noted that paragraph (3) (a) of Sec. 440.13, supra, contains the following language: "provided, however, that if the nature of the injury or the process of recovery requires medical, surgical, hospital, and other attendance or remedial treatment, in addition to the One Thousand Dollars...
...equires that we construe the words "as may be necessary to effect a recovery" to mean a recovery from the attacks which are brought about as the result of thrombophlebitis. The obvious legislative intent in the enactment of paragraph (3) (a) of Sec. 440.13, supra, was that the Commission might require payment of medical expenses beyond an expenditure of $1,000.00 until such time as the Claimant recovers from the injury....
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Delong v. 3015 West Corp., 491 So. 2d 1306 (Fla. 1st DCA 1986).

Cited 8 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 1688

...We reverse, however, the deputy commissioner's denial of authorization for attendant care services. The general rule is that shopping, cooking, and other household services performed by a spouse or other family member are considered gratuitous and cannot form the basis for an award of attendant care services. Section 440.13(2)(d), Florida Statutes (1983); B.G....
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Parodi v. Florida Contracting Co., Inc., 16 So. 3d 958 (Fla. 1st DCA 2009).

Cited 8 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 12743, 2009 WL 2602295

...s to the medical opinions admissible in a proceeding before a JCC: No medical opinion other than the opinion of a medical advisor appointed by the [JCC], ... an [IME], or an authorized treating provider is admissible in proceedings before the [JCC]. § 440.13(5)(e), Fla....
...one of these categories. See, e.g., Seminole County Sch. Bd. v. Tweedie, 922 So.2d 1011 (Fla. 1st DCA 2006). We have also held, however, when the E/C wrongfully denies medical care and the claimant is required to utilize the self-help provisions of section 440.13(2)(c), the JCC is not obliged to exclude the opinions of the doctors from whom Claimant was forced to obtain medical treatment....
...1st DCA 2006). When an employer abandons its obligation to provide appropriate care, however, it likewise *962 surrenders to the injured employee the right to select a physician and obtain treatment, provided the care is "compensable and medically necessary." § 440.13(2)(c), Fla. Stat. (2003). Under the self-help provision of section 440.13(2)(c)—a provision of the statute that theoretically, the employee should never need to use—the JCC can award past medical treatment at the "expense of the employer" only where care has been wrongfully denied and the employer or carrier has been afforded a reasonable opportunity to provide such care. See id. To the narrow extent this section allows a JCC to order payment to a physician, it also empowers the JCC to "authorize" the doctors for the past care provided. Cf. § 440.13(3)(a), Fla....
...Employer/carrier here argues that authorization of a physician can emanate only from the unassailable discretion of an employer or carrier, without regard to any breach of the obligation to provide appropriate care at the appropriate time. Logically, though, this would mean physicians who provide care pursuant to section 440.13(2)(c) may never be paid for their services, because of the limitations contained in section 440.13(3)(a)....
...of Education, and the Division of Administrative Hearings shall administer the Workers' Compensation Law in a manner which facilitates the self-execution of the system and the process of ensuring a prompt and cost-effective delivery of payments."). Section 440.13(2)(c) operates in the limited circumstances where the employer or carrier wrongfully denies medical care, contrary to the duty to provide necessary treatment. An essential piece of the workers' compensation statute remains the availability of appropriate treatment on a timely basis, so as to avoid public responsibility for such. Accordingly, we hold that, where section 440.13(2)(c) applies, the JCC has the statutory authority to authorize a doctor for care provided during the period of wrongful denial, and the doctor's medical opinion is admissible pursuant to section 440.13(5)(e). The employee retains the burden, however, to establish that he made a specific request for the care, allowed the employer or carrier a reasonable time to respond, and obtained care that was compensable, reasonable, and medically necessary. See § 440.13(2)(c), Fla....
...withholds benefits. For instance, if an E/C suspends benefits based on grounds of fraud or MCC that are warranted and later proven to be correct, the care obtained by Claimant (even if medically necessary) would not be compensable or awardable. See § 440.13(1)(e), Fla. Stat. (2003) (defining "compensable"); see also Alvarez v. Unicco, 958 So.2d 951 (Fla. 1st DCA 2007). Here, because Dr. Benezette and Dr. Kirkpatrick were authorized by operation of section 440.13(2)(c), Florida Statutes (2003), for the care provided during the E/C's wrongful denial of benefits, the JCC should not have excluded their medical opinions pursuant to section 440.13(5)(e)....
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Lamounette v. Akins, 547 So. 2d 1001 (Fla. 1st DCA 1989).

Cited 8 times | Published | Florida 1st District Court of Appeal | 1989 WL 90493

...ately addressed on appeal from a final order. We must concur, however, with the petitioners' suggestion that the deputy commissioner lacks jurisdiction to issue an order to show cause and to hold a hearing on the alleged overutilization of services. Section 440.13(4)(d)4 (Supp....
...Petitioners argue, and we agree, that while deputy commissioners are within the Department of Labor and Employment Security, they are not employees *1003 of or otherwise a part of the Division of Workers' Compensation. See §§ 20.171(2)(d); 120.52(1)(c); 440.021; and 440.45(3). Fla. Stat. (1987). Thus, we read section 440.13(4)(d)4 as requiring agency action in accordance with the Florida Administrative Procedure Act, chapter 120, Florida Statutes, with the division serving as the agency and the division director serving as agency head, §§ 120.52(1)(b) and (3), Fla....
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Jack Eckerd Corp. v. Coker, 411 So. 2d 1026 (Fla. 1st DCA 1982).

Cited 8 times | Published | Florida 1st District Court of Appeal

...Later that night she was taken to the emergency room by ambulance and remained in the hospital for the next 18 days. Over the ensuing months, claimant was treated by several doctors. Neither the doctors nor the hospital ever filed medical reports as required by § 440.13, Florida Statutes (1979)....
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Avalon Ctr. v. Hardaway, 967 So. 2d 268 (Fla. 1st DCA 2007).

Cited 7 times | Published | Florida 1st District Court of Appeal | 2007 WL 2733823

...Allison Tomme, a senior claims representative for Unisource Administrators, testified by deposition that after several years of ongoing treatment, she submitted Dr. Neal's charges to the E/C's attorney, appellate counsel Mark S. Spangler, for a utilization review pursuant to section 440.13(6), Florida Statutes (2006). That statute requires that workers' compensation insurance carriers review all bills submitted for payment by authorized health care providers, in order to "identify overutilization and billing errors." See § 440.13(6), Fla....
..., this rule does not apply to procedural enactments." See City of Clermont v. Rumph, 450 So.2d 573, 575 (Fla. 1st DCA 1984). In Terners of Miami Corp. v. Freshwater, 599 So.2d 674 (Fla. 1st DCA 1992) (en banc), this court held that the provisions of section 440.13 which grant jurisdiction in a reimbursement dispute, then section 440.13(2)(i)(1), are procedural in nature. Indeed, the court noted, "[i]n our opinion, section 440.13(2)(i)(1) does nothing more than specify the forum in which claims such as that which is the subject of this appeal shall be heard....
...§ 440.192(2)(h), Fla. Stat. (2006). We agree with the E/C that section 440.192(2)(h) does not expressly grant the JCC jurisdiction, but rather provides only the basic procedural criteria required to present a facially sufficient petition for benefits. Moreover, section 440.13(11)(c), Florida Statutes (2006), specifically provides exclusive jurisdiction to AHCA: The [Agency for Healthcare Administration] has exclusive jurisdiction to decide matters concerning reimbursement, to resolve any overutilization dis...
...), which question or dispute arises after January 1, 1994. (emphasis added). Accordingly, pursuant to the plain language of the statute, the JCC is without jurisdiction to resolve those listed issues. In this case, the JCC limited the application of section 440.13(11)(c) by finding that the JCC retains jurisdiction over all claims for medical bills except those resulting from a utilization review, and further, that an insurance carrier may resist the jurisdiction of the JCC only if it can prove that it conducted a proper utilization review in accord with the controlling authority. However, the JCC's strict interpretation ignores the plain wording of the statute itself. As noted above, section 440.13(11)(c) provides that AHCA has exclusive jurisdiction over reimbursement disputes and utilization reviews. A "reimbursement dispute" is defined as "any disagreement between a health care provider or health care facility and carrier concerning payment for medical treatment." § 440.13(1)(r), Fla....
...jurisdiction of the Judges of Compensation Claims: [U]tilization review . . . pertains only in connection with care which has been authorized, as when the employer/carrier has paid or incurred an obligation to pay for the doctor's services. Because section 440.13(3), Florida Statutes (1993), insulates the claimant from liability in such circumstances, the health care provider (or facility) and the employer/carrier are the parties with the legal interest affected by utilization review....
...ion Act specifically and expressly insulates the claimant from financially liability in a reimbursement dispute between the E/C and health care provider, and thereby deprives the claimant of standing to pursue a reimbursement dispute before the JCC. Section 440.13(3)(g), Florida Statutes (2006), states that "[t]he employee is not liable for payment for medical treatment or services provided pursuant to this section except as otherwise provided in this section." Additionally, section 440.13(14)(a), Florida Statutes (2006), providing for payment of medical fees and bills, notes, A health care provider may not collect or receive a fee from an injured employee within this state, except as otherwise provided in this chapter....
...th care provider regarding reimbursement for claimant's authorized medical or psychological treatment. Cf. S. Bakeries v. Cooper, 659 So.2d 339 (Fla. 1st DCA 1995) (discussing the source of payment for an independent medical examination, and noting "section 440.13(3)(g), Florida Statutes (Supp.1994), indicates that in the absence of an express statutory provision the claimant is not obligated to pay for medical services under this section")....
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Walsdorf Sheet Metal Works v. Gonzalez, 719 So. 2d 355 (Fla. 1st DCA 1998).

Cited 7 times | Published | Florida 1st District Court of Appeal | 1998 WL 729653

...red by the claimant, Angel Gonzalez. We affirm all issues raised on appeal and write only to address the employer/carrier's contention that the JCC erred in failing to rule on their request for an appointment of an expert medical advisor pursuant to section 440.13(9)(c), Florida Statutes (1995)....
...Mozingo and Cuervo, among others, were introduced. At the conclusion of the hearing, and after final argument, counsel for the employer/carrier, stating that there appeared to be "conflicting medical evidence," moved for the appointment of an expert medical advisor pursuant to section 440.13(9)(c), Florida Statutes (1995). Section 440.13(9)(c) provides in pertinent part: If there is disagreement in the opinions of the health care providers, if two health care providers disagree on medical evidence supporting the employee's complaints or the need for additional medical...
...The opinion of the expert medical advisor is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the judge of compensation claims. *357 In Palm Springs General Hosp. v. Cabrera, 698 So.2d 1352, 1356 (Fla. 1st DCA 1997), this court explained that "[t]he requirements of section 440.13(9)(c), Florida Statutes (1995), are mandatory and binding on the judge of compensation claims." Nonetheless, the Cabrera court also recognized the importance of a timely request for the appointment of an emergency medical advisor, as f...
...JCC are required to address the appointment of an expert medical advisor at the pretrial conference. Construction of rule 4.045 in this manner facilitates the orderly and efficient administration of justice fairly to all parties. We do not construe section 440.13(9)(c) as allowing a party to disrupt the orderly and efficient trial of a worker's compensation case by waiting until the end of the final hearing to request an expert medical advisor, when the conflict in the medical opinions was known well in advance of the pretrial conference....
...incorrect legal theory. Holland v. Holland, 458 So.2d 81, 85 n. 3 (Fla. 5th DCA 1984). [3] The appellants do not argue, and we do not address, whether the JCC had a duty to appoint an expert medical advisor on his own motion in the instant case. See § 440.13(9)(c), Fla....
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Marlowe v. Dogs Only Grooming, 589 So. 2d 990 (Fla. 1st DCA 1991).

Cited 7 times | Published | Florida 1st District Court of Appeal | 1991 WL 239907

...1st DCA 1989) (Absent medical testimony that the claimant has or has not reached MMI, the judge is unable to address the issue of permanent disability.). III. We affirm on the final issue raised by claimant, i.e., whether the judge erred in denying her claim for attendant care benefits. Section 440.13(2)(a), Florida Statutes (1989), authorizes attendant care benefits in the following language: [T]he employer shall furnish to the employee such medically necessary remedial *994 treatment, care, and attendance by a health care provider... . This court has interpreted section 440.13(2)(a) as authorizing compensation for attendant care services provided by a family member where such services go beyond ordinary household duties....
...und. Claimant next argues that she is entitled to attendant care benefits because her family must provide her with transportation. The record supports claimant's assertion that she is now unable to drive. [2] We do not, however, read the language in section 440.13(2)(a) that attendant care services must be medically necessary to mean that attendant care benefits are authorized to a claimant for transportation services for various and sundry purposes. Supportive services such as driving the claimant to the store and other places, other than transportation necessary for medical treatment pursuant to section 440.13(6), [3] constitute quality of life activities indemnified under disability compensation benefits rather than attendant care service that is medically necessary....
...1st DCA 1986), supports her claim for attendant care because it states that "[w]hen transportation is provided to a claimant beyond what would normally be provided by a family member on a gratuitous basis, attendant care benefits should be awarded." That case holds only that section 440.13(6) entitles a claimant to reimbursement of the reasonable actual cost of transportation for authorized medical treatment. Mills does not construe and apply the attendant care provision, section 440.13(2), and the language in the opinion that transportation expenses incurred transporting a claimant to obtain medical treatment are recoverable as an attendant care service, while admittedly ambiguous, must necessarily be read in context and limited to the transportation costs authorized for medical treatment pursuant to section 440.13(6) actually involved in the case....
...t when to start out into traffic. She has trouble judging the intervals between cars and the rate of speed that they are going. [3] The judge specifically awarded claimant transportation expenses incidental to her remedial treatment as authorized by section 440.13(6).
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City of Leesburg v. Balliet, 413 So. 2d 860 (Fla. 1st DCA 1982).

Cited 7 times | Published | Florida 1st District Court of Appeal

...rs prior to the claim for such services. Appellants argue they had no notice of the need for attendant care services. Alternatively, they contend the services rendered were primarily housekeeping services which are not compensable. Florida Statutes, Section 440.13, provides that an employee shall not be entitled to recover any amount personally expended for remedial treatment, care, and attendance unless the employee shall have requested the employer to provide such treatment or service and the...
...As to the second point raised by appellants, it does appear that some of the services listed by the deputy commissioner as the basis for the award of attendant care services included housekeeping services provided claimant by his father. Housekeeping services are not compensable under Florida Statutes, Section 440.13....
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Geiger Distributors, Inc. v. Snow, 186 So. 2d 507 (Fla. 1966).

Cited 7 times | Published | Supreme Court of Florida

...Snow's present suffering was a result of a pre-existing fungus condition. The question presented by Respondent's cross petition for certiorari is whether or not payment for medical bills for the third resumption of treatment may be allowed when medical reports are not filed within ten days as required by § 440.13(1), Florida Statutes, F.S.A....
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S & a Plumbing v. Kimes, 756 So. 2d 1037 (Fla. 1st DCA 2000).

Cited 7 times | Published | Florida 1st District Court of Appeal | 2000 WL 331938

...Kimes cross-appeals, challenging (i) the denial of his request for surgery to his left ankle; and (ii) the admission into evidence of a letter summarizing the substance of a meeting between Kimes' treating physician and representatives of the employer/carrier's attorney held pursuant to section 440.13(4), Florida Statutes (Supp.1994), arguing that section 440.13(4)(c) is facially unconstitutional as violative of the privacy provisions of Article I, section 23 of the Florida Constitution....
...Thus, the cases cited by the employer/carrier, State, Div. Of Risk Management/Dep't of Highway Safety and Motor Vehicles v. Martin, 690 So.2d 651 (Fla. 1st DCA 1997), and Ullman v. City of Tampa Parks Dep't, 625 So.2d 868 (Fla. 1st DCA 1993), are distinguishable. Constitutionality of Section 440.13(4)(c) Kimes argues that, by authorizing ex parte communications between his treating physician, Dr. Bernstein, and representatives of the employer/carrier, section 440.13(4)(c), Florida Statutes (Supp. 1994), infringes upon the privacy rights of a petitioner for worker's compensation benefits. We find this argument to be without merit. Section 440.13(4)(c) provides: 440.13 Medical services and supplies; penalty for violations; limitations.......
...t to this subsection, shall be subject by the division to one or more of the penalties set forth in paragraph (8)(b). In Pierre v. Handi Van, Inc., 717 So.2d 1115, 1117 (Fla. 1st DCA 1998), this court explained that, in enacting subsection (4)(c) to section 440.13, the legislature intended that the records and opinions of treating and examining *1041 physicians and other practitioners be freely available to E/Cs, and that claimants no longer enjoy the right to be present during discussions between E/Cs and those providers....
...We observed in Pierre that subsection (4)(c) "furthers the self-executing nature of the compensation system by ensuring that the E/C has ready access to medical information involving the claimant." Id. at 1116-1117. Reading subsection (4)(c) in pari materia with section 440.13 as a whole, we held that once a dispute has become sufficiently adversarial to require the appointment of an expert medical advisor (EMA) under section 440.13(9)(c), ex parte discussions may not be held between an expert and the employer/carrier....
...See § 440.015, Fla. Stat. (Supp. 1994). [2] Even though the conference between Dr. Bernstein and representatives of the employer/carrier occurred after the filing of Kimes' claim, the statute contemplates "discussions ... held before or after the filing of a claim." § 440.13(4)(c), Fla. Stat. (Supp.1994). Here, there had been no EMA appointed at the time of the conference with Dr. Bernstein. Thus, the ex parte conference pursuant to section 440.13(4)(c) was permissible under Pierre. We also hold that section 440.13(4)(c) does not violate Florida's constitutional right to privacy....
...The very foundation of an employee's right to receive benefits under the self-executing system in Chapter 440 requires a healthcare provider to assess the injury, establish a causal connection to the workplace accident, and communicate that information to the employer's insurance carrier. See § 440.13, Fla....
...y and assessment of whether it is attributable to his employment, Kimes consented to the provider disclosing to the carrier medical information relating to the claim. See Acosta v. Cary, 365 So.2d 4, 5 (La.Ct.App.1978). The discussions authorized by section 440.13(4)(c) simply furthers that disclosure system....
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Kirk v. Publix Super Markets, 185 So. 2d 161 (Fla. 1966).

Cited 7 times | Published | Supreme Court of Florida

...n's compensation proceeding. The whole intendment of the statute is that such reports and records as are pertinent to the injury involved and the determination of its results should be available to the Commission, the employer and the employee. F.S. Section 440.13(1), F.S.A....
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Daoud v. Matz, 73 So. 2d 51 (Fla. 1954).

Cited 7 times | Published | Supreme Court of Florida | 1954 Fla. LEXIS 1493

...ion of the monies paid to the employee prior to the entry of the compensation order by the deputy commissioner was intended to be applied, and was actually applied, in satisfaction of the employer's obligation to furnish medical benefits pursuant to section 440.13, Florida Statutes 1953, F.S.A....
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Carruth v. Allied Prods. Co., 452 So. 2d 634 (Fla. 1st DCA 1984).

Cited 7 times | Published | Florida 1st District Court of Appeal | 1984 Fla. App. LEXIS 13543

...ts for the period of time claimed. The deputy also found that the employer had provided transportation to and from work at the value of $66 per week, arriving at that figure by applying the statutory presumption of twenty cents per mile derived from section 440.13(4), Florida Statutes (Supp....
...er that he could leave early, we hold that such a departure from the employer-provided benefit was insignificant. Finally, in establishing the value of the employer-provided transportation, the deputy did not err in applying the presumption found in section 440.13(4), Florida Statutes (Supp. 1980) (now section 440.13(5), Florida Statutes (1983))....
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At & T Wireless Servs., Inc. v. Castro, 896 So. 2d 828 (Fla. 1st DCA 2005).

Cited 7 times | Published | Florida 1st District Court of Appeal | 2005 WL 405478

...1st DCA 2004) (citation omitted). For purposes of this appeal then, a written prescription for attendant care was not required since physician testimony provided the required elements. See Rockette v. Space Gateway Support, 877 So.2d 852, 853 (Fla. 1st DCA 2004); see also § 440.13(2)(b), Fla. Stat. (1997)-(2002) (E/C must provide attendant care performed at the direction and control of a physician). Section 440.13(2)(b) was amended in 2003, and now includes greater specifications for claims for attendant care....
...The employer or carrier shall not be responsible for such care until the prescription is received by the employer and carrier, which shall specify the time periods for such care, the level of care required, and the type of assistance required. A prescription for attendant care shall not prescribe such care retroactively. § 440.13(2)(b), Fla....
...[2] Moreover, testimony was provided that Claimant was able to independently perform meal preparation, laundry, and other daily routine activities, and that attendant care services were needed mostly for bill paying, filing prescriptions, and transportation to doctor's appointments. [3] See generally § 440.13(10), Fla. Stat. (2001); Fla. Admin. Code R. 38F-7.020 (2001). We note that on July 1, 2002, section 440.13(14)(b), Florida Statutes, was amended to exclude IME's from the statutory fee cap....
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Rivendell of Ft. Walton v. Petway, 833 So. 2d 292 (Fla. 1st DCA 2002).

Cited 7 times | Published | Florida 1st District Court of Appeal | 2002 WL 31887694

...The judge of compensation claims (JCC) issued a May 5, 2000, order finding that Claimant's back injury was unrelated to her industrial accident and not compensable. The JCC granted Employer/Carrier's motion for appointment of an expert medical advisor (EMA) under section 440.13(9), Florida Statutes (1995)....
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Jackson v. Publix Supermarkets, Inc., 520 So. 2d 50 (Fla. 1st DCA 1987).

Cited 7 times | Published | Florida 1st District Court of Appeal | 1987 WL 31972

...best interest. See Bradley Construction v. White, 457 So.2d 547 (Fla. 1st DCA 1984); Sears, Roebuck & Co. v. Viera, 440 So.2d 49 (Fla. 1st DCA 1983). Employer/carrier's failure to comply with this obligation would render them responsible pursuant to section 440.13(2), Florida Statutes, for the unauthorized chiropractic treatment if it is determined to be reasonable and necessary....
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Flagship Nat. Bk. of Broward v. Hinkle, 479 So. 2d 828 (Fla. 1st DCA 1985).

Cited 7 times | Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 2760

...Compensation for temporary disability and medical benefits provided by this chapter shall not be subject to apportionment under this subsection. [2] Section 440.15, Florida Statutes (1983), deals only with the right of "compensation for disability" by the employee. Medical benefits are provided for in section 440.13....
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Artigas v. Winn Dixie Stores, Inc., 622 So. 2d 1346 (Fla. 1st DCA 1993).

Cited 7 times | Published | Florida 1st District Court of Appeal | 1993 WL 299510

...This decision was upheld by the JCC, who determined that no factual evidence should be presented because the claim for payment of medical bills was ripe at the earlier, July 1989, hearing and, therefore, the present litigation of the claim was not timely. The JCC also ruled that the bills were not timely claimed pursuant to section 440.13(2)(d) which requires submission to the E/C within 14 days of treatment....
...bills because they were not submitted to the carrier in a timely manner. The claimant should have been given the opportunity to present evidence which would demonstrate whether good cause existed which would excuse the late submission of the claims. Section 440.13(2)(d), Fla....
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Stuckey v. Eagle Pest Control Co. Inc., 531 So. 2d 350 (Fla. 1st DCA 1988).

Cited 7 times | Published | Florida 1st District Court of Appeal | 1988 WL 81957

...Schwartz, the deputy found that appellant had been properly advised of the deauthorization and offered alternative care to which appellant did not object. The e/c was found to be entitled to deauthorize the chiropractor as they desired both a second opinion and a second treating physician. Under section 440.13(2)(a), Florida Statutes (1985), "once the claimant and employer or carrier agree on a treating physician and a satisfactory physician-patient relationship is established, when a change in the authorized treating physician is requested...
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Cortina v. State, Dept. of Hrs, 901 So. 2d 273 (Fla. 1st DCA 2005).

Cited 7 times | Published | Florida 1st District Court of Appeal | 30 Fla. L. Weekly Fed. D 1289

...dispute existed for which appellant was entitled to an independent medical examination (IME) with a psychiatrist; 2) whether the JCC erred in rejecting Dr. Freshwater's medical opinion and accepting his report for fact purposes only; and 3) whether section 440.13(5)(e), Florida Statutes, which excludes certain expert medical opinions from evidence that are not from an authorized treating provider, an independent medical examiner, or an appointed expert medical adviser, constitutes an unconstitutional violation of separation of powers....
...imant's burden of proving entitlement to permanent total disability benefits). As to issue I, the JCC denied claimant's request for an IME with a psychiatrist, determining "there is no competent substantial evidence of a `dispute' as contemplated by section 440.13(5), Fla. Stat." There was a dispute, however, concerning whether claimant had reached psychiatric maximum medical improvement (MMI) and as to claimant's entitlement to temporary partial disability (TPD) benefits. Section 440.13(5)(a), Florida Statutes, sets forth the basic criteria for obtaining an IME: In any dispute concerning overutilization, medical benefits, compensability, 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....
...when one party disagrees with the diagnosis of a treating physician or of the other party's independent medical examiner"). The dispute in this case arose in accordance with the second method, entitling the claimant to a psychiatric IME pursuant to section 440.13(5)(a)....
...In Union Camp, this court stated that it was incumbent upon a claimant who disputes the opinions of physicians furnished by an employer to seek an independent medical examination: The claimant was under an affirmative obligation to request an IME under section 440.13(5)(a), Florida Statutes (Supp.1994), by the physician of his choice, if he objected to the E/C's decision to controvert his request for benefits based *275 upon the opinions rendered in the independent medical evaluations obtained by E/C....
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Reed v. Reed, 643 So. 2d 1180 (Fla. 1st DCA 1994).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1994 WL 561839

...Pursuant to Florida Rule of Workers' Compensation Procedure 4.160, this court declined to review the claimant's appeal/petition for writ of certiorari but accepted jurisdiction of the E/C's cross-appeal. We reverse that portion of the JCC's order permitting the claimant to choose the examining physicians as it conflicts with section 440.13(2)(b), Florida Statutes (1993), which gives the E/C the right to select the health care provider "of its choice" to perform the IME....
...orkers' compensation action. In the circuit court action, claimant underwent IMEs with a psychiatrist, an orthopedist, and an internist. Thereafter, the E/C moved to compel IMEs by several specialists in this workers' compensation action pursuant to section 440.13(2)(b), Florida Statutes (1993)....
...would choose the physicians to perform the examinations. Relying upon Roberts v. Ben Hill Griffin, Inc., 629 So.2d 236 (Fla. 1st DCA 1994), and Farm Stores, Inc. v. Fletcher, 621 So.2d 706 (Fla. 1st DCA 1993), the JCC in essence reasoned that, since section 440.13(2)(b) imposes a "reasonableness" requirement, giving the claimant the right to select the examining physicians from three names supplied by the E/C was a reasonable means to ensure the objectiveness of the IME evaluations. [2] Section 440.13(2)(b) clearly provides that the E/C has the right to schedule an IME with a health care provider "of its choice" to assist in determining whether over-utilization by a health care provider has occurred and whether medical treatment is necessary....
...Adelman Steel Corp. v. Winter, 610 So.2d 494, 505 (Fla. 1st DCA 1992). [4] Thus, the JCC's order, in effect, gives the claimant the right to choose the E/C's expert witness. It is true that this court employed a "reasonableness" standard in construing section 440.13(2)(b) in Roberts v....
...gress in recuperation. The employer or carrier has the right to schedule an independent medical examination with a health care provider of its choice, at a reasonable time to assist in determining this status. (Emphasis added). [2] IME is defined in section 440.13(1)(c) to mean an IME is an objective medical or chiropractic evaluation of the injured employee's medical condition and work status. [3] In their brief, the E/C have noted that section 440.13 was substantially amended in the 1993 legislative session. Ch. 93-415, § 17, Laws of Florida, effective January 1, 1994. However, the E/C have not made the argument that the newly enacted section 440.13(5)(a) is a remedial statute which governs disposition of this case, and therefore the applicability of the amended statute will not be addressed....
...the request of the employer, the carrier, or the attorney for either of them, the medical records of an injured employee must be furnished to those persons and the medical condition of the injured employee shall be discussed with those persons... . Section 440.13(4)(c), Florida Statutes (Supp....
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Broward Child.'s Ctr., Inc. v. Hall, 859 So. 2d 623 (Fla. 1st DCA 2003).

Cited 6 times | Published | Florida 1st District Court of Appeal | 2003 WL 22799491

...'s independent medical examiner and rejecting those of the employer's and carrier's. Based on that factual determination, he held that the claim was compensable. The employer and carrier timely served a motion for rehearing in which they argued that section 440.13(9)(c), Florida Statutes (1997), mandated the appointment of an expert medical advisor....
...o request such a "temporary expert medical advisor" from the Agency for Health Care Administration. In response, the claimant argued that no temporary expert medical advisor should be appointed because the administrative rule was irreconcilable with section 440.13(9)(a), which addresses the certification of expert medical advisors, and because doing so would result in additional delay....
...tended to apply in situations such as that which was presented by this case, and because to do so would result in additional delay. Accordingly, he denied the motion for rehearing. This appeal and cross-appeal follow. II. A. To the extent pertinent, section 440.13(9)(c), Florida Statutes (1997), reads: If there is disagreement in the opinions of the health care providers [or] if two health care providers disagree on medical evidence supporting the employee's complaints ......
...an independent medical expert would offer assistance to the judge of compensation claims when he or she is faced with conflicting medical evidence from the parties' experts. It is further apparent that the legislature intended for the provisions of section 440.13(9)(c) to be mandatory....
...Moreover, the claimant's argument to the contrary notwithstanding, there is nothing in the plain language of the statute to suggest that a judge of compensation claims need make only one attempt to appoint an expert medical advisor in order to satisfy its mandate. B. Section 440.13(9)(a), Florida Statutes (1997), which provides for the certification of expert medical advisors, reads: The division [of workers' compensation] shall certify expert medical advisors in each specialty to assist the division and the judg...
...Accordingly, pursuant to rule 59A-30.006, the Agency for Health Care Administration had the authority to "select a qualified individual" to serve as a "temporary expert medical advisor" in this case. Id. R. 59A-30.006(1) & (3). C. The claimant argues that rule 59A-30.006 is in direct conflict with section 440.13(9)(a) in several respects and that, therefore, the latter, rather than the former, must control....
...1st DCA 1997) ("a duly promulgated administrative rule, although `presumptively valid until invalidated in a section 120.56 rule challenge,' ... must give way in judicial proceedings to any contradictory statute that applies"). However, we are not persuaded by the claimant's arguments that rule 59A-30.006 conflicts with section 440.13(9)(a). On the contrary, we believe that the two are consistent. Section 440.13(9)(a) places responsibility for certification, recertification and decertification of expert medical advisors on the Agency for Health Care Administration. It authorizes the Agency to adopt rules to implement that directive. Nothing in the language of section 440.13(9)(a) precludes temporary certification. Moreover, the clear intent of section 440.13(9)(c) is to require participation of an expert medical advisor in every case where a disagreement exists between healthcare providers. To read section 440.13(9)(a) as the claimant urges would thwart that clearly expressed intent in cases such as this, where no previously certified expert medical advisor is available in the appropriate area of expertise....
...*628 Moreover, to the extent that our decision will result in further delay, such delay is the result of the legislature's clearly expressed intent that the opinion of an expert medical advisor be obtained in cases of this type. III. In summary, we hold that section 440.13(9)(c), Florida Statutes (1997), mandates the appointment of an expert medical advisor in this case....
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Gassner v. Bechtel Const., 702 So. 2d 548 (Fla. 1st DCA 1997).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1997 WL 694960

...employer may treat the employee. 3. The agreement creates procedural requirements for the receipt of benefits that chapter 440 does not impose. 4. The agreement limits each claimant to a single second opinion on any issue, purportedly in contrast to section 440.13(5), which is said to allow each claimant an independent medical evaluation by a practitioner in each medical discipline pertinent to his condition....
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Khawam v. Collision Clinics Intern., Inc., 413 So. 2d 827 (Fla. 1st DCA 1982).

Cited 6 times | Published | Florida 1st District Court of Appeal

...Bald of Pajcic, Pajcic, Dale & Bald, Jacksonville, for appellant. John J. Schickel of Cowles, Coker & Myers, Jacksonville, for appellees. ERVIN, Judge. In this workers' compensation appeal, we reverse and remand the deputy commissioner's determination that benefits for attendant care requested, pursuant to Section 440.13, Florida Statutes (Supp....
...the kind of care or attention required to be furnished by the statute." Id. (e.s.) In Pan American World Airways, supra, at 802-803, the court's explication of Chizauskas disposed of any doubt as to the scope of compensable benefits available under Section 440.13, Florida Statutes....
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Terners of Miami Corp. v. Freshwater, 599 So. 2d 674 (Fla. 1st DCA 1992).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1992 WL 88870

...The employer and carrier argue that jurisdiction to hear and to decide the dispute regarding the amount that Dr. Freshwater was to be paid for his services is vested in the Division of Workers' Compensation of the Department of Labor and Employment Security (Division). They base their argument upon Section 440.13(2)(i)1., Florida Statutes (Supp. 1990), which states that "[t]he [D]ivision shall ... resolve reimbursement disputes based on criteria to be established by rule." Dr. Freshwater argues that Section 440.13(2)(i)1. does not apply to this dispute because he filed his claim with the judge of compensation claims in February 1989, and *675 Section 440.13(2)(i)1. was not enacted until July 1, 1990. The employer and carrier respond that, while this is true, Section 440.13(2)(i)1. nevertheless applies to this dispute because it constituted a procedural, rather than a substantive, change in the law; and because Section 440.13(2)(i)1....
..."While the substantive rights of the parties in a workers' compensation case are determined by the law in effect at the time of the claimant's injury, this rule does not apply to procedural enactments." City of Clermont v. Rumph, 450 So.2d 573, 575 (Fla. 1st DCA), review denied, 458 So.2d 271 (Fla. 1984). In our opinion, Section 440.13(2)(i)1....
...is appeal shall be heard. Accordingly, it has no effect upon substantive rights and, therefore, is merely procedural. See Sullivan v. Mayo, 121 So.2d 424 (Fla. 1960) (forum in which review may be had is a procedural matter, not a substantive right). Section 440.13(2)(i)1. became effective on July 1, 1990. Ch. 90-201, §§ 18, 121, Laws of Fla. Although Dr. Freshwater filed his claim in February 1989, it was not heard by the judge of compensation claims until October 1990. Because Section 440.13(2)(i)1....
...Freshwater's claim, and should have transferred it to the Division. The failure of the judge to do so constituted reversible error. We recognize that there is language in our prior decision in Atlantic Foundation v. Gurlacz, 582 So.2d 10 (Fla. 1st DCA 1991), which may be read as concluding that Section 440.13(2)(i)1., Florida Statutes (Supp....
...he issue based upon a substantive/procedural analysis, because in my judgment the Division has had, and continues to have, jurisdiction over such disputes since July 1, 1978, the effective date of Chapter 78-300, Section 4, Laws of Florida, amending Section 440.13, Florida Statutes (1977), or no later than August 1, 1979, the effective date of Chapter 79-312, Section 7, Laws of Florida....
...r reasonably implied therefrom. Florida Dep't of Corrections v. Provin, 515 So.2d 302 (Fla. 1st DCA 1987); Hall v. Career Serv. Comm'n, 478 So.2d 1111 (Fla. 1st DCA 1985). Chapter 78-300, section 4, incorporated in both the 1989 and 1991 versions of section 440.13, [1] empowered the Division to investigate hospitals and medical practitioners to determine if they are in compliance with the schedule of charges adopted by the division or if they are requiring unjustified treatment, hospitalization, or office visits....
...rmore, the hospital or medical practitioner shall be liable to return to the carrier or selfinsurer any such fees or charges already collected. (Emphasis added.) During the 1979 session, the legislature conferred additional powers on the Division in section 440.13(3)(d)(5), in the event it determined that a health care provider improperly overutilized, rendered or ordered inappropriate medical treatment, or charged inappropriate fees, to require such health-care provider to repay the amount which was paid for the rendering or ordering of such treatment or services....
...the division shall provide the licensing board of the health-care provider with full documentation of such determination. Ch. 79-312, § 7, Laws of Fla. (Underlined language added; crossed-out language deleted.) These provisions are also incorporated in the 1989 and 1991 versions of section 440.13....
...It appears to me that the legislature intended to repose jurisdiction solely in the Division to resolve disputes regarding costs of medical services, as part of an overall cost-containment program. The legislative purpose behind the enactment of the amendments to section 440.13 — to reduce spiraling health care costs — is clearly reflected in the following article by W.E....
...It is only at this point that the right to an administrative hearing under section 120.57, Florida Statutes, arises. The procedures, reports and recommendations of utilization review and peer review are not subject to the provisions of chapter 120. (Emphasis added.) (Footnotes omitted.) I recognize that Section 440.13(3)(c), Florida Statutes (1989), conferring on the Division the authority to make a finding that a health care provider has made excessive charges, does not contain an explicit provision, as does Section 440.13(3)(d)(4), Florida Statutes (1989), permitting a 120.57 hearing for the purpose of considering whether a physician, inter alia, was wrongly reimbursed for inappropriate medical treatment and services and should repay such amount....
...The absence of a 120.57 remedy in the former subsection does not, however, compel the conclusion — if the majority has so concluded — that the Division did not have jurisdiction until 1990 to determine in a quasi-judicial setting whether a physician should be paid for an excessive charge, when Section 440.13(2)(i)(1), Florida Statutes (Supp. 1990), was enacted, authorizing the Division to "resolve reimbursement disputes based on criteria to be established by rule." In my judgment, the provisions of section 440.13(3)(c), pertaining to excessive charges, and of section 440.13(3)(d)(4), relating to overpayments, should be considered in pari materia and read together....
...ted issues of material fact would be litigated. In my judgment the Division has had jurisdiction both before and after the 1990 amendments to consider whether medical charges submitted are excessive, and it is therefore unnecessary to decide whether Section 440.13(2)(i)(1), Florida Statutes (Supp. 1990), represents a procedural rather than a substantive change in the law. NOTES [1] § 440.13(3)(c), Fla. Stat. (1989), and § 440.13(4)(h), Fla. Stat. (1991). [2] § 440.13(3)(d)(4), Fla. Stat. (1989), and § 440.13(4)(i)(4), Fla....
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Stables v. Rivers, 562 So. 2d 784 (Fla. 1st DCA 1990).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1990 WL 71618

...Insofar as the child care and housekeeping services which the judge awarded were thus shown to have been necessitated by the industrial injury, and to be useful in mitigating the effects of the injury or facilitating the process of recovery, such services were properly awarded under section 440.13, Florida Statutes....
...Although recognizing that claimant's own psychological recovery would be served should her family also receive such counseling, the judge denied the claim for family counseling upon a determination that this medical benefit may be awarded only for such services rendered directly to an injured employee. But a section 440.13 medical benefit may include services to the claimant's family, such as child care, when it is necessary to facilitate the injured employee's treatment and recovery....
...The present case involves no issue as to the adequacy of the claim, and in the limited context before us we conclude that the judge should have awarded the requested psychological evaluation and counseling for claimant's husband and children, in order to facilitate claimant's own psychological treatment under section 440.13(2)(a), Florida Statutes....
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Robinson v. Howard Hall Co., 219 So. 2d 688 (Fla. 1969).

Cited 6 times | Published | Supreme Court of Florida

...fee from the employer and carrier. * * *" Our study of the case indicates we should reverse the Commission and reinstate the order of the Judge of Industrial Claims. In the first place, contrary to the Commission's quoted order, we do not find F.S. Section 440.13, F.S.A. or any provision of Chapter 440 precludes further diagnostic tests of claimant under the circumstances here appearing. Section 440.13 provides that within the limitations of time prescribed in subsection (3) (b) the employer shall furnish to the employee "such remedial treatment, care and attendance under the direction and supervision of a qualified physician or surg...
...mining whether further remedial treatment was required. The statute in requiring remedial treatment to be provided an employee contemplates that a preliminary medical examination may be necessary as an incident to such treatment. A reading from F.S. Section 440.13, F.S.A....
...may, as in the instant case, upon due notice and a hearing before the Judge of Industrial Claims, have a determination made of the issue whether he can substitute a physician of his own selection in lieu of the physician offered by employer-carrier. Section 440.13 provides in part: "* * * It shall be unlawful for any employer or representative of any insurance company or insurer to coerce or attempt to coerce a sick or injured employee in the selection of a physician, or surgeon or other attenda...
...Industrial Claims. We analogize this limited right of a claimant as to the initial selection of a physician to be essentially similar to a situation where a claimant desires a change in medical attention already provided him. In the latter situation Section 440.13 provides: "The commission may at any time, for good cause, shown in its discretion order a change * * *." We recognize that in certain instances it may be found to be in the best interest of an injured claimant to have the satisfaction of being treated by a physician of his own choosing....
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Riggenbach v. Rhodes, 267 So. 3d 551 (Fla. 5th DCA 2019).

Cited 6 times | Published | Florida 5th District Court of Appeal

...tutes. Myers v. Pasco Cty. Sch. Bd. , 246 So.3d 1278 (Fla. 1st DCA 2018). An injured workers' compensation claimant is entitled to a one-time change of "physician who practices in the 'same specialty' as the originally authorized doctor" pursuant to section 440.13(2)(f), Florida Statutes (2016)....
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SPEC. DIS. TRUST FUND v. Motor & Compressor Co., 446 So. 2d 224 (Fla. 1st DCA 1984).

Cited 6 times | Published | Florida 1st District Court of Appeal

...pairment, wage loss, permanent total disability, funeral expenses and death benefits. Subsection 2(e), which was relied upon by the deputy, provides for further reimbursable benefits specified as "remedial treatment, care, and attendance pursuant to s. 440.13." The deputy concluded that vocational rehabilitation benefits were includable under that category. The precise issue on appeal here appears not to have previously been presented to an appellate tribunal of this State. We must look to Section 440.13 for guidance inasmuch as the reimbursement section expressly incorporates by reference the Section 440.13 meaning of "remedial treatment, care and attendance." Section 440.13 Florida Statutes (1979), provides in pertinent part: (1) Subject to the limitations specified in s....
...recognized practitioner, *226 nurse, or hospital, and for such period as the nature of the injury or the process of recovery may require, including medicines, crutches, artificial members, and other apparatus. * * * Nothing in the above excerpt from Section 440.13 or any of the rest of its provisions suggest that remedial treatment, care and attendance contemplate anything other than of a medical or physical rehabilitative nature....
...49(2)(e) should be construed to provide for reimbursement to the employer/carrier for payment of vocational benefits where the language of the latter section was not amended but continued to read "remedial treatment, care, and attendance pursuant to s. 440.13." The fact that certain kinds of benefits are statutorily required to be paid by the employer/carrier does not mean that the legislature necessarily intended that all such benefits should be reimbursed from the Special Disability Trust Fund....
...termining legislative intent, see Great American Indemnity Company v. Williams, 85 So.2d 619 (Fla. 1956), we are unpersuaded that we are at liberty to read vocational rehabilitation benefits into "remedial treatment, care, and attendance pursuant to s. 440.13." As we stated in Rebich v....
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Chase v. Henkel & McCoy, 562 So. 2d 831 (Fla. 1st DCA 1990).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1990 WL 77397

...The judge reasoned that the employer/carrier, having authorized chiropractic care, albeit untimely, were not sent the reports required by law and to hold them responsible in this circumstance would require them to pay for services of which they were unaware. Pursuant to section 440.13(2), Florida Statutes (1987), the employer is required to furnish the claimant medically necessary treatment, and should such treatment not be provided after request, the claimant may seek such treatment at the expense of the employer,...
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Long Grove Builders, Inc. v. Haun, 508 So. 2d 476 (Fla. 1st DCA 1987).

Cited 6 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 1411

...The question presented in this workers' compensation appeal is whether a deputy commissioner may decide, at the claimant's request, the amount of an authorized treating physician's bill payable under the Medical Services Fee Schedule adopted by the Division of Workers' Compensation pursuant to section 440.13, Florida Statutes....
...Thomson's bill was payable under the schedule. Then, based on his own analysis of the nature of the services rendered by Dr. Thomson, the deputy commissioner conformed the bill to the schedule and found the e/c should have paid Dr. Thomson a total of $1,674. Section 440.13(3), Florida Statutes (1983), provides in part: The health care provider or health care facility providing services pursuant to this section shall be paid for the services solely by the employer or its insurance carrier, except for paym...
...The deputy commissioner therefore erred in deciding the issue. This Court observed in Mt. Sinai Medical Center v. Samuels, 453 So.2d 81 (Fla. 1st DCA 1984), that the issue of whether medical bills correspond to the Medical Services Fee Schedule is handled administratively pursuant to section 440.13(3)(a), Florida Statutes (1981) (now 440.13(4)(a))....
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Soriano v. Gold Coast Aerial Lift, Inc., 705 So. 2d 636 (Fla. 1st DCA 1998).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 886, 1998 WL 17045

...As to the second point, the JCC had CSE to deny fees to Soriano for his attorney's effort in obtaining authorization of an orthopedist, because the record shows that the E/C offered him four orthopedic physicians upon request, and Soriano's attorney declined them all and sought treatment from another physician. Under section 440.13(2)(c), Florida Statutes (1995), the E/C has the right to select a treating physician for a claimant, and the claimant may seek substitution of a physician of claimant's choice only if the E/C fails to provide the treatment or care requested within a reasonable time....
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Cedars of Lebanon Health Care Ctr., Inc. v. Summerset, 409 So. 2d 185 (Fla. 1st DCA 1982).

Cited 6 times | Published | Florida 1st District Court of Appeal

...ther doctors. We affirm the award of temporary total disability benefits. However, we find an absence of the necessary finding of "good cause" to excuse the failure of Dr. Ambrose to file reports of injury and treatment within the time prescribed by Section 440.13(1), Florida Statutes....
...ior authorization for treatment by Dr. Ambrose does not relieve the E/C of the burden of paying for his services, we are compelled to note the absence of any finding of "good cause" to excuse the failure of Dr. Ambrose to file reports as required by Section 440.13(1), Florida Statutes....
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Miami Beach First Nat'l Bank v. Dunn, 85 So. 2d 556 (Fla. 1956).

Cited 6 times | Published | Supreme Court of Florida

...ployer or carrier to submit specified reports in respect of the injury to the Commission from time to time, and Section 440.20 requires certain additional notices and reports, including a notice of final payment containing specified information; and Section 440.13 requires that the attending physician or physicians furnish certain reports....
...ee's right to make a claim for further compensation `at any time prior to two years after the date of the last payment of compensation' should not be foreclosed by a permature adjudication made at the request of the carrier. As to medical attention, Section 440.13(3)(b) provides that all rights for remedial attention shall be barred unless a claim therefor is filed within two years after the date of the last remedial treatment furnished by the employer, or after the date of the last payment of compensation....
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Publix Supermarket, Inc. v. Hart, 609 So. 2d 1342 (Fla. 1st DCA 1992).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 12324, 1992 WL 358122

...Suarez unless such was reasonably required by the nature of the injury or the process of recovery, Amoco Container Co. v. Singh, 418 So.2d 395 (Fla. 1st DCA 1982), and that the need for such services was required and the employer still failed to provide such services. § 440.13(2)(a) and (d), Fla....
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Perez v. Rooms to Go, 997 So. 2d 511 (Fla. 1st DCA 2008).

Cited 6 times | Published | Florida 1st District Court of Appeal | 2008 WL 5391917

...for certain medical treatment. On cross-appeal, the Employer/Carrier, appellees and cross-appellants, assert that the JCC erred in granting claimant's request for a change in physician. We affirm the issue on appeal without further comment. Because section 440.13(2)(f), Florida Statutes (2004), limits a claimant to "one change of physician during the course of treatment for any one accident," we reverse the issue on cross-appeal....
...ician. The JCC noted his previous finding regarding claimant's entitlement to a change in primary care physician, but found claimant had not yet requested a change in orthopedic physician. Consequently, he granted claimant's request. This was error. Section 440.13(2)(f) provides, in relevant part: Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident. In construing a statute, this court looks to its plain language. See Fla. Dep't of Educ. v. Cooper, 858 So.2d 394, 396 (Fla. 1st DCA 2003). Section 440.13(2)(f) is unambiguous....
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Phillips v. City of West Palm Beach, 70 So. 2d 345 (Fla. 1953).

Cited 6 times | Published | Supreme Court of Florida | 1953 Fla. LEXIS 1846

...on 440.20, subsection (13) of the Florida Statutes of 1941, and reads as follows: "The total compensation payable under this chapter for disability and death shall in no event exceed the sum of Five thousand dollars in addition to any benefits under § 440.13 for medical services and treatment and under subsection (1) of § 440.16 for funeral expenses." The Laws of 1947, Chapter 23921, § 2, amended Section 440.20, subsection 13 of the Florida Statutes of 1941, and provided as follows: "The total compensation payable under this chapter for disability and death shall in no event be payable for a period in excess of three hundred and fifty weeks in addition to any benefits under Section 440.13 for medical services and treatment, and under subsection (1) of Section 440.16 for funeral expenses." With the adoption of the 1949 Florida Statutes, § 440.20, subsection (13), as amended by Chapter 23921, § 2, of the Laws of 1947, w...
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Walgreen Co. v. Carver, 770 So. 2d 172 (Fla. 1st DCA 2000).

Cited 6 times | Published | Florida 1st District Court of Appeal | 2000 WL 1224735

...ability exaggeration. A functional capacity evaluation ordered by Dr. Gosselin reached the same conclusion. [3] An expert medical advisor's opinion is presumed to be correct and may only be rejected on the basis of clear and convincing evidence. See § 440.13(9)(c), Fla....
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Jones v. Plantation Foods, 388 So. 2d 590 (Fla. 1st DCA 1980).

Cited 6 times | Published | Florida 1st District Court of Appeal

...The authorization extended, however, only to the evaluation and not to the treatments. We would order the payment of Dr. Sternberg's bills based on the above holding if it were not for the fact that he failed to timely submit the reports required by Section 440.13, Florida Statutes (1975)....
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Don Harris Plumbing Co. v. Henderson, 454 So. 2d 745 (Fla. 1st DCA 1984).

Cited 6 times | Published | Florida 1st District Court of Appeal

...th the additional debilitations caused by his psychiatric condition. Further, his wife detailed her duties with him, testifying that she spent from two to six hours per day in performing them. Therefore, CSE supports this award. We agree and affirm. Section 440.13(2)(d), Florida Statutes (1983), provides that "a family member may not be paid [for custodial care] when the services they provide do not go beyond those normally provided by family members gratuitously." Ordinary household services, such as shopping and cooking, are gratuitous when performed by a spouse....
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Prestressed Decking Corp. v. Medrano, 556 So. 2d 406 (Fla. 1st DCA 1989).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1989 WL 87555

...While we sympathize with the deputy's intent and recognize that medical testimony indicated it was more desirable for claimant to remain in the home than to be institutionalized, awarding counseling services to members of claimant's family in order to indirectly benefit claimant was beyond the deputy's authority under Section 440.13(2)(a), Florida Statutes....
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Temps & Co. Servs. v. Cremeens, 597 So. 2d 394 (Fla. 1st DCA 1992).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1992 WL 76450

...The e/c contend that the JCC erred in awarding claimant the entire purchase price of the replacement vehicle, with no credit to the e/c for the trade-in value of claimant's prior vehicle. It is undisputed that claimant has a medical need of a modified vehicle with AT/PS pursuant to section 440.13(2)(a), Florida Statutes (1989); see Stables v....
...Brown v. Steego Auto Parts, 585 So.2d 401, 403 (Fla. 1st DCA 1991). It was the special AT/PS options, not the Camaro itself, that met this definition of "medically necessary" components, that is, apparatus used to mitigate the effects of the injury. Section 440.13(1)(c), Florida Statutes; Stables, 562 So.2d at 785....
...lack of cooperation, such that claimant and the e/c were unable to agree on a replacement car. As cross-appellant, claimant argues that the JCC erred in allowing the e/c to choose whether to have title to the replacement vehicle in claimant's name. Section 440.13(2)(a), Florida Statutes, requires the e/c to furnish medically necessary apparatus, which was done here. We recognized in Firestone Tire that an order requiring the e/c to furnish medically necessary apparatus pursuant to section 440.13, Florida Statutes, is not necessarily "an unconditional mandate for `vesting of title'" in claimant's name....
...r that is error. Aino's Custom Slip Covers v. DeLucia, 533 So.2d 862, 865 (1st DCA 1988), rev. den., 544 So.2d 199 (Fla. 1989). The vesting of title in claimant's name is not per se prohibited under Chapter 440, Florida Statutes. The test is whether section 440.13(1), Florida Statutes, required the e/c to furnish the medical apparatus....
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Prof'l Administrators v. MacIas, 448 So. 2d 1159 (Fla. 1st DCA 1984).

Cited 6 times | Published | Florida 1st District Court of Appeal | 1984 Fla. App. LEXIS 12710

...Employer/carrier seek review of a workers' compensation order entered by deputy commissioner Johnson by which, following a settlement excluding medical but stipulating a January 1982 MMI date, claimant was awarded continuing chiropractic care "as long as necessary." We affirm. Section 440.13(1) requires the provision of medical care "as the nature of the injury or the process of recovery may require ......
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Sistrunk v. City of Dunedin, 513 So. 2d 200 (Fla. 1st DCA 1987).

Cited 5 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 2228

...An employer must offer or furnish benefits when the employer knows, or reasonably should know from facts properly and diligently investigated, that such benefits are due. See Prestressed Systems v. Goff, 486 So.2d 1378 (Fla. 1st DCA 1986); Walt Disney World Co. v. Harrison, 443 So.2d 389 (Fla. 1st DCA 1983). Section 440.13(2)(b), Florida Statutes, requires the employer to provide nursing care benefits, even though not requested, if the nature of the injury requires such benefits....
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Bradley Const. v. White, 457 So. 2d 547 (Fla. 1st DCA 1984).

Cited 5 times | Published | Florida 1st District Court of Appeal

...Arslanian and Bourguignon, he pointed out that neither physician had treated claimant since June 1983, and thus they would not possess knowledge of claimant's impairments for the contested time period. The E/C's challenge to the deputy's August 23, 1983, order is based on the judicial gloss given to Section 440.13(1), Florida Statutes (1981), which section provides that an employer shall furnish to an injured employee remedial treatment for such period as the nature of the employee's injury or the process of recovery requires....
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Smith v. James Pirtle Constr. Co., 405 So. 2d 290 (Fla. 1st DCA 1981).

Cited 5 times | Published | Florida 1st District Court of Appeal

...laimant filed a motion for further medical examination. At the hearing on the motion claimant's counsel asserted a right to such examination without presentation of any evidence on need. Claimant appeals the order denying the motion, contending that § 440.13, Florida Statutes, compels reversal because it requires employers to furnish to those who suffer compensable injuries "such ......
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Delta Airlines v. Underwood, 406 So. 2d 1188 (Fla. 1st DCA 1981).

Cited 5 times | Published | Florida 1st District Court of Appeal

...Here, the claimant, absent a medical emergency, arbitrarily changed physicians while alternate treatment was still being provided by the employer/carrier and without seeking prior approval by the deputy commissioner. Therefore, the claimant did not properly comply with the procedures specified in Section 440.13(2), Florida Statutes (1979)....
...[1] See Redwing Carriers, Inc. v. Pinto, IRC Order 2-3089 (January 6, 1977); Schult Mobile Home Corp. v. Walling, 384 So.2d 251 (Fla. 1st DCA 1980). Reversed in part, and affirmed in part. ERVIN, WENTWORTH and JOANOS, JJ., concur. NOTES [1] Fla. Stat. § 440.13(2) provides: If an injured employee objects to the medical attendance furnished by the employer, it shall be the duty of the employer to select another physician to treat the injured employee unless a deputy commissioner determines that a c...
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In Re Florida Workmen's Comp. Rules of Pro., 285 So. 2d 601 (Fla. 1973).

Cited 5 times | Published | Supreme Court of Florida | 1973 Fla. LEXIS 4246

...party offering same has furnished a copy thereof to the opposing party or his attorney at least five (5) days prior to the hearing at which it is offered. (b) Medical reports furnished upon demand to injured employees or their attorneys, pursuant to Section 440.13(1), Florida Statutes, F.S.A., shall be without charge to the injured employee, except actual cost to the physician or hospital furnishing same....
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Hill v. Beverly Enter., 489 So. 2d 118 (Fla. 1st DCA 1986).

Cited 5 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 1144

...He denied payment of medical bills from Dr. Cordosa, Dr. Bajo, and Centro Asturiano Hospital. This appeal followed. We take this opportunity to reiterate the obligations of both claimants and employer/carriers with respect to physician selection and changes in authorized physicians. Section 440.13(2)(a), Florida Statutes (1985) provides: [T]he employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance by a health care provider and for such period as the nature of the injury or the process of recovery may require ... Further, Section 440.13(2)(b), purports to provide for the situation where the employer fails to provide treatment: If the employer fails to provide such treatment, care, and attendance after request by the injured employee, the employee may do so at the expe...
...The employee does so at the peril of having the deputy commissioner later rule that such treatment was not reasonable and necessary. See Fuchs Baking Company v. Szlosek, 466 So.2d 415 (Fla. 1st DCA 1985). In the situation where the employee becomes dissatisfied with the authorized physician, Section 440.13(3) provides: If an injured employee objects to the medical attendance furnished by the employer ......
...There was no basis for the deputy's finding that appellant's communication with the employer was an insufficient expression of her dissatisfaction with the authorized physician. The employer/carrier raised another defense below, namely, the health care providers' failure to comply with Section 440.13(2)(b) by the untimely filing of their reports, on which issue the deputy made no finding....
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Lowe's Home Centers, Inc. & Sedgwick CMS v. Sandra K. Beekman, 187 So. 3d 318 (Fla. 1st DCA 2016).

Cited 5 times | Published | Florida 1st District Court of Appeal

...1st DCA 2004). Because this question is one which has not been previously addressed – how broad is the brush of the presumption of correctness given to an opinion of an EMA – we begin our analysis with a review of the relevant statutory provisions. Section 440.13(9), Florida Statutes (2013), the provision addressing EMAs, provides in 3 subsection (a) that EMAs are to be certified “to assist ....
...the [JCCs] within the advisor’s area of expertise.” Subsection (b) provides that EMAs are intended “to provide peer review or expert medical consultation, opinions, and testimony . . . to a [JCC] in connection with resolving disputes relating to reimbursement, differing opinions of health care providers . . . .” § 440.13(9)(b), Fla....
...The [EMA] appointed to conduct the evaluation shall have free and complete access to the medical records of the employee. An employee who fails to report to and cooperate with such evaluation forfeits entitlement to compensation during the period of failure to report or cooperate. § 440.13(9)(c), Fla....
...It then simply states that “[t]he opinion of the [EMA] is presumed to be correct.” Id. Section 440.25(4)(d), Florida Statutes (2013), provides in part: When there is a conflict in the medical evidence submitted at the hearing, the provisions of s. 440.13 shall apply....
...The report or testimony of the [EMA] shall be admitted into evidence in a proceeding and all costs incurred in connection with such examination and testimony may 4 be assessed as costs in the proceeding, subject to the provision of s. 440.13. The process used in this case – whereby the JCC posed specific questions to the EMA – is one that has developed over time....
...lendar days following receipt of all medical records and examination of the injured employee. The medical records, which may be submitted to an [EMA] shall be within the discretion of the [JCC]. Neither the plain language of section 440.13(9)(c) nor the rules subsequently promulgated offer guidance regarding the question presented in this case: In assessing the role of the EMA, how broadly do we apply the presumption of correctness? Because the statute is ambiguous as...
...County, 991 So. 2d 407, 410-11 (Fla. 1st DCA 2008), that a physician authorized to treat only the claimant’s wrist was nonetheless an “authorized treating physician” whose testimony concerning the claimant’s shoulder was admissible under section 440.13(5)(e), Florida Statutes (2004), which provides that “[n]o medical opinion other than the opinion of a[n EMA], and 6 independent medical examiner, or an authorized treating provider is admissible in proceedings before the [JCCs]”....
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Wal-Mart Stores, Inc. v. Mann, 690 So. 2d 649 (Fla. 1st DCA 1997).

Cited 5 times | Published | Florida 1st District Court of Appeal | 1997 WL 108937

...The judge erred in authorizing psychiatric care absent evidence that such care is medically necessary. The claimant presented no medical testimony that her psychiatric condition was causally related to her industrial injury. The award was based on a waiver of medical necessity and causation under section 440.13(3)(d), Florida Statutes (Supp.1994). That provision applies only to a request for referral authorization under section 440.13(3)(c), which is not present in this case....
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Jackson v. Merit Elec., 37 So. 3d 381 (Fla. 1st DCA 2010).

Cited 5 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 8173, 2010 WL 2292934

...ensable injury. Confusion is also generated by the inexact and conflated use of the terms "accident" and "injury." An accident results in injuries which require treatment. Generally, treatment is not furnished for an accident, but for an injury. See § 440.13(2)(a), Florida Statutes....
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Exceptional Child.'s Home, Etc. v. Fortuna, 414 So. 2d 1130 (Fla. 1st DCA 1982).

Cited 5 times | Published | Florida 1st District Court of Appeal

...d on the summary, without waiting for the itemization, may tend to cast doubt on the good faith of the carrier's actions in the first instance. However there are other factors involved in this controversy which would preclude a finding of bad faith. Section 440.13(1) requires that hospital bills be forwarded to the employer or carrier within ten days....
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Sunshine Towing, Inc. v. Fonseca, 933 So. 2d 594 (Fla. 1st DCA 2006).

Cited 5 times | Published | Florida 1st District Court of Appeal | 2006 WL 1627795

...Claimant was injured in a workers' compensation accident and is now a quadriplegic. E/C accepted Claimant's injury as compensable, provided treatment at an in-patient facility, and agreed that it was responsible for modifying Claimant's home to meet his medical needs under section 440.13(2)(a), Florida Statutes (2004)....
...not read the term into the sections where it was omitted. Leisure Resorts Inc. v. Frank J. Rooney, Inc., 654 So.2d 911, 914 (Fla.1995). Here, E/C is not entitled to involuntarily impose a lien because there is no statutory authorization for a lien. Section 440.13(2)(a) does not provide for a lien, nor does any other section that E/C cites....
...Gibbs, 137 So.2d 553, 562 (Fla.1962) (explaining that workers' compensation "must be governed by what the statutes provide, not by what deciding authorities feel the law should be."). In addition, because the legislature used the term of imposing a lien in other areas of chapter 440 but not in section 440.13(2)(a), we cannot read this term into section 440.13(2)(a)....
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Clairson Intern. v. Rose, 718 So. 2d 210 (Fla. 1st DCA 1998).

Cited 5 times | Published | Florida 1st District Court of Appeal | 1998 WL 422445

...Massey of McCarty, Helm, Keeter, Marion, Standley, Davis & O'Connor, P.A., Ocala, for Appellants. Richard A. Sicking of Coral Gables, for Appellee. BENTON, Judge. Alfred Rose's former employer, Clairson International, and its servicing agent, Crawford and Company, appeal a compensation order, contending that section 440.13(5)(e), Florida Statutes (Supp.1994), required the judge of compensation claims to exclude the testimony of an unauthorized treating physician whose deposition was allowed in over objection at hearing....
..."No medical opinion other than the opinion of a medical advisor appointed by the judge of compensation claims or division, an independent medical examiner, or an authorized treating provider is admissible in proceedings before the judges of compensation claims." § 440.13(5)(e), Fla. Stat. (Supp.1994). Unless a physician is a duly appointed expert medical advisor, an independent medical examiner, or an authorized treating physician, section 440.13(5)(e), Florida Statutes (Supp....
...an independent medical examiner. An independent medical examiner is defined as "a physician selected by either an employee or a carrier to render one or more independent medical examinations in connection with a dispute arising under this chapter." § 440.13(1)(j), Fla....
...ected testimony of one or more witnesses," Florida Rule of Workers' Compensation 4.045(h)(4), no such requirement was imposed here. To the extent Dr. Freeman's testimony was adduced on purely factual matters, moreover, it was not objectionable under section 440.13(5)(e), Florida Statutes (Supp.1994), which pertains only to "medical opinion." Appellants' failure to object in the *213 pretrial stipulation to Dr....
...Whether "the ground of the objection is one that might have been obviated or removed if presented at" the deposition turns on what is required to designate a physician as an independent medical examiner. [3] The Workers' Compensation Act addresses independent medical examinations in section 440.13(5), Florida Statutes (Supp.1994), which provides, in part: (a) In any dispute concerning ......
...We said: The JCC concluded that when the E/C refuses to provide an IME upon request, the claimant has the right to proceed with obtaining the IME subject to the JCC at a later date determining the reasonableness and medical necessity of the examination. We reject the JCC's analysis under the circumstances. Although section 440.13(5) enables an employee to select an independent medical examiner, section 440.13(5)(c) provides that an "attorney representing a claimant is not authorized to schedule independent medical evaluations under this subsection." The claimant should have followed the procedures set forth in sections 440.191 and 440.192, if necessary....
...wn prior experience with the injured employee—permit "objective evaluation" of the medical condition. The Workers' Compensation Law defines an independent medical examination as "an objective evaluation of the injured employee's medical condition." § 440.13(1)(k), Fla. Stat. (Supp.1994). Nothing in the Act requires that an independent medical examination be performed by an examiner who is not already familiar with the injured employee's medical condition. § 440.13(5)(a), Fla....
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Champlain Towers v. Dudley, 481 So. 2d 532 (Fla. 1st DCA 1986).

Cited 5 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 130

...Crown, psychologist, the deputy found "a request was made for medical treatment ... and authorization was offered ... in the form of three doctors ... There was an objection raised ... and no subsequent authorization was made." He relied upon the following provisions of § 440.13, Florida Statutes: (3) If an injured employee objects to the medical attendance furnished by the employer pursuant to subsection (2), it shall be the duty of the employer to select another physician......
...Assuming each party properly complied with all statutory duties, these decisions appear to be proper implementations of the statute, even when we consider its further provision that "[i]t is unlawful ... to coerce or attempt to coerce a sick or injured employee in the selection of a physician... ." § 440.13(3), Florida Statutes....
...We also reverse that part of the order of November 5, 1984, awarding costs of past care by Drs. Stillman and Crown. The orders are otherwise affirmed. JOANOS and THOMPSON, JJ., concur. NOTES [1] The words are precisely those of the statutory prescription, § 440.13, Florida Statutes....
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Clair v. Glades Cnty. Bd. of Com'rs, 649 So. 2d 224 (Fla. 1995).

Cited 5 times | Published | Supreme Court of Florida | 1995 WL 16886

...Riley Davis of Katz, Kutter, Haigler, Alderman, Marks & Bryant, P.A., Tallahassee, amicus curiae for American Ins. Ass'n. WELLS, Justice. We have for review a decision presenting the following question certified to be of great public importance: WHETHER SECTION 440.13, FLORIDA STATUTES, PERMITS A PHYSICIAN, PRACTICING OUTSIDE THE PEER GROUP OF THE PHYSICIAN WHOSE CARE WAS AUTHORIZED, TO OPINE AS AN EXPERT THAT THE FURNISHED *225 CARE IS NOT REASONABLE AND NECESSARY? Clair v. Glades County Board of Commissioners, 635 So.2d 84, 87-88 (Fla. 1st DCA 1994). We have jurisdiction pursuant to article V, section 3(b)(4) of the Florida Constitution, and we answer the question with a qualified yes. We conclude that section 440.13, Florida Statutes (1983), [1] does not preclude physicians licensed under one statute from testifying regarding the reasonableness and necessity of treatment by a physician licensed under another statute, provided the testifying physic...
...Accordingly, the JCC held that although the carrier did not officially deauthorize treatment through its notice to controvert, [3] it was not liable for additional chiropractic charges. *226 Clair appealed, and the First District requested supplemental briefs on the issue of whether section 440.13 permits a physician practicing outside the peer group of a physician whose care has been authorized to testify as an expert that the furnished care is not reasonable and necessary....
...roup" in the definition of "medically necessary," the legislature indicated that it intended to have a group comprised of doctors licensed under the same authority as the treating physician deciding whether treatment is reasonable and necessary. See § 440.13(1)(c), Fla. Stat. (1983). In support of this conclusion, the court relied on section 440.13(1)(e), which defines "peer review committee" as a "committee composed of physicians licensed under the same statutory authority as the physician who rendered the serviced being reviewed." Although the court's majority surmised that section 440.13 should be interpreted to preclude reliance on testimony from doctors outside the treating physician's field, it ultimately held that its prior decision in Alford v....
...We agree with the majority's conclusion that Alford should control the outcome of this case. Further, we agree with Judge Kahn's conclusion that Alford was correctly decided. We hold in accord with Judge Kahn's separate opinion that the statutes regulating physicians do not support the majority's interpretation that section 440.13 permits only a doctor licensed under the same authority to testify as to the reasonableness and necessity of another doctor's care....
...s to give testimony such as that relied on by the JCC in this case. Clair, 635 So.2d at 88-89 (Kahn, J., concurring in part and dissenting in part) (footnote omitted). We note, as did Judge Kahn, that the district court's preferred interpretation of section 440.13 would prevent a physician who is certified to practice in one field from testifying regarding care provided by another physician who is certified in the same field but licensed under a different regulatory statute....
...We expressly reject the majority's suggestion that the First District's prior decision in Alford was wrongly decided. It is so ordered. GRIMES, C.J., and OVERTON, SHAW, KOGAN, HARDING and ANSTEAD, JJ., concur. NOTES [1] All subsequent references to section 440.13 pertain to the 1983 version of the statute unless otherwise indicated....
...We decline to comment on the JCC's conclusion with regard to this matter because the procedural aspects of the authorization and deauthorization processes are not relevant to our determination of who may testify as to the reasonableness and necessity of a physician's treatment pursuant to section 440.13. [4] Section 440.13(2)(b) provides that: If the employer fails to provide such [medically-necessary remedial] treatment, care, and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and necessity to be approved by the deputy commissioner. [5] While section 440.13(1)(c) requires any medically necessary service to be widely accepted by a physician's practicing peer group, that does not mean that only members of the practicing peer group may testify whether a particular service is medically necessary. Moreover, we observe that in 1993, the phrase "practicing peer group" was removed from the definition of "medically necessary" in section 440.13(1)(c) and replaced with the phrase "among practicing health care providers," a term expressly defined within the statute....
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Williams v. Triple J Enter., 650 So. 2d 1114 (Fla. 1st DCA 1995).

Cited 5 times | Published | Florida 1st District Court of Appeal | 1995 Fla. App. LEXIS 1853, 1995 WL 73563

...ocess are reimbursement of the health care provider for services rendered, and repayment by the health care provider to the carrier for services improperly or unnecessarily rendered. See e.g., Lamounette v. Akins, 547 So.2d 1001 (Fla. 1st DCA 1989); § 440.13(4)(a), Fla....
...the amounts provided by the schedules of maximum reimbursement allowances ... an individual health care provider or hospital shall be reimbursed either his usual charge for treatment, care and attendance or the maximum reimbursement allowance ..."); § 440.13(4)(c), Fla....
...alth care provider or health care facility may not receive payment under this chapter ... furthermore, the health care provider or health care facility is liable to return to the carrier or self-insurer any such fees or charges already collected."); § 440.13(4)(d)4., Fla....
...he physician's bill conformed with the fee schedule). The e/sa were statutorily authorized to initiate utilization review; however, the e/sa were obligated to continue providing the prescribed care to Mr. Williams during the pendency of that review. § 440.13(4)(d)1., Fla....
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Florida Detroit Diesel v. Nathai, 28 So. 3d 182 (Fla. 1st DCA 2010).

Cited 5 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 1644, 2010 WL 547148

...Workers' Compensation Law. The phrase "medically necessary" is defined in the applicable statute as any medical service that is used to identify or treat an illness or injury, and is appropriate to the patient's diagnosis and status of recovery. See § 440.13(1)(m), Fla....
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Exxon Co., USA v. Rodriguez, 410 So. 2d 571 (Fla. 1st DCA 1982).

Cited 5 times | Published | Florida 1st District Court of Appeal

...the onset of bleeding that required medical testing and treatment. See Looney v. W & J Construction Company, 289 So.2d 723 (Fla. 1974). We also reject the carrier's argument that because the doctors and hospitals did not file reports as required by Section 440.13, Florida Statutes (1979), their bills are not the carrier's responsibility....
...As a result of this confusing situation which was created by the employer, *573 the doctor was led to believe he had satisfied his reporting requirements, while the hospitals and their physicians were unaware that this was a workers' compensation case. Under these circumstances, we find that the failure to file reports under § 440.13 was not fatal to Rodriguez' claim for these medical benefits....
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Cover v. TG & Y, 377 So. 2d 792 (Fla. 1st DCA 1979).

Cited 5 times | Published | Florida 1st District Court of Appeal

...Instead, the repair cost claimed under the circumstances appears to be a reasonable method for providing the care recommended by the attending doctor under the statutory provision for furnishing the use of apparatus as the nature of the injury may require. Section 440.13(1), Florida Statutes....
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Jackson v. Columbia Pictures, 610 So. 2d 1349 (Fla. 1st DCA 1992).

Cited 5 times | Published | Florida 1st District Court of Appeal | 1992 WL 385367

...termine a date of MMI, and consider on its merits Jackson's claim for wage loss or permanent total disability benefits. On the attendant care issue, the JCC made the following findings: 18. The employee has also made a claim for attendant care under 440.13....
...dersigned accepts the opinion of Dr. Lloyd Miller that the employee is not in need of any attendant care. In addition, the undersigned finds that the `supervision' contemplated is not the type of medical supervision or attendant care contemplated by 440.13 F.S.A....
...The doctor focused mistakenly upon indications for "outpatient care," rather than upon the claimant's need for attendant or custodial care due to the nature of his injuries. Whether one requires inpatient or outpatient medical care is not dispositive of the attendant care issue under section 440.13(2)(d), Florida Statutes (1985)....
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Strickland v. Al Landers Dump Trucks, Inc., 170 So. 2d 445 (Fla. 1964).

Cited 5 times | Published | Supreme Court of Florida

...ng be made consistent with the provisions of this statute. The deputy commissioner also found that the claimant was not entitled to payment of his bill for medical services, because of his physician's failure to file medical reports as prescribed by Section 440.13(1), F.S.A. Claimant challenges the finding on the ground that the failure to file was excusable, because the respondent did not, at any time, offer to supply medical services. Claimant misinterprets the statute. Section 440.13(1) provides that an injured employee may select his own physician and require the employer to reimburse him or pay the physician for medical services only (1) if the employee requests and the employer refuses to furnish such services,...
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Timothy Bowser Const. Co. v. Kowalski, 605 So. 2d 885 (Fla. 1st DCA 1992).

Cited 5 times | Published | Florida 1st District Court of Appeal | 1992 WL 206368

...om and bathroom for Claimant's parents. See Prestressed Decking Corp. v. Medrano, 556 So.2d 406, 408-09 (Fla. 1st DCA 1989) (award of counseling for the claimant's family, although desirable and helpful to family, was beyond deputy's authority under section 440.13(2)(a), Florida Statutes, governing medical benefits "to the employee")....
...g a wheelchair lift and inside storage device. Likewise, we affirm the provision of a large four-door sedan or a full-size station wagon with child-proof locks and with sufficient room for safe accommodation of Claimant, who *887 is a large man. See section 440.13(2)(a), Florida Statutes (Supp....
...DeLucia, 533 So.2d 862, 865 (1st DCA 1988), rev. den., 544 So.2d 199 (Fla. 1989); Temps & Co. Services v. Cremeens, 597 So.2d 394, 398 (Fla. 1st DCA 1992). The Legislature enacted statutory law governing the issue of which transportation services relate to medical treatment. See section 440.13(2)(a) and (5), Florida Statutes (Supp....
...medically necessary apparatus." The claimant in Marlowe, 589 So.2d at 990, who was unable to drive, asserted that subsection (2)(a) entitled her to attendant care benefits because her family was required to provide her with transportation. We noted in that opinion: We do not, however, read the language in section 440.13(2)(a) that attendant care services must be medically necessary to mean that attendant care benefits are authorized to a claimant for transportation services for various and sundry purposes. Supportive services such as driving the claimant to the store and other places, other than transportation necessary for medical treatment pursuant to section 440.13(6) [previously numbered 440.13(5)], constitute quality of life activities indemnified under disability compensation benefits rather than attendant care service that is medically necessary....
...ticipate. Lichtblau testified that social outings such as those activities enumerated above and in the final order relate to Claimant's need for socialization and community reintegration. Marlowe indicates the Legislature did not intend the scope of section 440.13(2)(a), Florida Statutes (Supp. 1988), to encompass benefits to Claimant for transportation services relating to visits such as to the beach, the grocery store, the movies, and the mall. Section 440.13(5), Florida Statutes (Supp....
...ife activities" for which benefits and reimbursement were denied in Marlowe. Irrespective of how salutary and beneficial such social and recreational activities might be to all persons, not just to Claimant, we are compelled by the plain language of section 440.13(2)(a) and (5), Florida Statutes (Supp....
...a two-bedroom, two-bathroom home is a medical necessity for which the e/c must bear total responsibility. We agree, finding such an award is beyond the authority of the JCC under the statutory language governing an award of "medical apparatus." See section 440.13(2)(a), Florida Statutes (Supp....
...the particular claimant, "given the unique facts presented in this case." Id. at 303. Morrell is consistent with the e/c's assertion that the housing award must meet the requirements of what is medically necessary for a particular claimant, and that section 440.13(2)(a), Florida Statutes (Supp....
...Rivers, 562 So.2d 784 (Fla. 1st DCA 1990), we reversed an award that had denied a claim for psychological evaluations and counseling for the claimant's husband and children. The JCC had determined such an award was not an authorized medical benefit under section 440.13, Florida Statutes, because it was not a service rendered directly to the injured employee. We stated: [A] section 440.13 medical benefit may include services to the claimant's family, such as child care, when it is necessary to facilitate the injured employee's treatment and recovery......
...ons in Claimant's residence. Rather, the pertinent statutory provisions simply do not authorize the JCC to require the e/c to bear the cost of providing the parents with such accommodations. See Cremeens, 597 So.2d at 396-97. ATTENDANT CARE BENEFITS Section 440.13(2)(e)(2), Florida Statutes (Supp....
...Winn Dixie Stores, Inc., 578 So.2d 356, 358 (Fla. 1st DCA 1991). The current version of that provision retains the 12-hour cap on compensation for attendant care but permits the 12 hours of care to be provided by "a family member or a combination of family members." See section 440.13(2)(h)(2), Florida Statutes (1991)....
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Mills v. Walden-Sparkman, Inc., 493 So. 2d 64 (Fla. 1st DCA 1986).

Cited 5 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 1847

...ndividual case." In addition, the deputy commissioner held that as to the mileage claim, the claimant had not previously submitted it. We hold that under the circumstances of this case it was error to totally deny the claim for transportation costs. Section 440.13(4), Florida Statutes (1982) [now 440.13(5)] allows reimbursement for travel expenses to claimants who incur costs when attempting to receive authorized treatment....
...The amount should not necessarily be based upon the amount of wages lost but should be a reasonable amount for the services rendered if the wages lost exceed that amount. Unlike attendant care services, reimbursement for transportation costs are allowed only where they are "actual" costs because of the requirements of section 440.13(4), Florida Statutes (1982) [now 440.13(5)]....
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Allen v. Protel, Inc., 852 So. 2d 916 (Fla. 1st DCA 2003).

Cited 5 times | Published | Florida 1st District Court of Appeal | 28 Fla. L. Weekly Fed. D 1945

...the opinion of the EMA physician that claimant was incapable of employment from a psychiatric standpoint. Claimant points out that the presumption of correctness accorded to an EMA's opinion can only be overcome by clear and convincing evidence. See § 440.13(9)(c), Fla....
...reen Co. v. Carver, 770 So.2d 172, 175 (Fla. 1st DCA 2000). We observed, regarding the effect of such evidence: An expert medical advisor's opinion is presumed to be correct and may only be rejected on the basis of clear and convincing evidence. See § 440.13(9)(c), Fla....
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Carswell v. Broderick Const., 583 So. 2d 803 (Fla. 1st DCA 1991).

Cited 5 times | Published | Florida 1st District Court of Appeal | 1991 WL 152496

...ified treatment, hospitalization or office visits and excessive charges for medical care in a particular claimant's case must be made by the Division *804 of Workers' Compensation of the Department of Labor and Employment Security. The provisions of section 440.13, Florida Statutes (1991), dealing with the term "utilization review" and the reference to "overutilization" deal with the practices of a particular health care provider and give rise to deauthorization of that provider for treatment of...
...ployees as well as denial of payment or requirement for reimbursement in a specific case. It is not our purpose to differentiate between the Division and the Judge of Compensation Claims all of the various duties and responsibilities contemplated by section 440.13....
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Chapman v. Nationsbank, 872 So. 2d 390 (Fla. 1st DCA 2004).

Cited 5 times | Published | Florida 1st District Court of Appeal | 29 Fla. L. Weekly Fed. D 1076

...*391 Randy Ellison, Jupiter, for Appellant/Cross-Appellee. Joshua M. Levy, Bay Harbor Islands, for Appellees/Cross-Appellants. ERVIN, J. Claimant, Sandra Chapman, appeals from a final workers' compensation order denying her motion to appoint an expert medical advisor (EMA) pursuant to section 440.13(9), Florida Statutes (1997), and the employer/carrier (E/C), Nationsbank and Royal & Sunalliance Insurance, cross-appeals, urging that because the judge of compensation claims (JCC) decided that claimant had made a false, fraudulent or...
...ted Dr. Friedman's opinion of a causal relationship, because he had been furnished with an inaccurate history; therefore, his examination "at its worst [was] tainted, at its best it [was] completely unreliable." The JCC erred as to both conclusions. Section 440.13(9) on its face clearly mandates the appointment of an EMA in situations in which a conflict occurs between expert medical opinions: If there is disagreement in the opinions of the health care providers, if two health care providers dis...
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Townsley v. Miami Roofing & Sheet Metal Co., 79 So. 2d 785 (Fla. 1955).

Cited 5 times | Published | Supreme Court of Florida

...f our Workmen's Compensation Act which, like the Federal Longshoremen's and Harbor Workers' Compensation Act, 33 U.S.C.A. § 901 et seq., makes a clear distinction between the employer's obligations to pay compensation and to render medical aid. See Section 440.13(3) (b), Fla....
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Div. of Workers'comp., Etc. v. Mckee, 413 So. 2d 805 (Fla. 1st DCA 1982).

Cited 5 times | Published | Florida 1st District Court of Appeal

...It is thus unnecessary for this court to consider, and we expressly decline to address, the appropriateness of the proposed state-wide maximum fee schedule for workers' compensation medical payments. The order appealed is affirmed. ERVIN and SHIVERS, JJ., concur. NOTES [1] See § 440.13(3)(a), Florida Statutes.
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Howard Johnsons v. Pineda, 560 So. 2d 336 (Fla. 1st DCA 1990).

Cited 5 times | Published | Florida 1st District Court of Appeal | 1990 WL 52794

...The employer/carrier (E/C) appeals an order directing the E/C to pay attendant care benefits to the claimant's wife at the rate of $6.00 per hour for eight hours per day, seven days per week. It argues that the judge of compensation claims (JCC) erred by refusing to apply the provisions of Section 440.13(2)(e), Florida Statutes (Supp....
...NOTES [1] Because our disposition of this case is grounded upon the parties' stipulation, it is not necessary to reach the merits of the statutory argument. We do note, however, that but for the stipulation, the value of the attendant care services would be controlled by Section 440.13(2)(e), Florida Statutes (Supp....
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Applegate Drywall Co. v. Patrick, 559 So. 2d 736 (Fla. 1st DCA 1990).

Cited 5 times | Published | Florida 1st District Court of Appeal | 1990 WL 48645

...After a hearing the judge approved this arrangement, but ordered that employer/carrier remain responsible for "all insurance payments as well as all maintenance and repair" for the vehicle. Since a wheelchair van is awardable as a medical benefit under section 440.13(2), Florida Statutes, upon an appropriate showing of need, see generally, Aino's Custom Slip Covers v....
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Iowa Nat'l Mut. Ins. Co. v. Webb, 174 So. 2d 21 (Fla. 1965).

Cited 5 times | Published | Supreme Court of Florida

...Petitioner contends that Michigan Mutual ought to pay these benefits and claim refund for a portion thereof from the special disability fund. We agree that any responsibility of Iowa National for payment of medical benefits resulting from the 1956 injury is not barred by the statute of limitations. Section 440.13(3) (b), F.S....
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Arizona Chem. Corp. v. Hanlon, 605 So. 2d 938 (Fla. 1st DCA 1992).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1992 WL 235292

...iodetoxification treatment is experimental. Florida's Workers' Compensation Act requires that the employer furnish such medically necessary treatment, care and attendance by a health care provider for such period as the recovery process may require. § 440.13(2)(a), Fla. Stat. (1991). Section 440.13(1)(d), Florida Statutes (1991), provides that: "Medically necessary" means any service or supply used to identify or treat an illness or injury which is appropriate to the patient's diagnosis, consistent with the location of service and with the level of care provided....
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Teimer v. Pixie Playmates, 532 So. 2d 37 (Fla. 1st DCA 1988).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1988 WL 105511

...Lott, 473 So.2d 249, 254 (Fla. 1st DCA 1985). We agree with claimant that the employer's company policy does not alter the employer and carrier's obligation to provide chiropractic health care when it is desired and needed. We are also aware of the provisions of section 440.13(3), Florida Statutes, where it is stated: "[i]t is unlawful for any employer......
...to coerce a sick or injured employee in the selection of a physician ..." Claimant has the right to veto the employer and carrier's selection and compel the employer and carrier to authorize another selection. "[O]therwise, the guarantee against coercion contained in section 440.13(2) is made a mere sham." Cal Kovens at 254....
...or was not authorized upon claimant's request to seek chiropractic treatment, once she had seen the company doctor as required. The employer and carrier are required to include a chiropractor in its list of health care providers pursuant to sections 440.13(2)(a); 440.13(1)(f), Florida Statutes. Failure to provide the care or obtain a deputy's ruling renders the employer and carrier responsible for unauthorized treatment pursuant to section 440.13(2), Florida Statutes, if it is found by the deputy to be reasonable and necessary....
...Finally, with respect to the deputy's denial of future chiropractic care challenged in point three, we acknowledge that "[a] deputy commissioner may at any time, for good cause shown, in the deputy commissioner's discretion, order a change in such remedial attention, care or attendance." Section 440.13(3), Florida Statutes....
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Zabik v. Palm Beach Cnty. Sch. Dist., 911 So. 2d 858 (Fla. 1st DCA 2005).

Cited 4 times | Published | Florida 1st District Court of Appeal | 2005 WL 2297539

...Certiorari review lies if the JCC orders a psychiatric IME without statutory authority. See Taylor v. Columbia/HCA Doctors Hosp. of Sarasota, 746 So.2d 1244 (Fla. 1st DCA 1999). In the present case no statutory authority supports the issuance of the IME order. Section 440.13(5)(a), Florida Statutes (2000), permits an IME if the facts disclose a dispute regarding over utilization, medical benefits, compensability, or disability, and section 440.1925(1), Florida Statutes (2000), authorizes an IME on facts showing a dispute regarding maximum medical improvement or permanent impairment....
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Watson v. Freeman Decorating Co., 455 So. 2d 1097 (Fla. 1st DCA 1984).

Cited 4 times | Published | Florida 1st District Court of Appeal

...Zientz of Williams & Zientz, Coral Gables, for appellees. PER CURIAM. In this workers' compensation proceeding the deputy commissioner denied payment of claimant's hospital and doctor bills, finding no good cause shown for the failure to file reports timely as required by Section 440.13(1), Florida Statutes (1981)....
...Claimant's hospital discharge was on a Thursday, and he returned to work the following Monday. On October 22, 1981, Dr. Suarez-Pupo submitted a bill for his services. The employer/carrier controverted on the ground that Dr. Suarez-Pupo had not complied with the reporting requirement of Section 440.13(1)....
...The deputy commissioner found that claimant had suffered a compensable injury but denied payment of the medical bills on the grounds that the medical services were provided without the knowledge or authorization of the employer/carrier, and neither the doctor nor the hospital complied with the reporting requirement of Section 440.13(1), with which no good cause shown for failure to so comply....
...treating physician's tardy conduct. The legislature, however, has recognized the harshness of what might result if an inflexible rule were applied in all cases disallowing the payment of medical bills caused by a technical violation of the statute. Section 440.13(1) further provides that the deputy may excuse for good cause the failure of the physician to furnish the report during the period involved. We must now determine whether good cause was established to excuse such failure. We note at the outset that we reject the deputy commissioner's finding that Palmetto General Hospital failed to comply with the reporting requirement of Section 440.13(1)....
...1973); Milros-Sans Souci, Inc. v. Dade County, 296 So.2d 545, 548 (Fla. 3d DCA 1974). The employer/carrier here offered no such contrary showing. In the case at bar, there are two possible explanations for Dr. Suarez-Pupo's failure to timely file reports as required by Section 440.13(1)....
...Suarez-Pupo billed Bankers Insurance for medical services rendered to claimant, rather than the carrier, Hartford. No explanation was advanced that would explain why the doctor sent his bill to the *1100 wrong insurer. However, failure to timely file Section 440.13(1) reports has been excused when the record demonstrates confusion on the part of physicians over where they should send their bills, and the carrier was not hindered in evaluation of the claim by the absence of prompt formal reports....
...For example, inability to file, waiver or conduct by the employer, may support a finding of good cause to waive the ten-day requirement. Actual knowledge is an important element of waiver. The Torres decision is significant in several respects. First, it identifies the reasons for section 440.13(1)'s reporting provisions (to notify the employer in order to avoid the risks of inflated bills or treatment which duplicates treatment already made available, and to bring such treatment properly within the machinery of the workers' compensation program)....
...McDonald, 395 So.2d 203, 211 (Fla. 1st DCA 1981); Holiday Care Center v. Scriven, 418 So.2d 322, 327 (Fla. 1st DCA 1982). We therefore conclude that a claimant satisfies his burden of establishing a good cause excuse for a health care provider's failure to honor section 440.13's reporting requirements when under such circumstances as this case, he has presented evidence disclosing that the employer has conducted itself so inconsistently as to have waived its right to rely on those requirements as a defense to the claim....
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Hancock v. Suwannee Cnty. Sch. Bd., 149 So. 3d 1188 (Fla. 1st DCA 2014).

Cited 4 times | Published | Florida 1st District Court of Appeal | 2014 Fla. App. LEXIS 17871, 2014 WL 5487123

...dvance payment of $1500. The payment not yet resolved by the time of the exam, Claimant arrived with a videog-rapher, only to be turned away by the doctor. The doctor billed the E/C a cancellation fee (“no-show fee”) of $600 for the missed exam. Section 440.13(5)(d), Florida Statutes (2012), requires an injured employee to reimburse the E/C half of the no-show fee if the employee “fails to appear for the [IME] scheduled by the employer or carrier without good cause.” Upon the E/C’s mot...
...An IME is part of the discovery process in workers’ compensation proceedings. A physician undertaking the role as an IME is not at liberty to demand that payment be made on his or her terms, but is instead regulated by statutorily mandated reimbursement standards. See § 440.13(12)(d), Fla....
...ine the propriety and reasonableness of the doctor’s additional, in-advance, video fee. After determining the appropriateness of the fee, the JCC shall then determine (a) whether Claimant should be assessed half of the doctor’s no-show fee under section 440.13(5)(d), and (b) which party, if any, is responsible for payment of the doctor’s videographer fee at any future IME....
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Farm v. Ferrell, 458 So. 2d 1147 (Fla. 1st DCA 1984).

Cited 4 times | Published | Florida 1st District Court of Appeal

...married the claimant she was excluded from payment for her services because the services were of the type that fall within the gratuitous presumption when performed by a spouse." We find no such inference in this case. [1] Even the current statute, § 440.13(2)(d), Florida Statutes, as amended in 1983 to codify the earlier decisional rule, clearly contemplates compensation for family members who render nonprofessional custodial care except "when the services they provide do not go beyond those...
...such a presumption would be discrimination based on marital status. If services are needed, it would be discriminatory to pay a nurse's aide who lived in, but not pay a nurse due to the mere fact of marriage." [2] Cf. Walt Disney World v. Harrison, 443 So.2d 389, 393: "It is not the purpose of section 440.13 to burden family members with medically required ......
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Rodriguez v. Howard Indus., 588 So. 2d 646 (Fla. 1st DCA 1991).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1991 WL 216525

...of Miami, 491 So.2d 600, 603 (Fla. 1st DCA 1986) ("in the absence of medical evidence demonstrating an inability to work... [the claimant must show he or she] engaged in a bona fide but unsuccessful search for work") (emphasis added). Turning to the attendant care issue, Section 440.13(2), Florida Statutes (Supp....
...Jaen, the only physician who testified on that issue, stated on cross-examination that such services would be "helpful" to claimant but that they were not "medically necessary." In so ruling, the JCC has apparently overlooked the express language of section 440.13(2)(a), which requires the E/C to provide the employee with remedial treatment, care, and attendance "for such period as the nature of the injury or the process of recovery may require," and section 440.13(2)(d), which requires the E/C to provide appropriate professional and nonprofessional attendant care "when the nature of the injury so requires." (Emphasis added.) This includes palliative attentions of another which mitigate the conditions or effects of the claimant's injury....
...NOTES [1] Both doctors are, in fact, in agreement that claimant sustained a PI to his shoulder — Dr. Jaen opined 35 percent and Dr. Enriquez opined 15 to 20 percent. [2] In regard to the E/C's arguments concerning application of the 1989 and 1990 amendments to section 440.13, particularly the amendment requiring a physician to prescribe attendant care, this issue was not raised below and is therefore waived....
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Allied Disc. Tires v. Cook, 587 So. 2d 626 (Fla. 1st DCA 1991).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1991 WL 204595

...eeded unskilled attendant care. He did state that he had not seen claimant for over a year when he gave his deposition, and that if there had been changes in claimant's condition since then, he would defer to someone who continued to treat claimant. Section 440.13(2), Florida Statutes (1985), requires the E/C to provide medically necessary treatment, care, and attendance, including appropriate professional and nonprofessional attendant care....
...Vliegenthart testified that he would not quarrel with an award of fifteen hours and it is unclear whether Mr. Hoeffner's eight-to-ten hour estimate included the amount of time he considered was required for cooking. [4] In so saying, we observe that the applicability of Section 440.13(2)(f), Florida Statutes (Supp....
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Televisual Comm. v. St. Dept. of Labor, 667 So. 2d 372 (Fla. 1st DCA 1995).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1995 WL 698885

...Televisual Communications, Inc. (TVC) seeks review of a final order of the Division of Administrative Hearings, Department of Administration, dismissing its rule challenge petition for lack of standing. We reverse and remand for further proceedings. Section 440.13(3), Florida Statutes (Supp....
...The proposed rules establish the procedures and requirements to implement the certification of health care providers and establish the procedures and criteria for the approval of the minimum 5-hour training course required for physician certification in accordance with section 440.13....
...rofits from the sale of videos that it might, if the rule allowed home study, otherwise garner. The hearing officer observed that the proof demonstrates that TVC is "not a health care provider or a representative of health care providers affected by section 440.13(3), Florida Statutes (Supp....
...The rules also provide for revocation of approval of a course upon certain grounds. In summary, the rule purports to regulate the industry that provides the medium for education of health care providers. The hearing officer correctly noted that TVC was not a health care provider affected by section 440.13(3), Florida Statutes (Supp....
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Cent. Oil Co. v. Campen, 390 So. 2d 191 (Fla. 1st DCA 1980).

Cited 4 times | Published | Florida 1st District Court of Appeal

...Stat., is inapplicable because it does not provide for the assessment of costs, while § 440.29(1), Fla. Stat., is inapplicable for the same reason. See Lu-Mar Enterprises, Inc. v. Mazur, 8 FCR 248, 249 (1974). We recognize that treatment at a pain clinic may constitute remedial treatment pursuant to § 440.13(1), Fla. Stat. See Planning Research Co. v. Shy, 379 So.2d 1047 (Fla. 1st DCA 1980). Also, § 440.13(2), Fla....
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Oriente Exp. Inn v. Rodriguez, 406 So. 2d 55 (Fla. 1st DCA 1981).

Cited 4 times | Published | Florida 1st District Court of Appeal

...John W. Salmon of Whitman, Wolfe & Gross, Miami, for appellees. WENTWORTH, Judge. Employer/carrier appeals a workers' compensation order granting a claim for temporary total disability compensation, awarding medical care "pursuant to the provisions of F.S. 440.13," and finding claimant, a waitress, had not been rated for permanent disability....
...Wright, 389 So.2d 1074 (Fla. 1st DCA 1980). For similar reasons appellant's reliance on Cardinal Industries, Inc. v. Dawkins, 392 So.2d 368 (Fla. 1st DCA 1981), is misplaced insofar as the order finds entitlement to future medical attention "pursuant to ... *56 F.S. 440.13." No appeal is taken from the reservation of jurisdiction to determine permanent disability, and we find no conflict between the quoted language and the determination of maximum medical improvement based on the opinion of an examining physician....
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Ringling Bros.-Barnum & Bailey Comb. Shows v. Jones, 134 So. 2d 244 (Fla. 1961).

Cited 4 times | Published | Supreme Court of Florida

...Claimant says that he immediately reported the accident to the circus employer, who failed to file reports of the injury as required by § 440.36, Florida Statutes, F.S.A., and who failed to furnish medical treatment and compensation as required by § 440.13 and § 440.20, Florida Statutes, F.S.A....
...equired to resolve any doubts that may be shown to exist in favor of the working man. The second and last question presented is whether or not payment for medical bills may be allowed when medical reports are not filed within ten days as required by § 440.13(1), Florida Statutes, F.S.A., and good cause is not shown for failure to file them. It is true that § 440.13(1), Florida Statutes, F.S.A., directs the claimant to furnish the employer medical reports within ten days of the date first treatment is administered, on the pain of absolving the employer from liability for payment therefor....
...nefits after it was given notice of the injury and failed to file proper notice to controvert, in view of all of which it does seem that the conduct of the circus was so inconsistent and unreasonable that by its conduct it waived the requirements of § 440.13(1), Florida Statutes, F.S.A., Foster v....
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Atl. Found. v. Gurlacz, 582 So. 2d 10 (Fla. 1st DCA 1991).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1991 WL 75574

...The e/c moved to dismiss the claim on the grounds that the Division of Workers' Compensation, rather than the JCC, was the proper forum for resolution of the dispute. The JCC denied the motion, finding that he had jurisdiction pursuant to sections 440.10(1), 440.13(2)(a) and (b), and 440.25(1), Florida Statutes. This petition for writ of prohibition followed. Petitioners argue that by statute and rule the Division of Workers' Compensation clearly has jurisdiction of this matter, relying on section 440.13(2)(i)1., Florida Statutes (Supp....
...Sinai and Long Grove Builders decisions addressed the issue squarely and found that the Division of Workers' Compensation, rather than a Judge of Compensation Claims, is the proper forum for disposition of Dr. Lovaas' claim. The statutory authority for the agency's jurisdiction is section 440.13(4)(a), Florida Statutes (1989) and the pertinent rule appears at F.A.C....
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Farm Stores, Inc. v. Fletcher, 621 So. 2d 706 (Fla. 1st DCA 1993).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1993 Fla. App. LEXIS 5069, 1993 WL 143948

...r awarding care by Dr. Castellano. Such a general award merely begs the question of the reasonableness and necessity of proposed care and treatment. The E/SA's statutory right to an independent dental examination, however, is not without limitation. Section 440.13(2)(b), Florida Statutes (1991), seems to impose a "reasonableness" requirement subject to the scrutiny of the JCC....
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Walt Disney World Co. v. Schiebel, 397 So. 2d 1004 (Fla. 1st DCA 1981).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1981 Fla. App. LEXIS 19725

...to pay certain unauthorized medical bills. The Deputy Commissioner's order made no specific finding on whether good cause excused the failure of the claimant and her chiropractor to comply with the timely reporting requirements of Florida Statutes, Section 440.13(1) (1979)....
...Plescow, IRC 2-3690 (February 8, 1979). Accordingly, that portion of the order below which requires payment of unauthorized and unreported medical bills is reversed and remanded for a specific finding on whether good cause existed for the failure to comply with Section 440.13(1)....
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Mt. Sinai Med. Ctr. v. Samuels, 453 So. 2d 81 (Fla. 1st DCA 1984).

Cited 4 times | Published | Florida 1st District Court of Appeal

...Claimant testified at the hearing that she had received the bills; claimant's treating physician testified at his deposition as to the amount of the bills. Whether the bills correspond to the fee schedule is immaterial, as that matter will be handled administratively under section 440.13(3)(a), Florida Statutes (1981), allowing for the health care provider to be paid either his customary charge or the maximum charge under the schedule, whichever is the lesser amount....
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Dept. of Labor & Emp. Sec. v. Bradley, 636 So. 2d 802 (Fla. 1st DCA 1994).

Cited 4 times | Published | Florida 1st District Court of Appeal

...ed interdisciplinary team's evaluation," or limitation to one "accrediting" organization to the exclusion of other similar organizations that are equal to or exceed the "accrediting standards" of CARF [2] ; (4) the proposed new rules amend or modify section 440.13, and exceed the authority for rulemaking delegated to the Division, "constituting an invalid exercise of delegated ......
...The Division did not give consideration to the chiropractic rehabilitative association as an accrediting association for the proposed rules, because the association had not been formed when the proposed rules were promulgated. The Division relied upon sections 440.13(1)(d) and 440.591, Florida Statutes (1991) as authority for promulgation of the proposed rules. In ruling that proposed Rules 38F-7.802(1) and (5), 38F-7.803(2), and 38F-7.806(2)(f) are invalid, the hearing officer found the Division's adoption of the proposed rules was not in the manner prescribed by section 440.13(1), Florida Statutes....
...ery of disability and medical benefits to an injured worker at a reasonable cost to the employer... . See also Ch. 91-1, Preamble, Laws of Fla. The challenged rules were designed to implement delivery of the "medically necessary" services defined in section 440.13(1)(d), and the procedure outlined in section 440.13(2)(d)....
...rida Statutes, which provides: The division shall have the authority to adopt rules to govern the performance of any programs, duties, or responsibilities with which it is charged under this chapter. More specific rulemaking authority is provided in section 440.13(1)(d), which states: (d) "Medically necessary" means any service or supply used to identify or treat an illness or injury which is appropriate to the patient's diagnosis, consistent with the location of service and with the level of care provided....
...nt. See § 440.015, Fla. Stat. (1991). The second issue concerns the hearing officer's seeming determination that the Division's proposed rules must be formulated or reviewed by a peer review committee. The hearing officer's construction of sections 440.13(1)(c), (e), and (f), so as to require the Division to develop proposed rules through the vehicle of a "peer review committee" imposes an erroneous gloss upon the Division's rulemaking authority....
...of care of injured workers. See Agrico Chemical Co. v. DER, 365 So.2d at 763. We conclude the Division's authority to adopt proposed Rules 38F-7.802(1) and (5), 38F-7.803(2), and 38F-7.806(2)(f) is reasonably implied by the express terms of sections 440.13(1)(d) and 440.591....
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Malu v. Sec. Nat. Ins. Co., 848 So. 2d 373 (Fla. 4th DCA 2003).

Cited 4 times | Published | Florida 4th District Court of Appeal | 2003 Fla. App. LEXIS 7498, 2003 WL 21180173

...Allstate Insurance Co., 498 So.2d 514 (Fla. 5th DCA 1986), the court held that "reasonable expenses" for medical services under the PIP statute included the cost of auto transportation. The court based its reasoning on the fact that the workers' compensation statute, section 440.13(5), Florida Statutes (1985), included the "reasonable actual cost of transportation to and from the doctor's office, hospital or other place of treatment." The court also noted that even before the workers' compensation statute include...
...[1] We therefore conclude that the PIP statute does not include the transportation expenses claimed in this case. We affirm and certify conflict with Hunter. GROSS and TAYLOR, JJ., concur. NOTES [1] The legislature specifically added transportation costs to our workers' compensation statute, section 440.13(5), in 1977....
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Honeycutt v. RG Butlers Dairy, 525 So. 2d 984 (Fla. 1st DCA 1988).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1988 WL 50143

...mployee's injury, to place needed benefits in the hands of the injured worker. An employer must offer or furnish benefits when the employer knows, or reasonably should know from facts properly and diligently investigated, that such benefits are due. Section 440.13(2)(b) requires the employer to provide nursing care benefits, even though not requested, if the nature of the injury requires such benefits....
...The D/C denied the claim from January 1985 to the present and continuing finding that the evidence showed that the wife performed only gratuitous, household services on Honeycutt's behalf. The E/C argues that the D/C should be affirmed in that the no statute in effect at the time of Honeycutt's injury, Section 440.13(1), Florida Statutes (1979), should control....
...However, in Bonnie Heath Farms v. Ferrell, 458 So.2d 1147 (Fla. 1st DCA 1984), this *987 court affirmed a 1984 compensation order awarding attendant care services retroactively to 23 January 1976. In doing so, the court pointed out that the current statute, Section 440.13(2)(d) as amended in 1983 to codify earlier decisional rulings clearly contemplates compensation for family members who render nonprofessional custodial care....
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Farnam v. U.S. Sugar Corp., 9 So. 3d 41 (Fla. 1st DCA 2009).

Cited 4 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1922, 2009 WL 559915

...Skagfield Corp., 887 So.2d 434, 435 (Fla. 1st DCA 2004) (holding "the JCC improperly determined the compensability of claimant's back condition because the issue was not before the JCC"). Because the JCC erred in addressing the repetitive trauma claim, she erred in denying the IME. Section 440.13(5), Florida Statutes, allows for an IME when there is a dispute concerning compensability....
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James W. Windham Builders, Inc. v. Overloop, 951 So. 2d 40 (Fla. 1st DCA 2007).

Cited 4 times | Published | Florida 1st District Court of Appeal | 2007 Fla. App. LEXIS 3270, 2007 WL 649340

...Wiitala of Wiitala & Contole, P.A., North Palm Beach, for Appellee. THOMAS, J. In this workers' compensation case, Appellant-Employer/Carrier (E/C) seeks review of an order finding it responsible for Claimant's attendant care. We agree with E/C that section 440.13(2)(b), Florida Statutes (2004), requires that a prescription be in writing before attendant care will be provided; however, because we find that Claimant's failure to provide a written prescription was caused by E/C's willful ignorance, we affirm the findings of the Judge of Compensation Claims (JCC)....
...y. E/C received the prescription the next day. On the same date that E/C received the written prescription, Claimant filed a petition for benefits requesting, inter alia, payment of attendant care to his Wife. E/C denied coverage on the grounds that section 440.13(2)(b), Florida Statutes (2004), requires an attendant care prescription not only be in writing, but also that the prescription be written before the attendant care is actually provided....
...appeal follows. An award of attendant care is subject to the requirements of the statute in effect at the time the care was provided. See Socolow v. Flanigans Enters., 877 So.2d 742 (Fla. 1st DCA 2004). At the time Claimant received attendant care, section 440.13(2)(b), Florida Statutes (2004), stated the following: The employer shall provide appropriate professional or nonprofessional attendant care performed only at the direction and control of a physician when such care is medically necessary....
...interpretation and construction. The statute must be given its plain and obvious meaning. McLaughlin v. State, 721 So.2d 1170, 1172 (Fla.1998). A court has no power to modify an unambiguous statute by judicial interpretation. Id. A plain reading of section 440.13(2)(b), Florida Statutes (2004), states that attendant care is compensable *43 only if it is provided after E/C receives a written prescription....
...Accordingly, the JCC made a factual finding that E/C's actions were an attempt to hide behind a wall of willful ignorance. We agree. An employer must monitor a claimant's injuries and provide needed benefits. IMC Phosphates Co. v. Prater, 895 So.2d 1263 (Fla. 1st DCA 2005). Although E/C argues that the applicable version of section 440.13(2)(b), Florida Statutes (2004), has precluded the duty to investigate attendant care until a written prescription is received, we find this reasoning unfounded....
...E/C argues that despite this evidence, the statutory requirement of a written prescription for attendant care absolves E/C of any duty to inform a doctor or employee of the statutory requirement. We do not agree that this is a reasonable reading of section 440.13(2)(b), Florida Statutes (2004)....
...cal justification for attendant care; it does not authorize an e/c to willfully ignore an employee's need for treatment by failing to disclose the statutory requirement of the treating physician. Although we find that the JCC incorrectly interpreted section 440.13(2)(b), Florida Statutes (2004), we further find that E/C did not meet its burden in properly investigating and informing Claimant or his doctor concerning the assisted care requirements....
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Montgomery Ward v. Lovell, 652 So. 2d 509 (Fla. 1st DCA 1995).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1995 WL 133352

...very other day. Because performing these tasks now aggravates her back injury, she desired to have someone regularly clean her home according to her requirements. Consequently, she made a worker's compensation claim for attendant care benefits under section 440.13, Florida Statutes....
...ensated for such services which go beyond the scope of household duties performed gratuitously by a family member. "Attendant or custodial care" means care usually rendered by trained professional attendants and beyond the scope of household duties. § 440.13(2)(f), Fla....
...odified a concept found in existing case law, and did not, contrary to the appellee's argument, eliminate a "medically necessary benefit." "Medically necessary" constitutes the general defining term under which all compensable benefits awarded under section 440.13, Florida Statutes, must fall....
...1st DCA 1991), a case decided before the 1990 amendments, this court analyzed attendant care benefits in light of the statute requiring the employer to furnish to the employee "such medically necessary remedial treatment, care, and attendance by a health care provider... ." See § 440.13(2)(a), Fla....
...Sealey Mattress Co. v. Gause, 466 So.2d 399, 400 (Fla. 1st DCA 1985). Further, as the Marlowe court explained, "[s]upportive services such as driving the claimant to the store and other places, other than transportation necessary for medical treatment pursuant to section 440.13(6), constitute quality of life activities indemnified under disability compensation benefits rather than attendant care service that is medically necessary." 589 So.2d at 994 (footnote omitted)....
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City of Hialeah v. Jimenez, 527 So. 2d 936 (Fla. 1st DCA 1988).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1988 WL 67274

...1st DCA 1987). The employer was thus properly required to pay for chiropractic treatment which the claimant obtained after request, insofar as such treatment was determined to be reasonable and necessary. See Kirkland v. Harold Pratt Paving, supra ; section 440.13(2)(b), Florida Statutes....
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Fort v. Hood's Dairy, Inc., 143 So. 2d 13 (Fla. 1962).

Cited 4 times | Published | Supreme Court of Florida

...The second question presented is whether or not the deputy commissioner committed error as a matter of law in finding and holding that the employee would need or require medical care and treatment for the rest of his life. The employee contends that this question requires a negative answer. He relies on the language of §§ 440.13(1) and 440.13 (3) (b), Florida Statutes, F.S.A., to support this contention. Section 440.13(1) is as follows: "The employer shall furnish to the employee such remedial treatment, care, and attendance under the direction and supervision of a qualified physician or surgeon, or other recognized practitioner, nurse or hospital, and for such period, as the nature of the injury or the process of recovery may require * * *." Section 440.13(3) (b) is as follows: "All rights for remedial attention under this section including the right of the industrial commission to order additional treatment in excess of one thousand dollars, shall be barred unless a claim therefor is fi...
...ission acts on its own initiative within two years after the date of the last remedial treatment furnished by the employer, or after the date of the last payment of compensation." Employee's contention is that from the terms and clear implication of § 440.13(1) he is entitled to medical attention for such period as the nature of the injury or the process of recovery may require which the deputy commissioner found would be for the balance of his life. Section 440.13(3) (b) requires that employee must file his claim within two years or if the commission does not file it or act on it of its own initiative within two years, it is barred....
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CATV Support Servs., Inc. v. Lohr, 509 So. 2d 1189 (Fla. 1st DCA 1987).

Cited 4 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 1563

...and severity of claimant's injuries gave it constructive knowledge that claimant was in need of such care. The employer/carrier contends that the services which claimant's family members rendered were merely gratuitous and hence noncompensable under section 440.13(2)(d), Florida Statutes (1985), which provides: The employer shall provide appropriate professional or nonprofessional custodial care when the nature of the injuries so requires; but family members may not be paid for such care when th...
...provides services that go beyond those which would normally be provided on a gratuitous basis," and that in these circumstances, "compensation for nursing or attendant care services may be awarded." Id. This result is consistent with the purpose of section 440.13(1) which is not "to burden family members with medically required nursing services and unskilled attendant care when claimant leaves *1191 the hospital and returns home." Id....
...As in Walt Disney World v. Harrison , claimant's family substantially departed from their daily routine in caring for him, and the deputy commissioner correctly found that he was entitled to be compensated for this departure. If "[i]t is not the purpose for section 440.13 to burden family members with medically required nursing services and unskilled attendant care when claimant leaves the hospital and returns home," Walt Disney World, 443 So.2d at 393, then the purpose of the statute would surely have...
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Lakeland Reg'l Med. Ctr. v. Murphy, 695 So. 2d 895 (Fla. 1st DCA 1997).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1997 WL 338837

...We conclude that the JCC improperly admitted and relied upon these medical opinions. The medical opinions admissible in a proceeding before a JCC are limited to the opinions of (1) a medical advisor appointed by the JCC or division; (2) an independent medical examiner; or (3) an authorized treating provider. § 440.13(5)(e), Fla....
...a non-emergency situation it is the claimant's burden to seek a decision through the JCC or risk being required to pay the bill.). The JCC also erroneously concluded that the claimant had the authority to authorize a health care provider pursuant to section 440.13(5)(e), and had authorized Dr....
...Martinez was not authorized and the claimant did not receive authorization for the MRI prescribed by Dr. Martinez prior to the procedure, the JCC erred in ordering the E/C to pay for the April 10, 1995 MRI. Because Dr. Gonzalez, Dr. Martinez, and Dr. Barclay did not fall into any of the categories under section 440.13(5)(e), the JCC erred in admitting their medical opinions....
...The E/C failed to respond to the request, and the claimant's attorney scheduled an appointment with Dr. McClane on January 15, 1996. The JCC noted that there was a dispute concerning medical benefits and disability, entitling the claimant to select an independent medical examiner pursuant to section 440.13(5)....
...The JCC concluded that when the E/C refuses to provide an IME upon request, the claimant has the right to proceed with obtaining the IME subject to the JCC at a later date determining the reasonableness and medical necessity of the examination. We reject the JCC's analysis under the circumstances. Although section 440.13(5) enables an employee to select an independent medical examiner, section 440.13(5)(c) provides that an "attorney representing a claimant is not authorized to schedule independent medical evaluations under this subsection." The claimant should have followed the procedures set forth in sections 440.191 and 440.192, if necessary....
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Kraft Dairy Grp. v. Sorge, 509 So. 2d 1156 (Fla. 1st DCA 1987).

Cited 4 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 1494

...Fox, of Ress, Gomez, Rosenberg, Howland & Mintz, North Miami, for appellee. WENTWORTH, Judge. Appellant contends in this appeal from a workers' compensation order that the deputy erred in the award of attendant care by including ordinary household services. We affirm. As amended in 1983, section 440.13(2) states that: The employer shall provide appropriate professional or nonprofessional custodial care when the nature of the injury so requires; provided, however, family members shall not be paid for such care when the services they p...
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Norrell Corp. v. Carle, 509 So. 2d 1377 (Fla. 1st DCA 1987).

Cited 4 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 1777

...Our review of the record in this case leads us to conclude that there is no competent substantial evidence to support the deputy's order for psychiatric treatment. The claimant failed to adequately demonstrate that psychiatric treatment was reasonably required by the nature of the injury or the process of recovery. Section 440.13(2)(a), Florida Statutes (1985); Smith v....
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Wolk v. Jaylen Homes, Inc., 593 So. 2d 1058 (Fla. 1st DCA 1992).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1992 WL 862

...The judge found that due to the employer/self-insured's notice to claimant, and to Cloquet Chiropractic Clinic and Dr. LeSavage, of a finding of overutilization, he did not have subject matter jurisdiction to hear the claim. The issue in this case falls within the purview of section 440.13, Florida Statutes, which provides in pertinent part: (2)(a) ......
...Eagle Pest Control Co., Inc., 531 So.2d 350, 351 (Fla.1st DCA 1988); Cal Kovens Construction v. Lott, 473 So.2d 249, 253 (Fla.1st DCA 1985). The issue presented by claimant in this case requires a determination by the judge of compensation claims regarding whether deauthorization is in the best interests of the claimant. Section 440.13(2)(a), Fla....
...Deauthorization without an order by the judge is proper only where overutilization is the basis for deauthorizing such care, and where a determination has been made in accordance with the overutilization review procedures outlined in the statute, and alternate medical care has been offered by the employer or carrier. Section 440.13(2)(a), Fla. Stat. (1989). As justification for the unilateral deauthorization of the treating physician in this case, employer/carrier alleged overutilization, but failed to comply with the utilization review procedures prescribed by section 440.13(4)(d)1, Florida Statutes....
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City of North Miami v. Towers, 557 So. 2d 112 (Fla. 1st DCA 1990).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1990 Fla. App. LEXIS 826, 1990 WL 10883

...He based this figure upon the wife's testimony that she was paid either $5.75 or $5.78 per hour at her former job with J.C. Penney, and that she had also been provided with health and life insurance, profit sharing, a pension plan, paid vacations and holidays, and a fifteen percent discount on store merchandise. Section 440.13(2)(e)2, Florida Statutes (Supp....
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Seminole Cnty. Sch. Bd. v. Tweedie, 922 So. 2d 1011 (Fla. 1st DCA 2006).

Cited 4 times | Published | Florida 1st District Court of Appeal | 2006 WL 264061

...y 23, 2004, through August 16, 2004. The JCC also authorized the evaluation and treatment, if medically necessary, of claimant's left knee injury and awarded claimant penalties, interest, costs, and attorney's fees. This appeal followed. Pursuant to section 440.13(5)(e), Florida Statutes (2003), the only medical opinions admissible in proceedings before a JCC are the opinions of a medical advisor, an independent medical examiner, and an authorized treating provider....
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Dalton v. Orange Cnty. Sheriff, 503 So. 2d 406 (Fla. 1st DCA 1987).

Cited 4 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 602

...*407 Douglas H. Glicken, Orlando, for appellant. Steven A. Rissman and Robert C. Barrett, of Cooper, Rissman & Weisberg, Orlando, for appellees. ZEHMER, Judge. We review a workers' compensation order denying, in part, claimant's claim for benefits pursuant to section 440.13(2), Florida Statutes (1983), for attendant-care services performed by his wife, and denying his claim for attorney's fees for successful prosecution of his claim for medical benefits only, pursuant to section 440.34(3)(a), Florida Statutes (1983)....
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Hornfischer v. Manatee Cnty. Sheriff's Off., 136 So. 3d 703 (Fla. 2d DCA 2014).

Cited 4 times | Published | Florida 2nd District Court of Appeal | 37 I.E.R. Cas. (BNA) 1282, 2014 WL 538698, 2014 Fla. App. LEXIS 1826

...1st DCA 2010). In order to ensure that the system functions efficiently as intended, “[a]ny health care provider providing necessary remedial treatment, care, or attendance to any injured worker” is required to submit reports to the employer/carrier. § 440.13(4)(a), (c)....
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Strohm v. Hertz Corp., 685 So. 2d 37 (Fla. 1st DCA 1996).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1996 WL 708615

...*38 Law offices of Richard Sadow, and Steven R. Berger of Berger & Chafetz, Miami, for Appellant. Kimberly A. Hill of Conroy, Simberg & Lewis, P.A., Hollywood, for Appellees. KAHN, Judge. In this workers' compensation case, appellant Donald Strohm challenges the constitutionality of section 440.13(2)(a), Florida Statutes (1994 Supp.)....
...Appellees authorized chiropractic care immediately, and claimant sought treatment the day after the accident from chiropractor Michael Atwood. There is no dispute that appellee's ultimate deauthorization of Dr. Atwood fell within the provisions of section 440.13(2)(a): Medically necessary treatment, care and attendance does not include chiropractic services in excess of eighteen treatments or rendered eight weeks beyond the date of the initial chiropractic treatment, whichever comes first, unl...
...actic care at the time the Declaration of Rights in the Florida Constitution was adopted. Even assuming such a right, however, appellant has not carried his burden of demonstrating the abolition of such. The restriction crafted by the Legislature in section 440.13(2)(a) does not restrict the workers' compensation claimant's right to receive appropriate treatment; it merely diminishes, after a certain point in time, the range of providers who can offer such treatment under the Workers' Compensation Act. Under an access to courts analysis, we hold that the Legislature did not destroy or abolish a common law right of action by limiting chiropractic care under section 440.13(2)(a)....
...The statute before us does not abolish any common law right of action identified by appellant; nor does it deny a fair hearing or erect any classification scheme that fails to bear a reasonable relationship to a legitimate state interest. Accordingly, we declare that the restriction on chiropractic treatment in section 440.13(2)(a), Florida Statutes (1994 Supp.) is constitutional. AFFIRMED. DAVIS, J., concurs. BENTON, J., concurs with written opinion. BENTON, J., concurring. As Judge Kahn ably demonstrates, the claimant who brings this appeal need suffer no diminution in care nor any change in mode of therapy by virtue of section 440.13(2)(a), Florida Statutes (Supp.1994)....
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Com. Carriers, Inc. v. Porter, 424 So. 2d 155 (Fla. 1st DCA 1982).

Cited 4 times | Published | Florida 1st District Court of Appeal

...ating to the cingulotomies performed by Dr. Rivet. In my judgment there is competent and substantial evidence supporting the deputy's finding that there was no showing "that the employer ever offered to claimant any alternative to Dr. Rivet's care." Section 440.13(1), Florida Statutes (1975), provides in pertinent part: If the employer fails to provide the same [remedial treatment, care, etc.] after request by the injured employee, such injured employee may do so at the expense of the employer,...
...In reversing that portion of the deputy's order which refused to order the employer to pay for the requested evaluation and treatment of the unauthorized physician, we observed that the employer's reauthorization of the same doctor did not comply with the express provisions of Section 440.13(2), Florida Statutes (1979), which, in language identical to that of the 1975 statute, requires the employer "to select another physician to treat the injured employee" if the claimant objects to the medical treatment provided....
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St. Augustine Marine Canvas v. Lunsford, 917 So. 2d 280 (Fla. 1st DCA 2005).

Cited 4 times | Published | Florida 1st District Court of Appeal | 2005 WL 3454016

...Ravis, Esquire of Anderson & Howell, P.A., Jacksonville, for Appellee. BENTON, J. On this appeal from a compensation order, we conclude that the judge of compensation claims erred in deeming Arnold Graham-Smith, M.D., an authorized treating physician on the supposed authority of section 440.13(3)(d), Florida Statutes (2002)....
...Northrup referred her for pain management. These providers' authorization — at all pertinent times — to provide "such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require," § 440.13(2)(a), Fla....
...h counsel) requested authorization to see Dr. Graham-Smith for a second opinion regarding her treatment. Marine Canvas and its carrier refused to authorize such a second opinion on grounds that no managed care arrangement was in place. See generally § 440.134(6)(c)(9.), Fla....
...Graham-Smith saw her anyway on June 10, 2003, the day he began diagnosing and treating her, and billing her health insurer. Eventually, he decided that surgery to effect a left sacroiliac joint fusion was indicated, [4] and performed the surgery on October 9, 2003. [5] IV. Section 440.13, Florida Statutes (2002), establishes an employer's duty to see that an injured employee gets medical treatment, and prescribes the procedures for authorizing medical providers. The employer must secure provision of medically necessary treatment to an injured employee. See § 440.13(2)(a), Fla....
...But, after an employer has authorized a medical provider to evaluate and treat an injured employee, the employee may request a one-time change of physician. In that case, the employer must offer the employee a choice of at least three alternative physicians. See § 440.13(2)(f), Fla. Stat. (2002). If an injured employee requests medically necessary treatment, and the employer fails to provide it within a reasonable time, the employee may obtain *284 such treatment on her own at the employer's expense. See § 440.13(2)(c), Fla. Stat. (2002). Section 440.13 [6] does not, however, give the employee the right to treatment by the physician of her choice unless the employer refuses to provide a physician altogether. [7] Complementing one another, section 440.13(2) lists the employer's duties, while section 440.13(3) sets out the procedures under which physicians are authorized to receive payment for treating employees. Sections 440.13(2)(a) and (c) and 440.13(3)(d) are properly read together. [8] To be eligible for payment, a health care provider must receive authorization from the carrier before providing treatment (except in emergency situations). See § 440.13(3)(a), Fla. Stat. (2002). A health care provider's referral to another health care provider does not constitute authorization by the carrier. See § 440.13(3)(c), Fla. Stat. (2002). When one health care provider refers an employee to another health care provider for treatment, section 440.13(3)(d) applies....
...medical treatment by the close of the third business day after receipt of the request consents to the medical necessity for such treatment. All such requests must be made to the carrier. Notice to the carrier does not include notice to the employer. § 440.13(3)(d), Fla. Stat. (2002). Section 440.13(3)(d) "applies only to requests from doctors for referrals to other doctors." Schmitt, 694 So.2d at 145. If the employee makes the request, the employer has "a reasonable time" to respond; otherwise, treatment is deemed medically necessary. § 440.13(2)(c), Fla. Stat. (2002). If an authorized provider requests treatment, the employer has only three days to respond; otherwise, the treatment is deemed medically *285 necessary. See § 440.13(3)(d), Fla....
...Northrup. The claimant now argues that she had the right to treatment with Dr. Graham-Smith because Marine Canvas and its carrier did not respond to the "request for authorization," i.e., the petition for benefits, within three days. She argues that section 440.13(3)(d) should be applied without regard to what happened prior to the April 23, 2003 petition for benefits to which Dr....
...Marine Canvas and its carrier did not fail to authorize or provide treatment medically necessary for the claimant's injuries. The only thing they did not do was authorize the specific doctor that the claimant requested. This was their prerogative. They had the right to select the treating physician initially, and "[s]ection 440.13(2)(c), Florida Statutes, does not authorize the JCC to order treatment with a specific physician, where the E/C promptly offers qualified alternatives." City of Bartow, 896 So.2d at 933....
...stimony was not admissible at the hearing before the judge of compensation claims; and without his testimony there was no competent, substantial evidence to support the award of temporary total disability benefits for any period after June 10, 2003. Section 440.13(5)(e) states: No medical opinion other than the opinion of a medical advisor appointed by the judge of compensation claims or agency, an independent medical examiner, or an authorized treating provider is admissible in proceedings before the judges of compensation claims....
...Graham-Smith as an expert medical advisor. Neither Marine Canvas nor its carrier ever authorized him as a treating physician and, for the reasons explicated above, the judge of compensation claims erred in concluding that he was authorized as a treating physician by operation of section 440.13(3)(d), Florida Statutes (2002). While the judge of compensation claims did not reach the question whether Dr. Graham-Smith could be viewed as an independent medical examiner, it is clear on this record that the doctor did not meet statutory requirements. Section 440.13(5)(c), states: "An attorney representing a claimant is not authorized to schedule independent medical evaluations under this subsection." See also Lakeland Reg'l Med....
...ing examinations"). Additionally, an independent medical examiner is defined as "a physician selected by either an employee or a carrier to render one or more independent medical examinations in connection with a dispute arising under this chapter." § 440.13(1)(j), Florida Statutes (2002)....
...Graham-Smith. The claimant did not, moreover, designate Dr. Graham-Smith as an independent medical examiner until June 12, 2003, which was two days after Dr. Graham-Smith evaluated the claimant. Thus, Dr. Graham-Smith did not meet the criteria under section 440.13(5)(e) to testify at the hearing....
...Sullivan, 509 So.2d 268, 271 (Fla.1987). "[W]hen the language of the statute is clear ..., there is no occasion for resorting to the rules of statutory interpretation...." Id. (quoting A.R. Douglass, Inc. v. McRainey, 102 Fla. 1141, 137 So. 157, 159 (1931)). [7] See § 440.13(2)(c), Fla. Stat. (2002). Section 440.13(3)(d), Florida Statutes (2002), states only that failure to respond within three days means that the employer "consents to the medical necessity for such treatment." Whether this might have the effect of authorizing the specific provid...
...uld choose for a one-time change of physician. [8] Subsections of the same statute must be read in pari materia, especially when they are enacted into law simultaneously. See Okeechobee Health Care v. Collins, 726 So.2d 775, 776 (Fla. 1st DCA 1998). Section 440.13, Florida Statutes, was rewritten in 1993 when the Legislature made significant changes in the workers' compensation statutes: Section 440.13(3)(d) was added and sections 440.13(2)(a) and (c) were amended. See Ch. 93-415, § 17, at 100-102, Laws of Fla. Thus, they should be read together. See Okeechobee, 726 So.2d at 776. [9] The claimant argues that this long-standing rule does not apply to requests for authorization by a physician under section 440.13(3)(d), even though section 440.13(3)(d) does not specifically address the issue whether a claimant has a right to a particular physician simply because a treating physician recommended a specific physician....
...Nor does the claimant argue that the doctors who were provided — or the others who were offered — were in any way unqualified to treat her. [10] We do not hold that a letter addressed to and written by claimant's counsel should be deemed a referral within the meaning of section 440.13(3)(d)....
...rization, Marine Canvas and its carrier would only have been responsible for payment for an evaluation to determine whether she was a candidate for percutaneous nucleoplasty, not for the lengthy treatment and major surgery she in fact received. [12] Section 440.13(3)(i) states: "Notwithstanding paragraph (d), a claim for ......
...is not valid and reimbursable unless the [surgery] ha[s] been expressly authorized by the carrier, or unless the carrier has failed to respond within 10 days to a written request for authorization...." The claimant was required to request authorization for the surgery under section 440.13(3)(i), "notwithstanding" authorization under section 440.13(3)(d)....
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Padilla v. Liberty Mut. Ins. Co., 832 So. 2d 916 (Fla. 1st DCA 2002).

Cited 4 times | Published | Florida 1st District Court of Appeal | 2002 Fla. App. LEXIS 18630, 2002 WL 31833726

...Statutes (2001). Cf. § 627.736(5)(b), Fla. Stat. (2001). Nothing in Chapters 624 or 627 confers any authority on DOI to determine the amount an insurer should pay as personal automobile mileage reimbursement in an ordinary contract dispute. Compare § 440.13(12), Fla....
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Johns E. Co., Inc. v. Matta, 717 So. 2d 91 (Fla. 1st DCA 1998).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 9849, 1998 WL 455258

...judge of compensation claims erred in admitting the deposition testimony of Dr. Varraux in evidence. They maintain that Dr. Varraux did not qualify as a medical advisor and that there was no other basis for the admission of his testimony. We agree. Section 440.13(9), Florida Statutes (Supp....
...ion to provide peer review or medical consultation to the division or to a judge of compensation claims." See Fla. Admin. Code r.38F-54.002(10). An expert medical advisor may be appointed by the division or by the judge, depending on the criteria in section 440.13(9)(c), Florida Statutes, but, in either case, the selection must be made from those physicians who are certified by the division. In workers' compensation cases, the admission of medical opinion testimony is limited by statute to the testimony of a medical advisor, an independent medical examiner, or an authorized treating provider. Section 440.13(5)(e), Florida Statutes provides that "[n]o medical opinion other than the opinion of a medical advisor appointed by the judge of compensation claims or division, an independent medical examiner, or an authorized treating provider is a...
...hington v. Orange County School Board, 702 So.2d 1356 (Fla. 1st DCA 1997), the phrase "medical advisor" in this statute refers to an expert medical advisor certified by the division. Dr. Varraux is not an expert medical advisor within the meaning of section 440.13(9), Florida Statutes, because he was not selected and certified by the division. The parties concede that he was not an authorized treating physician and that he does not qualify as an independent medical examiner. Consequently, his testimony should have been excluded under section 440.13(5)(e), Florida Statutes....
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Brown v. Steego Auto Parts, 585 So. 2d 401 (Fla. 1st DCA 1991).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1991 WL 167290

...result of the industrial accident that claimant needs to be in a weight loss program." The JCC has either misinterpreted the testimony or misapplied the law. Treatment for a condition which preexists an industrial accident may be awarded pursuant to section 440.13(2)(a), Florida Statutes, if it would aid in the recovery *403 from the accident....
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Bassett v. Laber, 722 So. 2d 834 (Fla. 1st DCA 1998).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1998 WL 530178

...Epple of The Law Offices of James Richard Hooper, P.A., Orlando, for Appellee. PER CURIAM. We reverse the final order awarding medical and indemnity benefits to the claimant, Harry Laber, on the ground that the judge of compensation claims erred in admitting the testimony of Dr. Howard D. Weaver, D.O. Section 440.13(5)(e), Florida Statutes, limits medical opinion testimony in workers' compensation cases to the opinion of a medical advisor, an independent medical examiner, or an authorized treating provider....
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Attitudes & Trends v. Arsuaga, 616 So. 2d 1103 (Fla. 1st DCA 1993).

Cited 4 times | Published | Florida 1st District Court of Appeal | 1993 WL 102154

..., for appellee. JORGENSON, Associate Judge. The employer/carrier appeal a workers' compensation order by which the claimant was awarded attendant care benefits and found entitled to an attorney's fee. We reject the employer/carrier's contention that section 440.13(2)(f), Florida Statutes (Supp....
...City of Dunedin, 513 So.2d 200 (Fla. 1st DCA 1987); Walt Disney World Inc. v. Harrison, 443 So.2d 389 (Fla. 1st DCA 1983). The appealed order is affirmed. WIGGINTON and MICKLE, JJ., concur. NOTES [1] The claimant's accident and injury occurred prior to the effective date of section 440.13(2)(f), Florida Statutes (Supp....
...See e.g., City of Clermont v. Rumph, 450 So.2d 573 (Fla. 1st DCA), rev. denied, 458 So.2d 271 (Fla. 1984). But the statute should not be construed as imposing a condition precedent apart from the claimant's burden of proof. Given this limited construction, section 440.13(2)(f), Florida Statutes (Supp....
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Orange Cnty. v. Willis, 996 So. 2d 870 (Fla. 1st DCA 2008).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2008 WL 4362397

...The only *871 evidence was that the E/C's failure to pay the bills was merely a "mix-up." Nonetheless, rather than contact the E/C, Claimant's attorney filed a petition for benefits seeking payment of the bills. The claim for payment of bills was a reimbursement dispute, as that term is statutorily defined. See § 440.13(1)(r), Fla. Stat. (2006). Consequently, resolution of the claim was within the exclusive jurisdiction of the Agency for Health Care Administration. See § 440.13(11)(c), Fla....
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Witham v. Sheehan Pipeline Constr. Co., 45 So. 3d 105 (Fla. 1st DCA 2010).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 14220, 2010 WL 3703359

...Establishment of the causal relationship between a compensable accident and injuries for conditions that are not readily observable must be by medical evidence only, as demonstrated by physical examination findings or diagnostic testing. [MCC] must be demonstrated by medical evidence only. (Emphasis added.) Additionally, section 440.13(5)(e), Florida Statutes (2007), provides that "[n]o medical opinion other than the opinion of a medical advisor appointed by the [JCC] or the department, an independent medical examiner, or an authorized treating provider is admissible in proceedings before the [JCC]." (Emphasis added.)....
...cause of Claimant's April 12 incident and injuries specifically was not. Because Dr. Harbison is not a medical doctor, he was not qualified to testify as to the medical cause of Claimant's condition in this particular case. See §§ 440.09(1) & *109 440.13(5)(e), Fla....
...stimony of the toxicologist and the admissible medical testimony of Dr. Ross, the E/C's IME physician. On the basis of these two expert opinions, the JCC found clear and convincing evidence to rebut the presumed correctness of the EMA's opinion. See § 440.13(9)(c), Fla....
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Miller v. State, Div. of Ret., 796 So. 2d 644 (Fla. 1st DCA 2001).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2001 WL 1230262

...Miller's disability, even if technically competent, should be deemed insubstantial as a matter of law, because Dr. Waldman never treated or even examined Mr. Miller. *646 He contends that limitations the Workers' Compensation Law places on the use of medical experts support his position. See § 440.13(5)(e), Fla....
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Emma Gayle Weaver, etc. v. Stephen C. Myers, M.D., 229 So. 3d 1118 (Fla. 2017).

Cited 3 times | Published | Supreme Court of Florida

statute in the workers’ compensation arena. See § 440.13(4)(c), Fla. Stat. (2017). As with the amendments
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Lance v. Witters Constr., 270 So. 2d 4 (Fla. 1972).

Cited 3 times | Published | Supreme Court of Florida | 1972 Fla. LEXIS 3123

...nt is not solely determinative of the employer's obligation to pay for it if "the nature of the injury required such treatment" and the employer has knowledge of the injury and did not provide the treatment. This is the alternative "or" provision of § 440.13 of the Workmen's Compensation Act which provides that an employee is not entitled to recover such an amount expended by him for treatment unless: (1) he shall have requested employer to furnish it, or (2) unless the nature of the injury required it, and the employer failed to provide it....
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Cespedes v. Yellow Transp., Inc., 130 So. 3d 243 (Fla. Dist. Ct. App. 2013).

Cited 3 times | Published | District Court of Appeal of Florida | 2013 WL 6171266, 2013 Fla. App. LEXIS 19015

...Acebal were “emergency services and care,” compensable under chapter 440. Because of these errors, and based on our conclusion that the opinion testimony of those physicians who have provided compensable emergency services and care are admissible as “authorized treating provider[s]” under section 440.13(5)(e), Florida Statutes, we also conclude that the JCC used improper legal standards in determining that Dr....
...the accident is the MCC of the injury. See Engler v. Am. Friends of Hebrew Univ., 18 So.3d 613, 614 (Fla. 1st DCA 2009) (“Once compensability is established, an E/C can no longer contest that the accident is the MCC of the injuries at issue.”); § 440.13(1)(e), Fla....
...Emergency Services and Care We turn next to Claimant’s second point on appeal, which asserts' the JCC also applied an incorrect legal standard to determine that the medical care provided by Dr. Acebal did not constitute “emergency services and care.” Claimant’s argument on this point also has merit. Under section 440.13(l)(f), Florida Statutes, “emergency services and care” is defined, by its reference to section 395.002, Florida Statutes (2005), as follows: (10) “Emergency services and care” means medical screening, examination, and evaluatio...
...ists.” Under normal circumstances, these simple questions can be answered by the finder of fact without resort to medical opinion testimony. 1 If each of these questions is answered in the affirmative, then under section 395.002, and thereby under section 440.13(1), “emergency services and care” of some sort have been provided....
...ment for such care, is dependent on additional elements contained in the Workers’ Compensation Law. These two additional elements are the following. First, as with all medical care awardable under chapter 440, the care must be medically necessary. § 440.13(2)(a), Fla....
...(2005) (an employer has an obligation to provide “such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require,” including emergen- *252 ey care). Second, under section 440.13(3)(b), emergency care is “compensa-ble” if the “injury requiring emergency care arose as a result of’ the workplace accident....
...care were compensable under the standards announced above — without reliance on Dr. Acebal’s medical opinion testimony. We now turn to whether the JCC also erred in determining that Dr. Acebal’s medical opinion testimony was inadmissible under section 440.13(5)(e), Florida Statutes (2005). For the reasons that follow, we hold that a proper interpretation of section 440.13(5)(e) permits admission of medical opinion testimony from a physician who is first proven, through other admissible testimony or other permissible means, to have provided emergency care and services compensable under chapter 440. 2 Section jM0.13(5)(e) — “Authorized Treating Provider” Section 440.13(5)(e), Florida Statutes (2005), provides, in its entirety: (e) No medical opinion other than the opinion of a medical advisor appointed by the judge of compensation claims or the department, an independent medical examiner, or an autho...
...Emergency Providers Although all other physicians providing compensable care under chapter 440 must receive express authorization “from the carrier” 3 to be eligible for payment for *253 treatment provided to an injured worker, this rule does not apply to emergency care physicians. See § 440.13(3)(a), Fla....
...By legislative decree, “all licensed physicians and health care providers in this state shall be required to make their services available for emergency treatment of any employee eligible for workers’ compensation benefits,” with or without authorization from a carrier. § 440.13(3)(b), Fla. Stat. (2005). “To refuse to make such treatment available is cause for revocation of a license.” Id. Under the language of section 440.13(3)(a), routine medical care must be authorized by the carrier, and only through such authorization may a physician become eligible for payment (except where the self-help provisions of section 440.13(2)(c) are at play)....
...nd holding JCC may “authorize” physician where E/C has wrongfully denied care). In emergency care, however, all licensed physicians are both permitted and required to provide such care, regardless of whether authorization has been furnished. See § 440.13(3)(a)-(b), Fla....
...conclude that where the admissible medical and lay testimony establishes that a physician has provided compensable emergency medical services, that physician’s medical opinion testimony is admissible as an “authorized treating provider” under section 440.13(5)(e)....
...Claimant, the JCC must then find Dr. Acebal a treating provider “authorized” to provide such care under chapter 440. If such a finding is made, then, and only then, shall the JCC admit Dr. Aeebal’s medical opinion testimony into evidence under section 440.13(5)(e), to determine whether the surgery performed by Dr....
...d reasonably be expected to result” in serious impairment or dysfunction of any bodily function or part. Id. As a matter of law, contrary to the testimony of both Dr. Brown and Dr. Sala-mon, section 395.002(9)(a) (and thus sections 395.002(10) and 440.13(1)(f)) permits pain to serve as the basis of an emergency medical condition, if in “the absence of immediate medical attention” the claimant could reasonably be expected to suffer “serious impairment to bodily functions” or “serious dysfunction of any bodily organ or part.” § 395.002(9)(a), Fla....
...ndards announced herein. Finally, we hold that the JCC erred in ruling that Dr. Acebal’s emergency sur *255 gery was not compensable, because the emergency provider failed to give the E/C timely notice of the emergency treatment, as required under section 440.13(3)(b), Fla....
...(2005) (“A health care provider who renders emergency care must notify the carrier by the close of the third business day after it has rendered such care.”). It is undisputed that neither Dr. Acebal nor any other party from KRMC ever notified the Employer or Carrier after Dr. Acebal’s treatment. Section 440.13(3)(b), however, does not speak to the compensability of the care. It does not address whether the medical treatment or care is sufficiently related to a compensable condition, nor does it alter any facts that might establish that such care was provided on an emergency basis. Further, and dispositive here, section 440.13(3)(b) does not set forth any penalty to the claimant for the emergency health care provider’s failure to give the E/C timely notice of the emergency treatment....
...Ace-bal and the E/C relative to the provision of compensable care. See J.B.D. Bros. v. Miranda, 25 So.3d 1271 (Fla. 1st DCA 2010) (explaining JCC lacks jurisdiction over billing dispute between carrier and medical provider). Because the language of section 440.13(3)(b) does not indicate that the Legislature intended that an emergency health care provider’s failure to comply with the notice provisions contained therein renders a claimant responsible for the payment for emergency medical treatment, we decline to adopt such an interpretation here....
...Acebal was medically necessary and was provided on an emergency basis for a compensable injury, the JCC shall not decide any potential reimbursement dispute between the E/C and Dr. Acebal, as the Department of Financial Services has exclusive jurisdiction over such disputes. See § 440.13(11)(c), Fla....
...Racetrac Petroleum, Inc,, 827 So.2d 369 (Fla. 1st DCA 2002), where we concluded that the only evidence to support the causal relationship or the medical necessity of the emergency treatment was the opinion of the emergency room physician, which was inadmissible under section 440.13(5)(e); thus, we held the claimant failed to prove by admissible evidence or other permissible means that the emergency care was compensable....
...cal opinion testimony, until it is first proven by independently admissible testimony or other permissible means, such as stipulations or by operation of law, that the physician in question provided compensable medical services. . We observe that in section 440.13(3)(a), but not in section 440.13(5)(e), the Legislature qualified the term ''authorization” by adding the phrase "from the carrier.” If, however, the term "authorization” signals only that power emanating from a carrier’s express grant of authority, there would be no need for the Legislature to have qualified the term "authorized" in section 440.13(3)(a) by the phrase "from the carrier,” as such language would be surplusage, which would violate canons of statutory construction requiring that verba cum effectu sunt accipienda, "words are to be taken as having an effect.” See generally, Scalia and Gardner, Reading Law: The Interpretation of Legal Texts, p....
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Kraft Dairy Grp. v. Cohen, 645 So. 2d 1072 (Fla. 1st DCA 1994).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1994 WL 653461

...and purchase a new van for Claimant that includes any necessary modifications. The judge based his determination that Mrs. Cohen was entitled to $10 per hour on two facts: (1) Mrs. Cohen is a Certified Nursing Assistant and therefore not covered by section 440.13(2)(h), [1] and the going rate for CNAs is between $10 and $13.95 per hour; and (2) this represents the amount Mrs....
...ublic pool. The JCC also based his award of a new van on the testimony of both physicians, who testified that transportation in a van was medically necessary. On appeal, the E/C argue that the increase in the rate of attendant care benefits violates section 440.13(2)(h)2, Florida Statutes....
...Finally, the E/C appeal the JCC's award of a modified van rather than access to the van transportation services it offered. We will address each issue in turn. Turning first to the JCC's award of $10 per hour for attendant care services, it is clear that if Mrs. Cohen was not a Certified Nursing Assistant, section 440.13(2)(h)2 would apply to this award even though Claimant's injury took place before the statute's effective date of October 1, 1988....
...1st DCA 1990) (the 1988 amendment prescribing the value of the attendant or custodial care provided by a family member does not affect substantive rights); City of North Miami v. Towers, 557 So.2d 112 (Fla. 1st DCA 1990) (hourly value assigned to the care provided by claimant's wife should not exceed that prescribed by section 440.13(2)(e)2 (now 440.13(2)(h)2)). Under section 440.13(2)(h)2, Mrs....
...However, the JCC found this section inapplicable to Mrs. Cohen because she is a "professional, qualified, licensed and certified nursing assistant with a nursing background." No Florida *1075 court has addressed the question of whether Mrs. Cohen falls outside the ambit of section 440.13(2)(h)2 merely because she is a CNA....
...She also helps him with walking, exercises, physical therapy, swimming, puzzles, and washing and waxing the car. These types of services have been classified as services that go beyond ordinary household duties and constitute attendant care within the meaning of section 440.13(2)(a)....
...es and home health aides, but she testified that she had never worked as a professional or trained nurse or home care attendant. Id. at 393. The court concluded that because Mrs. Hayman was a nonprofessional, her rate should be limited to conform to section 440.13(2)(h)....
...o only sixteen (16) hours per day because Mrs. Cohen was willing to accept compensation for only sixteen (16) hours. Considered in the light of the record before us, it is clear that the JCC correctly found that Mrs. Cohen falls outside the ambit of section 440.13(2)(h)2, and that Hayman does not indicate a different result....
...e E/C to provide Claimant with a van to transport him to therapy and to the doctor's office without giving him ownership of it. In addition, Dr. Lustgarten testified that a van service would be sufficient to meet Claimant's needs. Two subsections in section 440.13 address a claimant's entitlement to transportation costs. Vehicles may constitute "other apparatus" under section 440.13(1), which requires the employer to furnish "remedial treatment, care and attendance ..., including medicines, crutches, artificial members and other apparatus." § 440.13(1), Fla. Stat. (Supp. 1978). Section 440.13(4), Florida Statutes (Supp....
...needs. Accordingly, the evidence does not support the award of a new van purchased by the E/C. "Supportive services such as driving the claimant to the store and to other places, other than transportation necessary for medical treatment pursuant to section 440.13(6), constitute quality of life activities indemnified under disability compensation benefits rather than attendant care service that is medically necessary." Marlowe v....
...ered by the compensation benefits. Id. at 887. This same logic dictates that the award of a new van to Claimant be reversed. There is competent, substantial evidence to support the provision of transportation for Claimant under the plain language of section 440.13(5), which provides that transportation should be provided under the "most economical means available." Therefore, we remand this cause to the JCC to order the furnishing of van service as the most economical means of transportation available to Mr....
...For the foregoing reasons, the JCC's order is AFFIRMED as to the number of hours and the increase in the hourly rate paid for attendant care benefits; is REVERSED as to the van, and is REVERSED and REMANDED as to the pool award. ERVIN and LAWRENCE, JJ., concur. NOTES [1] Section 440.13(2)(h), Florida Statutes (1993), provides: (h) The value of nonprofessional attendant or custodial care provided by a family member shall be determined as follows: 1....
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City of Pembroke Pines v. Ortagus, 50 So. 3d 31 (Fla. 1st DCA 2010).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 16608, 2010 WL 4292823

...1st DCA 1995) (rejecting assertion by employer/carrier that disability giving rise to section 112.18 presumption must be permanent). Indeed, the occupational disease is treated as if it were "an injury by accident." § 440.151(1)(a), Fla. Stat. (2004). As the JCC in this case correctly noted, section 440.13(2)(a), Florida Statutes (2004), requires employers to furnish medically necessary care for a compensable condition "for such period as the nature of the injury or the process of recovery may require...." The claimant here still suffers...
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Watson v. Delta Airlines, Inc., 288 So. 2d 193 (Fla. 1973).

Cited 3 times | Published | Supreme Court of Florida | 1973 Fla. LEXIS 3983

...employer without an award on account of such injury a claim may be filed within two (2) years after the date of the last payment of compensation or after the date of the last remedial treatment furnished by the employer." (emphasis added) Fla. Stat. § 440.13(3)(b) F.S.A....
...to conform to the already existing same exceptions in § 440.19(1)(a) to recover voluntary "compensation" payments. And so the two now have the same "predicate" or exceptions for recovery either of compensation or medical (remedial) payments. It was § 440.13(3)(b) regarding the remedial remedy that was involved in Miller which was relied upon by the JIC who failed to note that Miller was under the former statute which did not include then (as § 440.19(1)(a) did for "compensation") the present exceptions now also in § 440.13(3)(b)....
...Thus, on the dual basis of 1) "remedial" attention having been voluntarily furnished within the two years required by the same exceptions within the two statutes, and 2) compensation voluntarily paid "without an award" also within such two years, the claimant falls within the statutory exceptions in § 440.13(3)(b) and § 440.19(1)(a) and is within such "extended" two year statute of limitations as a basis for recovery....
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Florida Tile Indus. v. Dozier, 561 So. 2d 654 (Fla. 1st DCA 1990).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1990 WL 61934

...ly, have provided and continue to provide such supervision. Based on this showing of the need for 24-hour-a-day attendant care benefits, we affirm the award. We note, however, that benefits paid after October 1, 1989, must be paid in accordance with section 440.13(2)(e)2, Florida Statutes (1989)....
...involved a blood serum test. See e.g. Beasley v. Mitel of Delaware, 449 So.2d 365 (Fla. 1st DCA 1984); Austin v. Gardner, 440 So.2d 35 (Fla. 1st DCA 1983); City of Tampa v. Green, 390 So.2d 1220 (Fla. 1st DCA 1980). [2] Pursuant to the amendment to section 440.13(2)(e)2, Florida Statutes (1989), claimant's family members may be compensated for only 12 hours per day attendant care services rendered and paid after October 1, 1989, the effective date of the amendment....
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Crenshaw v. Florida Farm Bureau, 489 So. 2d 186 (Fla. 1st DCA 1986).

Cited 3 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 1227

...medical bills incurred for chiropractic treatment from two chiropractors deauthorized by Florida Farm Bureau and Florida Farm Bureau Casualty Insurance Company. Claimant contends that the E/C did not follow the proper statutory procedure mandated by section 440.13(2)(a), Florida Statutes (1983), when it deauthorized claimant's treating chiropractic physicians....
...horized treating physician, as with Drs. Dia and Faas, the E/C may not subsequently unilaterally deauthorize the physician or physicians without first obtaining an order from a deputy commissioner sanctioning the deauthorization, citing the statute, section 440.13(2)(a), and Cal Kovens Construction v....
...As carefully pointed out by the court in Cal Kovens, the burden is on the carrier seeking to change the status quo, "when the claimant disputes the change" (emphasis supplied), to secure an order from the deputy, or incur the risk of a ruling against good cause for the change under section 440.13....
...Claimant's mere continuation of the non-emergency chiropractic treatment, while also availing herself of the alternative care provided by the E/C, was insufficient to trigger the statutory duty on the part of the E/C to secure a ruling by the deputy under section 440.13(2)(a)....
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Firestone Tire & Rubber v. Knowles, 561 So. 2d 1293 (Fla. 1st DCA 1990).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1990 WL 71622

...However, we reverse that part of the order which compensates claimant's wife for providing such attendant care for more than 12 hours per day after October 1, 1989. According to Mr. C's TV Rental v. Murray, 559 So.2d 452 (Fla. 1st DCA April 12, 1990), section 440.13(2)(e)2, Florida Statutes, as it was amended effective October 1, 1989, applies to attendant care benefits awarded in a preamendment order where services are both rendered and paid for after the effective date of the amendment. Affirmed in part, reversed in part, and remanded for compliance with section 440.13(2)(e)2, Florida Statutes (1989)....
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At& T WIRELESS v. Frazier, 871 So. 2d 939 (Fla. 1st DCA 2004).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2004 WL 609298

...Glen Wieland, Orlando, and Bill McCabe, Longwood, for Appellee. PER CURIAM. The employer and the workers' compensation insurance carrier (E/C) appeal an order of the Judge of Compensation Claims (JCC) denying their request for appointment of an Expert Medical Advisor (EMA) pursuant to section 440.13(9), Florida Statutes, based upon substantial conflicts in the medical opinions of the treating physician and the physician who performed an independent medical examination (IME) of the claimant....
...They also appeal the ensuing compensation order awarding the claimant permanent total disability benefits based upon the JCC's acceptance of the opinion of the treating physician over the opinion of the IME physician. We reverse both orders, because the record demonstrates that the JCC misconstrued section 440.13(9) and misinterpreted the interplay between that provision and the time limit requirements of section 440.25, Florida Statutes (2002). Section 440.13(9) imposes upon the JCC a statutory duty to order that the claimant be evaluated by an EMA before ruling on the merits of the petition for benefits whenever it becomes apparent that there is a substantial conflict in the medical opinio...
...1st DCA 1998); Claims Management, Inc. v. Lake, 717 So.2d 140 (Fla. 1st DCA 1998). And see Broward Children's Center, Inc. v. Hall 859 So.2d 623 (Fla. 1st DCA 2003); Siemens Information & Communications Network v. Collins, 854 So.2d 271 (Fla. 1st DCA 2003). We read section 440.13(9) as consistent with the legislative intent expressed in section 440.015, that chapter 440 be interpreted "so as to assure the quick and efficient delivery of disability and medical benefits to an injured worker and to facilitate the...
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Butler Const. v. Walker, 524 So. 2d 691 (Fla. 1st DCA 1988).

Cited 3 times | Published | Florida 1st District Court of Appeal | 13 Fla. L. Weekly 813, 1988 Fla. App. LEXIS 1299, 1988 WL 27727

...e not new injuries and claimant has not recovered from the August aggravation, he has clearly not been at MMI since August 1986. We further note that if claimant had remained at MMI, it would have been illegal to award him remedial medical care. See Section 440.13(2)(a), Florida Statutes, and Gulf and Western Food Products v....
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Oak Crest Enter., Inc. v. Ford, 411 So. 2d 927 (Fla. 1st DCA 1982).

Cited 3 times | Published | Florida 1st District Court of Appeal

...When the E/C failed to select and authorize another physician to treat claimant, claimant's attorney sent her to Dr. Freed. Claimant, by cross-appeal, now assigns as error the deputy's failure to order the E/C to pay Dr. Freed's bills. Claimant argues in support of this contention that § 440.13(2), Fla. Stat. (1979), places the burden upon the E/C to offer alternative medical care or to obtain from the deputy a ruling that a change in medical care would not be in the best interest of the claimant. While claimant's interpretation of § 440.13(2) may be correct, her argument is unavailing since the statute deals only with change of physicians, and is inapplicable in this case....
...Freed's treatment was unauthorized and that the E/C should not be held responsible for payment of his charges. Affirmed in part and reversed in part. MILLS, J., concurs. WENTWORTH, J., dissenting. WENTWORTH, Judge, dissenting. I would affirm on all issues except for the patent error of the deputy in applying § 440.13, Florida Statutes, to require claimant "to ask for a hearing" in order to get either a change of physician, or new authorization if the majority has correctly viewed Dr....
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Citrus Cent., Inc. v. Gardner, 466 So. 2d 369 (Fla. 1st DCA 1985).

Cited 3 times | Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 636

...was a heart attack, covered by general health insurance, but noncompensable under workers' compensation. This confusion does not relieve Gardner of his burden to produce medical evidence of his inability to work or to show a good faith work search. Section 440.13(2), Florida Statutes, requires the deputy commissioner to make a finding of good cause in excusing the failure to file timely medical reports....
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Loughan v. Slutz Seiberling Tire, 483 So. 2d 1389 (Fla. 1st DCA 1986).

Cited 3 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 611

...Stein's bill as far as that portion of the *1391 treatment was concerned. The deputy further found that Dr. Genovese's bills and the related hospitalization expenses were not the responsibility of the employer because of Loughan's failure to timely file in compliance with Section 440.13, Florida Statutes (1983)....
...Stein's total bill be paid by the employer. As regards Loughan's second contention, we find that under the circumstances of this case it was not an abuse of discretion for the deputy to find no excuse for the failure to comply with the time requirements of Section 440.13(2)(b), Florida Statutes (1983)....
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IMC Phosphates Co. v. Prater, 895 So. 2d 1263 (Fla. 1st DCA 2005).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2005 WL 548232

...ers to have put E/C on notice of Appellee's need for attendant care. We hold that the pertinent statutes, Florida case law, and CSE in the record support the award of attendant care benefits. Several statutes come into play regarding attendant care. Section 440.13(1)(b), Fla....
...hat falls within the scope of household duties and other services normally and gratuitously provided by family members. "Family member" means a spouse, father, mother, brother, sister, child, grandchild, father-in-law, mother-in-law, aunt, or uncle. Section 440.13(2)(b), Florida Statutes (2001), states in pertinent part: "The employer shall provide appropriate professional or nonprofessional attendant care performed only at the direction and control of a physician when such care is medically nec...
...stances in which prior approval of [AHCA] has been obtained. [AHCA] shall adopt rules providing for such approval on a case-by-case basis when the service or supply is shown to have significant benefits to the recovery and well-being of the patient. § 440.13(1)(m), Fla....
...Space Gateway Support, 877 So.2d 852, 853 (Fla. 1st DCA 2004). Rather, "[i]t is sufficient that the physician provided the necessary testimony at the hearing." Id.; see also Attitudes & Trends v. Arsuaga, 616 So.2d 1103 (Fla. 1st DCA 1993) (construing similar language in 1990 version of § 440.13 so as not to preclude award of attendant care for services rendered before physician prescribes such care or states it is medically necessary, where required medical testimony was presented subsequently at hearing)....
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Avante Villa at Jacksonville v. Breidert, 958 So. 2d 1031 (Fla. 1st DCA 2007).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2007 WL 1593242

...NOTES [1] Federal Nursing Home Reform Act from the Omnibus Budget Reconciliation Act. [2] See § 408.032(8), Fla. Stat.; § 408.07(24), Fla. Stat.; § 400.602(2), Fla. Stat.; § 381.0303(3)(a)2., Fla. Stat.; § 159.27(16), Fla. Stat.; § 765.101(6) & (7), Fla. Stat.; § 154.205(8), Fla. Stat.; § 717.101(11), Fla. Stat.; § 440.13(1)(g), Fla....
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Schult Mobile Home Corp. v. Walling, 384 So. 2d 251 (Fla. 1st DCA 1980).

Cited 3 times | Published | Florida 1st District Court of Appeal

...loyer-carrier to pay medical bills for claimant's hospitalization and treatment by Dr. Wallace, a physician not authorized by the carrier to render medical services to claimant. The carrier contends that the order was in error because its duty under Section 440.13, Florida Statutes, to provide proper medical treatment was fully discharged by offering claimant the choice of several physicians other than Dr....
...d a situation as that sub judice was necessary to effect the intent and purpose of the Worker's Compensation Act. We find that the Deputy Commissioner's resolution of this controversy was in accord with the purposes of the Worker's Compensation Act. Section 440.13 reserves to the claimant the right to dispute the carrier's selection of a treating physician for good cause....
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Seidel v. Hill, 264 So. 2d 81 (Fla. 4th DCA 1972).

Cited 3 times | Published | Florida 4th District Court of Appeal

...laim was assigned to a judge of Industrial Claims; the treatment by a physician (defendant) during the pendency of such claim; the filing of a medical report in connection with such treatment with the Workmen's Compensation Division pursuant to F.S. Section 440.13(1), F.S.A....
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Tower Chem. Co. v. Hubbard, 527 So. 2d 886 (Fla. 1st DCA 1988).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1988 WL 62170

..."furnished by the employer." In Barnett v. EMR Telemetry, 396 So.2d 791 (Fla. 1st DCA 1981), in determining whether a physician's examination of a claimant constituted remedial attention furnished by the employer within the contemplation of Sections 440.13(3)(b) and 440.19(1)(a), Florida Statutes (1971), [3] we held: A distinction has been drawn between "examination" and "treatment"; however, such distinction should not be artificially and unrealistically made....
...of the settlement or whether the medical services being rendered by Dr. Matthews were pursuant to an award. Lack of such information does not, however, make any difference under our holding in this case. [3] Chapter 79-40, § 15, Laws of Fla., moved Section 440.13(3)(b), in substantially the same form, to Section 440.19(2)(b) (the statute at issue in the case sub judice )....
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Mobile Med. Indus. v. Quinn, 985 So. 2d 33 (Fla. 1st DCA 2008).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2008 WL 2228706

...rine of estoppel. See Specialty Employee Leasing v. Davis, 737 So.2d 1170 (Fla. 1st DCA 1999). Upon receipt of reports which created a dispute about claimant's condition, the employer/carrier acted appropriately in seeking the appointment of an EMA. § 440.13(9)(c), Fla. Stat. (2002). The legislature has established that an EMA's opinion is presumptively correct unless the JCC finds and articulates "clear and convincing evidence to the contrary." § 440.13(9)(c), Fla....
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Martinez v. Healthsouth Doctor's Hosp., 817 So. 2d 1080 (Fla. 1st DCA 2002).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2002 WL 1271566

...le for the EMA examination. She re-evaluated the evidence and found that there was no conflict in the doctors' opinions. Over the claimant's objection, she decided the case without benefit of the EMA's examination. This constituted reversible error. Section 440.13(9)(c), Florida Statutes (Supp.1996), provides that the sanction for a claimant's failure to cooperate with the EMA evaluation order is forfeiture of entitlement to compensation during the period of failure to cooperate, not withdrawal of the EMA order....
...datory provisions of this statute. The JCC's finding that there is no conflict in the medical testimony is unsupported by the record, which indicates clear disagreement regarding the fact of permanent impairment. Under this court's interpretation of section 440.13(9)(c) in Palm Springs General Hospital v....
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Rockette v. Space Gateway Support, 877 So. 2d 852 (Fla. 1st DCA 2004).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2004 WL 1531588

...On remand, the judge shall revisit the attendant care issue, and make findings of fact as to the number of hours reasonably expended by the claimant's wife for care that went beyond ordinary household duties and the hourly rate of pay for that care as provided in section 440.13(2)(b), Florida Statutes (2001)....
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Nunez v. Pulte Homes, Inc., 985 So. 2d 695 (Fla. 1st DCA 2008).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2008 WL 2626797

...Galen, of Eraclides, Johns, Hall, Gelman, Johanessen & Kempner, L.L.P., Sarasota, for Appellees. PER CURIAM. Appellant challenges the order of the Judge of Compensation Claims determining that he is not entitled to a one-time change in physician pursuant to section 440.13(2)(f), Florida Statutes (2006)....
...Lusk found no problems or anatomical reasons to justify appellant's pain complaints or to explain his condition. Dr. Lusk concluded that surgery was not warranted. Appellant filed a petition for benefits seeking authorization for evaluation and treatment with an alternate neurosurgeon pursuant to section 440.13(2)(f), Florida Statutes (2006)....
...e "Dr. Lusk's involvement was strictly for the purpose of providing a neurosurgical evaluation and recommendation as requested by Dr. Wilson." II. Analysis The appellant asserts an entitlement to a new neurosurgeon (rather than Dr. Lusk) pursuant to section 440.13(2)(f), Florida Statutes (2006)....
...cian shall be considered authorized if the treatment being provided is compensable and medically necessary. Id. (Emphasis added). The E/C, relying on Butler v. Bay Center/Chubb Insurance Co., 947 So.2d 570 (Fla. 1st DCA 2006), asserts that, although section 440.13(2)(f) gives appellant a right to a one-time change in treating physician regardless of medical necessity, in order for appellant to be entitled to an automatic change in physician pursuant to that section, appellant must have begun treatment with the physician from whom the change is requested....
...1st DCA 2005) (holding that an IME does not constitute medical treatment). Thus, Dr. Lusk's evaluation and diagnosis of appellant constitutes treatment. Because Dr. Lusk evaluated appellant "during the course of treatment," the appellant was entitled to a one-time change of physician as a matter of law. [1] § 440.13(2)(f), Fla. Stat. (2006). III. Conclusion For the foregoing reasons, we remand for the JCC to allow appellant to choose an alternative neurosurgeon to provide any neurosurgical treatment that is medically necessary and reasonable. See § 440.13(2)(f) (if E/C fails to authorize alternative physician within 5 days of receipt of request, employee may select physician and such physician will be deemed authorized to provide compensable and medically necessary treatment)....
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Rich Int'l Airways Inc. v. Cahvasquis, 416 So. 2d 902 (Fla. 1st DCA 1982).

Cited 3 times | Published | Florida 1st District Court of Appeal

...Several days after he left the hospital, Cahvasquis' wife arrived from New York and treated his injuries for 15 days. Thereafter, appellee cared for himself. On July 2, 1981, the deputy commissioner entered an order awarding Cahvasquis costs of nursing services for four weeks, costs of proceedings and attorney's fee. Section 440.13, Fla....
...Marlin, 389 So.2d 702 (Fla. 1st DCA 1980). The record provides an adequate basis for the award for the fifteen days the wife cared for the claimant. The record, however, indicates the claimant cared for himself before the wife arrived and after she left. Although Section 440.13(1) provides for an award if the employer refuses to pay and the employee personally expends money for nursing services, the statute does not provide for the payment of benefits for nursing services for the time during which the claimant cared for himself....
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Bright v. City of Tampa, 546 So. 2d 1122 (Fla. 1st DCA 1989).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1989 WL 77491

...d wage loss benefits in accordance with the foregoing. BOOTH and JOANOS, JJ., concur. NOTES [1] The claimant collected $2,000 in monthly pension benefits. [2] The value of this personal benefit, twenty cents, is presumptively established by applying Section 440.13(4), Florida Statutes (Supp. 1982) (now Section 440.13(5), Florida Statutes (Supp....
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Ariston v. Allied Bldg. Crafts, 825 So. 2d 435 (Fla. 1st DCA 2002).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2002 WL 1401899

...Ariston's union did not bargain away his inviolable right to utilize chapter 440; the legislature declared that it is not an inviolable right, and instead permitted the CBA mechanism to provide the only avenue for recovery of compensation benefits. Next, Ariston complains that the CBA is null and void because, unlike section 440.13(5), Florida Statutes (1997), it makes no provision for an independent medical examination (IME), and it thereby diminishes his right to benefits, contrary to section 440.211(2), which states: "Nothing in this section shall allow any ag...
...Any such agreement in violation of this provision shall be null and void." In her order, the JCC somewhat inconsistently ruled that because the CBA was silent regarding an employee's entitlement to an IME, the CBA does not replace the provisions of section 440.13(5) regarding such subjects; consequently, Ariston's entitlement to such benefit had not been diminished....
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Karell v. Miami Airport Hilton/Miami Hilton Corp., 668 So. 2d 227 (Fla. 1st DCA 1996).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1996 Fla. App. LEXIS 547, 1996 WL 34057

...While the E/C can point to no specific statutory provision conferring this authority upon the JCC, they nevertheless argue that the requisite jurisdictional authority can be implied from several statutory provisions as follows: sections 440.30; 440.33(1); 440.25(4)(h); 440.13(4)(c); and 440.13(5)(a), Florida Statutes (1994 Supp.)....
...of a petition for benefits. Subsection (4)(h) authorizes the JCC to require the appearance before him of the parties and counsel for an emergency conference where there is a bona fide emergency involving the health, safety or welfare of an employee. Section 440.13(4)(c), another provision cited by the E/C as authority for the JCC's jurisdiction to order an IME before the filing of a petition for benefits, provides for the access to and production of medical records, and also requires health care...
...o discuss claimant's workplace injuries with the employer, carrier, or the attorney for either of them. These statutory provisions are unrelated to the issue before us. Finally, the E/C point to the statutory provisions governing IMEs, specifically, section 440.13, as authority for the JCC's pre-claim jurisdiction to order the claimant to appear for an IME. We agree with the E/C that the E/C has the right to schedule an IME prior to the filing of a petition for benefits, just as they did under the statute as it existed in section 440.13(2)(b) prior to the 1994 amendments. The present statute clearly states that an IME may be scheduled "in any dispute" concerning overutilization, medical benefits, compensability, or disability. Section 440.13(5)(a). It is also abundantly clear that section 440.13(5)(d) provides remedies for the employee's failure to appear for a properly scheduled and noticed IME by *230 providing, among other things, that if the employee fails to appear "without good cause" and "fails to advise the physician a...
...As may be seen from the above review, the IME provisions are largely self-executing, the one exception being that the employee is given the right to "appeal" to the JCC in the event the E/C withholds payments in excess of the authority granted by this section. Section 440.13(5)(d)....
...Unlike section 440.30, dealing with the taking of depositions, and unlike section 440.33(1), as implemented by Rule 4.090, Florida Rules of Workers' Compensation Procedure, providing for the preclaim production of documents if the claimant is represented by an attorney, section 440.13(5) contains no authority for the JCC to issue an order to compel an IME prior to the filing of a petition for benefits....
...1st DCA 1995); Public Gas Co. v. Monette, 658 So.2d 673 (Fla. 1st DCA 1995). [2] Under the new IME statute, the E/C's right to schedule an IME before a petition for benefits is filed is not dependent upon the employee being represented by an attorney. Further, under section 440.13(5)(f) attorney's fees incurred by the employee in opposing an IME are not recoverable....
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Colace v. Hamlet Estates, Ltd., 573 So. 2d 994 (Fla. 1st DCA 1991).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1991 WL 10377

...hridge Hospital, and Victoria Hospital, were unauthorized, were not rendered in an emergency situation, and that employer/carrier provided alternate care. Consequently, the claim for payment of these medical bills was denied. The applicable statute, section 440.13(2)(a) and (b), Florida Statutes (1983), provides in part: (a) ......
...ive physicians. Nevertheless, the practical result of employer/carrier's conduct following the first surgery was to place the suffering claimant in limbo insofar as actual treatment of his injury was concerned. While the carrier was not bound, under section 440.13, Florida Statutes, to provide treatment by a surgeon specified by the claimant, the offer of evaluation by a different physician was not an offer of equivalent treatment by a different doctor....
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McClennan v. Am. Bldg. Maint., 648 So. 2d 1214 (Fla. 1st DCA 1995).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1995 WL 13427

...Because the employer/carrier did not establish a valid reason for excluding the claimant's attorney, the judge should have permitted the attorney to attend the examination. The employer/carrier scheduled an independent medical examination of the claimant pursuant to section 440.13(2)(b), Florida Statutes (1993)....
...When the claimant's attorney advised the attorneys for the employer/carrier *1215 that he would attend the examination, the employer/carrier filed a motion to exclude the claimant's attorney. The judge thereafter entered the challenged order precluding the attorney's attendance. Neither section 440.13(2)(b) nor the Florida Rules of Workers' Compensation Procedure address whether a claimant may have an attorney present during an independent medical examination....
...to be present to guarantee, for example, that the doctor does not interrogate the plaintiff on liability questions in order to seek damaging admissions. This reasoning is equally applicable in the context of an independent medical examination under section 440.13(2)(b)....
...And, as in Toucet, there is no basis here to conclude that the attorney would be unduly distracting or disruptive of the examination. The employer/carrier have failed to demonstrate any valid reason for excluding the claimant's attorney, and the judge therefore should have permitted the attorney's attendance at the section 440.13(2)(b) medical examination....
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Harrell v. Citrus Cnty. Sch. Bd., 25 So. 3d 675 (Fla. 1st DCA 2010).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 200, 2010 WL 143492

...equest for a "one-time change" in orthopedist. In an order dated June 4, 2009, the JCC denied Claimant's request for a change in orthopedic physician, finding the industrial accident was not the major contributing cause (MCC) of Claimant's symptoms. Section 440.13(2)(f), Florida Statutes (2006), provides in pertinent part: Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident....
...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. We have previously held that "the use of the word `shall' in . . . section 440.13(2)(f) means that this one-time change is mandatory, regardless of whether the initial authorized doctor opines that a compensable accident is no longer the MCC of a claimant's need for treatment." Providence Prop....
...Parr's authorization until October 28, 2008—nineteen days after Claimant's October 9th written request. Because the E/C failed to authorize a new physician within five days of Claimant's written request, the E/C failed to comply with the requirements of section 440.13(2)(f). Section 440.13(2)(f), Florida Statutes (2006), specifically states that "[t]he *678 carrier shall authorize an alternative physician who shall not be professionally affiliated with the previous physician within 5 days after receipt of the request." (emphasis added)....
...v. Williams, 85 So.2d 619, 622 (Fla.1956). Allowing an E/C to comply with its statutory duty by generally acknowledging its statutory obligation to provide a change would emasculate the statute and the five-day time period. As such, compliance with section 440.13(2)(f) requires an E/C to name at least one physician not professionally affiliated with the previous physician within five days of a claimant's written request....
...The E/C failed to authorize a specific alternative physician within the five-day time period. The record demonstrates that the E/C did not advise Claimant it selected Dr. Parr until October 28, 2008—nineteen days after Claimant requested a new physician. Consequently, Claimant was entitled to select her own physician. See § 440.13(2)(f), Fla....
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United Sheet Metal Co. v. Meyer, 520 So. 2d 616 (Fla. 1st DCA 1988).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1988 WL 2623

...We affirm. The E/C assert that the deputy erred in requiring reimbursement because: (1) prior to the claimant's acquisition and installation of the hot tub, the claimant failed to request the employer/carrier to furnish such equipment as required by Section 440.13(2)(b), Florida Statutes (1985); [1] and (2) the stringent criteria established in Firestone Tire and Rubber Company v....
...Finally, *618 installation of a swimming pool on the claimant's property is one thing. Firestone Tire & Rubber Co. v. Vaughn, supra . Requiring the carrier to furnish a portable hot tub is another. AFFIRMED. WENTWORTH, NIMMONS and ZEHMER, JJ., concur. NOTES [1] Section 440.13(2)(b) provides: If the employer fails to provide such treatment, care, and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by a deputy commissioner....
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Florida Structures, Inc. v. Morton, 443 So. 2d 444 (Fla. 1st DCA 1984).

Cited 3 times | Published | Florida 1st District Court of Appeal

...THOMPSON, Judge. In these consolidated cases the employer/carrier (E/C) appeal a compensation order awarding medical benefits and a subsequent order awarding attorney's fees. The E/C argue the award of medical benefits was barred by the statute of limitations, § 440.13(3)(b), Fla....
...Accordingly, the award of future medical benefits in this case is contrary to both the law and the facts and was reversible error. The last remedial attention was furnished and the last compensation benefits were paid to the claimant on or before March 19, 1980. Pursuant to § 440.13(3)(b), Fla....
...`Passage of time does not itself terminate the pendency of a proceeding.'" Turner v. Keller Kitchen Cabinets, 247 So.2d 35, 40 (Fla. 1971). In my view, the deputy was correct in finding the claim for future medical benefits to be still in effect. Neither can I agree that the statute of limitations provisions of section 440.13(3)(b), Florida Statutes, apply to require reversal of this case....
...As a timely claim for future medical benefits was still pending, I consider it illogical to expect Morton to file a second claim for future medical benefits within two years of either the last payment of compensation or his receipt of remedial attention. Such a tortured interpretation of section 440.13(3)(b) is clearly contrary to general rules of construction applicable in workers' compensation cases which call for liberal construction of such statutes in favor of claimants and compensation....
...in August of 1982. Because his timely claim remained pending and unresolved, however, the deputy correctly found that claim to be extant *448 on the original claim. A second claim was therefore unnecessary to satisfy the limitational requirements of section 440.13....
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Florida Transp. 1982, Inc. v. Quintana, 1 So. 3d 388 (Fla. 1st DCA 2009).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1006, 2009 WL 290528

...(jointly, the employer/carrier), challenge the order of the Judge of Compensation Claims (JCC) on three grounds. The employer/carrier argues that: (1) the award of permanent total disability (PTD) benefits to Carlos Quintana, the claimant and appellee, was premature; (2) section 440.13, Florida Statutes, did not require the employer/carrier to provide claimant with the choice of two additional psychiatrists; and (3) there was no basis to award claimant penalties, interest, costs, and attorney's fees....
...o findings in this regard; and based the PTD award solely on claimant's psychiatric condition. The JCC also found that the employer/carrier authorized psychiatric treatment, but that claimant requested his one-time change in physician, and, based on section 440.13(2)(f), Florida Statutes, ruled claimant was entitled to choose from three unaffiliated physicians....
...Thus, Emanuel does not support the award of temporary benefits in the case before us. In addition, the JCC erred because the record contains no competent, substantial evidence to support the JCC's award of PTD benefits based solely on claimant's psychiatric condition. Psychiatric Treatment Section 440.13, Florida Statutes, sets out the procedure to be used by the employer/carrier in authorizing medical providers. Because the statute is procedural, and the request was made in early 2006, the 2005 version of section 440.13, Florida Statutes, controls. See Butler v. Bay Center/Chubb Ins. Co., 947 So.2d 570, 572 (Fla. 1st DCA 2006) (procedural changes apply without regard to the date of accident). Section 440.13(2)(f), Florida Statutes (2005), allows a claimant to make one change in his treating physician during the course of treatment for an accident....
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Buckhalter v. Univ. of Florida, 411 So. 2d 1327 (Fla. 1st DCA 1982).

Cited 3 times | Published | Florida 1st District Court of Appeal

...NOTES [1] The deputy commissioner has a duty to adjudicate issues which are properly presented and ripe for adjudication. Dunn Lumber & Supply Co. v. Roy, 382 So.2d 51 (Fla. 1st DCA 1980). [2] Vargas v. Americana of Bal Harbour, 345 So.2d 1052 (Fla. 1977). [3] § 440.13, Florida Statutes....
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Prather v. Process Sys., 867 So. 2d 479 (Fla. 1st DCA 2004).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2004 WL 256515

...tantial evidence. The majority's deference to the JCC's decision appears at odds with the legislature's clearly expressed preference that opinions of EMAs be generally accepted. I cannot agree that after the passage of the EMA procedure, codified in section 440.13(9)(c), Florida Statutes (1995), a judge now retains the nearly unfettered power to disapprove an EMA's opinion in circumstances, such as those at bar, in which the advisor fully took into consideration all inconsistencies in the medica...
...he mental condition, but was rather only one of several contributing causes, including a combination of her wrist and non-compensable back injuries. As a result of the conflict in medical opinions, an EMA was appointed, pursuant to the provisions of section 440.13(9)(c)....
...the explanations by Drs. Doheny and Szmurlo that the claimant's mental condition made her a poor historian because it affected her memory and ability to recite historical facts. The order also ignored this court's decisions construing the effect of section 440.13(9)(c)....
...without hesitancy, as to the truth of the allegations sought to be established [and therefore the falsity or inaccuracy of the expert medical advisor's opinion].'" Id. (quoting McKesson Drug Co. v. Williams, 706 So.2d 352, 353 (Fla. 1st DCA 1998)). Section 440.13(9)(c), giving the EMA's opinion conclusive effect unless clear and convincing evidence to the contrary is presented, appears to be a legislative endeavor to alter drastically the trial arbiter's role in weighing and evaluating the evid...
...inion be approved, and remand the case for a determination, not reached by the JCC, as to whether the claimant suffered a loss in wage-earning capacity as a result of her major depression, and, if so, her entitlement to indemnity benefits. NOTES [1] Section 440.13(9)(c) provides, in pertinent part: "The opinion of the expert medical advisor is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the judge of compensation claims."
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Bradley v. Kraft Foods, Inc., 609 So. 2d 748 (Fla. 1st DCA 1992).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1992 WL 358127

...upport of the deep brain stimulation procedure in claimant's case. Although Dr. Friedman did state that it was "not medically necessary," unquestionably he was speaking in terms of life and death, and was not applying the legal standard contained in section 440.13(2)(a), Florida Statutes (1991), authorizing necessary medical treatment as the nature of the injury and the process of recovery would require....
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Alamo Rent-A-Car v. Phillips, 613 So. 2d 56 (Fla. 1st DCA 1992).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 13569, 1992 WL 387433

...Brumer, challenging the causal relationship between claimant's pneumonia and his job duties. Claimant filed a motion to strike the deposition testimony of Dr. Brumer on the ground that Dr. Brumer charged $500.00 per hour (total fee of $625.00) in contravention of Section 440.13(2)(k), Florida Statutes (Supp....
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Claims Mgmt., Inc. v. Grenier, 777 So. 2d 1039 (Fla. 1st DCA 2000).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2000 WL 33173142

...For the reasons that follow, we affirm. As a threshold matter, we treat the claimant's request for an "evaluation" by a vascular surgeon as a request for an independent medical examination (IME). First, we note that there is no provision for an "evaluation" per se in section 440.13, Florida Statutes (1997)....
...Sprehe (g) "vascular surgeon Finally, in the order under review the JCC referred to an "evaluation" by a vascular surgeon, but used the term IME with respect to Dr. Sprehe. Thus, from the record before us, we believe the "evaluation" by a vascular surgeon is, in substance, an IME. Where a managed care plan exists, under section 440.134(16), Florida Statutes (1997), the JCC must deny a claimant's request for an IME, if the purpose of the IME is to resolve a dispute regarding the provision of medical treatment, care and attendance. See Wiggins v. B & L Servs., Inc., 701 So.2d 570, 572 (Fla. 1st DCA 1997). Such disputes are to be resolved through a request for change *1041 of provider, see section 440.134(10)(c), Florida Statutes (1997), or a grievance under procedures established pursuant to section 440.134(15)....
...Dunkin Donuts, 728 So.2d 772 (Fla. 1st DCA 1999). When the dispute does not concern the provision of medical treatment, care and attendance, however, the managed care provisions do not govern the selection and use of medical expert witnesses under section 440.13(5)....
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BYSCZYNSKI v. United Parcel Servs., Inc., 53 So. 3d 328 (Fla. 1st DCA 2010).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 20235, 2010 WL 5306460

...ive changes, not the 2007 accident. However, Dr. Glasser acknowledged that the degenerative changes were likely related to the prior fusion. Based on an unopposed motion filed by the E/C, the JCC appointed an expert medical advisor (EMA) pursuant to section 440.13(9)(c) to resolve the perceived conflict between the opinions of Dr....
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Telcon, Inc. v. Williams, 500 So. 2d 266 (Fla. 1st DCA 1986).

Cited 3 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 5

...ng to authorized medical treatment of a compensable injury, the court is faced with a difficult policy choice in construing the statutory terms. On the one hand, the statute imposes upon the employer the cost of transportation for medical treatment, section 440.13(4), Florida Statutes (1979), and yet the employer cannot control the manner and route of the trip to insure that it is reasonably safe....
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Washington v. Orange Cnty. Sch. Bd., 702 So. 2d 1356 (Fla. 1st DCA 1997).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1997 WL 774801

...At the hearing, the claimant's attorney objected to introduction of depositions of physicians who had treated the claimant for the non-industrial injuries. The JCC erroneously declared these physicians to be "medical advisors" and admitted the depositions. Section 440.13(5)(e), Florida Statutes (Supp.1994), provides: "No medical opinion other than the opinion of a medical advisor appointed by the judge of compensation claims or division, an independent medical examiner, or an authorized treating provid...
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Kimmins Corp. v. Collier, 664 So. 2d 299 (Fla. 1st DCA 1995).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1995 WL 704259

...This defense activated the dispute resolution procedure set forth in section 440.1925 which vested jurisdiction before the JCC. In addition, the issue raised a dispute over claimant's entitlement to future medical care and indemnity, thus invoking the IME provisions of section 440.13(5)....
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Tri-State Motor Transit Co. v. Judy, 566 So. 2d 537 (Fla. 1st DCA 1990).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1990 WL 110288

...We disagree. The focus of the notice concept to which the E/C allude is on a claimant's failure to request payment for services; whether the E/C were prejudiced by the various providers' failure to request payment for services is irrelevant. Under section 440.13(2)(b), Fla....
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Artigas v. Winn Dixie Stores, Inc., 578 So. 2d 356 (Fla. 1st DCA 1991).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1991 WL 46823

...No error is asserted by any of the parties in the awarding of temporary total disability benefits prior to the date of maximum medical improvement, in the awarding of permanent total disability benefits thereafter, in the setting of the date of maximum medical improvement, or in relying upon Section 440.13(2)(e)(1), Florida Statutes, in setting the rate of compensation for attendant care services....
...The appellees argue in their cross-appeal that there was an absence of competent substantial evidence to support the finding that the claimant was in need of 24-hour per day attendant care. They also contend that a family member providing nonprofessional attendant care pursuant to Section 440.13(2)(e), Florida Statutes, can be compensated for no more than 12 hours per day. We hold that (1) competent substantial evidence supported the judge's finding that the claimant was in need of 24-hour per day attendant care; (2) a family member providing attendant care pursuant to Section 440.13(2)(e), Florida Statutes, can be compensated for no more than 12 hours per day; (3) the appellant's argument that the order should have provided for an automatic increase in the rate of compensation for attendant care upon an increase i...
...In any event, the judge did clearly find that the claimant's parents had been providing attendant care services since March 1, 1989, and he found that the parents should be compensated for those services at the rate of $3.35 per hour, the then-prevailing federal minimum wage. Section 440.13(2)(e)(1), Florida Statutes, was applied by the judge in reaching the compensation rate, because the mother was not employed and the nighttime care provided by the father did not require him to relinquish his daytime employment....
...The testimony as to the claimant's conduct, together with the opinions offered by the medical experts, provided a sufficient evidentiary basis for a finding that the claimant needed 24-hour per day attendant care. Next, we consider the appellee's/cross-appellant's argument that a family member providing attendant care under Section 440.13(2)(e), Florida Statutes (1989), can be compensated for no more than 12 hours per day. Chapter 89-289, § 10, Laws of Florida, which became effective on October 1, 1989, limited a family member providing nonprofessional attendant or custodial care under Section 440.13(2)(e), Florida Statutes, to a maximum of 12 hours compensation per day....
...Finally, we turn to that portion of the order which directed that the award of attendant care benefits would be reduced by the amount of the permanent total disability benefits. Permanent total disability benefits under Section 440.15(1), Florida Statutes (1989), and attendant care benefits under Section 440.13(2), Florida Statutes (1989), serve entirely different purposes....
...could conclude that the judge believed that the claimant was entitled to less than 24 hours per day of attendant care benefits, because during a portion of each day, the parents were providing services for the claimant which should be excluded under Section 440.13(2)(d), Florida Statutes (1989)....
...If the number of hours of attendant care awarded after that date is less than 24 hours per day, the order should explain the basis for the number of hours of attendant care compensation awarded and the basis for any reduction of attendant care benefits due to the requirements of Section 440.13(2)(d)....
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Thorarinsson v. Robert F. Wilson, Inc., 563 So. 2d 710 (Fla. 1st DCA 1990).

Cited 3 times | Published | Florida 1st District Court of Appeal | 1990 WL 48644

...appellees. THOMPSON, Judge. This case involves the appeal and cross-appeal of a workers' compensation order awarding attendant care. We affirm the order except as to the award of attendant care. The Judge of Compensation Claims (JCC) below held that § 440.13(2)(e)2, Fla. Stat. (1988), should not be retroactively applied. This court has previously held that the 1988 amendment of § 440.13(2)(e)2, applied to benefits awarded prior to, but paid after, the effective date of the amendment....
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State of Florida Dep't of Corr. v. Andrew Junod, 217 So. 3d 200 (Fla. 1st DCA 2017).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2017 Fla. App. LEXIS 5231

...Pianko acknowledged Claimant’s coronary risk factors traditionally associated with coronary artery disease, but concluded that the predominant cause of Claimant’s heart disease was work-related. An EMA opinion is presumptively correct to the extent it addresses disagreements in the opinions of healthcare providers. § 440.13(9)(c), Fla....
...d required judgment for the E/C. Punsky, 18 So. 3d at 584. 5 An EMA opinion is admissible as provided in § 440.25(4)(d), Fla. Stat., when there is a conflict in the medical evidence. However, an EMA opinion is not presumptively correct under § 440.13(9)(c) to the extent that it exceeds the scope of any identified disagreement between other authorized medical opinions....
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Jacaranda Manor v. Randolph, 755 So. 2d 781 (Fla. 1st DCA 2000).

Cited 3 times | Published | Florida 1st District Court of Appeal | 2000 WL 370090

...We conclude that it was thereby permissible for the judge to determine that the statutory presumption of correctness with regard to the expert medical advisor's opinion was overcome by clear and convincing evidence to the contrary, as specified in section 440.13(9)(c), Florida Statutes....
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Great Bay Distributors v. Everett, 513 So. 2d 187 (Fla. 1st DCA 1987).

Cited 2 times | Published | Florida 1st District Court of Appeal | 12 Fla. L. Weekly 2222

...t. The dc's order cites 2 A. Larson, The Law of Workmen's Compensation § 61.13(f), which approves the award of compensation benefits for such purpose. We agree that the use of plastic surgery is under the circumstances legislatively contemplated by Section 440.13(2)(a), Florida Statutes, providing that "the employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance by a health care provider and for such period as the nature of the injury or the process of recovery may require...." AFFIRMED....
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Robinson v. Shands Teaching Hosp., 625 So. 2d 21 (Fla. 1st DCA 1993).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1993 WL 369001

...not competent substantial evidence from which one could conclude that claimant's position was meritorious. [3] To entitle her to treatment by a psychiatrist, it was incumbent upon claimant to establish that such treatment was "medically necessary." Section 440.13(2)(a), Fla....
...ZEHMER, C.J., dissents with written opinion. ZEHMER, Chief Judge (dissenting). The issue on appeal is whether the employer and carrier are required to pay for Dr. Springer's psychiatric services to Claimant because the employer and carrier failed to comply with the requirements of section 440.13, Florida Statutes (Supp....
...Fabrick, Ph.D., I respectfully dissent from the majority's resolution of this issue. Claimant sought and obtained psychiatric evaluation and treatment from Dr. Springer based on the referral by her authorized treating physician, Dr. Lane. On July 1, 1990, only days before this medical referral was made, section 440.13(2)(a), as amended by the addition of the following emphasized language, became effective: (2)(a) Subject to the limitations specified in s....
...This is a laudable purpose with which I have no quarrel. But this purpose, I believe, was not intended be accomplished in the manner revealed by the record in this case; nor do I believe that the majority opinion accords with the intent of the statutory scheme in section 440.13, even after this 1990 amendment became effective. Seemingly, the amendment to subsection 440.13(2)(a) transferred, from an authorized treating physician trained in medicine to a claims manager not required to have any medical training whatsoever, the discretionary authority to determine whether and when an authorized physician ma...
...g authorization from the judge cannot, under that decision, be recovered from the carrier even though the medical services are subsequently shown to be reasonably necessary and required for "the process of recovery." Reading the 1990 amendment to subsection 440.13(2)(a) in conjunction with other related provisions in chapter 440, I conclude that this result is neither necessary nor consistent with the overall intent of the workers' compensation act....
...Before discussing my reasons for reaching this conclusion, however, two preliminary comments are in order. First, Claimant's accident in this case occurred on December 4, 1989, and the majority opinion has treated the July 1, 1990, amendment to subsection 440.13(2)(a) as a procedural statute that can be applied retroactively to accidental injuries occurring before its effective date....
...r or risk being responsible for payment of the bill. Chase v. Henkel & McCoy, 562 So.2d 831 (Fla. 1st DCA 1990); Kirkland v. Harold Pratt Paving, Inc., 518 So.2d 1320 (Fla. 1st DCA 1987); and Suez Motel v. Brouwer, 388 So.2d 627 (Fla. 1st DCA 1980) (Section 440.13 Fla....
...ment of the bill." [Emphasis added.] The legal deficiency in these findings is perfectly obvious. Dr. Fabrick, a Ph.D. psychologist (and presumably licensed as such under chapter 490, Florida Statutes), is not a physician within the definition in subsection 440.13(1)(h), Florida Statutes (Supp....
...Thus, the Carrier's offer of treatment by Dr. Fabrick, a psychologist, when it notified Claimant that psychiatric treatment by Dr. Springer would not be authorized, was not legally sufficient to constitute an offer of an alternative physician as required by sections 440.13(2) and (3), Florida Statutes (Supp. 1990). Subsection 440.13(2)(a) requires the employer and carrier to provide a claimant with "medically necessary remedial treatment ... as the nature of the injury or the process of recovery may require... ." Subsection 440.13(2)(c) requires that, "Any list of health care providers developed by a carrier, not including pharmacists, from which health care providers are selected to provide remedial treatment, care, and attendance shall include representation of each type of health care provider defined in s. 440.13(3)(d)1.d., Florida Statutes, 1981, and shall not discriminate against any of the types of health care providers as a class." [4] Subsection 440.13(2)(d) provides in part: If the employer fails to provide such treatment, care, and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by a judge of compensation claims....
...d, refused, or neglected to do so or unless the nature of the injury required such treatment, nursing, and services and *29 the employer or the superintendent or foreman thereof, having knowledge of such injury, has neglected to provide the same. Subsection 440.13(3) provides in part: If an injured employee objects to the medical attendance furnished by the employer pursuant to subsection (2), it shall be the duty of the employer to select another physician to treat the injured employee unless a...
...the requested psychiatric treatment for Claimant or obtain a ruling from the judge of compensation claims that such alternative care was not in Claimant's best interest; failure to comply with this obligation rendered them responsible pursuant to subsection 440.13(2) for the unauthorized psychiatric treatment if the judge should later determine that such treatment was reasonable and necessary....
...rs, Roebuck and Co. v. Viera, 440 So.2d 49 (Fla. 1st DCA 1983) (failure to offer alternative chiropractic care in response to claimant's request, and offer of orthopedic surgeons and neurologists instead, failed to comply with the requirements of subsection 440.13(2) and subjected employer and carrier to liability for unauthorized chiropractic treatment that was reasonable and necessary; claimant not required to seek order of authorization prior to receiving treatment); Deinema v....
...ay well have been in need of such examination and treatment, for they authorized, as found in the appealed order, psychiatric evaluation and care by Dr. Fabrick. Yet Dr. Fabrick was a psychologist who does not qualify as a physician as defined in subsection 440.13(1)(h). By no stretch of imagination can this offer of treatment be said to amount to alternative psychiatric care that complies with the requirements of subsections 440.13(2) and (3)....
...Lane, should have or did know the difference between the two. To require Claimant in these circumstances to advise the Carrier that she rejects the proffered psychologist because he was not a psychiatrist completely defeats the self-executing nature of Employer and Carrier's obligation under section 440.13....
...[3] We note that it is highly questionable whether the record contains competent substantial evidence from which one might conclude that claimant's need for treatment of her depression was causally related to her accident. However, as that issue was not raised below, we, likewise, decline to consider it. [4] Section 440.13(3)(d)1.d., Florida Statutes (1981), provides: "Health care provider" means a physician licensed under chapter 458, an osteopath licensed under chapter 459, a chiropractor licensed under chapter 460, a podiatrist licensed under chapter 461, an optometrist licensed under chapter 463, a pharmacist licensed under chapter 465, or a dentist licensed under chapter 466. Similar provisions are currently found in the definition of "physician" in subsection 440.13(1)(h), Florida Statutes (Supp. 1990). "Health care provider" is currently defined as "a physician or any recognized practitioner who provides skilled services pursuant to the prescription of or under the supervision or direction of a physician." Section 440.13(1)(b), Fla. Stat. (Supp. 1990). See also § 440.13(1), Fla....
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Perez v. E. Airlines, Inc., 569 So. 2d 1290 (Fla. 1st DCA 1990).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1990 WL 133226

...those associated with treatment of his diabetes, contesting any causal connection between Perez's back injury and his preexisting, diabetic condition. When Eastern attempted to have a private discussion with Perez's internist, Dr. Reid, pursuant to § 440.13(2)(c), Florida Statutes (1989), Perez objected to such ex parte communication, relying upon § 455.241(2), Florida Statutes (1989)....
...Reid's medical reports and advised Eastern that he had no objection to a deposition or conference where his attorney would be present. Nevertheless, Eastern desired an ex parte discussion and brought the issue before the judge of compensation claims. On April 4, 1990, the judge ruled that § 440.13(2)(c) provided authority for Eastern to conduct ex parte communications with Perez's physician....
...of a patient may not be discussed with, any person other than the patient or his legal representative or other health care providers involved in the care or treatment of the patient, except upon written authorization of the patient. Recently enacted § 440.13(2)(c), Florida Statutes, states in pertinent part, Notwithstanding the limitations in s....
...upon the request of the employer, the carrier, the attorney for either of them, or the rehabilitation provider, the medical records of an injured employee *1291 shall be furnished to such persons and the medical condition of the injured employee shall be discussed with such persons[.] The judge is correct that § 440.13(2)(c), Florida Statutes, is an exception to the confidentiality constraints of § 455.241, Florida Statutes, and allows Eastern to discuss Perez's medical condition with Dr. Reid. However, nothing in Section 440.13(2)(c) requires that such discussion be had in the absence of Perez's counsel....
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Vannice Const. Co. v. Silverman, 419 So. 2d 369 (Fla. 1st DCA 1982).

Cited 2 times | Published | Florida 1st District Court of Appeal

...nt (AMA Guides). The employer/carrier further urge as error paragraph five of the deputy's order [1] — which arguably requires them to pay claimant's psychiatric bills — on the ground that there was no compliance with the reporting requirements of Section 440.13(1), Florida Statutes (Supp....
...ting as this is supported by competent and substantial evidence in the record. Next, we find that payment of claimant's physicians' bills was a contested issue below and thus the deputy was required to determine whether the reporting requirements of Section 440.13(1) were met, or if not, whether there was an excuse for noncompliance....
...1st DCA 1981). Finally, we construe paragraph five of the deputy's order as requiring payment of claimant's psychiatrist's bill. This was error since the order does not set forth good cause for the psychiatrist's failure to follow the reporting requirements of Section 440.13(1)....
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Chudnof-James v. Racetrac Petroleum, Inc., 827 So. 2d 369 (Fla. 1st DCA 2002).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2002 WL 31250596

...of expenses and benefits associated with the emergency room visit of June 2000. We must first determine whether the Judge of Compensation Claims (JCC) properly excluded the medical opinion testimony of Dr. Ernest Block, an emergency room physician. Section 440.13(5)(e), Florida Statutes (1997), governs who can offer medical opinion testimony during workers' compensation hearings....
...Therefore, the JCC erred in awarding medical expenses for claimant's emergency room treatment and in awarding temporary total disability benefits for June 27, 2000, through July 10, 2000. AFFIRMED IN PART, REVERSED IN PART. VAN NORTWICK and POLSTON, JJ., concur. NOTES [1] Section 440.13(5)(e), Florida Statutes, provides in relevant part: (e) No medical opinion other than the opinion of a medical advisor appointed by the judge of compensation claims or division, an independent medical examiner, or an authorized treatin...
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ABC Liquors, Inc. v. Flores, 700 So. 2d 102 (Fla. 1st DCA 1997).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1997 WL 611725

...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...
...(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....
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Remington v. Ocala/united Self Insured, 940 So. 2d 1207 (Fla. 1st DCA 2006).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 18217, 2006 WL 3066797

...dial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require, including medicines, medical supplies, durable medical equipment, orthoses, prostheses, and other medically necessary apparatus. § 440.13(2)(a), Fla. Stat. (2001) (emphasis supplied); § 440.13(2)(a), Fla. Stat. (1997) (emphasis supplied). Under the Act, the word "`[m]edicine' means a drug prescribed by an authorized health care provider. . . ." § 440.13(1)(n), Fla. Stat. (2001); § 440.13(1)(n), Fla....
...at 46, along with the cost of the medical treatment itself, our supreme court answered with what remains the definitive construction of the statute: Chapter 440 does not specifically require or authorize payment of travel expenses incurred in obtaining medical treatment. Nevertheless, we are of the view that Section 440.13, which requires the employer to furnish to the employee "such remedial treatment, care and attendance" as the injury shall require, must be interpreted to include reasonable travel expenses incurred by the employee in presenting himself at the place where such treatment and care is provided....
...1st DCA 1996) ("[T]he legislature *1210 must be presumed to have continued its approval of the supreme court's construction of this language in Mobley to permit reimbursement of medical transportation."), statutory changes notwithstanding. The Legislature added a provision to section 440.13, after Mobley was decided, authorizing inclusion of certain medical mileage as "part of [an injured employee's] remedial treatment, care, and attendance," Ch....
...When the Legislature later removed the medical mileage provision it had added in 1977, see Ch. 93-415, § 17, at 98-111, Laws of Fla., it was simply excising surplusage. We so held in Bair, where [w]e conclude[d] that this omission did not abrogate the judicial construction in Mobley and its progeny that section 440.13(2)(a) implicitly authorizes such costs....
...urpose of travel, means of transportation, and mileage. Ch. 93-415, § 25, at 137, Laws of Fla. (codified at § 440.192(2)(g), Fla. Stat. (Supp.1994)). In the decade since Bair was decided, the Legislature has left the pertinent language in sections 440.13(2)(a) and 440.192(2)(g) intact, other amendments to the Act notwithstanding. See, e.g., Ch. 2006-197, § 91, at 1625, Fla. Sess. Law Serv. (West) (amending section 440.13, Florida Statutes)....
...*1211 II. Ostensibly recognizing the continued viability of Mobley and the authority of Bair's holding to that effect, the judge of compensation claims purported to distinguish those cases and to limit the principle that animated them, ruling that section 440.13(2)(a) "does not require an employer or carrier to provide reimbursement to an injured worker for travel related to obtaining prescription drugs or other pharmacy supplies." But the order under review identifies as its central underpinn...
...96-002024WJC, Final Order on Expedited Hr'g, at 6 (Oct. 13, 2005) (on file with clerk, Office of the Judge of Compensation Claims, Orlando District) (concluding that "pharmacy bills and mileage related thereto constitutes medical care and treatment under § 440.13(2)(a)"); O'Donnell v....
...atute or case law for a distinction between transportation expenses incurred to obtain treatment (other than medicine) at a doctor's office or hospital and transportation expenses incurred to obtain treatment from a pharmacy in the form of medicine. Section 440.13(2)(a) specifically includes "medicines" among the types of "treatment, care, and attendance" that an employer is legally obligated to provide a sick or injured employee. § 440.13(2)(a), Fla....
...(2001) ("[T]he employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require, including medicines. . . ."). Construing the language in section 440.13(2)(a), our supreme court plainly said that, where "travel expenses [are] necessarily incurred in enjoying the medical benefits provided by the Act," the "employer-carrier must either furnish such transportation or pay claimant the reasonable actual cost thereof." Mobley, 170 So.2d at 47. III. Although injured employees, not employers, have the right to choose their pharmacy or pharmacist, see § 440.13(3)(j), Fla. Stat. (2001); § 440.13(3)(j), Fla....
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Florida Hosp. Deland v. Wagner-Vick, 940 So. 2d 588 (Fla. 1st DCA 2006).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2006 WL 3066452

...are to be deemed medically necessary, the attending physician must be aware of the cause of an employee's injury. Nothing in the *591 law of workers' compensation, however, expressly so states or reasonably implies such a restrictive interpretation. Section 440.13(2)(a), Florida Statutes (2003), provides, in part: "[T]he employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require . . . ." Additionally, the statute's definition of the term centers on the provision of a medical service or supply, and says nothing about a treating physician's actual knowledge of the cause of a patient's injury. Section 440.13(1)( l ) provides, in pertinent part: "`Medically necessary' or `medical necessity' means any medical service or medical supply which is used to identify or treat an illness or injury, is appropriate to the patient's diagnosis and statu...
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Navarro v. Sugarcane Growers Coop. & Prof'l Administrators, Inc., 661 So. 2d 946 (Fla. 4th DCA 1995).

Cited 2 times | Published | Florida 4th District Court of Appeal | 1995 Fla. App. LEXIS 11338, 1995 WL 621346

...physician and a licensed massage therapist. In March 1994 the employer wrote letters to the physician and therapist informing them that it no longer authorized their services. The employer believed it could unilaterally withdraw authorization under section 440.13(2)(d), Florida Statutes (Supp....
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Wiseman v. At & T Tech., Inc., 569 So. 2d 508 (Fla. 1st DCA 1990).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1990 WL 157742

...bursement of $91.60 which she paid to Parkway General Hospital for emergency room care on June 12, 1984, and June 17, 1984; (5) the surgery performed by Dr. Guilianti for disc removal was reasonable and necessary, but claim for payment was barred by section 440.13, because claimant did not seek authorization from the employer and the surgery was not of an emergency nature; (6) the employer consented to claimant's request for future medical care by Dr....
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Phillip A. Fortune v. Gulf Coast Tree Care Inc./Florida Citrus etc., 148 So. 3d 827 (Fla. 1st DCA 2014).

Cited 2 times | Published | Florida 1st District Court of Appeal

...interpreted to give effect to every clause in it, and to accord meaning and harmony to all of its parts.”’ Jones v. ETS of New Orleans, Inc., 793 So. 2d 912, 914-15 (Fla. 2001) (citing Acosta v. Richter, 671 So. 2d 149, 153-54 (Fla. 1996)). Here, the relevant section is 440.13(2)(c), Florida Statutes (2010): 3 If the employer fails to provide initial treatment or care required by this section after request by the injured employee, the employee may obtain...
...initial treatment, nursing, and services and the employer or his or her superintendent or foreman, having knowledge of the injury, has neglected to provide the initial treatment or care. (Emphasis added.) The underlined portion of section 440.13(2)(c) is an exception to the general rule, detailed earlier in the subsection, and the rule relied upon by the JCC to deny reimbursement of the claimed expenses....
...1st DCA 2009) (“When an employer abandons its obligation to provide appropriate care, however, it likewise surrenders to the injured employee the right to select a physician and obtain treatment, provided the care is ‘compensable and medically necessary.’” (quoting § 440.13(2)(c), Fla....
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Marton v. Florida Hosp. Ormond Beach/Adventist Health Sys., 98 So. 3d 754 (Fla. 1st DCA 2012).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2012 WL 4839773, 2012 Fla. App. LEXIS 17767

...lated to the issues presented in this case.” Further, the JCC found “that the amounts charged by the physicians for depositions at issue are reasonable, not excessive, and consistent with workers’ compensation law.” The JCC declined to apply section 440.13(10), Florida Statutes (2007) (establishing amount health care providers can charge as witness fees), to the issues before him, determining that the dispute was not over the amount to be paid to a health care provider; rather, this case...
...ty, the prevailing party is entitled to be reimbursed its “costs necessary to maintain the claim,” or necessary to maintain the defense of the claim. Ch. 03-412, § 26, at 3943, Laws of Fla. (eff. Oct. 1, 2003). 1. Depositions of Medical Experts Section 440.13(10), Florida Statutes (2007), provides: Any health care provider who gives a deposition shall be allowed a witness fee....
...viewed medical records and provided an expert opinion or has provided only direct professional services that were unrelated to the workers’ compensation case may not be allowed a witness fee in excess of $200 per day. The JCC erred in finding that section 440.13(10) was not applicable to the dispute before him. Section 440.13(10) limits the amount expert witnesses may charge; accordingly, it also limits what a non-prevailing party must reimburse the prevailing party. Two types of medical experts were deposed in this case, both of which are addressed in section 440.13(10). First, section 440.13(10) provides that a health care provider, defined in part as “a physician ... who provides skilled services,” see section 440.13(l)(i), Florida Statutes (2007), may not charge more that $200 per hour. This includes physicians performing IMEs and who provide “direct professional services” in addition to reviewing medical records. Given the reference to review of medical records in section 440.13(10), titled “WITNESS FEES,” it is reasonable to conclude that the physician’s time spent preparing for the deposition, including the review of medical records, is to be compensated at the same rate, $200 per hour. Here, it is.undisputed that Drs. McBride and Williamson were authorized treating physicians and Dr. Harr was an IME physician. On remand, their fees should be calculated according to the section 440.13(10) guides. What is not provided for in section 440.13(10) are fees for services such as “Non-Refundable Reservation Fee for Deposition,” as was charged by Dr....
...ost under chapter 440. See Black’s Law Dictionary 620 (8th ed. 2004) (“A canon of construction holding that to express or include one thing implies the exclusion of the other, or of the alternative.”). Because the JCC erred in failing to apply section 440.13(10), he abused his discretion in awarding the entire amounts sought by the Employer/Carrier. Section 440.13(10) also provides fee parameters for physicians who have “provided only direct professional services that were unrelated to the workers’ compensation case,” and those fees are capped at $200 per day....
...ration, are limited to $200 per day. *758 On the other hand, if they were authorized treating providers or IMEs, their fees should be computed as outlined in the preceding paragraph. As stated above, the JCC abused his discretion in failing to apply section 440.13(10)....
...tegory of costs relates to the fees charged by Dr. Chacko. It was stipulated that Dr. Chacko was an authorized physician. His charges included $525 for Claimant’s alleged failure to appear for an appointment and $750 for review of medical records. Section 440.13 addresses “no-show” fees only in relation to IMEs. In section 440.13(5)(d), the Legislature chose to include only IMEs when countenancing a payment being due from a claimant. The Legislature did not intend to make a claimant liable for a “no-show” fee charged by an authorized provider. These charges are more in the nature of claims costs rather than litigation costs. As for the charge for records review, section 440.13(3)(g), Florida Statutes (2007), expressly provides that an “employee is not liable for payment for medical treatment or services provided pursuant to this section.” Thus, there is no basis for ordering reimbursement of any of Dr....
...A Non-Deposition Fees Charged by IMEs The final cost challenge is to the fees charged by Dr. Harr other than those related to his deposition. These fees relate to Dr. Harr’s IME, and include $950 for “Reserved time fee for updated IME” and $475 for “No-Show fee.” Section 440.13(5)(d) provides only that a claimant “shall reimburse the employer or carrier 50 percent of the [IME] physician’s cancellation or no-show fee.” There is no mention of entitlement to reimbursement of a charge for reserving time for...
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Philyaw v. Arthur H. Fulton, Inc., 569 So. 2d 787 (Fla. 1st DCA 1990).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1990 WL 154768

...compensation, and provides that "every employer coming within the provisions of this chapter ... shall be liable for, and shall secure, the payment to his employees, or any physician, surgeon, or pharmacist providing services under the provisions of s. 440.13, of the compensation payable under §§ 440.13, [7] 440.15, [8] and 440.16." [9] This section thus requires a determination of what is meant by employer and employee, and what gives rise to the employee's entitlement to receive the compensation benefits described, i.e., coverage under the act....
...Additionally, chapter 440 specifically creates liability on the part of the employer directly to "any physician, surgeon, or pharmacist providing services" to an employee injured in Florida, section 440.10(1), and such health care providers can expect to receive payment for their services in accordance with the provisions of section 440.13 and the appropriately adopted schedules....
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Pinnacle Benefits, Inc. v. Alby, 913 So. 2d 756 (Fla. 1st DCA 2005).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 17529, 2005 WL 2922185

...Mining & Materials v. Mobley, 649 So.2d 934 (Fla. 1st DCA 1995). *758 Second, E/C argue that the JCC erred in accepting the opinions of the expert medical advisor (EMA), Dr. Mikolajczak, over the opinions of the authorized treating physicians. Pursuant to section 440.13(9)(c), Florida Statutes (2000), the JCC appointed an EMA due to the "disagreement in the opinions of the health care providers." Under the plain terms of this statutory subsection, "[t]he opinion of the expert medical advisor is presum...
...trial accident is the major contributing cause of Alby's cervical condition and need for surgery. The record supports the JCC's finding the EMA's medical opinions to be presumptively correct, absent clear and convincing evidence to the contrary. See § 440.13(9)(c). As to E/C's argument that the EMA's report was untimely completed, see section 440.13(9)(d), Florida Statutes (2000), we find no prejudice arising therefrom....
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Goldsmith v. Buena Vista Constr. Co., 304 So. 2d 110 (Fla. 1974).

Cited 2 times | Published | Supreme Court of Florida

...l in the amount of $94. for safety glasses. On the basis of the stipulated facts related above I find: "That the employer is not responsible for the payment of the bill for the safety glasses as a matter of law under Florida Statute 44.13(1)." [Sic. § 440.13(1), F.S.] In its order of affirmance the Industrial Relations Commission said: "The Order on appeal is based on competent, substantial evidence, U.S....
...of competent, substantial evidence, citing U.S. Casualty Co. v. Maryland Casualty Co. (Fla. 1951), 55 So.2d 741, we conclude as did the Judge of Industrial Claims, that the question is one of law as applied to stipulated facts. It is our conclusion Section 440.13(1), F.S. was misapplied in the orders below. The portion of Section 440.13(1) applicable to the issue here reads as follows: "......
...her eye giving him his only remaining vision should be protected at all times and it was advisable that safety protective glasses be worn by claimant most of the time. It is our conclusion that a realistic meaningful reading of the quoted portion of Section 440.13(1), as distinguished from a technical, narrow reading, supports Petitioner's claim....
...a large degree of assurance of unimpaired vision in his remaining eye. It stands to reason that without the sight of his right eye claimant as a blind man would be so handicapped as to be a total loss for most employments. The pertinent language of Section 440.13(1) fits the permanent impairment condition of claimant....
...trial injury did not stop at the point of the medical treatment required for the loss of his left eye but that the resulting condition in which claimant was left after his injury also requires attention, protection, and care within the intendment of Section 440.13(1), F.S., to the extent the expert testimony indicated was essential....
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WS Badcock Corp. v. Knight, 720 So. 2d 619 (Fla. 1st DCA 1998).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1998 WL 798835

...Judge of Compensation Claims (JCC), determining that Ronnie H. Knight, appellee, is permanently and totally disabled. The employer/carrier argues that the JCC erred in denying as untimely their motion to appoint an expert medical advisor pursuant to section 440.13(9)(c) filed two days prior to the final hearing....
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Carmack v. State, Dep't of Agric., 31 So. 3d 798 (Fla. 1st DCA 2009).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 17145, 2009 WL 3817923

...Simply put, does the E/C retain the right to control the selection of the future treating physician after the JCC determines the E/C wrongfully denied entitlement to treatment previously requested by the claimant? Claimant argues this court's interpretation of section 440.13(2)(c), Florida Statutes (2005), in Butler that "the E/C is not required to authorize that physician [the one claimant obtained treatment with when the E/C failed to authorize the requested treatment] for the claimant [for future treatment]" is dicta and conflicts with other decisions of this court. 947 So.2d at 572. Claimant's argument fails to address the 2003 amendment to section 440.13(2)(c) whereby the Legislature inserted the term "initial" before the phrase "treatment and care." Rules of statutory construction require that when interpreting a statute, terms should be given their plain meaning....
..."[T]he primary and overriding consideration in statutory interpretation is that a statute should be construed and applied so as to give effect to the evident intent of the legislature." Deason v. Fla. Dep't of Corrs., 705 So.2d 1374, 1375 (Fla.1998) (quoting State v. Nunez, 368 So.2d 422, 423-24 (Fla. 3d DCA 1979)). Section 440.13(2)(c) addresses only the situation whereby the employer fails "to provide initial treatment or care" (emphasis added)....
...is subsection to only the circumstances described therein—the "beginning" treatment for a particular condition. Nothing in this subsection requires the employer to accept the employee's selection for future care. Reference should instead be made to section 440.13 generally, which has long been interpreted to make clear that the employer controls the selection of the treating physicians. [1] See TW Servs., Inc. v. Aldrich, 659 So.2d 318, 322 (Fla. 1st DCA 1994) (reversing JCC's authorization of a specific doctor for future medical treatment because section 440.13 gives the employer the right to select treating physicians). In Parodi, we made clear that "the JCC has the statutory authority [pursuant to section 440.13(2)(c)] to authorize a doctor for care provided during the period of wrongful denial." 16 So.3d at 962....
...sary, it is for the employer or its insurance carrier to choose which certified health care provider to authorize. In those circumstances, "a certified health care provider ... must receive authorization from the carrier before providing treatment." § 440.13(3)(a), Fla. Stat. (2008). See City of Bartow v. Brewer, 896 So.2d 931, 933 (Fla. 1st DCA 2005) ("Section 440.13(2)(c), Florida Statutes, does not authorize the JCC to order treatment with a specific physician, where the E/C promptly offers qualified alternatives."); TW Servs., Inc....
...1st DCA 2006). When an employer abandons its obligation to provide appropriate care, however, it likewise surrenders to the injured employee the right to select a physician and obtain treatment, provided the care is "compensable and medically necessary." § 440.13(2)(c), Fla....
...se to the petition for benefits, the judge of compensation claims could not award authorization of the specific physician sought by Butler. Id. at 572. See also Aldrich, 659 So.2d at 322. Although not pertinent here, the Butler court also ruled that section 440.13(2)(f), Florida Statutes, did not authorize the employee to make a one-time "change" where the employee never even saw the initially authorized physician....
...no longer provide care, thereby severing an established physician-patient relationship.'[] (emphasis supplied)." City of Bartow, 896 So.2d at 933-34 (quoting Stuckey v. Eagle Pest Control Co., 531 So.2d 350, 351 (Fla. 1st DCA 1988)). In interpreting section 440.13, Florida Statutes, as it existed after July 1, 1990, but before the 1994 amendments took effect, [2] we acknowledged that "an E/C had the statutory right to unilaterally deauthorize a health care provider based on overutilization witho...
...in the claimant's best interests in terms of the claimant's continuing need for medical services." Terners of Miami Corp. v. Busot, 764 So.2d 701, 703 (Fla. 1st DCA 2000). The current statutory basis for "de-authorization" appears in subsection *803 440.13(2)(d), which provides: "The carrier has the right to transfer the care of an injured employee from the attending health care provider if an independent medical examination determines that the employee is not making appropriate progress in recuperation." See Ch. 93-415, § 17, at 101, Laws of Fla. No such independent medical examination took place here. [3] Subsection 440.13(2)(d) applies without regard to who initially selects the medical provider. Dr. Walker was "the attending health care provider" once he was chosen in conformity with subsection 440.13(2)(c)....
...ician when such care is found to be medically necessary based on the particular facts of the case; for example, the treatment provided is so specialized that few, if any, other physicians are qualified in that specialty area. [2] Until July 1, 1990, section 440.13(2)(a) provided in pertinent part: "The carrier shall not deauthorize a health care provider furnished by the employer to provide remedial treatment, care, and attendance, without the agreement of the employer, unless a deputy commissioner determines that the deauthorization of the health care provider is in the best interests of the injured employee." § 440.13(2)(a), Fla....
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Furtick v. William Shults Contractor, 664 So. 2d 288 (Fla. 1st DCA 1995).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1995 WL 678113

...ment Manual that such services be medically necessary. The claimant thereafter proceeded to a hearing before the judge of compensation claims, seeking to compel payment for the services for which reimbursement had been disallowed. In accordance with section 440.13(4)(i)3, Florida Statutes (1993), the doctor's care was subject to the utilization review process in section 440.13. The statute addresses two levels of utilization review, as such review may be conducted by either an employer/carrier or the division. See § 440.13(2)(i); § 440.13(2)(j)1, Fla. Stat. (1993). While the division may initiate its own review and is independently empowered to investigate health care providers and facilities pursuant to section 440.13(4)(h), Florida Statutes (1993), it also entertains proper requests for utilization review. § 440.13(2)(j)1; § 440.13(4)(i)1, Fla. Stat. (1993). This process encompasses reimbursement disputes as referenced in section 440.13(2)(j)1 and 2. See Fla. Admin. Code R. 38F-7.507(1)(c). If such disputes remain unresolved after an employer/carrier's in-house review, they may be submitted for further review by the division. See Fla. Admin. Code R. 38F-7.518. Consistent with section 440.13(4)(i)1 and 2, Florida Statutes (1993), utilization review (in both the concurrent and retrospective mode) pertains only in connection with care which has been authorized, as when the employer/carrier has paid or incurred an obligation to pay for the doctor's services. Because section 440.13(3), Florida Statutes (1993), insulates the claimant from liability in such circumstances, the health care provider (or facility) and the employer/carrier are the parties with the legal interest affected by utilization review....
...Terners of Miami v. Freshwater, 599 So.2d 674 (Fla. 1st DCA 1992); Lamounette v. Akins, 547 So.2d 1001 (Fla. 1st DCA 1989); Long Grove. An employer/carrier may deauthorize a provider's care [2] upon a determination of overutilization after in-house review, see section 440.13(2)(c), Florida Statutes (1993), but such a determination remains subject to the division's oversight if the provider requests subsequent review by the division....
...bligation for care which has been authorized. See Platzek v. Rock-A-Way, Inc., 512 So.2d 233 (Fla. 1st DCA 1987). Instead, utilization review addresses *291 the appropriateness of the level and quality of care, based on medically accepted standards. § 440.13(1)(i), Fla. Stat. (1993). Any inquiry into medical necessity in this context is generally limited to whether the care is appropriate to the diagnosis, [3] as within the range of reasonable practice parameters accepted by the doctor's peers. See § 440.13(1)(d), Fla....
...Lott, 473 So.2d 249 (Fla. 1st DCA 1985), which more thoroughly explain that when such deauthorization is made over the claimant's objection the employer incurs the risk that the judge may subsequently find such deauthorization to be without good cause. See also § 440.13(2)(d); § 440.13(3), Fla. Stat. [3] Questions as to the diagnosis itself, apart from whether it was made within reasonable practice parameters, must be pursued before the judge of compensation claims. This would ordinarily involve a medical dispute within the ambit of section 440.13(2)(j)3.a, Florida Statutes (1993).
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Smith v. DRW Realty Servs., 569 So. 2d 462 (Fla. 1st DCA 1990).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1990 WL 129094

...claimant to make the judgment regarding his need for care fulfills its obligation to investigate and offer benefits, if needed. The motion for rehearing is denied. SHIVERS, C.J., and MINER, J., concur. NOTES [1] We note that, effective July 1, 1990, section 440.13(2)(f), Florida Statutes (Supp....
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Ken Lones Landscaping, Inc. v. Tucker, 382 So. 2d 1368 (Fla. 1st DCA 1980).

Cited 2 times | Published | Florida 1st District Court of Appeal

...are exclusively prescribed by § 440.15(3)(f), Fla. Stat. IV. Whether the instant record fails, as a matter of law, to support an award of temporary total disability benefits from July 26, 1977, to November 16, 1978. We affirm as to Points I and II. § 440.13(3)(b) and § 440.19(1)(a), Fla....
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Jamar Sportswear, Inc. v. Miller, 413 So. 2d 811 (Fla. 1st DCA 1982).

Cited 2 times | Published | Florida 1st District Court of Appeal

...a rating in excess of that permitted. Decor Painting v. Rohn, 401 So.2d 899 (Fla. 1st DCA 1981). The carrier's third point concerns the deputy's excusal of the noncompliance of the physicians and hospitals involved with the reporting requirements of section 440.13, Florida Statutes (1979)....
...The deputy excused the reporting requirements because of his determination that the carrier had set up a "wall of ignorance." The deputy's excusal is for the wrong reason, because the wall of ignorance principle is inapplicable to the reporting requirements of section 440.13....
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Walt Disney World Co. v. Schiebel, 414 So. 2d 602 (Fla. 1st DCA 1982).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1982 Fla. App. LEXIS 20150

...Schmudde, Lake Buena Vista, for appellant. Thomas Mooney, Orlando, for appellee. BOOTH, Judge. The employer appeals a workers' compensation order excusing the failure of the claimant and of her chiropractor, Dr. Bartlett, to file timely medical reports as required by Florida Statutes, Section 440.13(1)....
...le reports. [1] See St. Francis Hospital, Inc. v. Feinberg, 192 So.2d 753 (Fla. 1966); Hood's Dairy v. Severino, 178 So.2d 588 (Fla. 1965). The cause was remanded for a specific finding as to whether good cause existed for the failure to comply with Section 440.13(1)....
...by the employer to rescind a previous denial of benefits. Torres v. Eden Roc Hotel, 238 So.2d 639, 643 (Fla. 1970). Therefore, untimely medical reports have been excused for good cause only where, for example, the employer waives the requirements of Section 440.13(1) with actual knowledge, see Torres v....
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Tomaskovich v. Lapointe, 904 So. 2d 538 (Fla. 1st DCA 2005).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2005 WL 1249062

...Wolff was authorized, [1] to treat, he must actually provide treatment before Claimant would receive a benefit that would trigger the section 440.20(4), pay and investigate provisions. Both Florida Statutes and our case law interpreting those statutes clearly show an IME is not treatment. An IME is defined in section 440.13(5)(a), Florida Statutes (2001)....
...NOTES [1] In this case, the record evidence indicates Dr. Wolff's authorization as a treating physician occurred from the March 3 stipulation, subsequent to the January 10 IME. We do not address whether retroactive authorization affects the analysis since Dr. Wolff did not provide treatment. [2] Section 440.13(5)(a) states 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."
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Alvarado v. Wackenhut Corp., 951 So. 2d 937 (Fla. 1st DCA 2007).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2007 WL 649348

...over his objection. Taylor v. Columbia/HCA Doctors Hosp., 746 So.2d 1244, 1245 (Fla. 1st DCA 1999). It was proper for the JCC to order the appointment of an EMA in this case because there was a disagreement in opinion between health care providers. § 440.13(9)(c), Fla. Stat. (2002); Broward Children's Ctr., Inc. v. Hall, 859 So.2d 623, 627 (Fla. 1st DCA 2003) (holding that "the clear intent of section 440.13(9)(c) is to require participation of an expert medical advisor in every case where a disagreement exists between healthcare providers.") However, the JCC departed from the essential requirements of the law by ordering the appointment of a neuropsychologist as an EMA. Florida Administrative Code Rule 59A-30.002(10) (2006) defines an EMA as a "physician." Section 440.13(1)(r), Florida Statutes (2002), defines a physician as a person "licensed under chapter 458, an osteopathic physician licensed under chapter *939 459, a chiropractic physician licensed under chapter 460, a podiatric physician licensed...
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Punsky v. Clay Cnty. Bd. of Cnty. Commissioners, 60 So. 3d 1088 (Fla. 1st DCA 2011).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 4410, 2011 WL 1167205

..., rejecting claimant’s arguments that sections *1091 440.19(6) and 440.24(4), Florida Statutes (2004), controlled. In response to a motion for rehearing filed by claimant, the judge entered an amended final order, rejecting arguments that sections 440.13(5) and 440.30, Florida Statutes (2004), applied, and reaffirming the rejection of claimant’s previously advanced statutory arguments....
...a statute, it is presumed to have intended some specific objective or alteration of law, unless a contrary indication is clear.” Mangold v. Rainforest Golf Sports Ctr., 675 So.2d 639, 642 (Fla. 1st DCA 1996). *1093 Claimant contends that sections 440.13(5) and 440.30, Florida Statutes (2004), control the disposition of this dispute, and that they override section 440.34(3). However, section 440.13(5)(a) addresses only independent medical examinations and sets out the circumstances under which a claimant may obtain reimbursement should the opinion of the claimant’s independent medical examiner be relied on in determining the claimant’s course of treatment. Section 440.34(3), on the other hand, directs the judge of compensation claims to award “reasonable costs” to the prevailing party. When read in conjunction with section 440.34(3), section 440.13(5) may broaden the circumstances under which a claimant may obtain reimbursement for the costs of an independent medical examination, but it in no way impacts an employer’s or carrier’s entitlement to reimbursement of reasonable costs when the employer or carrier is the prevailing party....
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Barnett v. Emr Telemetry, 396 So. 2d 791 (Fla. 1st DCA 1981).

Cited 2 times | Published | Florida 1st District Court of Appeal

...Lawless of Dickinson, O'Riorden, Gibbons, Quale, Shields & Carlton, P.A., Sarasota, for appellees. PER CURIAM. The sole issue for our determination is whether claimant's examination by Dr. Padar on August 7, 1978 constituted remedial attention or remedial treatment as contemplated by Sections 440.13(3)(b) and 440.19(1)(a), Florida Statutes (1971). The deputy commissioner found that it did not and concluded therefore that the claim for compensation benefits, filed April 2, 1979, should be dismissed with prejudice. We reverse. Section 440.13(3)(b) provides: All rights for remedial attention under this section shall be barred unless a claim therefor is filed with the division within two years after the time of injury, except that if payment of compensation has been made or...
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Blackshear v. Bethune Cookman Coll., 467 So. 2d 721 (Fla. 1st DCA 1985).

Cited 2 times | Published | Florida 1st District Court of Appeal | 24 Educ. L. Rep. 1071

...ally related to the [industrial] injury." Since she deemed there was no causal relationship between claimant's injury and his current condition, the deputy denied the claim for benefits, attorney's fees, and costs. Claimant contends that pursuant to Section 440.13(1), Florida Statutes (1981), and the recommendation of Dr....
...Derbenwick, the deputy erred in refusing to order the employer and carrier to provide a psychiatric evaluation for him, and in refusing to award attorney's fees. We agree with claimant on point one and reverse the denial of a psychiatric evaluation. The applicable portion of Section 440.13(1) provides: the employer shall furnish to the employee such remedial treatment, care, and attendance under the direction and supervision of a qualified physician or surgeon or other recognized practitioner, nurse or hospital and for s...
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Perez v. Se. Freight Lines, Inc., 159 So. 3d 412 (Fla. 1st DCA 2015).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2015 Fla. App. LEXIS 4044, 2015 WL 1268017

...And in the absence of a challenge to the causal chain, Claimant had met his burden to prove the causal relationship between the compensable injury and the requested benefit. Claimant still retained the burden to establish other aspects of proof required by statute, such as the medical necessity of the requested benefit. See § 440.13(2)(a), Fla....
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Merritt Sea Wall v. Revels, 594 So. 2d 855 (Fla. 1st DCA 1992).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1992 WL 37145

...Hurley and John C. Bachman of Zimmerman, Shuffield, Kiser & Sutcliffe, Orlando, for appellants. R.W. Simmermon, Orlando, and Bill McCabe, Longwood, for appellee. KAHN, Judge. This workers' compensation case presents a claim for attendant care benefits under section 440.13(2), Florida Statutes....
...ty from March 22, 1988 until October 1, 1989." Before October 1, 1988, family members performing attendant care were compensated at the market rate. See Southland Corp. v. Anaya, 513 So.2d 203 (Fla. 1st DCA 1987). On October 1, 1988, an amendment to section 440.13(2), Florida Statutes, became effective. This amendment, codified as section 440.13(2)(e), Florida Statutes (Supp....
...custodial care, the per hour value of that care shall be at the per hour value of such family member's former employment, not to exceed the per hour value of such care available in the community at large. In 1989, the legislature once again amended section 440.13(2)(e) to limit benefits to a family member providing nonprofessional attendant care to no more than 12 hours a day....
...t total order on March 22, 1989. On remand, the JCC should clarify which date the reimbursement begins. AFFIRMED in part, REVERSED in part and remanded for further proceedings. BOOTH and WOLF, JJ., concur. NOTES [1] This subsection was renumbered as section 440.13(2)(g) in 1990 and as section 440.13(2)(h) in 1991.
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Am. Grinding & Equip. v. Rodman, 411 So. 2d 917 (Fla. 1st DCA 1982).

Cited 2 times | Published | Florida 1st District Court of Appeal

...of benefit to his recovery. We will not second-guess the finding of the deputy commissioner on this issue. However, it is necessary for the deputy commissioner to further find "good cause" to excuse non-compliance with the reporting requirements of Section 440.13(1), Florida Statutes, before ordering payment by the E/C....
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Universal Corp. v. Lawson, 447 So. 2d 293 (Fla. 1st DCA 1984).

Cited 2 times | Published | Florida 1st District Court of Appeal

...n the exercise of due diligence could have discovered, that claimant was dissatisfied with the treatment afforded by Dr. Coury. The E/C then became obligated to offer alternative care by "select[ing] another physician to treat the injured employee." Section 440.13(2), Fla....
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Diana v. Hls Companies, 670 So. 2d 125 (Fla. 1st DCA 1996).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1996 WL 100839

...ld services. That was an error. Indeed, this court recently recognized that there were numerous cases permitting such awards. Beverly Enterprises v. Collingsworth, 670 So.2d 102 (Fla. 1st DCA 1996). The JCC also erred by ruling that the amendment to section 440.13(2)(f), adding language describing attendant care as "beyond the scope of household duties" could be applied to preclude an award for such services after the effective date of the statute without regard to the date of the claimant's injury....
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Liberty Mut. Ins. Co. v. Fuchs Baking Co., 577 So. 2d 603 (Fla. 1st DCA 1991).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1991 Fla. App. LEXIS 1938, 1991 WL 30421

...These awards were ordered to be paid both by Fuchs Bakery and Liberty Mutual. After consideration of appellant's motion for rehearing, which was denied, this appeal followed. Considering first appellant's statute of limitations defense, we agree with appellant that under section 440.13(3)(b), Florida Statutes (1975), a claim for remedial attention is barred unless filed within two years after the date of the last payment of compensation, or within two years after the last remedial attention "furnished by the employer...
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Laura Lewis v. Dollar Rent A Car & ESIS WC Claims, 220 So. 3d 1246 (Fla. 1st DCA 2017).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2017 WL 2491550, 2017 Fla. App. LEXIS 8541

...ble for wage-loss benefits under section 440.15, Florida Statutes. 2 Due to pending PFB, no issue existed as to jurisdiction of the JCC to consider the motion. 2 into evidence pursuant to “F.S. 440.13” without authentication, and because there was no evidence that Claimant did not have access to the records before the hearing. To obtain a writ of certiorari, Claimant must show that the order here is “(1) a departure from the...
...Here, the parties’ substantive rights are determined by the law in effect in 1988. The 1988 statute contains no provision for an FCE per se. Although 1988 law does not expressly provide for FCEs, Claimant may be compelled to submit to an FCE if the requisite authority is found in the statute. Section 440.13(2)(a), Florida Statutes (Supp....
...termining the future course of claimant’s treatment.” Under that circumstance, an FCE may be 5 considered a medical benefit that the JCC could order the E/C to provide under the authority of paragraph 440.13(2)(a), if Claimant had filed a claim for the FCE....
...n three grounds: there was no pending petition for benefits, there was no statutory right to an FME per se within Chapter 440, Florida Statutes, and there was insufficient proof that the FME was “medically necessary” as that phrase is used in section 440.13(2)(a), Florida Statutes....
...total disability benefits. The FCE was ultimately denied for lack of proof of “medical necessity.” West Coast Elevator relates only to those circumstances where a claimant requests an FCE (therefore, logically acquiescing to attendance) as a benefit due under section 440.13(2)(a), Florida Statutes, and can demonstrate “medical necessity.” This ruling does not apply to an E/C’s attempt to force a claimant’s 7 attendance at an FCE, or to whether the JCC h...
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& SC13-1976 Bradley Westphal v. City of St. Petersburg, etc. & City of St. Petersburg, etc. v. Bradley Westphal, 194 So. 3d 311 (Fla. 2016).

Cited 2 times | Published | Supreme Court of Florida | 2016 WL 3191086

...For example, during the same period of time in which the Legislature reduced the provision of disability benefits, the Legislature also gave employers and insurance carriers the virtually unfettered right to select treating physicians in workers’ compensation cases. See § 440.13(2)(f), Fla....
...Other changes have included a heightened standard that the compensable injury be the “major contributing cause” of a worker’s disability and need for treatment, and a requirement that the injured worker pay a medical copayment after reaching maximum medical improvement. See §§ 440.09(1), 440.13(14)(c), Fla....
...During briefing, we *318 treated Westphal as the petitioner and the City as the respondent, and we accordingly employ those same designations here. . Section 440.12(1), Florida Statutes (2009), provides: "No compensation shall be allowed for the first 7 days of the disability, except benefits provided for in s. 440.13....
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Terners of Miami Corp. v. Busot, 764 So. 2d 701 (Fla. 1st DCA 2000).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2000 WL 777154

...District Court of Appeal of Florida, First District. June 19, 2000. Robert L. Teitler of Walton, Lantaff, Schroeder & Carson, Miami, for petitioners. Richard E. Zaldivar; Jay M. Levy, P.A., Miami, for respondent. WOLF, J. The issue before us is whether section 440.13(2)(d), Florida Statutes (1997), eliminates the role of the judge of compensation claims (JCC) in determining, after the fact, whether an employer/carrier's (E/C's) unilateral *702 deauthorization and transfer of care, accomplished in apparent accordance with the terms of the statute, was appropriate....
...nal surgery. After Dr. Eastlick conducted his IME of claimant, he advised the E/C that, in his opinion, claimant was not making appropriate progress in recuperation under the care of Dr. Cabrera. [3] The E/C later notified claimant that, pursuant to section 440.13(2)(d), Florida Statutes (1997), they were deauthorizing Dr....
...Cabrera and requested a hearing before the JCC to determine whether Dr. Cabrera should be deauthorized based on the opinion of Dr. Eastlick. After an evidentiary hearing, the JCC determined that the E/C had improperly deauthorized Dr. Cabrera. In so doing, the JCC rejected the E/C's contention that section 440.13(2)(d), Florida Statutes (1997), divested the JCC of any role in determining whether a unilateral deauthorization, accomplished in apparent accordance with the statute's terms, had been in the best interests of the claimant. In this proceeding, the E/C argues only that the JCC misinterpreted section 440.13(2)(d), Florida Statutes (1997) by concluding that the provision did not altogether eliminate the role of a JCC in determining, after the fact, the appropriateness of a unilateral deauthorization of a health care provider and transfer of care accomplished in accordance with the statute's provisions. Section 440.13(2)(d), Florida Statutes (1997) provides in pertinent part as follows: The carrier has the right to transfer the care of an injured employee from the attending health care provider if an independent medical examination determines *703 that the employee is not making appropriate progress in recuperation. This provision was enacted as part of the sweeping reforms to the Workers' Compensation Act made in 1994. See Ch. 93-415, § 17, at 101, Laws of Fla. Prior to this enactment, as claimant points out in her response, this court had interpreted section 440.13, Florida Statutes, as requiring the E/C, before any deauthorization of an existing treating physician and transfer of care could occur over a claimant's objection, to obtain an order from the JCC allowing the transfer or bear the burde...
...transfer in care. See Cal Kovens Constr. v. Lott, 473 So.2d 249, 253 (Fla. 1st DCA 1985); see also Wolk v. Jaylen Homes, Inc., 593 So.2d 1058, 1060 (Fla. 1st DCA 1992); Stuckey v. Eagle Pest Control Co., Inc., 531 So.2d 350, 351 (Fla. 1st DCA 1988). Section 440.13, Florida Statutes, as it existed prior to 1989, read in pertinent part as follows: The carrier shall not deauthorize a health care provider furnished by the employer to provide remedial treatment, care, and attendance, without the agreement of the employer, unless a deputy commissioner determines that the deauthorization of the health care provider is in the best interests of the injured employee. § 440.13(2)(a), Fla....
...The legislature, however, retained the language in the statute which required the E/C in all other circumstances to obtain prior approval from a JCC before deauthorizing a health care provider and transferring care to another physician. See id. In 1990, the legislature eliminated from section 440.13 the language emphasized above which had required prior JCC approval for deauthorization. See Ch. 90-201, § 18, at 923-924, Laws of Fla. In interpreting section 440.13, Florida Statutes, as it existed after 1990 but before the 1994 amendments, this court acknowledged that an E/C had the statutory right to unilaterally deauthorize a health care provider based on overutilization without prior JCC appro...
...As this court found in Furtick, the JCC still has a role in determining, after a seemingly statutorily authorized unilateral deauthorization, whether the deauthorization was, in fact, in the claimant's best interests. See Furtick, 664 So.2d at 290. We find that the JCC's interpretation of section 440.13(2)(d), Florida Statutes (1997), did not constitute a departure from the essential requirements of law....
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Snider v. Mumford, Inc., 65 So. 3d 579 (Fla. 1st DCA 2011).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 10576, 2011 WL 2638165

...In this workers' compensation appeal, we must address whether a statute providing for the use of an Expert Medical Advisor applies retroactively. Here, Claimant challenges the order of the Judge of Compensation Claims (JCC) on three grounds: (1) the JCC erred in applying sections 440.13(5) and (9), Florida Statutes (2003), to this 1982 accident; (2) the JCC erred in denying Claimant's request for a one-time change in treating psychiatrist; and (3) the JCC erred in denying Claimant's claim for non-professional attendant care. We affirm the second issue without further comment, finding that the JCC correctly applied the relevant law. We affirm in part and reverse in part on issues one and three, finding that section 440.13(9), cannot apply retroactively....
...McClane recommended Claimant be provided attendant care for emotional reasons and to allay her fears. Dr. Tyson opined the care was not medically necessary. Because of the disagreement between the two physicians, the E/C requested the JCC appoint an expert medical advisor (EMA) pursuant to section 440.13(9), Florida Statutes (2003)....
...Claimant objected, arguing that the 2003 EMA statutory provision could not be applied retroactively to her 1982 accident. Claimant relied in part on this court's decision in Southern Bakeries v. Cooper, 659 So.2d 339 (Fla. 1st DCA 1995). The E/C argued that because section 440.13 addressed the procedure whereby a claimant is provided medical care, any changes to section 440.13 were procedural in nature and applied retroactively to dates of accidents prior to their enactment. For this proposition, the E/C relied on the authority of this court's decision in Butler v. Bay Center, 947 So.2d 570 (Fla. 1st DCA 2007). The JCC agreed and found that, based on Butler, the EMA statute, section 440.13(9), Florida Statutes, could be applied retroactively and appointed Dr. Edgar as the EMA. Analysis Although understandable based on the broad language of our decision in Butler, the JCC's reliance on Butler to find that section 440.13(9) is procedural is misplaced, as Butler addressed only section 440.13(2)(c) and (f), Florida Statutes (2005). See id. at 572-73 (holding that changes to section 440.13(2)(c) and (f), which address procedure for authorizing medical providers, are remedial and apply to all accidents, regardless of date). Any references in Butler to section 440.13 beyond subsections (2)(c) and (f) are dicta. We conclude that section 440.13(9) effects a substantive change, using an analysis similar to that which we applied in Southern Bakeries v. Cooper regarding section 440.13(5), as that statute addresses an issue much more closely related to the *581 EMA statutory provision. 659 So.2d 339 (Fla. 1st DCA 1995). In Southern Bakeries, this court determined that the 1994 amendment to section 440.13(5), Florida Statutes, creating a new independent medical examination (IME) procedure was substantive because "it alters the parties' obligation to pay for the claimant's [IME]." 659 So.2d at 341....
...Notably, in Southern Bakeries, there was no provision generally obligating the E/C to pay for the claimant's medical examination: In giving the claimant the right to select an [IME] and obtain such an examination without having to pay for this service, section 440.13(5) departs from the prior law under which the claimant could not always avoid such costs....
...ideration by the deputy commissioner as is accorded other medical evidence submitted in the proceeding; and all costs incurred in connection with such examination and testimony may be assessed as costs in the proceeding, subject to the provisions of s. 440.13(3)(a)....
...y not require E/C to pay for examination unless, as stated in section 440.25(3)(b), Florida Statutes (1987), there is conflict in medical evidence). Eventually, the "tie-breaker" provision in section 440.25(3)(b) became the EMA provision codified at section 440.13(9), Florida Statutes (Supp. 1994), and, with the statutory amendments effective October 1, 2003, a significant shift took place in *582 a party's burden to bear the cost of the "tie-breaker" examination, when section 440.13(9) was amended to require a claimant to pay for the examination if the claimant made the request. See Ch. 03-412, § 15, at 3904, Laws of Fla. As with the IME provision in section 440.13(5) addressed in Southern Bakeries, the EMA provision in section 440.13(9) affects the substantive rights of the parties—the entitlement to a service and the source of payment therefor—and cannot be applied retroactively....
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Morrow v. Sam's Club, 17 So. 3d 763 (Fla. 1st DCA 2009).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 10488, 2009 WL 2342920

...ive complaints." It is inapplicable in determining whether a claimant is entitled to a specialist evaluation recommended by his or her authorized treating physician. Entitlement to such a referral is governed, as is all medical treatment or care, by section 440.13(2)(a), Florida Statutes (2007), which requires a showing of medical necessity....
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City of Riviera Beach v. Napier, 791 So. 2d 1160 (Fla. 1st DCA 2001).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2001 WL 788509

...The E/C, however, fail to recognize that the present dispute is not one concerning a fee dispute between an authorized medical provider and a workers' compensation carrier. Cf. Terners of Miami Corp. v. Freshwater, 599 So.2d 674, 675 (Fla. 1st DCA 1992) (en banc) (holding that section 440.13(2)(i)1., Florida Statutes (Supp.1990), divested the JCC of jurisdiction to hear disputes between a health care provider and the E/C as to the amount the health care provider is to be paid). Instead, the issue presented to the JCC was whether Dr. Leighton could testify as an IME under section 440.13(5)(e), Florida Statutes (1997)....
...In this case, the JCC simply made a determination as to the admissibility of evidence. The JCC has jurisdiction to determine the admissibility of evidence, a function properly within his authority. The JCC also reached the right result in this case. Section 440.13(5)(e) limits the medical testimony that is admissible before the JCC to the opinions of expert medical advisors, independent medical examiners, and authorized treating providers. See Gallagher Bassett v. Laber, 722 So.2d 834, 834 (Fla. 1st DCA 1998)("Section 440.13(5)(5)(e), Florida Statutes, limits medical opinion testimony in workers' compensation cases to the opinion of a medical advisor, an independent medical examiner, or an authorized treating provider."); Lakeland Reg'l Med. Ctr. v. Murphy, 695 So.2d 895, 897 (Fla. 1st DCA 1997) ("Because [the doctors] did not fall into any of the categories under section 440.13(5)(e), the JCC erred in admitting their medical opinions.") Dr. Leighton's action in charging in excess of the allowable amount, and the E/C's action in acquiescing to and paying that charge, took Dr. Leighton out of the statutory category of independent medical examiner. Under the limiting provisions of section 440.13(5)(e), the JCC properly excluded Dr....
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Copeland v. Bond, 528 So. 2d 458 (Fla. 1st DCA 1988).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1988 WL 68087

...*459 WENTWORTH, Judge. Claimant seeks review of a workers' compensation order by which a claim for attendant care was denied. We find that the requested care was necessitated by claimant's industrial injury and thus should have been awarded pursuant to section 440.13(2)(a), Florida Statutes....
...The physician who treated claimant for his industrial injuries recommended that he avoid overhead reaching and stooping or bending at the waist, and indicated that these restrictions would make it difficult for claimant to care for his foot condition without assistance. Section 440.13(2)(a), Florida Statutes, directs the employer of a claimant who sustains an industrial injury to furnish such medical attendance as the nature of the injury or the process of recovery requires. In the present case the deputy declined to award such care, reasoning that claimant's need was necessitated by the nonindustrial surgeries. However, medical care is properly awarded pursuant to section 440.13(2)(a) when the need for such care arises from the combined effect of industrial and nonindustrial conditions....
...onindustrial surgeries, it is the industrial injuries which are producing the need for assistance in administering such care. The claim should therefore have been awarded in accordance with Jordan and Gonzales, supra, as attendant care authorized by section 440.13(2)(a), Florida Statutes....
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Musgrove v. Child.'s Home Soc'y, 573 So. 2d 100 (Fla. 1st DCA 1991).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1991 WL 567

...loyer's and carrier's (EC's) liability for claimant's future medical expenses in contravention of § 440.20(12)(a), Fla. Stat. The medical benefits for which the EC is responsible include medical treatment and care, as well as medicines, pursuant to § 440.13, Fla....
...Therefore the prohibition of § 440.20(12) clearly precludes a claimant from accepting a lump sum payment in exchange for any limitation on future medical care or medication. If the EC is concerned with claimant's overutilization of any health care professional, they can avail themselves of the remedies afforded by § 440.13(2)(a), Fla....
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Clair v. Glades Cnty. Bd. of Com'rs, 635 So. 2d 84 (Fla. 1st DCA 1994).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1994 WL 17259

...Thereafter, an attorney filed a reply brief on appellant's behalf; but, after considering the briefs, and because Alford, which involved the same issue, was pending, we ordered the parties in the instant case to file supplemental briefs addressing the issue of whether Section 440.13, Florida Statutes, permits a physician, practicing outside the peer group of the physician whose care had been authorized, to opine as an expert that the furnished care is not reasonable and necessary. In questioning whether Drs. Arpin and Conant are qualified to express such opinion, we note that Section 440.13(2)(a), Florida Statutes (1983), [1] provides in part: The carrier shall not deauthorize a health care provider furnished by the employer to provide remedial treatment, care, and attendance, without the agreement of the employer, unless...
...Any list of health care providers developed by a carrier not including pharmacists from which health care providers are selected to provide remedial treatment, care, and attendance shall include representation of each type of health care provider defined in s. 440.13(3)(d)1.d, Florida Statutes, 1981, and shall not discriminate against any of the types of health care providers as a class. (Emphasis added; footnote omitted.) Section 440.13(3)(d)1.d, Florida Statutes (1981), referred to in subsection 1(2)(a) above, provides: *86 "Health care provider" means a physician licensed under chapter 458, an osteopath licensed under chapter 459, a chiropractor licensed under chapt...
...This does not mean that an E/C is required to offer a list of health care providers solely from the class of providers requested by an employee; however, the "carrier's list of health care providers must include a representative of each type of provider defined in Section 440.13(1)(f), Florida Statutes." [2] Deriso v....
...1st DCA 1988). The above opinions clearly state that during the selection process of a requested list of physicians, discrimination against a specific requested class may occur if an E/C fails to offer a representative from such class. We consider that section 440.13 may also reasonably be interpreted as stating that discrimination occurs as well during the deauthorization process if a JCC relies upon the testimony of a physician practicing outside the peer group of the physician whose care was furnished in reaching any decision to deny such treatment. This conclusion, we think, is reinforced by reading the above provisions of subsections 440.13(2)(a) and 440.13(3)(d)1.d in pari materia with those of subsection 440.13(1)(c), defining the term "medically necessary" as any service or supply used to identify or treat an illness or injury which is appropriate to the patient's diagnosis, consistent with the location of service and with the level of care provided....
...asonably within the legislature's contemplation that physicians of one school of practice be deemed qualified to give opinions regarding the appropriateness of treatment provided by physicians of another school or community of practice. For example, section 440.13(1)(e) defines "peer review committee" as meaning "a committee composed of physicians licensed under the same authority as the physician who rendered the services being reviewed." (Emphasis added.) Admittedly, the term "peer review comm...
...Akins, 547 So.2d 1001, 1002 (Fla. 1st DCA 1989) (to determine whether chiropractic *87 physician overutilized services rendered to an injured employee, the physician's records were submitted to the Chiropractic Peer Review Committee). Our interpretation of section 440.13(3) is consistent with the general rule recognizing that physicians of one school of practice are incompetent to testify in malpractice actions against physicians of other schools regarding whether such physicians' treatments conformed with the requisite degree of skill and care in their practice areas....
...sity of the care furnished, we have not overlooked section 90.702 of the Florida Evidence Code, which broadly states that "a witness [may be] qualified as an expert by knowledge, skill, experience, training, or education," [5] yet we find nothing in section 440.13 evincing any legislative intent to incorporate the provisions of section 90.702. It is a well-recognized statutory maxim that a more specific statute dealing with a particular subject (here section 440.13) controls over a statute that covers the same subject more generally....
...Conant, but properly relied, under Alford, on the opinion of Dr. Arpin in denying the claims for continuation of chiropractic care, as we must assume that she was fully qualified to testify about chiropractic medicine. Nevertheless, claimant did preserve the issue of whether section 440.13 permits a physician, practicing outside the peer group of a physician whose care has been authorized, to testify as an expert on the reasonableness of the furnished care, notwithstanding that such physician may be qualified to testify as an expert under 90.702. Accordingly, because it appears that the issues raised in both this case and in Alford may be recurring, we certify the following question to the Florida Supreme Court as one of great public importance: WHETHER SECTION 440.13, FLORIDA STATUTES, PERMITS A PHYSICIAN, *88 PRACTICING OUTSIDE THE PEER GROUP OF THE PHYSICIAN WHOSE CARE WAS AUTHORIZED, TO OPINE AS AN EXPERT THAT THE FURNISHED CARE IS NOT REASONABLE AND NECESSARY? AFFIRMED....
...Similarly, an orthopedic surgeon specializing in foot surgery would be incompetent to comment on the need for the attention of a podiatrist. I seriously doubt the legislature intended such a result when it listed the various classes of health care providers and their licensing chapters in section 440.13(3)(d)1.d, Florida Statutes (1981)....
...A judge of compensation claims, with ample evidentiary support, has now decided that no need exists to require the employer/carrier to provide additional chiropractic care, many years after the injury and the washout settlement. This case should be marked "CLOSED." NOTES [1] In that section 440.13 has undergone numerous changes since 1983, the year of claimant's compensable accident, all references to section 440.13 in this opinion relate to the 1983 version, except as otherwise indicated. [2] This provision is currently renumbered 440.13(1)(h), and includes medical physicians, osteopaths, chiropractors, podiatrists, optometrists, and dentists. Section 440.13(1)(h), Fla. Stat. (Supp. 1992). [3] Although peer is not defined in section 440.13, the term is commonly defined as "a person or thing of the same rank, value, quality, ability, etc." Webster's New World Dictionary 1048 (2d college ed....
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Sunland Ctr. at Miami v. Rudolph, 521 So. 2d 132 (Fla. 1st DCA 1988).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1988 WL 804

...She also submitted a claim for temporary total disability benefits for five emergency hospitalizations due to severe depression. Appellants defended on the ground that appellee had not suffered a change of condition, psychiatric care was not authorized, and hospital and medical bills were not payable under section 440.13, Florida Statutes....
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Russell v. Pie Nationwide, 668 So. 2d 696 (Fla. 1st DCA 1996).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1996 WL 82767

...The claimant, who injured his back in a work-related accident in 1989, appeals a workers' compensation order allowing the employer/carrier to "deauthorize" further chiropractic care, contending that the judge of compensation claims erred in retroactively applying the following provision of section 440.13(2)(a), Florida Statutes (Supp.1994): Medically necessary treatment, care, and attendance does not include chiropractic services in excess of 18 treatments or rendered for more than 8 weeks beyond the date of the initial chiropractic tr...
...ount of the appellate attorney fee. KAHN, J., and SMITH, Senior Judge, concur. NOTES [1] Mr. C's T.V. Rental v. Murray, 559 So.2d 452 (Fla. 1st DCA 1990), cited by appellee, is distinguishable from this case because it involved the 1989 amendment to section 440.13(2)(e)2, which establishes the value of nonprofessional attendant care provided by a family member who leaves his or her employment to care for the injured employee as the per hour value of the family member's former employment, not to...
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Sunbelt Health Care v. Galva, 7 So. 3d 556 (Fla. 1st DCA 2009).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1549, 2009 WL 485043

...Levy of Jay M. Levy, P.A., Miami, for Appellee. PER CURIAM. In this workers' compensation case, the employer and carrier challenge an order of the judge of compensation claims granting claimant's request for a "one-time" alternate orthopedist pursuant to section 440.13(2)(f), Florida Statutes (2006)....
...Because of this disposition, it is unnecessary for us to address the remaining issues raised by the employer and carrier. Background On August 20, 2003, claimant suffered injuries to her wrist, shoulder, hip and back. Claimant's employer initially provided medical care pursuant to a managed care arrangement as authorized by section 440.134(2)(a), Florida Statutes (2002)....
...Macksoud as her one-time change in doctor. Claimant began treatment (which included surgery) with Dr. Macksoud in December 2003, and continued to treat with him for four years. On January 1, 2006, the employer and carrier discontinued their managed care arrangement as permitted by section 440.134(2)(a), Florida Statutes (2005)....
...At the hearing, the numerous letters confirming claimant's selection of Dr. Macksoud were introduced into evidence. The judge excluded the handwritten note based on claimant's authenticity objection. He subsequently entered an order granting claimant's request for a one-time change in physician pursuant to section 440.13(2)(f), Florida Statutes (2006). According to the judge, section 440.13(2)(f) requires a carrier to authorize an alternate physician who is not professionally affiliated with the prior treating physician, and claimant did not (and could not) waive that requirement....
...pursuant to Florida workers' compensation law, she has received all to which she is legally entitled. Under Florida worker's compensation law, an employer and carrier may elect to deliver medical benefits by an approved managed care arrangement. See § 440.134(2)(a), Fla. Stat. (2002). When they do so, workers subject to the managed care arrangement must receive medical services for work-related injuries as prescribed in the contract. See § 440.134(17), Fla....
...Under the managed care statute, the managed care plan must include a provision for the employee's selection of a primary care provider, one change to another provider, and one second opinion within the same specialty and provider network as the treating physician. See §§ 440.134(10)(c), 440.134(6)(c) 9-10, Fla....
...Here, under the operable managed care arrangement, claimant could choose her alternate physician from a network provider list. A similar and parallel provision operating outside the managed care arrangement also affords a claimant the right to a change in treating physician. See § 440.13(2)(f), Fla....
...he *561 alternate physician, as long as he or she is not professionally affiliated with the previous physician. See id.; see also Butler v. Bay Center/Chubb Ins. Co., 947 So.2d 570, 573 (Fla. 1st DCA 2006). The right to change physicians pursuant to section 440.13(2)(f) is not without limitations....
..."[T]he language of the statute plainly indicates a claimant may request a change of treating physician only once, no matter the number and variety of treatments needed by a claimant arising from the original accident." Id. (emphasis in original). The means by which an alternate treating physician is selected pursuant to section 440.13(2)(f) is a procedural right. Id. (holding that prior versions of the statute governing the means of identifying the physicians with whom a claimant could seek alternate care were procedural enactments). As we held in Butler, the benefit provided in section 440.13(2)(f) is a claimant-initiated, one-time change of physician, the substantial equivalent of which claimant in this case received by selecting Dr. Macksoud. The means of identifying and selecting the alternate physician — i.e., whether by claimant's choice (managed care), or by the employer and carrier pursuant to section 440.13(2)(f) — is a procedural mechanism in which a claimant has no vested substantive right. Because claimant received the substantial equivalent of the change in physician contemplated by section 440.13(2)(f), Florida Statutes (2006), while she was under the managed care arrangement, there is no legal basis to award a "second" one-time change in orthopedic physicians....
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Falcon Farms v. Espinoza, 79 So. 3d 945 (Fla. 1st DCA 2012).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2012 WL 580512, 2012 Fla. App. LEXIS 2782

...Best Int’l, 996 So.2d 233, 234 (Fla. 1st DCA 2008) (holding if error is one that first appears in final order, aggrieved party must bring it to judge’s attention by filing motion for rehearing). Given that the accident is not compensa-ble, the E/C’s argument on appeal has merit. Section 440.13(2)(f), Florida Statutes (2009), provides that “[u]pon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course *946 of treatment for any one accident.” Section 440.134(10)(c), Florida Statutes (2009), likewise provides that a managed care arrangement must grant the right to “one change to another provider within the provider network as the authorized treating physician during the course of treatment for a work-related injury, in accordance with the procedures provided in s. 440.13(2)®.” The plain language of section 440.134(10)(c) requires the injury to be a “work-related injury.” The JCC here found Claimant presented no “persuasive medical evidence” that an injury arose out of employment, and Claimant does not challenge that finding....
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Borges v. Osceola Farms Co., 651 So. 2d 173 (Fla. 1st DCA 1995).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1995 WL 66956

...ant's best interest. If the E/C does provide alternative care and the parties do not agree on the physician offered, then, in a nonemergency case, it is the claimant's burden to seek a decision through the JCC or risk being required to pay the bill. § 440.13(2), Fla....
...Cohen's past bills and the mileage *176 reimbursement. [2] The JCC apparently concluded, however, that it was in claimant's best interest to continue treatment with Dr. Cohen based on the satisfactory doctor-patient relationship and therefore authorized the doctor for future care. See § 440.13(3), Fla....
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Hinzman v. Winter Haven Facility Operations LLC, 109 So. 3d 256 (Fla. 1st DCA 2013).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2013 WL 599122, 2013 Fla. App. LEXIS 2478

PER CURIAM. In this workers’ compensation case, Claimant appeals an order of the Judge of Compensation Claims (JCC) in which he ruled that the “5 days” in section 440.13(2)(f), Florida Statutes (2011), means business days rather than calendar days....
...ent. Courts should give statutory language its plain and ordinary meaning, and may not add words that were not included by the legislature.” (citations omitted)). Seen another way, because the Legislature specified “business days” elsewhere in section 440.13, canons of statutory interpretation (particularly the presumption of consistent usage) dictate that the Legislature’s use of the unmodified term “days” here refers to consecutive or calendar days....
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E. Elevator Co. v. Hedman, 290 So. 2d 56 (Fla. 1974).

Cited 2 times | Published | Supreme Court of Florida

...Since we determine herein that a physician does not have standing to file an independent claim, the above-cited cases are hereby overruled to the extent that they may intimate otherwise. *58 The basis for a recovery in a workmen's compensation claim for medical expenses is found in F.S. § 440.13, F.S.A., which provides that the duty of the employer is to provide medical care for the employee and establishes limits on the medical fees which may be recovered. If the medical fee (1) falls within the categories of recoverable medical expenses set forth in F.S. § 440.13(1), F.S.A., (2) arises out of a compensable incident; and (3) comes within the limitations of F.S. § 440.13(3), F.S.A., the physician is entitled to payment of the appropriate amount for his services....
...This does not mean, however, that the physician may independently bring a claim before the JIC. In this regard, F.S. § 440.10(1), F.S.A., is controlling. In pertinent part, it provides that the employer "shall be liable for and shall secure the payment to his employees of the compensation payable under §§ 440.13, 440.15 and 440.16." (emphasis ours) Thus, the statute specifically makes the employer liable to his employee for payment of the recoverable medical expenses and any payment must be on the employee's behalf....
...Even if the physician in this cause did have proper standing, the order below would have to be reversed. Although there are certain recognized exceptions to the conclusiveness of the amounts provided for in the fee schedule promulgated pursuant to F.S. § 440.13(3)(a), F.S.A., there is no competent, substantial evidence in this record to support an award of medical fees in excess of those provided in the fee schedule, none of these exceptions having been properly shown to be present....
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Lovell Bros., Inc. v. Kittles, 518 So. 2d 319 (Fla. 1st DCA 1987).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1987 WL 2653

...ause there is no competent substantial *322 evidence that claimant performed an adequate job search; and (4) The deputy commissioner erred in awarding claimant attorney's fees, interest, and costs. Only the first point requires extensive discussion. Section 440.13(2)(b), Florida Statutes (1983), states that "if the employer fails to provide such [medically necessary remedial] treatment, care and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by a deputy commissioner." Section 440.13(3) further provides: If an injured employee objects to the medical attendance furnished by the employer pursuant to subsection (2), it shall be the duty of the employer to select another physician to treat the injured employee unless a...
...Jones was, under the statute, a matter within the deputy commissioner's discretion, and we find no abuse of that discretion on the particular facts of this case. Appellants contend that this case is governed by certain cases construing the quoted provisions of section 440.13 as requiring, before payment for services may be ordered, that the claimant first obtain the deputy commissioner's approval of his requested physician when he and the carrier cannot agree to a treating physician in a non-emergency situation, citing Champlain Towers v....
...Unlike the cases cited by appellants, here the carrier never offered any physician other than the three doctors objected to by claimant. Likewise, we find no error in the deputy commissioner's excusing the untimely filing of past medical bills and reports *323 under the provisions of section 440.13(2)....
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Shafer & Miller, Inc. v. Moore, 499 So. 2d 871 (Fla. 1st DCA 1986).

Cited 2 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 2571

...The e/c issued a notice to controvert on grounds that Dr. Stillman was not authorized, his billing for the evaluation was not authorized, and the claimant already had been provided care by Dr. Daruna. Appellee then requested a hearing to determine his entitlement to psychiatric care by Dr. Stillman. Section 440.13, Florida Statutes (1982 Supp.), provides: (1) Subject to the limitations specified in section 440.19(2)(b), the employer shall furnish to the employee such remedial treatment, care, and attendance under the direction and supervision of...
...request of the employer (insurance carrier) for a particular treatment is not solely determinative of the employer's obligation to pay for it if `the nature of the injury required such treatment' and the employer has knowledge of the injury and did not provide the treatment. This is the alternative `or' provision of section 440.13 of the Workmen's Compensation Act which provides that an employee is not entitled to recover such an amount expended by him for treatment unless: (1) he shall have requested employer to furnish it, or (2) unless the nature of the injury required it, and the employer failed to provide it....
...eatment of Dr. Davis. But since Dr. Davis acknowledges that the treatment was providing claimant relief from his injury, albeit temporary, such treatment falls within the statute as required treatment and therefore proper and compensable. (e.s.) [2] Section 440.13 was amended, effective October 1, 1983....
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Smith v. Gen. Conf. of SDA, 535 So. 2d 611 (Fla. 1st DCA 1988).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1988 WL 129124

...First of all, we note that the penalty provision is part of Section 440.20, Florida Statutes, entitled "Payment of compensation," whereas the provision covering payment for medical services, and for reimbursement to claimant for payment of medical services, is Section 440.13, Florida Statutes....
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Gen. Elec. Co. v. Spann, 479 So. 2d 289 (Fla. 1st DCA 1985).

Cited 2 times | Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 2691

...t of medical bills, and treatment by Dr. Freed "as the nature of his injury and the process of his recovery might require." The deputy refused to invoke the limitation provisions of Section 440.28. The limitation statutes relevant to this case are §§ 440.13(3)(b) and 440.28, F.S....
...Elberta Crate & Box Co., 156 So.2d 844 (Fla. 1963), that it was not incumbent upon the claimant to establish a change of condition under Section 440.28 in order to obtain additional medical care. [2] Therefore, the two-year limitation period under Section 440.28 is not applicable. Section 440.13(3)(b) (1977) (currently 440.19(1)(b) (1983)) provides for the circumstances under which the right to remedial attention will be time barred: (b) All rights for remedial attention under this section shall be barred unless a claim theref...
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Marin v. Aaron's Rent to Own, 53 So. 3d 1048 (Fla. 1st DCA 2010).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 18350, 2010 WL 4909235

or the process of recovery may require .... ” § 440.13(2)(a), Fla. Stat. (2009). By the stipulation here
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Calleyro v. Mt. Sinai Med. Ctr., 554 So. 2d 1208 (Fla. 1st DCA 1989).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1989 WL 155599

...However, the judge declined to award such care prior to the date of formal claim, suggesting that employer/carrier was not on notice of the need prior to the date of claim. [1] It has been established that reimbursement for attendant care obtained prior to formal request may be awarded under section 440.13, Florida Statutes, where the employer was aware that the nature of an injury necessitated such care....
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Helmsman Mgmt. Servs. v. Garner, 725 So. 2d 1188 (Fla. 1st DCA 1998).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1998 WL 896638

...rmanent total disability benefits. The employer/carrier raise two issues, only one of which has merit. Specifically, they contend the JCC should have granted their motion for the appointment of and evaluation by an expert medical advisor pursuant to section 440.13(9)(c), Florida Statutes (1995)....
...l hearing so that the hearing can proceed without interruption and the JCC may adjudicate the merits of the claim expeditiously. In addition, if rule 4.045 is followed, ordinarily any need for the appointment of an expert medical advisor pursuant to section 440.13(9)(c) would be known well in advance of the final hearing....
...As a result, the determination of claimant's benefits must be delayed to allow for the evaluation of claimant by an expert medical advisor. REVERSED and REMANDED for further proceedings consistent with this opinion. BOOTH and BENTON, JJ., CONCUR. NOTES [1] Section 440.13(9)(c), Fla....
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Gilley Trucking Co. v. Morrell, 591 So. 2d 302 (Fla. 1st DCA 1991).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1991 WL 272765

...nsable industrial accident, the E/C's obligations to that employee are discharged by the offer of an "Enabler II" or its equivalent. The benefits to be provided are to be based upon the proof of what is medically necessary for a particular claimant. Section 440.13(2)(a), Florida Statutes (1989)....
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Workman v. McDonnell Douglas Corp., 590 So. 2d 1035 (Fla. 1st DCA 1991).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1991 WL 265064

...The record reveals that claimant requested this treatment in her October 1989 claim for benefits. Having made a request, which was apparently ignored by the e/c, the claimant was entitled to obtain the treatment without authorization subject to a later determination by the JCC as to its reasonableness and necessity. See § 440.13(2)(b), Fla....
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Roberts v. Ben Hill Griffin, Inc., 629 So. 2d 236 (Fla. 1st DCA 1993).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1993 Fla. App. LEXIS 12281, 1993 WL 513324

...mpel an independent medical examination (IME). We have jurisdiction, Fla.R.Work.Comp.P. 4.160(b)(5), and reverse. In November 1992, Roberts filed a claim for benefits based on an alleged exposure to toxic chemicals. At Ben Hill's request pursuant to section 440.13(2)(b), Florida Statutes (1991) [1] , Roberts thereafter underwent an IME by Dr....
...Rule 4.140(a) provides that the JCC " will promptly hear and decide" such motions, after giving the parties " not less than 5 days written notice" (emphasis supplied). The JCC did not comply with this rule, and thus entered the appealed order in error. We further find that the error was not harmless. Section 440.13(2)(b) provides, in pertinent part: The [employer's] right to conduct an [IME] includes, but is not limited to, instances when the authorized treating physician has not provided current medical reports; determining whether overutilizati...
...red; whether a change in health care provider is necessary; or whether treatment is necessary or the employee appears not to be making appropriate progress in recuperation. This court has held that this right to an IME is not without limits and that section 440.13(2)(b) "seems to impose a `reasonableness' requirement subject to the scrutiny of the JCC." Farm Stores, Inc....
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Scotty's Hardware, Inc. v. Northcutt, 883 So. 2d 859 (Fla. 1st DCA 2004).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2004 WL 2093254

...fect at the time the care was provided. See Socolow v. Flanigans Enters., 877 So.2d 742 (Fla. 1st DCA 2004) (reh'g denied July 28, 2004); Walt Disney World Co. v. McCrea, 754 So.2d 196, 197 (Fla. 1st DCA 2000). Honeycutt involved the 1985 version of section 440.13(2)(b), which required employers to provide attendant care benefits, even if such benefits were not requested if the nature of the injury required it. Honeycutt, 525 So.2d at 986; see also § 440.13(2)(b), Fla. Stat. (1985). In contrast, the language of the 2000 version of the statute requires that attendant care benefits be awarded only if performed "at the direction and control of a physician when such care is medically necessary." § 440.13(2)(b), Fla....
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Smith v. Gen. Parcel Serv., Inc., 699 So. 2d 741 (Fla. 1st DCA 1997).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1997 WL 528282

...Claimant, David Mike Smith, challenges a final workers' compensation order which denied his claims for authorization of Dr. Rosenberg, a pain psychologist, and attorney's fees. Claimant asserts that the judge of compensation claims (JCC) erred in determining that he was precluded by section 440.13, Florida Statutes, from approving the treating physician's referral to Dr....
...In denying claimant's request for authorization of Dr. Rosenberg, the JCC found that a psychologist is not a physician or medical doctor licensed under chapter 458, Florida Statutes; therefore, he could not approve Dr. Imfeld's referral to Dr. Rosenberg as authorized pursuant to the provisions of section 440.13, Florida Statutes....
...Bernstein, a psychiatrist, to conduct an evaluation to determine whether claimant's depression was caused by the industrial injury. Additionally, the JCC denied attorney's fees to claimant based on a finding that the employer and insurance carrier (collectively, the "E/C") were in compliance with section 440.13, because alternative *743 care through the Pain Management Program at Florida South or Dr. Bernstein was timely offered. Claimant argues that the JCC reached the erroneous conclusion that he could not authorize a psychologist upon a treating doctor's referral, because he applied the 1994 version of section 440.13 rather than the 1992 version that was in effect on the date of the accident....
...Both statutes permit referrals to other "health care providers," and that term is defined in both statutes as "a physician or any recognized practitioner who provides skilled services pursuant to a prescription or under the supervision or direction of a physician." § 440.13(1)(b), Fla. Stat. (Supp.1992); § 440.13(1)(i), Fla....
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Cimino v. US SEC. Ins. Co., 715 So. 2d 1092 (Fla. 1st DCA 1998).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1998 WL 476218

...the employer, the carrier, and the attorney for either of them, the statute was silent as to whether the claimant's attorney could attend such discussions. We held that the claimant was entitled to have his attorney present, reasoning, "[N]othing in Section 440.13(2)(c) requires such discussion be had in the absence of Perez's counsel." 569 So.2d at 1291....
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Burris v. Goodyear, 577 So. 2d 1376 (Fla. 1st DCA 1991).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1991 WL 46824

...ight hours per day for attendant care; (2) the JCC erred in awarding only $4.00 per hour for attendant-care services from August 5, 1982, to April 25, 1989; (3) the JCC erred in not ordering reimbursement for attendant care after April 25, 1989; (4) section 440.13(2)(e)(2), Florida Statutes (1989), which limits reimbursement for nonprofessional attendant care provided by a family member to 12 hours a day is unconstitutional; (5) the JCC erred by not ordering the carrier to reimburse the claimant...
...Both witnesses acknowledged that mere companion care would be somewhat lower, but neither witness testified as to *1379 the actual cost. In addition, all attendant care rendered by the wife after October 1, 1988, would be governed by the provisions of section 440.13(2)(e), Florida Statutes (Supp....
...Wilson, Inc., 563 So.2d 710 *1380 (Fla. 1st DCA 1990); Firestone Tire & Rubber v. Knowles, 561 So.2d 1293 (Fla. 1st DCA 1990); King Lumber Co. v. Bloomfield, 560 So.2d 389 (Fla. 1st DCA 1990); and Williams v. Amax Chemical Corp., 543 So.2d 277 (Fla. 1st DCA 1989), construing Section 440.13(2)(e), Florida Statutes (Supp. 1988), as applying to injuries occurring before the effective date of that amended statute, I feel constrained to concur with the majority's opinion. I agree with the majority that it is premature to consider whether that portion of section 440.13(2)(e)2, limiting reimbursement for nonprofessional attendant care provided by a family member to twelve hours a day is unconstitutional....
...Nevertheless, I wish to express some doubts about the construction of that statute in this court's opinions which state or imply that subsequent amendments to the statute are applicable to workers who suffered industrial injuries before the effective date of the amendments. Effective October 1, 1988, section 440.13(2) was amended to provide, inter alia, that in the event a family member is not employed, the per-hour value of reimbursement for attendant care shall be that provided by the federal minimum wage, and, if the family member was employed...
...njured worker was entitled to reimbursement at the market rate in the community where the worker resided. See Southland Corp. v. Anaya, 513 So.2d 203 (Fla. 1st DCA 1987); Sheraton Bal Harbour v. Platis, 447 So.2d 987 (Fla. 1st DCA 1984). Thereafter, section 440.13(2)(e)2 was again amended, effective October 1, 1989, by adding the following sentence: "In no event shall a family member providing nonprofessional attendant or custodial care pursuant to this paragraph be compensated for more than 12 hours per day." Ch. 89-289, §§ 9, 45, Laws of Fla. In my judgment the above amendments to section 440.13(2) have no applicability to industrial accidents or injuries occurring before the amendments' effective dates because they work substantive changes and thus may be applied only to injuries occurring subsequent to their enactment....
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Sunland Training Ctr. v. Brown, 396 So. 2d 278 (Fla. 1st DCA 1981).

Cited 2 times | Published | Florida 1st District Court of Appeal

...In one point, appellants argue that the deputy commissioner erred in ordering employer/carrier to pay for past medical treatment by Dr. Sanchez and the bills from Union General Hospital and Gainesville Radiology Group. Without seeking authorization from her employer as required by § 440.13(1), Florida Statutes, appellee consulted Dr. Sanchez, who hospitalized her for tests. Appellee did not inform her employer of her hospitalization until after her discharge. Neither Dr. Sanchez, the hospital, nor the radiology group submitted the proper forms as required by § 440.13(1). In ordering payment of the medical bills, the deputy commissioner found that the treatment and the hospitalization was the result of an emergency situation, thereby excusing noncompliance with § 440.13(1). However, the record is void of competent substantial evidence indicating emergency. Therefore, because of appellee's noncompliance with § 440.13(1), the award of payment of those medical bills was error....
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Marcy v. Charlotte Cty. Sheriff's Off., 599 So. 2d 1319 (Fla. 1st DCA 1992).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1992 WL 85085

...ician of her choice, other than the physician previously authorized by the E/C, obligates the E/C to either authorize the physician preferred by the claimant, or to offer treatment by yet another physician. The answer is no. The pertinent statute is section 440.13(3), Florida Statutes (1989), which provides in part: If an injured employee objects to the medical attendance furnished by the employer ......
...aware that appellant did not like or was dissatisfied with Dr. Van Arsdale. Both appellant and appellee agree that this court's opinion in Hill v. Beverly Enterprises, 489 So.2d 118 (Fla. 1st DCA 1986) correctly spelled out the duty of the E/C under section 440.13(3), when the employee becomes dissatisfied with the authorized physician....
...Flanders, 416 So.2d 1234 (Fla. 1st DCA 1982); Delta Airlines v. Underwood, 406 So.2d 1188 (Fla. 1st DCA 1981); and Mt. Sinai Medical Center v. Lack, 381 So.2d 304 (Fla. 1st DCA 1980). Cf. Lovell Bros., Inc. v. Kittles, 518 So.2d 319 (Fla. 1st DCA 1987) (cases construing section 440.13(3) as requiring prior approval by a judge of claimant's requested physician do not apply where the carrier never offered any physician other than three doctors objected to by claimant)....
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Ellerbee v. Concorde Roofing Co., 487 So. 2d 388 (Fla. 1st DCA 1986).

Cited 2 times | Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 961

...We do not accept the employer and carrier's argument that because there are three doctors in the May Orthopedic Group authorized to treat claimant he is not entitled to have another authorized physician appointed but must, instead, go to one of the three members of that group for a second opinion. Section 440.13(3), Florida Statutes (1983) states: If an injured employee objects to the medical attendance furnished by the employer ......
...e, the record does not support a finding that the requested change in medical attendance can be satisfied by merely directing claimant to see another doctor in this same orthopedic group. Because the employer and carrier has not met its burden under section 440.13, claimant is entitled to an evaluation and treatment, if necessary, by a new authorized physician....
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Russell v. Orange Cnty. Pub. Schs. Transp., 36 So. 3d 743 (Fla. 1st DCA 2010).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 5242, 2010 WL 1542648

...Richard Smith, who was at one time claimant's authorized provider. Further, as a result of this erroneous exclusion, we likewise find the JCC erred in declining to order an expert medical advisor's opinion (EMA) based on the disagreement of two admissible medical opinions as required by section 440.13(9)(c), Florida Statutes (Supp.1998)....
...other cause. The JCC denied the request for an EMA, finding "the foundational support for the conflict did not exist because the opinion that reportedly established the conflict came from a physician whose opinions could not be accepted pursuant to section 440.13(5)(e)." Section 440.13(5)(e), Florida Statutes (Supp.1998), governs medical opinion testimony in workers' compensation proceedings and provides in pertinent part: No medical opinion other than the opinion of a medical advisor appointed by the [JCC] or divisi...
...ny of a physician who does not fall into one of these categories." Seminole County Sch. Bd. v. Tweedie, 922 So.2d 1011, 1012 (Fla. 1st DCA 2006). Further, although not defined in chapter 440, an "authorized treating provider," as the term is used in section 440.13(5)(e), Florida Statutes, means "a treating provider authorized by the E/SA." Rucker v....
...1st DCA 1996); see also Tweedie, 922 So.2d at 1012 (holding "authorized treating provider" means "provider who has been authorized by an E/SA"). However, the question of whether a currently de-authorized provider who was, at one time, an authorized provider may qualify to provide testimony pursuant to section 440.13(5)(e) is a question of first impression before this court....
...Thus, because the statute is ambiguous on its face, this court must look to legislative intent. Murray v. Mariner Health, 994 So.2d 1051 (Fla.2008) (holding when a statute is unclear or ambiguous on its face, the court must next determine legislative intent)( citing Starr Tyme, Inc. v. Cohen, 659 So.2d 1064 (Fla. 1995)). Section 440.13 was amended in 1993 to include subsection (5)(e), limiting medical opinion testimony to only EMAs, providers, and IMEs....
...The Division *746 of Workers' Compensation shall administer the Workers' Compensation Law in a manner which facilitates the self-execution of the system and the process of ensuring a prompt and cost-effective delivery of payments. See Ch. 93-415, Laws of Fla. We find that interpreting section 440.13(5)(e) to preclude the admission of a de-authorized physician's medical opinion would contravene the purposes of both section 440.13(5)(e) and chapter 440....
...Likewise, a claimant could preclude the admission of a physician's disadvantageous opinion by simply requesting his or her one-time change, thereby requiring the E/SA to de-authorize the current treating physician. This type of "doctor shopping" stimulated the need to add section 440.13(5)(e) in 1993....
...Specifically, last minute de-authorizations and authorizations of medical providers can cause meaningful delays in petition for benefits hearings and hinder a prompt determination of whether an injured employee is due payments and/or services. Further, interpreting section 440.13(5)(e) to preclude medical testimony of previously authorized treating physicians could lead to absurd and unintended results. There are countless examples evidencing the need for a common sense interpretation of section 440.13(5)(e)....
...e employee has no condition to treat. Surely this previously authorized, but no longer "treating" physician is permitted to testify as to the employee's condition. This scenario demonstrates the difficulties that may arise with the interpretation of section 440.13(5)(e) suggested by appellee. Thus, we find the JCC erred in excluding Dr. Smith's testimony because the statutory provision is ambiguous on its face, and interpreting section 440.13(5)(e) as a per se ban against all de-authorized treating physicians contravenes the statute's stated purpose, as well as may lead to many unintended quagmires. [*] Further, because the JCC erred in excluding the testimony, the JCC likewise erred in failing to order an EMA as required when a disagreement arises between two admissible medical opinions pursuant to section 440.13(5)(e), Florida Statutes (Supp.1998)....
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Kohout v. Benefit Administrators, 781 So. 2d 1164 (Fla. 1st DCA 2001).

Cited 2 times | Published | Florida 1st District Court of Appeal | 2001 WL 309953

...Levy, Esq. of Jay M. Levy, P.A., Miami, for Respondents. PER CURIAM. We grant Anthony Kohout's petition for writ of certiorari seeking review of an order declining to grant his motion for an independent medical examination by a health care provider, see § 440.13(1)(i), Fla....
...Kohout seeks an independent assessment of the cause or etiology of his medical condition. An employer or its workers' compensation insurance carrier may provide medical diagnosis and treatment through a managed care arrangement that meets statutory requirements. See § 440.134(2)(a), Fla....
...1st DCA 1999). In such cases, the employee has no right to go outside the managed care arrangement for an independent evaluation as to diagnosis or treatment without following the grievance *1165 procedures required by the managed care arrangement. See § 440.134(15)-(16), Fla. Stat. (2000); Weather Eng'rs v. Presgraves, 774 So.2d 938, 939 (Fla. 1st DCA 2001) ("When an employee is covered under a managed care arrangement pursuant to section 440.134, Fla....
...1st DCA 1997). But here, having controverted Mr. Kohout's claim in its entirety, the employer and carrier have offered no medical care whatsoever. Mr. Kohout is therefore entitled to an independent medical examination by an examiner he selects, see § 440.13(5)(a), Fla....
...f the purpose of the IMEs was to resolve a dispute regarding entitlement to indemnity benefits."). Because the employer and carrier are contesting causation, Mr. Kohout is entitled to an independent medical examination by an examiner he selects. See § 440.13(5)(a), Fla....
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Lindsey v. Urban, 559 So. 2d 734 (Fla. 1st DCA 1990).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1990 WL 48641

...Belk Lindsay and Liberty Mutual Insurance Company have appealed an order of the judge of compensation claims awarding various medical and compensation benefits and an attorney's fee, and finding that an acupuncturist is a "health care provider" as defined in Section 440.13(1)(b), Florida Statutes (Supp. 1986), so that, pursuant to Section 440.13(2)(b), Florida Statutes (Supp....
...Ou was also awarded, based on the December 1988 medical opinion that his treatment was psychiatrically valuable. An employer is required to furnish to the employee "such medically necessary treatment, care, and attendance by a health care provider ... as the nature of the injury or the process of recovery may require." § 440.13(2)(a), Fla....
...If the employer fails to provide such treatment, care, and attendance after request by the employee, the employee may obtain it "at the expense of the employer, the reasonableness and the necessity to be approved by a [judge of compensation claims]." Section 440.13(2)(b), Florida Statutes (Supp....
...This holding was in error. The Workers' Compensation Act specifically states that a health care provider is "a physician, or any recognized practitioner who provides skilled services pursuant to the prescription of or under the supervision or direction of a physician." § 440.13(1)(b), Fla. Stat. (Supp. 1986). *736 It is clear that Ou is not himself a physician, that is, "a physician licensed under Ch. 458, an osteopath ..., a chiropractor ..., a podiatrist ..., an optometrist ..., or a dentist... ." § 440.13(1)(f), Fla....
...Further, until Dr. McClane notified the carrier on December 5, 1988 that Ou's care was medically necessary from a psychiatric standpoint, the care was not provided "pursuant to the prescription of or under the supervision or direction of a physician." § 440.13(1)(b), Fla. Stat. (Supp. 1986). Therefore, it was error to classify Ou as a statutory health care provider. It necessarily follows that, because appellants were obligated to provide treatment only by such providers, § 440.13(2)(a), Fla....
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Stand. Blasting & Coating v. Hayman, 597 So. 2d 392 (Fla. 1st DCA 1992).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1992 WL 76443

...She testified that he sleeps approximately 6 hours per night. Id. at 1386. Because Mr. Hayman sleeps 6 hours per night, the JCC awarded attendant care benefits for 18 hours per day instead of 24. Mrs. Hayman was not employed prior to the accident. Effective October 1, 1988, subsection (2)(e) was added to section 440.13, Florida Statutes....
...by a family member shall be determined as follows: 1. If the family member is not employed, the per hour value shall be that of the federal minimum wage." Ch. 88-372, § 1, Laws of Fla. Effective October 1, 1989, the following sentence was added to section 440.13(2)(e)(2), Florida Statutes: "In no event shall a family member providing nonprofessional attendant or custodial care pursuant to this paragraph be compensated for more than 12 hours per day." Ch. 89-289, § 10, Laws of Fla. In 1990 this court determined that the 1989 amendment to section 440.13(2)(e)(2) does not affect a claimant's substantive rights, and therefore "the amendment applies to attendant care benefits awarded pursuant to the preamendment order where services are both rendered and paid for after the amendment's effective date." Mr....
...Mrs. Hayman, Mr. Hayman *394 would most likely need to be institutionalized. Mr. Hayman is like a small child. The JCC denied the e/sa's motion for a reduction of the amount of hours and the hourly rate payable to Mrs. Hayman. The order states that section 440.13(2)(e) does not apply to Mrs....
...They emphasize that Mrs. Hayman cannot be a professional because she has never been licensed or trained as an attendant. We conclude that Mrs. Hayman is a non-professional. Therefore, Mr. C's TV Rental applies and payment for her attendant care services is limited by subsection 440.13(2)(h), Florida Statutes (1991) (formerly subsection (2)(g) in 1990 and (2)(e) in 1989)....
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Globe SEC. v. Pringle, 559 So. 2d 720 (Fla. 1st DCA 1990).

Cited 2 times | Published | Florida 1st District Court of Appeal | 1990 WL 43144

...ey were necessitated by the industrial accident. Such rationale does not comport with the language of the Workers' Compensation *721 Act (Act) and encroaches on the legislative domain. First, Chapter 440 provides coverage only for employees. [1] See Section 440.13(2)(a), Florida Statutes (1985) ("[T]he employer shall furnish to the employee such medically necessary treatment......
...rt of the claimant's body. Moreover, claimant maintains that the medical expenses at issue were awarded directly to the claimant herself because these expenses were necessary remedial treatment required by the nature of claimant's injury pursuant to Section 440.13(2)(a), Florida Statutes (1985)....
...AFFIRMED in part and REVERSED in part. BOOTH and ZEHMER, JJ., concur. NOTES [1] The only benefits provided by Chapter 440 for an employee's children are those benefits by virtue of a dependent child surviving a deceased employee as provided in Section 440.16, Florida Statutes. [2] Section 440.13(2)(a) provides that "the employer shall furnish to the employee such medically necessary treatment, care and attendance by a health care provider and for such period as the nature of the injury or the process of recovery may require......
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Ford v. Alexander Cabinet Co., 467 So. 2d 1050 (Fla. 1st DCA 1985).

Cited 2 times | Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 929

...Ford thereafter sought greater PPD benefits and retroactive TTD benefits. The deputy denied retroactive TTD benefits, but awarded greater PPD benefits. The order, as amended, was entered on 30 April 1982. On 11 April 1983, Ford filed a claim again requesting pain clinic treatment. He argued the claim was timely under Section 440.13(3)(d), Florida Statutes (Supp....
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Griffin Ex Rel. Griffin v. Jb Hunt Transp., 795 So. 2d 155 (Fla. 1st DCA 2001).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2001 WL 1001247

...(Division) to file a brief addressing the question of whether Dr. Silcox could properly serve as an IME physician. The Division filed a brief supporting the JCC's decision. Because the JCC did not err in admitting Dr. Silcox's testimony, we affirm. Section 440.13(1)(k), Florida Statutes (1999), defines "independent medical examination" as "an objective evaluation of the injured employee's medical condition, including, but not limited to, impairment or work status, performed by a physician or an expert medical advisor at the request of a party, a judge of compensation claims, or the division to assist in the resolution of a dispute arising under this chapter." (emphasis added). Section 440.13(1)(j), Florida Statutes (1999), defines "independent medical examiner" as "a physician selected by either an employee or a carrier to render one or more independent medical examinations in connection with a dispute arising under this chapter." (emphasis added). Finally, section 440.13(1)(r), Florida Statutes (1999), defines "physician" or "doctor": "Physician" or "doctor" means a physician licensed under chapter 458, an osteopathic physician licensed under chapter 459, a chiropractic physician licensed under chapter...
...Baker, 668 So.2d 989 (Fla.1996); Holly v. Auld, 450 So.2d 217 (Fla.1984). The requirement that an independent medical examiner be licensed under chapter 458, Florida Statutes, and certified by the Division of Workers' Compensation, is clearly and unambiguously stated in section 440.13(1)(r), Florida Statutes (1999)....
...territory or foreign country." Subsection (1)(b) can hardly be deemed relevant to requests for independent medical examinations, designed to resolve "disputes" between authorized health care providers. Even if it could arguably be said that sections 440.13(1)(j) and (r), and 458.303(1)(a) and (b), read in pari materia, are ambiguous, thereby requiring resort to extrinsic aids, another long-standing rule of construction recognizes that a special statute covering a particular subject controls over...
...Save the Manatee Club, Inc., 773 So.2d 594 (Fla. 1st DCA 2000) (discussing scope of administrative rulemaking authority under 1999 law). Rule 38F-53.002(3)(d), dealing generally with the subject of requirements for certification of health care providers, cites sections 440.13(3)(a) and 440.591, Florida Statutes, as specific authorities for its adoption, and sections 440.13(3) and 440.13(13), as the laws it implements, none of which pertains to the procedure afforded by section 440.13(5) for independent medical examinations....
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Jackson Manor Nursing Home v. Ortiz, 606 So. 2d 422 (Fla. 1st DCA 1992).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1992 WL 217182

...er requiring them to provide claimant Anita Ortiz with attendant care. We reverse the order of the judge of compensation claims (JCC) because the record before us lacks competent substantial evidence of medical need for attendant care as required by section 440.13(2)(a), Florida Statutes (Supp. 1988). *423 Section 440.13(2)(a), Florida Statutes (Supp....
...she is unable to adequately care for herself at home and requires assistance in dressing, bathing, ambulating with the use of a walker; transportation to and from her attending physicians and preparation of her meals." Although the 1990 amendment to section 440.13(2)(f), Florida Statutes, Ch....
...The JCC's determinations *424 concerning attendant care must be based on competent substantial evidence. Builders Square v. Drake, 557 So.2d 115 (Fla. 1st DCA 1990). Attendant care is awardable only under that section of the Workers' Compensation Act requiring the employer to furnish certain medical services and supplies. § 440.13, Fla. Stat. (Supp. 1988). In addition to the medical attendance referenced in section 440.13(2)(a), quoted above, the statute also requires the employer to provide "appropriate professional or nonprofessional custodial care when the nature of the injury so requires. . . ." § 440.13(2)(d), Fla....
...Collision Clinics International Inc., 413 So.2d 827 (Fla. 1st DCA 1982) (claimant blinded in industrial accident demonstrated medical necessity for attendant care); Walt Disney World Co. v. Harrison, 443 So.2d 389, 393 (Fla. 1st DCA 1983) ("It is not the purpose of section 440.13 to burden family members with medically required nursing services and unskilled attendant care ..."); Farm v....
...also was suffering from a serious back condition and receiving workers' compensation benefits for such condition) were medically required by claimant's physical condition beyond those services that family members *425 normally provide gratuitously. Section 440.13(2)(d), Florida Statutes (1987)....
...1st DCA 1987), rev. denied, 513 So.2d 1062 (Fla. 1987). We REVERSE the award to claimant of attendant care benefits. SMITH, J., concurs. ERVIN, J., dissents with written opinion. ERVIN, Judge, dissenting. The majority acknowledges that the 1990 amendment to Section 440.13(2)(f), Florida Statutes, requiring that a physician prescribe home or custodial care, is not applicable to a work-related injury which occurred, as here, prior to the effective date of the amendment....
...n recommending such care, in that "the overwhelming weight of the evidence in this record" supported the need for such care). As a general rule, nonmedical evidence may establish a claimant's need for medically necessary treatment or apparatus under section 440.13(2)(a), so long as such need is readily apparent from nonmedical testimony and evidence....
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Gen. Tire Serv. v. Spec. Disability Tr. Fund, 569 So. 2d 481 (Fla. 1st DCA 1990).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1990 WL 141892

...nt for excess permanent total disability compensation, actually pay permanent total disability benefits for more than 175 weeks before being entitled to reimbursement for temporary disability and remedial medical benefits previously paid pursuant to section 440.13; and (2) it was error to disallow reimbursement for wage loss benefits, paid pursuant to section 440.15(3)(b) during the first six months after the claimant reached maximum medical improvement with a permanent impairment, for the sole...
...d for permanent impairment, wage loss, permanent total disability, or death shall be reimbursed from such fund for 50 percent of the first $10,000 paid as compensation for temporary disability and remedial treatment, care, and attendance pursuant to s. 440.13, for the same injury; thereafter, the employer shall be reimbursed from such fund for all sums paid by the employer as compensation for temporary disability and remedial treatment, care and attendance pursuant to s. 440.13 which are in excess of $10,000....
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Gallagher Bassett Servs.-orlando v. Mathis, 990 So. 2d 1214 (Fla. 1st DCA 2008).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2008 WL 4287159

...cident is the MCC) without, at least in part, dealing with Mathis' noncompensable neck condition, we note that the workers' compensation statutes help to define the scope and nature of the medical treatment and care to be provided in such instances. Section 440.13(2)(a), Florida Statutes (2006), states in pertinent part that, "[s]ubject to the limitations specified elsewhere in this chapter, the employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require...." Section 440.13(1)( l ), Florida Statutes (2006), states: "Medically necessary" or "medical necessity" means any medical service or medical supply which is used to identify or treat an illness or injury, is appropriate to the patient's diagnosis and s...
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Bennett v. H & L Builders, Inc., 567 So. 2d 33 (Fla. 1st DCA 1990).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1990 WL 136860

...eatment, the E/C must either provide such treatment or obtain a ruling that the treatment is not in the claimant's best interest. If the E/C fail to provide the care or obtain a ruling, they will be responsible for unauthorized treatment pursuant to section 440.13(2), Florida Statutes, if the treatment is found by the JCC to be reasonable and necessary....
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Robin Tucker, As Assignee of Palm Beach Nightclub Enter., Inc. v. John Galt Ins. Agency, 743 So. 2d 108 (Fla. Dist. Ct. App. 1999).

Cited 1 times | Published | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 12368, 1999 WL 741119

injury or the process of recovery may require.” § 440.13(2)(a), Fla. Stat. (1997). Such periodic payments
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Romano v. Trinity Sch. for Child., 43 So. 3d 928 (Fla. 1st DCA 2010).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 13568, 2010 WL 3584389

...physician who provided treatment to Claimant during a period when the employer/carrier (E/C) wrongfully withheld medical care. Because claimant met her evidentiary and legal burden in proving the physician became authorized by operation of law under section 440.13(2)(c), Florida Statutes (2007), we reverse....
...Walker, future psychiatric care with Dr. Walker, rather than Dr. Forman, and temporary disability benefits. At the final hearing, in support of her request for temporary benefits, Claimant sought to admit Dr. Walker’s deposition, which was otherwise prohibited by section 440.13(5)(e), Florida Statutes because Dr....
...Walker was neither an (1) expert medical advisor; (2) independent medical examiner; and/or (3) authorized treating physician. Claimant argued that because she made a specific request for psychiatric treatment and that request was wrongfully denied, she was entitled to use the self-help provisions of section 440.13(2)(c), Florida Statutes....
...Claimant asserted this entitlement authorized the admission of Dr. Walker’s otherwise prohibited testimony pursuant to this court’s decision in Parodi v. Fla. Contracting Co., 16 So.3d 958 (Fla. 1st DCA 2009). In Parodi , this court held, notwithstanding the limitation embodied in section 440.13(5)(e), Florida Statutes, when an E/C “wrongfully denies medical care and the claimant is required to utilize the self-help *930 provisions of section 440.13(2)(c), the JCC is not obliged to exclude the opinions of the doctors from whom Claimant was forced to obtain medical treatment.” Id....
...ecific request for care, (2) allowed the E/C a reasonable time to respond, and (3) obtained care that was compensable, reasonable, and medically necessary, the JCC has statutory authority to admit the otherwise prohibited medical opinion pursuant to section 440.13(5)(e)....
...Walker’s opinion on the basis that Claimant’s request for psychiatric care was not supported by a recommendation for such treatment, the JCC erred as a matter of law. Contrary to the JCC’s determination, Claimant was not required to obtain a referral prior to unilaterally seeking treatment with a psychiatrist. § 440.13(2)(c), Fla....
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Claims Mgmt., Inc. v. Lake, 717 So. 2d 140 (Fla. 1st DCA 1998).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1998 WL 597866

...(respectively the E/C), ask us to overturn both the award and the denial of its request that claimant be evaluated by an expert medical advisor (EMA). The judge of compensation claims erred in refusing to grant the E/C's motion to appoint an EMA, notwithstanding the mandatory language of section 440.13(9)(c), Florida Statutes (1995)....
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Lee Cnty. Parks & Rec. v. Fifer, 996 So. 2d 229 (Fla. 1st DCA 2008).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2008 WL 4722533

...r, or an expert medical advisor, his testimony regarding Claimant's condition and need for care was inadmissible and could not form the basis for a change in doctor or additional care. In reaching this conclusion, the JCC applied the 2003 version of section 440.13(5)(e), Florida Statutes, which provides that only the opinion testimony of a doctor who falls into one of these categories is admissible....
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Banuchi v. Dep't of Corr., 122 So. 3d 999 (Fla. 1st DCA 2013).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2013 WL 5629659, 2013 Fla. App. LEXIS 16487

...The August 2011 petition for benefits was addressed at a March 19, 2012, merits hearing, without the benefit of an EMA opinion. At the conclusion of that hearing, the JCC denied Claimant’s entitlement to the claimed temporary partial disability benefits. This appeal followed. Legal Background Section 440.13(9), Florida Statutes (2008), is entitled “Expert Medical Advis- or.” The stated role of the EMA is “to assist the ... judges of compensation claims within the advisor’s area of expertise.” § 440.13(9)(a), Fla. Stat. (2008). The circumstances which dictate the appointment of an EMA are those instances in which “there is a disagreement in the opinions of the health care providers.” § 440.13(9)(c), Fla....
...In that instance, “the [JCC] shall, upon his or her own motion ..., order the injured employee to be evaluated by an [EMA].” Id. Further, “[i]f a[JCC], upon his or her own motion, finds that an [EMA] is needed to resolve the dispute, the carrier must compensate *1001 the advisor for his or her time.” § 440.13(9)(f), Fla....
...Claimant’s notice did no more than bring to the JCC’s attention a disagreement in the opinions of the health care providers. In substance, Claimant’s filing was merely a request that the JCC take notice of his mandatory obligation to appoint an EMA under section 440.13(9)(c)....
...At that point, it was the JCC’s statutory obligation to review the opinions and, if the JCC agreed that there was in fact a disagreement sufficient to require the appointment of an EMA, to direct on his own motion that the employee be evaluated. Section 440.13(9)(f) provides that in such an instance, where the JCC directs that the evaluation take place, it is the obligation of the carrier to compensate the EMA....
...Because the JCC erred in reading Claimant’s notice to be Claimant’s motion for the appointment of an EMA, we reverse the appealed order. On remand, the JCC shall, on its own motion, order Claimant be evaluated by the EMA and direct the carrier to pay for the evaluation. Thereafter, the JCC shall, in accord with sections 440.13(9)(c) and 440.25(4)(d), Flor *1002 ida Statutes, consider the opinion of the EMA in determining Claimant’s entitlement to the claimed temporary partial disability benefits....
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Keller Kitchen Cabinets v. Holder, 586 So. 2d 1132 (Fla. 1st DCA 1991).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1991 WL 151971

...Section 440.10 reads in pertinent part: (1) Every employer coming within the provisions of this chapter ... shall be liable for, and shall secure, the payment to his employees, or any physician, surgeon, or pharmacist providing services under the provisions of s. 440.13, of the compensation payable under ss. 440.13, 440.15, and 440.16. (Emphasis added.) Of course, section 440.13 establishes the employee's right to receive remedial medical treatment, while sections 440.15 provides for compensation for disability. Thus, it is evident that section 440.10 treats the payment of medical benefits under 440.13 as "compensation" payable by the employer under the act, and is to that extent seemingly in conflict with the definition of compensation in 440.02(6)....
...ge for the employee, Daniel v. Holmes Lumber Co., 490 So.2d 1252 (Fla. 1986), it would seem only reasonable that the compensation referred to in the section 440.28 time limitation must necessarily include payments for remedial medical benefits under section 440.13....
...total knee replacement operation. Thus, even though claimant was said to have reached MMI in February 1980, that finding was not made in recognition that he would not have further need for "remedial treatment" from a physician or surgeon pursuant to section 440.13, nor that when such surgery was required that he would not sustain further temporary, and possibly even greater permanent, disability....
...y precludes future resort to benefits in the first if the employee's changing medical condition should give rise to a new claim in the first benefit category. This is so in respect to both medical treatment and to compensation benefits. For example, section 440.13 establishes an injured employee's right to "medically necessary remedial treatment, care, and attendance" by persons qualified to do so, and provides that this medical benefit shall be furnished "for such period as the nature of the in...
...The nature of this medical condition was such that a flare-up occurred every two or three months, at which time the claimant's legs became swollen, red, and tense, his temperature rose, and he experienced considerable pain. The supreme court construed section 440.13(3)(a), which required the employer and carrier to furnish "such additional treatment as may be necessary to effect a recovery" as the nature of the injury required, to mean that the employer was obligated to provide continuing treatment to the claimant in that case....
...His physician told him to take every precaution to protect his remaining eye from injury, and prescribed protective glasses for this purpose. The employer and carrier refused to pay for them and the deputy commissioner denied the claim. The supreme court held that section 440.13(1) required the employer and carrier to provide the glasses because the nature of the injury created a lasting condition requiring permanent protection or care of the right eye because of the possibility of hazard that might cause its loss....
...trial injury did not stop at the point of the medical treatment required for the loss of his left eye but that the resulting condition in which claimant was left after his injury also requires attention, protection, and care within the intendment of Section 440.13(1), F.S., to the extent the expert testimony indicated was essential....
...The deputy commissioner denied the claim for such treatment for the rest of his life or as long as qualified doctors continued to indicate a need therefor on the ground that such an order would be tantamount to tolling the statute of limitations in section 440.13(3)(b), Florida Statutes. The supreme court reversed, stating that section 440.13 drives us to a conclusion that when it is shown that the claimant's need for remedial attention will continue for a long and indefinite period of time, the statutory language lends itself to a construction which permits the claimant to file a claim and secure an order requiring the employer *1145 to "......
...Recognizing that remedial medical treatment may be warranted after an injured employee has reached MMI without modifying the order establishing MMI, the courts have now concluded that medical care characterized as "palliative" is in fact "remedial" within the meaning of sections 440.13 and 440.19, and have allowed recovery on claims therefor filed under section 440.19 more than two years after the claimant reached MMI because the employer had made payments for "palliative" care during the two year time limitation period....
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Md Transp. v. Paschen, 996 So. 2d 902 (Fla. 1st DCA 2008).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2008 WL 4949269

...It appears the JCC relied on Honeycutt for the proposition that, based on the self-executing nature of the Workers' Compensation Act, the E/C's knowledge of yet-to-be-litigated issues would prevent the application of res judicata. The JCC's reliance was misplaced. Honeycutt applied section 440.13(2)(b), Florida Statutes (1985), which "require[d] the employer to provide nursing care benefits, even though not requested, if the nature of the injury requires such benefits," when it held the claim was not barred by res judicata....
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Fairpay Solutions v. AGENCY FOR HEALTH CARE, 969 So. 2d 455 (Fla. 1st DCA 2007).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2007 WL 3376251

...nity Hospital, Inc. THOMAS, J. We have for our review two consolidated appeals involving final orders entered by the Agency for Health Care Administration ("AHCA") against various workers' compensation carriers. We hold that AHCA's interpretation of section 440.13, Florida Statutes (2005), does not violate the carriers' rights under the Administrative Procedure Act because the carriers had 10 days in which to challenge the medical providers' petitions seeking higher reimbursement....
...ical review company," paid substantially less than the requested amount and indicated the charges and/or items they would not pay. The process for disputing the cost of health care services provided to workers' compensation claimants is set forth in section 440.13(7), Florida Statues (2005)....
...rative hearing, citing the first case and other similar decisions, and ordered the carriers to reimburse the hospital for services rendered. Analysis The only argument preserved for our review that we will address is whether AHCA's interpretation of section 440.13, Florida Statutes (2005), denies Appellants' right to a hearing under the Administrative Procedure Act....
...However, this court also stated that "an agency must grant affected parties a clear point of entry, within a specified time after some recognizable event in investigatory or other free-form proceedings, to formal or informal proceedings under Section 120.57." Gopman, 908 So.2d at 1122. We hold that AHCA's interpretation of section 440.13, Florida Statutes, does not violate the carriers' right to an administrative hearing....
...It should be noted that here, it was the carriers' failure to act that resulted in the denial of Appellants' request for hearing. We agree with AHCA's interpretation that a carrier's failure to file a response to a provider's petition serves as an absolute bar to raise any defense under section 440.13(7)(b)....
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Frederick Elec. v. Pettijohn, 619 So. 2d 14 (Fla. 1st DCA 1993).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1993 WL 143945

...wentyfour hours a day by the e/c from an outside service named Allied Medical Services. Counsel for Pettijohn argued that Mrs. Pettijohn should be paid for attendant care after August 4, and should be paid more than the minimum wage for all periods. Section 440.13(2)(e), Florida Statutes (1989), states in part: The value of nonprofessional attendant or custodial care provided by a family member shall be determined as follows: 1....
...epresents 2.5 hours for attendant care plus 1.2 hours for the extra time she spent orienting health care aides before Allied transferred her case to Orlando. The JCC further found that Mrs. Pettijohn qualifies as a professional attendant. Therefore, section 440.13(2)(e) does not apply, and the e/c must pay Mrs....
...Therefore, we remand for the JCC to make a determination on this issue consistent with the reasoning in Chumney. Dr. Deutsch does not meet the requirements of a "health care provider." Chapter 440 requires that an e/c furnish remedial care and attendance only if medically necessary and only by a health care provider. Section 440.13(2)(a), Florida Statutes (1989). A health care provider is "a physician or any recognized practitioner who provides skilled services pursuant to the prescription of or under the supervision or direction of the physician." Section 440.13(1)(b), Florida Statutes (1989). The term "physician" refers only to one who is licensed in Florida. Section 440.13(1)(f), Florida Statutes (1989)....
...Deutsch is not a physician licensed in Florida, nor was he providing services under the supervision or direction of a physician. Therefore, Dr. Deutsch does not qualify as a health care provider and the e/c are not responsible for his services under section 440.13(2)(a)....
...Pettijohn was improper, *17 given that the e/c provide continuous attendant care from Allied. The final issue raised on appeal is whether the JCC erred by awarding attendant care benefits at the market rate of $6.00 per hour. The e/c argue that the rate should be set at the federal minimum wage pursuant to section 440.13(2)(e). We affirm the payment of the market rate for Mrs. Pettijohn's attendant care of her husband based on Buena Vida Townhouse Ass'n v. Parciak, 603 So.2d 26 (Fla. 1st DCA 1992). In Parciak this court held that section 440.13(2)(e) does not apply to attendant care by a family member who maintains employment, and the e/c are obligated to pay for the family member's services at the prevailing market rate where the family member is able to provide attendant care without reducing her hours of employment....
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Reynolds v. Oakley Const., 561 So. 2d 1298 (Fla. 1st DCA 1990).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1990 WL 70410

...The surgery was successfully performed almost a year after the carrier became aware of claimant's desire for the surgery. Both of claimant's doctors opined that the surgery was reasonably, medically necessary. The carrier paid the doctor's bill for this surgery but refused to pay the hospital bill. Pursuant to section 440.13(2)(a) and (b), Florida Statutes, the employer is required to furnish the claimant medically necessary treatment which includes a prosthesis, and should the employer fail to provide such treatment after request, the claimant may seek su...
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City of Miami v. Granlund, 153 So. 2d 830 (Fla. 1963).

Cited 1 times | Published | Supreme Court of Florida | 1963 Fla. LEXIS 2765

neglected to provide the same; * * *.” F.S.A. § 440.13. The record indicates that other objections by
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Bryan LGH Med. Ctr. v. Florida Beauty Flora, Inc., 36 So. 3d 795 (Fla. 1st DCA 2010).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 6963, 2010 WL 1994094

...on Law. See Rebich v. Burdine's, 417 So.2d 284 (Fla. 1st DCA 1982) (interpreting 1974 amendment to section 440.10(1) as creating independent standing on behalf of physician to bring an action against insurance company for payment of bills); see also § 440.13(14), Fla....
...ided by the chapter. Such providers have recourse against the employer or carrier for services rendered in accordance with this chapter."). However, the proper forum for disposition of this dispute is within the Department of Financial Services. See § 440.13(7)(a), Fla. Stat. (2009) (providing health care provider's petition for payment of medical services "must" be filed with Department of Financial Services); § 440.13(11)(c), Fla....
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Bronson's Inc. v. Mann, 70 So. 3d 637 (Fla. 1st DCA 2011).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 7242, 2011 WL 1879197

...Champion Int'l, 906 So.2d 363, 365 (Fla. 1st DCA 2005). The applicable statute for awarding compensation for attendant care is the statute in effect at the time the compensable care was given. Socolow v. Flanigans Enters., 877 So.2d 742, 744 (Fla. 1st DCA 2004). Section 440.13(2)(b), Florida Statutes (2009), provides in relevant part: The employer shall provide appropriate professional or nonprofessional attendant care performed only at the direction and control of a physician when such care is medically necessary....
...Sharfman's March 18, 2010, note stating that it is medically reasonable and medically necessary to implement all of the recommendations made in the life care plan is deemed sufficient to incorporate by reference the portions of the life care plan pertinent to attendant care, it still does not meet the requirements of section 440.13(2)(b) because it fails to specify the type of assistance and the level of care required....
...1st DCA 2005) ("Normally, only direct care that is medically necessary is compensable."). Finally, we reject Claimant's suggestion that the deposition testimony of Pennachio and the testimony of Claimant's mother at the final hearing adequately described the kind of attendant care recommended by Dr. Sharfman. Section 440.13(2)(b) requires that the prescription itself specify the time periods for such care, the level of care required, and the type of assistance required....
...Indeed, this court has concluded such care is awardable when medically necessary. Jackson v. Columbia Pictures, 610 So.2d 1349 (Fla. 1st DCA 1992). The question in this case is whether such care is medically necessary and specifically prescribed by a physician as required by section 440.13(2)(b)....
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Southwood Timber Co. v. Hicks, 959 So. 2d 318 (Fla. 1st DCA 2007).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2007 WL 1434935

...pensation Claims erred in awarding attendant care for household services, and that cases allowing attendant care for household services were superceded by the statutory definition of attendant care. We disagree. At the time the claimant was injured, section 440.13(1), Fla....
...life.,'" numerous "decisions of this court have established that there are a variety of situations in which household services may be awarded." Diana v. HLS Cos., 670 So.2d 125 (Fla. 1st DCA 1996). [2] "The JCC erred by ruling that the amendment to section 440.13(2)(f), adding language describing attendant care as `beyond the scope of household duties' could be applied to preclude an award for such services after the effective date of the statute without regard to the date of the claimant's injury....
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Boggs v. USA Water Ski, Inc., 18 So. 3d 610 (Fla. 1st DCA 2009).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 5033, 2009 WL 1313225

...Consequently, the denial of benefits for this period is reversed. The JCC’s denial of TTD benefits from May 14, 2007, through December 31, 2007, was predicated in large part on his ruling that Dr. Latif s medical opinion was inadmissible pursuant to section 440.13(5)(e), Florida Statutes (2006)....
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King Lumber Co. v. Bloomfield, 560 So. 2d 389 (Fla. 1st DCA 1990).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1990 Fla. App. LEXIS 3088, 1990 WL 57789

...1st DCA 1990), and Builders Square v. Drake, 557 So.2d 115 (Fla. 1st DCA 1990). This court's opinions in Mr. C's TV Rental v. Murray, 559 So.2d 452 (Fla. 1st DCA 1990), and Williams v. Amax Chemical Corp., 543 So.2d 277 (Fla. 1st DCA 1989), indicate that the 1989 amendment to section 440.13(2)(e)2 (the validity of which is not questioned by the parties) should be applied to payments for services rendered after the effective date of the amendment, whether or not such benefits had been awarded by a prior order. That amendment limits to 12 hours per day the amount of compensation payable to a family member providing claimant with attendant care services. However, because "family member" is defined to exclude a nephew, section 440.13(2)(e), Florida Statutes (1989), claimant's nephew should be compensated for providing 24 hour-per-day care to his uncle both before and after October 1, 1989, even assuming applicability of the *391 amendment to those attendant care benefits payable after October 1, 1989....
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Alpizar v. Star Styled Dancing Co., 808 So. 2d 286 (Fla. 1st DCA 2002).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2002 Fla. App. LEXIS 2280, 2002 WL 341052

...Bernard Germain, a specialist in internal medicine and rheumatology. Dr. Germain was not an authorized treating provider, nor was he a medical advisor appointed by the judge. He did not qualify as an independent medical examiner, because his medical fee exceeded the maximum amount authorized by statute. See § 440.13(5), 10, Fla....
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Riggenbach v. Rhodes, 267 So. 3d 551 (Fla. 5th DCA 2019).

Cited 1 times | Published | Florida 5th District Court of Appeal

...tutes. Myers v. Pasco Cty. Sch. Bd. , 246 So.3d 1278 (Fla. 1st DCA 2018). An injured workers' compensation claimant is entitled to a one-time change of "physician who practices in the 'same specialty' as the originally authorized doctor" pursuant to section 440.13(2)(f), Florida Statutes (2016)....
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Amfesco Duramil Div. v. Guzman, 596 So. 2d 732 (Fla. 1st DCA 1992).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1992 WL 59213

...Casademont regarding the need for attendant care. Although the JCC awarded such care "through the balance of claimant's life," this language should be construed as an award of attendant care only for "such period as the nature of the injury or the process of recovery may require." Section 440.13(2)(a), Fla....
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Eques v. Best Knit Textile Corp., 382 So. 2d 736 (Fla. 1st DCA 1980).

Cited 1 times | Published | Florida 1st District Court of Appeal

...ent causally related to her industrial accident. It follows that the appellant could not show the psychiatric treatments provided by Dr. Borges were reasonable and necessary to excuse her failure to obtain prior authorization for his treatments. See Section 440.13, Florida Statutes (1975)....
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Hertz Rent-A-Car v. Sosa, 670 So. 2d 73 (Fla. 1st DCA 1996).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1996 WL 27886

...temporary partial disability, wage-loss benefits, impairment benefits, death benefits and rehabilitation temporary total benefits.... It stated that the employer would still be required to provide any future remedial or palliative medical care under section 440.13, and that the claimant would retain the right to apply to the Division of Workers' Compensation "for appropriate retraining and education under F.S....
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Rafael Echevarria v. Luxor Investments, LLC & Associated etc., 159 So. 3d 991 (Fla. 1st DCA 2015).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2015 WL 1223705

...Neither the relevant statutory provisions within chapter 440, nor our case law, establish such an entitlement in the absence of evidence of medical necessity for the treatment, defined in part as “appropriate to the patient’s diagnosis” – the diagnosis being the compensable injury. See § 440.13(2)(a), Fla. Stat. (2006) (requiring employer to furnish medically necessary care); § 440.13(1)(l), Fla....
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Catron Beverages, Inc. v. Maynard, 395 So. 2d 261 (Fla. Dist. Ct. App. 1981).

Cited 1 times | Published | District Court of Appeal of Florida | 1981 Fla. App. LEXIS 19641

...The sole issue before the deputy commissioner concerned the reasonableness of certain charges for medicines prescribed for claimant. The carrier, correctly asserting that its obligation to pay for medicines was limited to the customary and reasonable charges for like medicines in the community, Section 440.13(3)(a), Florida Statutes (1979), refused to pay for that part of the cost of medicines which it felt to be in excess of the statutory standard....
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Us Agri-chemicals Corp. v. Camacho, 975 So. 2d 1219 (Fla. 1st DCA 2008).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2008 WL 623224

...van Loveren, a neurosurgeon who repaired claimant's rupture. Because Dr. van Loveren was not an authorized treating provider, an independent medical examiner or an expert medical advisor, we agree that the judge should have sustained the timely objection and not admitted the deposition and records. See § 440.13(5)(e), Fla....
...ensation claims"); Chudnof-James v. Racetrac Petroleum, Inc., 827 So.2d 369, 370-71 (Fla. 1st DCA 2002) ("[t]he law is clear that a JCC errs in admitting the opinion testimony of a physician who does not fall into one of the [] categories" listed in section 440.13(5)(e))....
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Theiss v. City of Panama City Beach, 65 So. 3d 117 (Fla. 1st DCA 2011).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 10345, 2011 WL 2578566

...h he was furnished authorized medical care by his employer and its workers' compensation carrier (E/C), under a managed care arrangement. Claimant sought to exercise his right to select or change his primary care provider, as seemingly guaranteed by section 440.134(6)(c)10., Florida Statutes (2008), and Florida Administrative Code Rule 59A-23.003(7)(i) (providing injured employee "shall have the right to select a primary care provider and thereafter, to request one change of primary care provider....
...o persuasively establish such a right. The JCC alternatively concluded that Claimant was required to prove that a primary care provider, or a change in same, was medically necessary. Because every workers' compensation managed care arrangement under section 440.134 "must include" a provision "for the selection of a primary care provider by the employee," and further, because the Florida Administrative Code Rule regulating managed care authorization procedures provides that every "injured employe...
...during the course of treatment for each injury," we conclude it was error for the JCC to require Claimant to introduce the managed care plan into evidence to establish such a legal right. The right is established as a matter of legislative decree, to which any contractual rights would be subordinate. See § 440.134(6)(c)10., Fla....
...1st DCA 2009) (stating "[u]nder the managed care statute, the managed care plan must include a provision for the employee's selection of a primary care provider," and declaring that such right is "similar and parallel" to right to change in physician contained in section 440.13(2)(f)—a right not dependent on showing of medical necessity)....
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One Beacon Ins. v. Agency for Health Care, 958 So. 2d 1127 (Fla. 1st DCA 2007).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2007 Fla. App. LEXIS 10001, 2007 WL 1827226

...n a procedure is performed which is not listed in the manual, . . . carriers must reimburse ambulatory surgical centers 70% of the ambulatory surgical center's usual and customary charge." [2] This administrative rule implemented the 1992 version of section 440.13(4)(b)5., Florida Statutes (1992), which states in pertinent part that "[r]eimbursement of a compensable ambulatory surgical center charge not itemized in the schedule of maximum reimbursement allowances shall be at 70 percent of the am...
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Sol Dale Bldgs., Inc. v. Schweickert, 656 So. 2d 606 (Fla. Dist. Ct. App. 1995).

Cited 1 times | Published | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 6905, 1995 WL 376672

...Shea was furnishing medical care and treatment to the claimant for injuries sustained as a result of his 1985 industrial accident. We note that it is the physician’s duty to properly bill for treatment of compensable injuries, and to furnish reports to the E/C. Section 440.13(2)(d), Florida Statutes....
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Star Emp. Serv., Inc. v. Florida Indus. Comm'n, 122 So. 2d 174 (Fla. 1960).

Cited 1 times | Published | Supreme Court of Florida | 1960 Fla. LEXIS 2190

Chapter 28241, Laws of Florida, 1953, F.S.A. § 440.-13 et seq. It will be recalled that formerly circuit
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Hernandez v. Paris Indus. Maint., 39 So. 3d 466 (Fla. 1st DCA 2010).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 9890, 2010 WL 2671799

...No Legal Basis to Exclude Provider's Report Although the Legislature has expressly limited workers' compensation litigants to one independent medical examination *470 ("IME") "per accident," it has not created such a limit on vocational/rehabilitation providers. See § 440.13(5), Fla....
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Horticulture Plus, Inc. v. Ash, 791 So. 2d 535 (Fla. 1st DCA 2001).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2001 WL 838192

...Ash's death was caused by (i) heart disease, or (ii) exposure to the herbicide Diquat Dibromide in combination with the physical exertion necessitated to spray the herbicide. Appellants assert that the Judge of Compensation Claims ("JCC") erred by not appointing an expert medical advisor ("EMA") pursuant to section 440.13(9)(c), Florida Statutes. Contrary to the JCC's ruling, section 440.13(9)(c), Florida Statutes, provides for the mandatory appointment of an EMA where the issue is one of causation. See Palm Springs General Hospital v. Cabrera, 698 So.2d 1352, 1355-56 (Fla. 1st DCA 1997) (§ 440.13(9)(c) is mandatory; EMA should have been appointed where there was a dispute over whether the claimant's injuries resulted from his accident at work or due to a preexisting condition). Because the JCC ruled as a matter of law that section 440.13(9)(c) was not applicable to this case, he did not reach the factual determination as to whether there was disagreement in the opinions of health care providers under the statute. A "physician" is a health care provider, if certified by the Division of Workers' Compensation. See sections 440.13(1)(r), 440.13(1)(i), Fla. Stat. (1997); Pierre v. Handi Van, Inc., 717 So.2d 1115, 1117 n. 3 (Fla. 1st DCA 1998)(physicians are considered to be health care providers by general definition, citing § 440.13(1)(i))....
...pendent medical examiners ("IME"). We agree. The JCC overruled Appellants' objection to the use of two IMEs "based on the different medical specialties" of the two physicians. Because the claimant did not make the showing for another IME required by section 440.13(5)(b), Florida Statutes (1997), the JCC's admission of two IME's testimony was in error. See Watkins Engineers and Constructors v. Wise, 698 So.2d 294, 296 (Fla. 1st DCA 1997) (E/C failed to make showing under § 440.13(5)(b)(1) that second IME was permitted because an aspect of the employee's illness was outside of one physician's field and otherwise within the field of another physician; "[w]e reject the E/C's argument that the statute permits multiple IME's by physicians of different specialties")....
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Platzer v. Burger, 144 So. 2d 507 (Fla. 1962).

Cited 1 times | Published | Supreme Court of Florida | 1962 Fla. LEXIS 2813

...ion of his urethra, anti-infection prescriptions and possible treatment for prosta-titis, could be made, but the deputy commissioner denied Platzer’s claim on the ground that such an order would be tantamount to tolling the statute of limitations, § 440.13(3) (b), Florida Statutes, F.S.A., in favor of the petitioner. On appeal the full commission affirmed the order of the deputy commissioner. The question for our determination is whether or not § 440.13(3) (b), Florida Statutes, F.S.A., authorizes the deputy commissioner to enter an order providing medical treatment for an “indefinite” period of time for a claimant under circumstances shown in this case. The answer to the question turns upon the interpretation of § 440.13, Florida Statutes, F.S.A., which governs the furnishing of medical services and supplies to an injured claimant. Section 440.13(3) (b) provides : “All rights for remedial attention under this section including the right of the industrial commission to order additional treatment in excess of one thousand dollars, shall be barred unless a claim therefor is filed or the commission acts on its own initiative within two years after the date of the last remedial treatment furnished by the employer, or after the date of the last payment of compensation.” (Emphasis supplied) Careful consideration of § 440.13(3) (b), together with other pertinent provisions of § 440.13, particularly § 440.13(1), drives us to a conclusion that when it is shown that the claimant’s need for remedial attention will continue for a long and indefinite period of time, the statutory language lends, itself to a construction which permits the claimant...
...ent, care, and attendance under the direction and supervision of a qualified physician or surgeon, or other recognized practitioner, nurse or hospital, and for such period, as the nature of the injury or the process of recovery may require * * [F.S. § 440.13(1), F.S.A.] *509 Such an interpretation protects the claimant from his own inadvertence without placing any substantial additional burden upon the commission or the employer-carrier....
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Dorsch, Inc. v. Hunt, 15 So. 3d 836 (Fla. 1st DCA 2009).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 10132, 2009 WL 2191382

...the specified time. It requires merely that the appointment be timely authorized. At times, chapter 440 has required an E/C to offer a claimant a list of at least three physicians from which to select when a one-time change was requested. See, e.g., § 440.13(2)(f), Fla....
...Here, although the Claimant did not request a one-time change, the E/C's willingness to offer Claimant a choice, as opposed to simply scheduling an appointment, did not represent a failure or a refusal on the E/C's part to meet its statutory obligation to provide Claimant the requested medical treatment pursuant to section 440.13(2)(c), Florida Statutes (2002). See, e.g., City of Bartow v. Brewer, 896 So.2d 931, 933 (Fla. 1st DCA 2005) ("Section 440.13(2)(c), Florida Statutes, does not authorize the JCC to order treatment with a specific physician, where the E/C promptly offers qualified alternatives.")....
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State v. Vice, 601 So. 2d 1294 (Fla. 1st DCA 1992).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1992 WL 150975

...reatment because the treating physician was not authorized, and no evidence was offered which would excuse claimant's failure to obtain authorization; and because the treating physician failed to provide medical reports to appellants, as required by Section 440.13(2)(b), Florida Statutes (Supp....
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Amerisure Ins. Co.-Fl v. Martin Mem'l Med., 67 So. 3d 353 (Fla. 1st DCA 2011).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 11179, 2011 WL 2752622

...The order found that Appellant did not properly reimburse Appellee, a hospital, for its care of an injured employee. We hold the Department lacked subject matter jurisdiction to rule on the Petition for Reimbursement as the medical benefits were denied based on the non-compensability of the worker's heart condition. See § 440.13(11)(c), Fla....
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Buena Vida Townhouse Ass'n v. Parciak, 603 So. 2d 26 (Fla. 1st DCA 1992).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1992 WL 162302

...ttendant or custodial care, the per hour value of that care shall be at the per hour value of such family member's former employment, not to exceed the per hour value of such care available in the community at large. This enactment, now contained in section 440.13(2)(h), Florida Statutes (1991), was in effect during the periods in which attendant care was provided to the claimant....
...f her employment, she was able to provide such care without reducing the hours of her employment. The employer/carrier contend that payment should be made at the minimum wage, because the family member did not elect to leave her employment. However, section 440.13(2)(h)1 authorizes a minimum wage award only when the family member is not employed. See Winn Dixie Stores, Inc. v. King, 579 So.2d 313 (Fla. 1st DCA 1991). But section 440.13(2)(h)2 authorizes an award at the family member's former rate of pay only when the family member elects to leave the former employment....
...the existing case law remains unchanged and the employer/carrier is obligated to pay for the family member's services at the prevailing market rate. The award in the present case was made at the family member's rate of pay in her outside employment. Section 440.13(2)(h)2 *28 indicates that such payment may not be awarded in excess of the prevailing market rate....
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Kessler v. Cmty. Blood Bank, 621 So. 2d 539 (Fla. 1st DCA 1993).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1993 WL 255581

...apparent from the record. See H & A Frank's Constr., 582 So.2d at 780, 781; South v. Heartland Employment & Training Admin., 527 So.2d 270, 272 (Fla. 1st DCA 1988). Third, the JCC determined that the E/C had authorized "qualified medical treatment." Section 440.13(2)(a), Florida Statutes (1989), requires an employer to furnish medically necessary treatment and care to an employee....
...ter a request by an injured employee, "the employee may do so at the expense of the employer, the reasonableness and necessity to be approved" by the JCC. The E/C denied Claimant's request for chiropractic care without fulfilling the requirements of section 440.13(2) and Bennett v....
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Torres v. Costco Wholesale Corp., 115 So. 3d 1111 (Fla. 1st DCA 2013).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2013 WL 3305784, 2013 Fla. App. LEXIS 10540

DCA 1998). Second, we recognize that under section 440.13, Florida Statutes (2001), either party may
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Ulico Cas. Co. v. Fernandez, 825 So. 2d 988 (Fla. 1st DCA 2002).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2002 WL 1401695

...nstituted a per se diminution of claimant's entitlement to benefits, relying upon the reasoning of this court in Wiggins v. B & L Services, Inc., 701 So.2d 570 (Fla. 1st DCA 1997). In that case, the issue was whether a managed-care arrangement under section 440.134, Florida Statutes (1995), could limit the claimant's choice of an IME physician to those within the carrier's managed-care provider network. The JCC had ruled that the managed-care plan required the claimant to exhaust the grievance procedure before seeking an IME as allowed by section 440.13(5), Florida Statutes....
...211(1)(b), allowing the parties to a CBA to agree upon "[t]he use of an agreed-upon list of certified health care providers of medical treatment which may be the exclusive source of all medical treatment under this chapter." (Emphasis added.) Unlike section 440.134, interpreted by Wiggins to apply only to requests for IMEs involving exclusively medical care, [5] and not to claims for IMEs for the purpose of determining an injured employee's entitlement to potential indemnity benefits, the langua...
...l medical treatment." In any event, although the agreement before us does not explicitly afford an employee the benefit of an IME, it does provide him or her with the right to a second opinion, which, while not identical to the procedure afforded by section 440.13(5), Florida Statutes, is somewhat comparable because, if the employee is dissatisfied with the opinion of the physician selected, he or she has the right to seek the opinion of a different physician designated in the list. Although the employee does not have the broader range of care available under section 440.13(5)....
...[3] Subsection (2) of the statute provides: "Nothing in this section shall allow any agreement that diminishes an employee's entitlement to benefits as otherwise set forth in this chapter. Any such agreement in violation of this provision shall be null and void." [4] Section 440.13(5)(a) states 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." [5] Wiggins relied primarily on section 440.134(16), which refers to the medical care described under subsections 440.13(2)(a) and (b), Florida Statutes (1995), involving "medically necessary remedial treatment, care, and attendance."
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Williams v. Am. Sur. Co., 99 So. 2d 877 (Fla. Dist. Ct. App. 1958).

Cited 1 times | Published | District Court of Appeal of Florida

...holding denying such an award appears to be correct. There is no evidence in the record that the employer or carrier had any notice of the necessity for such services, nor that Petitioner requested them. Petitioner points out in his brief that Sec. 440.13, F.S.A....
...440.20(13) Florida Statutes, 1949, F.S.A., in effect at the time of injury reads: “(13) The total compensation payable under this chapter for disability and death shall in no event be payable for a period in excess of three hundred fifty weeks in addition to any benefits under Section 440.13 for medical services and treatment, and under Subsection (1) of Section 440.16 for funeral expenses.” Since the Carrier paid 68 weeks temporary total and 2271/2 weeks permanent partial disability, only 54(4 weeks additional compensat...
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Quiroga v. First Baptist Church at Weston, 124 So. 3d 936 (Fla. 1st DCA 2013).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2013 WL 163430, 2013 Fla. App. LEXIS 565

...Notably, Claimant does not challenge the issue of whether the record evidence supports the denial of benefits. Rather, Claimant raises a very specific legal argument, positing that, although he never made a request for the JCC to appoint an expert medical advisor (EMA) as provided for in section 440.13(9)(c), Florida Statutes (2008), the JCC committed fundamental error by not appointing, sua sponte, an EMA to resolve the disagreement in medical opinions....
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Cook v. Palm Beach Cnty. Sch. Bd., 51 So. 3d 619 (Fla. 1st DCA 2011).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 221, 2011 WL 103548

...1st DCA 2008) (viewing evidence in light most favorable to nonmoving party, on review of summary final order). Hence, there is no genuine question of *620 material fact—only a disputed question of law as to whether this is a reimbursement. The JCC correctly resolved the legal dispute. Under section 440.13(1)(r), Florida Statutes (2009), "any disagreement between a health care provider or health care facility and carrier concerning payment for medical treatment" is a reimbursement dispute. The Department of Financial Services has exclusive jurisdiction over such disputes. See § 440.13(11)(c), Fla....
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Friendly Ford v. Hurrell, 427 So. 2d 207 (Fla. 1st DCA 1983).

Cited 1 times | Published | Florida 1st District Court of Appeal

...The E/C controverted the claim contending that any injury relating to claimant's back was not compensable and that the E/C were not responsible for the cost of claimant's medical treatment because claimant had failed to comply with the filing requirements set forth in section 440.13, Fla....
...ed upon a showing of proper proof. We also reverse the order awarding payment for past medical expenses on the ground that the DC never made a finding concerning the question of whether claimant had complied with the filing requirements set forth in section 440.13(1), Fla....
...(1981), even though the E/C affirmatively alleged claimant's noncompliance with this statute as a defense to the claim. Although the DC found that the medical benefits in question were necessary, he never made a finding as to whether claimant was in compliance with the filing requirements of section 440.13, and, if not in compliance, whether "good cause" existed for his noncompliance. A finding that medical treatment is necessary is not analogous to a finding of excusal for failure to comply with the filing requirements set forth in section 440.13(1). On this basis, we reverse the award of medical benefits and remand the matter for determination as to whether claimant submitted his medical bills as required by section 440.13(1), and, if not, whether there was prejudice to the E/C or whether "good cause" was shown....
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Elmer v. Southland Corp./7-11, 5 So. 3d 754 (Fla. 1st DCA 2009).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1686, 2009 WL 500628

...t, but failed to respond at all. Despite this finding, the JCC denied Claimant's request for this referral because he found the medical evidence showed the referral was not reasonably and medically necessary. Claimant argues that, pursuant to either section 440.13(3)(d) or (i), Florida Statutes (2002), the E/C was estopped from arguing the referral was not medically necessary because it failed to timely respond to the doctor's written referral requests. We agree. Section 440.13(3)(d) provides in relevant part: A carrier must respond, by telephone or in writing, to a request for authorization by the close of the third business day after receipt of the request. A carrier who fails to respond to a written request for authorization for referral for medical treatment by the close of the third business day after receipt of the request consents to the medical necessity for such treatment. (Emphasis added). Section 440.13(3)(i) provides in relevant part: Notwithstanding paragraph (d), a claim for specialist consultations ......
...is not valid and reimbursable unless the services have been expressly authorized by the carrier, or unless the carrier has failed to respond within 10 days to a written request for authorization, or unless emergency care is required. (Emphasis added.) This court has held that section 440.13(3)(d) must be read in pari materia with sections 440.13(2)(a), and (c). See St. Augustine Marine Canvas & Upholstery, Inc. v. Lunsford, 917 So.2d 280, 284 (Fla. 1st DCA 2005) (holding these sections are *756 properly read together). The latter two statutes provide a caveat that any medical care provided under section 440.13 must be medically necessary as a result of a compensable injury....
...If there is no response, the plain language of statute provides that the E/C has consented to the medical necessity of the treatment. Thus, an E/C who fails to comply with the statutory requirement forfeits the right to contest whether the referral is reasonably and medically necessary. Applying section 440.13(2)(a), an E/C that fails to timely respond to a referral request is only required to continue providing the recommended treatment so long as it is reasonably and medically necessary....
...Wilson, 990 So.2d 1224 (Fla. 1st DCA 2008); Dawson v. Clerk of the Cir. Ct.— Hillsborough County, 991 So.2d 407 (Fla. 1st DCA 2008) (holding that, although an E/C is obligated to comply with a claimant's request for a one-time change of physician pursuant to section 440.13(2)(f) regardless of the E/C's opinion as to the medical necessity of further treatment, an E/C is only obligated to provide treatment recommended by the new doctor that is reasonably and medically necessary). Because the E/C here failed to respond to the authorized treating doctor's written requests for a referral to a pain management specialist, the E/C violated both sections 440.13(d), and (i) and thus it was error for the JCC to deny authorization of a pain management specialist on the ground it was not reasonably and medically necessary....
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Steinberg v. City of Tallahassee/City of Tallahassee Risk Mgmt., 186 So. 3d 61 (Fla. 1st DCA 2016).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2016 Fla. App. LEXIS 2645, 2016 WL 699139

...orized to treat shoulder). Dr. Borzak’s opinion here constitutes CSE because it has a solid foundation. Even though it was by paper review only, nothing in the definition of “independent medical examination” precludes a records review IME. See § 440.13(l)(j), Fla....
...Burkart, that does not make his review “incomplete” on these facts because those two post-MMI notes do not bear on an assessment of PIR, which must be assigned at the date of MMI. Timeliness of EMA request The EMA statute- does not set a deadline for EMA requests. § 440.13(9)(c), Fla....
..., such error must be preserved for review. See Quiroga v. First Baptist Church at Weston, 124 So.3d 936 (Fla. 1st DCA 2013). A party that requests an EMA must pay for it; in contrast, when a JCC sua sponte appoints an EMA, the cost falls on the E/C. § 440.13(9)(f), Fla....
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Taylor v. TGI Friday's, Inc., 108 So. 3d 698 (Fla. 1st DCA 2013).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2013 WL 646662, 2013 Fla. App. LEXIS 2959

...pinion, we REVERSE. An EMA’s opinion has nearly conclusive effect, Pierre v. Handi Van. Inc., 717 So.2d 1115 (Fla. 1st DCA 1998), and is presumed to be correct unless the JCC finds and articulates clear and convincing evidence to the contrary. See § 440.13(3)(c), Fla....
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Gadol v. Masoret Yehudit, Inc., 132 So. 3d 939 (Fla. 1st DCA 2014).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2014 WL 660199, 2014 Fla. App. LEXIS 2386

VAN NORTWICK, J. In this workers’ compensation case, Claimant appeals an order of the Judge of Compensation Claims (JCC) denying Claimant his choice of doctor to serve as the “one-time change” of physician to which he is entitled under section 440.13(2)(f), Florida Statutes (2012)....
...horization of a one-time change. We agree, reverse the order, and remand for entry of an order consistent with this opinion. The parties agree to the following facts. On October 22, 2012, Claimant requested a one-time change of physician pursuant to section 440.13, Florida Statutes (2012)....
...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. The substantive benefit provided in section 440.13(2)(f) is a claimant-initiated, one-time change of physician, without regard to medical necessity....
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Allen v. Tyrone Square 6 AMC Theaters, 731 So. 2d 699 (Fla. 1st DCA 1999).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1999 WL 41098

..."free time" before honoring a specific request to provide a worker injured in a covered industrial accident medical benefits the carrier knows to be reasonable and necessary because of injury the accident caused. Addressing non-emergency situations, section 440.13(2)(c), Florida Statutes (1997), provides simply that "[t]here must be a specific request for the treatment, and the employer or carrier must be given a reasonable time period within which to provide the treatment or care." In this connection, see section 440.13(3)(d) and (i), Florida Statutes (1997)....
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Myers v. Sherwin-Williams Paint, Co., 838 So. 2d 608 (Fla. 1st DCA 2003).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2003 WL 341032

...[2] The employer of a claimant who suffers an industrial injury must "furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury *611 or the process of recovery may require." § 440.13(2)(a), Fla. Stat. (Supp.1996). "[M]edical care is properly awarded pursuant to section 440.13(2)(a) when the need for such care arises from the combined effect of industrial and nonindustrial conditions....
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Martin Cnty. Bd. of Cty. Com'rs v. Jones, 595 So. 2d 125 (Fla. 1st DCA 1992).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1992 WL 25836

...ing a claim. The E/C correctly asserts that claimant never filed a claim or received authorization for treatment with Dr. Rosen and that without authorization or the need for emergency treatment, they are not liable for claimant's medical bills. See § 440.13(2)(b), Fla....
...Absent findings of fact as to whether or not the JCC found the treatment was on an emergency basis, we must reverse the award of outstanding medical bills and remand for a determination of whether facts exist that would require payment by the E/C under § 440.13(2), Florida Statutes....
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Arnau v. Winn-dixie Stores, Inc., 76 So. 3d 1117 (Fla. 1st DCA 2011).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 20906, 2011 WL 6851187

...Badell that an evaluation by a thoracic surgeon was medically necessary. The JCC, in the order under review, denied the claim for an evaluation by a thoracic surgeon, but failed to identify any specific evidence justifying rejection of the EMA's opinion. Analysis Section 440.13(9)(c), Florida Statutes (2008), mandates that the JCC appoint an EMA when there is a disagreement in the opinions of the health care providers....
...Cabrera, 698 So.2d 1352, 1356 (Fla. 1st DCA 1997). The opinion of the EMA shall be admitted into evidence. See § 440.25(4)(d), Fla. Stat. (2008). The opinion of the EMA is presumed correct unless the JCC finds clear and convincing evidence to the contrary. See § 440.13(9)(c), Fla....
...In Mobile Medical Industries v. Quinn, 985 So.2d 33, 36 (Fla. 1st DCA 2008), we made clear "that an EMA's opinion is presumptively correct unless the JCC finds and articulates `clear and convincing evidence to the contrary.'" (emphasis added) (quoting § 440.13(9)(c), Fla....
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Town & Country Farms v. Peck, 611 So. 2d 63 (Fla. 1st DCA 1992).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1992 WL 385380

...nt's suicide *64 attempt; (2) for claimant to provide proper proof of the amount of bills resulting from her suicide attempt and bills for her acupuncture treatment; and (3) for the taking of further evidence on claimant's need for future treatment. Section 440.13(2)(d), Florida Statutes, provides in part: The employee shall not be entitled to recover any amount personally expended for such treatment or service unless he has requested the employer to furnish the same and the employer has failed,...
...Vandermeer, Darbyshire, and Healey and Cape Cod Psych Hospital and Cape Cod Hospital for prospective treatment without making findings and without evidence as to the type of treatment required or the medical necessity of such treatment as required by section 440.13(2), Florida Statutes....
...s allowed by this court and those benefits retained on remand after the JCC has made further findings. We affirm in part, and reverse in part, the JCC's order. We remand the cause to the JCC with directions (1) to make a specific finding pursuant to section 440.13(2)(d) as to whether good cause exists to excuse the failure of the health care providers to provide E/C with the appropriate medical reports; (2) to allow claimant to present proper proof on the amount of bills in question; and (3) to take further evidence on the need for future medical treatment by Drs....
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TW Servs., Inc. v. Aldrich, 659 So. 2d 318 (Fla. 1st DCA 1994).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1994 WL 716686

...Hafling was authorized to evaluate only; and (5) Dr. Hafling thought he had been authorized to evaluate and treat Claimant and the E/SA never told Dr. Hafling that he was not authorized to provide treatment. The JCC found that the adjuster was trying to circumvent section 440.13 by authorizing health care providers to perform "evaluations only" and then refusing to allow them to treat claimants....
...Hafling's past bills because they were not timely filed with the Division. We agree with the E/SA that it should not have been ordered to pay Dr. Hafling's medical bills because he was never authorized and because the E/SA offered psychological treatment as soon as it was aware that it was needed. Section 440.13, Florida Statutes (1991), sets forth the employer's and claimant's duties with regard to the provision of medical care and treatment. Section 440.13(2)(a) requires the employer to furnish the claimant with remedial treatment deemed to be medically necessary....
...It also provides: "The health care provider performing the independent medical examination shall not be the health care provider to provide the treatment or follow-up care, unless the carrier or self-insurer and the employee so agree or unless an emergency exists." Section 440.13(2)(d) further provides: If the employer fails to provide such treatment, care and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by a judge of compensation claims....
...he time he returned to Dr. Hafling for treatment. Thus, when Claimant visited Dr. Hafling on August 30, 1993, he risked paying the bill. The JCC similarly erred if she intended to authorize Dr. Hafling to provide psychological treatment to Claimant. Section 440.13 gives the employer the right of initial selection of a physician....
...horized to continue treatment with Dr. Hafling." She also found that the E/SA was not justified in its position that Dr. Hafling was authorized to evaluate only and that Dr. Hafling's initial evaluation of Claimant was not an IME within the terms of section 440.13(2)(b)....
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Lindsey v. J.R. & R. Enter., 575 So. 2d 1296 (Fla. Dist. Ct. App. 1990).

Cited 1 times | Published | District Court of Appeal of Florida | 16 Fla. L. Weekly 57, 1990 Fla. App. LEXIS 9671, 1990 WL 212141

...wn) hospitalization in 1989 was not an emergency (contrary to the description as such by the referring physician), although accomplished with the approval of the authorized treating physician. The cross-appeal presents issues on the applicability of section 440.13(2)(e)(l), Florida Statutes, as amended October 1, 1988, as to which remand appears necessary, and as to alleged error in the provision of the order, following the award (not appealed) of detoxification and psychiatric treatment in claimant’s state of residence, Tennessee, as follows: ......
...We do not, therefore, consider the level of recoupment, if any, finding only that the order does not reflect any patent abuse of discretion by the judge. Contrary to the contention here that the potential for any award whatever “completely eviscerates section 440.13,” we conclude that the essential mandates of section 440.13(2)(b), Florida Statutes, and the decisions to which we are referred, are met by the order on this point....
...ual treatment is unavailable in Florida,” Deall , p. 99, citing Keifer v. Cajun Diner, 2 FCR *1299 258 (1957). 4 That principle has been fully respected by the order before us. With respect to the second point on cross-appeal, the applicability of section 440.13(2)(e), Florida Statutes (1988), the order correctly finds “that this amendment ......
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Castro v. At & T Wireless Servs., Inc., 780 So. 2d 917 (Fla. 1st DCA 2000).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2000 WL 1867569

...[1] We hold that the JCC had no jurisdiction to determine the medical necessity pending Claimant's exhaustion of her employer's managed care grievance procedure. Claimant concedes that she failed to exhaust the managed care grievance procedure, as required by statute, before she filed her petition for these benefits. Section 440.134(16), Florida Statutes (1997), provides a presumption that an employee "shall be deemed to have received all the benefits to which they are entitled pursuant to s. 440.13(2)(a) and (b)." The employer entering into such a managed care arrangement is deemed to have complied completely with the managed care provisions, and those provisions "shall govern exclusively unless specifically stated otherwise in this section." § 440.134(16). Also, section 440.134(16) provides a presumption that covered employees "shall be deemed to have received all the benefits to which they are entitled pursuant to s. 440.13(2)(a) and (b)." If dissatisfied with the managed care received, an employee must file a grievance pursuant to procedures established by the Agency for Health Care Administration. §§ 440.134(1)(d) and 440.134(15)(a), Fla....
...See also Claims Management, Inc. v. Grenier, 777 So.2d 1039 (Fla. 1st DCA 2000) ("When the dispute does not concern the provision of medical treatment, care and attendance,... the managed care provisions do not govern the selection and use of medical expert witnesses under section 440.13(5).") Due to the JCC's lack of jurisdiction pending the exhaustion of managed care grievance procedures, we reverse that part of the Compensation Order finding that Claimant's attendant care and remedial treatment were not medically necessary....
...REVERSED and REMANDED. BOOTH, KAHN and BROWNING, JJ., concur. NOTES [1] As an alternate ground for denying these benefits, the JCC correctly ruled she lacked jurisdiction because Claimant failed to exhaust the managed care grievance procedures, as required by section 440.134, Florida Statutes (1997)....
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Seamco Labs., Inc. v. Pearson, 424 So. 2d 898 (Fla. 1st DCA 1982).

Cited 1 times | Published | Florida 1st District Court of Appeal

...by the statute of limitations and found that the statute of limitations had been tolled by the rendering of treatment by the authorized physician. Appellants correctly point out the two pertinent statutes: section 440.19(1)(a), Fla. Stat. (1977) and section 440.13(3)(d), Fla....
...reatment has been furnished by the employer without an award on account of such injury a claim may be filed within 2 years after the date of the last payment of compensation or after the date of the last remedial treatment furnished by the employer. Section 440.13(3)(d) reads in part: All rights for remedial attention under this section shall be barred unless a claim therefor is filed with the division within 2 years after the time of injury, except that if payment of compensation has been made...
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Stahl v. Hialeah Hosp., 127 So. 3d 1283 (Fla. 1st DCA 2013).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2013 WL 6635893, 2013 Fla. App. LEXIS 19919

...the choice of independent medical examiner. Claimant’s objection to the ex amination is based on his assertion that there is no dispute. This objection fails, as follows. The statutory authority for an independent medical examination exists under section 440.13(5)(a), Florida Statutes (2003), for “any dispute concerning overu-tilization, medical benefits, compensability, or disability under this chapter[.]” In Cortina v....
...hich is still pending, and which the E/C is contesting. Claimant’s objection to the examiner is based on his argument that the E/C already selected its independent medical examiner, Dr. Diaz, and thus cannot use Dr. Hyde. This objection has merit. Section 440.13(5)(a), Florida Statutes (2003), provides in part that “[t]he employer and employee shall be entitled to only one independent medical examination per accident and not one independent medical examination per medical specialty.” In Gomar v....
...1st DCA 2010), this court interpreted that quoted language, holding it permits one independent medical examiner (one single doctor) per accident to conduct multiple independent medical examinations as the need for such arises with various different disputes. There is an exception, under subsection 440.13(5)(b), which provides that each party is entitled to “an alternate examiner” only in four circumstances: 1....
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Brigham & Winningham v. Mapes, 610 So. 2d 623 (Fla. 1st DCA 1992).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1992 WL 366071

...s medically necessary. As argued by the E/C, where an industrial injury necessitates the modification or substitution of an automobile in order to accommodate a wheelchair or other equipment, such cost may be awarded as "other apparatus" pursuant to section 440.13(2)(a), Florida Statutes; but where the claimant's need is not readily apparent, medical evidence as to necessity must be adduced....
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Gore v. Lee Cnty. Sch. Bd., 43 So. 3d 846 (Fla. 1st DCA 2010).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 12702, 2010 WL 3421581

...ibed by an authorized doctor, the statute of limitations is tolled during such use. We agree with Claimant that a prosthetic device qualifies as a medical apparatus, the use of which may toll the statute of limitations pursuant to section 440.19(2). Section 440.13(2)(a), Florida Statutes (2001), provides that an "employer shall furnish to the employee such medically necessary remedial treatment,......
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Gulledge v. Dion Oil Co., 605 So. 2d 482 (Fla. 1st DCA 1992).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1992 WL 201044

...ettlement agreement. Upon receipt of this notice, Carrier was immediately under a duty to make a reasonable investigation of the claim, Dolphin Tire Co. v. Ellison, 402 So.2d 36, 37 (Fla. 1st DCA 1981), to timely provide medical benefits pursuant to section 440.13, and to pay temporary total disability compensation pursuant to subsection 440.15(2) within 14 days thereafter unless it timely controverted the claim, § 440.20, Fla....
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Miller Elec. Co. v. Oursler, 113 So. 3d 1004 (Fla. 1st DCA 2013).

Cited 1 times | Published | Florida 1st District Court of Appeal | 2013 WL 1715445, 2013 Fla. App. LEXIS 6497

...Mouhanna’s medical opinion was admissible, a ruling evidenced by the April 2012 order. Notwithstanding that cure, there is reversible error at the trunk of the EMA tree—the JCC erred in admitting Dr. Mouhanna’s medical opinion on this record, over the intent of the Legislature set forth in section 440.13(5)(e), Florida Statutes—and, thus, on remand the EMA’s medical opinion on MCC should be excluded, and the JCC should not rely on it....
...Whereas parties have vested rights in the substantive law, they do not have vested rights in the procedure. As such, procedural or remedial changes to law apply without regard to the date of a claimant’s accident.” (citations omitted)). Here, the applicable version of section 440.13(2)(c) requires Claimant to prove that the care at issue “is compensa-ble and medically necessary,” that there was “a specific request for the treatment,” and that “the employer or carrier [was] given a reasonable time period...
...Parodi also required proof that the care is “initial,” and “is in accordance with established practice parameters and protocols of treatment as provided for in this chapter,” which the Parodi opinion characterized as *1009 “reasonable”-ness. Additionally, both versions of section 440.13(2)(c) require a claimant seeking “to recover any amount personally expended for the treatment or service” to prove either that he “has requested the employer to furnish that treatment or service and the employer has failed, refus...
...or was compensable (compensability generally indicating that the care is/was causally related to the compensable injury to the degree required by chapter 440)— are matters of medical opinion and as such require medical opinion evidence. And third, section 440.13(5)(e) excludes only medical opinions from certain sources, not testimony or evidence admitted “for fact purposes only” — that is, the source himself is not incompetent to testify; only his medical opinion is inadmissible. The import of these three observations is that a claimant seeking either to establish that certain care from unauthorized providers should be authorized, or to introduce medical opinions ordinarily excluded by section 440.13(5)(e), can establish the factual circumstances of the care at issue with “fact-purposes only” evidence from the provider of that care, but must also present medical opinions from another source, one who is already qualified under section 440.13(5)(e) to provide medical opinions, to establish (if at issue and challenged) the compensability and medical necessity (and reasonableness, if required by the applicable version of section 440.13(2)(c)) of the care at issue. A claimant cannot use medical opinion evidence barred by section 440.13(5)(e) to “bootstrap” itself — or other medical opinions from the same source — into evidence. To permit such bootstrapping would contravene the legislative intent of section 440.13(5)(e), and potentially violate the separation of powers doctrine, which forbids the court, in interpreting a statute, from “questioning] the merit of a policy preference or ... substituting] its preference for the legislature’s judgment.” Fast Tract Framing, Inc. v. Caraballo, 994 So.2d 355, 357 (Fla. 1st DCA 2008). Once the provider of care in controversy becomes an authorized provider, however, section 440.13(5)(e) no longer bars that provider’s medical opinion....
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Hunter v. Hernando Cnty. Bd. of Com'rs, 578 So. 2d 798 (Fla. 1st DCA 1991).

Cited 1 times | Published | Florida 1st District Court of Appeal | 1991 WL 60016

...d that claimant failed to provide notice to the employer/carrier (E/C) that she was receiving attendant care from her daughter. This portion of the order cannot be affirmed as to either of the reasons stated. Neither the 1988 nor the 1989 version of Section 440.13(2)(e)2, Florida Statutes, provides that a family member affording attendant care is required to leave his or her employment in order to be compensated at the same rate of pay that he or she previously earned....
...nth before her September 1989 surgery, which necessitated the attendant care. The E/C, however, defends the JCC's order reimbursing the family member's service at minimum wage on the theory that it was the claimant's burden, pursuant to the terms of Section 440.13(2)(e), Florida Statutes (Supp....
...e from *801 the daughter's former employment exceeded the per hour value of attendant care available in the particular community. See § 90.302, Fla. Stat. (1989); C.W. Ehrhardt, Florida Evidence § 302.1 (2d ed. 1984). We consider that the terms of section 440.13(2)(e) permit a JCC to set the per hour value of attendant care service furnished by a family member at the level of the federal minimum wage only in the following circumstances: if the family member was not employed at the time he or s...
...aimant's daughter be paid at the rate of $7.54 per hour, her former hourly wage; and we AFFIRM that portion of the order awarding attendant care at the rate of sixteen hours per week for all times thereafter. JOANOS and MINER, JJ., concur. NOTES [1] Section 440.13(2)(e) provides: The value of nonprofessional attendant or custodial care provided by a family member shall be determined as follows: 1....
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Adams v. Florida Indus. Comm'n, 110 So. 2d 455 (Fla. Dist. Ct. App. 1959).

Cited 1 times | Published | District Court of Appeal of Florida | 1959 Fla. App. LEXIS 3167

...hundred and fifty weeks except as provided in subsection (1) of § 440.-12.” The subsection just referred to provides that no compensation shall be allowed for the first four days of the disability, except certain medical benefits provided for. in Section 440.13....
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Holiday Inn v. Re, 643 So. 2d 13 (Fla. Dist. Ct. App. 1994).

Published | District Court of Appeal of Florida | 1994 Fla. App. LEXIS 8656, 1994 WL 478670

...Whether or not the ex parte showing of surveillance videotapes to the claimant’s physician must be deemed, by its very nature, adversarial as a matter of law, such practice does not appear authorized by the limited exception to the confidentiality requirements of section 455.241(2), Florida Statutes, found in section 440.13(2)(f), which provides for the furnishing of medical records to the E/C’s representatives and for discussions concerning “the medical condition of the injured employee ......
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Ghamra, M. D., Lung Assocs. of Sarasota, LLC v. Williams, Est. of Derrick Williams (Fla. 2d DCA 2025).

Published | Florida 2nd District Court of Appeal

...3d at 440 (alteration in original) (quoting Specialty, American Heritage Dictionary (2011 ed.));2 accord B&A Gourmet Foods, LLC v. Mora-Abreu, 352 So. 3d 29, 31 (Fla. 1st DCA 2022) (quoting Specialty, American Heritage Dictionary of the English Language 1669 (4th ed. 2000)) (considering section 440.13(2)(f), Florida Statutes)....
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Burns v. Hilton Enter., 853 So. 2d 1107 (Fla. 1st DCA 2003).

Published | Florida 1st District Court of Appeal | 2003 Fla. App. LEXIS 13295, 2003 WL 22056263

...We affirm the second challenged ruling without discussion. As to the first issue, we conclude that the JCC here improperly determined that the statutory presumption of correctness, with regard to the EMA’s opinion, was overcome by clear and con- *1108 vineing evidence to the contrary. See § 440.13(9)(c), Fla....
...r, 755 So.2d at 782 . See also Allen v. Protel, Inc., 852 So.2d 916, 920 (Fla. 1st DCA 2003) (following Carver). Criticism by the EMA of one of the disagreeing physicians is not alone a reasonable basis for rejecting the report of an EMA when, under section 440.13(9), the EMA is appointed with an expectation that his testimony will contradict one of the health care providers already in the record. See § 440.13(9)(b), Fla....
...isagreeing with the employer/carrier’s independent medical examiner (IME). Instead, the EMA’s report and deposition are a reasoned and thorough critique of the IME’s evaluation of the claimant — apparently as contemplated by the statute. See § 440.13(9)(b), Fla....
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Hughes v. Chloride, Inc., 474 So. 2d 1262 (Fla. 1st DCA 1985).

Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 2083, 1985 Fla. App. LEXIS 15704

Giulio was not “reasonable and necessary,” Section 440.-13(2)(a), Florida Statutes (1983), was supported
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Jackson Manor Nursing Home v. Ortiz, 606 So. 2d 422 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 9441

...er requiring them to provide claimant Anita Ortiz with attendant care. We reverse the order of the judge of compensation claims (JCC) because the record before us lacks competent substantial evidence of medical need for attendant care as required by section 440.13(2)(a), Florida Statutes (Supp.1988). *423 Section 440.13(2)(a), Florida Statutes (Supp.1988), the statute in effect at the time of the injury, provides: Subject to the limitations specified in s....
...e is unable to adequately care for herself at home and requires assistance in dressing, bathing, ambulating with the use of a walker; transportation to and from her attending physicians and preparation of her meals.” Although the 1990 amendment to section 440.13(2)(f), Florida Statutes, Ch....
...mpetent substantial evidence. Builders Square v. Drake, 557 So.2d 115 (Fla. 1st DCA1990). Attendant care is awardable only under that section of the Workers’ Compensation Act requiring the employer to furnish certain medical services and supplies. § 440.13, Fla.Stat. (Supp.1988). In addition to the medical attendance referenced in section 440.13(2)(a), quoted above, the statute also requires the employer to provide “appropriate professional or nonprofessional custodial care when the nature of the injury so requires _” § 440.13(2)(d), Fla.Stat....
...Collision Clinics International Inc., 413 So.2d 827 (Fla. 1st DCA1982) (claimant blinded in industrial accident demonstrated medical necessity for attendant care); Walt Disney World Co. v. Harrison, 443 So.2d 389, 393 (Fla. 1st DCA 1983) (“It is not the purpose of section 440.13 to burden family members with medically required nursing services and unskilled attendant care ......
...was suffering from a serious back condition and receiving workers’ compensation benefits for such condition) were medically required by claimant’s physical condition beyond those services that family mem *425 bers normally provide gratuitously. Section 440.13(2)(d), Florida Statutes (1987)....
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Braun v. Brevard Cnty., 44 So. 3d 1216 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 14885, 2010 WL 3783441

...Golovac, the authorized physician who had been treating Mr. Braun for the 1993 accident, was originally authorized to treat him for the 2005 accident, as well. Later, in connection with his 2005 accident only, Mr. Braun sought and obtained a one-time change in physician, pursuant to section 440.13(2)(f), Florida Statutes (2005)....
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Ago (Fla. Att'y Gen. 1996).

Published | Florida Attorney General Reports

...s and others." 9 It is a policy for administering the workers' compensation statute, however, that reasonable access to medical information be given to all parties to facilitate the self-executing features of the law. 10 In carrying out this policy, section 440.13 (4)(c), Florida Statutes, provides: Notwithstanding the limitations in s....
...e injured person, so long as such discussion is limited to conditions related to the workplace injury. There is nothing contained in Chapter 440 , Florida Statutes, that would prevent the city from discussing the medical records obtained pursuant to section 440.13 , Florida Statutes, and the condition of an injured employee related to the subject's workplace injury during a closed-door meeting pursuant to section 286.011 (8), Florida Statutes, as long as such discussion is necessarily related to settlement negotiations or to setting strategy for litigation expenditures....
...90-88 (1990), in which this office concluded that a notice of injury form filed with a municipality pursuant to the workers' compensation statutes is a public record, regardless that the form includes medical information that is otherwise confidential. 10 Section 440.13 (4)(c), Fla. Stat. (1995). 11 Section 455.241(2), Fla. Stat. (1995), states that, with the exception of s. 440.13 (2), patient records may not be furnished to any person other than the patient or the patient's legal representative or other health care providers involved in the care or treatment of the patient without the patient's written authorization....
...(1995), states that the identity of any person upon whom a human immunodeficiency virus test has been performed and the test results are confidential and shall not be released except as specified therein. 12 Section 455.241, Fla. Stat. (1995), refers to s. 440.13 (2), Fla. Stat., and does not reflect the substantial rewrite of s. 440.13 , Fla. Stat., in s. 17, Ch. 93-415, Laws of Florida, where the authorization for medical records to be provided to employers in workers' compensation cases was moved from s. 440.13 (2)(f) to s. 440.13 (4)(c)....
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K-9 of Orlando v. Davenport, 605 So. 2d 587 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 10352, 1992 WL 240603

...tion Advisors. In April 1991, employer/carrier began providing appellee the services of a registered nurse, who is employed by appellant carrier as its medical management nurse. Even though Ms. Gould is not a “health care provider” as defined in Section 440.13(l)(b), Florida Statutes (1985), the JCC granted appellee’s claim, finding that Ms. Gould has considerable experience and no logical reason justified terminating her services to appellee. Section 440.13(2)(a), Florida Statutes (1985) requires an employer to furnish to a claimant “such medically necessary remedial treatment, care and attendance by a health care provider and for such period as the nature of the injury or process of re...
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Accurate Reporters v. Moore, 605 So. 2d 585 (Fla. 1st DCA 1992).

Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 10353, 1992 WL 240602

...mporoman-dibular joint (TMJ) disease and to have massage therapy. We find the award of massage therapy is supported by competent substantial evidence, including the testimony of chiropractor Dr. Ciasen, and we affirm that provision in the order. See Section 440.13(l)(c), Florida Statutes (1987)....
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Sedgwick Claims Mgmt. Servs., the GEO Grp., Inc. v. Ryan Thompson (Fla. 1st DCA 2025).

Published | Florida 1st District Court of Appeal

...Roush because his opinions were not based on sufficient information to pass muster under Daubert. The JCC denied the E/C’s motion finding it was nonspecific and failed on the merits. He certified a conflict in medical opinions and appointed Dr. Cameron as an EMA to “break the tie” regarding the causation issue. See § 440.13(9)(c), Fla....
...As such, he causally related Claimant’s performance of the work activities to his cervical herniated disc. The E/C filed a motion to strike Dr. Cameron’s EMA report and testimony, raising a Daubert objection. In response, Claimant argued that section 440.13(9)(c) dictated that Dr....
...Cameron, over its objection based on section 90.702, Florida Statutes, which codifies the federal Daubert standard. In response—although acknowledging that Daubert applies generally in Florida workers’ compensation cases—Claimant asserts that nothing about Daubert or section 90.702 applies to an EMA appointed under section 440.13(9), Florida Statutes....
...Section 440.25 governs “[p]rocedures for mediation and hearings” in workers’ compensation proceedings and was last amended in 2003. It now provides, in relevant part: When there is a conflict in the medical evidence submitted at the hearing, the provisions of s. 440.13 shall apply....
...The report or testimony of the expert medical advisor shall be admitted into evidence in a proceeding and all costs incurred in connection with such examination and testimony may be assessed as costs in the proceeding, subject to the provisions of s. 440.13. § 440.25(4)(d), Fla....
...the [JCCs] within the advisor’s area of expertise” and “to provide peer review or expert medical consultation, opinions, and testimony . . . to [a JCC] in connection with resolving disputes relating to reimbursement, [and] differing opinions of health care providers . . . .” § 440.13(9)(a)–(b), Fla. Stat. (2020). Subsection (9)(c) further clarifies that “[t]he opinion of the [EMA] is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the [JCC].” § 440.13(9)(c), Fla....
...horized treating health care providers relating to the claimant and subject accident shall be received into evidence by the [JCC].” Finally, Henson submits that Frye testing is unnecessary to assure evidentiary reliability, because section 440.13(9)(c) provides for the appointment of expert medical advisors to assist the JCC with issues of medical causation and requires that the EMA [expert medical advisor] opinion “is presumed to be correct unless there is clear and convincing evidence to the contrary.” Henson, 823 So....
...See § 440.29(4), Fla. Stat. (2001). Thus, section 440.29 has no bearing on the question before us. Id. (emphasis added). Then, the supreme court pivoted to specifically address expert medical opinions as follows: Section 440.13(9), Florida Statutes (2001), defines the role and appointment of expert medical advisors (EMA’s) in workers’ compensation proceedings. While the statutory framework certainly allows the JCC to rely upon an EMA’s expert opinion, see § 440.13(9)(c) (“The opinion of the [EMA] is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the [JCC].”), none of the provisions of chapter 440 preclude or conflict with use of the Frye criteria to test and ensure the reliability of novel scientific methods utilized by any expert witness. See § 440.13(9), Fla....
...See Daubert, 509 U.S. 579; *The Florida Legislature renumbers section 440.25(3)(b) to (4)(d) and amends it as follows: When there is a conflict in the medical evidence submitted at the hearing, the provisions of s. 440.13 shall apply....
...given the same consideration by the judge of compensation claims as is accorded other medical evidence submitted in the proceeding; ... § 440.25(4)(d), Fla. Stat. (1993) (emphasis added). *The Florida Legislature enacts the EMA provision in section 440.13(9) which declares that the report or testimony of an expert medical advisor is “presumed correct unless there is clear and convincing evidence to the contrary as determined by a judge of compensation claims.” § 440.13(9)(c), Fla....
...12 2003: The Legislature again amends section 440.25(4)(d) to read as follows, “When there is a conflict in the medical evidence submitted at the hearing, the provisions of s. 440.13 shall apply. The report or testimony of the expert medical advisor shall be admitted into evidence in a proceeding ....
...No other courts may be established by 11 This amendment deleted disinterested doctor and substituted expert medical advisor. It also removed language regarding the EMA opinion being given the same consideration as other medical evidence, removing any conflict with section 440.13. 13 the state, any political subdivision or any municipality.” The Office of the Judges of Compensation Claims (OJCC) is not a court of this State because it is...
...12 This Court has since consistently held that it is within the Legislature’s purview to establish rules of evidence for workers’ compensation. See, e.g., Booker, 166 So. 3d at 192; Cortina v. State, Dep’t of HRS, 901 So. 2d 273, 274 (Fla. 1st DCA 2005) (holding section 440.13(5)(e)’s limit on admissible medical witnesses to authorized treating IME or EMA does not violate separation of powers because “this court has consistently recognized and upheld the Legislature's prerogative as to evidentiary issues...
...2d. at 477–78; and (3) the 2003 amendment deleted from section 440.24(4)(d), the instruction that “expert medical advisors” shall be considered like other medical experts, erasing the explicit conflict with the treatment of EMA opinions under 440.13(9)(c), requiring that the opinion is presumed correct unless there is clear and convincing evidence to the contrary. In the 2020 version of section 440.24(4)(d) the Legislature’s deliberate use of language that the report or testimony...
...the weight or credibility to be afforded the opinions. See Booker, 166 So. 3d at 192 (citing Daubert, 509 U.S. at 597). Notably, in the 2003 amendments to Chapter 440, the Legislature used this same modal verb, “shall,” in another subsection of 440.13 which allows for a “consensus IME” (the parties mutually agree to a specific doctor to perform an evaluation). Pursuant to the amended version of section 440.25(4)(d), there is no threshold of admissibility for the report and opinions of an EMA. This is not to say that the EMA opinion cannot be challenged as unreliable, as the party opposing the presumption of correctness 16 may overcome it by clear and convincing evidence. See § 440.13(9)(c), Fla....
...The JCC, having determined that a Daubert challenge may be raised to EMA opinions, considered the factors and determined Dr. Cameron’s report and testimony were admissible. Accordingly, the JCC ultimately considered the EMA opinions as dictated by section 440.13(9)(c) in reaching his determination of compensability, and competent, substantial evidence exists to support the JCC’s conclusion that the E/C failed to rebut the EMA presumption of correctness by clear and convincing evidence....
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Daniel Murphy v. Polk Cnty. Bd. of Cnty. Commissioners, & Com. Risk Mgmt. (Fla. 1st DCA 2025).

Published | Florida 1st District Court of Appeal

...disability and medical benefits to an injured worker and to facilitate the worker’s return to gainful reemployment at a reasonable cost to the employer.” (emphasis supplied)); § 440.10(1)(a), Fla. Stat. (making employers liable for “the compensation payable under ss. 440.13, 440.15, and 440.16,” Florida Statutes—that is, medical treatment and attendant care 4 Contrary to what the concurring opinion suggests, this court did not answer the precise question in American Airlines Group v. Lopez, 388 So....
...or to his or her dependents as provided for in this chapter”); cf. Lopez, 388 So. 3d at 845 (noting “two clearly defined types of benefits: indemnity benefits, governed by section 440.15 of the Florida Statutes; and remedial treatment, care, or attendance, governed by section 440.13”). It is clear from the referenced statutory provisions that an award of attorney’s fees is neither of these forms of benefits (i.e., neither indemnity nor medical treatment)—so, not benefits at all under this state’s compensation regime....
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ABM Indus., Inc. & ACE/ESIS v. Maritza Valencia (Fla. 1st DCA 2021).

Published | Florida 1st District Court of Appeal

...llowing a compensable workplace accident. The E/C authorized Dr. Rosabal to treat her. Dr. Rosabal did not think surgery was necessary, and released Claimant back to work. Claimant sent the adjuster a request for a one-time change of physician under section 440.13(2)(f), Florida Statutes (2018), identifying Dr....
...status need not exist at the time of the benefits hearing). In short, Dr. Lazzarin counted as an authorized provider, and because his opinions conflicted with Dr. Rosabal’s, the JCC was required to appoint an EMA to resolve the conflict. See § 440.13(9)(c), Fla....
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Protocol Commc'ns, Inc. v. Andrews, 991 So. 2d 429 (Fla. 1st DCA 2008).

Published | Florida 1st District Court of Appeal | 2008 WL 4362017

...Among other issues, the employer asserts that medical care should not have been awarded with a doctor who was designated for the claimant's independent medical examination. However, the employer did not contest that designation and the doctor's care was properly awarded under sections 440.13(5)(a) and 440.13(2)(c), Florida Statutes....
...s ongoing problems were related to the industrial injury and required further medical care. The judge accepted that evidence and awarded such care with the treating doctor who had been designated for the independent medical examination. Referring to section 440.13(5)(a), the employer contends that when the treating doctor was designated for the examination he could no longer provide treatment....
...Although the employer did not expressly agree to the designation of the treating doctor as the claimant's independent medical examiner, the employer was aware of and did not challenge or otherwise contest that status. Such tacit agreement is sufficient to bring the doctor within the provisions of section 440.13(5)(a), which allow the doctor to also provide treatment. Furthermore, as the judge found in awarding such care, the employer was not furnishing the necessary treatment under section 440.13(2) and the claimant was entitled to obtain the medical care on her own in accordance with section 440.13(2)(c)....
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Keller Bldg. Prods. v. Townsend, 438 So. 2d 188 (Fla. Dist. Ct. App. 1983).

Published | District Court of Appeal of Florida | 1983 Fla. App. LEXIS 21812

medical bills were submitted as required by Section 440.13(1), Florida Statutes, and, if not, whether
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State Attorney v. Johnson, 770 So. 2d 187 (Fla. 1st DCA 2000).

Published | Florida 1st District Court of Appeal | 2000 Fla. App. LEXIS 12275, 2000 WL 1369874

unilateral transfer of medical care pursuant to section 440.13(2)(d), Florida Statutes. We conclude that the
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Suez Motel v. Brouwer, 388 So. 2d 627 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 17691

the bills of the unauthorized doctors. However, § 440.13, Florida Statutes, sets forth the procedures for
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McDonald's v. Lopez, 990 So. 2d 1227 (Fla. 1st DCA 2008).

Published | Florida 1st District Court of Appeal | 2008 WL 4298541

...Claimant thereafter went to chiropractor Dr. Friedman approximately sixty times for back treatment and filed a petition for benefits seeking authorization for that treatment. Ultimately, the JCC found Dr. Friedman was authorized, in relevant part, by section 440.13(2)(c), Florida Statutes (2005), and he ordered the E/C to pay all of Dr. Friedman's past bills and Claimant's attorney's fees. The JCC erred in awarding payment for more than twenty-four treatments with Dr. Friedman because there is no evidence that such extended treatment was authorized by the carrier. Under section 440.13(2)(c), the JCC is empowered to award only that care which is reasonable and medically necessary. Section 440.13(2)(a), Florida Statutes (2005), provides in part that "medically necessary treatment, care, and attendance does not include chiropractic services in excess of twenty-four treatments or rendered twelve weeks beyond the date of the initi...
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Holiday Inn v. Johnson, 719 So. 2d 942 (Fla. 1st DCA 1998).

Published | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 11942, 1998 WL 646537

Gonzalez, which the employer denied. Under section 440.13(3), Florida Statutes (1991), the statute in
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May v. Broward Corr. Inst., 513 So. 2d 723 (Fla. 3d DCA 1987).

Published | Florida 3rd District Court of Appeal | 12 Fla. L. Weekly 2291, 1987 Fla. App. LEXIS 10430

supplies which the employer must provide under section 440.-13(2), including professional or nonprofessional
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Noe Guerra v. C.A. Lindman, Inc., & Argonaut Ins. Co., 146 So. 3d 527 (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal

...Schechter and Pagan do not constitute evidence of a “disagreement in the opinions of the health care providers” regarding the legal issue in dispute, i.e., Claimant’s current need for discectomy and fusion given the unrefuted worsening of his injury, the JCC erred in appointing an EMA. See § 440.13(9)(c), Fla....
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AA Gutter Cleaning, Inc. v. Cesario, 49 So. 3d 281 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 14001, 2010 WL 3655901

PER CURIAM. In this workers’ compensation case, the employer and carrier argue that the judge of compensation claims erroneously interpreted section 440.13(9)(c), Florida Statutes (2004), to require that the disagreement between health care providers necessary for the appointment of an expert medical advisor be between health care providers within the same specialty....
...We agree and, accordingly, reverse and remand for further proceedings. Here, an orthopedic specialist and a pain management specialist expressed differing opinions as to whether the workplace injury remained the major contributing cause of claimant’s low back condition and need for treatment. The fact that section 440.13(9)(a), Florida Statutes (2004), requires that the Agency for Health Care Administration “certify expert medical ad-visors in each specialty” does not compel the judge’s narrow interpretation of paragraph (c). Paragraph (c) addresses the situation where there is a “disagreement in the opinions of the health care providers.” A “health care provider” is a physician “certified by the agency.” § 440.13(l)(h), Fla....
...A claimant’s treatment for a particular condition may encompass multiple specialists, and causation issues may arise which various health care providers can appropriately address. Because the judge erred as matter of law in his interpretation of section 440.13(9), we reverse the denial of the request for appointment of an expert medical advisor, and remand for further proceedings consistent with this opinion. See Horticulture Plus, Inc. v. Ash, 791 So.2d 535, 536 (Fla. 1st DCA 2001) (reversing a determination that, as matter of law, section 440.13(9)(c) did not apply, and remanding because the judge failed to make a determination as to whether a factual disagreement existed between health care providers)....
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Palm Beach Cnty. Sheriff's Off. v. Bair, 965 So. 2d 1210 (Fla. 1st DCA 2007).

Published | Florida 1st District Court of Appeal | 2007 Fla. App. LEXIS 14678, 2007 WL 2733825

...Such statutory presumption arises only after a determination that a claimant has heart disease (among other things), and any conflict in the medical testimony relating to the existence of a heart disease requires appointment of an expert medical advisor. Because of the conflicting medical testimony, section 440.13(9)(e), Florida Statutes (2002), mandated the appointment of an expert medical advisor before applying the section 112.18 presumption, and the JCC erred in denying the E/C’s motion for the appointment of an expert medical advisor....
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Amendments to the Florida Rules of Workers' Comp. Procedure, 829 So. 2d 791 (Fla. 2002).

Published | Supreme Court of Florida | 27 Fla. L. Weekly Supp. 795, 2002 Fla. LEXIS 1884, 2002 WL 31084673

...(C) The parties were unable to resolve the dispute within 30 days after a request for assistance was made to the EAO. (D) If medical care is being provided to the employee through managed care and the petition includes a claim for medical care under section 440.13(2)(a) and (b), Florida Statutes, the certificate must indicate that the grievance procedures required by section 440.134(15), Florida Statutes, were exhausted before filing the petition under section 440.192(3), Florida Statutes....
...mendments to chapter 440, Florida Statutes. The request or application for hearing is now incorporated in the petition and no longer is a separate pleading. The grievance procedures referred to in subdivision (a)(5)(D) are the procedures required by section 440.134(15), Florida Statutes, and not chapter 120, Florida Statutes....
...advances -under sections 440.20(12)(c)2 and 440.20(12)(d), Florida Statutes, appeals of administrative fines or penalties under section 440.106, Florida Statutes, motions for appointment of guardians, motions to appoint expert medical advisors under section 440.13, Florida Statutes, requests for imposition of sanctions under these rules, motions to disqualify a judge or a mediator, motions to recuse counsel, motions to correct the appellate record, and motions to appoint independent medical examiners under section 440.13, Florida Statutes, shall be filed and handled in the manner as provided for a claim in rule 4.025, except the motion shall be filed with the presiding judge in cases where a petition is pending....
...ontinuing at a rate of $-per week. _Death benefits payable under Ssection 440.16, Florida Statutes. __ Correction of AWW and resulting Compensation Rate due to- _Medical E-expenses incurred for treatment of the employee’s injury'as provided under Ssection 440.13(2), Florida Statutes....
...Date(s) notice(s) of denial filed: Claimant: date: _ date: _ date: _ E/C/SA: date: _ date: _ date: _ 13. Maximum medical improvement, if reached, giving date, name of physician, and impairment rating: Claimant: date: _ doctor:_ rating:_ E/C/SA: date: _ doctor:_ rating:_ 14. If medical benefits under section 440.13, Florida Statutes, are determined to be due or stipulated due in this document, the parties agree that the exact amounts payable to health care providers will be handled administratively and medical bills need not be placed into evidence at trial....
...Assistant to the Judge of Compensation Claims (d) Settlements Under Sections 440.20(ll)(b) and (ee), Florida Statutes (49942001), in which Right to Compensation Benefits Has Been Settled Previously. [For caption and style of pleadings, see form 4.901] ORDER FOR RELEASE FROM LIABILITY FOR MEDICAL BENEFITS PAYABLE UNDER SECTION 440.13, FLORIDA STATUTES, AS AUTHORIZED BY SECTIONS 440.20(ll)(b) and (ee), FLORIDA STATUTES (49942001) The parties jointly petition for an order approving a stipulation for settlement under sections 440.20(1l)(b) and (ee), Florida Statutes (...
...ovisions. B. On payment of the additional consideration set forth in the joint petition and supporting stipulation for settlement, the liability of the employer and its carrier (servicing agent) for the payment or provision of medical benefits under section 440.13, Florida Statutes, because of the industrial accident and injury referred to in this order is fully and forever discharged and released....
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Miller v. State, Dep't of Transp., 679 So. 2d 854 (Fla. Dist. Ct. App. 1996).

Published | District Court of Appeal of Florida | 1996 Fla. App. LEXIS 9723, 1996 WL 523188

...t for chiropractic care, and August 11, 1993, when the employer/carrier authorized a choice of three chiropractors for evaluation and treatment.” On appeal claimant argues the JCC erred by not ordering payment of all bills from Dr. Vannucci. Under section 440.13(2), Florida Statutes, when a claimant requests alternative treatment, the employer must authorize such treatment, offer alternative treatment, or obtain a ruling from the judge that such treatment is not in the claimant’s best interest....
...“If the employer fails to provide such treatment, care, and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by a judge of compensation claims.” § 440.13(2)(d), Fla....
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Dump All, Inc. v. Grossman, 475 So. 2d 976 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 2149, 1985 Fla. App. LEXIS 15855

...In the same order, Deputy Commissioner Wieland required the E/C, among other things, to pay all necessary medical expenses for claimant’s treatment by Dr. Grossman. The E/C made all payments required under this order until February 1981, when the E/C filed a petition for modification pursuant to Section 440.13(2)(a), Florida Statutes (1981), alleging that claimant’s physical condition was such that he no longer required chiropractic treatment....
...nued necessity for chiropractic treatment of claimant’s compensable lower back injury. Pursuant to the statutory method for resolving such disputes, the E/C had petitioned the deputy to disallow such treatment and to deauthorize Dr. Grossman {See, Section 440.13, Florida Statutes (1981)), and after an adversary hearing on the issue, the deputy granted the E/C’s petition, effective November 12, 1982....
...Howard Hall Company, 219 So.2d 688 (Fla.1969). As stated in Cal Kovens, "... the [party] seeking to change the status quo ... should obtain an order from the deputy commissioner or incur the risk of a ruling against good cause for the change under Section 440.13,” Id....
...care by requesting the name or names of physicians who could provide it. While Dr. Grossman argues that his “request” for reauthorization on December 21, 1982 was sufficient to constitute a “request” for alternative medical care pursuant to Section 440.13(2)(b), Florida Statutes (1981), as we interpret the statute only the injured employee (or his legal representative) may make a request legally sufficient to trigger an E/C’s statutory obligation....
...See, Section 440.10(1), Florida Statutes (1981), which provides in pertinent part: (1) Every employer coming within the provisions of this chapter ... shall be liable for, and shall secure, the payment of his employees, or any physician, surgeon, or pharmacist providing services under the provisions of Section 440.13.... (emphasis supplied) . In so holding, we do not imply that a request for alternative medical care for a claimant made by a physician cannot constitute notice to the E/C of the need for such care, pursuant to Section 440.13(2)(b), (3). Notice, however, is not the issue here. .See, Section 440.13(2)(a), Florida Statutes (1981): Subject to the limitations specified in Section 440.19(2)(b), the employer shall furnish to the employee such remedial treatment, care, and attendance under the direction and supervision of a qualified p...
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James Harman v. Merch. Transp., CCMSI (Fla. 1st DCA 2021).

Published | Florida 1st District Court of Appeal

...Stephenson, Judge. Date of Accident: May 16, 2017 September 15, 2021 M.K. THOMAS, J. James Harman argues the Judge of Compensation Claims (JCC) correctly ordered the Employer/Carrier (E/C) to provide him with an alternate physician pursuant to section 440.13(2)(f), Florida Statutes (2017), but erred in preserving the E/C’s right of selection....
...in whether the refusal was based on refusal to accept patients injured at work generally or to accept payment under the Florida Workers’ Compensation Health Care Provider Reimbursement Manual. See Fla. Admin. Code Ann. r. 69L-7.020(1) and sections 440.13(12) and (13), Florida Statutes (2017). 2 “is the cut-off for reasonable distance in Florida per Commercial Carrier.” See Commercial Carrier Corp....
...attorney’s fee and costs. Harman filed a motion for partial rehearing or to vacate the order, arguing that the JCC erroneously determined that because the E/C provided an allergist’s name within five days, despite declaring Dr. Mark as an unreasonable alternate, section 440.13(2)(f) was satisfied, and the E/C retained the right of selection—effectively giving the E/C a second bite at the apple....
...Tuer to another claimant-selected physician or introduce evidence of his chosen allergist practicing 2 In the award provision, the JCC footnoted the following: “No claim has been made that the Employer/Carrier’s response was not provided within the statutory 5-day timeframe, as required by section 440.13(2)(f), Florida Statutes.” 5 within a 50-mile radius who accepted workers’ compensation patients and/or fee schedule payment....
...Harman never argued that the E/C failed to timely provide an alternate physician but only that the authorization was unreasonable, based solely on distance factors. 4 Additionally, he never asserted that the right of selection was forfeited by the E/C. Section 440.13(2)(f), specifically the fourth sentence, states, “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.” § 440.13(2)(f), Fla....
...The third sentence of the 3 In Flores, an E/C authorized an alternate doctor the day after the request for one-time change but did not provide an appointment date until 56 days after receiving the request. 301 So. 3d at 1093. This Court held that section 440.13(2)(f) dictates that “the E/C forfeits the right of selection if it subsequently fails to provide the alternate physician by unreasonable delay in acquisition of an appointment date.” Id....
...medical specialty. Id. Here, the E/C satisfied both. The statute imposes no criteria regarding distance of travel as a criterion for the E/C’s retaining its right of selection. In Flores, this Court held that the E/C forfeits the right of selection under section 440.13(2)(f) if it fails to provide the authorized alternate physician by “unreasonable delay in acquisition of an appointment date.” 301 So....
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Joshua Holcombe v. City of Naples/Johns E. Co., Inc. (Fla. 1st DCA 2021).

Published | Florida 1st District Court of Appeal

...compensability after concluding that the examination contained evidence of hypertension, precluding Claimant’s reliance on the presumption. Medical Evidence Both parties obtained experts via independent medical examinations (IME), pursuant to section 440.13(5), Florida Statutes....
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Bituminous Cas. Corp. v. Hawes, 82 So. 2d 731 (Fla. 1955).

Published | Supreme Court of Florida

...ount equal to: “1. A reasonable attorney’s fee as determined by the commission and the court costs, in respect of such proceedings or compromise. “2. The cost of all benefits actually furnished (or to be furnished) by him to the employee under § 440.13, Florida Statutes....
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City of Auburndale v. Searfoss, 43 So. 3d 927 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 13567, 2010 WL 3584387

...Florida Contracting Co., 16 So.3d 958 (Fla. 1st DCA 2009) (holding medical opinions of unauthorized doctors admissible where E/C wrongfully denied care after specific request for treatment made by claimant, requiring *928 claimant to resort to self-help provisions of section 440.13(2)(c))—and, thus, no competent evidence supports the award of TTD for the period in question. See § 440.13(5)(e), Fla....
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Bellamy v. Golden Flake Snack Foods, Inc., 97 So. 3d 941 (Fla. 1st DCA 2012).

Published | Florida 1st District Court of Appeal | 2012 WL 3930366, 2012 Fla. App. LEXIS 15111

...Gevity/Fire Equipment Services, 43 So.3d 834 (Fla. 1st DCA 2010). In Lehoullier , we noted that IMEs are appropriate when a “dispute” arises “ ‘concerning overutilization, medical benefits, compensability,’ or disability.” Id. at 836 . See also § 440.13(5)(a), Fla....
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Chemco Elec. Supply, Inc. v. Gonzalez, 475 So. 2d 724 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 2090, 1985 Fla. App. LEXIS 15720

...Mozingo, indicate that Gonzalez would suffer recurring back problems; (2) Gonzalez’ letter of 7 April 1982 to Sentry; (3) Gonzalez’ testimony that she intended her letter to be a request for treatment; and (4) Sentry did not submit to her a choice of three doctors from which to choose a treating physician as required by Section 440.13, Florida Statutes....
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Dane Hidden v. Day & Zimmerman/Florida Power & Light etc., 202 So. 3d 441 (Fla. 1st DCA 2016).

Published | Florida 1st District Court of Appeal | 2016 Fla. App. LEXIS 15055

...a determination that the injuries diagnosed by Drs. Brown and Estes are compensable. At the hearing before the JCC, Claimant submitted the depositions of Drs. Brown and Estes in support of the petition. The E/C objected to the medical opinions in the depositions based on section 440.13(5)(e), Florida Statutes (2014), which prohibits the admission of medical opinion evidence in workers’ compensation proceedings from anyone other than an authorized treating physician, independent medical examiner (IME), or expert medical advisor (EMA). Claimant responded that the opinions of Drs. Brown and Estes were admissible because the two doctors were authorized by operation of law pursuant to section 440.13(2)(c), which permits an injured employee to obtain so-called “self-help” at an E/C’s expense when the E/C “fails to provide initial treatment ....
...ies were work- related, the JCC denied the petition seeking compensability and all other benefits sought by Claimant. 3 This appeal follows. Analysis Section 440.13(5)(e), by its plain language, excludes from workers' compensation proceedings the medical opinions of any doctor (other than IMEs and EMAs) who has not been authorized by the employer/carrier. And section 440.13(2)(c), by its plain language, permits self-help (and thus authorization by operation of law) only “if the initial treatment or care is compensable and medically necessary.” Thus, the medical opinions of an unauthorized self-help...
...medical opinions—that the care rendered by the self-help doctor was compensable and medically necessary. See Miller Elec. Co. v. Oursler, 113 So. 3d 1004, 1009 (Fla. 1st DCA 2013) (explaining that “a claimant seeking . . . to introduce medical opinions ordinarily excluded by section 440.13(5)(e), can establish the factual circumstances of the care at issue with 'fact-purposes only' evidence from the provider of that care, but must also present medical opinions from another source ....
...The self-help doctor's opinion that the care was compensable and medically necessary cannot "bootstrap" 4 itself into evidence. See Oursler, 113 So. 3d at 1009 (“A claimant cannot use medical opinion evidence barred by section 440.13(5)(e) to ‘bootstrap’ itself—or other medical opinions from the same source—into evidence. To permit such bootstrapping would contravene the legislative intent of section 440.13(2)(c) ....
...3d 610 (Fla. 1st DCA 2009); Parodi, supra. Claimant is correct that, in each of those cases, the employer/carrier involved provided at least some authorized care for some condition, but Claimant is mistaken about the law. The requirements in section 440.13(2)(c) apply equally whether the care rendered by the self-help doctor is “initial” care (as contemplated by the plain language of the statute) or whether it is care obtained after an employer/carrier that initially accepted comp...
...However, we reject this argument because, as the E/C pointed out in its answer brief, there are a number of ways that an employee in Claimant’s situation could proceed. For example, the employee could designate the self-help doctor as his or her IME, thereby making the doctor’s opinion admissible under section 440.13(5)(e), or the employee could petition for an advance under section 440.20(12) to pay for another doctor who could be designated as an IME that could be used establish the compensability prerequisite for the admission of the self-help...
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McLeod v. Air Tech., 643 So. 2d 659 (Fla. Dist. Ct. App. 1994).

Published | District Court of Appeal of Florida | 1994 Fla. App. LEXIS 9564, 1994 WL 540645

...1st DCA 1980) (where CSE supports JCC’s finding that claimant did not sustain impairment causally related to industrial accident, it follows that claimant could not show that treatment was reasonable and necessary to excuse failure to obtain prior authorization); section 440.13(2), Fla.Stat....
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Kilyn Constr., Inc./ FRSA SIF v. Dedrick Pierce, 200 So. 3d 259 (Fla. 1st DCA 2016).

Published | Florida 1st District Court of Appeal | 2016 Fla. App. LEXIS 14759, 2016 WL 5747921

...bedroom apartment costing around $1,000 per month to a four-bedroom home costing more than three times that much was reasonable. Regardless of whether the Employer fell short in its obligations, the benefits sought—and more importantly, awarded—must be consistent with section 440.13, Florida Statutes (2012), and this court’s prior decisions. See Fitzgerald v. Osceola Cty. Sch. Bd., 974 So. 2d 1161, 1164 (Fla. 1st DCA 2008) (“Claimant bore the burden over the course of the proceedings below to prove her entitlement to workers’ compensation benefits.”). Section 440.13(2)(a) provides that the employer shall provide an injured worker with “medically necessary remedial treatment, care, and attendance ....
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C & N Serv. Corp. v. Garzia, 439 So. 2d 1016 (Fla. 1st DCA 1983).

Published | Florida 1st District Court of Appeal | 1983 Fla. App. LEXIS 23552

competent evidence and proper in law. See section 440.-13, Florida Statutes (1977), Di Giorgio Fruit
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Desir v. Nouveau Assocs., 969 So. 2d 1089 (Fla. 1st DCA 2007).

Published | Florida 1st District Court of Appeal | 2007 WL 3144833

...In this workers' compensation case, Lemil Desir, a catastrophically injured worker, sought an award of certain living expenses. The Judge of Compensation Claims (JCC) found that the expenses sought, water and utility bills, were not medically necessary under section 440.13, Florida Statutes, and denied the benefit....
...ve of whether claimant's need for water and sewer has become a medically necessary benefit. As a result, the JCC attributed all of claimant's pre-injury payment of $700 to rent; found that water, sewer, and garbage were not medically necessary under section 440.13; and denied claimant's request for payment of these utilities....
...wed as uniquely attributable to the accident. Moreover, at the hearing below, Desir's counsel noted in closing argument that the medical necessity of utility service was not the issue before the JCC. The E/C take the position that each benefit under section 440.13 must be viewed individually and determined medically necessary....
...payment, which he is now willing to replicate, included the disputed utilities. In the context of this case, the JCC erred by focusing solely on medical necessity, although that principle is more often than not controlling under the express terms of section 440.13....
...cal benefit as well would provide for a duplicative award." 576 So.2d at 838 n. 2. Here, Desir does not enjoy a windfall. Conversely, though, were he to bear the water utility expense, shown by the evidence as $161 a month, his medical benefit under section 440.13 would actually be diminished by that amount....
...ent, the majority opinion's reference to "a medically necessary device, the new residence," ante p. 1092, does not adequately describe the situation or assist the analysis. In reversing the judge of compensation claims, the majority opinion invokes "section 440.13," [1] ante p....
...1091, entitled "Medical *1094 services and supplies; penalty for violations; limitations," while ruling that "the JCC erred by focusing solely on medical necessity." Ante p. 1091. But the "focus" on medical necessity comes straight from the statute. See §§ 440.13(1)(m) (defining "[m]edically necessary" as "used to . . . treat an illness or injury, . . . appropriate to the patient's diagnosis and status of recovery, and . . . consistent with the location of service, the level of care provided, and applicable practice parameters") and 440.13(2)(a), Fla....
...ied the claim for $161.00 a month, stating: It is a well settled principle, as supported by the caselaw provided by both sides, that the Judge of Compensation Claims can only award medically necessary benefits. "Medical necessity" is defined under F.S. 440.13(1)(m) as any medical service used to identify or treat an illness or injury....
...The judge of compensation claims also ruled (and the claimant stipulated) that the "[c]laimant shall pay the sum of $700.00 per month for rent toward the modified housing provided by the Employer/Carrier beginning immediately." Perceiving no error in these rulings, I dissent from the decision to overturn them. NOTES [1] Section 440.13, Florida Statutes (2002), begins with a series of definitions and provides in pertinent part: (2) MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.—(a) Subject to the limitations specified elsewhere in this chapter, the employer shall f...
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Newport Trucking v. Gonzalez, 497 So. 2d 690 (Fla. Dist. Ct. App. 1986).

Published | District Court of Appeal of Florida | 11 Fla. L. Weekly 2302, 1986 Fla. App. LEXIS 10379

...The record contains evidence that Gonzalez con *692 ducted an adequate good faith work search during this period. Issue five presents a more difficult question, namely: Is there competent substantial evidence in the record to support the deputy commissioner’s excusal of the ten-day filing requirement contained in Section 440.13, Florida Statutes (1983)....
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Harman v. Gadsden Corr. Facility, 46 So. 3d 1140 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 16536, 2010 WL 4273382

...ier refused to provide an evaluation on the ground that there were no objective relevant medical findings under section 440.09(1), and the judge erroneously accepted this position. The error is the same in both cases. The judge should have relied on section 440.13(2)(a), Florida Statutes (2007), and its test of whether the requested benefit is medically necessary, and not section 440.09(1), and its test of whether objective relevant medical findings exist to support an award....
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Pan Am. Hosp. v. Fleitas, 645 So. 2d 1033 (Fla. 2d DCA 1994).

Published | Florida 2nd District Court of Appeal | 1994 Fla. App. LEXIS 10465

and timely submitted as required by statute. See § 440.13(2)(d), Fla.Stat. (1991). Since these bills were
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Paradise Inn v. Hegedus, 389 So. 2d 342 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 17863

Hernandez, IRC Order 2-3071 (November 22,1976). Section 440.13(1), Florida Statutes (1975), requires the employer
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Tyson v. Palm Beach Cnty. Sch. Bd., 913 So. 2d 105 (Fla. 1st DCA 2005).

Published | Florida 1st District Court of Appeal | 2005 WL 2756026

...needs from seventeen hours per week to twenty-four hours per day. The accident itself caused most of the increased need, but part of the increased need is because of new obstacles to treatment of her compensable, work-related injuries. We have held: Section 440.13(2)(a), Florida Statutes, directs the employer of a claimant who sustains an industrial injury to furnish such medical attendance as the nature of the injury or the process of recovery requires.... [M]edical care is properly awarded pursuant to section 440.13(2)(a) when the need for such care arises from the combined effect of industrial and nonindustrial conditions....
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Westinghouse Elec. Corp. v. Dale, 439 So. 2d 989 (Fla. Dist. Ct. App. 1983).

Published | District Court of Appeal of Florida | 1983 Fla. App. LEXIS 22738

...mployer is responsible for the benefits awarded in the prior order, costs, and attorney’s fees.” He otherwise denied Dale’s claim, finding the heart attack not causally related to the industrial accident. The applicable statute of limitations, section 440.13(3)(b), Florida Statutes (1975), which is substantially the same as section 440.19(2)(b), Florida Statutes (1981), provides in pertinent part: [A]ll rights for remedial attention under this section pursuant to the terms of an award shal...
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Manuel v. Amstaff, 915 So. 2d 679 (Fla. 1st DCA 2005).

Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 16843, 2005 WL 2736566

...r and convincing. Burns v. Hilton Enterprises, 853 So.2d 1107, 1108 (Fla. 1st DCA 2003). Contradiction between the EMA and one of the disagreeing physicians is not, by itself, a reasonable basis for the JCC to reject the EMA’s opinion since, under section 440.13(9), Florida Statutes (2001), the EMA is appointed with the expectation that the EMA’s testimony will contradict the record testimony of one of the health care providers....
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Pic N' Save v. Singleton, 551 So. 2d 1244 (Fla. Dist. Ct. App. 1989).

Published | District Court of Appeal of Florida | 14 Fla. L. Weekly 2510, 1989 Fla. App. LEXIS 6028, 1989 WL 128067

...Further argument was presented, and an order was then entered denying employer/carrier’s motion. 1 An employer/carrier’s access to medical information is a crucial aspect of the self-executing workers’ compensation law, see Walt Disney World v. Schiebel, 414 So.2d 602 (Fla. 1st DCA 1982), and section 440.13(2)(b), Florida Statutes, specifies that the employer/carrier shall be provided with medical reports as to treatment for which a claim has been made....
...Chapter 440, as effective in the proceeding below, neither provided for any such waiver nor created any right of direct oral communication, and section 455.241, Florida Statutes (1988 Supp.), is not limited in application by any statutory language addressed to workers’ compensation claims. While section 440.13(2)(c), Florida Statutes (1989), has been amended so as to provide for such communication notwithstanding the limitations in section 455.241, this enactment was not yet effective when the present dispute arose, and does not govern the disposition of this appeal....
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Delgado v. J.C. Concrete, 721 So. 2d 353 (Fla. 1st DCA 1998).

Published | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 13508, 1998 WL 736307

...e duties of his [or her] office.” § 440.33(1), Fla. Stat. (1993). In disallowing recovery for attorney’s fees by an injured employee opposing an independent medical examination “including, but not limited to, motions for protective orders,” section 440.13(5)(f), Florida Statutes (Supp.1994), implies jurisdiction in the judge of compensation claims to grant protective orders and, conversely, motions to compel independent medical examinations to which employers or their insurance carriers are entitled....
...As we observed in Karell, 668 So.2d at 229-230 , in discussing the same statutory provisions at issue here: The present statute clearly states that an IME [independent medical examination] may be scheduled “in any dispute” concerning overutilization, medical benefits, compensability, or disability. Section 440.13(5)(a). It is also abundantly clear that section 440.13(5)(d) provides remedies for the employee’s failure to appear for a properly scheduled and noticed IME by providing, among other things, that if the employee fails to appear “without good cause” and “fails to advise the physicia...
...ew and, secondly, it involved a Motion to Compel an IME during the informal dispute resolution process. The instant case involves a dispute between [CNA] and the [health care] provider which is not subject to the informal dispute resolution process. Section 440.13(6), Florida Statutes (Supp. 1994), dealing with utilization review, specifically provides: “Carriers ... may conduct independent medical ... evaluations.” Section 440.13(7), Florida Statutes (Supp.1994), confers jurisdiction not on the judge of compensation claims, but on the Division of Workers’ Compensation of the....
...A utilization dispute will never give rise, therefore, to the “filing of a petition for benefits.” Karell, 668 So.2d at 230 . But, as our decision in Compcare indicates, the judge of compensation claims does have a role to play when a party to a utilization dispute resorts to the sanctions authorized by section 440.13(5)(d), Florida Statutes (Supp.1994). As we pointed out in Kwrell, “the employee is given the right to ‘appeal’ to the JCC in the event the E/C [employer/carrier] [demands reimbursement of “50 percent of the physician cancellation or no-show fee,” § 440.13(5)(d), Fla. Stat. (Supp.1994) or] withholds payments in excess of the authority granted by this section. Section 440.13(13)(5)(d).” Id., 668 So.2d at 230 . Similarly, if “the employee fails to appear for the independent medical examination without good .cause,” § 440.13(5)(d), Fla. Stat. (Supp. 1994), the judge of compensation claims has jurisdiction to enforce the rights of “the employer and its carrier ... to the independent medical examination they seek[] under section 440.13(5)(a), Florida Statutes (Supp....
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Montero v. Dept. of Transp., 570 So. 2d 1015 (Fla. 1st DCA 1990).

Published | Florida 1st District Court of Appeal | 1990 Fla. App. LEXIS 8077, 1990 WL 157752

...If an injured employee objects to the medical attendance furnished by the employer, it is the employer’s duty to select another physician to treat the employee unless a judge of compensation claims determines that a change in medical attendance is not in the employee’s best interest. § 440.13(3), Pla.Stat....
...However, although the judge herein granted the motion, he made no finding that treatment with Raven-Sti-gler would be in Montero’s best interest. This was erroneous as a matter of law, in that it is unlawful for any employer to coerce a sick or injured employee in the selection of a physician. § 440.13(3), Fla....
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Ago (Fla. Att'y Gen. 1990).

Published | Florida Attorney General Reports

...l or special law . . . ." 10 However, as The Florida Supreme Court has stated, the law exempts only those public records which are provided by statutory law to be confidential or which are expressly exempted by general or special law. 11 Pursuant to s. 440.13 , F.S., of the Workers' Compensation Law, certain medical records are confidential. Section 440.13 (2)(e), F.S., as amended by s....
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Esad Babahmetovic v. Scan Design Florida Inc/ Zenith Ins. Co., 176 So. 3d 1006 (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal

...ts place. We deny the motion for rehearing en banc. In this workers’ compensation case, Claimant appeals an order of the Judge of Compensation Claims (JCC) denying him a one-time change in authorized treating physician, as permitted by section 440.13(2)(f), Florida Statutes (2013)....
...e medical evidence’ that an injury arose out of employment,” which was not challenged on appeal. 79 So. 3d at 946. For the foregoing reasons, we reverse the order on appeal and remand to the JCC for the award of a one-time change under section 440.13(2)(f). REVERSED and REMANDED with instructions. WOLF and RAY, JJ., CONCUR; BENTON, J., CONCURS WITH OPINION. 7 BENTON, J., concurring in the judgment. “When an E/C become...
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Florida Mining & Materials v. Calderon, 625 So. 2d 951 (Fla. 1st DCA 1993).

Published | Florida 1st District Court of Appeal | 1993 Fla. App. LEXIS 10658, 1993 WL 417561

...It is undisputed that claimant requested chiropractic treatment; and that the employer refused to authorize such treatment. Under such circumstances, if the treatment is later found to have been reasonable and necessary, the employer will be responsible for its cost. § 440.13(2)(d), Fla.Stat....
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Rolle v. City of Riviera Beach/Gallagher Bassett Serv., 826 So. 2d 1075 (Fla. 1st DCA 2002).

Published | Florida 1st District Court of Appeal | 2002 Fla. App. LEXIS 14237, 2002 WL 31174388

...oom 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....
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Coca-Cola Co.—Foods Div. v. Long, 420 So. 2d 900 (Fla. 5th DCA 1982).

Published | Florida 5th District Court of Appeal | 1982 Fla. App. LEXIS 21432

barred because claimant did not comply with Section 440.13(1), Florida Statutes (1973), is without merit
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Sonny Glassbrenner, Inc. v. Dowling, 913 So. 2d 82 (Fla. 1st DCA 2005).

Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 16460, 2005 WL 2649222

...for a disabled parking permit, given that claimant did not request that the E/C furnish him with the permit before he purchased it and given that neither the nature of claimant’s injury nor the medical reports reflected a need for the permit. See § 440.13(2)(c), Fla....
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Cowins v. Landmark Learning Ctr., 885 So. 2d 421 (Fla. 1st DCA 2004).

Published | Florida 1st District Court of Appeal | 2004 Fla. App. LEXIS 15329, 2004 WL 2330803

...Burak, a chiropractor with whom she had been treating for a number of years. The employer/carrier (E/C) objected, arguing that, because Dr. Burak was not a medical advisor appointed by the Judge of Compensation Claims, an independent medical examiner, nor an authorized treating physician, section 440.13(5)(e), Florida Statutes (Supp.1994) barred the admission of his testimony. The E/C further argued this statutory provision was procedural, and could be applied to the Claimant’s date of accident. The JCC accepted both arguments and excluded this testimony. In so doing, the JCC erred. Section 440.13(5)(e), Florida Statutes (Supp.1994), is substantive in nature and cannot be applied retroactively....
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Ernesto Blanco v. Creative Mgmt. Servs., LLC/ Tech. Ins. Co. (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...of exposure injuries like Blanco’s alleged injury. But despite Dr. McCluskey’s medical training and expertise, Blanco argues that Dr. McCluskey could not serve as an expert because he is not “board certified” in internal medicine or pulmonology. Yet section 440.13(5)(a), which provides for the selection of an IME, does not limit that selection to a board-certified physician. Still, Blanco argues that Dr....
...* Blanco did not present any argument or evidence to show that Dr. McCluskey rendered an opinion “outside his . . . area of expertise, as demonstrated by licensure and applicable practice parameters” as prohibited under the specific IME provision in Chapter 440. See § 440.13(5)(a), Fla....
...the specific intent to defend against Blanco’s claims. We disagree. The holding in McElroy does not apply in workers’ compensation cases for at least three reasons. First, Chapter 440 specifically provides for the selection of IME doctors to resolve disputes. See § 440.13(5)(a), Fla. Stat. (2017). Second, the admissibility of medical opinions in workers’ compensation disputes is limited to certain providers, which includes IME doctors. See § 440.13(5)(e), Fla....
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City of Inverness v. Volmar, 768 So. 2d 1253 (Fla. 1st DCA 2000).

Published | Florida 1st District Court of Appeal | 2000 Fla. App. LEXIS 13465, 2000 WL 1527909

PER CURIAM. The City of Inverness and the Florida League of Cities appeal an order of the judge of compensation claims contending the judge should have granted their motion for the appointment of an expert medical advisor. See § 440.13(9)(c), Fla....
...material element, we reverse. See Claims Management, Inc. v. Lake, 717 So.2d 140, 141 (Fla. 1st DCA 1998) (“The judge of compensation claims erred in refusing to grant the E/C’s motion to appoint an EMA, notwithstanding the mandatory language of section 440.13(9)(c), Florida Statutes (1995).”); Palm Springs Gen....
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Tropicana Prods., Inc. v. Gunther, 643 So. 2d 698 (Fla. Dist. Ct. App. 1994).

Published | District Court of Appeal of Florida | 1994 Fla. App. LEXIS 9951, 1994 WL 561863

...“Absent findings of fact as to whether or not the JCC found the treatment was on an emergency basis, we must reverse the award of outstanding medical bills and remand for a determination of whether facts exist that would require payment by the E/C under section 440.13(2), Florida Statutes.” Id....
...1st DCA 1992), this court reversed an award of future medical treatment and remanded for the JCC to take further evidence where the JCC authorized prospective treatment without making findings and without evidence as to the type of treatment required or the medical necessity of such treatment as required by section 440.13(2), Florida Statutes....
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Oolite Concrete Co. v. Carver, 145 So. 2d 733 (Fla. 1962).

Published | Supreme Court of Florida

...Burtner, the physician of his own choice, which finding is supported by competent substantial evidence. But the deputy also ruled that Dr. Burtner “is hereby excused from filing the required reports” and it is with that ruling that we are concerned. *735 Under the provisions of Section 440.13(1), F.S.A., an employee who is found to be justified in receiving treatment from a physician of his own choosing rather than one furnished by the employer, is not entitled to payment of, or reimbursement for, the cost of medical treatm...
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Patty Davis v. Sheridan Healthcare, Inc. & Sheridan Radiology Servs. of Pinellas, Inc. (Fla. 2d DCA 2019).

Published | Florida 2nd District Court of Appeal

...After a period of complex litigation in both lawsuits, Sheridan and Labcorp moved for judgments on the pleadings. They argued that Davis's FCCPA claims depend on her showing an illegitimate debt, and the law determining the legitimacy of that debt is the WCL. Section 440.13(11)(c) grants exclusive jurisdiction to the Department of Financial Services over "any matters concerning reimbursement." Since Davis's FCCPA claims are actually matters concerning reimbursement of Sheridan and Labcorp, her workers'...
...to resolve any overutilization dispute under subsection (7), and to decide any question concerning overutilization under subsection (8), which question or dispute arises after -4- January 1, 1994." § 440.13(11)(c) (emphasis added)....
...responsible for providing Davis's medical services. Sheridan and Labcorp provided those medical services on behalf of Commercial Risk Management. It follows that the only party who can reimburse Sheridan and Labcorp is Commercial Risk Management. Indeed, section 440.13(13)(a) provides that "[a] health care provider may not collect or receive a fee from an injured employee within this state, except as otherwise provided by this chapter." Thus, claims that Sheridan and Labcorp have engaged in unlawful practices to "collect" consumer debts from Davis under the FCCPA are not "matters concerning reimbursement" committed to the exclusive jurisdiction of the Department of Financial Services under section 440.13(11)(c). Rather, "reimbursement" under section 440.13(11)(c) in this context involves Commercial Risk Management making Sheridan -6- and LabCorp whole for services they rendered to Davis....
...to be due for those services. Different parties as well as different kinds of activity are involved. The dissent appears to conflate "reimbursement" and "collection" to conclude that the phrase "matters concerning reimbursement" in section 440.13(11)(c) unambiguously embraces collecting a consumer debt when that debt is a charge covered by the WCL....
...Because reimbursement and collection consist of demonstrably different conduct, we find it difficult to conclude that debt collection is a matter "concerning" reimbursement in this context. At most, the dissent's view of the term "concerning" introduces an ambiguity into our analysis of section 440.13(11)(c), a choice between two reasonable but competing interpretations....
...reimbursing a health care provider while the other reaches conduct only indirectly or tangentially related to reimbursement, such as the activity of collection.1 Any ambiguity is easily resolved in favor of the former interpretation. 1The dissent points out that section 440.13(1)(q) defines a "reimbursement dispute" as "any disagreement between a health care provider and carrier concerning -7- It is "presumed that statutes are passed with the know...
...2d DCA 1986)); see also McKendry v. State, 641 So. 2d 45, 46 (Fla. 1994) ("[A] specific statute covering a particular subject area always controls over a statute covering the same and other subjects in more general terms."). Applying this rule, section 440.13(11)(c)'s language eliminating circuit court jurisdiction over "any matters concerning reimbursement" is very general and broad....
...These collection practices are a small subset of issues that might "concern reimbursement." Because section 559.77(1) thus creates a private cause of action in very specific circumstances, it would constitute an exception to the more general jurisdictional restrictions of section 440.13(11)(c)....
...ore to do with illegal harassment by creditors and a bill collector than quick and efficient resolution of an unpaid workers' compensation bill. Her dispute centers on practices that the FCCPA was specifically designed to address. It follows that section 440.13(11)(c) is not meant to interfere with the FCCPA. To hold otherwise would transform section 440.13 from a sword that enforces compliance with the WCL into a shield for medical providers, insulating them from ordinary civil liability for abusive collection practices....
...diction over Davis's FCCPA claims. Rather, Sanders discusses the historical trend of Florida courts - 11 - interpreting the WCL to exclude circuit court jurisdiction in contexts that do not involve 440.13(11)(c)....
...rkers and employers or carriers. Id. Similarly, rules 69L-34.001 and .003 lay out violations of the WCL and channels for reporting violations. While it is indeed a WCL violation for a health care provider to improperly bill an injured worker, see § 440.13(13)(a), and such a worker can submit collection letters to report such a violation, it does not follow that improper collection is a matter concerning reimbursement....
...We are perplexed and disappointed by the dissent's implication that, by resolving an apparent conflict between the WCL and the FCCPA, we are deciding an issue that has not been raised in order to reach a desired result. Properly interpreting section 440.13(11)(c) is at the heart of Davis's appeal....
...Matter Jurisdiction to Adjudicate Ms. Davis's FCCPA Claims," contains a subsection titled "The Workers' Compensation Provisions regarding 'Reimbursement Disputes' are completely inapposite to Ms. Davis's Claims." And within that subheading, Davis explicitly argues that section 440.13(11)(c) does not deprive the circuit court of jurisdiction over her FCCPA claims....
...The court found the question preserved nonetheless because the court of appeals had reached other questions (the ones the parties had raised) involving the statute. Id. at 881. We do not need to go that far in this case because, unlike in D.H. the parties have presented the question of whether section 440.13(11)(c) precludes Ms. Davis from bringing her FCCPA claims. The resolution of that question requires that we determine whether her claims constitute "any matters concerning reimbursement" under section 440.13(11)(c), which, in turn, requires that we give meaning to that statutory phrase....
...uiring us to do so would undermine this court's purpose of correctly resolving the issues brought before us. 4Itis worth noting that the arguments made before the trial courts included a host of issues in addition to interpreting section 440.13(11)(c), and the trial judges' dismissals based on jurisdiction did not precisely delineate their rationale. Section 440.13(11)(c) came to the forefront as the parties developed their arguments in this court. - 14 - Accordingly, we reverse the dismissals and hold that section 440.13(11)(c) does not preclude circuit court jurisdiction over Davis's FCCPA claims against her WCL medical providers. Additionally, we certify to the Florida Supreme Court the following question of great public importance pursuant to Florida Rule of Appellate Procedure 9.030(a)(2)(A)(v): DOES SECTION 440.13(11)(c) OF THE WORKERS' COMPENSATION LAW PRECLUDE CIRCUIT COURT JURISDICTION OVER CLAIMS UNDER SECTION 559.77(1) OF THE FLORIDA CONSUMER COLLECTION PRACTICES ACT? Re...
...from Ms. Davis for providing treatment to her. It is also undisputed that Commercial Risk Management authorized the treatment and that Sheridan and Labcorp violated the WCL by seeking reimbursement for their services directly from Ms. Davis. See § 440.13(13)(a)....
...y of payments" rather than "economic or administrative burden[s]." § 440.015. And the legislature specified that the Department of Financial Affairs (Department) shall have "exclusive jurisdiction to decide any matters concerning reimbursement." § 440.13(11)(c) (emphasis added). Clearly and unequivocally, any matters that concern chapter 440 reimbursement fall within the exclusive jurisdiction of the Department....
...between a health care provider and a carrier and not a dispute between a health care provider and an injured worker - 19 - the exclusive jurisdiction of the Department is not invoked in this case.6 See § 440.13(1)(q). But the phrase "any matters concerning reimbursement" in section 440.13(11)(c) plainly encompasses more than "reimbursement dispute[s]" as that term is defined in section 440.13(1)(q)....
...Dep't of Health, 129 So. 3d 1083, 1085 (Fla. 1st DCA 2013) (first alteration in original) (quoting Hammond v. State, 34 So. 3d 58, 59 (Fla. 4th DCA 2010)). 7The majority concedes that "matters concerning reimbursement" as contemplated by section 440.13(11)(c) are not limited only to "reimbursement disputes" as contemplated by section 440.13(1)(q)....
...debt collection practices. Of course this court can only address Ms. Davis's claims and not every potential FCCPA claim. In that respect, this court is not in a position to determine that any and every claim under section 559.77(1) of the FCCPA is precluded by section 440.13(11) of the WCL; nor could the circuit courts so determine. Rather, this court can determine only whether Ms. Davis's claims—as claims related to reimbursement, a fact she does not dispute—are precluded by section 440.13(11).8 Section 440.13(11) clearly supersedes the FCCPA for claims related to reimbursement, precluding Ms....
...1st DCA 1980). The majority's conclusion otherwise frustrates the stated intent of the WCL, creating a burden on society through unnecessary litigation. See Sam Rogers Enters. v. Williams, 401 So. 2d 1388, 1390-91 (Fla. 1st DCA 1981). Because section 440.13(11)(c) plainly and unambiguously grants exclusive jurisdiction to the Department with regard to any matters concerning reimbursement in the workers' compensation context and Ms....
...(alteration in original) (quoting M.W. v. Davis, 756 So. 2d 90, 101 (Fla. 2000)). To the extent that such consideration is necessary in this case, it is apparent that giving effect to the related statutory provisions of the WCL further supports affirmance. Section 440.13(13)(a) states that "[a] health care provider may not collect or receive a fee from an injured employee within this state, except as otherwise provided by this chapter." See also § 440.13(3)(g) ("The employee is not liable for payment for medical treatment or services provided pursuant to this section except as otherwise provided in this section."). Section 440.13(11)(a) provides that "[t]he department may investigate health care providers to determine whether providers are complying with this chapter and with rules adopted by the department" and to determine "whether providers are engaging i...
...the Department determines that a health care provider has engaged in improper billing practices or has otherwise failed to comply with chapter 440 and the rules of the Department, the health care provider may have to forfeit payment from the carrier or face penalties as set forth in section 440.13(8).9 § 440.13(11)(a). As referenced in section 440.13(11)(a), through the authority to administer the WCL, administrative rules have been promogulated....
...related injuries under his or her workers' compensation benefits. Cf. Plantation Gen. Hosp. Ltd. P'ship v. Horowitz, 895 So. 2d 484, 487 (Fla. 4th DCA 2005). And "[a]bsent an indication of legislative intent to create a private cause of action for a violation of [section 440.13], such a remedy may not be judicially engrafted onto the FCCPA." See Ramos v....
...3d 1149, 1152 (Fla. 5th DCA 2015) (quoting Thomas v. Commercial Recovery Sys., Inc., No. 8:07-cv-1104-T-23MAP, 2008 WL 5246296, at *4 (M.D. Fla. Dec. 16, 2008)). "Had the Florida legislature intended to enact a private right of action for violating [section 440.13], it could have done so, either by explicitly including language authorizing a private right of action in the statute, or by referencing [chapter 440] in [section] 559.72." See id....
...Davis's claims but that the distinction between reimbursement and collection is relevant only when the person seeking to collect is not also the person entitled to reimbursement. The majority also fails to recognize that the "debt" sought to be collected or reimbursed is the same medical payment. See, e.g., § 440.13(1)(q) (stating that reimbursement disputes concern "payment for medical treatment"); Fla....
...the provisions in the WCL usurp the circuit court's jurisdiction over her claims. As to the latter part of the argument, Ms. Davis asserts that Sheridan and Labcorp's contention that the Department has exclusive jurisdiction over her claims pursuant to section 440.13(11)(c) "is belied by the plain language of Section 440.13(1)(q)," which defines "reimbursement dispute" as "between a medical provider and a carrier." The majority contends that the proper interpretation of section 440.13(11)(c) "is at the heart of [Ms.] Davis's appeal," and yet Ms. Davis devoted a mere four sentences to section 440.13(11)(c) in her initial brief....
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Brandywine Convalescent v. Ragoobir, 124 So. 3d 344 (Fla. 1st DCA 2013).

Published | Florida 1st District Court of Appeal | 2013 WL 5629761, 2013 Fla. App. LEXIS 16492, 38 Fla. L. Weekly Fed. D 2183

...l advisor’s (EMA’s) opinion a presumption of correctness and awarded Claimant permanent total disability (PTD) benefits. Because the JCC was not free, on this record, to reject the EMA’s opinion, we reverse. The JCC here appointed an EMA under section 440.13(9), Florida Statutes (2008), to resolve a conflict in medical opinions regarding Claimant’s work restrictions from the industrial injury....
...examination changed his opinions expressed in the report. No re-direct was conducted. Under the statute, the opinion of an EMA is presumed to be correct “unless there is clear and convincing evidence to the contrary as determined by the [JCC].” § 440.13(9)(c), Fla....
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Citrus World, Inc. v. Mullins, 704 So. 2d 128 (Fla. 1st DCA 1997).

Published | Florida 1st District Court of Appeal | 1997 Fla. App. LEXIS 11573, 1997 WL 634088

...R CURIAM. We affirm all issues raised in this workers’ compensation appeal. In regard to appellant’s point that the judge of compensation claims erred in allowing into evidence the deposition testimony of unauthorized physicians, in violation of section 440.13(5)(e), Florida Statutes (Supp.1994), we note that the parties’ stipulation agreed that “all depositions properly noticed and filed of witnesses, either expert or non-expert, will be stipulated into evidence.” No contention is made that the depositions in question were not properly noticed and filed....
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J.C. Penney Co. v. Levine, 420 So. 2d 416 (Fla. 3d DCA 1982).

Published | Florida 3rd District Court of Appeal | 1982 Fla. App. LEXIS 21374

Summerset, 409 So.2d 185 (Fla. 1st DCA 1982); Section 440.13(1), F.S. However, where it is clear from the
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Amendments to the Florida Rules of Workers' Comp. Procedure, 795 So. 2d 863 (Fla. 2000).

Published | Supreme Court of Florida | 25 Fla. L. Weekly Supp. 866, 2000 Fla. LEXIS 2275, 2000 WL 1508551

...hedule the final hearing; and (7) consider and determine, as appropriate, such other matters as may aid in the disposition of the case, including, but not limited to, referral to additional mediation or appointment of an expert medical advisor under section 440.13(9)(c), Florida Statutes....
...advances under sections 440.20(12)(c)2 and 440.20(12)(d), Florida Statutes, appeals of administrative fines or penalties under section 440.106, Florida Statutes, motions for appointment of guardians, motions to appoint expert medical advisors under section 440.13, Florida Statutes, requests for imposition of sanctions under these rules, motions to disqualify a judge or a mediator, motions to recuse counsel, motions to correct the appellate record, and motions to appoint independent medical examiners under section 440.13, Florida Statutes, shall be filed and handled in the manner as provided for a claim in rule 4.025, except the motion shall be filed with the presiding judge in cases where a petition is pending....
...These benefits are in default and are presently -ripe, due, and owing. = (F) Death-benefits payable under-.section 440.16, Florida Statutes. = (6) Correction of AWW and resulting-compensation-rate.-Basis: = (H) Medical-expenses -incurred for treatment of the employee’s-i-nj-u-ry-as-provided under section 440.13(2), Florida Statutes....
...These benefits are in default and are presently ripe,--duer-and-owing-7 = ££) Death benefits payable under section-440.16, Florida-Statutes. — ¿G) Correction of- -AWW— and-resulting compensation rate. Basis: - ^=(H) Medical-expenses incurred for treatment of the employee^ injury as provided under section-440.13(2), Florida Statutes....
...nd continuing at a rate of $_per week. _Death benefits payable under Section 440.16, Florida Statutes. _ Correction of AWW and resulting Compensation Rate due to _ _Medical Expenses incurred for treatment of the employee’s injury as provided under Section 440.13(2), Florida Statutes....
...date:_ E/C/SA: date:_ date:_:_ date:_ 13. Maximum medical improvement, if reached, giving date, name of physician, and impairment rating: EmployeeClaimant: date:_ doctor:_ rating:_____ E/C/SA: date:._, doctor:_ rating:__ 14. If medical benefits under section 440.13, Florida Statutes, are determined to be due or stipulated due heremin this document, the parties agree that the exact amounts payable to health care providers will be handled administratively and medical bills need not be placed into evidence at trial....
...Sections 440.20(ll)(b) and (c), Florida Statutes (1994), in which Right to Compensation Benefits Has Been Settled Previously. ' [For caption and style of pleadings, see form 4.901] ORDER FOR RELEASE FROM LIABILITY FOR MEDICAL BENEFITS PAYABLE UNDER SECTION 440.13, FLORIDA STATUTES, AS AUTHORIZED BY SECTIONS 440.20(ll)(b) and (c), FLORIDA STATUTES (1994) The parties jointly petition for an order approving a stipulation for settlement under sections 440.20(ll)(b) and (c), Florida Statutes (1994),...
...thereof. B. On payment of the additional consideration set forth in the joint petition and supporting stipulation for settlement, the liability of the employer and its carrier (servicing agent) for the payment or provision of medical benefits under section 440.13, Florida Statutes, because of the industrial accident and injury referenee-dred to in this order herein is hereby fully and forever discharged and released....
...duced to the undersigned attorney on or before the scheduled date of production. You may require from the attorney whose name appears on this subpoena advance payment of the reasonable cost of the preparation of the copies and items furnished. Under section 440.13(4)(b), Florida Statutes (1994), the Division of Workers’ Compensation sets standard copy costs for medical records of an injured employee....
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Liotta v. Publix Supermarket, 718 So. 2d 935 (Fla. Dist. Ct. App. 1998).

Published | District Court of Appeal of Florida | 1998 Fla. App. LEXIS 12789, 1998 WL 704152

an expert medical advisor in accordance with section 440.13(9)(c), Florida Statutes (1997), because of
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Live Oak Manor v. Miller, 625 So. 2d 898 (Fla. Dist. Ct. App. 1993).

Published | District Court of Appeal of Florida | 1993 Fla. App. LEXIS 10337, 1993 WL 405170

...age weekly wage. The award of permanent total disability benefits is based upon competent substantial evidence and we will not disturb the ruling of the JCC. The authorization and payment of medical treatment is similarly supported by the record and section 440.13, Florida Statutes....
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Crown Hotel v. Friedman, 438 So. 2d 993 (Fla. 1st DCA 1983).

Published | Florida 1st District Court of Appeal | 1983 Fla. App. LEXIS 22499

...iled timely under section 440.20(6). Therefore, the penalties attaching to the temporary total disability benefits are affirmed. In their final point, employer/carrier challenge the deputy’s excusal of the nonfil-ing of medical reports required by section 440.13(1), Florida Statutes....
...The only two reasons cited by the deputy in the instant case to establish good cause for the refusal to file medical bills — that employer/carrier contested the claim and has not provided any *995 medical services — have been specifically held by this Court to be insufficient grounds alone for excusal of the section 440.13(1) requirement....
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City of Plantation v. Seaman, 590 So. 2d 1 (Fla. Dist. Ct. App. 1991).

Published | District Court of Appeal of Florida | 1991 Fla. App. LEXIS 10014, 1991 WL 204615

...The contested language is surplusage and awards no benefits. The employer and carrier correctly contend, however, that reversal is necessary with regard to payment of Dr. Wallace’s bills. The employer and carrier raised the defense of failure to comply with the billing and reporting requirements of section 440.13, Florida Statutes (1988), in the pre-trial stipulation and at the hearing. The judge did not include failure to comply with section 440.13 among the defenses listed in the order and did not specifically address this matter....
...This *2 finding appears to be directed to the contention that the physicians were unauthorized, a defense raised by the employer and carrier which was noted by the judge in his order. It is unclear if the judge rejected the defense of failure to comply with the reporting requirements of section 440.13, Florida Statutes....
...Rowlett, 565 So.2d 404 (Fla. 1st DCA 1990); McMeans v. F.E. Booker Co., 507 So.2d 135 (Fla. 1st DCA 1987). The order appealed is REVERSED as to the payment of Dr. Wallace's medical bills. On remand the judge should address the pending issue of compliance with section 440.13, Florida Statutes (1988)....
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Dementry v. Danis Shook Constr. Co., 587 So. 2d 611 (Fla. 1st DCA 1991).

Published | Florida 1st District Court of Appeal | 1991 Fla. App. LEXIS 10011, 1991 WL 204619

...inimum wage. The determination concerning the amount of attendant-care is supported by competent substantial evidence and may be affirmed without further comment. We find, however, that the award of benefits at the federal minimum wage was in error. Section 440.13(2)(g), Florida Statutes, states: The value of professional attendant or custodial care provided by family members shall be determined as follows: 1....
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Phillips v. Triangle Constr. Co., 145 So. 2d 479 (Fla. 1962).

Published | Supreme Court of Florida

...Additional medical treatment was sought by petitioner on or before December 20, 1960, when petitioner secured treatment for reactivation of the original injury. The respondent refused to pay the medical costs incurred by the petitioner in the latter part of 1960 on the ground the statute of limitations, § 440.13, Florida Statutes, F.S.A., barred such claim....
...modification as a petition for compensation and medical to which petitioner may be entitled, he ordered the respondents to reimburse claimant for drug bills, medical travel expenses and doctors’ bills. As stated by the deputy, “It is clear under Section 440.13(1), Florida Statutes, and the prior order that the carrier had a legal responsibility to furnish or pay any medical treatment which the claimant incurred .as a result of his original injury.” On review of the order of the deputy comm...
...of the last remedial treatment furnished by the employer or the last payment of compensation.” With respect to the question of remedial medical treatment, we are convinced the full commission’s decision is based upon an erroneous application of § 440.13, Florida Statutes, and that the deputy’s order represents a correct disposition of this aspect of the petitioner’s claim....
...nt “has incurred or may incur” as the result of his injury, is supported by our recent decisions in Fort v. Hood’s Dairy, Inc., Fla.1962, 143 So.2d 13 , and Platzer v. Burger, Fla.1962, 144 So.2d 507 . In said decisions we carefully considered § 440.13(3) (b), Florida Statutes, F.S.A., and concluded that it is within the deputy’s power to enter an order requiring the employer to “ * * * furnish to the employee such remedial treatment, care, and attendance under the direction and su *481 pervision of a qualified, physician or surgeon, or other recognized practitioner, nurse or hospital, and for such a period, as the nature of the injury or the process of recovery rnay require * * [F.S. § 440.13(1), F.S.A.] Although the deputy’s order of September 12, 1958, did not track the language of § 440.13, Florida Statutes, F.S.A., with precision, we think it was a substantial compliance with said statute....
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Avery v. City of Coral Gables, 100 So. 3d 749 (Fla. 1st DCA 2012).

Published | Florida 1st District Court of Appeal | 2012 Fla. App. LEXIS 19290, 2012 WL 5416208

...In this workers’ compensation appeal, Maggie Avery, Claimant, argues that the Judge of Compensation Claims (JCC) erred in approving the deauthorization by the City of Coral Gables and Johns Eastern, appellees, jointly the Employer/Carrier (E/C), of Claimant’s two authorized treating physicians pursuant to section 440.13(2)(d), Florida Statutes (2011), based on the JCC’s finding that Claimant was not making “appropriate progress” in her recuperation. Because Claimant had reached maximum medical improvement (MMI) and was receiving only palliative care, section 440.13(2)(d) is inapplicable here....
...Greer’s findings, the E/C advised Claimant that her psychiatric care had been transferred from Drs. Pino and McDougall to Dr. Michael Amiel with whom an appointment was scheduled. On November 5, 2009, the E/C issued a notice of denial deauthorizing treatment with Drs. Pino and McDougall, under section 440.13(2)(d), Florida Statutes (2011), on the basis that Claimant was not making “appropriate progress.” Final Hearing On December 17, 2009, Claimant filed a petition for benefits (PFB) seeking contin *751 ued treatment with Drs....
...Pino and McDou-gall, costs, and attorney’s fees. The E/C denied continued treatment with Drs. Pino and McDougall and indicated that Dr. Amiel had been provided as Claimant’s alternate psychiatrist. The E/C further asserted that Claimant had not made appropriate progress under section 440.13(2)(c), Florida Statutes (2011), and that there was overutilization....
...Greer testified that Claimant should have made progress before the frequency and chronicity of the visits reached the point that it did, he further testified that he did not expect any additional improvement in Claimant’s condition. After the JCC denied Claimant’s motion for rehearing, Claimant timely appealed. Analysis Section 440.13(2)(d), Florida Statutes (2011), provides that “[t]he carrier has the right to transfer the care of an injured employee from the attending health care provider if an independent medical examination determines that the employee is not making appropriate progress in recuperation.” (Emphasis added). See State Attorney v. Johnson, 770 So.2d 187, 188 (Fla. 1st DCA 2000) (holding because section 440.13(2)(d) does not adversely affect parties’ substantive rights, its application is not governed by date of accident). The issue presented here, which has not yet been addressed by this court, is whether section 440.13(2)(d) is applicable to a claimant who is post-MMI and receiving only palliative treatment....
...The E/C then furnished to Claimant palliative treatment, provided by Dr. McDougall and Dr. Pino. Palliative treatment, by definition, is not designed to improve Claimant’s condition. What is disputed by Claimant is whether she was “in recuperation” for purposes of section 440.13(2)(d) upon reaching MMI and undergoing palliative care....
...longer reasonably be anticipated, based upon reasonable medical probability.” § 440.02(8), Fla. Stat. (1989). Palliative care, awarded post-MMI, is defined as non-curative medical services that mitigate the conditions, effects, or pain of injury. § 440.13(1)(n), Fla....
...thereafter. A claimant who has reached MMI, however, cannot be “in recuperation,” as a matter of law, where the treatment being provided is not curative. In other words, in the absence of curative treatment necessitated by a compensable injury, section 440.13(2)(d) is inapplicable....
...s finding that palliative treatment by another psychiatrist would be in the claimant’s best interest. Id. Imprescia, however, is distinguishable from this case on both legal and factual grounds. Id. Legally, Imprescia was affirmed on the basis of section 440.13(3), Florida Statutes (1989) (“[A] judge of compensation claims may at any time, for good cause shown, in the judge of compensation claims’ discretion, order a change in such remedial attention, care, or attendance”) — which has since been repealed — and did not involve section 440.13(2)(d)....
...Because the IME physician opined that the claimant was not making appropriate progress in recuperation, the JCC determined that the deauthorization and subsequent transfer was improper. Id. In Busot , the only issue on appeal was whether the JCC’s role was eliminated under section 440.13(2)(d), or rather, whether the IME’s opinion regarding the appropriateness of the claimant’s progress was dispositive of the issue. Id. at 703 . Conversely, here the issue on appeal is whether section 440.13(2)(d) is applicable as a matter of law after the date of MMI....
...nt was unwarranted and excessive. These findings are more in accordance with a utilization review analysis and do not address the question of whether Claimant had made appropriate progress *753 in her recuperation — the focus of the analysis under section 440.13(2)(d)....
...Under these circumstances, where the E/C has concerns of overutilization, the proper remedy is for the E/C to obtain a determination of overutilization from the Department of Financial Services, Division of Worker’s Compensation, under section 440.18, Florida Statutes (2011). See § 440.13(11)(c), Fla....
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Deriso v. Great W. Meats, 534 So. 2d 748 (Fla. Dist. Ct. App. 1988).

Published | District Court of Appeal of Florida | 13 Fla. L. Weekly 2490, 1988 Fla. App. LEXIS 4845, 1988 WL 117183

...Several days later, he filed a claim requesting authorization for Dr. Sun. The E/SA sent notices of controversion in three successive months, during which claimant continued to see Dr. Sun. Dr. Sun regularly forwarded his bills to the E/SA but did not send medical reports as required by Section 440.13(2)(b), Florida Statutes (1987). It is unclear from the record and the order whether the reports were ever filed. Shortly before the hearing on the claim, the E/SA authorized a different osteopath. Claimant testified he preferred Dr. Sun. Under Section 440.13(2)(a), Florida Statutes (1987), a carrier’s list of health-care providers must include a representative of each type of provider defined in Section 440.13(l)(f), Florida Statutes (1987). Osteopathic physicians are one such provider, and if the E/SA do not provide such treatment after request, the claimant may proceed and have the reasonableness of his actions determined later by the deputy commissioner. § 440.13(2)(b), Fla.Stat....
...Providing the care initially requested by a *750 claimant does not bar claimant from subsequently requesting different care if needed; offering alternative care does not meet the E/SA’s obligation unless the alternatives offered include a health-care provider of the type described in Section 440.13(l)(f), Florida Statutes (1987), and requested by claimant; and ultimately providing the requested treatment does not meet the E/SA’s obligation to timely provide the requested care or seek a hearing....
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Miami Donuts Payroll, Dunkin Donuts v. Villarreal (Fla. 1st DCA 2024).

Published | Florida 1st District Court of Appeal

...tion. Appellants were deprived of the medical evidence on which their defense was based five weeks before the final hearing, after which they continuously worked to obtain an independent medical examiner, to which they were statutorily entitled. See § 440.13(5), Fla....
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Hamilton v. Rl Best Intern., 996 So. 2d 233 (Fla. 1st DCA 2008).

Published | Florida 1st District Court of Appeal | 2008 WL 4809902

...Court's finding that the Employer/Carrier, in fact, unilaterally de-authorized Dr. Jungries, the undersigned rejects the Claimant's argument that the Employer/Carrier may not unilaterally de-authorize a physician under the terms of Florida Statutes § 440.13 (1997) [emphasis added]." I believe this statement irrefutably shows that Claimant did present the issue of E/C's authority to unilaterally de-authorize Claimant's treating physician to the JCC....
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Publix Supermarkets, Inc. v. Simpson, 478 So. 2d 844 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 2472, 1985 Fla. App. LEXIS 16605

...The remainder of the wage-loss award, from July 1, 1983, through January 5, 1984, is affirmed, as there is competent, substantial evidence in the record of a good-faith work search for this time period. Finally, the medical bills of Dr. Struhl and Dr. Herskowitz were not properly filed, as required by Section 440.13(1), Florida Statutes....
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Gen. Elec. Co. v. Shepard, 440 So. 2d 462 (Fla. 1st DCA 1983).

Published | Florida 1st District Court of Appeal | 1983 Fla. App. LEXIS 23560

mailed to the incorrect address.” The bar of section 440.13(3)(b), Fla.Stat. (1975) applies notwithstanding
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Orange Cnty. Bd. of Cnty. Commissioners v. Davis, 440 So. 2d 462 (Fla. 1st DCA 1983).

Published | Florida 1st District Court of Appeal | 1983 Fla. App. LEXIS 23561

is therefore susceptible of a finding that section 440.13 lapsed in its self-executing purpose because
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Tiznado v. Orlando Reg'l Healthcare Sys., 773 So. 2d 584 (Fla. 1st DCA 2000).

Published | Florida 1st District Court of Appeal | 2000 Fla. App. LEXIS 15398, 2000 WL 1742049

...The claimant appeals a workers’ compensation order by which her claim for medical care was denied. We conclude that the judge should not have applied the provider reimbursement manual to this dispute between the claimant and the employer, and that the care should have been awarded pursuant to section 440.13(2)(a), Florida Statutes, upon the judge’s determination of medical necessity....
...tion with the reimbursement and utilization review process under Florida Administrative Code chapter 38F-7, and properly applies to billing disputes between medical providers and employers (or insurance carriers or servicing agents). As indicated in section 440.13(7), Florida Statutes, such reimbursement disputes may be pursued by health care providers in proceedings before the Division....
...1st DCA 1995), which indicate that the award of medically necessary care is to be made without regard to the possibility that a payment dispute might arise between the employer and the provider. The claim in the present case, involving a medical care dispute between the claimant and the employer, is therefore governed by the section 440.13(2)(a) provision obligating the employer to furnish medically necessary treatment and care....
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W. Liquors Corp. v. Studer, 391 So. 2d 250 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 18220

...y the claimant with treatment by Dr. Hoover or under his direction as he deems necessary.” Employer/carrier asserts that the order is an award of lifetime treatment and argues that it effectively overcomes or waives the limitations period found in Section 440.13(3)(b), Florida Statutes (1975) (current version at Section 440.19(2)(b), Florida Statutes (1979)). We disagree with that construction of the order and affirm the deputy commissioner on evidentiary issues argued by appellant. Section 440.13(3)(b), Florida Statutes (1975) provides that all rights to remedial attention are barred unless a claim for them is made within two years of the date of the last payment of compensation or the date of the last remedial attention furnished by the employer, or within two years of an award of medical treatment. Section 440.13(1), Florida Statutes (1975) provides, “subject to the limitations specified in paragraph (3)(b), the employer shall furnish to the employee such remedial treatment ......
...e., “for such period as the nature of the injury or the process of recovery may require.” Cf. Ocala Jai-Alai, Inc. v. Johnson, IRC Order 2-3783 (April 24, 1979) (concurring and dissenting opinion). That construction necessarily encompasses the limitations period to which Section 440.13(1) is expressly subject....
...established by affirmative evidence other than the ambiguous phraseology of an order for benefits. See Platzer v. Burger, 144 So.2d 507 (Fla.1962), decided under a former statute which did not contain the proviso of the current law expressly making Section 440.13(1) subject to the limitations period of Section 440.13(3)(b). AFFIRMED. JOANOS, J., and WOODIE A. LILES (Ret.), Associate Judge, concur. . Section 440.13(1), Florida Statutes (1979) reads “subject to the limitations specified in S. 440.19(2)(b)_” Chapter 79-40, 1979 Florida Laws, moved Section 440.13(3)(b) to Section 440.19(2)(b) in substantially the same form.
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Orange Cnty. Sch. Bd. v. Ebanks, 608 So. 2d 578 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 12057, 17 Fla. L. Weekly Fed. D 2656

or neurosurgeon to perform the evaluation. Section 440.13(2)(a), Florida Statutes (1989), provides that
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Wojick v. State, Dep't of Child. & Families, 75 So. 3d 362 (Fla. 1st DCA 2011).

Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 18591, 2011 WL 5842822

...We further note, without addressing the constitutional argument that the order to compel violates Claimant’s right to privacy, that a claimant always has the right to reject medical assistance, although the consequences may include forfeiture of certain workers’ compensation benefits. See, e.g., § 440.13(5)(d), Fla....
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Dean v. McLeod, 270 So. 2d 726 (Fla. 1972).

Published | Supreme Court of Florida | 1972 Fla. LEXIS 3179

act to toll the limitation period of Fla.Stat. § 440.13(3) (b), F.S.A., which specifically deals with
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Winn Dixie Stores, Inc. v. Frank, 665 So. 2d 271 (Fla. 2d DCA 1995).

Published | Florida 2nd District Court of Appeal | 1995 Fla. App. LEXIS 12184, 1995 WL 686033

Ortiz, 606 So.2d 422 (Fla. 1st DCA 1992). Under section 440.13(2)(g), Florida Statutes (1993), the claimant
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Vincent Sansone v. Frank Crum/Frank Winston Crum Ins., Inc., 201 So. 3d 1289 (Fla. 1st DCA 2016).

Published | Florida 1st District Court of Appeal | 2016 Fla. App. LEXIS 16230

...e hospital himself. Sansone became “insulated from financial responsibility” for the hospital bill after the employer/carrier accepted responsibility. See Bergstein v. Palm Beach Cty. Sch. Bd., 97 So. 3d 878, 879 (Fla. 1st DCA 2012); see also § 440.13(3)(g), (13)(a), Fla. Stat....
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St. Francis Hosp., Inc. v. Feinberg, 192 So. 2d 753 (Fla. 1966).

Published | Supreme Court of Florida | 1966 Fla. LEXIS 3172

...trovert the claimant’s claim to medical treatment after they knew the claimant was being treated after her discharge by the hospital physician, notwithstanding the failure of the claimant’s physicians to file the reports required by the statute [§ 440.13, F.S.]; * * *....
...testimony that the deputy commissioner had before him to make his finding that the hospital-employer failed to provide the claimant with proper remedial care and treatment, or to arrive at his conclusion to order a change in medical treatment under § 440.13(2), other than to say that the claimant’s evidence fairly consisted of refusals to see her, telephone calls without response, dissatisfaction with her treatment at the hospital, a statement to her that she was getting to be an expense, in...
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A & M Gerber Chiropractic LLC v. GEICO Gen. Ins. Co., 291 F. Supp. 3d 1318 (S.D. Fla. 2017).

Published | District Court, S.D. Florida

compensation, as determined under Florida Statutes, § 440.13 and rules adopted thereunder which are in effect
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Cem Enter., Inc. v. Thompson, 859 So. 2d 1247 (Fla. 1st DCA 2003).

Published | Florida 1st District Court of Appeal | 2003 WL 22697279

...roperly denied the E/SA's request for an offset or credit based on the value of claimant's current vehicle. As explained in Applegate Drywall Co. v. Patrick, 559 So.2d 736 (Fla. 1st DCA 1990), the award of medically necessary medical apparatus under section 440.13(2)(a), Florida Statutes (2000), is not apportionable....
...Although claimant's wife, who provides the attendant care, is a licensed practical nurse, and she received additional training to help her care for claimant, there is record support for the JCC's finding that only nonprofessional attendant care is medically required; therefore, the limitations set forth in section 440.13(2)(b) apply....
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Boley Centers, Inc. v. Vines, 179 So. 3d 464 (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal | 2015 Fla. App. LEXIS 17159, 2015 WL 7156955

...th our opinion herein. In the first issue on appeal, the E/C correctly points out that the JCC improperly considered the medical opinions of a physician who was not a treating physician, independent medical examiner (IME), or expert medical advisor. § 440.13(5)(e), Fla. Stat. (2013). See also Cespedes v. Yellow Transp., Inc., 130 So.3d 243, 250-51 (Fla. 1st DCA 2013) (holding proof of compensable emergency care requires medical opinion admissible under subsection 440.13(5)(e) which establishes emergency care was both medically necessary for, and causally related to, compen-sable workplace injury)....
...Relative to Claimant’s cross-appeal, which challenges the JCC’s finding that Claimant’s first psychiatric hospitalization was not compensable emergency care, we conclude that the facts that establish the second hospitalization as emergency services, as was concluded by the JCC-(under sections 440.13(1)(f) and 395.002(10), Florida Statutes (2013)), are not meaningfully different than the facts surrounding the first hospitalization....
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Keeton v. Kentucky Fried Chicken, 74 So. 3d 1125 (Fla. 1st DCA 2011).

Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 18139, 2011 WL 5561247

...The Workers' Compensation Law provides that a claimant and a carrier may each select an independent medical examiner, who "may not render an opinion outside his or her area of expertise, as demonstrated by licensure and applicable practice parameters." § 440.13(5)(a), Fla. Stat. (2005). The Law provides further that "[i]f there is a disagreement in the opinions of the health care providers, ... the judge of compensation claims shall ... order the [claimant] to be evaluated by an expert medical advisor." § 440.13(9)(c), Fla....
...The Judge of Compensation Claims appointed one, who opined the carpal tunnel syndrome was not work-related. The claimant opposed the appointment of the expert medical advisor, arguing the Employer/Carrier was bound by the opinion of its independent medical examiner. In support, the Claimant cited subsection (5)(b) of section 440.13, which provides in part that "[e]ach party is bound by his or her selection of an independent medical examiner, including the selection of the independent medical examiner in accordance with s. 440.134 and the opinions of such independent medical examiner." The Judge of Compensation Claims rejected the claimant's argument, reasoning the limitation in subsection (5)(b) precludes serial independent medical examinations and does not preclud...
...n two doctors on causation of a shoulder injury and the claimant argued that one doctor's opinion was inadmissible and lacked a proper foundation. 991 So.2d at 410. This court reversed, holding that the doctor's testimony could not be excluded under section 440.13(5)(e), Florida Statutes, because he was authorized to treat the claimant (specifically, her wrist), but there was no actual conflict in the medical opinions because that doctor was not authorized to treat the shoulder, did not examine...
...the judge of compensation claims shall, upon his or her own motion or within 15 days after receipt of a written request by either the injured employee, the employer, or the carrier, order the injured employee to be evaluated by an expert medical advisor." § 440.13(9)(c), Fla....
...1st DCA 2009) ("If there is a disagreement in the opinions of health care providers, the legislature has mandated that the JCC shall appoint an EMA."); Palm Springs Gen. Hosp. v. Cabrera, 698 So.2d 1352, 1356 (Fla. 1st DCA 1997) ("The requirements of section 440.13(9)(c), Florida Statutes (1995), are mandatory and binding on the judge of compensation claims.")....
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Ben Franklin Crafts v. Geurtze, 646 So. 2d 773 (Fla. Dist. Ct. App. 1994).

Published | District Court of Appeal of Florida | 1994 Fla. App. LEXIS 11132, 1994 WL 637295

...Morris Drywall Spray, 595 So.2d 60 (Fla. 1st DCA 1991). The pivotal issue raised by the E/C is whether claimant was required to request and obtain authorization for her cardiac care and treatment, specifically the cath-eterization and angioplasty. We hold that under section 440.13(2)(a), Florida Statutes (1991), claimant was required to seek such authorization. Section 440.13(2)(a) states, in part, that an employer shall furnish the employee medically necessary remedial treatment and care as the nature of the injury or process of recovery may require....
...This section further states: However, no health care provider may refer the employee to another health care provider, diagnostic facility, pain program, ... or other facility without the prior authorization from the carrier or the employer if self-insured except in cases where emergency care is required. § 440.13(2)(a), Fla.Stat....
...Dupay referred claimant to Dr. Weiner for evaluation of her cardiac condition. The procedures performed by Dr. Weiner, specifically the catheterization and the subsequent angioplasty, were not requested by either the claimant or her physicians. See § 440.13(2)(d), Fla.Stat. Nor were the procedures authorized by the E/C, as required by the plain language of section 440.13(2)(a), Florida Statutes....
...sable absent a finding of emergency. Because the holding below allowed the expenses on another, improper, basis, the JCC did not reach the question of whether the unauthorized medical expenses were due to an emergency, and thus were allowable, under section 440.13(2)(a), Florida Statutes. Since the order failed to address this important issue, we REVERSE and REMAND for further consideration. BOOTH, ALLEN and BENTON, JJ., concur. . Prior to the 1990 amendments to section 440.13(2)(a), authorized doctors were able to refer an employee/patient to another doctor for the purpose of obtaining medical diagnoses, evaluation or treatment without an E/C's consent and authorization....
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Ulmer v. Jon David Coiffures, 458 So. 2d 1218 (Fla. Dist. Ct. App. 1984).

Published | District Court of Appeal of Florida

...Prior to development of dermatitis the claimant had performed all of the shampoos for her clients to avoid the additional expense of shampoo girls. Appellant filed the claim below for reimbursement of the cost of using these shampoo girls, asserting that this compensation was available as a medical benefit provided for by § 440.13(1), Florida Statutes (1981), which provides in pertinent part: [T]he employer shall furnish to the employee such remedial treatment, care, and attendance under the direction and supervision of a qualified physician or surgeon or other recog...
...r wage-loss benefits. It is not necessary, here, to express any opinion as to the merits of the appellant’s entitlement to rehabilitation or wage-loss benefits as we note that she did not pursue either avenue. Instead, she elected to proceed under § 440.13(1)....
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City of Hollywood v. Benoit, 830 So. 2d 254 (Fla. 1st DCA 2002).

Published | Florida 1st District Court of Appeal | 2002 Fla. App. LEXIS 16899, 2002 WL 31520082

...Since that time, he has received workers’ compensation benefits, including treatment by Paul Wand, M.D., and services provided by the Biseayne Institute and its director, Dr. Marie DiCowden. In 1999, the employer/carrier conducted a utilization review in accordance with section 440.13(6), Florida Statutes, and began disallowing payment of the bills submitted by Dr. Wand and by the Biseayne Institute. The Institute requested resolution of the disputes in accordance with section 440.13(7), Florida Statutes, although apparently Dr....
...To date, the disputes remain pending before the Agency for Health Care Administration (AHCA). The employer/carrier petition this Court for a writ of mandamus to compel AHCA to promptly resolve the matters pending before it as described above, relying on section 440.13(7)(e), which provides: Within 60 days after receipt of all documentation, the agency must provide to the petitioner, the carrier, and the affected parties a written determination of whether the carrier properly adjusted or disallowed payment....
...The agency must be guided by standards and policies set forth in this chapter, including all applicable reimbursement schedules, in rendering its determination. Petitioners also ask this Court to compel AHCA to take action against Dr. Wand and the Biseayne Institute in accordance with sections 440.13(8) and 440.13(11). We grant the petition insofar as it relates to AHCA’s failure to act in a timely manner on the dispute between the em~ ployer/earrier and the Biseayne Institute as contemplated by section 440.13(7)(c)....
...ndate in this cause. If the agency does not have all the information needed, it shall promptly notify the parties so that the pertinent documents may be submitted and the entire matter resolved in a timely fashion. With regard to agency action under section 440.13(8) or 440.13(11), or both, we agree with AHCA that these are matters which are within its discretion....
...The employer/carrier may not compel the agency to undertake actions in accordance with those statutory subsections. We accordingly deny the petition for writ of mandamus to the extent it requests this Court to compel AHCA to initiate proceedings pursuant to sections 440.13(8) and 440.13(11), Florida Statutes....
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Pinellas Towers, Inc. v. Osborne, 215 So. 2d 735 (Fla. 1968).

Published | Supreme Court of Florida | 1968 Fla. LEXIS 2084

attention in accordance with the provisions of Section 440.-13(1) of the Act. When one views the provisions
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Velasquez v. Malaja Constr., Inc., 720 So. 2d 302 (Fla. Dist. Ct. App. 1998).

Published | District Court of Appeal of Florida | 1998 Fla. App. LEXIS 14165, 1998 WL 777058

medical benefits, compensability, or disability.” § 440.13(5)(a), Fla. Stat. (1995). Because Mr. Velasquez
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Dramis v. Palm Beach Cnty. Sch. Bd., 829 So. 2d 346 (Fla. 1st DCA 2002).

Published | Florida 1st District Court of Appeal | 2002 WL 31431593

...Instead, Dramis chose to use her private health insurance and select her own physician, Dr. Campbell. Dramis also selected Dr. Campbell as her independent medical examination (IME) physician, so his testimony was admissible in the proceeding before the JCC. See § 440.13(5)(e), Fla....
...Indeed, in Wiggins, the court explained, "A straightforward reading of the statutes at issue indicates that the managed care provisions were intended to govern only the E/C's provision of `medically necessary remedial treatment, care, and attendance' *350 under subsections 440.13(2)(a) and (b)...." 701 So.2d at 572 (emphasis added)....
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Stokes v. Schindler Elevator Corp./Broadspire, 60 So. 3d 1110 (Fla. 1st DCA 2011).

Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 6601, 2011 WL 1744156

...Analysis In reaching her conclusion regarding the legal (in)sufficieney of the pathologists’ testimony, the JCC of necessity adopted or accepted the toxicologist’s opinion on issues of medical causation upon which he was not qualified to testify under the Workers’ Compensation Law. See § 440.13(5)(e), Fla....
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Girardin v. AN Fort Myers Imports, LLC, Gallagher Bassett (Fla. 1st DCA 2024).

Published | Florida 1st District Court of Appeal

...The JCC could not order compensation under chapter 440 for the husband’s provision of “nonprofessional attendant care . . . that falls within the scope of household duties and other services normally and gratuitously provided by family members.” § 440.13(1)(b), Fla....
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Miller v. Jupiter Med. Ctr., 928 So. 2d 485 (Fla. 1st DCA 2006).

Published | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 6899, 2006 WL 1210308

...petition for benefits, because the only requirement for scheduling an IME is a dispute regarding overutilization, medical benefits, compensability, or disability). Miller claims the E/C failed to prove need for an alternate IME examiner, required by section 440.13(5)(b), Florida Statutes (2001), viz., the examiner is not qualified to render an opinion about the condition, no longer practices in the relevant specialty, is unavailable, or the parties agree to an alternate examiner. On the contrary, this provision simply means that once a party has selected an IME physician to address a dispute under section 440.13(5)(a), the party is generally bound by that physician’s opinion as it applies to the particular dispute, even if it does not support the party’s position....
...nd there has been no IME addressing what the E/C asserts is a shoulder condition that is attributable to an event post-dating the IME, the E/C is entitled to select a new — not an alternate — IME physician. In addition, there is no limitation in section 440.13(5) regarding the geographical location of an IME....
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Winn Dixie Stores, Inc. v. King, 579 So. 2d 313 (Fla. Dist. Ct. App. 1991).

Published | District Court of Appeal of Florida | 1991 Fla. App. LEXIS 4391, 1991 WL 75620

...This is a workers’ compensation appeal from an order in which the Judge of Compensation Claims (JCC) awarded nonprofessional attendant care services to the claimant. The employer/carrier (E/C) contend that the claimant is not entitled to benefits under Section 440.13(2)(e)2., Florida Statutes (Supp.1988)....
...ices that his wife provided at a rate of $4.30 per hour for five hours per day, seven days per week for the period from October 15, 1988 to April 29, 1989, except for any days the claimant was hospitalized. The E/C argue that, correctly interpreted, Section 440.13(2)(e)2....
...The claimant contends that the JCC correctly interpreted the statute to hold that if a family member is employed and elects to leave that employment to provide nonprofessional attendant care, the per hour value of such care shall be the per hour value of such family member’s former employment. Section 440.13(2)(e), Florida Statutes (Supp.1988), provides: (e) The value of nonprofessional attendant or custodial care provided by a family member shall be determined as follows: 1....
...ture has not opted to peg the hourly rate to the federal minimum wage. And this is so even though the hours of attendant care services exceed the hours worked in the family member’s former part-time job. As can be seen from the above provisions of Section 440.13(2)(e), the legislature has seen fit to impose the federal minimum wage limitation only in the instance where the “family member is not employed” (subsection 1, supra)....
...We have no quarrel with the assertion that the federal minimum wage would be a reasonable limitation as to those attendant care hours which exceed the care provider’s former employment hours. However, it is not for us to redraft subsection 2 to so provide. Appellant also asserts that the purpose of Section 440.13(2)(e)2., Florida Statutes (Supp.1988) is to replace the “market rate” concept which this Court espoused in Sistrunk v....
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Gonzalez v. Publix, 654 So. 2d 634 (Fla. Dist. Ct. App. 1995).

Published | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 4870, 1995 WL 258942

based upon application of the amendments to section 440.13(5) enacted by chapter 93-415, Laws of Florida
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Sieracki v. Pizza Hut, 599 So. 2d 678 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 5057, 1992 WL 88931

...t to the employer/carrier when he called for authorization is puzzling. Also puzzling is the judge’s focus upon the reasonableness of the claimant’s- decision to seek an evaluation from someone other than her authorized treating physician. While Section 440.13, Florida Statutes, recognizes an employer /carrier’s right to exercise some control over the treatment given to an injured employee, that control naturally gives way when the employee requires emergency medical care....
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Senna v. Cargill, Inc., 489 So. 2d 192 (Fla. Dist. Ct. App. 1986).

Published | District Court of Appeal of Florida | 11 Fla. L. Weekly 1234, 1986 Fla. App. LEXIS 8087

...at the injury was job-related. At the hearing on the claim for payment of medical bills, the employer/carrier raised as a defense that the treating physician failed to submit the medical reports to the employer/carrier within ten days as required by Section 440.13(2), Florida Statutes (1983). 1 The deputy commissioner denied the claim for payment of medical bills, finding that there was an insufficient showing of good cause to waive application of the ten day filing requirement of Section 440.13(2)....
...nt’s situation and were not prejudiced by the reporting failure. We conclude that there is not competent substantial evidence to support the deputy’s finding that there was no good cause to excuse enforcement of the ten-day filing requirement of Section 440.13(2)....
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Guardian Detective & Sec. Agency v. Schreyer, 489 So. 2d 1186 (Fla. Dist. Ct. App. 1986).

Published | District Court of Appeal of Florida | 11 Fla. L. Weekly 1236, 1986 Fla. App. LEXIS 8088

...od cause is not necessary. J.C. Penney Co. v. Levine, 420 So.2d 416 (Fla. 1st DCA 1982). We find no error in the deputy’s ruling on the hospital bill. The claimant, as well as the hospital, share the responsibility of the reporting requirements of section 440.13(1), Florida Statutes (1981)....
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Esad Babahmetovic v. Scan Design Florida Inc/ Zenith Ins. Co. (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal

...Rogner of Hurley, Rogner, Miller, Cox, Waranch & Westcott, P.A., Winter Park, for Appellees. PER CURIAM. In this workers’ compensation case, Claimant appeals an order of the Judge of Compensation Claims (JCC) denying him a one-time change in authorized treating physician, as permitted by section 440.13(2)(f), Florida Statutes (2013)....
...medical evidence’ that an injury arose out of employment,” which was not challenged on appeal. 79 So. 3d at 946. For the foregoing reasons, we reverse the order on appeal, and remand to the JCC for the award of a one-time change under section 440.13(2)(f). REVERSED and REMANDED with instructions. WOLF, BENTON, and RAY, JJ., CONCUR. 9
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Dep't of Labor & Emp. Sec., Div. of Workers' Comp. v. Bradley, 636 So. 2d 802 (Fla. Dist. Ct. App. 1994).

Published | District Court of Appeal of Florida | 1994 Fla. App. LEXIS 4048

...sciplinary team’s evaluation,” or limitation to one “accrediting” organization to the exclusion of other similar organizations that are equal to or exceed the “accrediting standards” of CARF 2 ; (4) the proposed new rules amend or modify section 440.13, and....
...for promulgation of the proposed rules. In ruling that proposed Rules 38F-7.802(1) and (5), 38F-7.803(2), and 38F-7.806(2)(f) are invalid, the hearing officer found the Division’s adoption of the proposed rules was not in the manner prescribed by section 440.13(1), Florida Statutes....
...of disability and medical benefits to an injured worker at a reasonable cost to the employer. ... See also Ch. 91-1, Preamble, Laws of Fla. The challenged rules were designed to implement delivery of the “medically necessary” services defined in section 440.13(l)(d), and the procedure outlined in section 440.13(2)(d)....
...rida Statutes, which provides: The division shall have the authority to adopt rules to govern the performance of any programs, duties, or responsibilities with which it is charged under this chapter. More specific rulemaking authority is provided in section 440.13(l)(d), which states: (d) “Medically necessary” means any service or supply used to identify or treat an illness or injury which is appropriate to the patient’s diagnosis, consistent with the location of service and with the level of care provided....
...See § 440.015, Fla.Stat. (1991). The second issue concerns the hearing officer’s seeming determination that the Division’s proposed rules must be formulated or reviewed by a peer review committee. The hearing officer’s construction of sections 440.13(l)(c), (e), and (f), so as to require the Division to develop proposed rules through the vehicle of a “peer review committee” imposes an erroneous gloss upon the Division’s rulemaking authority....
...care of injured workers. See Agrico Chemical Co. v. DER, 365 So.2d at 763 . We conclude the Division’s authority to adopt proposed Rules 38F-7.802(1) and (5), 38F-7.803(2), and 38F-7.806(2)(f) is reasonably implied by the express terms of sections 440.13(l)(d) and 440.591....
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HMSHOST Corp. v. Frederic, 102 So. 3d 668 (Fla. 1st DCA 2012).

Published | Florida 1st District Court of Appeal | 2012 WL 1929917, 2012 Fla. App. LEXIS 8556

PER CURIAM. In this workers’ compensation case, the Employer/Carrier appeals an order of the Judge of Compensation Claims (JCC) awarding Claimant her own selection of a “one-time” change of physician under section 440.13(2)(f), Florida Statutes (2009). We reverse because, although we agree with the JCC that Claimant’s purported petition for benefits constituted the “written request” required by section 440.13(2)(f), we hold the JCC erred in finding the Employer/Carrier (E/C) did not comply with the request within the five days section 440.13(2)(f) allows. The E/C’s informing Claimant of a particular doctor’s name within five days of receiving the request satisfied section 440.13(2)(f), even though the E/C did not contact the doctor....
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ABC Liquors, Inc. v. Acree, 695 So. 2d 813 (Fla. 1st DCA 1997).

Published | Florida 1st District Court of Appeal | 1997 Fla. App. LEXIS 5666, 1997 WL 274260

...Barsa’s responses to questions, based on purported facts that appellants offered to prove, demonstrated that the proffered evidence would have been pertinent on issues the judge of compensation claims had to decide. Although expert testimony is required to show that attendant care is “medically necessary,” § 440.13(2)(b), Fla....
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Lab'y Corp. of Am. v. Patty Davis, etc. & Sheridan Radiology Servs. of Pinellas, Inc. v. Patty Davis, etc. (Fla. 2022).

Published | Supreme Court of Florida

...2d DCA 2019), in which the court held the WCL exclusive jurisdiction provision to be inapplicable as a bar to suit by an injured worker against a health care provider for prohibited debt collection practices. Id. at 1261. The Second District certified the following question to be of great public importance: DOES SECTION 440.13(11)(c) OF THE WORKERS’ COMPENSATION LAW PRECLUDE CIRCUIT COURT JURISDICTION OVER CLAIMS UNDER SECTION 559.77(1) OF THE FLORIDA CONSUMER COLLECTION PRACTICES ACT? Id....
...debt, violating section 559.72, Florida Statutes (2014), of the FCCPA. In response, Sheridan and Labcorp asserted that the trial courts lacked subject matter jurisdiction for the alleged FCCPA violations. Under Sheridan and Labcorp’s reasoning, section 440.13(11)(c) of the WCL unequivocally states that DFS “has exclusive jurisdiction to decide any matters concerning reimbursement.” Consequently, Sheridan and Labcorp claimed, because their billing Davis was merely a “matter[] conce...
...erson violating the provisions of s. 559.72.” Subsection (2) provides for the award of “actual damages and for additional statutory damages . . . not exceeding $1,000.” Punitive damages and other equitable relief are also authorized. Section 440.13 of the WCL establishes the framework for the provision of medical services to injured workers and for the reimbursement of medical providers by carriers and employers for those services....
...may not collect or receive a fee from an injured employee within this state” unless otherwise provided and that “providers have recourse against the employer or carrier for payment for services rendered in accordance with [the WCL].” 3 Subsection (11)(a) of section 440.13 grants DFS the power to “investigate health care providers to determine whether providers are complying with [the WCL] and with rules adopted by [DFS],” including “whether the providers are engaging in overutilization, 3. Under subsection (5)(a) of section 440.13, an employee “requesting and selecting [an] independent medical examination shall be responsible for all expenses associated with said examination, including, but not limited to, medically necessary diagnostic testing performed and p...
...e any overutilization dispute under subsection (7), and to decide any question concerning overutilization under subsection (8).” (Emphasis 4. Undergirding the authority of DFS regarding providers is the provision of subsection (3)(f) of section 440.13 that “[b]y accepting payment under [the WCL] for treatment rendered to an injured employee, a health care provider consents to the jurisdiction of [DFS] as set forth in subsection (11)” and to the submission of records relevant to...
...III According to the petitioner healthcare providers, the claim made by Davis under the FCCPA that the providers had improperly billed her—rather than the workers’ compensation carrier—in violation of the WCL fell within the scope of section 440.13(11)(c)’s provision vesting “exclusive jurisdiction” in DFS “to decide any matters concerning reimbursement.” The petitioners contend that the only basis for Davis’s claim under the FCCPA was the WCL’s “particularize...
...tly enacted generally applicable provisions of the FCCPA. In making this argument, they invoke the specific-controls-the-general canon and the presumption against implied repeals. Respondent Davis’s core argument is that the reference in section 440.13(11)(c) to “any matters concerning reimbursement” cannot be understood to include the matter at issue here, which arises from claims for payment by providers directly from a patient. Davis relies on the ordinary meaning of “rei...
...We decline to address other arguments that have been presented. - 11 - IV Answering the certified question requires us to determine the scope of the “exclusive jurisdiction” provision of section 440.13(11)(c)....
...Under the whole-text canon, proper interpretation requires consideration of “the entire text, in view of its structure and of the physical and logical relation of its many parts.” Id. Here, we must determine the meaning of the phrase “exclusive jurisdiction to decide any matters concerning reimbursement.” § 440.13(11)(c), Fla....
...Contrary to the line of analysis advanced by the petitioners, “reimburse” is not a synonym for “pay.” In common usage, all reimbursements are payments but not every payment is a reimbursement. Similarly, the fact that a provision of the WCL—section 440.13(13)(a), for example—refers to reimbursement using the term “payment” does not establish that reimbursement and payment are synonymous terms in the WCL....
...As is apparent from the foregoing review of the relevant provisions of the WCL, in the overwhelming number of instances when those words appear in the WCL, they refer to payment made by a carrier to a provider for services rendered to an injured worker. The definition of “reimbursement dispute” in section 440.13(1)(q) as “any disagreement between a health care provider or health care facility and carrier concerning payment for medical treatment” sets the stage for the usage of the terms “reimbursement” and “reimburse” throughout the section....
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Terry Pearson v. BH Transfer & Chartis Claims, Inc., 163 So. 3d 1280 (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal

...aimant, Terry Pearson, argues that the Judge of Compensation Claims (JCC) erred when he denied Claimant’s request for authorization of spinal surgery on grounds that the surgery was not medically necessary. Because the JCC’s interpretation of section 440.13(3)(i), Florida Statutes (2011), was erroneous, we reverse. Claimant filed a petition for benefits requesting authorization for the surgical procedure recommended by his authorized treating physician and attached to the petition a copy of the doctor’s office note recommending the procedure....
...More than ten days after receipt of the written request, Chartis Claims, the carrier, filed its response to the petition. The JCC denied the request on the grounds that the procedure was not medically necessary. However, this Court has previously held that section 440.13(3)(i) requires a carrier to respond to a request within a specific timeframe or forfeit its right to contest the medical necessity of the requested service. Andino-Rivera v. Se. Atl. Beverage Co., 132 So. 3d 1191, 1193 (Fla. 1st DCA 2014) (“Under sections 440.13(3)(d) and (i), an employer or carrier ‘forfeits the right to contest’ the medical necessity of an authorized doctor’s referral for (additional) medical treatment, unless the employer or carrier responds to the authorized doctor’s wr...
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BROADSPIRE, A Crawford etc. v. James E. Jones, 164 So. 3d 708 (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal

...provided by a family member in the ordinary course of family life (so-called gratuitous services). The Judge of Compensation Claims (JCC) awarded Mr. Jones twelve hours of daily attendant care from his wife, which is the maximum allowable from a family member under section 440.13(2)(b), Florida Statutes (2013). 2 II. A. The first issue is whether the JCC’s decision to apply the causation standard in effect at the time of Mr....
...may not be compensated under this chapter for care that falls within the scope of household duties and other services normally and gratuitously provided by family members. “Family member” means a spouse . . . . § 440.13(1)(b), Fla....
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Irigoyen v. Aircraft Servs., Inc., 544 So. 2d 1054 (Fla. Dist. Ct. App. 1989).

Published | District Court of Appeal of Florida | 14 Fla. L. Weekly 1295, 1989 Fla. App. LEXIS 3053, 1989 WL 57857

...anent impairment finding. The E/C’s claims adjustor acknowledged receiving a June 22, 1987 claim for benefits which requested chiropractic care from Dr. Horowitz. This claim sufficed to apprise the E/C of claimant’s desire for chiropractic care. Section 440.13(2)(b), Fla.Stat....
...Here the E/C did not undertake to obtain a ruling that chiropractic care was not in the claimant’s best interest until the hearing below. In Teimer the DC’s determination did not include a finding that chiropractic treatment was either “medically or reasonably necessary” pursuant to sec *1056 tion 440.13(2)(b) and Jackson v....
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Bass v. Fertilizer, 655 So. 2d 1225 (Fla. 3d DCA 1995).

Published | Florida 3rd District Court of Appeal | 1995 Fla. App. LEXIS 5637, 1995 WL 313867

(Fla. 1st DCA 1983) (“it is not the purpose of § 440.13 to burden family members with medically required
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Am. Airlines Grp. Am. Airlines & Sedgwick CMS v. Alejandro Lopez (Fla. 1st DCA 2024).

Published | Florida 1st District Court of Appeal

...e separation-of-powers doctrine). The statute includes in its tolling effect only two clearly defined types of benefits: indemnity benefits, governed by section 440.15 of the Florida Statutes; and remedial treatment, care, or attendance, governed by section 440.13. Attorney’s fees are neither of these. We have previously followed the plain language of section 440.19(2) to hold that payment of attorney’s fees does not toll the one-year limitations period....
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Dixie Transp., Inc. v. Kellom, 507 So. 2d 757 (Fla. 5th DCA 1987).

Published | Florida 5th District Court of Appeal | 12 Fla. L. Weekly 1314, 1987 Fla. App. LEXIS 8355

in Dale held that the claim was barred under Section 440.13(3)(b) [now Section 440.19(2)(b), Florida Statutes
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Univ. of Florida v. Opel, 415 So. 2d 52 (Fla. 1st DCA 1982).

Published | Florida 1st District Court of Appeal | 1982 Fla. App. LEXIS 20094

...hysical therapy, costs, attorney’s fees, and reimbursement for past medical care by Dr. Moore in the amount of $102.00. We reverse the award of the $102.00 bill, as Dr. Moore failed to submit timely medical reports as required by Florida Statutes, Section 440.13(1)....
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AT&T Commc'ns & Sedgwick CMS v. Victoria Murray Rosso, 217 So. 3d 1183 (Fla. 1st DCA 2017).

Published | Florida 1st District Court of Appeal | 2017 WL 1655233, 2017 Fla. App. LEXIS 6125

...ialized shoes because the E/C have shown no error in the JCC’s determination that the E/C forfeited the right to contest medical necessity for these items by failing to timely respond to a written request by an authorized health care provider. See § 440.13(3)(d), Fla....
...In workers’ compensation, the E/C may be responsible for providing an accessible living environment under the statutory requirement for the furnishing of “medically necessary apparatus.” See Timothy Bowser Constr. Co. v. Kowalski, 605 So.2d 885, 888 (Fla. 1st DCA 1992) (citing § 440.13(2)(a), Fla....
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Lyng v. Rao, 87 So. 2d 108 (Fla. 1956).

Published | Supreme Court of Florida | 1956 Fla. LEXIS 3716

assignments of error are, therefore, without merit. Section 440.13(1) provides that: “The employer shall furnish
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Napp-Deady Assocs. v. Ramsey, 599 So. 2d 228 (Fla. 1st DCA 1992).

Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 5222, 1992 WL 102908

...In light of our recent en banc decision in Terners of Miami Corp. and Atlas General v. M. Felix Freshwater and Luisa Valdez, 599 So.2d 674 (Fla. 1st DCA 1992), we hold that the JCC in the instant case lacked jurisdiction to resolve the issue. 1 *229 In Terners of Miami, this court ruled that section 440.13(2)(i)1., Florida Statutes (Supp.1990), is procedural in nature and therefore applied in that case to deprive the JCC of jurisdiction, since the statute was in effect when the hearing was held. 2 Since section 440.13(2)(i)l....
...dispute in the instant case, we note that the E/C did not argue this point before the JCC, but, instead, relied on the “dicta" in Long Grove holding that the remedy for this type of dispute lies within the administrative framework provided by then section 440.13(3)(a), Florida Stat *229 utes (now section 440.13(4)(a)), i.e., with the Division. . Section 440.13(2)(i)l....
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Librada Gonzalez Izaguirre v. Beach Walk Resort/Travelers Ins. (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...Izaguirre, a workers’ compensation claimant, appeals the order denying benefits. The Judge of Compensation Claims (“JCC”) denied benefits after striking Izaguirre’s independent medical examiner (“IME”) report. As authority, the JCC relied on section 440.13(5)(a), Florida Statutes (2015), which requires parties selecting IMEs to notify all parties within fifteen days of the examination. “Failure to timely provide such notification shall preclude the requesting party from submitting the findings of such IME in a proceeding before a [JCC].” § 440.13(5)(a), Fla....
...y must be considered whenever evidence is excluded based on untimely disclosure. See, e.g., Med. Logistics, Inc. v. Marchines, 911 So. 2d 823, 824-25 (Fla. 1st DCA 2005). We reject Izaguirre’s characterization of the exclusionary language in section 440.13(5)(a), as merely directory....
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Elsa Dominguez v. Compass Grp. & Gallagher Bassett Ser etc., 219 So. 3d 223 (Fla. 1st DCA 2017).

Published | Florida 1st District Court of Appeal | 2017 WL 2130237, 2017 Fla. App. LEXIS 6940

...Zientz, P.A., Miami, for Appellant. Mary Frances Nelson of Eraclides, Gelman, Hall, Indek, Goodman & Waters, Ft. Myers, for Appellees. PER CURIAM. In this workers’ compensation case, Claimant appeals an order of the Judge of Compensation Claims (JCC) denying her claim for a one-time change of physician under section 440.13(2)(f), Florida Statutes (2011)....
...lusion that the May 2 2015 final order was res judicata as to the need for future medical care. This appeal followed the final order denying claimant’s request for a one-time change of physician. Section 440.13(2)(f) provides that “[u]pon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident.” In Wilson, we said that the ...
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In re Amendments to the Florida Rules of Workers' Comp. Procedure, 674 So. 2d 631 (Fla. 1996).

Published | Supreme Court of Florida | 21 Fla. L. Weekly Supp. 223, 1996 Fla. LEXIS 827, 1996 WL 268079

...Proposed rule 4.028(a)(5)(D) is amended to clarify that in cases in which an injured employee is required to exhaust all managed care grievance procedures before filing a petition for benefits under section 440.192(3), Florida Statutes (1995), any claims for benefits under section 440.13(2)(a) and (b), Florida Statutes (1995), brought after the grievance procedures required by section 440.134(15) are exhausted are to be determined by a judge of compensation claims and not by administrative appeal brought under chapter 120, Florida Statutes (1995)....
...(C) The parties were unable to resolve the dispute within 30 days after a request for assistance was made to the EAO. (D) If medical care is being provided to the employee through managed care and the petition includes a claim for medical care under section 440.13(2)(a) and (b), Florida Statutes, the certificate must indicate that the grievance procedures required by section 440.134(15), Florida Statutes, were exhausted before Sling the petition under section 440.192(3), Florida Statutes....
...3 amendments to chapter 440, Florida Statutes. The request or application for hearing is now incorporated in the petition and no longer a separate pleading. The grievance procedures referred to in subdivision (a)(5)(D) are the procedures required by section 440.134(15), Florida Statutes, and not chapter 120, Florida Statutes....
...advances under sections 440.20(12)(c)2 and 440.20(12)(d), Florida Statutes, appeals of administrative fines or penalties under section 440,106, Florida Statutes, motions for appointment of guardians, motions to appoint expert medical advisors under section 440.13, Florida Statutes, requests for imposition of sanctions under these rules, motions to disqualify a .judge or a mediator, motions to recuse counsel, motions to correct the appellate record, and motions to appoint independent medical exa...
...These benefits are in default and are presently ripe, due, and owing. (F) Death benefits payable under section 440.16, Florida Statutes. (G) Correction of AWW and resulting compensation rate. Basis: (H)Medical expenses incurred for treatment of the employee’s injury as provided under section 440.13(2), Florida Statutes....
...Date(s) notice(s) to controvert filed: Employee: date: _ date: _ date: _ E/C/SA: date: _ date: _ date: _ *696 13. Maximum medical improvement, if reached, giving date, name of physician, and impairment rating: Employee: date: - doctor: -- rating: - E/C/SA: date: _ doctor:- rating: - 14. If medical benefits under section 440.13, Florida Statutes, (medieals)-are determined to be due or stipulated due herein, the parties agree that the exact amounts payable to health care providers will be handled administratively and medical bills need not be placed into evidence at trial....
...to Sections 440.20(ll)(b) and (c) (1994), Florida Statutes, in which Right to Compensation Benefits Has Been Settled Previously. [For caption and style of pleadings, see form 4,901] ORDER FOR RELEASE FROM LIABILITY FOR MEDICAL BENEFITS PAYABLE UNDER SECTION 440.13, FLORIDA STATUTES, AS AUTHORIZED BY SECTIONS 440.20(11)(b) and (c) (1994), FLORIDA STATUTES The parties .jointly petition for an order approving a stipulation for settlement under sections 440.20(11)(b) and (c) (1994), Florida Statutes...
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Bryant v. Home Depot, 845 So. 2d 292 (Fla. 1st DCA 2003).

Published | Florida 1st District Court of Appeal | 2003 Fla. App. LEXIS 7120, 2003 WL 21087123

...At the final hearing, on January 15, 2002, Bryant attempted to introduce the deposition testimony of Dr. Bollo, over objection, arguing the E/C waived their objection by failing to object at the deposition or when Dr. Bollo was fisted as a witness. The JCC excluded Dr. Bollo’s testimony pursuant to section 440.13(5)(e), Florida Statutes, because he was not an appointed medical advisor, designated IME, or authorized treating physician, and the deposition was taken for discovery purposes....
...ng physician during the deposition could not later challenge the admissibility of the deposition on grounds that the physician was not an appointed medical advisor, designated IME, or authorized treating physician. See 718 So.2d at 213-14 ; see also § 440.13(5)(e), Fla....
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Amendments to Florida Rules of Workers' Comp. Procedure, 603 So. 2d 425 (Fla. 1992).

Published | Supreme Court of Florida | 17 Fla. L. Weekly Supp. 296, 1992 Fla. LEXIS 1054, 1992 WL 99236

...Date(s) notice(s) to controvert filed: Employee: date: ~ date: date:.. .. E/C/SA: date: I date: I date:. .. 13. Maximum medical improvement, if reached, giving date, name of physician, and impairment rating: Employee: date: _ doctor:_ rating: E/C/SA: date: _ doctor:__ _ rating: 14. If benefits under section 440.13, Florida Statutes, (medicals) are determined to be due or stipulated due herein, the parties agree that the exact amounts payable to health care providers will be handled administratively and medical bills need not be placed into evidence at trial....
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Compcare of Florida, Inc. v. Cason, 693 So. 2d 127 (Fla. Dist. Ct. App. 1997).

Published | District Court of Appeal of Florida | 1997 Fla. App. LEXIS 4998, 1997 WL 240925

...Compcare of Florida, Inc., and Florida Preferred Risk appeal an order denying their motion for an independent medical examination to assess alleged overutilization. We find that the employer and its insurance carrier are entitled to the independent medical examination they seek, under section 440.13(5)(a), Florida Statutes (Supp.1994), which provides: In any dispute concerning overutilization, medical benefits, compensability, or disability under this chapter, the carrier or the employee may select an independent medical examiner....
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Clements v. Morrow's Nut House, 598 So. 2d 279 (Fla. 1st DCA 1992).

Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 5233, 1992 WL 98635

...Kal-lins believed that because the chiropractic care had not afforded claimant a “progressive and sustained benefit,” that the chiropractic care was not medically reasonable and necessary. Claimant’s entitlement to chiropractic care, however, is governed by Section 440.13(2)(a), Florida Statutes (1983), which provides in pertinent part: [T]he employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance by a health care provider and for such period as the nature of the injury or the process of recovery may require,.......
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Gephart v. Silver Springs Shores Golf & Country Club, 545 So. 2d 330 (Fla. 2d DCA 1989).

Published | Florida 2nd District Court of Appeal | 14 Fla. L. Weekly 1170, 1989 Fla. App. LEXIS 2606, 1989 WL 49612

unmistakable, this should not have ended the inquiry. Section 440.-13(2)(b), Florida Statutes (1987), provides: If
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Maria Suarez v. Steward Enter. & Travelers Ins. Co., 164 So. 3d 132 (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal

...certiorari, Claimant argues that the Judge of Compensation Claims (JCC) departed from the essential requirements of law by denying her request to limit the deposition fee of the expert medical advisor (EMA) to $200 per hour, the amount referenced in section 440.13(10), Florida Statutes (2011), and that error represents material harm that cannot be remedied on appeal....
...Rozencwaig’s office staff was that the doctor believed he was not limited to $200 per hour because he was the appointed EMA. Following a hearing on Claimant’s motion to determine the fee, the JCC declined to determine the fee, concluding that giving a deposition is not a service contemplated by either section 440.13(9), Florida Statutes (2011), the section addressing EMAs, or by Florida Administrative Code Rule 69L-30, also addressing EMAs. Further, the JCC concluded that because “the EMA is not a mere health care provider, but an expert,” the fee limitation in section 440.13(10) did not apply. When requesting review of an order via a petition for writ of certiorari, the petitioning party is required to demonstrate that the challenged order “(1) constitutes a departure from the essential requirem...
...ultimately prevails in the case. See Marton v. Florida Hosp. Ormond Beach, 98 So. 3d 754, 757 (Fla. 1st DCA 2012) (reversing JCC’s award of cost reimbursement to employer/carrier for amounts paid for depositions in excess of amount permitted by section 440.13(10))....
...Upon review of multiple statutory subsections, it is clear that an EMA is a health care provider, and the JCC acknowledged as much—“the EMA is not a mere health care provider, but an expert”—and, as such, is limited to a witness fee of $200 per hour. Section 440.13(9)(a) requires that “the qualifications, training, impartiality, and commitment of the health care provider” be considered in identifying physicians to serve as EMAs. Sections 440.13(9)(b) and section 440.25(4)(d) anticipate that EMAs may provide “testimony” to the JCC....
...In addition, section 440.25(4)(d) goes on to provide that “the testimony of the [EMA] shall be admitted into evidence . . . and all costs incurred in connection with such . . . testimony may be assessed as costs in the proceeding, subject to the provisions of s. 440.13.” The section that is at the heart of Claimant’s petition, section 440.13(10), provides that “[a]ny health care provider who gives a deposition shall be allowed a witness fee....
...The amount charged by the witness may not exceed $200 per hour.” When these provisions are read together, we conclude that Dr. Rozencwaig is a health care provider; thus, his fee for deposition testimony is limited to $200 per hour as required by the plain language of section 440.13(10). Accordingly, nothing in sections 440.13 or 440.25 supports the JCC’s conclusion. Case law further supports this view....
...In Marton, 98 So. 3d at 757, we limited 4 authorized treating physicians and independent medical examiners, two of the three categories of individuals who can provide admissible medical opinion testimony per section 440.13(5)(e), to $200 per hour in payment for their testimony....
...deposition. Accordingly, we conclude that the JCC departed from the essential requirements of law, in a manner not remediable on appeal, when he denied Claimant’s request that Dr. Rozencwaig’s deposition fee be limited to that permitted by section 440.13(10)....
...purposes, simply cannot be remedied on appeal. That is, if Claimant pays the $750 hourly deposition fee, * deposes the EMA, and ultimately loses her case, she will be without an appellate remedy because the improperly charged fee—which here is expressly prohibited by section 440.13(10) and more than three times the amount permitted by statute—could not be taxed as a cost since Claimant would not be the prevailing party....
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Media Gen., Inc. v. McGuire, 871 So. 2d 1045 (Fla. 1st DCA 2004).

Published | Florida 1st District Court of Appeal | 2004 Fla. App. LEXIS 6475, 2004 WL 1058117

...In reaching her decision, the judge of compensation claims rejected Dr. Companioni’s opinion and accepted Dr. Trimble’s and Dr. Maser’s. The failure to appoint an expert medical advisor was error. See AT & T Wireless v. Frazier, 871 So.2d 939 , 2004 WL 609298 (Fla. 1st DCA March 30, 2004) (“Section 440.13(9) imposes upon the JCC a statutory duty to order that the claimant be evaluated by an EMA before ruling on the merits of the petition for benefits whenever it becomes apparent that there is a substantial conflict in the medical opinio...
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Marine Max, Inc., & Seabright Ins. Co. v. Charles Blair, 268 So. 3d 839 (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...is without statutory authority. See generally City of Bartow v. Brewer, 896 So. 2d 931, 933 (Fla. 1st DCA 2005). And according to Blair, the statute permits deauthorization only if the claimant is not making appropriate progress in recuperation, see § 440.13(2)(d), Fla. Stat., or if the provider was engaged in a pattern or practice of overutilization, see § 440.13(8)(b)2....
...tatutory rates are allowed only if the employer agrees to pay the higher amount and the provider “specifically agrees in writing to follow identified procedures aimed at providing quality medical care to injured workers at reasonable costs.” See § 440.13(13)(b), Fla. Stat. According to Marine Max, because it had no agreement with Yunis, it was left with only one real option: to provide medically necessary care—as section 440.13(2)(a) required—by authorizing someone else....
...says ‘pay.’” See also Ans. Br. at 12 (“[T]he JCC does not have the statutory authority to force the E/C to pay for medical services in excess of fee schedule.”). Reimbursement is handled under section 3 440.13(7), Florida Statutes, and all reimbursement disputes fall under the exclusive jurisdiction of DFS. See § 440.13(11)(c), Fla. Stat....
...doctor’s bill”). Moreover, even if the JCC could resolve payment disputes, it could not compel prepayment, which chapter 440 does not contemplate for medical treatment. The relevant statutes and rules use the term “reimbursement,” see, e.g., § 440.13, Fla....
...prepay the demanded amounts and later seek relief through administrative channels. The administrative dispute process begins with an employer’s refusing to pay a provider’s bill (or refusing to pay it in full), called “disallowance” (or “adjustment”). See § 440.13(6), (8), Fla. Stat. But if Marine Max paid in advance as a condition of service, Yunis would have no occasion to submit a bill afterward. Moreover, section 440.13(7)(a)—which previously allowed both employers and providers to initiate reimbursement disputes at DFS—changed in 2016....
...employer and the provider.” Tiznado v. Orlando Reg’l Healthcare Sys., 773 So. 2d 584, 585-86 (Fla. 1st DCA 2000). The JCC was therefore required to determine whether Yunis’s continued authorization was “reasonable” and “medically necessary,” see § 440.13(2)(a), Fla....
...of compensation claims can force Yunis to provide treatment he does not wish to provide. Marine Max can (and must, for now) continue to “authorize” Yunis, but all authorization does is allow Yunis to demand compensation if he chooses to treat Blair. See § 440.13(3)(a), Fla....
...nders services 5 must receive authorization from the carrier before providing treatment.”). If Yunis elects to provide treatment, his authorization will permit him to seek compensation under Chapter 440. See id. § 440.13(13)(a) (noting that authorized providers “have recourse against the employer or carrier for payment for services rendered in accordance with this chapter”). If he and Marine Max reach a different agreement, he can operate under that agreement. See id. § 440.13(13)(b)....
...Indeed, as Blair acknowledges in his brief, 6 permissible range of rates. And the Legislature has said that “[f]ees charged for remedial treatment, care, and attendance, . . . may not exceed the applicable fee schedules adopted under this chapter and department rule.” § 440.13(13)(b), Fla....
...The opinion fails to recognize that under 10 statutory law and case law, the E/C has a significant burden to demonstrate a change of facts that provide a legal reason for severing the physician-patient relationship. While section 440.13, Florida Statutes, has been amended so that it no longer requires prior approval from the JCC to deauthorize a doctor, the underlying premise that the E/C cannot deauthorize a physician without proving that doing so is in the best interest of the claimant is still controlling....
...importance of the physician-patient relationship by only allowing the employer “to transfer the care of an injured employee from the attending health care provider if an independent medical examination determines that the employee is not making appropriate progress in recuperation.” § 440.13(2)(d), Fla....
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Greene v. Maharaja of India, Inc., 558 So. 2d 461 (Fla. Dist. Ct. App. 1990).

Published | District Court of Appeal of Florida | 1990 Fla. App. LEXIS 1575, 1990 WL 25953

Dunedin, 513 So.2d 200 (Fla. 1st DCA 1987) (Section 440.-13, Florida Statutes, requires the E/C to provide
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Scullin v. Gamlin Sys., 780 So. 2d 972 (Fla. 1st DCA 2001).

Published | Florida 1st District Court of Appeal | 2001 Fla. App. LEXIS 2376, 2001 WL 209129

...Contrary to appellant’s argument, in the absence of evidence of medical necessity accepted by the judge of compensation claims, no per se rule requires that a handicap-equipped van be provided to a claimant even though he has been rendered quadriplegic in a compensable accident. See §§ 440.13(2)(a), 440.13(5), Fla....
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Brown v. Vanguard Sec., 7 So. 3d 572 (Fla. 1st DCA 2009).

Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1704, 2009 WL 528785

...JCC) denying her motion to appoint an expert medical advisor (EMA) and denying her request for a methacholine bronchoprovocation study. Because the opinions of the medical experts were in conflict, the JCC was obligated to appoint an EMA pursuant to section 440.13(9)(c), Florida Statutes (2000). Accordingly, we reverse both issues on appeal and remand for further proceedings. Section 440.13(9)(c) is mandatory....
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Soverel Harbour, Inc. v. Roberts, 634 So. 2d 298 (Fla. 1st DCA 1994).

Published | Florida 1st District Court of Appeal | 1994 Fla. App. LEXIS 3046, 1994 WL 106230

are noncompensable. Walt Disney World, supra; § 440.13(2)(d), Fla. Stat. (1989); Doctors Hospital v.
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Manatee Mem'l Hosp. v. Love, 382 So. 2d 751 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 16528

...The record contains no explanation by the attorney of why he did not so communicate with his client, and the attorney has made no appearance here. No reason is suggested why the attorney’s apparent fault should result in an award of fees for unauthorized medical care against the employer and carrier. Section 440.13, Florida Statutes (79)....
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South Coast Constr. Co. v. Chizauskas, 172 So. 2d 442 (Fla. 1965).

Published | Supreme Court of Florida | 1965 Fla. LEXIS 3247

...* * * ” On review the Full Commission reversed the award to the claimant’s husband apparently on the ground that the services found by the deputy to be rendered by the husband were not of the kind required to be furnished by the employer under Section 440.13, F.S.A....
...These findings clearly show that the claimant does not need “ * * * remedial treatment, care and attendance under the direction and supervision of a qualified physician or surgeon, or other recognized practitioner, nurse or hospital. * * * ” These are the kind of services which Section 440.13 requires an employer-carrier to furnish in an appropriate case....
...are or attention required to be furnished by the statute. The Full Commission’s directions to the deputy to “reconsider and redetermine claimant’s need for personal attendance or care” must be held to mean attendance or care authorized under Section 440.13....
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Camus v. Manatee Cnty. Sch. Bd., 923 So. 2d 1266 (Fla. 1st DCA 2006).

Published | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 4365, 2006 WL 778637

...In her Final Compensation Order, the JCC excluded Dr. McGarahan’s medical opinion relating to his September 21, 2004 evaluation of claimant, because she found that Dr. McGarahan was not an “authorized treating provider” at the time he evaluated claimant in 2004. See § 440.13(5)(e), Fla....
...004. The JCC further noted that because claimant already had one independent medical examination, Dr. McGara-han’s testimony relating to the September 21, 2004 visit should be admitted for factu *1268 al purposes only and not as a medical opinion. Section 440.13(5)(e), Florida Statutes (1995), provides that only the medical opinions of a medical advisor appointed by the JCC, an independent medical examiner, or an authorized treating provider are admissible in proceedings before a JCC. An “authorized treating provider,” as that term is used in section 440.13(5)(e), Florida Statutes, is a treating provider authorized by the E/C....
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Mehrer v. Creative Hairdressers, Inc., 659 So. 2d 333 (Fla. 1st DCA 1995).

Published | Florida 1st District Court of Appeal | 1995 Fla. App. LEXIS 3188, 1995 WL 132333

...ad been authorized. An employer must furnish to an injured employee "such medically necessary remedial treatment, care, and attendance by a health care provider and for such period as the nature of the injury or the process of recovery may require." § 440.13 (2)(a), Fla....
..."If the employer fails to provide such treatment, care, and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by a judge of compensation claims." § 440.13(2)(d), Fla. Stat. (1991). Because the E/C did not fulfill its obligation under section 440.13(2)(a), the JCC should have made a determination of the reasonableness and necessity of the treatment rendered by Dr....
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Prescription Partners, LLC v. State, Dep't of Fin. Servs., 109 So. 3d 1218 (Fla. 1st DCA 2013).

Published | Florida 1st District Court of Appeal | 2013 WL 1235893, 2013 Fla. App. LEXIS 5161

...enging the dismissals of thirty-five Petitions for Resolution of Reimbursement Dispute by the Department’s Office of Medical Services (“OMS”). We reverse. This cause is rooted in chapter 440, Florida Statutes. According to the plan outlined in section 440.13, Florida Statutes, workers’ compensation physicians licensed to dispense prescription medication to injured claimants may seek reimbursement from the claimants’ employers or the employers’ compensation insurance carriers based on the pharmacy fee schedule set forth in section 440.13(12)(c), Florida Statutes....
...ion of Bill Review (“EOBR”) explaining the reason why it denied, disallowed or adjusted the payment. See Fla. Admin. Code R. 69L-7.602(5)(j)l. & (q). If the provider chooses to challenge the reimbursement amount, or the refusal to reimburse, section 440.13(7), Florida Statutes, along with its corresponding provisions in chapter 69L-31, Florida Administrative Code, provides the mechanics for resolving the dispute....
...provider, carrier, or employer who elects to contest the disallowance or adjustment of payment by a carrier ... must, within 30 days after receipt of notice of disallowance or adjustment of payment, petition the department to resolve the dispute.” § 440.13(7)(a), Fla....
...sed to workers’ compensation claimants. The OMS adjudicated many of the petitions in Partners’ favor, but dismissed others ruling they had not been filed within thirty days “of notice of disallowance or adjustment of payment,” as required by section 440.13(7)(a)....
...The hearing officer also rejected Partners’ request for a formal administrative hearing. On review, the Department entered its Final Order fully adopting the hearing officer’s findings of fact and conclusions of law. The Department concluded that section 440.13(7)(a) “expressly authorizes only health care providers, carriers, or employers to contest the disallowances or payment adjustments here in question,” and Partners “fits into none of those categories.” (Emphasis in original.) Fu...
...l doctors allowing it to retain all the monies it collects on their respective claims.... Thus, it is clear that the economic interest at stake here is that of the doctors’ selling, and Prescription Partners’ buying, of debt. There is nothing in Section 440.13(7), Fla....
...Department of Environmental Regulation, 406 So.2d 478 (Fla. 2d DCA 1981) test to be considered a Chapter 120, Fla. Stat., “party” in this matter because its economic interests are not within the type or nature of interests sought to be protected by Section 440.13(7), Fla....
...Applying the foregoing principles to the Department’s Final Order in the present case, we find two fundamental flaws in its analysis. First, in holding that Partners is not a “health care provider[ ], carrier[ ], or employer[ ]” as contemplated in section 440.13(7)(a), the Department misconstrues Florida law in regard to assignments of interest....
...sistent voice: An assignee stands in the shoes of his assignor.’ ” Id. (quoting Bledsoe, 989 F.2d at 809-810 ) (emphasis in original). Here, a physician’s right to pursue a dispute resolution cause of action with the Department is derived from section 440.13(7)(a)....
...In other words, Partners seeks to protect by its administrative action the identical interests protected by the dispute resolution process set forth in the applicable statutes and rules. Focusing primarily on the second prong of the Agrico test, as did the Department, we are convinced that section 440.13(7)(a) unquestionably intends to protect the economic interests of a health care provider who has not been made whole by an insurance carrier for the services rendered to an injured employee under chapter 440. Thus, it is incorrect for the Department to claim that Partners lacks standing because its “only interest in the proceeding is economic.” To the contrary, section 440.13(7)(a) does not purport to protect any interests other than economic interests....
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Miller v. Tribune Co., 275 So. 2d 242 (Fla. 1973).

Published | Supreme Court of Florida | 1973 Fla. LEXIS 4666

employer furnish medical treatment as provided by § 440.13(1), Florida Statutes, F.S.A. His request was granted
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Formite, Inc. v. Jaynes, 208 So. 2d 614 (Fla. 1968).

Published | Supreme Court of Florida | 1968 Fla. LEXIS 2312

within the provisions of Florida Statutes, Section 440.13, F.S.A., and were therefore not required to
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Arlotta v. City of West Palm Beach, 82 So. 3d 1221 (Fla. 1st DCA 2012).

Published | Florida 1st District Court of Appeal | 2012 Fla. App. LEXIS 4604, 2012 WL 987401

...for treatment for Claimant's gynecomastia were moot because Claimant had undergone the surgery, the only treatment recommended for the condition. Because Claimant failed to meet his burden of proof, the JCC denied and dismissed the claims. Analysis Section 440.13(9)(c), Florida Statutes (2007), mandates the appointment of an EMA if there is a disagreement among healthcare providers....
...physicians is admissible evidence; in contrast, their medical opinions are not. See Office Depot, Inc. v. Sweikata, 737 So.2d 1189, 1191 (Fla. 1st DCA 1999) (holding it was reversible error to *1224 exclude deposition of unauthorized physician under section 440.13(5)(e), Florida Statutes and explaining: "Dr....
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Kenney v. Juno Fire Control Dist. 3, 576 So. 2d 905 (Fla. 1st DCA 1991).

Published | Florida 1st District Court of Appeal | 1991 Fla. App. LEXIS 2731, 1991 WL 39310

WIGGINTON, Judge. We affirm the judge of compensation claims’ order denying claimant’s claim for medical care and treatment on the basis that the treatment rendered by Dr. Neil Ahner, was experimental in nature as contemplated by section 440.13(l)(c), Florida Statutes (1989)....
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Sarasota Cnty. Sch. Bd. v. Castagna, 577 So. 2d 635 (Fla. 1st DCA 1991).

Published | Florida 1st District Court of Appeal | 1991 Fla. App. LEXIS 2751, 1991 WL 39315

...1st DCA 1989); Travelers Ins. Co. v. Sitko, 496 So.2d 920 (Fla. 1st DCA 1986); Greynolds Park Manor v. George, 417 So.2d 990 , appeal after remand, 423 So.2d 485 (Fla. 1st DCA 1982). Claimant is also entitled to seek reimbursement for any amounts personally expended. § 440.13(2)(b), Fla.Stat....
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Turnberry Isle Country Club v. Reyes, 469 So. 2d 787 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 784, 1985 Fla. App. LEXIS 13171

...y have been made a part of the record, although the medical bills were not placed in evidence. The employer and carrier contend the deputy erred in awarding payment of the medical bills, alleging that claimant failed to comply with the provisions of Section 440.13(1), Florida Statutes (1981)....
...in the case.” American Grinding & Equipment v. Rodman, 411 So.2d 917, 918 (Fla. 1st DCA 1982). Implicit in the deputy’s order directing payment of the medical bills is a finding of “good cause” to excuse the non-reporting requirements of Section 440.13(1), Florida Statutes (1981). Good cause has been shown in cases where there are complex factual circumstances or a confused legal situation, or where the employer waives the requirement of Section 440.13(1) with actual knowledge of the medical care provided....
...American Finnish Nursing Home, 450. So.2d 1262 (Fla. 1st DCA 1984); Walt Disney World Co. v. Schiebel, 414 So.2d 602 (Fla. 1st DCA 1982). On remand, “it is necessary for the deputy to find ‘good cause’ to excuse noncompliance with the' requirements of Section 440.13(1), Florida Statutes, before ordering payment by the E/C.” American Grinding, at 918....
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Thomas v. U Haul of West Coast Florida, 467 So. 2d 719 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 783, 1985 Fla. App. LEXIS 13168

...According to claimant, the EMG report indicated that he has severe nerve damage to his back. Claimant’s allegations were not disputed by the employer and carrier, who defended on the ground that any physical difficulty the claimant currently has is unrelated to his industrial accident of September 26, 1979. Section 440.13(1), Florida Statutes, requires an employer to furnish medical care to the employee “for such period as the nature of the injury or the process of recovery may require.” The care to be provided is not just remedial care, “but also...
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Stahl v. Hialeah Hosp., 160 So. 3d 519 (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal | 2015 Fla. App. LEXIS 4294, 2015 WL 1422502

...ovement, and the 2003 elimination of permanent partial disability (PPD) benefits, make the Workers’ Compensation Law an inadequate exclusive replacement remedy for a tort action. See Ch. 93-415, § 17, at 110, Laws of Fla. (substantially rewriting section 440.13, Florida Statutes); Ch....
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Seigler v. Rmc Americas of Florida, LLC, 57 So. 3d 913 (Fla. 1st DCA 2011).

Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 3889, 2011 WL 985215

...Christine Davis Graves of Carlton Fields, P.A., Tallahassee, for Appellees. PER CURIAM. In this workers' compensation appeal, the Judge of Compensation Claims (JCC) erred in concluding the Employer/Carrier (E/C) timely responded to Claimant's request for a change in physician under section 440.13(2)(f), Florida Statutes (2008)....
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Geoffrey Meehan v. Orange Cnty. Data & Appraisals & Johns E. Co., Inc., 272 So. 3d 458 (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...f the need for treatment or disability; and 2) the prescriptions are not medically necessary. No EMA was appointed. 1 Following the merits hearing, the JCC entered an order denying all claims. The JCC accepted the testimony of Dr. Brooks 1 Section 440.13(9)(c), Florida Statutes, dictates that the JCC “shall” appoint an EMA when there is a “disagreement in the opinions of the health care providers.” Here, the parties expressly waived appointment of an EMA and stipulated on the record that neither would raise the EMA issue on appeal....
...Granted, despite the E/C’s acceptance of compensability of the work-related exposure and illness, the Claimant retained the burden to establish other aspects of proof required by statute, such as the medical necessity of the requested benefits. See § 440.13(2)(a), Fla....
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Klug v. Popeye's, 593 So. 2d 1228 (Fla. 1st DCA 1992).

Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 1875, 1992 WL 37149

...d for reconsideration of this issue. We must also remand as to the second issue, in that the JCC made no finding as to whether the chiropractic care which claimant received after the commencement of orthopedic treatment was reasonable and necessary. Section 440.13(2), Florida Statutes; Bennett v....
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Dynair Servs., Inc. v. L'Herisson, 690 So. 2d 659 (Fla. Dist. Ct. App. 1997).

Published | District Court of Appeal of Florida | 1997 Fla. App. LEXIS 2472, 1997 WL 119747

chiropractic care in excess of eighteen visits. Section 440.13(2)(a), Florida Statutes (Supp. 1994), requires
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Perez v. F. W. Woolworth Co., 220 So. 2d 904 (Fla. 1969).

Published | Supreme Court of Florida | 1969 Fla. LEXIS 2447

before the Judge of Industrial Claims. See F.S. Section 440.13, F.S.A. See also, Robinson v. Howard Hall Company
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DeCuba v. Indian River Cmty. Coll., 867 So. 2d 1257 (Fla. 1st DCA 2004).

Published | Florida 1st District Court of Appeal | 2004 Fla. App. LEXIS 3492, 2004 WL 524721

...Appellant seeks reversal of an order denying her workers’ compensation claim for *1258 a heated home pool because the judge of compensation claims (JCC) relied in part on the testimony of an independent medical examiner who was paid more than permitted by section 440.13(14)(b), Florida Statutes (1999). Because the independent medical examiner is disqualified from testifying in this case, we reverse. Dr. Davidson performed an independent medical examination (IME) for $750 in 1999. Because section 440.13(14)(b) limits IME fees to $400, the carrier moved for a second IME....
...Davidson was told that opinions from the first IME were inadmissible, and was told to limit his opinion to his second IME. This deposition was considered by the JCC at the final hearing; a prior deposition from Dr. Davidson was excluded. Accordingly, the JCC reversibly erred. Appellees argue for affirmance that section 440.13(14)(b) was amended on July 1, 2002, to exclude an IME from the $400 limit and that such amendment should be applied here....
...ies to all IMEs taken after that date, including those taken in cases where the injury occurred before that date. Cf. Paulk v. Sch. Bd. of Palm Beach County, 615 So.2d 260, 261 (Fla. 1st DCA 1993) (in considering the limit imposed on witness fees in section 440.13(2)(k), holding that “where the claimant’s entitlement to a service is not diminished, a limitation on the amount paid for the service does not impact a substantive right and may apply to services rendered after the effective date of the statutory limitation”)....
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Freshwater v. Baker, 707 So. 2d 937 (Fla. 4th DCA 1998).

Published | Florida 4th District Court of Appeal | 1998 Fla. App. LEXIS 2682, 1998 WL 117517

...of the Workers’ Compensation Law. See id. at 670-72 . In our view, the Fourth District correctly interpreted both the legislative history and the plain language of the statute. It seems clear that, *939 as Sun Bank recognized, “the evolution of section 440.13(3) in the context of the system established by chapter 440 ......
...under the [Workers' Compensation] Act and also seek to avoid the statutory limits by contracting for a higher fee with the worker. To the extent it sought compensation in excess of the fee schedule, [the health care provider's] contract contravened section 440.13 and was void....
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City of Tampa v. Thompson, 923 So. 2d 558 (Fla. 1st DCA 2006).

Published | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 3729, 2006 WL 658859

...Kneze-vich, on the issue of causation, the judge of compensation claims committed reversible error when he denied the employer’s and servicing agent’s request for appointment of an expert medical advisor. See, e.g., Broward Children’s Ctr., Inc. v. Hall, 859 So.2d 623, 627 (Fla. 1st DCA 2003) (“the clear intent of section 440.13(9)(c) is to require participation of an expert medical advisor in every case where a disagreement exists between healthcare providers”)....
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Myers v. Sherwin-Williams Paint Co., 898 So. 2d 264 (Fla. 1st DCA 2005).

Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 3577, 2005 WL 607913

...for two-thirds of the cost of future psychotherapy. Claimant raises two points on appeal. First, claimant argues that she should be reimbursed in full, rather than at the fee schedule, for her out-of-pocket payments made to her psychotherapist under section 440.13(2)(c), Florida Statutes (1995). We agree with the employer/carrier that section 440.13(2)(c) (providing that “[i]f the employer fails to provide initial treatment or care required, by this section after request by the injured employee, the employee may obtain such treatment at the expense of the employer”) (emphasis added) must be read in conjunction with section 440.13(14)(b) (stating that “[f]ees charged for remedial treatment, care, and attendance may not exceed the applicable fee schedules adopted under this chapter”)....
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Pyles v. Bridges, 259 So. 2d 724 (Fla. Dist. Ct. App. 1972).

Published | District Court of Appeal of Florida | 1972 Fla. App. LEXIS 7139

...Subsequently, Pyles instituted a common law action against the physicians, Drs. Thomas, Bridges and Walch, and Sarasota County Public Hospital Board, alleging that the treatment rendered him was done negligently. Defendants assert that since the medical treatment was done and paid for under Section 440.13 of the Workmen’s Compensation Act, they share in the immunity from suit which is conferred upon the employer under Section 440.11 of said Act. Pursuant to Florida Appellate Rule 4.6, 32 F.S.A., the trial judge of Sarasota County has certified the following question to this court: DO PHYSICIANS AND HOSPITAL WHO RENDER MEDICAL SERVICE TO ANY EMPLOYEE UNDER SECTION 440.13, FLORIDA STATUTES (WORKMEN’S COMPENSATION ACT), SHARE IN THE IMMUNITY FROM COMMON LAW SUIT CONFERRED UPON AN EMPLOYER UNDER SECTION 440.11 OF SAID ACT WHERE IT IS ALLEGED IN A SUIT BROUGHT BY THE EMPLOYEE AGAINST SAID PHYSICIANS AND...
...ce at the time of the accident, and was an active participant in the company’s activities as they related to the safety of the employees. In the instant case while services performed by the doctors and hospital were performed pursuant to Fla.Stat. § 440.13, F.S.A., (Workmen’s Compensation Act) they were done subsequent to and independently of services rendered to the employer....
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Bd. of Cnty. Commissioners v. S. Florida Sanitarium & Hosp. Corp., 173 So. 2d 131 (Fla. 1965).

Published | Supreme Court of Florida | 1965 Fla. LEXIS 3322

...ng anything for the treatments because it had failed to file the reports required by F.S. § 410.13, F.S.A. The deputy resolved the claim in favor of petitioners by finding that the failure of Hialeah Hospital lo file the reports as required by F.S. § 440.13, F.S.A....
...or similar treatment of injured persons of like standard of living.” This holding was based on the Commission’s determination that the medical fee schedule did not apply to hospitals, and that hospitals were only limited in their charges by F.S. § 440.13(3) (a), F.S.A., “ * * * that is, such charges as prevail in the same community for similar treatment of injured persons of like standard of living.” The Commission also determined that hospitals were not required to file the reports set forth in F.S. § 440.13, F.S.A. We agree with petitioners’ contention that the filing of reports as required by F.S. § 440.13, F.S.A., applies to hospitals as well as physicians and other practitioners....
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Reddick v. Charles W. Infinger Constr., 617 So. 2d 723 (Fla. 1st DCA 1993).

Published | Florida 1st District Court of Appeal | 1993 Fla. App. LEXIS 2977, 1993 WL 72306

We therefore adhere to our conclusion that section 440.13(2)(k), Florida Statutes (Supp.1990), does not
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Ruben Rodriguez v. Tallahassee Fire Dep't/ City of Tallahassee, 240 So. 3d 788 (Fla. 1st DCA 2018).

Published | Florida 1st District Court of Appeal

...Cox and opined that Mr. Rodriguez was entitled to a 16% PIR under the Class 2 category because an ablation procedure is analogous to having a pacemaker. To resolve the doctors’ disagreement about the impairment rating, the JCC appointed Dr. Castello as EMA. See § 440.13(9)(c), Fla....
...The JCC rejected Dr. Castello’s opinion, accepted the 0% PIR assigned by Dr. Cox, and denied payment of permanent impairment benefits. II. When there is a disagreement in the medical opinions in a workers’ compensation case, § 440.13(9)(c) mandates the appointment of an EMA whose opinion “is presumed to be correct 2 unless there is clear and convincing evidence to the contrary as determined by the [JCC].” See also Taylor v....
...The JCC here assigned a Class 1 rating after deciding, contrary to the EMA’s testimony, that the aspirin prescribed by Mr. Rodriguez’s cardiologist was not a “drug.” To support this conclusion, the JCC misplaced reliance on the definition of “medicine” under paragraph 440.13(1)(l) (“[A] drug prescribed by an authorized health care provider [which] includes only generic drugs or single-source patented drugs ....
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Miami-Dade Cnty. v. Mitchell, 754 So. 2d 773 (Fla. 1st DCA 2000).

Published | Florida 1st District Court of Appeal | 2000 Fla. App. LEXIS 2631, 2000 WL 266320

requirements of section 440.13(3)(a) and (4)(a), Florida Statutes (1995). (Section 440.13(2)(c) provides
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Univ. Pine Ret. v. Myers, 752 So. 2d 1259 (Fla. 1st DCA 2000).

Published | Florida 1st District Court of Appeal | 2000 Fla. App. LEXIS 2623, 2000 WL 266345

...ith any health care provider involved in this case because the nurse was an independent contractor, not a “direct ‘in-house’ employee” of the E/C. In support of their petition, the E/C argue only that rehabilitation providers are included in section 440.13(4)(e), Florida Statutes, as among those authorized to conduct ex parte communications with a claimant’s health care providers....
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Orona v. Baucom's of Florida, 689 So. 2d 431 (Fla. Dist. Ct. App. 1997).

Published | District Court of Appeal of Florida | 1997 Fla. App. LEXIS 2355, 22 Fla. L. Weekly Fed. D 668

...He asserts specifically that the judge erred (1) in finding there was no medically necessary reason for granting his request for another authorized treating physician, and (2) in denying his request for an independent medical examination (IME), pursuant to section 440.13(5)(a), Florida Statutes (Supp.1994)....
...Obviously, there was no dispute among the physicians as to claimant’s condition; therefore, the judge’s finding in this regard is affirmed. We cannot agree, however, with the judge’s denial of claimant’s request for an IME. Claimant’s injury occurred after the 1994 amendment to section 440.13(5)(a), which changed the procedure for IMEs. Before its amendment, section 440.13(2)(b) allowed only the employer the right to select an IME physician and arrange for the exami *433 nation. Following the amendment, the employer and the employee both have the right to select a doctor of their choosing; however, limited control over the scheduling of the examination appears, under section 440.13(5)(c), to remain with the employer to the extent that the claimant’s attorney is precluded from scheduling the examination....
...Nothing in the record therefore supports the judge’s finding that claimant selected Dr. Rosen as his IME physician, and that he was therefore not entitled to a second IME. In our judgment, the amendments to the statute were specifically designed to resolve disputes of this sort, in that section 440.13(5)(a) permits either party to select an examiner in order, among other things, to address disputes over medical benefits....
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Vickers v. Unity of Lake Worth, 680 So. 2d 470 (Fla. 4th DCA 1996).

Published | Florida 4th District Court of Appeal | 1996 Fla. App. LEXIS 2322, 1996 WL 108424

payment for any additional care be controlled by section 440.13(2)(e)l, Florida Statutes (1989), as that provision
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Gonzalez v. AMC/CCMSI, 160 So. 3d 932 (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal | 2015 Fla. App. LEXIS 3569, 2015 WL 1086137

PER CURIAM. In this workers’ compensation case, Claimant filed a petition for writ of certio-rari challenging an order of the Judge of Compensation Claims that appoints an expert medical advisor (EMA) under the authority of section 440.13(9), Florida Statutes (2011)....
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Flagler Hosp. Inc. v. Ass'n Ins. Co., 133 So. 3d 644 (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal | 2014 WL 982554, 2014 Fla. App. LEXIS 3605

...injury for which services were provided is in dispute), with Bryan LGH Med. Ctr. v. Fla. Beauty Flora, 36 So.3d 795, 796 (Fla. 1st DCA 2010) (holding Judge of Compensation Claims does not have jurisdiction over reimbursement dispute actionable under section 440.13(7)(a))....
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Mayra Gonzalez v. AMC/CCMSI (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal

...Respondent. PER CURIAM. In this workers’ compensation case, Claimant filed a petition for writ of certiorari challenging an order of the Judge of Compensation Claims that appoints an expert medical advisor (EMA) under the authority of section 440.13(9), Florida Statutes (2011)....
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Torres v. Yoder Bros., 614 So. 2d 45 (Fla. 1st DCA 1993).

Published | Florida 1st District Court of Appeal | 1993 Fla. App. LEXIS 2494, 1993 WL 64498

...Under the statute in effect during this period, deauthorization without an order by the JCC was proper only where over-utilization was the basis for deauthorizing such care, and where a determination was made in accordance with the over-utilization review procedures outlined in § 440.13(4)(d)l., and alternate medical care was offered by the employer/carrier. Section 440.13(2)(a), Florida Statutes (1989); and Wolk v....
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Brevard Cnty. Sch. Bd. v. Acosta, 141 So. 3d 233 (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal | 2014 Fla. App. LEXIS 8788, 2014 WL 2565925

JCC’s determination and is consistent with section 440.13(2), Florida Statutes (2012). That provision
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Catalano v. Hillsborough Cnty. Bd. of Pub. Instruction, 249 So. 2d 24 (Fla. 1971).

Published | Supreme Court of Florida | 1971 Fla. LEXIS 3589

...ween the facts in the case sub judice and the conclusion reached in Food Fair Stores, Inc. v. Tokayer, 167 So.2d 563 (Fla.1964), wherein we held that the taking of an electro-cardi-ogram constituted remedial treatment within the meaning of Fla.Stat. § 440.13, F.S....
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Venice Nursing Pavilion v. Walchle, 637 So. 2d 996 (Fla. 1st DCA 1994).

Published | Florida 1st District Court of Appeal | 1994 Fla. App. LEXIS 5420, 1994 WL 244418

...etween the parties that claimant’s medical bills would be, automatically paid if found related to the industrial accident. Accordingly, the E/C are only responsible for payment of medical bills properly and timely submitted as required by statute. § 440.13(1), Fla.Stat....
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Bowman Nurseries v. King, 155 So. 2d 871 (Fla. 1963).

Published | Supreme Court of Florida | 1963 Fla. LEXIS 2655

...Nadler, check with the carrier for authorization for further treatment. This order was affirmed by the Full Commission and was never modified. The record does not disclose that the carrier refused the claimant medical treatment although it did, as it had the right, refuse further treatment by Dr. Nadler. 2 Section 440.13(1) Florida Statutes, F.S.A., provides in part as follows: “If the employer fails to provide the same [medical service and supplies] *874 after request by the injured employee, such injured employee may do so at the expense of the emp...
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Laura Myers v. Pasco Cnty. Sch. Bd. & Johns E. Co., Inc., 246 So. 3d 1278 (Fla. 1st DCA 2018).

Published | Florida 1st District Court of Appeal

...Rosen, Judge. Date of Accident: August 26, 2016. June 4, 2018 JAY, J., In this workers’ compensation case, the Claimant seeks relief from a summary final order of the Judge of Compensation Claims (JCC) denying her request for a “one-time change” of physician as permitted by section 440.13(2)(f), Florida Statutes (2016)....
...Because orthopedic surgeons and neurosurgeons both treat back injuries, and because the Claimant has a compensable back problem, the JCC concluded that the E/C’s authorization was in compliance with the statute. However, the JCC’s analysis is not grounded in the language of the statute. Section 440.13(2)(f) requires that the one-time change be made with a physician who practices in the “same specialty” as the originally authorized doctor....
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Wuesthoff Mem'l Hosp. v. Schmitt, 694 So. 2d 145 (Fla. 5th DCA 1997).

Published | Florida 5th District Court of Appeal | 1997 Fla. App. LEXIS 6184, 1997 WL 291486

Compensation Claims (JCC) erroneously relied on section 440.13(3)(d), Florida Statutes (Supp.1994), because
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Castillo v. Total Source, Inc., 65 So. 3d 120 (Fla. 1st DCA 2011).

Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 10300, 2011 WL 2578572

...filed March 31, 2011, and substitute the following: In this workers’ compensation case, Claimant appeals an order of the Judge of Compensation Claims (JCC), which finds, in part, that he is not entitled to a “onetime” change of physician under section 440.13(2)(f), Florida Statutes, because he had already exercised that option....
...ange by continuing to treat with Dr. Jarolem, and Dr. Ellowitz was deauthorized as a matter of law. On appeal, Claimant argues his request that resulted in authorization of Dr. Jaro-lem was a request for a specialist consultation (as contemplated in section 440.13(3)(i), Florida Statutes) in accordance with Dr. Ellowitz’s prescription, made under section 440.13(2)(a), Florida Statutes, which provides that an E/C “shall furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require.” Claimant also argues no evidence supports the JCC’s finding that Dr....
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Ago (Fla. Att'y Gen. 1989).

Published | Florida Attorney General Reports

and "[e]mployment" for purposes of the act. 4 Section 440.13(1)(b), F.S. (1988 Supp.). 5 When two statutes
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Dairies v. LaRose, 434 So. 2d 17 (Fla. 1st DCA 1983).

Published | Florida 1st District Court of Appeal | 1983 Fla. App. LEXIS 20861

whether claimant is entitled to an award under Section 440.-13(1), Florida Statutes (1981) for services rendered
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Trejo-Perez v. Arry's Roofing, 141 So. 3d 220 (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal | 2014 WL 2472264, 2014 Fla. App. LEXIS 8384

...ruary 19, 2013, office visit, that a Spanish-speaking psychologist “is a must.” Rather, a fair reading of Dr. Alves’ testimony is that a Spanish-speaking psychologist would be merely preferable under the circumstances. Preferable, perhaps; but section 440.13(2)(a), Florida Statutes (2011), requires that recommended treatment be medically necessary if the employer is to pay for it....
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Heath & Co. v. Greifzu, 545 So. 2d 959 (Fla. 1st DCA 1989).

Published | Florida 1st District Court of Appeal | 14 Fla. L. Weekly 1571, 1989 Fla. App. LEXIS 3704, 1989 WL 72740

...services of the psychiatrist, Dr. Lakdawala. Dr. Lakdawala saw claimant on nine occasions between November 20, 1987 and January 25, 1988, but failed to timely report to the employer or carrier his evaluation and treatment of claimant as required by section 440.13, Florida Statutes....
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Baycare Home Care Med. Supply v. Santiago, 220 So. 3d 1286 (Fla. 1st DCA 2017).

Published | Florida 1st District Court of Appeal | 2017 WL 2790707, 2017 Fla. App. LEXIS 9304

...Others, however, determined the accident caused the injury. After Santiago filed a petition seeking temporary partial disability benefits, the judge of compensation claims appointed an expert medical advisor to examine Santiago and resolve the conflict. See § 440.13(9)(e), Fla....
...” Ultimately, the JCC found Santiago was not at MMI and authorized TPD benefits. The employer/carrier appeal. The same statute that authorizes a JCC to appoint an EMA also imposes a presumption of correctness on the EMA’s subsequent opinion. See § 440.13(9)(c) (“The opinion of the expert medical advisor is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the judge of com *1288 pensation claims.”)....
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Consultants & Designers v. Brown, 697 So. 2d 1228 (Fla. Dist. Ct. App. 1997).

Published | District Court of Appeal of Florida | 1997 Fla. App. LEXIS 7254, 1997 WL 352893

...industrial accident before such treatment is authorized, the JCC erred in ordering the E/C to authorize a psychiatric evaluation and/or treatment “in the event” one of Brown’s treating physicians prescribes or refers her to a psychiatrist. See § 440.13(2)(a), Fla....
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Purex Corp. v. Fay, 400 So. 2d 1021 (Fla. Dist. Ct. App. 1981).

Published | District Court of Appeal of Florida | 1981 Fla. App. LEXIS 20268

Corp. v. Pittman, 49 So.2d 200 (Fla.1950); Section 440.13, Florida Statutes (1977). The claimant in the
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Smith v. Walt Disney World Co., 471 So. 2d 637 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 1564, 1985 Fla. App. LEXIS 14797

...Pavlik. Claimant’s attorney responded by inquiring of the reason for the employer’s refusal to authorize Dr. Stansbury, and requesting a list of three or four chiropractors. At a subsequent hearing held on the April claim, claimant argued that section 440.13(2)(a), Florida Statutes (1983), requires the employer to offer not one, but a choice of at least three or four chiropractic physicians, and its failure to do so amounted to discrimination against chiropractors as a class....
...d that its offer of treatment by one chiropractor satisfied that requirement. The employer also contended that Dr. Stans-bury’s medical reports had not been timely filed. The deputy commissioner agreed with the employer’s position and found that section 440.13(2)(a) “only requires that one representative of each class be included on any list of pertinent health care providers” and that the employer’s list had satisfied that requirement....
...0.-13 mandates there be no discrimination against any of the various types of health care providers, and that should the statute be susceptible to more than one interpretation, the interpretation most favoring the injured employee should be adopted. Section 440.13(2)(a) directs the employer to furnish to the employee necessary medical treatment and provides: Any list of health care providers developed by a carrier ... from which health care providers are selected to provide *639 remedial treatment, care, and attendance shall include representation of each type of health care provider defined in s. 440.13(3)(d)l.d., Florida Statutes, 1981, and shall not discriminate against any of the types of health care providers as a class....
...Instead, it provides only that no list may exclude, or “discriminate” against, a particular health care provider. Claimant’s argument has no foundation in the statute. The employer’s list of physicians offered to claimant complied with the statutory mandate. 2 AFFIRMED. BOOTH and BARFIELD, JJ., concur. . Section 440.13 was substantially amended in 1983....
...Although we can understand claimant’s desire to choose her treating physician, we have recognized that a claimant is not necessarily entitled to the physician of his or her choice. The employer’s responsibility is only to provide necessary medical treatment. Section 440.13(2)(a)....
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Albertini v. McDonald's, 400 So. 2d 160 (Fla. Dist. Ct. App. 1981).

Published | District Court of Appeal of Florida | 1981 Fla. App. LEXIS 20283

...Turke’s name was written under the latter heading, which does not limit its terms to medical “treatment,” the claimant agreed not to seek recovery of any expenses associated with Dr. Turke. Reimbursement for medical treatment is covered by Florida Statutes, Section 440.13, which, with certain exceptions, requires that a physician’s treatment be authorized by the employer/carrier....
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Richardson v. Showell Farms, 734 So. 2d 590 (Fla. Dist. Ct. App. 1999).

Published | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 8277, 1999 WL 410324

...Nita Richardson, the claimant in this workers’ compensation case, appeals an order denying her claim for attorney’s fees incurred in obtaining an independent medical examination over the opposition of employer/carrier (E/C). Under the JCC’s interpretation of section 440.13(5)(f), Florida Statutes (Supp.1994), a workers’ compensation claimant is not entitled to an attorney’s fee payable by E/C with respect to an independent medical examination....
...E/C took the depositions of three medical providers, and claimant’s attorney took the deposition of the carrier’s adjuster. On the day before the scheduled hearing on claimant’s petition, E/C agreed to the independent medical examination requested by claimant. Claimant’s attorney construed the language of section 440.13(5)(f) to mean that an attorney’s fee is not due if the claimant attempts to fight an independent medical examination sought by E/C, but a fee should be payable by E/C to claimant’s attorney when the attorney is successful in obtaining an independent medical examination which E/C opposed and delayed....
...While we recognize the provision here at issue is not a model of clarity, we must reject the JCC’s construction. Even if this were a proper literal reading of the provision, when read in the context of subsection (5) in its entirety, the interpretation leads to an unreasonable or absurd result. The subject matter of section 440.13(5) is the general rights and obligations of the parties with regard to independent medical examinations....
...by an injured employee in connection with delay of or opposition to an independent medical examination, including, but not limited to, motions for protective orders, are not recoverable under this chapter. Read together with the other provisions of section 440.13(5), particularly with subpar-agraph (e), subparagraph (f) precludes recovery of attorney’s fees incurred by an injured employee in those situations where the employee delays or opposes an independent medical examination sought by E/C....
...The provision does not preclude an attorney’s fee to an injured employee who seeks an independent medical examination, and then incurs attorney’s fees due solely to E/C’s opposition. Recent workers’ compensation decisions issued by this court illustrate this preferred construction and application of section 440.13(5)(f)....
...The issue decided in Washington concerned the JCC’s admission, over claimant’s objection, of depositions of physicians who had treated claimant for non-industrial injuries. The JCC viewed the physicians as “medical advis-ors” and admitted the depositions. The court deemed the JCC’s conclusion was erroneous, because section 440.13(5)(e), Florida Statutes (Supp.1994), identifies admissible medical opinions in a workers’ compensation proceeding as those rendered by a physician appointed by the JCC or division, an independent medical examiner, or an authorized treating provider....
...ngton , the *593 Washington panel affirmed the JCC’s award of an attorney’s fee to claimant’s attorney for securing an independent medical examination which had been opposed by E/C. 702 So.2d at 1357 . Thus, this court consistently has applied section 440.13(5)(f) as precluding an attorney’s fee only when the injured employee opposes and delays E/C’s effort to obtain an independent medical examination. See Delgado v. J.C. Concrete, 721 So.2d 353, 353 (Fla. 1st DCA 1998)(section 440.13(5)(f) disallows recovery for attorney’s fees by an injured employee opposing an independent medical examination)....
...After depositions were taken, and on the day before the final hearing, E/C agreed to authorize the independent medical examination requested by claimant. Because E/C forced claimant to incur attorney’s fees in litigation of the independent medical examination issue, section 440.13(5)(f) may not be construed to preclude an attorney’s fee to claimant’s attorney....
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Nathanson v. Dep't of Labor & Emp. Sec., Div. of Workers' Comp., 620 So. 2d 1066 (Fla. Dist. Ct. App. 1993).

Published | District Court of Appeal of Florida | 1993 Fla. App. LEXIS 6557, 1993 WL 215584

...ake his arguments regarding the validity of the subpoena in circuit court. Dr. Nathanson received a letter advising him that the Division was “performing” a utilization review of the care he provided to six claimants listed on an attachment. See § 440.13(4)(h) and (i), Florida Statutes (1991)....
...or enforcement in the circuit court [[Image here]] *1068 It is our view that under the circumstances of this case, the parties are required to proceed under section 120.58. Although utilization review by the Division is exempt from Chapter 120 under section 440.13(4)(i)l., we construe this exemption as only applying to the utilization review process itself....
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Romero v. Jb Painting & Waterproofing, Inc., 38 So. 3d 836 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 8909, 2010 WL 2472276

...Finding Claimant failed to prove he suffered a 5% permanent impairment, the JCC denied Claimant's request for permanent impairment benefits. This appeal followed. Analysis If there is a disagreement in the opinions of health care providers, the JCC shall appoint an EMA. See § 440.13(9)(c), Fla. Stat. (2008). "While [section 440.13(9)] contains no provisions governing the timeliness of requests for appointments of [EMAs], the absence of statutory deadlines does not authorize unreasonable delays in requests for evaluation by [EMAs] once material disagreement in the opinions of health care providers comes to a party's attention." Palm Springs Gen. Hosp. v. Cabrera, 698 So.2d 1352, 1354 (Fla. 1st DCA 1997). "On the other hand, sections 440.13(9)(c) and 440.25(4)(d) contemplate resort to an [EMA], even if the disagreement between medical providers becomes evident only after the merits hearing has begun," and even if neither party requests appointment of an EMA....
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Kendall Assocs. v. Alvarez, 638 So. 2d 198 (Fla. Dist. Ct. App. 1994).

Published | District Court of Appeal of Florida | 1994 Fla. App. LEXIS 5948, 1994 WL 267925

...s, to be provided by claimant’s wife, by a professional provider of unskilled attendant care, and by a rehabilitation center. Subsequently, the employer and carrier (E/C) filed petitions for modification of the attendant care award on the basis of section 440.13(2)(e)2, Florida Statutes (1989), under which family members providing attendant care may not be compensated for more than 12 hours per day, and the fact that claimant and his wife had divorced, such that the wife was no longer providing attendant care benefits....
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Spinelli v. Florida Dep't of Com., 490 So. 2d 1294 (Fla. 1st DCA 1986).

Published | Florida 1st District Court of Appeal | 11 Fla. L. Weekly 1393, 1986 Fla. App. LEXIS 8457

also did not file any reports as required by section 440.13, Florida Statutes. Nevertheless, some of the
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Dep't of Transp. v. Allen, 384 So. 2d 240 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 16873

...eaches maximum medical improvement. As for that portion of the order providing for evaluation and treatment by Dr. Stiefel, we find that order to be improper because there is absent from the record any request for treatment by Dr. Stiefel, and under Section 440.13(1), Florida Statutes, the employer-carrier should be given the opportunity to furnish their own qualified physician, rather than be required to pay for treatment by a doctor neither party requested....
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Velez v. CoAdvantage, Epoch Mgmt., 220 So. 3d 1253 (Fla. 1st DCA 2017).

Published | Florida 1st District Court of Appeal | 2017 WL 2628009, 2017 Fla. App. LEXIS 8911

...Munson with Jewett Orthopedic Clinic to treat the claimant’s compensable injury. When Dr. Munson retired in 2015, the E/C authorized Dr. Weber with Orlando Orthopaed-ics. On June 2, 2016, the claimant filed a petition for benefits (PFB) seeking a new orthopedic physician pursuant to section 440.13(2)©....
...Meinhardt as the claimant’s one-time change. The E/C filed a motion for summary final order, and after a hearing, the Judge of Compensation Claims (JCC) granted the motion and denied the claimant’s second PFB. The JCC rejected the claimant’s argument that section 440.13(2)© “should be read to say the E/C must authorize a physician who is not professionally affiliated with ANY prior physician, hospital, or medical group who treated the claimant at any time in his case” (emphasis in JCC’s order)....
...Instead, the JCC reasoned that the statute prohibited professional affiliation with only the immediately preceding authorized doctor, which in this case was Dr. Weber — who was undisputedly not professionally affiliated with Dr. Meinhardt. This appeal followed. Section 440.13(2)© authorizes the claimant to request a change of physician once during the course of treatment of the com-pensable injury....
...Mein-hardt was not professionally affiliated with Dr. Weber, but he was professionally affiliated with Dr. Munson through Jewett Orthopedic Clinic. Thus, resolution of this case boils down to which, physician — Dr. Weber or Dr. Munson — is “the previous physician" for purposes of section 440.13(2)©....
...lar includes the plural and vice versa.” However, under the plain language of that statute, this interpretive tool only applies “when context will permit,” and here, the context of the phrase “the previous physician” within the language of section 440.13(2)(f) as a whole does not permit the interpretation urged by the claimant....
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Com. Carrier Corp. v. Fox, 400 So. 2d 154 (Fla. Dist. Ct. App. 1981).

Published | District Court of Appeal of Florida | 1981 Fla. App. LEXIS 20151

...House and the claimant furnish a sufficient basis for the appealed order. Additionally, the employer contends the deputy commissioner erred in excusing the late filing of Dr. House’s medical reports and bills without a showing of good cause. We do not agree. Although the reports were untimely filed under Section 440.13(1), Florida Statutes (1977), since 29 days passed between claimant’s initial visit to Dr....
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Teresita De Jesus Abreu v. Riverland Elementary Sch. & Broward Cnty. etc. (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...Compensation Claims. Geraldine B. Hogan, Judge. Date of Accident: June 1, 2015. June 18, 2019 M.K. THOMAS, J. In this workers’ compensation case, the Claimant appeals the denial of shoulder surgery, arguing that section 440.13(9)(c), Florida Statutes, which provides a presumption of correctness to expert medical advisor (“EMA”) opinions, is unconstitutional....
...examiner (“IME”), his opinions were not admissible. 1 Accordingly, the Claimant obtained an IME with Dr. Aparicio. Dr. Aparicio reported his review of diagnostic studies revealed a full thickness rotator cuff tear which he causally related to the work accident. In 1 Section 440.13(5)(e), Florida Statutes (2015), allows only the opinions of an authorized treating physician, IME or EMA as admissible in proceedings before a Judge of Compensation Claims. 2 his opinion, additional surgical repair was warranted and medically necessary. Because of the conflict in medical opinions, the Judge of Compensation Claims (“JCC”) appointed Dr. Rozencwaig as an EMA pursuant to section 440.13(9), Florida Statutes....
...convincing evidence existed to reject it. The Claimant moved to reopen the evidence and allow the deposition of the EMA. The JCC denied both motions as an attempt to relitigate issues previously determined. The Claimant now challenges the constitutionality of section 440.13(9)(c), the “EMA statute,” which grants a presumption of correctness to EMA opinions and appeals the denial of surgery....
...the [JCC] within the advisor’s area of expertise,” and that EMAs are intended to “provide peer review or expert medical consultation, opinions, and testimony . . . to a [JCC] in connection with resolving disputes relating to . . . differing opinions of health care providers . . . .” § 440.13(9)(a)-(b), Fla....
...the injured employee to be evaluated by an expert medical advisor. The opinion of the expert medical advisor is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the judge of compensation claims. § 440.13(9)(c), Fla....
...the entitlement to a service and the source of payment therefor.” Snider v. Mumford, Inc., 65 So. 3d 579, 582 (Fla. 1st DCA 2011) (relying on S. Bakeries v. Cooper, 659 So. 2d 339, 341 (Fla. 1st DCA 1995)). Thus, the EMA statute cannot be applied retroactively. Id. An EMA is a form of IME. Section 440.13(1)(i), Florida Statues, provides: “Independent medical examination” means an objective evaluation of the injured employee’s medical condition, 4 including, but not limited to, impa...
...be applied in isolation but must be considered in light of other statutory processes. Cooper, 659 So. 2d at 340. Section 440.25(4)(d), Florida Statutes, further provides: When there is a conflict in the medical evidence submitted at the hearing, the provision of s. 440.13 shall apply....
...The report or testimony of the expert medical advisor shall be admitted into evidence in a proceeding and all costs incurred in connection with such examination and testimony may be assessed as costs in the proceeding, subject to the provisions of s. 440.13. Separation of Powers First, the Claimant raises a constitutional challenge to the presumption of correctness afforded an EMA, asserting it is a “procedural rule” which violates the guarantee of separation o...
...2d 52, 59 (Fla. 2000). Furthermore, only the supreme court, not the Legislature or the Office of the Judge of Compensation Claims (“OJCC”), has the authority to promulgate procedural rules of evidence. She contends that the overreaching nature of section 440.13(9)(c) is apparent in comparison to the statutory rules of evidence per Chapter 90, Florida Statutes, which do not impose such restrictions on experts....
...any expert, medical or otherwise, nor does it give any preference to the testimony of an EMA. The Claimant asserts that the presumption is also contrary to the post-2011 amended version of section 440.29(3). Notably, the Claimant does not challenge the applicability of section 440.13(9)(c) to her date of accident which would require a procedural or substantive review. She acknowledges that this Court declared section 440.13(9) in its broad form to be substantive. See Snider, 65 So. 3d at 580-82. Instead, she asserts that subsection 440.13(9)(c), declaring the presumption of correctness to the EMA opinion, in and of itself, constitutes an impermissible, unconstitutional procedural component therein which violates separation of powers. The Claimant argues that sections 440.13(5) and (9) are “impermissible” because a single IME cannot produce the evidence necessary to reach the standard of contrary, clear and convincing evidence sufficient enough to successfully challenge an EMA opinion, and as such, section 440.13(9)(c) cannot take precedence over the rules of procedure, pertaining to evidence, that are promulgated by the supreme court. In support, the Claimant cites to the supreme court’s recent holding in Delisle, finding the statute imposing the Daubert 3 evidentiary standard unconstitutional....
...The Court specifically noted it was not “readdressing the correctness” of DeLisle. Id. at *1. 5 In addition to the EMA statute at issue here, Chapter 440 is replete with examples of the Legislature dictating procedure in workers’ compensation actions. Section 440.13(5)(b), the “IME statute,” embodies legislative directive on IME application in a workers’ compensation proceeding. The subsection dictates, “[e]ach party is bound by his or her selection of an independent medical examiner, including the selection of the independent medical examiner in accordance with s. 440.134 and the opinions of such independent medical examiner.” § 440.13(5)(b) Fla. Stat. (emphasis added). A “consensus IME” is another option available to the parties under section 440.13(5)(g)....
...usions of such mutually agreed upon consensus independent medical examination shall be binding on the parties and shall constitute resolution of the medical dispute addressed in the independent consensus medical examination and in any proceeding.” § 440.13(5)(g) Fla....
...Beekman, 187 So. 3d 318, 321 (Fla. 1st DCA 2016) (quoting Broward Children’s Ctr., Inc. v. Hall, 859 So. 2d 623, 626 (Fla. 1st DCA 2003)). The EMA statute is no different. 9 The heightened burden of persuasion created by section 440.13(9)(c) does not violate the constitution because it falls within the purview of the Legislature regarding evidentiary issues in workers’ compensation cases. Cortina v. State, Dep’t of HRS, 901 So. 2d 273, 274 (Fla. 1st DCA 2005) (holding section 440.13(5)(e)’s limit on admissible medical witnesses to authorized treating IME or EMA does not violate separation of powers because “this court has consistently recognized and upheld the Legislature’s prerogative as to evidentiary issues in workers’ compensation cases”); see also Home Depot v....
...2d 836 (Fla. 1st DCA 1996) (holding claimant’s due process rights were not violated by statute excluding testimony by unauthorized treating physician, in part because claimant had other options, such as seeking an IME). For these reasons, we find that section 440.13(9)(c), does not violate the separation of powers guarantee. Procedural Due Process Second, the Claimant challenges section 440.13(9)(c), as an unconstitutional denial of procedural due process in violation of Article 1, section 9, of the Florida Constitution, which provides “[n]o person shall be deprived of life, liberty or property without due process of law ....
...process requirements in the administrative process.” Hadley v. Dep’t of Admin., 411 So. 2d 184, 187 (Fla. 1982). Under the EMA statute, unless the JCC determines that clear and convincing evidence exists to the contrary, the EMA opinion prevails to resolve the medical conflict. § 440.13(9)(c), Fla....
...Further, the heightened burden of persuasion does not completely deny the right to present evidence because it still permits notice and opportunity to be heard. See Rucker, 684 So. 2d at 841. In Rucker, a claimant argued that his due process rights were violated by the IME statute (section 440.13(5)(e))....
...nity to be heard and, thus, was not denied access to court. The Claimant made the strategic decision not to depose the EMA before the merits hearing, despite denial of her motion to strike the EMA opinion. This certainly diminishes her argument that section 440.13(9)(c) essentially forecloses any reasonable means, such as a deposition of the EMA, by which an EMA opinion may be challenged. Under these facts, due process requirements were satisfied. Accordingly, we reject the contention that section 440.13(9)(c) violates the Claimant’s constitutional right to procedural due process under the Florida or federal constitutions. Equal protection Third, the Claimant contends that the presumption of correctness in section 440.13(9)(c), is unconstitutional as a violation of her equal protection rights guaranteed by Article I of the Florida Constitution and the Fourteenth Amendment which provides that “[n]o State shall ....
...The JCC acted within her discretion in denying the surgery based on the presumption of correctness of the EMA opinion as she found no clear and convincing evidence to the contrary. III. Conclusion The presumption of correctness attributed to an EMA pursuant to section 440.13(9)(c), is not an unconstitutional violation of separation of powers, due process, or equal protection guarantees....
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Imprescia v. J.B. Sonnier Stables, 600 So. 2d 539 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 6548, 1992 WL 131889

...Whether good cause appears for deauthorization of a physician and whether authorization of another physician was in claimant’s best interest are questions of fact to be decided by the JCC. Cal Kovens Constr. v. Lott, 473 So.2d 249, 254 (Fla. 1st DCA1985); Wolk v. Jaylen Homes, Inc., 593 So.2d 1058, 1059 (Fla. 1st DCA1992). Section 440.13(3), Florida Statutes (1989), provides, in part: “[A] judge of compensation claims may at any time, for good cause shown, in the judge of compensation claims’ discretion, order a change in such remedial attention, care, or attendanc...
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Steak 'N Shake, Inc. v. Amber Nicole Spears & Eric Spears (Fla. 5th DCA 2025).

Published | Florida 5th District Court of Appeal

...tutory definition that states: “Compensable” means a determination by a carrier or judge of compensation claims that a condition suffered by an employee results from an injury arising out of and in the course of employment. Id. § 440.13(1)(d) (emphasis added)....
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Carter v. Am. Finnish Nursing Home, 450 So. 2d 1262 (Fla. Dist. Ct. App. 1984).

Published | District Court of Appeal of Florida | 1984 Fla. App. LEXIS 13548

...not present any evidence of any bills or reports from Doctors Hospital or Dr. Levitt on the proper workers’ compensation forms, nor an excuse as to why such bills and reports were not timely and properly submitted. We find no error in this order. Section 440.13(1), Florida Statutes, requires that within ten (10) days after a physician or hospital furnishes their first remedial treatment to a claimant, a report of the claimant’s injuries and treatment must be furnished to appropriate entities. Untimely medical reports may be excused by the deputy commissioner for good cause. Good cause has been found in cases where a confused legal situation exists, or where the employer waives the requirements of section 440.13(1) with actual knowledge, or where complex factual circumstances exist....
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Palm Beach Cnty. Sch. Dist. v. Josaphat (Fla. 1st DCA 2024).

Published | Florida 1st District Court of Appeal

...3d 1091, 1094 (Fla. 1st DCA 2020). Section 440, Florida Statutes, requires that E/Cs furnish “medically necessary” treatment and care for employees injured “for such period as the nature of the injury or the process of recovery may require.” § 440.13(2)(a), Fla. Stat. “Medical necessity” involves showing that a medical service “is appropriate to the patient’s diagnosis and status of recovery.” § 440.13(1)(k), Fla....
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Marie Lafleur v. The Arbor Holding Co. LLC d/b/a Barrington Terrace of Fort Myers & United Wisconsin Ins. Co., 272 So. 3d 885 (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...June 12, 2019 RAY, J. In this workers’ compensation case, Claimant appeals an order of the Judge of Compensation Claims (JCC) denying Claimant the right to select the doctor who would serve as her one- time change of physician available under section 440.13(2)(f), Florida Statutes (2014)....
...five calendar days of Claimant’s request for a one-time change, satisfied their statutory obligation to provide a physician in the “same” specialty as the previously authorized physician who specializes in physical medicine and rehabilitation. Section 440.13(2)(f) contemplates that the originally authorized physician be “in the same specialty as the changed physician.” Myers held that “[a] physician who provides similar services in a different specialty does not qualify as a doctor i...
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MIMI/Medpartners, Inc. v. Boestfleisch, 822 So. 2d 512 (Fla. 1st DCA 2002).

Published | Florida 1st District Court of Appeal | 2002 Fla. App. LEXIS 8225, 2002 WL 1285469

...1st DCA 1998), stand for the proposition that, if a conflict in medical testimony is apparent at or before the pretrial conference, there was no error when the JCC denied as untimely the request for the appointment of an emergency medical ad-visor pursuant to section 440.13(9)(c) made during or at the eve of trial....
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Heller Bros. v. Avans, 414 So. 2d 1191 (Fla. 1st DCA 1982).

Published | Florida 1st District Court of Appeal | 1982 Fla. App. LEXIS 20286

reasonably required by the nature of his injury. Section 440.-13(1), Florida Statutes; Bryant v. Elberta Crate
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Smurfit-Stone Container Corp. v. Taylor, 786 So. 2d 1207 (Fla. 1st DCA 2001).

Published | Florida 1st District Court of Appeal | 2001 Fla. App. LEXIS 7575, 2001 WL 584343

statutory scheme, in any event. See generally § 440.13, Fla. Stat. (1997). . Section 440.25(4)(h) does
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Crego v. Southland Corp., 638 So. 2d 572 (Fla. Dist. Ct. App. 1994).

Published | District Court of Appeal of Florida | 1994 Fla. App. LEXIS 5099, 1994 WL 231212

denied payment of the resulting hospital bills. Section 440.13(2)(a), Fla.Stat. (1990), provides that a health
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Reason v. Motorola, Inc., 432 So. 2d 644 (Fla. Dist. Ct. App. 1983).

Published | District Court of Appeal of Florida | 1983 Fla. App. LEXIS 19537

attendant or nursing type care within the purview of § 440.13, Fla.Stat. The claim for attendant and nursing
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Florida Sod Co. v. Myers, 432 So. 2d 645 (Fla. Dist. Ct. App. 1983).

Published | District Court of Appeal of Florida | 1983 Fla. App. LEXIS 19538

timely reports of their treatment as required by section 440.13(1), Florida Statutes (1979). The dep*646uty’s
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Marlene Altemar v. Lifespace Communities, & Communities, etc., 249 So. 3d 1319 (Fla. 1st DCA 2018).

Published | Florida 1st District Court of Appeal

...l advisor (EMA) with regard to the Claimant’s need for attendant care, and that this presumption was inappropriate because the evidence does not demonstrate a sufficient disagreement in the opinions of the health care providers on that ground. See § 440.13(9)(c), Fla....
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Chism v. Hillsborough Cnty. Sch. Bd., 788 So. 2d 418 (Fla. 1st DCA 2001).

Published | Florida 1st District Court of Appeal | 2001 Fla. App. LEXIS 9452, 2001 WL 761342

...Claimant Helen Chism appeals the JCC’s denial of payment for her past psychiatric medical treatment with Dr. Arturo Gonzalez. Because the JCC’s denial did not adequately address whether this past treatment was medically necessary as provided by Section 440.13(2), Florida Statutes (1995), we reverse and remand for consideration. See Bradley v. Kraft Foods, Inc., 609 So.2d 748, 751 (Fla. 1st DCA 1992)(ruling that the JCC did not properly consider legal standards of § 440.13(2), which authorizes medically necessary treatment as the nature of the injury or the process of recovery requires)....
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Byrons v. Green, 602 So. 2d 638 (Fla. 1st DCA 1992).

Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 7627, 1992 WL 160197

...Appellants/cross-appellees contend that the judge of compensation claims erred in awarding attendant care benefits for purely household services. Claimant/cross-appellant contends that the JCC erred in calculating the average weekly wage based on part-time employment. Section 440.13(2)(f), Florida Statutes (1990 Supp.), states in pertinent part: The employer shall provide appropriate professional or nonprofessional custodial care when the nature of the injury so requires and -is performed at the direction and control of a physician....
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SC13-1976 Bradley Westphal v. City of St. Petersburg, etc. & City of St. Petersburg, etc. v. Bradley Westphal – Corrected Opinion (Fla. 2016).

Published | Supreme Court of Florida

...440.12(1), and s. 440.14(3).[4] Once the employee reaches the maximum number 4. Section 440.12(1), Florida Statutes (2009), provides: “No compensation shall be allowed for the first 7 days of the disability, except benefits provided for in s. 440.13....
...For example, during the same period of time in which the Legislature reduced the provision of disability benefits, the Legislature also gave employers and insurance carriers the virtually unfettered right to select treating physicians in workers’ compensation cases. See § 440.13(2)(f), Fla....
...Other changes have included a heightened standard that the compensable injury be the “major contributing cause” of a worker’s disability and need for treatment, and a requirement that the injured worker pay a medical copayment after reaching maximum medical improvement. See §§ 440.09(1), 440.13(14)(c), Fla....
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United Auto. Ins. Co. v. Cent. Therapy Ctr., Inc., a/a/o Vanessa Lopez (Fla. 3d DCA 2022).

Published | Florida 3rd District Court of Appeal

...Section 456.057, F.S. However, when such examinations, tests, procedures, or treatments are pursuant to a court order or rule or are conducted as part of an independent medical examination pursuant to Section 440.13 or 627.736(7), F.S., the record maintenance requirements of Section 456.057, F.S., and this rule do not apply....
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Michael Guglielmo v. State of Florida-DOC Zephyrhills C I/Div. of Risk Mgmt. (Fla. 1st DCA 2025).

Published | Florida 1st District Court of Appeal

medical benefits related to that condition under section 440.13, Florida Statutes, as qualifying treatment
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Noe Guerra v. C.A. Lindman, Inc., & Argonaut Ins. Co. (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal

...Schechter and Pagan do not constitute evidence of a “disagreement in the opinions of the health care providers” regarding the legal issue in dispute, i.e., Claimant’s current need for discectomy and fusion given the unrefuted worsening of his injury, the JCC erred in appointing an EMA. See § 440.13(9)(c), Fla....
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City of North Miami v. Towers, 584 So. 2d 38 (Fla. 1st DCA 1991).

Published | Florida 1st District Court of Appeal | 1991 Fla. App. LEXIS 6564, 1991 WL 119678

...rather than the rate charged by the individual health care employee. There is competent substantial evidence in the record to support the JCC’s order awarding attendant care benefits valued at the rate charged by the health care agency pursuant to Section 440.13(2)(e)2, Florida Statutes (1989). However, the JCC erred in awarding those benefits on a 24-hour-per-day basis. Section 440.13(2)(e)2, amended effective October 1, 1989, states in pertinent part: In no event shall a family member providing nonprofessional attendant or custodial care pursuant to this paragraph be compensated for more than 12 hours per day....
...The amendment simply limits the number of hours of care for which the claimant’s wife may be paid. Therefore, we reverse the JCC’s order insofar as it requires the claimant’s wife be paid for 24 hours of attendant care after October 1, 1989, the effective date of Section 440.13(2)(e)2, Florida Statutes (1989)....
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Burgess v. Wal-Mart Store 6020, 789 So. 2d 1238 (Fla. 1st DCA 2001).

Published | Florida 1st District Court of Appeal | 2001 Fla. App. LEXIS 10378, 2001 WL 838200

...Robert Burgess, the claimant in this workers’ compensation case, appeals the final order of the judge of compensation claims (JCC) denying payment of his past psychiatric treatment with an unauthorized provider. Because the JCC erroneously limited the scope of section 440.13(2)(c), Florida Statutes, we reverse and remand for further proceedings....
...Gonzalez was not authorized, there was no emergent condition with a denial of medical or psychiatric care by the employer/carrier, and no justification for the claimant refusing the psychiatric care tendered. Claimant argues that he does not have to file a petition for benefits to invoke the protections of section 440.13(2)(c), Florida Statutes. *1239 The applicable statute provides that “the employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require .... ” § 440.13(2)(a), Fla....
...o within a reasonable time or unless the nature of the injury requires such treatment, nursing, and services and the employer or his or her superintendent or foreman, having knowledge of the injury, has neglected to provide the treatment or service. § 440.13(2)(c), Fla....
...(1995) (“It is the intent of the Legislature that the Workers’ Compensation Law be interpreted so as to assure the quick and efficient delivery of disability and medical benefits to an injured worker and to facilitate the worker’s return to gainful reemployment at a reasonable cost to the employer.”). We hold that section 440.13(2), Florida Statutes, does not require a claimant to file a petition for benefits to trigger the employer’s obligation under that statute....
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City of Panama City v. Bagshaw, 65 So. 3d 614 (Fla. 1st DCA 2011).

Published | Florida 1st District Court of Appeal | 2011 Fla. App. LEXIS 11447, 2011 WL 2937301

...In this workers’ compensation appeal, the City of Panama City and Preferred Governmental Claim Solutions (E/C) challenge an order of the Judge of Compensation Claims (JCC) awarding medical benefits and finding the E/C responsible for Claimant’s attorney’s fees and costs. At issue are whether, under section 440.13(3)(i), Florida Statutes (2002), an E/C must authorize or deny a written request for treatment within ten days of receiving the request, and whether failing to timely respond precludes an E/C from later contesting the causal connection between the compensable injury and the treatment sought. The JCC ruled that section 440.13(3)0) required the E/C to either authorize or deny Claimant’s requests for left knee arthroscopy and Su-partz injections within the ten-day response period. The JCC also concluded that the E/C waived its right to challenge Claimant’s claims because it did not timely respond 1 to requests from Claimant’s authorized treating physician for the treatment. We find the JCC incorrectly construed section 440.13(3)0)....
...1st DCA 2009), neatly addresses the issues raised in this appeal. In Elmer we were asked to decide whether the E/C was precluded from challenging the medical necessity of the requested treatment because the E/C failed to timely respond, under sections 440.13(3)(d) 2 and (3)(i) 3 , Florida Statutes (2002)....
...d (3)(i) together, we held *616 that “an E/C who fails to comply with the statutory requirement forfeits the right to contest whether the referral is reasonably and medically necessary.” Id. at 756 . In the instant case, the JCC ruled that under section 440.13(3)(i), an E/C must either authorize or deny the requested treatment within ten days....
...Indeed, paragraph (3)(i) contemplates that an E/C may seek an opinion from an expert medical advisor (EMA) — which could take more than 10 days — before making a final determination on the referral request. We also reaffirmed in Elmer that sections 440.13(2)(a) and (2)(c) “provide a caveat that any medical care provided under section 440.13 must be medically necessary as a result of a compensable injury.” Id. (emphasis added). In other words, both medical necessity and a causal connection between the compensable injury and the requested treatment must exist. Therefore, even if under section 440.13(3)(i) an E/C waives its right to question the medical need for requested treatment, it may yet contend that the claimant’s compensable injury is not the reason treatment is needed. See City of Pembroke Pines v. Ortagus, 50 So.3d 31, 32 (Fla. 1st DCA 2010) (explaining that employer’s duty under section 440.13(2)(a) to furnish medically necessary care ‘“for such period as the nature of the injury or the process of recovery may require’” obliges E/C to pay for claimant’s injury-related treatment “as long as the condition remains the major contributing cause of his need for medical care”); Engler v....
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Trevino v. Dep't of Revenue, 82 So. 3d 930 (Fla. 1st DCA 2011).

Published | Florida 1st District Court of Appeal | 2011 WL 2937374, 2011 Fla. App. LEXIS 11449

...sia pain clinic. We affirm Claimant's first point on appeal and reverse the second. In Claimant's first point, she argues the JCC rejected the opinion of the EMA when the record contains no clear and convincing evidence to support such a denial. See § 440.13(9)(c), Fla....
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Arkin Bldg. Corp. v. Miller, 401 So. 2d 874 (Fla. 1st DCA 1981).

Published | Florida 1st District Court of Appeal | 1981 Fla. App. LEXIS 20581

...The order of the deputy commissioner is affirmed except insofar as it requires the employer/carrier to reimburse claimant for medical expenses incurred and to pay outstanding medical bills. Appellant argues that claimant did not comply with the reporting requirements of Section 440.13, Florida Statutes, and the record does not indicate such compliance....
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Mayo Clinic v. Tomblin, 715 So. 2d 1016 (Fla. 1st DCA 1998).

Published | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 8723, 1998 WL 399651

...The judge of compensation claims (“JCC”) ordered that “[pjayment of all past psychological treatment shall be born[e] by the Employer/Carrier.” As far as the record reflects, Sheila Tomblin did not request authorization for psychological treatment until December 4, 1995. See § 440.13(2)(d), Fla....
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Langenfelder v. Regina, 601 So. 2d 1279 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 7336, 1992 WL 150862

...o also was suffering from a serious back condition and receiving workers’ compensation benefits for such condition) were medically required by claimant’s physical condition beyond these services that family members normally provide gratuitously. § 440.13(2)(d), Fla.Stat....
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Gustafson's Dairy, Inc. v. Phillips, 656 So. 2d 1386 (Fla. Dist. Ct. App. 1995).

Published | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 7697, 1995 WL 421034

...*1389 Section 440.10(l)(a), Florida Statutes (1991), provides that every employer coming ■within the provisions of the chapter shall “be hable for, and shall secure, the payment to his employees, or any physician, surgeon, or pharmacist providing services under the provisions of s. 440.13, of the compensation payable under ss. 440.13, 440.15, and 440.16.” (Emphasis added). Section 440.13 is the statutory provision for medical benefits....
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Ogden Allied Servs. v. Bryant, 647 So. 2d 195 (Fla. 1st DCA 1994).

Published | Florida 1st District Court of Appeal | 1994 Fla. App. LEXIS 7063, 1994 WL 372929

...to May 27, 1991. Medical and lay testimony indicated claimant required attendant care both before and after his hip surgeries for at least 12 hours per day. Further, the duties performed by claimant’s parents were not ordinary household tasks. See § 440.13(2)(d), Fla.Stat....
...Harrison, 443 So.2d 389 (Fla. 1st DCA 1983); Barkett Computer Service v. Santana, 568 So.2d 520 (Fla. 1st DCA 1990). We do hold, however, that the JCC erred in establishing March 1, 1990 as the starting date for the award of attendant care benefits. Under section 440.13(2)(b), Florida Statutes, the E/C are required to pay the employee for attendant care services, if actually needed, when requested by the employee....
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Imperial Elec., Inc. v. Reeves, 647 So. 2d 199 (Fla. 1st DCA 1994).

Published | Florida 1st District Court of Appeal | 1994 Fla. App. LEXIS 7073, 1994 WL 372937

...McDonnell Douglas Corp., 590 So.2d 1035 (Fla. 1st DCA 1991). The record reveals that claimant did not request psychiatric care from the E/C until after this first treatment. Nor were claimant’s psychiatric problems known or apparent to the E/C at the time. § 440.13(2)(b), Fla.Stat....
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Tampa Aluminum Prods. Co. v. Watts, 132 So. 2d 414 (Fla. 1961).

Published | Supreme Court of Florida

...t more power or a broader discretion to modify or set aside judgments of lower courts or tribunals to make them square with the law of the case or justice of the cause. By his order dated July 20, 1960, the deputy commissioner found that pursuant to § 440.13, Florida Statutes, F.S.A., Joseph M....
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Palm Beach Cnty. Sch. Bd. v. Zabik, 906 So. 2d 362 (Fla. 1st DCA 2005).

Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 10998, 2005 WL 1660795

...ices a week. Specifically, the award involves assistance in “carrying groceries and laundry up the three flights of stairs to her apartment.” Given the facts stated in the JCC’s order, we conclude that the definition of “attendant care” in section 440.13(l)(b), Florida Statutes (2000), construed with section 440.13(2)(a)-(b), Florida Statutes (2000), does not encompass the types of services for which attendant care.was awarded to Appellee....
...Dogs Only Grooming, 589 So.2d 990, *363 994 (Fla. 1st DCA 1991). Appellee misplaces her reliance on certain language in Allied Discount Tires v. Cook, 587 So.2d 626 (Fla. 1st DCA 1991), which might support affirmance here if Cook had not been decided pursuant to an earlier, different version of section 440.13....
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Thompson v. Awnclean USA, Inc., 849 So. 2d 1129 (Fla. 1st DCA 2003).

Published | Florida 1st District Court of Appeal | 2003 Fla. App. LEXIS 10850, 2003 WL 21663685

...(Manual). The Manual states that the maximum fee to be paid for an IME is $200 per hour for a maximum of two hours, for a total maximum payment of $400_In this case, [the IME physician] charged, and the E/C paid, $700 for the IME.... [[Image here]] Section 440.13(5)(e) limits the medical testimony that is admissible before the JCC to the opinions of expert medical advisors, independent medical examiners, and authorized treating providers.......
...[The IME physician’s] action in *1132 charging in excess of the allowable amount, and the E/C’s action in acquiescing to and paying that charge, took [the IME physician] out of the statutory category of independent medical examiner. Under the limiting provisions of section 440.13(5)(e), the JCC properly excluded [the IME physician’s] testimony as an inadmissible medical opinion, (citations omitted)....
...As counsel for the claimant argued, there is no statutory support for the JCC to award costs against the claimant, except those costs incurred if the claimant fails to appear for the IME without good cause and fails to advise the physician at least 24 hours before the examination that he cannot appear. See § 440.13(5)(d), Fla....
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Off. Depot, Inc. v. Sweikata, 737 So. 2d 1189 (Fla. Dist. Ct. App. 1999).

Published | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 9519, 1999 WL 497876

The JCC excluded the deposition pursuant to section 440.13(5)(e), Florida Statutes (Supp.1994), which
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Victor Gonzalez v. Quinco Elec. & Zenith, 171 So. 3d 153 (Fla. 1st DCA 2015).

Published | Florida 1st District Court of Appeal

...Rogner, Orlando, for Appellees. KELSEY, J. Claimant appeals a final compensation order of the Judge of Compensation Claims holding, among other things, that the employer/carrier is deemed to have timely responded to claimant’s request for a one-time change of physician under section 440.13(2)(f), Florida Statutes (2013)....
...document that, according to its title and on its face, appeared to have an entirely different purpose. Under these circumstances, the JCC acted within his discretion in concluding that the E/C’s response to the request was deemed timely. Section 440.13(2)(f), Florida Statutes (2013), allows the E/C only five days to respond to a request for a one-time change of physician, failing which the claimant’s requested physician must be considered authorized if the treatment being provided is compensable and medically necessary....
...document titled “Notice of Appearance,” which contained the information typically 2 included in such a notice. On the second page, however, counsel inserted a request for a one-time change of treating physician pursuant to section 440.13(2)(f)....
...E.g., Roberson v. Winn Dixie Stores, Inc., 669 So. 2d 294, 296 (Fla. 1st DCA 1996). Consistent with these requirements and the stated intent of the workers’ compensation statutory scheme, a claimant’s request for a one-time change of physician under section 440.13(2)(f) should not be inserted into a document that appears on its face to have exclusively another purpose....
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Winter Haven Hosp. v. Nevius, 761 So. 2d 1250 (Fla. 1st DCA 2000).

Published | Florida 1st District Court of Appeal | 2000 Fla. App. LEXIS 8948, 2000 WL 966358

...Susan Filsov to administer neuropsychological testing because the claimant offered no legally valid reason for her refusal to submit to testing by the individual authorized by the employer and *1251 servicing agent. See TW Services, Inc. v. Aldrich, 659 So.2d 318 (Fla. 1st DCA 1994) (section 440.13, Florida Statutes, gives to the employer and carrier the right of initial selection of treating and evaluating health care providers)....
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Thomas v. Com. Carrier Corp., 529 So. 2d 758 (Fla. Dist. Ct. App. 1988).

Published | District Court of Appeal of Florida | 13 Fla. L. Weekly 1634, 1988 Fla. App. LEXIS 3056, 1988 WL 72182

...der workers’ compensation, the claimant properly notified the E/C that he intended to seek treatment on his own and to hold the E/C responsible for payment. Since the E/C had failed or neglected to provide treatment, claimant was authorized, under section 440.13(2)(b), Florida Statutes, to seek treatment at the E/C’s expense, subject to a later determination of the reasonableness and necessity of the treatment by the deputy commissioner....
...Even if the claimant had specifically requested authorization of those physicians, he was not required, as found by the deputy, to seek an order authorizing those physicians prior to treatment since the E/C had refused to provide treatment after claimant’s request. Section 440.13(2)(b), Florida Statutes....
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Salazar v. Adecco Emp. Serv./Constitution State Serv. Co., 789 So. 2d 517 (Fla. 1st DCA 2001).

Published | Florida 1st District Court of Appeal | 2001 Fla. App. LEXIS 9714, 2001 WL 789266

departure from the essential requirements of law. Section 440.13(5), Florida Statutes (Supp.1998), addresses
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City of Fort Lauderdale v. Kennedy, 532 So. 2d 96 (Fla. Dist. Ct. App. 1988).

Published | District Court of Appeal of Florida

...he E/C and through Rogoff himself. Claimant was, therefore, entitled to seek treatment from Dr. Frank at the E/C’s expense, subject to a determination of the reasonableness and necessity of the treatment by the deputy commissioner at a later time. Section 440.13(2)(b), Florida Statutes; Fuchs Baking Company v. Estate of Szlosek, 466 So.2d 415 (Fla. 1st DCA 1985). The record also establishes, however, that Dr. Frank failed to file medical reports with the E/C as required by section 440.13(2)(b), Florida Statutes....
...Therefore, that portion of the deputy’s order awarding reimbursement to the claimant for payment of Dr. Frank's medical bills is reversed, and the cause is remanded for a specific finding as to whether good cause existed for the failure to comply with section 440.13(2)(b), Florida Statutes....
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Frito Lay Inc. v. Anderson, 453 So. 2d 135 (Fla. 1st DCA 1984).

Published | Florida 1st District Court of Appeal | 1984 Fla. App. LEXIS 14270

...unauthorized, treating physician, Dr. Gutman, since there is competent, substantial evidence showing good cause why claimant should remain under the successful treatment of Dr. Gutman, as opposed to the treatment offered by the employer/carrier. See section 440.13(2), Florida Statutes (1981) (providing, in pertinent part, that “a deputy commissioner may at any time, for good cause shown, in the deputy commissioner’s discretion, order a change in such remedial attention, care, or attendance.”); Robinson v....
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FCCI Mut. Ins. v. Schnupp, 697 So. 2d 1234 (Fla. 1st DCA 1997).

Published | Florida 1st District Court of Appeal | 1997 Fla. App. LEXIS 7857, 1997 WL 386113

prostheses, and other medically necessary apparatus.” § 440.13(2)(a), Fla.Stat. (1991). Statutory amendments
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Perez v. Pennsuco Cement & Aggregates, 474 So. 2d 293 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 1704, 1985 Fla. App. LEXIS 15445

...Thus, the deputy commissioner acknowledged, on the one hand, claimant’s need for a “facilitator” or attendant but, on the other hand, denied claimant’s need for attendant care, even though it is clear from the testimony that the services expected of the facilitator have been provided by Mrs. Perez. Section 440.13, Florida Statutes (1971), states that the employer shall pro *296 vide remedial treatment, care, and attendance for such period as the nature of the injury or process of recovery may require....
...1st DCA 1984); Sealey Mattress Co. and Hartford Insurance Co. v. Spencer Gause, 466 So.2d 399 (Fla. 1st DCA 1985). Mrs. Perez has provided claimant with these and other services that surpass the ordinary services generally expected of and rendered by a family member. Section 440.13, Florida Statutes (1971), provides that an employee shall not be entitled to recover any amount personally expended for remedial treatment, care, or attendance unless the employee has requested the employer to provide such treatment or...
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Stand. Wholesale Grocery Co. v. Reppa, 122 So. 2d 563 (Fla. 1960).

Published | Supreme Court of Florida | 1960 Fla. LEXIS 2284

...440.28, F.S.A.) ; that testimony of a medical witness for carrier was improperly limited; that the order erroneously requires payment of costs of examination by claimant’s physician and "other outstanding medical bills for treatment of the claimant in respect to this claim,” in the absence of compliance with F.S.A. § 440.13, F.S.A.; that the order erroneously requires payment of a lump sum in the amount of $3,000, to be deducted from the end of the permanent disability benefits (700 weeks) without security or specific statement of the statutory discount; and t...
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Ams Staff Leasing, Inc. v. Arreola, 976 So. 2d 612 (Fla. 1st DCA 2008).

Published | Florida 1st District Court of Appeal | 2008 WL 244665

...II. Analysis The appellants claim that the definition of "physician" under Chapter 458 does not include doctors living outside the United States who do not meet the same national requirements and qualifications to practice in the USA. According to section 440.13(2)(a), Florida Statutes (2005), an employer must provide medical care "only *614 when such care is given based on a referral by a physician as defined in this chapter." (Emphasis added). "Physician" is defined in section 440.13(1)(q), as follows: [A] physician licensed under chapter 458, an osteopathic physician licensed under chapter 459, a chiropractic physician licensed under chapter 460, a podiatric physician licensed under chapter 461, an optometrist licensed under chapter 463, or a dentist licensed under chapter 466, each of whom must be certified by the agency as a health care provider. § 440.13(1)(q), Fla....
...Rodriguez, 421 So.2d 701 (Fla. 1st DCA 1982); § 440.02(15)(a), Fla. Stat. (2005) (defining employee as "any person who receives remuneration from an employer . . . whether lawfully or unlawfully employed, and includes, but is not limited to, aliens and minors"). To construe section 440.13(2)(a) in a manner that would limit authorized treatment for a claimant injured in the State of Florida to a physician licensed in the State of Florida, or anywhere else in the United States, would preclude workers injured in this state (including illegal aliens) who return to their home country from receiving authorized remedial care for clearly compensable injuries. See § 440.13(2)(a), Fla....
...apply to health care providers of medical services outside the State of Florida. That rule provides that health care providers rendering services outside the state of Florida are not required to be certified in order to provide services pursuant to section 440.13, Florida Statutes....
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Wal-Mart Store 0649 v. Kirksey, 728 So. 2d 268 (Fla. Dist. Ct. App. 1999).

Published | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 816, 1999 WL 35543

Hurst, 696 So.2d 873 (Fla. 1st DCA 1997), under section 440.13(5)(e), Florida Statutes (1995), the medical
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Serv. Painting/Amerisure Companies v. Goff, 724 So. 2d 1262 (Fla. Dist. Ct. App. 1999).

Published | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 812, 1999 WL 36300

appoint expert medical advisors pursuant to section 440.13(9), Florida Statutes. While *1263petitioners
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Jbd Brother's v. Miranda, 25 So. 3d 1271 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 544, 2010 WL 255980

...isdiction to order payment of the MRI bill. Disputes concerning an E/C's failure to pay medical bills submitted to it by an authorized physician are subject to the exclusive jurisdiction of the Agency for Health Care Administration, not the JCC. See § 440.13(1)(r) and (11)(c), Fla....
...Moreover, Claimant has no standing to seek payment of a bill on behalf of a health care provider because he is not responsible for paying the bill and the provider's sole recourse is to seek payment from the E/C. See Avalon Center, 967 So.2d at 274 (quoting sections 440.13(3)(g) and (14)(a))....
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Lerman v. Broward Cnty. Bd. of Cnty. Commissioners, 574 So. 2d 229 (Fla. 1st DCA 1991).

Published | Florida 1st District Court of Appeal | 1991 Fla. App. LEXIS 480, 1991 WL 7107

...for psychiatric or psychological counseling. In addition, the revised order states that the judge accepted Dr. Zager's opinions, and seemingly viewed those opinions as evidence that claimant is not in need of psychiatric or psychological counseling. Section 440.13, Florida Statutes, provides that an employee shall not be entitled to reimbursement for expenses incurred for remedial treatment or care, unless the employer was requested to provide such treatment or care, and failed to do so, or, unl...
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Fed. Express Corp. v. Lupo, 77 So. 3d 899 (Fla. 1st DCA 2012).

Published | Florida 1st District Court of Appeal | 2012 Fla. App. LEXIS 968, 2012 WL 178367

...In finding that the aggravation of Claimant’s pre-existing condition alone necessitated the requested treatment (evaluation and treatment with a podiatrist), the JCC impermissibly rejected the EMA’s opinion, and failed to articulate clear and convincing evidence to do so, as required by section 440.13(9)(c)....
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RetailFirst Ins. Co. & Servpro of S. E. Tampa v. Brenton Davis, 207 So. 3d 1035 (Fla. 1st DCA 2017).

Published | Florida 1st District Court of Appeal | 2017 WL 280891, 2017 Fla. App. LEXIS 622

...Bill McCabe, Longwood, for Appellee. MAKAR, J. Under Florida’s workers compensation laws, an employee is entitled to a one- time “change of physician during the course of treatment for any one accident” upon submission of a written request to do so. § 440.13(2)(f), Fla....
...employee Brenton Davis to change his authorized family practice physician to an orthopedist because the employer/carrier (here Retailfirst Insurance Company and Servpro, Inc.) didn’t respond timely to his request for a one-time change under subsection 440.13(2)(f), Florida Statutes....
...The Judge of Compensation Claims (JCC) interpreted the statute to entitle Davis to select any physician of Davis’s choice in any specialty, an interpretation we review de novo. Lombardi v. S. Wine & Spirits, 890 So. 2d 1128, 1129 (Fla. 1st DCA 2004). Section 440.13(2)(f) says: Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident....
...any specialty no matter how far afield from the scope of his course of treatment; authorization for treatment provided by the new physician is to be considered at a later time. This interpretation fails to account for the second sentence of 440.13(2)(f), which specifically provides for the deauthorization of the originally authorized physician in the same specialty: “Upon the granting of a change of physician, the originally authorized physician in the same specialty as the changed...
...g only a one-for-one exchange of physicians within the same specialty under these circumstances. Procedures exist for claimants to seek authorization for physicians beyond the specialties originally established for their workplace accidents. But section 440.13(2)(f) cannot be read to allow that result simply because an employer/carrier has not timely responded to a one-time change of physician. We therefore REVERSE and REMAND for further consideration of Davis’s request for a one-time change of physician in accordance with our interpretation of 440.13(2)(f), Florida Statutes. WOLF and RAY, JJ., CONCUR. 4
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Perez v. United Parcel Serv., 725 So. 2d 423 (Fla. Dist. Ct. App. 1999).

Published | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 462, 1999 WL 22397

...fic criteria, and determined to be reasonably safe. The service must not be of an experimental, investigative, or research nature, except in those instances in which prior approval of the Agency for Health Care Administration has been obtained. *424 Section 440.13(l)(m), Florida Statutes (1995)....
...Hirschfeld also testified, however, that the cosmetic surgery Ms. Perez has requested was not “medically necessary.” When considered in context, “unquestionably he was speaking in terms of life and death, and was not applying the legal standard contained in section 440.13(2)(a), Florida Statutes (1991), authorizing necessary medical treatment as the nature of the injury and the process of recovery would require.” Bradley v....
...The dc’s order cites 2 A. Larson, The Law of Workmen’s Compensation § 61.13(f), which approves the award of compensation benefits for such purpose. We agree that the use of plastic surgery is under the circumstances legislatively contemplated by Section 440.13(2)(a), Florida Statutes, providing that “the employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance by a health care provider and for such period as the nature of the injury or the process of recovery may require.......
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Mosquera v. Home Shopping Network En Espanol, LLC, 890 So. 2d 1237 (Fla. 1st DCA 2005).

Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 224, 2005 WL 94508

...The employer and the employer’s carrier concede the cause must be reversed and remanded for appointment of an EMA. The claimant requested appointment of an EMA when it became apparent that the opinion of her IME conflicted with the opinion of her authorized treating physician. Section 440.13(9)(c), Florida Statutes (2001), “mandates the appointment of an EMA in situations in which a conflict occurs between expert medical opinions.” Chapman v....
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Del Mar v. Schneider, 682 So. 2d 146 (Fla. Dist. Ct. App. 1996).

Published | District Court of Appeal of Florida | 1996 Fla. App. LEXIS 288, 1996 WL 16568

SHIVERS, Senior Judge. The employer and earner appeal a workers’ compensation order granting the claimant’s request for authorization of alternative and additional medically necessary remedial care. The Appellants urge that section 440.13(5), Florida Statutes (Supp.1994) operates to preclude the authorization awarded. In light of this court’s previous ruling that section 440.13(5) departed from prior law as a matter of substance, we affirm....
...On March 2, 1994, the employer/carrier authorized John Bodden, M.D., or Gary Krulik, M.D., as orthopedic doctors to treat the foot. These doctors were authorized with the understanding that a choice of either constituted claimant’s election of her one IME physician permitted under section 440.13(5), Fla.Stat....
...On June 10, 1994, claimant requested the names of three podiatrists. *147 6. On June 14, 1994, the employer/carrier offered James Clancy, D.P.M., or Steven Jaffe, D.P.M., podiatrists, with the understanding that claimant’s choice would constitute her selection of an IME physician under section 440.13(5) Fla.Stat....
...rthopedic and podiatrie care. Following a hearing on the matter, the JCC rendered an order granting “[t]he claimant’s request for authorization of alternative and additional medically necessary remedial orthopedic care and podiatrical care under section 440.13, Fla.Stat. (as amended, 1994).” On that basis, the JCC found that the claimant was entitled to a reasonable attorney’s fee. This appeal timely followed. This court has previously held that section 440.13(5) departed from prior law as a matter of substance “insofar as it alters the parties’ obligation to pay for the claimant’s independent medical examination.” Southern Bakeries v. Cooper, 659 So.2d 339, 341 (Fla. 1st DCA 1995). Although the issue raised in Southern Bakeries was whether section 440.13(5)(e), Florida Statutes (Supp. 1994) operated to exclude certain medical testimony, the court resolved that issue on the basis of its determination that the issue presented depended on “a new independent medical examination process under section 440.13(5), which alters the parties’ substantive rights.” 659 So.2d at 339 . In this case, we hold that the fundamental holding of Southern Bakeries determines the issue in that the new process created in section 440.13(5) “broadly address[es] the parties’ general rights to independent medical examinations” as a matter of substance. 1 Since, as the parties have stipulated, the claimant was injured before the amended act became effective, section 440.13(5), Florida Statutes (Supp.1994) does not apply to this ease....
...See Colace v. Hamlet Estates, Ltd., 573 So.2d 994, 997 (Fla. 1st DCA 1991), and the cases cited therein. The question presented to the JCC was whether the treatment sought is reasonable and necessary. Although the JCC based the award upon a determination that section 440.13 applies retroactively but does not limit the number of treating physicians, we affirm the order on the basis that the record supports a finding that alternative care is reasonable and necessary....
...Accordingly, the JCC properly found entitlement to a reasonable attorney’s fee and taxable costs. We therefore reject without further discussion the challenge to that portion of the order. The order is AFFIRMED. BARFIELD and KAHN, JJ., concur. . 659 So.2d at 340 . "[W]hile the independent medical examination process trader section 440.13(5) may have some procedural aspects, it also effects a change in the parties' substantive rights." Id.
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Martin-Brower Co. v. Crews, 648 So. 2d 853 (Fla. Dist. Ct. App. 1995).

Published | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 195, 1995 WL 16831

...RI PER CURIAM. This cause concerns the propriety of a non-final workers’ compensation order, in which the judge of compensation claims determined that treating physicians of an injured worker would be designated “medical advisors,” pursuant to section 440.13(5)(e), Florida Statutes (Supp.1990), in cases where the employer contests compensability and there is no authorized treating physician....
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Redwing Owner Operators v. Cardenas, 648 So. 2d 1205 (Fla. Dist. Ct. App. 1995).

Published | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 80, 1995 WL 6408

This conclusion accords with decisions under Section 440.13, Florida Statutes, at the time the services
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Aircraft Servs., Inc. v. Bradley, 448 So. 2d 1045 (Fla. Dist. Ct. App. 1984).

Published | District Court of Appeal of Florida | 1984 Fla. App. LEXIS 11669

...ard of the medical bills for the treatment of the heart condition. Neither the claimant nor Dr. *1048 Goldberg ever requested that the E/C authorize Goldberg’s treatment. In addition, Dr. Goldberg failed to file reports with the E/C as required by § 440.13(1), Fla.Stat....
...The deputy made no finding, and the record includes no evidence which could have supported a finding that the doctor’s failure to obtain authorization and to submit reports was excusable. Therefore, the award of the costs of Goldberg’s medical treatment was erroneous. Section 440.13(1), Fla....
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Benson v. Okeechobee Cnty. Sheriff's Dep't, 632 So. 2d 100 (Fla. 2d DCA 1994).

Published | Florida 2nd District Court of Appeal | 1994 Fla. App. LEXIS 595, 1994 WL 30321

been properly deauthorized in compliance with section 440.13(2)(a), Florida Statutes (1987). We have held
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Hillsborough Cnty. Sch. Bd. v. Suarez, 920 So. 2d 167 (Fla. 1st DCA 2006).

Published | Florida 1st District Court of Appeal | 2006 Fla. App. LEXIS 1421, 2006 WL 264043

...We affirm all the awards as supported by competent, substantial evidence (CSE), except that authorizing claimant to substitute orthopedist Dr. Dale Bramlet as her one-time change of orthopedic surgeon, because the award fails to follow the procedure prescribed by section 440.13(2)(f), Florida Statutes (2002). In authorizing the change in orthopedic care from Dr. Umesh Raturi to Dr. Brain-let, the JCC failed to heed the following provisions of section 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 the course of treatment for any one accident....
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Arnau v. Winn Dixie Stores, 105 So. 3d 669 (Fla. 1st DCA 2013).

Published | Florida 1st District Court of Appeal | 2013 WL 425881, 2013 Fla. App. LEXIS 1686

...Spirer regarding the nature of Claimant’s condition and denied Claimant’s request for an evaluation by a thoracic surgeon. In addition, the JCC denied Claimant’s claim for temporary indemnity benefits based upon the opinion of Dr. Spirer that Claimant reached MMI as of July 1, 2009. Analysis Section 440.13(9)(c), Florida Statutes (2008), mandates that the JCC appoint an EMA when there is a disagreement in the opinions of the health care providers. See Palm Springs Gen. Hosp. v. Cabrera, 698 So.2d 1352, 1356 (Fla. 1st DCA 1997). The opinion of an EMA is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the JCC. See § 440.13(9)(c), Fla....
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Monex Corp. v. Mercado, 379 So. 2d 439 (Fla. 1st DCA 1980).

Published | Florida 1st District Court of Appeal

...nce the doctor in question received authorization by telephone, so there was no abuse of discretion in finding the doctor's treatment reasonable and necessary. The provision for future medical care, however, failed to comport with the limitations of § 440.13(3)(b), Florida Statutes (1975), and is amended to reflect those limitations....
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Andino-Rivera v. Se. Atl. Beverage Co., 132 So. 3d 1191 (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal | 2014 WL 444000, 2014 Fla. App. LEXIS 1373

...onded to either of the author *1193 ized physicians’ requests that a pain management specialist be authorized, as well. We reject appellant’s alternative theory that he was entitled to elect a pain management physician in lieu of a surgeon under section 440.13(2)(f), Florida Statutes (2011), and so leave intact his prerogative to invoke his rights under section 440.13(2)(f) in appropriate circumstances in the future....
...on April 16, 2012, and continuing. Accordingly, we reverse the order under review insofar as it denies compensation benefits, and remand for entry of an order awarding temporary partial disability benefits beginning on April 16, 2012. Under sections 440.13(3)(d) and (i), an employer or carrier “forfeits the right to contest” the medical necessity of an authorized doctor’s referral for (additional) medical treatment, unless the employer or carrier responds to the authorized doctor’s written request for a referral within the time allowed. Elmer v. Southland Corp. 7-11, 5 So.3d 754, 756 (Fla. 1st DCA 2009). Although a carrier is not required to grant the request for a referral within the times specified in sections 440.13(3)(d) (three days) and (i) (ten days), it must respond to each written request within the time prescribed....
...er, based on the stated ground that pain management was not “warranted” or “re *1194 quired.” No findings were made as to how, or when (if ever), Southeast or Gallagher responded to the authorized, referring medical providers, as required by section 440.13(3)(i)....
...4 If on remand the judge of *1195 compensation claims finds that the carrier did not timely respond to the Lakeside referral, Mr. Andino-Rivera shall be awarded an evaluation with an authorized pain management specialist. See Elmer, 5 So.3d at 756 . We affirm the denial of the claim for a one-time change in physician under section 440.13(2)(f). We reverse the unexplained denial of an evaluation by a pain management specialist sought under section 440.13(3)(i), and the denial of temporary partial disability benefits beginning April 16, 2012. We also reverse the denial of penalties and interest for the disability benefits, and the denial of attorney’s fees and costs, as to all issues except the section 440.13(2)(f) claim....
...We do not reach the question of medical necessity because it is irrelevant to any issue on appeal. . At oral argument held in this case, counsel for the claimant conceded that, because Dr. Hirsch requested the authorization of a specialist, the ten-day response period provided for in section 440.13(3)(i) pertains....
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Tri-City Elec. v. Werner, 5 So. 3d 752 (Fla. 1st DCA 2009).

Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1678, 2009 WL 500629

...When he became dissatisfied with the authorized orthopedic physician, he once again requested a change of physician. The E/C denied his request. The JCC found the E/C’s denial was “untenable because the nature of the claimant’s injuries requires different specialties.” We addressed whether section 440.13(2)(f), Florida Statutes, permitted one change in physician for each accident, or one change per specialty, in Perez v....
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Tire v. Casteel, 595 So. 2d 210 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 1854, 1992 WL 36304

...ry. Once again, the E/C have raised an issue on appeal regarding the applicability of a newly amended statute to the attendant care awarded, which was not raised in the proceeding below. Specifically, the E/C contend that the JCC should have applied section 440.13(2)(f), Florida Statutes (Supp.1990) to the award of attendant care....
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Special Disability Trust Fund v. Stephens, 595 So. 2d 206 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 1857

...In that case, the Fund argued that vocational rehabilitation benefits were not among those benefits for which reimbursement could be ordered under section 440.49(2). The portion of the statute at issue provided for reimbursable benefits specified as “remedial treatment, care, and attendance pursuant to s. 440.13.” Section 440.13 required the employer to furnish remedial treatment, care, and attendance under the direction and supervision of a qualified physician or surgeon....
...should be construed to provide for reimbursement to the employer/carrier for payment of vocational benefits where the language of the latter section was not amended but continued to read ‘remedial treatment, care, and attend- *209 anee pursuant to s. 440.13/ ” In contrast to the present situation, the employer’s new burden of paying for vocational rehabilitation was clearly not included as one of the benefits for which the employer could be reimbursed....
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Beavers v. Carpenter Contractors of Am., 107 So. 3d 551 (Fla. 1st DCA 2013).

Published | Florida 1st District Court of Appeal | 2013 Fla. App. LEXIS 3001, 2013 WL 678620

...In this workers’ compensation appeal, Steve Beavers argues the judge of compensation claims (JCC) erred in denying his request that pain management with Dr. Khan be continued or reauthorized. In ruling that Dr. Khan was properly deau-thorized by the employer/carrier under section 440.13(2)(d), Florida Statutes (2010), the JCC did not have the benefit of this court’s decision in Avery v....
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Broomhall v. Mario's Restaurant, 576 So. 2d 769 (Fla. Dist. Ct. App. 1991).

Published | District Court of Appeal of Florida | 1991 Fla. App. LEXIS 1720, 1991 WL 27212

...r the copying and to have them redo all the bills.... 1 The JCC determined 50 cents per page to be a reasonable charge for the cost of photocopying the records and ordered appellant to pay RCS $38. This appeal ensued. On appeal appellant argues that section 440.13, Florida Statutes (198.7) controls the outcome of this matter....
...Alternatively appellant argues there is no record evidence to support the JCC’s finding that 50 cents per page is a reasonable amount. 3 We reject both of appellant’s arguments. There is no evidence in this record that appellant made a request pursuant to section 440.13 to receive his records from his medical provider....
...The person upon whom the subpoena is served may condition the preparation of copies on the payment in advance on the reasonable costs of preparing the copies. (Emphasis added). Given that there is no evidence appellant made a request for the documents pursuant to section 440.13 and given that appellant specifically invited the JCC to award a reasonable amount as reimbursement for the costs of photocopying, we cannot say on this record that the JCC erred in not determining and awarding the actual cost of photocopying pursuant to section 440.13. 5 Moreover, even if we determined that section 440.13 applied the record is clear that five cents per copy is not the actual cost to the medical provider....
...Appellant’s brief admits there is competent evidence to support a finding that 25 cents a page is reasonable. . Neither party introduced the subpoena into evidence but it was discussed by counsel and the JCC at the hearing. . Although the JCC’s order states that section 440.13 is the relevant section, the JCC determined what a reasonable amount would be, not the actual cost....
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Hampton v. Fantastic Sam's, 977 So. 2d 667 (Fla. 1st DCA 2008).

Published | Florida 1st District Court of Appeal | 2008 WL 482329

...After a merits hearing held in 2003, the Judge of Compensation Claims (JCC) issued a final order granting Claimant indemnity benefits. In his 2004 order, the JCC admitted Dr. Gonzalez's testimony over E/C's objection, finding that Dr. Gonzalez became an authorized provider by operation of law pursuant to section 440.13(2), Florida Statutes (2001), as Claimant had requested psychiatric care on January 31, 2003, but E/C had refused "for some time" to provide such treatment....
...Champion Int'l, 906 So.2d 363, 365 (Fla. 1st DCA 2005). *670 Although he did not specifically rule on Claimant's entitlement to psychiatric care in 2004, the JCC accepted Dr. Gonzalez's testimony as that of an authorized treating provider "for all purposes" by operation of law under section 440.13(2)(c), Florida Statutes (2001)....
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Orlando Reg'l Med. Ctr. v. Johnson, 394 So. 2d 207 (Fla. Dist. Ct. App. 1981).

Published | District Court of Appeal of Florida | 1981 Fla. App. LEXIS 19518

...eatment by Dr. Baker is tenuous indeed. More importantly, however, the record is devoid of any evidence to show that the emergency room physician had either real or apparent authority to speak for his employer in authorizing medical attendance under Section 440.13, Florida Statutes....
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Wynn v. Hogan Baptist Church, 483 So. 2d 551 (Fla. Dist. Ct. App. 1986).

Published | District Court of Appeal of Florida | 11 Fla. L. Weekly 478, 1986 Fla. App. LEXIS 6524

...Hay-cook finally filed the report on 23 May 1984, stating that he believed the trip to have been approved in December, 1983. Wynn filed the instant claim in July, 1984. The E/C controverted, arguing that the trip had not been authorized. It also pointed out the Clinic’s failure to submit the report of treatment required by Section 440.13(2)(b), Florida Statutes (1983)....
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Hernandez v. Hialeah Solid Waste Dep't, 238 So. 3d 418 (Fla. 1st DCA 2018).

Published | Florida 1st District Court of Appeal

...Jose Luis Hernandez, a workers' compensation claimant, was prescribed certain spinal-injection treatments. His employer authorized the treatment, but insisted that another physician-not Hernandez's treating *419 physician-perform them. The Judge of Compensation Claims sided with the employer, and Hernandez appeals. Section 440.13(2)(d) allows the employer "to transfer the care of an injured employee from the attending health care provider if an independent medical examination determines that the employee is not making appropriate progress in recuperation." Here, the employer did not satisfy the statute's requirements....
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Jose Luis Hernandez v. Hialeah Solid Waste Dept. & Sedgwick CMS (Fla. 1st DCA 2018).

Published | Florida 1st District Court of Appeal

...prescribed certain spinal-injection treatments. His employer authorized the treatment, but insisted that another physician— not Hernandez’s treating physician—perform them. The Judge of Compensation Claims sided with the employer, and Hernandez appeals. Section 440.13(2)(d) allows the employer “to transfer the care of an injured employee from the attending health care provider if an independent medical examination determines that the employee is not making appropriate progress in recuperation.”...
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Hillsborough Cnty. Sch. Bd. v. Kubik, 110 So. 3d 928 (Fla. 1st DCA 2013).

Published | Florida 1st District Court of Appeal | 2013 WL 614183, 2013 Fla. App. LEXIS 2777

PER CURIAM. In this workers’ compensation case, the Employer/Servicing Agent (E/SA) appeals an order of the Judge of Compensation Claims (JCC) to the extent it awards Claimant a one-time change of physician, under section 440.13(2)(f), Florida Statutes (2010), and denies the E/SA prevailing-party costs, under section 440.34(3)....
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Wuesthoff Mem'l Hosp. v. Schmitt, 777 So. 2d 465 (Fla. 1st DCA 2001).

Published | Florida 1st District Court of Appeal | 2001 Fla. App. LEXIS 1759, 2001 WL 137368

determined by the judge of compensation claims. § 440.13(9)(c), Fla.Stat. (Supp.1994). See Walgreen Co
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Plan. Rsch. Co. v. Shy, 379 So. 2d 1047 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 15947

PER CURIAM. AFFIRMED. This is a case of first impression which squarely poses the issue of whether, under appropriate circumstances, treatment at a pain clinic constitutes remedial treatment pursuant to § 440.13(1), Florida Statutes....
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Joy Footwear Corp. v. Folgueral, 409 So. 2d 188 (Fla. Dist. Ct. App. 1982).

Published | District Court of Appeal of Florida | 1982 Fla. App. LEXIS 19132

...The combined testimony of Folgueral and his physician supported the deputy’s finding of temporary total disability. The carrier argues reversible error occurred in the deputy’s award of the treating physician’s bills since the doctor failed to meet the reporting requirements of Section 440.13(1), Florida Statutes (Supp.1980)....
...This receipt of payment led the doctor to believe he had done all the reporting that was required. As primary physician, his treatment of Fol-gueral necessarily continued. A confused legal situation or complex factual circumstances may constitute good cause for failure to file section 440.13 reports....
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Girardin v. AN Fort Myers Imports, LLC, Gallagher Bassett (Fla. 1st DCA 2025).

Published | Florida 1st District Court of Appeal

...The JCC could not order compensation under chapter 440, Florida Statutes, for the husband’s provision of “nonprofessional attendant care . . . that falls within the scope of household duties and other services normally and gratuitously provided by family members.” § 440.13(1)(b), Fla....
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Advanced Masonry Sys. v. Molina, 4 So. 3d 62 (Fla. 1st DCA 2009).

Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 1294, 2009 WL 400371

...1st DCA 1999) (explaining that “[a] claimant’s unexplained refusal of a specific offer of suitable employment available in the open labor market is inconsistent with permanent total disability”). Here, the EMA determined Claimant could work at a sedentary level. Under section 440.13(9)(c), Florida Stat *65 utes (2001), the EMA’s opinion has a nearly conclusive effect....
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Newham v. Union Corr. Inst., 485 So. 2d 3 (Fla. Dist. Ct. App. 1986).

Published | District Court of Appeal of Florida | 11 Fla. L. Weekly 451, 1986 Fla. App. LEXIS 6421

Hospital at Chattahoochee, are compensable under Section 440.13, Florida Statutes (1979). We affirm the deputy’s
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Iacobelli Contracting, Inc. v. Griffin, 409 So. 2d 1206 (Fla. Dist. Ct. App. 1982).

Published | District Court of Appeal of Florida | 1982 Fla. App. LEXIS 19241

...Rose for an eye examination. The deputy ordered that the bill for Dr. Rose’s services should be borne by the employer/earrier. The bills for Dr. Rose’s services were not admitted into evidence. There is no evidence that Dr. Rose timely submitted the reports required by Section 440.13(1), Florida Statutes....
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Peckham v. Speegle Constr., Inc., 896 So. 2d 815 (Fla. 1st DCA 2005).

Published | Florida 1st District Court of Appeal | 2005 Fla. App. LEXIS 1655, 2005 WL 371746

relying on the conflicting opinion of the PA. Section 440.13(5)(e) explicitly allows only the opinions of
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Johnson Drug Co. v. Thaxton, 121 So. 2d 158 (Fla. 1960).

Published | Supreme Court of Florida

...made by the employer’s physician and the operation was not performed with the knowledge and consent of the employer. This of course is not a case where the employer “failed, refused or neglected,” after request, to provide the care needed, for Section 440.13, F.S.A....
...The deputy ordered them to pay “the costs of medical care incurred as a result of his injury and subsequent surgery.” There is no question as to the petitioners’ liability for medical care rendered decedent by Dr. Beyer. In his order, the deputy commissioner said: “ * * * Even assuming that under F.S. 440.13 the employee was not entitled to reimbursement for monies paid for such medical care, there is no provision of the workmen’s compensation law relieving the carrier of liability from complications resulting from medical care that was unauthorized.” The deputy then, as seen above, held the carrier liable for such medical care, apparently deciding that Section 440.13 does not require notice to or special authorization by the employer or carrier. In this respect he erred. The first portion of Section 440.13, F.S.A....
...The employer in that case happened to be a physician, doing business as a hospital, and he rendered the services himself. Consequently, the case is not one in which the 'employer did not consent to the medical care or have knowledge thereof. We find that other language employed in Section 440.13, F.S.A., which language follows that portion of the statute quoted above, makes it mandatory for the em *163 ployee to request the employer to furnish the medical care or that the employer have knowledge of the need for such care, yet fail to provide it....
...This requirement may not be applicable in cases of first aid or where in actuality there is an emergency relating to the injury, but we are not compelled to rule thereon in this case, where we have determined there was no such emergency. This portion of Section 440.13(1) reads as follows: “ * * * If the employer fails to provide the same after request by the injured employee, such injured employee may do so at the expense of the employer, the reasonableness and the necessity to be approved by the commission....
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Juan Alvarez v. Fort Pierce Police Dep't, 186 So. 3d 581 (Fla. 1st DCA 2016).

Published | Florida 1st District Court of Appeal | 2016 WL 606707

...competent substantial evidence; to the extent it involves an interpretation of law, the standard is de novo. See Benniefield v. City of Lakeland, 109 So. 3d 1288, 1290 (Fla. 1st DCA 2013). 2 Under paragraph 440.13(2)(a), Florida Statutes (2013), employers are required to furnish “such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or process of recovery may require.” Medically necessary treatment includes “any medical service or medical supply which is used to identify or treat an illness or injury.” § 440.13(1)(k), Fla. Stat....
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Pulido v. Sugar Cane Growers Coop., 556 So. 2d 543 (Fla. Dist. Ct. App. 1990).

Published | District Court of Appeal of Florida | 1990 Fla. App. LEXIS 924, 1990 WL 13522

ERVIN, Judge. Appellant sought payment pursuant to Section 440.13(2)(b), Florida Statutes (1987), for medical treatment rendered by an unauthorized physician who had treated him after the employer/carrier had failed to respond timely to his request for such treatment....
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Beasley & Son, Inc. v. Norris, 379 So. 2d 1316 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 23699

...medical improvement. The record does not support a need for the narco-analysis. The claimant is being treated for his complaints, and there is no indication that narco-analysis is here required by the nature of the injury or the process of recovery, § 440.13, Florida Statutes (1977)....
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William Rente v. Orange Cnty. BOCC & Cannon Cochran Mgmt. Servs., Inc., 263 So. 3d 294 (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...Stat. 6 Exclusion of Testimony A JCC’s exclusion of evidence is reviewed for an abuse of discretion. See Escutia v. Greenleaf Prods., Inc., 886 So. 2d 1059, 1060 (Fla. 1st DCA 2004). Section 440.13(5)(e), Florida Statutes (2015), provides the only medical opinion testimony admissible before the JCC is that of expert medical advisors, independent medical examiners, and authorized treating physicians. Nevertheless, this court has determined the testimony of a physician other than those enumerated in section 440.13(5)(e) is admissible to the extent it is limited to “a factual report of the information contained in [a doctor’s] office records” regarding the claimant....
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Hall's Camp, Inc. v. Decker, 394 So. 2d 1041 (Fla. 2d DCA 1981).

Published | Florida 2nd District Court of Appeal | 1981 Fla. App. LEXIS 19585

the prescribed workers’ compensation forms, Section 440.-13(1), Florida Statutes (1973) provides the deputy
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Sears Outlet & Sedgwick CMS v. James Brown, 152 So. 3d 785 (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal

...e hindrance it created to treating the compensable back injury. The JCC also ruled that Claimant’s failure to request authorization for the kidney surgery was excused 2 under the self-help provision of section 440.13(2)(c), Florida Statutes (2010). Accordingly, the JCC directed the E/C to pay the hospital for the admission for the kidney surgery and to reimburse Claimant for the related payments he made directly to the hospital. On appeal, the E/C argues that the JCC applied an incorrect test to find the kidney treatment received at the hospital compensable under the hindrance-to- recovery doctrine and misinterpreted the requirements of the self-help provision of section 440.13(2)(c)....
...To the extent these issues involve the JCC’s application of undisputed facts to the law, review is de novo. See Gilbreth v. Genesis Eldercare, 821 So. 2d 1226, 1228 (Fla. 1st DCA 2002). Because we find that the E/C is not legally responsible under section 440.13(2)(c) for the medical bills related to the kidney surgery—even assuming the compensability of Claimant’s unrelated kidney problem, we find it unnecessary to address the JCC’s application of the hindrance- to-recovery doctrine. The JCC found section 440.13(2)(c) applicable based solely on his determination that the E/C wrongfully denied the medical care. Section 440.13(2)(c) expressly provides, however, that “[t]here must be a specific request for the initial treatment or care, and the employer or carrier must be given a reasonable time period within which to provide the initial treatment or care” before a claimant is entitled to recover any amount expended for initial treatment or care. See Parodi v. Fla. 3 Contracting Co., 16 So. 3d 958, 962 (Fla. 1st DCA 2009) (holding that section 440.13(2)(c) operates in limited circumstances where e/c wrongfully denies medical care but noting that claimant “retains the burden....
...This language cannot be reasonably construed as a specific request for treatment from the E/C. The JCC, therefore, erred when he determined that Claimant was entitled to recover the cost of his kidney surgery from the E/C under the statutory provision of section 440.13(2)(c)....
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Jennings v. Nat'l Linen Servs., 995 So. 2d 1153 (Fla. 1st DCA 2008).

Published | Florida 1st District Court of Appeal | 2008 WL 5101671

...ts of Claimant's attorney have secured no benefit not otherwise being provided Claimant by the E/C." Analysis An E/C has an affirmative duty to furnish all "remedial treatment, care, and attendance" necessary to treat an employee's workplace injury. § 440.13(2)(a), Fla....
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Spivey v. Battaglia Fruit Co., 287 So. 2d 302 (Fla. 1973).

Published | Supreme Court of Florida | 1973 Fla. LEXIS 4064

limitations involving remedial treatment, Fla.Stat. § 440.13(3) (b), F.S.A., has expired. At the hearing, both
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City of Fort Pierce/Florida Mun. Ins. Trust v. Spence, 155 So. 3d 1197 (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal | 2014 Fla. App. LEXIS 20918, 2014 WL 7384125

...awarding the facet injections. We affirm the other issue on appeal without further comment. On the cross-appeal, we note that, given the JCC’s unchallenged finding that care provided by Dr. Roush is compensa-ble, the JCC erred in excluding, under section 440.13(5)(e), Florida Statutes, Dr....
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Sink v. Bob Bell Roofing, Inc., 590 So. 2d 504 (Fla. 1st DCA 1991).

Published | Florida 1st District Court of Appeal | 1991 Fla. App. LEXIS 12207, 1991 WL 259461

...arding attendant-care benefits at minimum wage rather than market rate. We affirm as to issue I without comment, but reverse in regard to issue II. We find that the JCC’s award of attendant-care benefits “at the minimum wage in accordance with F.S. 440.13(2)(e)” was erroneous. The 12-week period for which benefits were awarded occurred prior to October 1,1988, the effective date of the statute relied upon by the JCC. Prior to the 1988 amendment to section 440.13(2), Florida Statutes, case law held that a family member providing custodial care to an injured worker was entitled to reimbursement at the market rate in the community where the claimant lived....
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Adams Bldg. Materials, Inc. v. Brooks, 892 So. 2d 527 (Fla. 1st DCA 2004).

Published | Florida 1st District Court of Appeal | 2004 Fla. App. LEXIS 19998, 2004 WL 2996782

...Claimants who need attendant care have the burden of proving the quantity, quality, and duration of attendant services claimed. See Orange County Sheriff’s Dep’t v. Perez, 541 So.2d 652, 654 (Fla. 1st DCA 1989). A physician must indicate attendant care services are medically necessary. See § 440.13(2)(b), Fla....
...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 § 440.13(2)(b), Fla....
...The JCC is instructed to award eight hours of attendant care benefits per day from July 16, 2001 onward, consistent with the previous medical testimony, with credit for payments already made. If Claimant’s physicians determine additional attendant care is necessary in the future, they can prescribe such care. See § 440.13(2)(a), Fla....
...attendant care before that date); Rockette v. Space Gateway Support, 877 So.2d 852, 853 (Fla. 1st DCA 2004) (finding that although physician did not initially prescribe attendant care, he testified at a hearing that such care was needed). . We note section 440.13(2)(b) was amended in 2003, and now includes greater specifications for claims for attendant care....
...The employer or carrier shall not be responsible for such care until the prescription is received by the employer and carrier, which shall specify the time periods for such care, the level of care required, and the type of assistance required. A prescription for attendant care shall not prescribe such care retroactively. § 440.13(2)(b), Fla....
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Dade Cnty. Sch. Bd. v. Grier, 648 So. 2d 805 (Fla. 1st DCA 1994).

Published | Florida 1st District Court of Appeal | 1994 Fla. App. LEXIS 12869, 1994 WL 716787

...idence to support the award of attendant care during non-crisis periods. The majority of tasks performed by claimant’s daughters, i.e., cooking and cleaning, are not those going beyond the scope of duties performed gratuitously by a family member. § 440.13(2)(g), Fla.Stat....
...Harrison, 443 So.2d 389 (Fla. 1st DCA 1983). The other tasks performed by claimant’s daughters, although extraordinary in nature, are not compensable in this case because Dr. Jacome did not testify that claimant needed assistance with such tasks. § 440.13(2)(g), Fla.Stat....
...aring lunch, giving claimant leg and back massages, and retriev *806 ing drinks. Although these tasks appear to be of a type normally compensable as attendant care, again, Dr. Jacome did not specify that claimant required assistance for these tasks. § 440.13(2)(g), Fla.Stat. Further, driving claimant to her mother’s home and driving claimant’s daughters to the store are not compensable under section 440.13(2)(a). Marlowe v. Dogs Only Grooming, 589 So.2d 990 (Fla. 1st DCA 1991) (supportive services such as driving claimant to the store and other places, other than transportation necessary for medical treatment pursuant to section 440.13(6), constitute quality of life activities indemnified under disability compensation benefits rather than attendant care service that is medically necessary); Timothy Bowser Construction Co....
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Staff Mgmt. Sys. v. Wilkes, 659 So. 2d 324 (Fla. 1st DCA 1994).

Published | Florida 1st District Court of Appeal | 1994 Fla. App. LEXIS 12875, 1994 WL 716796

...Based on our review of the record, we find the order of the judge of compensation claims (“JCC”) supported by competent substantial evidence and affirm except in one respect. Employer/Carrier challenge the award of medical benefits contending the JCC erred in failing to make a finding, consistent with section 440.13(2)(d), Florida Statutes, as to whether the medical benefits awarded were reasonable and necessary....
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Ortiz v. Winn-Dixie, Inc., Travelers Ins., & Sedgwick CMS (Fla. 1st DCA 2024).

Published | Florida 1st District Court of Appeal

...other appellees: Travelers Insurance, which served as Winn-Dixie’s carrier to satisfy its statutory obligation to provide benefits under chapter 440, Florida Statutes; and Sedgwick CMS, which managed the claim as Travelers’s servicing agent. See § 440.13(2)(a), Fla....
...my) later that same year. Winn-Dixie did not dispute compensability for this injury and authorized long-term remedial care in the form of annual “kidney follow-ups” with a urologist, more frequent visits being allowed if Ortiz needed them. 3 Cf. § 440.13(2)(a), Fla....
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Rubber Prods. of Tampa v. Henderson, 391 So. 2d 728 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 18272

...Anonymous must be stricken. It was not reversible error for the Deputy Commissioner to allow Dr. Godard to refer to his notes, over the employer/carrier’s objection that the notes were not provided to counsel within five days prior to the hearing (Section 440.13, Florida Statutes)....
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Cook v. Georgia Grocery, Inc., 125 So. 2d 837 (Fla. 1960).

Published | Supreme Court of Florida | 1960 Fla. LEXIS 2071

...d appliances in his home as the nature of his condition and care requires, even though the same exceeds the cost of his care in a private nursing home. The statutory authority upon which the deputy commissioner arrived at his conclusion evolves from Section 440.13(1) : “(1) The employer shall furnish to the employee such remedial treatment, care, and attendance under the direction and supervision of a qualified physician or surgeon, or other recognized practitioner, nurse or hospital, and for...
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Teco Energy, Inc/ Teco Servs., Inc. v. Michael K. Williams (Fla. 1st DCA 2017).

Published | Florida 1st District Court of Appeal

...ough Claimant had pre-existing degenerative arthritis, as the continued pain was the factor necessitating surgery. Due to the conflict in medical experts, the E/C requested, and the JCC appointed, an expert medical advisor (“EMA”) pursuant to section 440.13(9), Florida Statutes....
...viscosupplementation injection recommended in that report. In closing argument at the final hearing, Claimant specifically argued that the E/C accepted his left knee condition, including the preexisting arthritis, as a compensable workplace injury pursuant to section 440.13(1)(b), Florida Statutes. Citing the definition of “compensable” under this subsection, Claimant relied, in part, on the evidence that the E/C authorized the treatment expressly recommended by Dr....
...n did not qualify as a “preexisting condition” under section 440.09(1)(b), Florida Statutes. In response, the E/C asserted that Claimant failed to satisfy his burden regarding MCC with respect to ongoing medical care. Further, regarding section 440.13(1)(b), a break in the causal chain occurred when the E/C’s liability fell below fifty percent....
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Anderson v. City of Leesburg, 695 So. 2d 711 (Fla. 1st DCA 1995).

Published | Florida 1st District Court of Appeal | 1995 Fla. App. LEXIS 13017, 1995 WL 744936

...Because the judge was without statutory authority to order the appellant to pay $800 toward the cost of the prepaid examination, we reverse that part of the order. * The order is affirmed in all other respects. ALLEN and DAVIS, JJ., and SMITH, Senior Judge, concur. Section 440.13(5)(d), Florida Statutes (Supp....
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Scudder v. Rainbow Video, 591 So. 2d 298 (Fla. Dist. Ct. App. 1991).

Published | District Court of Appeal of Florida | 1991 Fla. App. LEXIS 12714, 1991 WL 265078

...It is undisputed that no wage loss benefits were paid to Scudder after March 5, 1990. Second, the JCC twice refers to Dr. Wittmer as a deauthorized health care provider in the final order. However, there is no evidence that the carrier complied with — or attempted to comply with — the deauthorization requirements of section 440.13(2)(a), Florida Statutes (1989)....
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Inn Serv. Corp. v. Diaz-Aller, 536 So. 2d 307 (Fla. Dist. Ct. App. 1988).

Published | District Court of Appeal of Florida | 13 Fla. L. Weekly 2738, 1988 Fla. App. LEXIS 5590, 1988 WL 133935

...Swanigan v. Dobbs House, 442 So.2d 1026 (Fla. 1st DCA 1983). Also, the DC properly excused the work search because the E/C failed to apprise claimant of her duty to conduct one. Lopez v. Nabisco Brands, Inc., 516 So.2d 993 (Fla. 1st DCA 1987). As required by section 440.13(2)(b), Fla.Stat....
...She then procured Dr. Lopez whose treatment the DC found to be compensable. The same statute also requires the health care provider to furnish the E/C with a report of the injury and treatment; failure to so furnish may be excused by the DC for good cause. Section 440.13(2)(b)....
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Olson v. Wagner, 390 So. 2d 1247 (Fla. 1st DCA 1980).

Published | Florida 1st District Court of Appeal | 1980 Fla. App. LEXIS 18199

...file medical bills and reports presents a troublesome point. The deputy’s order excuses the physicians’ filings “because of the nature of the case and the fact that they [the doctors] very rarely deal with workmen’s compensation matters”. § 440.13, Fla.Stat....
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United States Fire Ins. Co. & Oxford Shops of South Florida v. Virginia Hackett, 260 So. 3d 532 (Fla. 1st DCA 2018).

Published | Florida 1st District Court of Appeal

...ive date. Rustic Lodge v. Escobar, 729 So. 2d 1014 (Fla. 1st DCA 1999). 2 point of entry for an E/C to compel an IME on the basis of allegedly changed circumstances; and that IMEs are available solely as provided in section 440.13(5), which Claimant argues does not apply here....
...can petition for a modification under section 440.28, there can be no IME to prove the factual basis for the petition. The statute defines an IME as an objective evaluation of the claimant’s medical condition “to assist in the resolution of a dispute arising under this chapter.” § 440.13(1)(i), Fla. Stat. The statutory provisions governing IMEs authorize the carrier or the employee to select an IME “[i]n any dispute concerning overutilization, medical benefits, compensability, or disability under this chapter.” § 440.13(5)(a)....
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Flagship Nat'l Bank of Broward Cnty. v. Hinkle, 479 So. 2d 828 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 2760, 1985 Fla. App. LEXIS 17297

...Compensation for temporary disability and medical benefits provided by this chapter shall not be subject to apportionment under this subsection. . Section 440.15, Florida Statutes (1983), deals only with the right of "compensation for disability” by the employee. Medical benefits are provided for in section 440.13....
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Hunt v. Staff Leasing, 996 So. 2d 254 (Fla. 1st DCA 2008).

Published | Florida 1st District Court of Appeal | 2008 WL 5191704

...The JCC agreed and, in so doing, erred. The issue before the JCC was not a tax dispute. Rather, it involved Claimant's attempt to have the E/C correct an admittedly harmful technical error in the manner by which it provided medical benefits to Claimant. Section 440.13(2)(b), Florida Statutes, requires an e/c to provide attendant care in a certain manner....
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Saddlebrook Resorts, Inc. v. Heath, 686 So. 2d 667 (Fla. 4th DCA 1996).

Published | Florida 4th District Court of Appeal | 1996 Fla. App. LEXIS 12878, 1996 WL 710778

payment. *669Because the attendant care statute, section 440.13, Florida Statutes, has undergone substantial
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Mcclung-gagne v. Harbour City Volunteer, 721 So. 2d 799 (Fla. 1st DCA 1998).

Published | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 15613, 1998 WL 852301

...context of this statute, in interpreting this statute, we construe its meaning in a manner most favorable to the claimant. Schafrath, 608 So.2d at 109, n. 3. As a result, we read the Legislature's use of the broad term "other governmental entity" in section 440.13(d)(3) as providing workers' compensation coverage to volunteers of quasi-public corporations which, under contract with a public body, perform services that are traditionally performed by government....
...Because the JCC below erroneously dismissed the instant claim for lack of subject matter jurisdiction, the JCC did not have the opportunity to weigh the record evidence to determine whether under the facts of this case HCVAS should be deemed an "other governmental entity" under section 440.13(d)(3)....
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Simon v. Developmental Preschool, 572 So. 2d 538 (Fla. Dist. Ct. App. 1990).

Published | District Court of Appeal of Florida | 1990 Fla. App. LEXIS 9472, 1990 WL 205392

...The claimant in this workers' compensation case appeals an order of the judge of compensation claims (JCC) denying her claim for payment of past medical bills on the basis of her physician’s failure to comply with the ten-day billing and reporting requirements of section 440.13, Florida Statutes....
...At the conclusion of the hearing, the JCC announced his intention to rule in claimant’s favor on the issue of compensability, but to rule in the E/C’s favor on the claim for. payment of past medical bills, on the basis that claimant’s physicians had failed to timely submit bills and reports in accordance with section 440.13(2)(b), Florida Statutes....
...After hearing arguments from both attorneys, the JCC found that claimant had failed to establish that the E/C had waived their, right to rely on the statutory reporting requirement, utilizing the three-pronged test set out in Wynn v. Hogan Baptist Church, 483 So.2d 551 (Fla. 1st DCA 1986). Section 440.13(2)(b), Florida Statutes (1989) provides that claims for medical benefits shall not be valid and enforceable unless: *539 Within ten days following the first treatment ......
...We disagree, however, with the JCC’s apparent conclusion that the three-pronged test set out in Wynn was the only manner in which the claimant could have established good cause for failure to comply with the statutory reporting requirements. The good cause language contained in section 440.13(2)(b) has appeared in the workers’ compensation statutes since at least 1961....
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Alcoma Packing Co. v. Jones, 571 So. 2d 73 (Fla. Dist. Ct. App. 1990).

Published | District Court of Appeal of Florida | 1990 Fla. App. LEXIS 9466, 1990 WL 205422

...otice that claimant desired chiropractic treatment. Claimant’s attorney was supplied the names of four alternative chiropractors authorized to provide claimant with care. Under the circumstances, the employer and carrier met their obligation under section 440.13(2) to provide claimant with the treatment when he requested it by supplying to him the names of authorized chiropractors....
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Hansen & Adkins Auto Transp. & Gallagher Bassett Servs. v. James Martin, 259 So. 3d 994 (Fla. 1st DCA 2018).

Published | Florida 1st District Court of Appeal

...E/C raised a major contributing cause defense to both claims. In the order now on appeal, the JCC correctly noted that an injured worker may obtain wrongfully denied medical treatment at the expense of the E/C under the self-help provisions of section 440.13(2)(c), Florida Statutes (2015). See, e.g., Parodi v. Fla. Contracting Co., 16 So. 3d 958, 962 (Fla. 1st DCA 2009) (holding “where section 440.13(2)(c) applies, the [JCC] has the statutory authority to authorize a doctor for care provided during the period of wrongful denial”)....
...condition and the need for the surgery recommended by Dr. Ero, we find no reversible error. The record supports the JCC’s conclusion that the E/C wrongfully denied the surgery recommended by Dr. Ero. But Claimant’s burden under the self-help provision of section 440.13(2)(c) was to show that surgery he actually received—a different surgery than Dr....
...from the unauthorized provider. Dr. Ero expressly testified that he could not state that this surgery was medically necessary. And the JCC only cited evidence of medical necessity based on the medical records from the self-help provider. This was error. Under section 440.13(5)(e), only medical opinions from authorized providers, independent medical examiners, and expert medical advisors are admissible in workers’ compensation proceedings....
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E.M. Scott Contractors v. Baker, 479 So. 2d 292 (Fla. Dist. Ct. App. 1985).

Published | District Court of Appeal of Florida | 10 Fla. L. Weekly 2713, 1985 Fla. App. LEXIS 17257

...No such hearing was held by the deputy. Instead, the deputy made an appointment with another orthopedic surgeon and drafted an order authorizing that surgeon to treat the claimant “as he deems fit.” Notwithstanding the deputy’s authority under § 440.13(3) to order a change in medical attention “for good cause shown,” the procedural requirements of § 440.25 must be followed in determining whether “good cause” has been shown for the change. Section 440.13(3) does not authorize a deputy commissioner to act without giving the parties an opportunity to be heard....
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Royals v. Owens, 423 So. 2d 476 (Fla. Dist. Ct. App. 1982).

Published | District Court of Appeal of Florida | 1982 Fla. App. LEXIS 21769

in the Palm Beach County area as required by Section 440.13, Florida Statutes. Furthermore, the issues
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Mcdonald's v. Weiler, 423 So. 2d 978 (Fla. 5th DCA 1982).

Published | Florida 5th District Court of Appeal | 1982 Fla. App. LEXIS 21776

non-compliance with the reporting requirements of section 440.13(1), Florida Statutes (1981) existed. Otherwise
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Lowry v. Jim Bassitts Auto, 566 So. 2d 303 (Fla. Dist. Ct. App. 1990).

Published | District Court of Appeal of Florida | 1990 Fla. App. LEXIS 5994, 1990 WL 115532

...basis that it was not authorized. We agree. An employer is required to furnish such medically necessary treatment, care and attendance by a health care provider and for such periods as the nature of the injury or the process of recovery may require. § 440.13(2)(a), Pla.Stat....
...(1987). If the employer fails to provide such treatment, care and attendance after request by the injured employee, the employee may do so at the expense of the employer, the reasonableness and necessity to be approved by a judge of compensation claims. § 440.13(2)(b), Fla.Stat....
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Lehoullier v. Gevity/Fire Equip. Servs., 43 So. 3d 834 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 12703, 2010 WL 3398143

...iatric condition and the longevity of Claimant's medical care with one of his authorized treating physicians. In response, Claimant argued the JCC lacked authority to compel his attendance at an IME because no "dispute" existed within the meaning of section 440.13(5)(a), Florida Statutes (2007). *836 After conducting a hearing on the E/C's motion, the JCC entered an order compelling Claimant's attendance at a neuropsychiatric IME. Reasoning that an E/C is permitted to transfer medical care pursuant to section 440.13(2)(d), Florida Statutes (2007), if an independent medical examiner determines the employee is not making appropriate progress in recuperation, the JCC concluded that Claimant could be compelled to attend an IME. Claimant seeks review of the JCC's order, asserting that it departs from the essential requirements of law because there is no dispute between the parties, as required by section 440.13(5)(a)....
...of irreparable harm may be found based on the notion that once the invasive harm of the examination occurs, it cannot be undone on appeal."). In the present case, no statutory authority supports the order compelling Claimant's attendance at an IME. Section 440.13(5)(a), Florida Statutes (2007), permits an IME if the facts disclose a dispute "concerning overutilization, medical benefits, compensability," or disability....
...1st DCA 2005); Zabik, 911 So.2d at 859 (holding that it is incumbent upon party seeking IME to prove existence of dispute). We read "dispute" to mean a legal dispute cognizable under the Florida Worker's Compensation Law. See, e.g., 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....
...Simply expressing unilateral speculative concerns over a claimant's progress with an authorized physician is insufficient. See Zabik, 911 So.2d at 859 (holding E/C's speculative but unrealized concern over claimant's psychiatric condition insufficient to constitute dispute warranting IME). The JCC, relying on section 440.13(2)(d), determined that the E/C created a "dispute" by questioning Claimant's progress with the authorized treating physician. Section 440.13(2)(d) provides that "[t]he carrier has the right to transfer the care of an injured employee from the attending health care provider if an [IME] determines that the employee is not making appropriate progress in recuperation." Contrary to the reasoning of the JCC, section 440.13(2)(d) does not grant an E/C an independent right to an IME whenever the E/C suspects a claimant is not adequately progressing. Rather, this section presumes the existence of a dispute warranting *837 the initial appointment of an IME, as required by section 440.13(5)(a). Section 440.13(2)(d) applies only after an E/C establishes a dispute pursuant to section 440.13(5)(a) and the IME takes place. Because the E/C failed to prove the existence of a dispute as required by section 440.13(5)(a), the JCC should not have compelled Claimant's attendance at an IME....
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Merritt Manor Nursing Home v. Caldwell, 667 So. 2d 265 (Fla. Dist. Ct. App. 1995).

Published | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 9170, 1995 WL 511600

Kaplan’s testimony was inadmissible pursuant to section 440.13(5)(e), Florida Statutes (Supp.1994), because
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Ramada Inn v. Gates, 418 So. 2d 1160 (Fla. Dist. Ct. App. 1982).

Published | District Court of Appeal of Florida | 1982 Fla. App. LEXIS 21029

...Immediately after claimant informed her employer that an accident occurred on December 11, 1979, she was provided with authorized medical care by Dr. Green, an orthopedic surgeon, who instructed her to return if she had further problems. Nevertheless, without following the procedures set forth in Section 440.13(2), Florida Statutes (1979), or seeking alternative treatment, claimant continued to receive duplicate unauthorized treatment by Dr....
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Faulkner v. Asplundh Tree Expert Co., 739 So. 2d 154 (Fla. 5th DCA 1999).

Published | Florida 5th District Court of Appeal | 1999 Fla. App. LEXIS 10437, 1999 WL 560231

appointment of an expert medical advisor pursuant to section 440.13(9)(c), Florida Statutes, based on an alleged
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Beneficial Payroll Servs., Inc. v. Tobon, 714 So. 2d 668 (Fla. 1st DCA 1998).

Published | Florida 1st District Court of Appeal | 1998 Fla. App. LEXIS 9731, 1998 WL 432493

...Kirkpatrick elects not to treat Ms. Tobon. In purporting to authorize one physician to name an unspecified successor, the order under review interferes with the employer’s and carrier’s prerogative to make the initial selection of a treating physician, as contemplated by section 440.13(2) and (3), Florida Statutes (1993)....
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Cornelius & Sons, Inc. v. McGrew, 387 So. 2d 508 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 17545

performance of this service in the amount of $1,900. Section 440.13, Florida Statutes (1975), provides that an
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Sch. Bd. of Manatee Cnty. v. Chrisman, 678 So. 2d 498 (Fla. Dist. Ct. App. 1996).

Published | District Court of Appeal of Florida | 1996 Fla. App. LEXIS 8904, 1996 WL 476877

...The E/SA argue that the Judge of Compensation Claims lacked jurisdiction to authorize Dr. Rea to provide sauna biodetoxifieation therapy because they had submitted the matter to the Agency for Health Care Administration (AHCA) and AHCA’s review was still pending at the time of the final hearing. Because section 440.13(l)(m), Florida Statutes (Supp....
...ered its previously issued determination moot. We hold that the Judge of Compensation Claims had jurisdiction to determine the medical necessity and the nonexperimental nature of the sauna biodetoxifieation therapy while AHCA’s review was pending. Section 440.13(l)(m), Florida Statutes (Supp.1994), 1 provides in pertinent part: ‘Medically necessary’ means any medical service or medical supply which is used to identify or treat an illness or injury, is appropriate to the patient’s diagnos...
...ion Claims to determine the experimental nature of the requested therapy. The only evidence presented before the Judge of Compensation Claims revealed that the sauna biodetoxification therapy was medically necessary and was not experimental. Because section 440.13(l)(m), Florida Statutes (Supp.1994), did not preclude the Judge of Compensation Claims from exercising jurisdiction to determine the medical necessity and nonexperi-mental nature of the sauna biodetoxification therapy while review was...
...tion Claims acted within her jurisdiction in authorizing Dr. Rea to provide the requested therapy. Accordingly, the order of the Judge of Compensation Claims is AFFIRMED. ERVIN and KAHN, JJ., concur. . Although the parties cite different versions of section 440.13, Florida Statutes, in their briefs, the only pertinent change in the 1994 statute is the requirement that approval regarding the experimental, investigative or research nature of the service be sought from the Agency for Health Care Ad...
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Collins v. Mosaic Fertilizer, LLC, 121 So. 3d 1119 (Fla. 1st DCA 2013).

Published | Florida 1st District Court of Appeal | 2013 WL 4482492, 2013 Fla. App. LEXIS 13303

...iterature in which the delay in the onset of hemato-mas was as long as the delay in Claimant’s case. “The opinion of the [EMA] is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the [JCC].” § 440.13(9), Fla....
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Robert Schiano v. City of Hollywood Police Deparment/ Emp.'s Mut., Inc. (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...Facts On August 30, 2017, Claimant’s counsel transmitted by facsimile (“fax”) a letter to the E/C informally requesting two benefits: authorization of a replacement neurologist due to Dr. Ballweg’s death and authorization of an orthopedist as a one-time change of authorized treating physician pursuant to section 440.13(2)(f), Florida Statutes....
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Safeco Ins. Co. of Illinois v. Md Now Med. Centers, Inc. d/b/a Md Now Patient: Shelley Holmstock (Fla. 4th DCA 2023).

Published | Florida 4th District Court of Appeal

...care is not reimbursable under Medicare Part B, as provided in this sub- subparagraph, the insurer may limit reimbursement to 80 percent of the maximum reimbursable allowance under workers’ compensation, as determined under s. 440.13 and rules adopted thereunder which are in effect at the time such services, supplies, or care is provided....
...required to pay those charges. We hold that Code S9088 is properly reimbursable under both the Workers’ Compensation statute as well as 4 under the corresponding Administrative Code provisions and related guides. Sections 440.13(12)–(13), Florida Statutes (2020), create a guide to MRAs and payment of medical fees for Workers’ Compensation. Those sections adopt a schedule of MRAs for medically necessary services and establish that “[p]ayment to health care providers or physicians shall be subject to the medical fee schedule . . . .” § 440.13(12)–(13), Fla. Stat. (2020). In conjunction with section 440.13, Florida Administrative Code Rule 69L-7.020 adopts the Manual that “establishes reimbursement policies, guidelines, codes and MRAs for services provided by health care providers.” Fla....
...cable statutes allows for reimbursement of Code S9088 as long as the services rendered were medically necessary within the meaning of the Workers’ Compensation statute as “medical services . . . used to identify or treat an illness or injury.” § 440.13(1)(k), Fla....
...First, Insurers assert that a facility code already exists in the schedule which it previously paid. However, the payment of another code does not necessarily mean that this code—Code S9088—cannot also be reimbursed as an additional urgent care facility fee. Second, Insurers point to a provision in section 440.13(12)(a) of the Workers’ Compensation statute to suggest a reimbursement payment can only be the amount of an “agreed-upon contract price or the maximum reimbursement allowance in the appropriate schedule.” But rather than limiting...
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Bergstein v. Palm Beach Cnty. Sch. Bd., 97 So. 3d 878 (Fla. 1st DCA 2012).

Published | Florida 1st District Court of Appeal | 2012 WL 3537820, 2012 Fla. App. LEXIS 13716

...lls for medical care to be a reimbursement dispute over which she has no jurisdiction, on the authority of Avalon Ctr. v. Hardaway, 967 So.2d 268, 271 (Fla. 1st DCA 2007). We agree, and hold that assertion of this jurisdictional defense (codified at section 440.13(ll)(c), Florida Statutes (1994)) is a de facto concession by the Employer/Carrier (E/C) that the services or products billed were provided by an authorized provider for compensable injuries “in accordance with” or “pursuant to”...
...ed any challenge to the medical necessity of the care such as was asserted in Williams v. Triple J Enter *879 prises, 650 So.2d 1114 (Fla. 1st DCA 1995). Thus, if any entity is financially responsible for these disputed bills, it is the carrier (per section 440.13(14)(a), Florida Statutes (1994)), and Claimant is thereby insulated from financial responsibility (per section 440.13(3)(g), Florida Statutes (1994))....
...act or ultimate fact to support the ruling, we disagree; the operative finding here, premised on the affirmative averments made by the E/C, is contained in the order: the dispute is a reimbursement dispute. It follows from that finding, though, that section 440.13(3)(g) insulates Claimant from financial responsibility for the disputed bills....
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Shea v. Durty Two, Inc., 738 So. 2d 510 (Fla. Dist. Ct. App. 1999).

Published | District Court of Appeal of Florida | 1999 Fla. App. LEXIS 11039, 1999 WL 618107

admissible in proceedings before the JCC. See § 440.13(5)(v), Fla. Stat. (1995). Nevertheless, in this
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Purcell v. Padgett, 658 So. 2d 1237 (Fla. Dist. Ct. App. 1995).

Published | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 8706, 1995 WL 488334

DAVIS, Judge. Dr. Purcell appeals an order of the Judge of Compensation Claims (JCC) construing section 440.13(10), Florida Statutes (1994), as limiting his right to an expert witness fee for giving a deposition to $200 a day....
...An expert witness who has never provided direct professional services to a party but has merely reviewed medical records and provided an expert opinion or has provided only direct professional services that were unrelated to the workers’ compensation case may not be allowed a witness fee in excess of $200 per day.” Section 440.13(10), Florida Statutes (1994).
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Gulf & W. Food Prods. v. Campbell, 417 So. 2d 1168 (Fla. Dist. Ct. App. 1982).

Published | District Court of Appeal of Florida | 1982 Fla. App. LEXIS 20885

with medical care in a manner consistent with Section 440.13,” Florida Statutes. The applicable portion
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Beverly Mathis v. Broward Cnty. Sch. Bd. & The Sch. etc., 224 So. 3d 852 (Fla. 1st DCA 2017).

Published | Florida 1st District Court of Appeal | 2017 WL 3469413, 2017 Fla. App. LEXIS 11635

...that the carrier “initiate payment and continue the provision of all benefits and compensation as if the claim had been accepted as compensable.” Ch. 03-412, § 24, at 3934, Laws of Fla. 5 requires prior authorization under section 440.13(3)(c), Florida Statutes (2014). Second, because the services provided to Claimant cost more than $1,000, the E/C were entitled to a ten-day approval period under section 440.13(3)(i), Florida Statutes (2014), and the emergency-care exception to that ten-day period....
...This paragraph does not limit the carrier’s obligation to identify and disallow overutilization or billing errors. The ten-day approval period applies for services that cost more than $1,000 and other designated specialty services, “unless emergency care is required.” See also § 440.13(3)(b), Fla....
...Unless the emergency care exception applied, as Claimant argues it does, the E/C are not liable for the hospital bill. The JCC found that hospitalization was considered necessary to treat Claimant’s infection, but these findings do not resolve whether it was “emergency care” within the meaning of section 440.13(3)(i)....
...The JCC here did not, however, address the E/C’s other defenses or the remainder of the analysis under Cespedes, including whether the hospitalization met the definition of “emergency services and care” under section 395.002 as referenced in section 440.13(1)(e)....
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Milmar Roofing Co. v. Jones, 566 So. 2d 25 (Fla. Dist. Ct. App. 1990).

Published | District Court of Appeal of Florida | 1990 Fla. App. LEXIS 6221, 1990 WL 115514

...internal failure “accident” within the requisite standards for compensability. The medical costs necessary to resolve that issue appear to us to be indistinguishable from those previously awarded in this jurisdiction, and within the language of section 440.13, (1) and (2), Florida Statutes, providing for medically necessary care “as the nature of the injury ......
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Wendy's of Brevard v. Stickney, 436 So. 2d 346 (Fla. Dist. Ct. App. 1983).

Published | District Court of Appeal of Florida | 1983 Fla. App. LEXIS 20126

“reasonable and necessary” medical care on her own. Section 440.13(1), Florida Statutes (1981). The deputy approved
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Gomar v. Ridenhour Concrete & Supply, 42 So. 3d 855 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 11695, 2010 WL 3119939

...Fox of Fox & Loquasto, P.A., Tampa; Richard W. Ervin, III, of Fox & Loquasto, Tallahassee, for Appellant. Lori Pearson-Wise of the Law Office of Lori Pearson-Wise, P.A., Maitland, for Appellees. PER CURIAM. At issue in this workers' compensation appeal is whether section 440.13(5)(a), Florida Statutes, permits a claimant, who previously obtained an independent medical examination on the issue of compensability, to have a subsequent independent medical examination on the issue of maximum medical improvement if he disputes that determination....
...Gomar obtained an updated independent medical examination ("IME") from the same physician who conducted his initial IME. The updated IME concluded that Mr. Gomar has not reached MMI. The Judge of Compensation Claims' ("JCC") disallowed evidence relating to the second IME, because section 440.13(5)(a) states a party may have only one IME per accident....
...Gomar filed the petition for benefits at the center of this appeal. After this was denied by the E/C, he underwent an "updated" IME with Dr. Simon directed to whether he has in fact reached MMI. At the final hearing, the JCC excluded from evidence all testimony and records related to the 2009 IME because section 440.13(5)(a) allows parties to have only one IME per accident....
...f authorized treating physicians Drs. Weber and Flynn placing Mr. Gomar at MMI in 2007. The JCC denied the petition for benefits, finding no evidence that Mr. Gomar's pain and need for treatment were attributable to the work-related injury. Analysis Section 440.13(5)(a), Florida Statutes (2005), provides, in pertinent 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.......
...We disagree with the JCC's restrictive reading of this provision, as it essentially forever limits a party to one IME. In Cortina v. State, Department of HRS, 901 So.2d 273, 274 (Fla. 1st DCA 2005), we stated that "the only condition required for a party to request an IME [under section 440.13(5)(a) ] is a dispute. " (Emphasis in original.) In other words, when " any dispute concerning overutilization, medical benefits, compensability, or *858 disability" arises, a claimant or employer may request an IME. § 440.13(5)(a), Fla....
...MI, her claim for temporary partial disability benefits was denied. Cortina, 901 So.2d at 275. We held that the claimant's disagreement with the MMI determination and the e/c's denial of benefits created a dispute, thus entitling her to an IME under section 440.13(5)(a)....
...ctober 1, 2003, date of accident); Bell v. Univ. of Fla., 652 So.2d 460, 461 (Fla. 1st DCA 1995) (restating that substantive workers' compensation rights are fixed at the time of injury). We also acknowledge that Cortina involved the 1996 version of section 440.13(5) which, as with the 2005 version, provided for an IME "[i]n any dispute concerning overutilization, medical benefits, compensability, or disability under this chapter ...." § 440.13(5)(a), Fla....
...For purposes of the issue before us now, the crucial difference between the 1996 and 2005 versions of this section is that the latter limits a party to "only one independent medical examination per accident and not one independent medical examination per specialty." § 440.13(5)(a), Fla....
...rier to render one or more independent medical examinations in connection with a dispute arising under this chapter." (Emphasis added.) When read in pari materia, we think that the only way to read these three provisions harmoniously is to interpret section 440.13(5)(a) as allowing for one independent medical examiner per accident, and not, as was formerly the case, one per specialty....
...We observe that in the clause "only one independent medical examination per accident and not one independent medical examination per specialty," the exclusionary phrase "and not" is indicative of the legislature's intent. Prior to the 2003 amendment, parties could use section 440.13(5)(a) to obtain IMEs for multiple specialties....
...1st DCA 1996), we held that the employer's request for a second IME was reasonable because more than a year had passed since the first IME, and a dispute arose as to the claimant's work restrictions and entitlement to permanent total disability benefits. We acknowledge that the court in Liggon addressed the 1991 version of section 440.13....
...orts; determining whether overutilization by a health care provider has occurred; whether a change in health care provider is necessary; or whether treatment is necessary or the employee appears not to be making appropriate progress in recuperation. § 440.13(2)(c), Fla....
...Gomar. [2] We review de novo the JCC's interpretation and application of the statute, as it is a question of law. See Lanham v. Dep't of Envtl. Prot., 868 So.2d 561, 562 (Fla. 1st DCA 2004). [3] This limitation is subject to the exception found in section 440.13(5)(b), Florida Statutes (2005), which provides for an "alternate" independent medical examiner under certain enumerated circumstances....
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Capital Cities/ABC-TV N.Y. v. Wagner, 742 So. 2d 347 (Fla. 1st DCA 1999).

Published | Florida 1st District Court of Appeal | 1999 Fla. App. LEXIS 10631, 1999 WL 594193

...ation. The surgery was performed by an authorized doctor, but the carrier had refused the claimant’s request for authorization of the surgical procedure. The judge found the surgery to be medically necessary, and payment was properly awarded under section 440.13(2)(c), Florida Statutes....
...This statute permits a claimant to obtain necessary care which the employer declines to provide after request, when there is no equivalent alternative authorization. See, e.g., Colace v. Hamlet Estates, Ltd., 573 So.2d 994 (Fla. 1st DCA 1991). Although section 440.13(3)(a), Florida Statutes, conditions eligibility for payment on authorization, and section 440.13(3)(i), Florida Statutes, likewise contemplates the authorization of surgical procedures such as that involved in the present case, those provisions must be read in context with section 440.13(2)(c), which clearly permits the claimant to obtain care which the employer has refused to provide, and which is medically necessary....
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Pub. Gas Co. v. Monette, 658 So. 2d 673 (Fla. Dist. Ct. App. 1995).

Published | District Court of Appeal of Florida | 1995 Fla. App. LEXIS 8483, 1995 WL 469658

compensation claims (JCC) erroneously assumed that section 440.13(5), Florida Statutes (Supp.1994), which went
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Jones v. Petland Orlando S., 622 So. 2d 1114 (Fla. 1st DCA 1993).

Published | Florida 1st District Court of Appeal | 1993 WL 299509

...In females the condition results in diffuse hair loss or thinning of the frontoparietal areas. At the time the case came on for hearing, all parties mistakenly believed that Rogaine had not been approved to treat hair loss in women. At the commencement of the hearing, counsel for the E/C immediately contended that under section 440.13(1)(c), Florida Statutes (1985), Rogaine is an experimental drug....
...Relying upon this information, the JCC determined "that the use of the prescription medication Rogaine, by the claimant, to treat hair loss as a result of the side effect of medication or depression, is experimental in nature." The JCC never addressed whether the use of Rogaine would be medically necessary under section 440.13(2)(a), Florida Statutes (1985), or whether Ms....
...1st DCA 1992). In Arizona Chemical the claimant requested biodetoxification treatment to treat his injuries which resulted from exposure to toxic chemicals. At the hearing, the E/C defended the claim on the basis that the treatment was experimental. Section 440.13(1)(d), Fla....
...[3] The E/C have not, however, pointed to case law or a statute that requires such deference to the FDA in a Florida workers' compensation matter. The determination of medical necessity must be made by the JCC on the facts in a given case, not by the FDA. § 440.13(2)(a), Fla....
...We also vacate the denial of attorney's fees and costs, and direct the JCC to reconsider these matters on remand. Section 440.34(3)(a), Fla. Stat. REVERSED and REMANDED for proceedings consistent with this opinion. BOOTH and BARFIELD, JJ., concur. NOTES [1] This statute is the same as section 440.13(1)(c), Florida Statutes (1985)....
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Bustamante v. Amber Constr. Co., 118 So. 3d 921 (Fla. 1st DCA 2013).

Published | Florida 1st District Court of Appeal | 2013 WL 3942487, 2013 Fla. App. LEXIS 12086

...R CURIAM. We have for review an order of the Judge of Compensation Claims (JCC) that finds the Employer/Carrier timely authorized a change in Claimant’s authorized treating physician following Claimant’s request for a one-time change pursuant to section 440.13(2)(f), Florida Statutes (2011)....
...Following consideration of this issue— *922 whether the Employer/Carrier timely responded to Claimant’s request — at an expedited hearing, the JCC determined Dr. Kaplan to be the “appropriate authorized treating physician as the Employer/Carrier complied with the statutory provision of F.S. § 440.13(2)(f) in authorizing the alternative physician within five (5) days.” The JCC based this conclusion on his finding that the Employer/Carrier “actually authorized a change of physician to Dr....
...Frederic, 102 So.3d 668 (Fla. 1st DCA 2012). This court reversed the JCC’s finding that the E/C had not timely authorized a change in physician. Id. “The E/C’s informing Claimant of a particular doctor’s name within five days of receiving the request satisfied section 440.13(2)(f), even though the E/C did not contact the doctor.” Id....
...Kaplan with Jacksonville Orthopaedic Institute when it faxed its letter of authorization to that provider on September 28, 2012,” and the JCC erred in determining that unilateral notice to Jacksonville Orthopaedic Institute was sufficient to comply with section 440.13(2)(f), the JCC abused his discretion in naming Dr....
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Nova Se. Univ. v. Majnerich, 953 So. 2d 715 (Fla. 1st DCA 2007).

Published | Florida 1st District Court of Appeal | 2007 WL 1038109

...d Gallagher pay for covered prescriptions as part of their duty to "furnish to the employee such medically necessary remedial treatment . . . for such period as the nature of the injury or the process of recovery may require, including medicines[.]" § 440.13(2)(a), Fla. Stat. (2001). See also § 440.13(3)(j), Fla....
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Vickers v. Unity of Lake Worth, 693 So. 2d 62 (Fla. Dist. Ct. App. 1997).

Published | District Court of Appeal of Florida | 1997 Fla. App. LEXIS 3508, 1997 WL 162753

...he claimant’s physicians. Because the findings in the order on appeal are supported by competent substantial evidence, the order on appeal is affirmed. We find it necessary, however, to reverse the order on cross-appeal. Effective January 1, 1994, section 440.13(4)(c), Florida Statutes provides in part: (c) It is the policy for the administration of the workers’ compensation system that there be reasonable access to medical information by all parties to facilitate the self-executing features of the law....
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Foster Wheeler Energy Corp. v. Faircloth, 577 So. 2d 1382 (Fla. 1st DCA 1991).

Published | Florida 1st District Court of Appeal | 1991 Fla. App. LEXIS 3530, 1991 WL 46825

up to October 1, 1988, the effective date of Section 440.13(2)(e)l, Florida Statutes (Supp. 1988). Thereafter
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Florida Refreshment & Gen. Adjustment Bureau v. Whaley, 577 So. 2d 1368 (Fla. Dist. Ct. App. 1991).

Published | District Court of Appeal of Florida | 1991 Fla. App. LEXIS 3173, 1991 WL 46831

...Preliminarily, we find the award of twenty-four hours daily care by the wife abundantly supported by the evidence of record, as partially recited in the JCC’s order. As to the $5.00 hourly rate, the E/C urge that since the wife is unemployed, the hourly rate is limited to the federal minimum wage under section 440.13(2)(e)(l), Florida Statutes (1988)....
...1st DCA 1990). Even if the twenty-four hour attendant care award was justified under the evidence, however, the E/C contend that the JCC’s order was in error insofar as it extended twenty-four hour daily care beyond October 1, 1989, the effective date of section 440.13(2)(e)(2), Florida Statutes (1989)....
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Deconna Ice Cream Co. v. Desourdy, 382 So. 2d 138 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 23704

timely reports to the employer and carrier. Section 440.-13(1), Florida Statutes (1979). The order is also
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McMahon v. Huntington, 246 So. 2d 743 (Fla. 1971).

Published | Supreme Court of Florida | 1971 Fla. LEXIS 3879

...cessary; this was confirmed by correspondence from one of the treating physicians in which he stated that claimant “[W]ould need assistance for few weeks after getting out of the hospital.” The services rendered were compen-sable under Fla.Stat. § 440.13(1), F.S.A....
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McGehee v. Broward Cmty. Coll., 559 So. 2d 368 (Fla. Dist. Ct. App. 1990).

Published | District Court of Appeal of Florida | 1990 Fla. App. LEXIS 2324, 1990 WL 39908

...riencing psychiatric difficulties related to his industrial injury, as indicated in earlier medical reports as well as claimant’s own letter to the servicing agent. In these circumstances the payment of Dr. Corwin’s bills may be awarda-ble under section 440.13(2)(a), Florida Statutes, if the doctor provided reasonable and necessary treatment required by “the nature of the injury or the process of recov-ery_” See Gephart v....
...Silver Springs Shores Golf & Country Club, 545 So.2d 330 (Fla. 1st DCA 1989); see also, e.g., Thomas v. Commercial Carrier Corp., 529 So.2d 758 (Fla. 1st DCA 1988). The judge also noted that Dr. Corwin’s bills were not timely filed, as required by section 440.13(2)(b), Florida Statutes....
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Church's Chicken v. Anderson, 112 So. 3d 545 (Fla. 1st DCA 2013).

Published | Florida 1st District Court of Appeal | 2013 WL 1338699, 2013 Fla. App. LEXIS 5474

...competent, substantial evidence failed to support finding of medical necessity and causal relationship). It was Claimant’s burden to prove that the treatment was necessitated by the injury which “arose as a result of a work-related accident.” § 440.13(3)(b), Fla....
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Scherer & Sons, Inc. v. Hoepelman, 397 So. 2d 760 (Fla. 1st DCA 1981).

Published | Florida 1st District Court of Appeal | 1981 Fla. App. LEXIS 19677

...aid, the order is REVERSED and the case REMANDED to the deputy for further consideration in light of this court’s decision in Belam Florida Corp. v. Dardy, 397 So.2d 756 (Fla. 1st DCA 1981). Moreover, because there was a failure of compliance with Section 440.13(1), Florida Statutes (1977), and no showing of circumstances excusing compliance with that requirement for a request to the employer/carrier for medical services, and requiring medical reports to the carrier, the deputy erroneously required payment of the bill submitted by Dr....
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Randstad North Am./ESIS Worker's Comp. Claims v. Alfred Barr, 267 So. 3d 564 (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...Nofsinger is neither an authorized treating doctor, Independent Medical Examiner (IME), or EMA, his records and opinions are inadmissible and, thus, providing them to the EMA would cause them prejudice. The JCC rejected the E/C’s argument, finding that the EMA statute, section 440.13(9)(c), Florida Statutes, provides that the appointed expert is to have “free and complete access to the medical records of the employee” and does not include any restrictions or limitations on which records may be provided....
...The JCC also stated he was not making any findings regarding the admissibility of Dr. Nofsinger’s records, testimony, or opinions. In their petition for writ of certiorari, the E/C argue that the JCC’s interpretation of the EMA statute is incorrect because it fails to consider that section 440.13(5)(e) limits admissible opinions to those rendered by authorized doctors, IMEs, and EMAs and, thus, an EMA can consider only admissible medical evidence in formulating an opinion....
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Sharon Varricchio v. St. Lucie Cnty. Clerk of Courts & Ascension Ins., 271 So. 3d 1206 (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...THOMAS, J. Sharon Varricchio (“Claimant”) appeals a workers’ compensation order denying her claim for temporary disability benefits. We affirm but write to address retroactive assignment of maximum medical improvement (“MMI”) and the claim that section 440.13(4)(c), Florida Statutes (2013), allowing ex parte conferences, violates the privacy clause of the Florida Constitution. I....
...Constitutional Right to Privacy The attorney for the E/C had a one-on-one meeting with Dr. Weidenbaum shortly before he completed the April 2017 questionnaire specifying the MMI date of June 30, 2015. The Claimant contends that section 440.13(4)(c)—the statutory provision giving the E/C the right to discuss Claimant’s medical condition with her doctors, outside of her presence and without prior notice—violates her constitutional right to privacy. Our review of constitutional claims is de novo....
...1st DCA 2000) (citing City of N. Miami v. Kurtz, 653 So. 2d 1025, 1028 (Fla. 1995)). 6 Here, no legitimate expectation of privacy can be asserted. See Kimes, 756 So. 2d at 1041. In Kimes, this Court expressly held that section 440.13(4)(c) does not violate Florida’s constitutional right to privacy. 756 So. 2d at 1041. The Claimant suggests that Kimes no longer controls the constitutional question here in light of the supreme court’s decision in Weaver v. Myers, 229 So. 3d 1118 (Fla. 2017), and the 2003 amendments to section 440.13(4)(c)....
...dicta in Weaver, is an acknowledgement by the supreme court that the Kimes decision turned on an injured worker’s lack of an expectation of privacy with regard to only those physicians authorized to treat under workers’ compensation law. The Claimant argues that section 440.13(4)(c) was substantially amended in 2003 and these amendments expand the scope of the law to permit E/Cs to obtain records from, and secretly meet with, all physicians, not just those authorized to treat workplace injuries....
...the discussion was limited to the workplace injury. As a consequence, the Claimant has not demonstrated injury that is anything more than conjecture. And, because Claimant has provided no support in the record that the recent amendments to 7 section 440.13(4)(c) violate her right to privacy causing ‘“an injury which is both real and immediate, not conjectural or hypothetical,’” her constitutional challenge must also fail....
...1st DCA 2011) (holding claimant’s constitutional argument must fail where evidence fails to show real and immediate injury) (quoting Montgomery v. Dep’t of Health & Rehab. Servs., 468 So. 2d 1014, 1016 (Fla. 1st DCA 1985)). Accordingly, we find that section 440.13(4)(c), as amended, does not violate the constitutional right to privacy. AFFIRMED. B.L....
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Smith v. DRW Realty Servs., 578 So. 2d 507 (Fla. Dist. Ct. App. 1991).

Published | District Court of Appeal of Florida | 1991 Fla. App. LEXIS 3842, 1991 WL 65350

...See rule 1.310(b)(7), Fla.R.Civ.P., and rule 2.070(c)(1), Fla.R.Jud. Administration. We also find that the JCC did not abuse his discretion in denying the claimant’s request for reimbursement of long-distance telephone calls made to his doctor. See § 440.13(2)(a), F.S....
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Quest Diagnostics, Inc. v. Cheri Haynie (Fla. 4th DCA 2021).

Published | Florida 4th District Court of Appeal

care provider and, as such, was governed by section 440.13(13)(a), Florida Statutes (2019), which provides
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Thomas v. M.S. & S. Toyota, Inc., 732 So. 2d 25 (Fla. 2d DCA 1999).

Published | Florida 2nd District Court of Appeal | 1999 Fla. App. LEXIS 5459, 1999 WL 247339

chiropractor treatments, it exercised its right under section 440.13(2)(a), Florida Statutes (Supp.1994), to stop
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Fortune Ins. Co. v. Figueroa, 597 So. 2d 435 (Fla. 1st DCA 1992).

Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 4728

...ngly, he is entitled as the trial court found, to PIP coverage for such bills under his insurance policy with Fortune; we therefore affirm the orders under review. We reject Fortune’s contention that there is no PIP coverage for such bills because Section 440.13(4)(a), Florida Statutes (1989) insulates Figueroa entirely from any further liability for such bills; plainly, the acceptance of Figueroa’s workers’ compensation benefits by the medical care providers in this case 1 in part payment...
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Pruitt v. Se. Pers. Leasing Inc., 33 So. 3d 112 (Fla. 1st DCA 2010).

Published | Florida 1st District Court of Appeal | 2010 Fla. App. LEXIS 5543, 2010 WL 1656866

...Accordingly, the JCC denied Claimant's request for a change in treating physician. On appeal, Claimant does not argue that the JCC's findings are not supported by competent substantial evidence; rather, he contends that the JCC erred as a matter of law because under section 440.13(2)(f), Florida Statutes (2007), he was entitled to a one-time change to a treating physician of his choice based upon the E/C's failure to timely respond to his request. We disagree. Section 440.13(2)(f) provides in pertinent part: Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident.......
...1st DCA 2010), we explained that it is not enough for the E/C to simply acknowledge the employee's statutory entitlement to a one-time change in physician or for the E/C to agree to authorize a new physician without actually selecting the physician, and we held that in order to comply with section 440.13(2)(f), the E/C must actually authorize at least one specific physician *115 within five days of receiving the request for a change in physician....
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Cont'l Cas. Co. v. Buchan, 72 So. 2d 269 (Fla. 1954).

Published | Supreme Court of Florida | 1954 Fla. LEXIS 1395

...That institution sought recovery from the carrier the sum of $150 quarterly for the care, custody, and maintenance of the employee. And on June 15, 1953, the Deputy Commissioner held that the carrier was responsible for such payments *270 under the provisions of Section 440.13, Florida Statutes 1951, F.S.A., which requires an employer to furnish such medical, surgical and hospital and other attendance or remedial treatment as the nature of the injury or the process of recovery requires, and directed such payments to be made beginning as of January 10, 1952, the date of commitment. The Full Commission affirmed the order of the Deputy Commissioner. On cer-tiorari here the carrier contends that such quarterly charges by the State Hospital do not constitute the furnishing of benefits within the provisions of said Section 440.13, supra....
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C & J Delivery v. Garcia, 560 So. 2d 1292 (Fla. Dist. Ct. App. 1990).

Published | District Court of Appeal of Florida | 1990 Fla. App. LEXIS 2932, 1990 WL 52792

...Because of the restrictions that had been placed on claimant as a result of his industrial injuries, claimant required assistance to carry out the necessary therapy associated with his subsequent unrelated injuries. This court held that claimant was entitled to attendant care benefits. According to the court: Section 440.13(2)(a), Florida Statutes, directs the employer of a claimant who sustains an industrial injury to furnish such medical attendance as the nature of the injury or the process of recovery requires. In the present case the deputy declined to award such care, reasoning that claimant’s need was necessitated by the nonindustrial surgeries. However, medical care is properly awarded pursuant to section 440.13(2)(a) when the need for such care arises from the combined effect of industrial and nonindustrial conditions....
...onindustrial surgeries, it is the industrial injuries which are producing the need for assistance in administering such care. The claim should therefore have been awarded in accordance with Jordan and Gonzales, supra, as attendant care authorized by section 440.13(2)(a), Florida Statutes....
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Lord v. Santa Rosa Corr. Inst., 135 So. 3d 1170 (Fla. 1st DCA 2014).

Published | Florida 1st District Court of Appeal | 2014 WL 1641072, 2014 Fla. App. LEXIS 6054

...The JCC here did not apply that test, which error is likewise not harmless, given that the JCC found Dr. VerVoort was authorized “as a result of’ his orders, which were prompted by Claimant’s motion to enforce, and given this court’s prior analogous holding that a “one-time” change of physician under section 440.13(2)(f), Florida Statutes, has not been authorized until the E/C has named at least one doctor....
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Lake Highland Nursing Home v. Everett, 397 So. 2d 380 (Fla. 1st DCA 1981).

Published | Florida 1st District Court of Appeal | 1981 Fla. App. LEXIS 19264

erroneously overlooks the time limitations of Section 440.-13(3)(b), Florida Statutes (1977) in its award
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Donald v. Albertson's & Specialty Risk Servs., Inc., 10 So. 3d 666 (Fla. 1st DCA 2009).

Published | Florida 1st District Court of Appeal | 2009 Fla. App. LEXIS 6625, 2009 WL 1035013

...on the doctors' testimony. "[I]f two health care providers disagree on medical evidence supporting the employee's complaints or the need for additional medical treatment, ... the JCC shall ... order the injured employee to be evaluated by an [EMA]." § 440.13(9)(c), Fla....
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State of Florida v. Young (Fla. 2d DCA 2025).

Published | Florida 2nd District Court of Appeal

...1st DCA 2017) ("We typically view the Legislature's use of varied language in the same statute as a sign the Legislature intended varied things."); Hinzman v. Winter Haven Facility Operations LLC, 109 So. 3d 256, 257 (Fla. 1st DCA 2013) ("[B]ecause the Legislature specified 'business days' elsewhere in section 440.13, canons of statutory interpretation (particularly the presumption of consistent usage) dictate that the Legislature's use of the unmodified term 'days' here refers to consecutive or calendar days."). In Tumlinson, there was only one memorialized confession—the one Mr....
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Lemus v. Ocala Star Banner, 672 So. 2d 76 (Fla. 1st DCA 1996).

Published | Florida 1st District Court of Appeal | 1996 Fla. App. LEXIS 3892, 21 Fla. L. Weekly Fed. D 945

minimum wage, pursuant to section 440.13(2)(h)l, Florida Statutes (1991). Section 440.13(2)(h) provides: The
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Walt Disney World Co. v. McCrea, 754 So. 2d 196 (Fla. 1st DCA 2000).

Published | Florida 1st District Court of Appeal | 2000 Fla. App. LEXIS 4485, 2000 WL 380217

...(JCC) awarding Charlene McCrea, claimant, 24 hours of daily attendant care. The E/SI contends that the award of 24 hours of attendant care provided by McCrea’s mother and stepdaughter between July 30, 1998, and February 16, 1999, was precluded by section 440.13(2)(b)(2), Florida Stat *197 utes (1997), which limits attendant care by a combination of family members to 12 hours daily; that the indefinite duration of the award of future attendant care was prohibited; and that the JCC did not have competent, substantial evidence to award 24 hours of daily care. McCrea cross-appeals, contending that the JCC erroneously considered her stepdaughter to be a “family member” -under the definition of section 440.13(l)(b), and thus subject to the limitation on attendant care provided by a combination of family members....
...Systematic Air Servs., 576 So.2d 372 (Fla. 1st DCA 1991). The award, however, should not have been indefinite. We therefore construe the order as awarding 24 hours of attendant care only so long as the nature of McCrea’s injury or process of recovery may require, consistent with section 440.13(2)(a)....
...Turning to McCrea’s cross-appeal, we conclude the JCC erred in finding that “stepchild” is synonymous with “child” for the purpose of determining that claimant’s stepdaughter, Cynthia McCrea, was a “family member” subject to the 12-hour attendant-care limitation. 1 Section 440.13(2)(b)(2) provides, in pertinent part: A family member or a combination of family members providing nonprofessional attendant care under this paragraph may not be compensated for more than a total of 12 hours per day. 2 (Emphasis added.) Section 440.13(l)(b) defines “family member” as follows: “Family member” means a spouse, father, mother, brother, sister, child, grandchild, father-in-law, mother-in-law, aunt, or uncle....
...hild, adopted child, or otherwise.” The JCC thus looked to the definition of “child” provided in section 440.02(5), Florida Statutes (1997), and found that the inclusion of “stepchild” in that definition should also apply to “child” in section 440.13(l)(b)....
...t encompass Cynthia McCrea, because a “stepchild” is considered a “child” of the employee only if the stepchild is under 18 and a dependent at the time the employee dies. 3 To rule otherwise would result in our reading section 440.02(5) into section 440.13(l)(b) expansively, thereby favoring the E/SI, which we are not permitted to do....
...(1997) (“[T]he laws pertaining to workers’ compensation are to be construed in accordance with the basic principles of statutory construction and not liberally in favor of either employee or employer.”). Cf. King Lumber Co. v. Bloomfield, 560 So.2d 389 (Fla. 1st DCA 1990) (the definition of “family member” in section 440.13 does not include a nephew)....
...Because the legislative did not include the term “stepchild” within the definition of “family member,” and the terms “child” and “stepchild” are legally distinct, we conclude the JCC erred in finding that Cynthia McCrea, as claimant’s stepdaughter, is subject to section 440.13’s 12-hour limitation on attendant care provided by a “combination of family members.” We therefore reverse the award of attendant-care benefits and remand with directions for the JCC to order that only Clara Amic, claimant’s mother, is limited by the 12-hour daily care provision....
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S. Bell Tel., Inc. v. Cordell, 693 So. 2d 1012 (Fla. Dist. Ct. App. 1997).

Published | District Court of Appeal of Florida | 1997 Fla. App. LEXIS 3974, 1997 WL 180167

...rder, awarding Claimant home attendant care based upon the following finding: 8. [I] find that claimant Sharon Cordell, requires on-call home attendant care, 24 hours per day with actual home attendant care assistance 12 hours per day. Pursuant to F.S. 440.13(2)(g)(2) (1991), 1 Kenneth Cordell, as claimant’s husband is limited to being compensated therefore for only 12 hours per day....
...ovided by Kenneth Cordell. b) Provide claimant home attendant care at market rate for the remaining 12 hours per day. 6. Claimant’s claim for full payment to her husband for 24 hour per day past attendant care based upon the employer’s waiver of 440.13(2)(g)2 (1991) and es-toppe[l] is denied. Claimant’s motion for rehearing, arguing that estoppel should have applied to preclude application of the statutory 12-hour cap of § 440.13(2)(h)2 was denied....
...during the time in question. The JCC’s order, and the First District’s affirmance thereof, specifically denied Claimant her claim for the other twelve hours of attendant care provided by her husband, on the basis of the limitations contained in § 440.13(2)(h)2....
...of the circuit court. We reverse the Final Judgment of the Circuit Court and remand for the entry of a final judgment that is consistent with the terms of the JCC’s order and this opinion. Reversed and remanded. . This subsection was renumbered as § 440.13(2)(h)2 in 1991....
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Westinghouse Elec. v. Widlan, 623 So. 2d 511 (Fla. 1st DCA 1993).

Published | Florida 1st District Court of Appeal | 1993 Fla. App. LEXIS 4351, 1993 WL 116707

...4(3)(a), Florida Statutes (1987). The E/C challenged the subject matter jurisdiction of the JCC and moved for dismissal, which motion was denied. In Carswell v. Broderick Construction, 583 So.2d 803 (Fla. 1st DCA 1991), we reviewed the provisions of section 440.13, Florida Statutes (1991), in an appeal following the JCC’s dismissal, on jurisdictional grounds, of a request for payment of medical benefits....
...at 804 ; Wolk v. Jaylen Homes, Inc., 593 So.2d 1058, 1059-60 (Fla. 1st DCA 1992). Having determined the issue in Carswell was “excessive treatment, i.e., gouging,” we affirmed the JCC’s dismissal of the matter. 583 So.2d at 804 . The 1991 version of section 440.13 is applicable to the case sub judice regarding the jurisdictional issue only....
...See Travelers Insurance Co. v. Sitko, 496 So.2d 920 (Fla. 1st DCA 1986) (because workers’ compensation is purely statutory creation, deputy commissioner’s power to hear and determine issues stems from statute). We find the following language from section 440.13(2)(b), Florida Statutes (1987), supports the JCC’s findings on the issue of payment of Dr....
...Frankl testified the medical treatment rendered to Claimant’s back was reasonable and necessary, and the JCC so found. Bennett v. H & L Builders, Inc., 567 So.2d 33 (Fla. 1st DCA 1990) (if E/C fail to provide care or obtain ruling, they will be responsible for unauthorized treatment pursuant to section 440.13(2) if JCC finds treatment to be reasonable and necessary)....
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Dep't of Health & Rehab., Div. of Risk Mgmt. v. Lucas, 466 So. 2d 1269 (Fla. 1st DCA 1985).

Published | Florida 1st District Court of Appeal | 10 Fla. L. Weekly 972, 1985 Fla. App. LEXIS 13454

in accordance with the medical fee schedule. § 440.-13(3)(a), Florida Statutes (1981); Mt. Sinai Medical
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Scott v. Sears Holding Corp., 189 So. 3d 1035 (Fla. 1st DCA 2016).

Published | Florida 1st District Court of Appeal | 2016 Fla. App. LEXIS 5676, 2016 WL 1460851

PER CURIAM. In this workers’ compensation appeal, the claimant challenges (1) the number of hours of attendant care'awarded by the judge of- compensation claims (JCC), and (2) the constitutionality of the section 440.13(2)(b)l., Florida Statutes, which limits payment of nonprofessional attendant care by family members to the federal minimum hourly wage....
...provision applies only to “employees” as defined by federal law, and family members providing nonprofessional attendant care do not fall within that definition. See Marin v. Travelers Ins. Co., 771 So.2d 625, 626 (Fla. 3d DCA 2000). Accordingly, section 440.13(2)(b)T....
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State, Hendry Cnty. Corr. Inst., Div. of Risk Mgmt. v. Hughes, 412 So. 2d 922 (Fla. Dist. Ct. App. 1982).

Published | District Court of Appeal of Florida | 1982 Fla. App. LEXIS 19764

available and suitable in the individual case.” Section 440.-13(4), Florida Statutes (1977). The statute does
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Goodyear Serv. Store v. Rockey, 382 So. 2d 816 (Fla. Dist. Ct. App. 1980).

Published | District Court of Appeal of Florida | 1980 Fla. App. LEXIS 16549

...Appellee concedes that the issue of future medical services was not before the Deputy Commissioner but argues that the quoted portion of the Order merely requires appellant to do what the law requires. We disagree with appellee’s contention that the Order merely requires appellant to comply with Section 440.13(1), F.S....
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Hyatt v. Armstrong Cork Co., 121 So. 2d 793 (Fla. 1960).

Published | Supreme Court of Florida | 1960 Fla. LEXIS 2183

...We do this because our answer comprehends all questions argued. Section 440.20(13), Florida Statutes 1945, F.S.A., provides: “The total compensation payable under this chapter for disability and death shall in no event exceed the sum of five thousand dollars in addition to any benefits under § 440.13 for medical services and treatment and under subsection (1) of § 440.16 for funeral expenses.” This court is committed to the doctrine that Workmen’s Compensation Law is notice of its provisions to employers and employees alike and tha...
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Kurt Falk v. Harris Corp. & Liberty Ins. Corp. (Fla. 1st DCA 2019).

Published | Florida 1st District Court of Appeal

...order denying permanent total disability benefits and impairment benefits. The Judge of Compensation Claims (JCC) based the denial on the opinion of an expert medical advisor (EMA) who deferred to another physician on the primary issues in disagreement. Although section 440.13(9)(c), Florida Statutes (2011), affords an EMA’s opinion a presumption of correctness, here the EMA did not offer an opinion but merely deferred to the opinion of another....
...Tatum as an “indirect,” but nevertheless appropriate, response to the disagreement about the head injury. The JCC then applied the presumption of correctness to Dr. Theofilos’s decision to defer to the opinions of Dr. Tatum, finding no clear and convincing evidence to do otherwise. Section 440.13(9)(c) mandates the appointment of an EMA when a disagreement exists between the opinions of two healthcare providers. See, e.g., Amos v. Gartner, Inc., 17 So. 3d 829, 831 (Fla. 1st DCA 2009). The advisor’s opinion “is presumed to be correct unless there is clear and convincing evidence to the contrary as determined by the [JCC].” § 440.13(9)(c), Fla....
...2d 1115, 1117 (Fla. 1st DCA 1998)). But here, the EMA offered no independent opinion regarding the head injuries or any view that Dr. Tatum’s opinion was correct. He simply deferred to Dr. Tatum. A blanket deference is not an EMA opinion for purposes of section 440.13(9)(c). Because Dr....
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Kurt Falk v. Harris Corp. & Liberty Ins. Corp., 267 So. 3d 578 (Fla. Dist. Ct. App. 2019).

Published | District Court of Appeal of Florida

the primary issues in disagreement. Although section 440.13(9)(c), Florida Statutes (2011), affords an
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Fuentes v. Caribbean Elec., 596 So. 2d 1228 (Fla. 1st DCA 1992).

Published | Florida 1st District Court of Appeal | 1992 Fla. App. LEXIS 4226, 1992 WL 74962

...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), ......
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Collura v. Multi Line Can Co., 598 So. 2d 1072 (Fla. Dist. Ct. App. 1992).

Published | District Court of Appeal of Florida | 1992 Fla. App. LEXIS 4254, 1992 WL 74961

...The perceived rarity of occurrence of a life-threatening, random emergency is not, under the circumstances of this case, an adequate justification for rejecting the medical evidence. *1074 Claimant is therefore entitled to an award of 24-hour-per-day attendant care. We reject the employer/carrier’s argument that Section 440.13(2)(e)2, Florida Statutes (1989), 2 renders immaterial the claimant’s argument that the JCC erred in awarding only 12 hours per day of attendant care....
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Thatcher Glass Mfg. Co. v. Buyna, 411 So. 2d 1029 (Fla. Dist. Ct. App. 1982).

Published | District Court of Appeal of Florida | 1982 Fla. App. LEXIS 19583

...services were performed. There is no competent substantial evidence that claimant’s disability, i.e. the nature of her compensable injury and process of recovery, required the services in question as a matter of medical need under the standards of § 440.13, Fla.Stat., for the ten-year period in question and continuing....

This Florida statute resource is curated by Graham W. Syfert, Esq., a Jacksonville, Florida personal injury and workers' compensation attorney. Attorney Syfert regularly works with Chapter 440 in the context of workers' compensation claims and represents clients throughout Northeast Florida. For legal consultation, call 904-383-7448.