In St. Lucie Public Schools/Relation Insurance Services of Florida v. Dianne Alexander, 1D20-2266, 2021 WL 2451259 (Fla. 1st DCA June 16, 2021) the First District Court of Appeal clarified its prior interpretation of Section 440.13(2)(f), Florida Statutes, governing the right to a one-time change of physician. The Court held that despite providing the name of a one-time change provider within two days of the request, the employer’s provision of medical records to the doctor 16 days after the request, and actual contact with doctor’s office 21 days after the request, constituted an unreasonable delay. Citing to City of Bartow v. Flores, 301 So. 3d 1091 (Fla. 1st DCA 2020), the Court stated that an employer/carrier “forfeits the right of selection if it subsequently fails to provide the alternate physician by unreasonable delay in acquisition of an appointment date.”
The record reflected that the employer’s servicing agent called the prospective one-time change physician two days after the one-time change request. The call was not returned by the doctor’s office for five days, at which point the office asked to review the prior medical records. The records were provided on the same day, but the servicing agent did not follow up with the doctor’s office until approximately two weeks later. 30 days after the one-time change request, and following discussions with the servicing agent’s representative, the doctor declined to treat. On day 34, an alternative provider was named, but the employee contended that this was unreasonably late.
At the trial level, the Judge of Compensation Claims (“JCC”) was sympathetic to the employer’s position, noting that the doctor’s review of medical records was outside its control. However, the JCC noted that “there was a gap with no effort to follow up for a period of sixteen days,” and that “[i]n some instances, it may be necessary to prod the physician’s office into action.”
The appellate opinion still leaves ambiguity as to what constitutes a reasonable time period for an employer/carrier to provide a one-time change, though it narrows the 30-plus day period at issue in City of Bartow.
Despite the ambiguity, carriers, servicing agents, and self-insured employers should take the following steps upon receiving a one-time change request: notify the employee’s lawyer of the new doctor’s name within five days, provide the new doctor’s office with written authorization to evaluate and treat and the relevant medical records as soon as practicable, and follow up regularly and document all follow-up efforts until an appointment date is secured. Best practices may also include providing regular updates to the employee’s lawyer regarding the status of authorization and any request to review medical records.
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