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Florida: Self-Help Physician May Not “Bootstrap” Medical Necessity of Treatment into Evidence

October 13, 2016 (1 min read)

§ 440.13(5)(e), Fla. Stat., by its plain language, excludes from workers’ compensation proceedings the medical opinions of any doctor (other than independent medical examiners and expert medical advisors) who has not been authorized by the employer/carrier. Accordingly, the medical opinions of an unauthorized self-help doctor were not admissible unless and until it was established—by other admissible evidence and medical opinions—that the care rendered by the self-help doctor was compensable and medically necessary. The self-help doctor’s opinion that the care was compensable and medically necessary cannot “bootstrap” itself into evidence. That the care here was “initial” care did not change anything, held the Florida appellate court. The appellate court noted that the employee could have designated the self-help doctor as his or her IME, thereby making the doctor’s opinion admissible, or the employee could petition for an advance under § 440.20(12), Fla. Stat., to pay for another doctor who could have been designated as an IME for the purposes of establishing the compensability prerequisite for the admission of the self-help doctor’s opinions.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is the co-author of Larson’s Workers’ Compensation Law (LexisNexis).

LexisNexis Online Subscribers: Citations below link to Lexis Advance.

See Hidden v. Day & Zimmerman, 2016 Fla. App. LEXIS 15055 (1st DCA, Oct. 7, 2016)

See generally Larson’s Workers’ Compensation Law, § 94.02.

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law