Last week I wrote about the Parodi decision which reinforces the self help section of chapter 440.  [see s. 440.13(2)(c)]   The main thrust of my post was that the stakes are now considerably raised with such a decision.

In that case the First DCA found that should Claimant receive unauthorized treatment on his own, and prove that the treatment was compensable and medically necessary, then the doctors providing said treatment could testify in Claimant’s case in chief. 

After talking with a mediator about the Parodi case, he declared that Claimant’s no longer need to use their IME anymore.  They can just go and find a doctor to provide treatment under a letter of protection (LOP).  While I see his point, I don’t think the situation is as dire as that for Employers and Carriers.

Claimant still has to prove compensability via the major contributing cause standard and that the treatment for the injury is medically necessary.  Will simply getting an LOP from an unauthorized doctor work to prove such a case?  Sure.  But, in all cases?  That’s a stretch.

For denials, a Claimant is likely to do better under a LOP–if the doctor is willing to accept her under such conditions–than an IME.  Most IME doctors are known to the courts to have liberal or conservative biases anyway.  A long time treating doctor might have more weight.

But remember, if there already is an authorized treater willing to testify that the accident, injury, or subsequent treatment is not compensable or medically necessary, then that is difficult for a Claimant to overcome; especially if the only doctor to treat her is one who is banking on getting paid by a favorable verdict.

Getting a LOP on every disputable issue is not practical for Claimant nor is it favorable.  I still think E/C’s should be thoroughly investigate a claim before issuing a denial.  The self help provision is just added exposure to consider should Claimant be successful at trial.

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