Attention all Carriers, the First DCA wants your undivided attention.  If you do not respond timely to a Claimant’s request for change in physician, in a specific manner, you will lose your right to choose the change in doctors.

As I wrote earlier, the E/C need not schedule the appointment with a doctor of its choice within 5 days of Claimant’s request for a change.  In Florida Fun Superbike Center v. Hunt, the adjuster simply forwarded a list of psychiatrists and the Court found that is good enough to meet the requirements of  s. 440.13(2)(f)

But, what if the E/C responds within 5 days, doesn’t provide a list or the name of the change? Is that good enough?  According to the First DCA, no it is not.

In Harrell v. Citrus County School Board, Claimant requested a one time change and the E/C responded with in 5 days.  While the adjuster forwarded a letter back acknowledging receipt of the request and promised to authorize the change, the adjuster never named the new doctor.  The E/C waited 19 days before sending a second letter advising Claimant of the appointment date and the name of the doctor.

At final hearing, Claimant argued the E/C did not comply with s. 440.13(2)(f) because the E/C did not announce the specific change in doctors until well past the 5 days after he request.  The JCC denied her claim, citing the Hunt decision since the E/C sent its inital letter within the 5 days.

The First DCA reversed, reasoning that simply acknowledging Claimant’s right to a change of doctors is insufficient.  For s. 440.13(2)(f) to have any teeth, the E/C must be bound to name that doctor within 5 days.  Instead, the acknowledgement of Claimant’s request is hollow.  An E/C can respond within 5 days and then set the appointment whenever the E/C wants to, shucking its responsibility to honor chapter 440 as self-adminstrating.

As I wrote previously on Hunt: I think this is a reasonable ruling for a real world scenario.  Keep in mind though, you do not have to provide a list for a one time change  within 5 days or a request of treatment.   If you are going to authorize, just pick the doctor you most feel comfortable with and schedule.  That is the purest way to show you met your statutory requirement.

Once again, I think this is a reasonable decision.  If you as an adjuster already acknowledge receipt of Claimant’s request, you might as well inform her of your choice of doctors.   Keep a list of trusted doctors nearby, in each specialty, and list that doctor in your response letter to Claimant.  This way, you comply with the statute and you still get to control the medical aspect of the claim. 

But, as I review these 5-day rule line of cases, the best advice I can give is: treat requests for change in doctors with the same importance as final orders from judges.  They have that much impact on your claim.

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