I’ve written before about the E/C’s jurisdictional defense to a claim for unpaid bills from authorized providers.  The Claimant has no standing to sue for payment of the bills and the Judge has no jurisdiction to order the payment of the bills.

Only the Agency for Health Care Administration (AHCA) has jurisdiction to settle such disputes.   In fact, sections 440.13(11)(c) and 440.13(3)(g) state that the Claimant does not have responsibility for such bills.   In the past, I’ve written the following on the matter:

Section 440.13(11)(c) dictates that the Agency for Health Care Administration (“AHCA”) has “exclusive jurisdiction” to decide any matters regarding provider reimbursement.  As long as the Carrier authorizes care with the doctor, the dispute about the doctor’s bills is outside the jurisdiction of the Judges of Compensation Claims.”

However, it is important that when the E/C asserts this defense, it is “buying” the bills and the treatment connected with said bills. (more…)

Jurisdiction cases are messy and very fact intensive.   Claimants who have out of state accidents offer confusing claims as to whether they are eligible for W/C benefits.   The key is s. 440.09(1)(d) which dictates that if a Claimant is injured outside of this state,  Florida W/C coverage only applies if the contracts of employment was made in Florida.

Of course, with out of state employment, the question arises: what is “made in Florida”?

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