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Morgan’s Tip of the Week – Distance to Doctors

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Greetings,

Many claimant attorneys continue to fight us over the distance claimant’s have to travel for appointments.   See below for my past tip on the state of the law on distance.

My partner in Tampa, Ya’Sheaka Campbell just won a JCC case on this issue.   The distance was 45 miles but the travel time was an issue.   In siding with the E/C, the JCC ruled:

I find (1) the E/C made a reasonable but unsuccessful effort to find a neurosurgeon located closer to Claimant’s home who is willing to take over her treatment, (2) the E/C agrees to provide transportation to and from all scheduled appointments, (3) Claimant has no medically-imposed restrictions on the length of time she can travel, and (4) travel time will not affect Claimant’s work schedule because she is permanently and totally disabled.

https://www.jcc.state.fl.us/jccdocs19/LKL/Polk/1988/001551/88001551_366_08102018_04584863_i.pdf

So make sure you can document any efforts made to find a closer doctor, and offer transportation.  The 4th reason may not help you in a different case, but 1-3 can be your argument.

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(Monday, September 12, 2016)

Greetings,

Over the last two weeks I have seen several claimant’s attorneys objecting to our selection of doctors for either the initial treatment or a 1-time change based on distance.  It does seem enough to be a trend.         

Many in the industry use the 50-mile distance as reasonable.   However, that is not in the statute.   There is a 1981 1st DCA case,  Commercial Carrier Corporation v. Fox, where they found making a claimant travel from Brooksville to Lakeland and Tampa, 50 miles away, was unreasonable.   In that case, when the carrier finally authorized a local doctor, it was an ob/gyn and not an orthopaedic.   The court found the carrier’s actions to be manipulative and not reasonable.  The court does not say specifically that 50 miles is the measuring stick for reasonableness.

So, the standard is reasonableness, not specifically 50 miles, but many use this as the definition of what is reasonable.  There are times where you may have to go beyond 50 miles, especially in the more remote areas of the state where there are not many doctors who accept WC.   Offering transportation often helps the argument that it is reasonable.

Managed care cases do have a 60 minute requirement for travel time…., Florida Administrative Rule 59A-23.003(6) speaks to the travel time issue.  The rules states  “[a]verage travel time from the employee’s usual employment site to the nearest provider of specialty physician services, ancillary services, specialty inpatient hospital services and all other health services shall be no longer than 60 minutes under normal circumstances.”

However, if the claimant attends at least one appointment, the argument is they have acquiesced to the doctor/distance.  In Pruitt v. Southeast Personnel Leasing, Inc.  the Claimant acquiesced in the selection of the physician by attending the appointment and receiving treatment.  33 So.3d 112 (Fla. 1st DCA 2010).  The same result was found in the Crenshaw v. Florida Farm Bureau case, where the Claimant acquiesced to the IME physician selection.  489 So. 2d 186 (Fla. 1st DCA 1986). 

The courts typically give much more leeway in the selection of our IME on distance.

Sincerely,

Morgan Indek | Partner