In the last week I received a few questions about how far is too far for a claimant to travel for medical treatment. A big thank you to Ryan Knight of our Miami office for helping with the caselaw below on this one. (if you need anything in Miami-Ft/ Lauderdale, Ryan is fantastic: firstname.lastname@example.org)
There is a prevailing concept that there is a 50-mile limit on distance for a claimant to travel for treatment. That is NOT the law. One of the cases on the issue below does state that 50 miles was too far, but it wasn’t the mileage per se, it was the unreasonableness of the reason for the longer distance. The test is whether the distance is reasonable.
In many cases, especially if the claimant lives in a remote area, we may have to schedule them with a provider that is more than 50 miles away. If there are very few physicians in the specialty that accept WC, that may also affect how far they must travel (cardiac, pulmonology, ENT, etc…). This also comes into play if the claimant requests a 1-time change. They may have to travel greater than 50 miles.
If the claimant objects, the JCC will look at whether the distance is reasonable. Were there other providers that accept WC closer? Document your efforts to find a closer provider that accepts WC. Offering transportation would help us in the argument.
And here’s some of the case law dealing with the distance:
Reasonableness of the provision of authorized medical care has been looked at both from a mileage standpoint within a city and when medical care has been authorized in other non-contiguous communities/cities. For example, in Kessler v. Community Blood Bank, 621 So.2d 539 (Fla. 1st DCA 1993), the JCC erred by finding that authorization of a physician 25 miles from the claimant’s home was sufficient without addressing reasonableness and necessity when claimant testified the trip was burdensome. This involved a cross-county trip from Miami Beach to Hialeah.
A number of cases involved authorized medical care offered outside the city where the claimant lived (in non-metropolitan areas). This was considered inappropriate. Kessler cited to Commercial Carrier Corp. v. Fox, 400 So.2d 154 (Fla. 1st DCA 1981) where the First District Court of Appeal affirmed the deputy commissioner’s determination that the claimant should not be required to travel approximately 50 miles one way for treatment when claimant suffered from a painful back condition which was aggravated by riding long distances. The Claimant lived in the Brooksville area and the Employer/Carrier wanted to send him to Lakeland or Tampa for authorized medical treatment.
In Wright v. Golf Drive Residence, Inc., 412 So.2d 884 (Fla. 1st DCA 1982), the First District Court of Appeal held that it was error to force the claimant to travel to Fort Myers for further treatment, when no medical or practical necessity for such travel was shown. The Court held that it was unreasonable for the deputy to require her to travel outside her home community in Naples where adequate treatment was available.
In Hall’s Camp, Inc. v. Decker, 394 So.2d 1041 (Fla. 1st DCA 1980), it was considered unreasonable to expect the claimant to travel outside the local Arkansas community for treatment by another orthopedic surgeon. At the time, the only orthopedic surgeons in the Fayetteville area were in the requested doctor’s clinic. Decker at 1043-1044.
Morgan Indek | Managing Partner