Morgan’s Tip of the Week- Getting timely medical reports
Greetings,
Sometimes, it can be difficult to obtain medical records and DWC-25’s timely from doctors’ offices so we can ensure we are following the work status and not creating over or underpayments.
Well, the FL WC statute (along with the Dept of Financial Services regulations) does give you some guidance on how you can encourage doctor’s offices to comply. I would caution you to be gentle in how you use these rules with the doctors’ offices, we do not want the doctors to stop accepting claimants.
The FL WC statute does state that the health care provider, if they want to be paid, must provide the form (DWC-25) within 3 days of the initial treatment and within 15 days after that the entire narrative report.
And below the WC statute section I added some excerpts from the DWC-25 rules which state the form is due by the end of the next business day for follow-ups. There is a link to the entire DWC-25 instructions if you need to send them to a doctor’s office.
(emphasis added by me).
440.13( 4) NOTICE OF TREATMENT TO CARRIER; FILING WITH DEPARTMENT.—
(a) Any health care provider providing necessary remedial treatment, care, or attendance to any injured worker shall submit treatment reports to the carrier in a format prescribed by the department. A claim for medical or surgical treatment is not valid or enforceable against such employer or employee, unless, by the close of the third business day following the first treatment, the physician providing the treatment furnishes to the employer or carrier a preliminary notice of the injury and treatment in a format prescribed by the department and, within 15 days thereafter, furnishes to the employer or carrier a complete report, and subsequent thereto furnishes progress reports, if requested by the employer or insurance carrier, at intervals of not less than 3 weeks apart or at less frequent intervals if requested in a format prescribed by the department.
From the Dept’s DWC-25 instructions:
• All physicians who provide the first treatment immediately after the reported work related injury shall submit the accurately completed Form DFS-F5-DWC-25 to the insurer, and to the employer, immediately but no later than three (3) business days after the date of service. This submission requirement must be met in order for the claim for medical or surgical treatment to be valid, pursuant to Section 440.13(4)(a), F.S.
• All principal, consulting or referral physicians providing subsequent treatment shall submit to the insurer, and to the employer upon request, the accurately completed Form DFS-F5- DWC-25 by close business of the next business day following each visit or a maximum of 30 days from the date of the prior Form DFS-F5-DWC-25 submission, even when the physician receives no new information since the last visit or does not re-examine the patient.
No reimbursement shall be made for completion of the Form DFS-F5-DWC-25. (Page 2)
Use your best judgement in how to use these tools!
Join is for our upcoming FL, GA and TN webinars!
Tuesday- TN webinar
Thursday- FL 4-hour law and ethics
You can register right on our website events page: https://eraclides.com/events/
Sincerely,
Morgan Indek | Managing Partner