Greetings, there have been some recent JCC level decisions regarding delays in “providing” a 1-time change that have concluded an Employer/Carrier can lose control of the choice of doctor even if they timely authorized one if the appointment is too far in the future.
Below is the controlling DCA caselaw on the issue, St. Lucie Public Schools v. Alexander, there was a 16-day delay in following up on getting an actual appointment. The DCA found that unreasonable, and the claimant had the right to select the doctor.
A recent JCC level decision, Parrott v. Winn Dixie (24-020543RAA), found that although the adjuster timely responded and authorized a doctor, not following up from 12/24/24 through 1/6/25 (13 days, happy holidays) as well as not looking for another doctor when the appt was not until March was unreasonable, and the claimant was entitled to select their own doctor. The JCC also noted that with the first doctor de-authorized, the claimant would be without care for 3 months. Ultimately, although in my opinion there was not much else the adjuster could do, the 1-time change (with 3rd doctor the adjuster tried) was set for 66 days after the request.
So what do we do to retain control of the medical when it is the doctor’s offices that delay and hem and haw as to whether the doctor will see the claimant?
- Follow up at least once to twice a week until we have an appt date. And in each follow up ask if they need anything such as a prepay, questionnaire, medical records, etc…
- If the 1-time change appt is scheduled a long time from the request, consider allowing the claimant to return to the prior treater for a follow-up or potentially offer the walk-in clinic pending the appointment so there is no gap in treatment.
- Alternatively, if the appointment is an unreasonable amount of time away, keep looking for an alternative doctor.
- And most importantly, document everything you do in the adjuster notes.
Here is the original case on “unreasonable delays” City of Bartow v. Flores:
https://www.1dca.org/content/download/636687/opinion/181927_1284_06012020_101752_i.pdf
St. Lucie Public Schools vs Alexander
https://www.jcc.state.fl.us/jccdocs20/WPB/St%20Lucie/2019/013133/19013133_291_06162021_04030215.pdf
As always, let me know if you have any questions. Hope to see you at the WCCP Board Cert Forum next week, please let me know if you are attending!
Sincerely,
Morgan Indek | Managing Partner