Florida law entitles injured workers to a one-time change in physicians. This one-time change is a procedural right, per Florida Statute 440.13(2)(f). When the change is granted, the employer or carrier must deauthorize the originally authorized physician and authorize an alternative physician within five days. But your responsibility doesn’t stop there.

Authorizing a one-time change in physician related to an injured worker’s claim is just the first step. The employer/carrier must then provide the requested benefit – an appointment with the new physician – within a reasonable time.

While a “reasonable time” has not been defined, it’s important to know that one recent ruling found it was not reasonable for an injured worker to wait 60 days to see the new physician. To avoid potential legal costs, carriers should follow up with the newly designated physician’s office frequently to avoid appointment delays.

About Florida Statute 440.13(2)(f):

Florida Statute 440.13(2)(f) states: “Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident. Upon the granting of a change of physician, the originally authorized physician in the same specialty as the changed physician shall become deauthorized upon written notification by the employer or carrier. The carrier shall authorize an alternative physician who shall not be professionally affiliated with the previous physician within five days after receipt of the request. If the carrier fails to provide a change of physician as requested by the employee, the employee may select the physician, and such physician shall be considered authorized if the treatment being provided is compensable and medically necessary.”

The request for a one-time change must be in writing. Additionally, not only must an employer/carrier respond timely to a one-time change request, the employer/carrier shall select a physician of the same specialty as the prior authorized physician. Moreover, Florida case law has established injured workers are entitled to a one-time change of physicians per accident, not one-time per specialty. Failure to authorize an alternate physician within five calendar days results in the injured worker being able to select the physician of their choosing.

Responsibility Falls to the Employer/Carrier

Once a timely authorization has been made, the employer/carrier’s work is not done. The employer/carrier must then provide the requested benefit, an appointment with the one-time change physician, within a reasonable time. Whether an employer/carrier provides an alternate physician in a reasonable time is a fact-based question that is determined by the Judge of Compensation Claims. Therefore, there is no clear guideline as to an “unreasonable delay” in provision of an one-time change physician. A recent ruling found the employer/carrier did not furnish treatment within a reasonable time as the injured worker waited approximately 60 days to be seen.

It Pays to Follow Up

When a Judge of Compensation Claims determines an employer/carrier’s delay in providing an alternative physician is unreasonable, the employer/carrier forfeits their right to select the one-time change physician. Thus, the injured worker then selects the physician. Additionally, the injured worker’s attorney may be awarded attorney’s fees and costs.

Therefore, it is a best practice for carriers to frequently follow up with the doctor’s office as to avoid a delay in securing an appointment. If you have any questions about one-time change requests in defending your workers’ compensation claim, please contact one of the qualified Florida Workers’ Compensation attorneys at Goldberg Segalla.