FREDDIE MARTINEZ, APPELLANT,
v.
ASSOCIATION OF POINCIANA AND LIBERTY MUTUAL, APPELLEES
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Medical services are compensable if performed in connection with complaints suspected to be related to an industrial accident, regardless of whether the testing confirms the causal relationship.
[1] Workers' compensation is payable for diagnostic testing and evaluation undertaken in connection with complaints believed to be attributable to an industrial accident, eve…
[2] The purpose for which medical services are undertaken, rather than the results of those services, determines compensability in workers' compensation cases.
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Join FLexlaw to unlock all legal intelligenceClaimant injured his wrist in an industrial accident and subsequently developed various complaints. He was referred to the Mayo Clinic where doctors i…
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ALLEN, Judge.
The claimant appeals a workers’ compensation order denying a claim for payment for diagnostic testing and evaluation which did not confirm a causal relationship between the claimant’s complaints and his industrial accident. Because these medical services were performed in connection with complaints which the doctors felt were most likely attributable to the industrial accident, we conclude that such services are compensable.
The claimant injured his wrist in an industrial accident, and later developed problems including chest and neck pain as well as weakness and pain in his leg and hand. After being seen by various doctors during several months of persistent complaints, the claimant was referred to the Mayo Clinic. The clinic doctor who initially saw the claimant felt that he might be developing post-traumatic reflex sympathetic dystrophy as a result of the industrial accident, which the doctor described as the “most probable cause.” Additional testing and evaluation did not substantiate this theory, and the clinic doctors eventually suggested that the claimant’s complaints were of unknown etiology which may not be attributed to the industrial accident.
Even though the diagnostic testing and evaluation ultimately failed to relate the claimant’s complaints to the industrial accident, the purpose for which such services are undertaken, rather than the results thereof, determines compensability. See Watkins v. Resources Property Management, 596 So. 2d 768 (Fla. 1st DCA 1992); Nealy v. City of West Palm Beach, 491 So. 2d 585 (Fla. 1st DCA 1986); Barris v. Toppers of Florida, 382 So. 2d 441 (Fla.1980). Because the medical evidence indicates that the diagnostic testing and evaluation at the Mayo Clinic was undertaken upon the theory that the claimant was developing a condition which resulted from the industrial accident, the employer/carrier should have been ordered to pay for such services. Watkins; Nealy; Barris.
The appealed order is reversed, and the cause remanded.
LAWRENCE, J., and SHIVERS, Senior Judge, concur.
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Grainger v. Indian River Transport/Zurich U.S., 869 So. 2d 1269 (Fla. 1st DCA 2004)…etermine the etiology of his medical problem. It is the purpose of the diagnostic testing and evaluation, not the results thereof, that determines the com-pensability of such services. See Prince, 556 So. 2d at 1196; Martinez v. Assoc, of Poinciana, 642 So. 2d 118, 119 (Fla. 1st DCA 1994). The employer and carrier attempt to distinguish the Sumner case by pointing out that the version of the workers’ compensation statute in effect at the time of Sumner made no formal provision for an independent medical exam…
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Roberts v. Spartan Premier Staffing, Inc., 909 So. 2d 529 (Fla. 1st DCA 2005)…the time of the hearing on claimant’s petition for benefits. It should be observed that it is the purpose for which the tests are undertaken, rather than the results, which determines the compensability of same. See Martinez v. Ass’n of Poinciana, 642 So. 2d 118 (Fla. 1st DCA 1994). Obviously, the discogram would not resolve any question of whether claimant’s fractured upper spine was caused by the work-related accident, which was not at issue. The only other possible purpose would be to ascertain whether s…
Authorities Cited
- Lanoris Nealy v. City OF W. Palm Beach & Crawford & Co., 491 So. 2d 585 (Fla. 1st DCA 1986)
- Barris v. Toppers OF Fla., Inc., 382 So. 2d 441 (Fla. 1st DCA 1980)
- Vicente H. Uribe v. State, 596 So. 2d 768 (Fla. 5th DCA 1992)