CITY OF RIVIERA BEACH AND GALLAGHER BASSETT SERVICE, INC., APPELLANTS,
v.
ALBERT NAPIER, APPELLEE

Fla. 1st DCA | 2001-07-13
No. 1D00-290
ERVIN and POLSTON, JJ., concur.
791 So. 2d 1160 Florida District Court of Appeal, First District (2001) Caution
Cited by 15 cases

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Synopsis

The Florida District Court of Appeal affirmed a Judge of Compensation Claims' decision to exclude testimony from a physician hired to perform an independent medical examination (IME) in a workers' compensation case because the physician charged and was paid nearly double the statutory maximum fee allowed for IMEs.


Holding

The JCC had jurisdiction to determine the admissibility of Dr. Leighton's testimony because the issue was one of admissibility of evidence under section 440.13(5)(e), Florida Statutes, not a fee dispute. The JCC properly excluded Dr. Leighton's testimony because by charging and accepting payment in excess of the allowable amount, Dr. Leighton no longer qualified as an independent medical examiner under the statutory definition, and only testimony from independent medical examiners, medical advisors, and authorized treating providers is admissible in workers' compensation cases.


Headnotes

[1] A Judge of Compensation Claims has jurisdiction to determine the admissibility of evidence presented in a workers' compensation case.

[2] A physician's charging and collecting fees in excess of statutory limits for an independent medical examination disqualifies them as an independent medical examiner under…

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Key Quotes

“Section 440.13(5)(e) limits the medical testimony that is admissible before the JCC to the opinions of expert medical advisors, independent medical examiners, and authorized treating providers.”

Establishes the statutory framework limiting who may testify as a medical expert in workers' compensation cases

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Facts & Procedural History

Dr. Leighton was hired by the employer and carrier to perform an IME in connection with Albert Napier's workers' compensation claim. The statutory max…

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Opinion of the Court
KAHN, J.

KAHN, J.

May the Judge of Compensation Claims (JCC) disallow the testimony of a physician who, after being hired by the employer and carrier (E/C) to perform an independent medical evaluation or examination (IME), charges and collects an amount in excess of the maximum allowed by law for IMEs in workers’ compensation cases? Here, the JCC did just that. We hold the JCC had jurisdiction to make this determination and that the JCC reached the correct result.

Dr. Leighton, a doctor chosen by appellants to perform an IME in conjunction with appellee’s workers’ compensation claim, charged, and appellants paid, almost double the amount allowed by law for an IME. The Division of Workers’ Compensation has adopted, in Rule 38F-7.020, Florida Administrative Code, the limits set forth in the 1997 edition of the Florida Workers’ Compensation Health Care Provider Fee for Service Reimbursement Manual (Manual).

The Manual states that the maximum fee to be paid for an IME is $200 per hour for a maximum of two hours, for a total maximum payment of $400. The E/C agree that this is the upward limit of the fee that can be charged for an IME. In this case, Dr. Leighton charged, and the E/C paid, $700 for the IME, while the fee for Claimant’s IME physician was well within the statutory limit. Claimant moved to strike Dr. Leighton as the E/C’s IME physician due to the overpayment. In a lengthy order, the JCC struck Dr. Leighton and allowed the E/C to choose an alternate IME physician.

The E/C first argue that the JCC did not have jurisdiction to strike Dr. Leighton because a fee dispute is properly settled in a utilization review proceeding before the Division of Workers’ Compensation. The E/C, however, fail to recognize that the present dispute is not one concerning a fee dispute between an authorized medical provider and a workers’ compensation carrier. Cf. Terners of Miami Corp. v. Freshwater, 599 So. 2d 674, 675 (Fla. 1st DCA 1992) (en banc) (holding that section 440.13(2)(i)l., Florida Statutes (Supp.1990), divested the JCC of jurisdiction to hear disputes between a health care provider and the E/C as to the amount the health care provider is to be paid).

Instead, the issue presented to the JCC was whether Dr. Leighton could testify as an IME under section 440.13(5)(e), Florida Statutes (1997).

Because, under that statute, Dr. Leighton’s opinion testimony would be admissible only if he were an independent medical examiner, the JCC properly entertained the claimant’s motion. See Fla.R.Work.Comp.P. 4.120(a)(‘Whenever a question of the admissibility of evidence is presented for consideration of the judge of compensation claims, the judge shall promptly rule on it.”)(1999 edition).

In this case, the JCC simply made a determination as to the admissibility of evidence. The JCC has jurisdiction to determine the admissibility of evidence, a function properly within his authority.

The JCC also reached the right result in this case.

Section 440.13(5)(e) limits the medical testimony that is admissible before the JCC to the opinions of expert medical advisors, independent medical examiners, and authorized treating providers. See Gallagher Bassett v. Laber, 722 So. 2d 834, 834 (Fla. 1st DCA 1998)(“Section 440.13(5)(5)(e), Florida Statutes, limits medical opinion testimony in workers’ compensation cases to the opinion of a medical advisor, an independent medical examiner, or an authorized treating provider.”); Lakeland Reg’l Med. Ctr. v. Murphy, 695 So. 2d 895, 897 (Fla. 1st DCA 1997) (“Because [the doctors] did not fall into any of the categories under section 440.13(5)(e), the JCC erred in admitting their medical opinions.”) Dr. Leighton’s action in charging in excess of the allowable amount, and the E/C’s action in acquiescing to and paying that charge, took Dr. Leighton out of the statutory category of independent medical examiner. Under the limiting provisions of section 440.13(5)(e), the JCC properly excluded Dr. Leighton’s testimony as an inadmissible medical opinion.

AFFIRMED.

ERVIN and POLSTON, JJ., concur.


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Citator

Cited By

  • AT & T Wireless Servs., Inc. v. Castro, 896 So. 2d 828 (Fla. 1st DCA 2005)
    …hat no physician could be obtained to perform the testing within the statutory limits. A JCC may refuse to allow testimony by an IME when the IME charges a fee in excess of the $400.00 fee limit allowed by law.3 See City of Riviera Beach v. Napier, 791 So. 2d 1160, 1160 (Fla. 1st DCA 2001). We have suggested that an exception might apply in situations where it would be impossible to obtain an IME within the statutory fee limit. See Thompson v. Awnclean USA Inc., 849 So. 2d 1129, 1132 (Fla. 1st DCA 2003). Her…
  • Hancock v. Suwannee Cnty. Sch. Bd. & Fla. Sch. Bd. Ins., 149 So. 3d 1188 (Fla. 1st DCA 2014)
    …e the medical opinions of a purported IME physician who refuses to be bound by the proper legal billing process for such services under the Workers’ Compensation Law, as such physician does not qualify as an IME, see City of Riviera Beach v. Napier, 791 So. 2d 1160, 1161 (Fla. 1st DCA 2001); it follows that a JCC should not require an individual to attend a physical examination to be conducted by a physician who is not qualified to serve as a witness in the case. Because the record before us contains no founda…
  • Alpizar v. Star Styled Dancing Co., 808 So. 2d 286 (Fla. 1st DCA 2002)
    …he a medical advisor appointed by the judge. He did not qualify as an independent medical examiner, because his medical fee exceeded the maximum amount authorized by statute. See § 440.13(5), 10, Fla. Stats. (1999); City of Riviera Beach v. Napier, 791 So. 2d 1160 (Fla. 1st DCA 2001). The employer and carrier did not show that the statutes limiting testimony to certain qualified witnesses deprived them of any constitutional right in the presentation of their case. Because we cannot say that the judge’s relian…

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