Appeals court rejects effort to strike doctor over fees

A Florida appellate court overturned a judge of compensation claims decision disallowing a duly authorized treating physician whose initial evaluation and treatment fee exceeded base fee schedule rates.

“We reverse because the Workers’ Compensation Code doesn’t authorize a (judge of compensation claims) to strike a duly authorized treating physician because of a fee-related problem,” the court said in Wednesday’s ruling in Palm Beach County School District v. Smith, filed in First District Court of Appeal in Tallahassee.

Frances Smith sought a one-time change in physician that her employer granted. The employer appointed a new treating physician, scheduled an appointment and deauthorized the initial treating provider. The employer and new doctor completed a form fee agreement authorizing an advance payment of $800 for the initial evaluation and treatment, an amount that exceeded the base fee schedule rate, according to the ruling.

Smith argued that the higher payment transformed the authorized treating provider into an independent medical examiner, nullified the provider’s authorization and entitled her to another change of physician.

The employer refused to authorize a change and instead revised language in the fee agreement with the doctor to align the $800 payment with a statutory provision allowing fees in excess of the fee schedule.

After a hearing, a judge of compensation claims concluded that a physician “is not an authorized treating physician where the physician charges in excess of the maximum amount allowed by law.” The judge terminated the employer-provided physician and ordered that Smith receive a one-time change of her choice.

The appellate court said it has already recognized that a judge of compensation claims can’t order an employer to pay an authorized provider in excess of the fee schedule rate.

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