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Fla. L. Weekly D2581aTop of Form
Fla. L. Weekly D2581aTop of Form
Workers’
compensation — No error in awarding psychiatric treatment and temporary total
disabilities based on finding that claimant suffered compensable and disabling
mental injury — Evidence — Although judge of compensation claims improperly
considered medical opinions of physician who was not treating physician,
independent medical examiner, or expert medical advisor, error was harmless —
JCC reversibly erred by ordering employer/carrier to pay providers and any
third-party payers for services provided — JCC had jurisdiction only to
conclude that care was for compensable injury and medically necessary, and
therefore not claimant’s responsibility — JCC erred in concluding that
claimant’s first psychiatric hospitalization was not compensable emergency care
compensation — No error in awarding psychiatric treatment and temporary total
disabilities based on finding that claimant suffered compensable and disabling
mental injury — Evidence — Although judge of compensation claims improperly
considered medical opinions of physician who was not treating physician,
independent medical examiner, or expert medical advisor, error was harmless —
JCC reversibly erred by ordering employer/carrier to pay providers and any
third-party payers for services provided — JCC had jurisdiction only to
conclude that care was for compensable injury and medically necessary, and
therefore not claimant’s responsibility — JCC erred in concluding that
claimant’s first psychiatric hospitalization was not compensable emergency care
BOLEY CENTERS, INC./ COMP OPTIONS,
Appellants/Cross-Appellees, v. WILLIAM VINES, Appellee/Cross-Appellant. 1st
District. Case No. 1D14-5869. Opinion filed November 16, 2015. An appeal from
an order of the Judge of Compensation Claims. Stephen L. Rosen, Judge. Date of
Accident: January 8, 2014. Counsel: Ben H. Cristal and Gian-Franco Melendez of
Cristal Hanenian, LLC, Tampa, for Appellants/Cross-Appellees. Bill McCabe,
Longwood, and John H. Thompson, IV, St. Petersburg, for
Appellee/Cross-Appellant.
Appellants/Cross-Appellees, v. WILLIAM VINES, Appellee/Cross-Appellant. 1st
District. Case No. 1D14-5869. Opinion filed November 16, 2015. An appeal from
an order of the Judge of Compensation Claims. Stephen L. Rosen, Judge. Date of
Accident: January 8, 2014. Counsel: Ben H. Cristal and Gian-Franco Melendez of
Cristal Hanenian, LLC, Tampa, for Appellants/Cross-Appellees. Bill McCabe,
Longwood, and John H. Thompson, IV, St. Petersburg, for
Appellee/Cross-Appellant.
(PER CURIAM.) In this workers’ compensation case, the
Employer/Carrier (E/C) raises four issues on appeal to challenge the Judge of
Compensation Claims’ (JCC’s) award of psychiatric treatment and temporary total
disability benefits. On cross-appeal, Claimant raises one issue and argues the
JCC erred by concluding the first of his two psychiatric hospitalizations was
not compensable emergency medical care. As explained below, we affirm in part,
reverse in part, and remand for entry of an order consistent with our opinion
herein.
Employer/Carrier (E/C) raises four issues on appeal to challenge the Judge of
Compensation Claims’ (JCC’s) award of psychiatric treatment and temporary total
disability benefits. On cross-appeal, Claimant raises one issue and argues the
JCC erred by concluding the first of his two psychiatric hospitalizations was
not compensable emergency medical care. As explained below, we affirm in part,
reverse in part, and remand for entry of an order consistent with our opinion
herein.
In the first issue on appeal, the E/C correctly points out
that the JCC improperly considered the medical opinions of a physician who was
not a treating physician, independent medical examiner (IME), or expert medical
advisor. § 440.13(5)(e), Fla. Stat. (2013). See also Cespedes v.
Yellow Transp., Inc., 130 So. 3d 243, 250-51 (Fla. 1st DCA 2013) (holding
proof of compensable emergency care requires medical opinion admissible under
subsection 440.13(5)(e) which establishes emergency care was both medically
necessary for, and causally related to, compensable workplace injury).
Nevertheless, based on this court’s review of the appellate record as a whole,
such error is harmless — as we conclude there is no reasonable possibility
that this error contributed to the result in this case, nor is there a
reasonable possibility that a different result would be reached were this case
remanded for reconsideration of the issue of compensability without the benefit
of the emergency room physician’s opinions. See Special v. W. Boca
Med. Ctr., 160 So. 3d 1251, 1256 (Fla. 2014) (holding that the test for
harmless error requires beneficiary of error to establish there was no
reasonable possibility that the error contributed to verdict).
that the JCC improperly considered the medical opinions of a physician who was
not a treating physician, independent medical examiner (IME), or expert medical
advisor. § 440.13(5)(e), Fla. Stat. (2013). See also Cespedes v.
Yellow Transp., Inc., 130 So. 3d 243, 250-51 (Fla. 1st DCA 2013) (holding
proof of compensable emergency care requires medical opinion admissible under
subsection 440.13(5)(e) which establishes emergency care was both medically
necessary for, and causally related to, compensable workplace injury).
Nevertheless, based on this court’s review of the appellate record as a whole,
such error is harmless — as we conclude there is no reasonable possibility
that this error contributed to the result in this case, nor is there a
reasonable possibility that a different result would be reached were this case
remanded for reconsideration of the issue of compensability without the benefit
of the emergency room physician’s opinions. See Special v. W. Boca
Med. Ctr., 160 So. 3d 1251, 1256 (Fla. 2014) (holding that the test for
harmless error requires beneficiary of error to establish there was no
reasonable possibility that the error contributed to verdict).
We find no merit to the E/C’s second point on appeal, which
argues the JCC used an improper legal standard to find Claimant’s mental injury
compensable, and affirm without further comment.
argues the JCC used an improper legal standard to find Claimant’s mental injury
compensable, and affirm without further comment.
On the E/C’s third point on appeal, we agree the JCC
reversibly erred when he ordered the E/C to pay the providers and any third
party payers for all psychiatric bills incurred after April 2, 2014. The JCC
had no jurisdiction to award payment to the emergency care providers or
reimbursement to any third party payer for services. Instead, the JCC could
only conclude that the care was for a compensable injury and was medically
necessary — and therefore not Claimant’s responsibility. See Williams
v. Triple J Enters., 650 So. 2d 1114, 1116 (Fla. 1st DCA 1995) (explaining
that although JCC does not have jurisdiction over reimbursement disputes
between medical providers and carriers, JCC has jurisdiction to resolve issues
of medical necessity as between claimant and carrier).
reversibly erred when he ordered the E/C to pay the providers and any third
party payers for all psychiatric bills incurred after April 2, 2014. The JCC
had no jurisdiction to award payment to the emergency care providers or
reimbursement to any third party payer for services. Instead, the JCC could
only conclude that the care was for a compensable injury and was medically
necessary — and therefore not Claimant’s responsibility. See Williams
v. Triple J Enters., 650 So. 2d 1114, 1116 (Fla. 1st DCA 1995) (explaining
that although JCC does not have jurisdiction over reimbursement disputes
between medical providers and carriers, JCC has jurisdiction to resolve issues
of medical necessity as between claimant and carrier).
Because we find no reversible error regarding the JCC’s
finding and conclusion that Claimant suffered a compensable and disabling
mental injury, the E/C’s fourth point on appeal, which challenges an award of
disability benefits attributable to such injury, is affirmed.
finding and conclusion that Claimant suffered a compensable and disabling
mental injury, the E/C’s fourth point on appeal, which challenges an award of
disability benefits attributable to such injury, is affirmed.
Relative to Claimant’s cross-appeal, which challenges the
JCC’s finding that Claimant’s first psychiatric hospitalization was not
compensable emergency care, we conclude that the facts that establish the
second hospitalization as emergency services, as was concluded by the JCC
(under sections 440.13(1)(f) and 395.002(10), Florida Statutes (2013)), are not
meaningfully different than the facts surrounding the first hospitalization.
Accordingly, we reverse the JCC’s conclusion that the first hospitalization was
not compensable emergency medical care.
JCC’s finding that Claimant’s first psychiatric hospitalization was not
compensable emergency care, we conclude that the facts that establish the
second hospitalization as emergency services, as was concluded by the JCC
(under sections 440.13(1)(f) and 395.002(10), Florida Statutes (2013)), are not
meaningfully different than the facts surrounding the first hospitalization.
Accordingly, we reverse the JCC’s conclusion that the first hospitalization was
not compensable emergency medical care.
In summary, we AFFIRM the appealed order to the extent it
finds Claimant suffered a compensable psychiatric injury, REVERSE that portion
of the order requiring the E/C to make payment to medical providers, REVERSE
the JCC’s finding that Claimant’s first hospitalization was not compensable
emergency medical care, and REMAND for entry of an order consistent with this
opinion. (WOLF, THOMAS, and KELSEY, JJ., CONCUR.)
finds Claimant suffered a compensable psychiatric injury, REVERSE that portion
of the order requiring the E/C to make payment to medical providers, REVERSE
the JCC’s finding that Claimant’s first hospitalization was not compensable
emergency medical care, and REMAND for entry of an order consistent with this
opinion. (WOLF, THOMAS, and KELSEY, JJ., CONCUR.)
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