Put it in Practice February 2022: Monthly Tips for Florida WC Professionals
ONE-TIME CHANGE CHANGE-UP: WHAT’S “REASONABLE?”
“Reasonable” is one of the most subjective words in law, and its interpretation remains so after the Jan. 11 dismissal of City of Bartow v. Flores, which had been pending before Florida’s Supreme Court.
The petition sought review of the 1st DCA’s 2020 opinion, which examined what constitutes an E/C’s “unreasonable delay” in acquiring a one-time change appointment date.
Last June the First DCA found (based on Flores) that 16 days to provide records and 21 days to contact the doctor was not reasonable.
What does the Flores dismissal mean for claim professionals?
It means that after timely naming a one-time change doctor, the adjuster must act with all dispatch to provide that doctor with records and continue to follow up and obtain (1) an acceptance of authorization and (2) an appointment date and time.
We recommend
- Setting a very short diary for follow-up.
- Telling the doctor, nurse case manager and anyone else involved in scheduling the initial authorization that time is of the essence.
- Notifying the claimant/claimant’s attorney of your ongoing efforts.
Although adjusters are often at the mercy of the doctor’s scheduling office, your efforts to avoid unreasonable delay need to be documented.
If you have any questions, please feel free to call us.
This month’s author is Rogers Turner. Questions? rturner@hrlawflorida.com