Luks Santaniello's Florida Workers Compensation blog

This August 7, 2012 1 DCA opinion affirmed Judge D’Amrosio’s ruling. The 1DCA held that any E/C asserting the jurisdictional defense that the payment of outstanding bills for medical care is a reimbursement is conceding that, if any entity is financially responsible for the disputed bills, it is the carrier and not the claimant. The 1DCA indicated that raising a 440.13(11)(c) defense is a de facto concession by the Employer/Carrier that the services or products billed were provided by an authorized provider for compensable injuries “in accordance with” or “pursuant to” chapter 440 and that the claimant is insulated from financial liability for such charges. Furthermore, the E/C’s representation was a binding legal concession, by operation of section 440.32(3), and it waived any challenge to the medical necessity of the care.   Click here to see the 1DCA opinion