Florida workers' comp medical care, explained. Authorized treatment, the one-time change of physician, and the IME mechanics that decide most disputed claims.
Call 904-383-7448Reviewed by Graham W. Syfert, Esq., Florida Bar No. 39104. Last updated .
Section 440.13, Florida Statutes, governs medical benefits in Florida workers' compensation. The carrier authorizes the treating doctor. The worker generally cannot pick. The most useful tool the statute gives the worker is the one-time change of physician under section 440.13(2)(f). Use it deliberately. Section 440.13(5) governs Independent Medical Examinations, which often decide disputed claims at the final hearing. Read the full statute at syfert.com.
"Subject to the limitations specified elsewhere in this chapter, the employer shall furnish to the employee such medically necessary remedial treatment, care, and attendance for such period as the nature of the injury or the process of recovery may require..." Section 440.13(2)(a), Florida Statutes. Read the full statute.
"Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident." Section 440.13(2)(f), Florida Statutes.
The most leveraged subsection in the statute. Once during the life of the claim, the worker may request a change of authorized physician in writing. The carrier has five days to authorize an alternate. If the carrier does not act within five days, the worker may select the alternate.
This is a single shot. Use it strategically. Identify the preferred alternate before sending the request. Send the request by means that produce a verifiable timestamp. Calendar the five-day clock. If the carrier misses it, exercise the worker's right to select.
Either side may obtain one IME per accident, per medical specialty, per claim. The IME doctor does not treat; the IME doctor opines on a disputed issue (causation, MMI, impairment rating, work restrictions). The IME report becomes evidence at the final hearing.
Carrier IMEs are typically defense-friendly. The roster of doctors who do high volumes of carrier IMEs is well known. Plaintiff IMEs counter with treating physicians or with reputable independent specialists.
Expert Medical Advisor (EMA) opinions under section 440.13(9) carry presumptive weight in disputes between IMEs. The EMA doctor is appointed by the Judge of Compensation Claims, not by the parties.
For an updated, treatment-flagged list of Florida appellate decisions citing section 440.13, see syfert.com/florida/statutes/0440.13.html. Florida workers' comp appellate practice runs through the First District Court of Appeal, which hears appeals from the Office of the Judges of Compensation Claims.
Send the one-time change request in writing, by certified mail or by means that produce a verifiable timestamp. Calendar the five-day clock the day you send it. The carrier will sometimes try to count business days; the statute does not.
Identify the preferred alternate physician in the request. If the carrier authorizes any other doctor, the worker can argue the request was not honored.
For the IME, prepare the worker like a deposition. The IME doctor is not the treating doctor. The doctor is gathering ammunition for a report that will be filed in the case.
Generally no. Section 440.13 requires authorized treatment. Emergency treatment is the exception.
Section 440.13(2)(f) gives an injured worker one change of authorized physician during the life of the claim. The carrier has five days to authorize an alternate; otherwise the worker may select.
An Independent Medical Examination by a doctor selected by the carrier or the worker to address a disputed issue. The IME doctor does not treat. The IME report is evidence at the final hearing.
Denied care, IME pushback, one-time-change problems. Call for a free read.
Call: 904-383-7448