Jeffrey P. Gale, P.A. // Employer/Carrier’s Responsibility to Pay for Unrelated Medical Care

Following compensable work-related accidents, employers and their insurance carriers (commonly collectively referred to as “E/C”), are supposed to furnish injured workers with the medical care prescribed in Florida Statute section 440.13.(2)(a). The key language of the statute reads as follows:

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….

Interestingly, this provision has been interpreted to include medical treatment for unrelated conditions if such treatment will aid or improve recovery of the work injury. The principle has been recognized since 1966.

In Jordan v. Fla. Industrial Commission, 183 So. 2d 529 (Fla. 1966), the Florida Supreme Court reversed the rulings of two lower tribunals which denied treatment of a pre-existing deformity, and compensation for healing time during and following same. The injured worker in the case had sustained a leg injury in a prior accident which healed at an abnormal angle shortening his leg by two and one-fourth inches, giving him a limp, curvature of the spine and abnormal stress on the leg muscles, tendons, etc. Four years later he suffered a job-connected accident resulting in a back injury. Medical testimony demonstrated that were it not for the abnormal stress on his back caused by the earlier deformity, claimant’s back would have healed from the compensable injury in four to eight weeks, and that the only effective treatment for the compensable back injury was to correct the leg length discrepancy. The Judge of Compensation Claims declined to require that the employer provide treatment or appliances to correct the deformity. The Full Industrial Commission affirmed the JCC. (It should be noted that the Industrial Commission no longer exists to review workers’ compensation trial judge rulings. That responsibility now lies with the First District Court of Appeal.) The Supreme Court  reversed both tribunals and ordered E/C to furnish the medical treatment.

Other examples include:

Treatment for diabetes. Urban v. Morris Drywall Services, 595 So. 2d 60 (Fla. 1st DCA 1991). Claimant proposed that his diabetes was caused by the industrial accident. The JCC rejected the causation claim and request for treatment of the diabetes necessary to the effective treatment of his compensable injuries. The First DCA agreed with the judge’s ruling denying compensability of the diabetes. However, it said this about the request for treating the diabetes:

In the present case, there is record evidence to suggest the necessity of treating claimant’s diabetic condition in order to render effective treatment of claimant’s compensable injuries. If such is the case, we hold that claimant is entitled to that treatment of his diabetic condition necessary for effective treatment of his compensable injuries. It will, however, be necessary for the JCC to make specific findings as to whether such diabetes treatment was indeed a necessary adjunct to the treatment of claimant’s compensable injuries. If such is the case, claimant is entitled to compensation for his diabetes treatment not only for the limited period in which his diabetic condition was exacerbated, but for the period in which stabilization of the diabetes was necessary to assist claimant in attaining maximum recovery from his compensable injuries.

Cancer treatment. City of Miami v. Korostishevski, 627 So. 2d 1242 (Fla. 1st DCA 1993). Claimant, who for 13 years worked around tennis court clay and herbicides, asserted that his job duties caused a hernia and liver cancer. The JCC entered an order finding that both conditions were related to his employment. The JCC found alternatively that, if the cancer was not compensable, the E/C was nevertheless responsible for treating it on the theory that treatment for a condition not causally related to employment is the E/C’s responsibility if one of the primary purposes of that treatment is to remove a hindrance to recovery from the compensable hernia, citing Urban v. Morris Drywall Services, 595 So. 2d 60 (Fla. 1st DCA 1991). The First DCA agreed with the finding of compensability of the hernia, rejected compensability of the cancer, but agreed with the JCC’s alternative theory regarding the necessity of treatment.

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