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Florida law- workers comp case managers have legal right to

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Florida law- workers comp case managers have legal right to obtain their patient medical records and status etc, but do they also have the right to be present during a doctors examination ? If you know the answer I also need to know the exact place to find the law which states such and or a copy of that section.

richanne96 :

Hello, and welcome to Just Answers. The Florida Statutes dealing with Worker's Compensation are at Title XXXI Chapter 440. Specifically, 440.13(5) deals with Independent Medical Exams. I presume this is the type of doctor exam you are referring to, where a doctor other than the doctor who has been treating you is going to exam you to verify that your injury qualifies for continuing coverage. No where in the statute does the worker's comp case manager have a right to be present at that exam.

richanne96 :


(a) In any dispute concerning overutilization, medical benefits, compensability, or disability under this chapter, the carrier or the employee may select an independent medical examiner. If the parties agree, the examiner may be a health care provider treating or providing other care to the employee. An independent medical examiner may not render an opinion outside his or her area of expertise, as demonstrated by licensure and applicable practice parameters. The employer and employee shall be entitled to only one independent medical examination per accident and not one independent medical examination per medical specialty. The party requesting and selecting the independent medical examination shall be responsible for all expenses associated with said examination, including, but not limited to, medically necessary diagnostic testing performed and physician or medical care provider fees for the evaluation. The party selecting the independent medical examination shall identify the choice of the independent medical examiner to all other parties within 15 days after the date the independent medical examination is to take place. Failure to timely provide such notification shall preclude the requesting party from submitting the findings of such independent medical examiner in a proceeding before a judge of compensation claims. The independent medical examiner may not provide followup care if such recommendation for care is found to be medically necessary. If the employee prevails in a medical dispute as determined in an order by a judge of compensation claims or if benefits are paid or treatment provided after the employee has obtained an independent medical examination based upon the examiner’s findings, the costs of such examination shall be paid by the employer or carrier.
Customer: This is not exactly my case. I have after a total of 39 years of employment with just two different emplyerrs had an accident at my current firefighter position. The incident happened just 4 months ago and after being on light duty during the early stages 7 weeks to be exact and going to physical therapy 3 times a week, got worst. Upon a follow up visit to my orthopedic sergeon, he suggested that I have a closed shoulder manipulation next. That procedure was scheduled for August first, due to my families long awaited vacation which had previously been long scheduled and paid for mostly in advance ( this vacation was deducted from my own personal time and had nothing to do with workers comp. after the procedure, I have been in extreme pain and discomfort and under narcotic pain medication. During this period post surgical procedure I was placed on no work status although continuously being harassed by my case manager as to when I was going back to work. All of that is totally understood by me, except when after my last visit, he stated he would meat me at my next doctor appointment. This last act truly offends me and makes me feel violated if he has the right to be in the room when the doctor is examining me.
richanne96 :

He does not have that right, but the law that applies is federal, not state. While it is true that in order to receive workers compensation benefits, patients are forced to waive certain privacy rights they would otherwise have with respect to healthcare (for example, allowing the worker's comp people access to your medical records), these are spelled out in the workers compensation Chapter 440. All the privacy rights that you have to waive are enumerated, and no where does it state that you have to allow your case manager to witness your visit to the doctor. In fact, the doctor may refuse to examine you if anyone else other than your spouse is in the room.

richanne96 :

The federal law that applies is the Healthcare Information Portability and Accountability Act (HIPAA). Any privacy rights not specifically waived under the Florida workers compensation statute remain in place.

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