Appeals court: Marine Max can't be forced to overpay for workers' comp claims, but can't order different doctor

By Scott Holland | Mar 8, 2019

Florida FIrst District Court of Appeals   Michael Rivera [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]

TALLAHASSEE — A Florida appeals court ruled March 7 a possible payment dispute can’t force a workers’ compensation claimant to change doctors.

But, they said, the doctor can't compel payment beyond what workers' compensation law allows.

Judge Allen Winsor wrote the majority opinion for the Florida First District Court of Appeal. Judges Harvey Jay and James Wolf concurred, although Wolf also offered a partial dissent.

On Oct. 22, 2010, Charles Blair fell from a ladder. HIs employer, Marine Max Inc., said the accident entitled him to compensation and authorized Dr. Jonathan Yunis to treat Blair.

While practicing with Vascular Associates, Yunis operated on Blair multiple times from 2010 through 2014, billing at both statutory and higher rates. Yunis started his own practice in 2015, Center for Hernia Repair. When Blair attempted to seek treatment in 2017, the new firm required advance payments beyond the statutory rate, court documents show.

The ensuing dispute landed with Diane Beck, a judge of compensation claims, who ordered Marine Max to continue to pay Yunis to treat Blair. Marine Max appealed to the FIrst District court.

“Marine Max correctly argues that (Beck) had no authority to order it to pay Yunis,” Winsor wrote.

Even thought the judge could force payment, the panel said, it could not compel advance payment under the relevant law. As such, the panel reversed that portion of Beck’s order.

However, the court said Beck was correct to order Marine Max to authorize Yunis to keep treating Blair as opposed to forcing him to see another doctor who had a different payment structure. The judges said compensation judges aren’t able to consider the likelihood of a payment dispute, only if medical care is still reasonable or necessary.

“The JCC found that Blair had established a satisfactory patient-physician relationship with Yunis, and that Marine Max had ‘not established a valid reason for deauthorization of Dr. Yunis under these circumstances,’ ” Winsor wrote. “These conclusions were supported by competent substantial evidence.”

If Yunis agrees to treat Blair, he can either seek compensation under the law or work out a different agreement with Marine Max, the court said. If Yunis declines to have Blair as a patient, the panel said, then Blair can seek authorization of a new doctor. 

However, Winsor wrote that the court found no reason Marine Max should be forced to pay any more than what the law allows for compensation claims, and reversed that portion of Beck’s order.

In his dissent, Wolf said the panel should have given more weight to Yunis’ testimony that he never accepted the statutory fee schedule, that Beck found no evidence of negotiations between Yunis and Marine Max and that Marine Max didn’t object to paying more than the law requires for matters like office visits while Yunis was still with Vascular Associates.

“The majority opinion fails to recognize the significance of over 30 years of continuous decisions from this court recognizing the importance of providing a continued course of treatment once a satisfactory patient-physician relationship is established,” Wolf wrote.

Marine Max is represented by Jones, Hurley and Hand PA, of Orlando.

Blair is represented by attorney Kimberly A. Hill, of Fort Lauderdale; and by Lancaster & Eure PA, of Sarasota.

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