Long Grove Builders, Inc. v. Haun, BO-248

Decision Date05 June 1987
Docket NumberNo. BO-248,BO-248
Parties12 Fla. L. Weekly 1411 LONG GROVE BUILDERS, INC. and General Accident Insurance, Appellants, v. Warren Michael HAUN, Appellee.
CourtFlorida District Court of Appeals

Thomas A. Koval of Moss, Henderson & Lloyd, P.A., Vero Beach, for appellants.

Rodney Guy Romano of Cone, Wagner, Nugent, Johnson, Roth & Romano, P.A., West Palm Beach, for appellee.

MILLS, Judge.

The question presented in this workers' compensation appeal is whether a deputy commissioner may decide, at the claimant's request, the amount of an authorized treating physician's bill payable under the Medical Services Fee Schedule adopted by the Division of Workers' Compensation pursuant to section 440.13, Florida Statutes. We hold he may not, and reverse the order appealed.

The claimant, Warren Haun, injured his left hand in a power saw accident on 23 November 1983. An authorized treating physician, Dr. Thomson, submitted a bill for $3,010 to the employer/carrier (e/c). The e/c paid Dr. Thomson only $478, contending that was the full amount due under the Medical Services Fee Schedule.

In his client's behalf, the claimant's attorney requested a hearing before a deputy commissioner on the issues of medical fees due Dr. Thomson, interest, attorneys' fees and costs. The claimant's attorney also submitted a request in behalf of Dr. Thomson, pursuant to Florida Administrative Code Rule 38F-7.021 (formerly 38F-7.21), to the Office of Medical Services of the Division of Workers' Compensation, seeking a determination of the correctness of the amount paid Dr. Thomson by the e/c. Pursuant to the latter request, Dr. Thomson's bill was reviewed by a registered nurse employed by the Office of Medical Services, who determined that under the Medical Services Fee Schedule the e/c owed Dr. Thomson an additional $84. The e/c paid the additional $84, resulting in a total payment to Dr. Thomson of $562.

At the hearing before the deputy commissioner, the e/c objected to consideration of Dr. Thomson's bill on the ground that administrative review of the medical bill pursuant to Rule 38F-7.021 deprived the deputy of subject matter jurisdiction to hear the claim. In his order, the deputy commissioner concluded he had jurisdiction to decide how much of Dr. Thomson's bill was payable under the schedule. Then, based on his own analysis of the nature of the services rendered by Dr. Thomson, the deputy commissioner conformed the bill to the schedule and found the e/c should have paid Dr. Thomson a total of $1,674.

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8 cases
  • Vickery v. North Dakota Workers Compensation Bureau
    • United States
    • North Dakota Supreme Court
    • April 8, 1996
    ...The Bureau's argument might have more force if Vickery and the medical provider were in North Dakota. See Long Grove Builders, Inc. v. Haun, 508 So.2d 476 (Fla.Ct.App.1987). However, in this case, the statutes the Bureau relies on may not insulate Vickery from liability for payment of the d......
  • Avalon Center v. Hardaway
    • United States
    • Florida District Court of Appeals
    • September 21, 2007
    ...facility) and the employer/carrier are the parties with the legal interest affected by utilization review. See Long Grove Builders v. Haun, 508 So.2d 476 (Fla. 1st DCA 1987) [holding that the claimant was without standing to bring dispute over amount owing to authorized treating physician].......
  • Sun Bank/South Florida, N.A. v. Baker
    • United States
    • Florida District Court of Appeals
    • February 23, 1994
    ...carrier legally responsible for paying medical bills, while the employee is insulated from liability. See Long Grove Builders, Inc. v. Haun, 508 So.2d 476, 477 (Fla. 1st DCA 1987); Secs. 440.10(1)(a) and 440.13(3), Fla.Stat. (1993). 6 To deliver medical benefits to the injured worker quickl......
  • Furtick v. William Shults Contractor, 94-51
    • United States
    • Florida District Court of Appeals
    • November 16, 1995
    ...facility) and the employer/carrier are the parties with the legal interest affected by utilization review. See Long Grove Builders v. Haun, 508 So.2d 476 (Fla. 1st DCA 1987). Reimbursement disputes within the scope of utilization review must thus be pursued as between the provider (or facil......
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