Van Sickle v. Allstate Ins. Co.

• Decision Date: 05 February 1987
• Docket Number: No. 86-158,86-158
• Citation: 12 Fla. L. Weekly 448,503 So.2d 1288
• Parties: 12 Fla. L. Weekly 448 Adele VAN SICKLE, Appellant, v. ALLSTATE INSURANCE COMPANY, Appellee.
• Court: Florida District Court of Appeals

Page 1288

503 So.2d 1288

12 Fla. L. Weekly 448

Adele VAN SICKLE, Appellant, v. ALLSTATE INSURANCE COMPANY, Appellee.

No. 86-158.

District Court of Appeal of Florida,

Fifth District.

Feb. 5, 1987.

Rehearing Denied March 17, 1987.

Lamar D. Oxford of Dean, Ringers, Morgan & Lawton, Orlando, for appellant.

F. Bradley Hassell of Smalbein, Eubank, Johnson, Rosier & Bussey, P.A., Daytona Beach, for appellee.

COWART, Judge.

We exercise our discretion under Florida Rule of Appellate Procedure 9.030(b)(4) to review a final order of the County Court of Orange County, Florida, wherein that court certified to be of great public importance the following question:

May an expert witness in the field of orthopedic medicine render expert testimony or opinions regarding the reasonableness and/or ¹ necessity of chiropractic care and treatment? ²

The answer to this question, as worded, is "yes." This answer to this question merely means that an expert in orthopedic medicine is not, for that very reason, unqualified from also being sufficiently knowledgeable of chiropractic healing as to render an expert opinion on the reasonableness of chiropractic care and treatment in a particular case.

An orthopedic physician duly and regularly engaged in the practice of orthopedic medicine with special professional training and experience in orthopedic medicine is not thereby alone necessarily an expert as to every, or any, aspect of chiropractic healing because these two fields are not the same discipline or school of practice. However, expertise in the field of orthopedic medicine may be relevant to expertise on the necessity and reasonableness of chiropractic care and treatment in a particular case, and a particular orthopedic physician may also be possessed of "special knowledge or skill" (Fla.R.Civ.P. 1.390(a)) [or of specialized "knowledge, skill, experience, training, or education" (§ 90.702, Fla.Stat.) ] about chiropractic healing as to be qualified as an "expert witness" entitled to testify in the form of an opinion about some aspect of that subject. ³

The qualification of an expert witness and the perimeters of his expertise are conclusions of fact to be determined advisedly by the trial judge and affirmed on appeal if supported by competent evidence. We find no error in the trial court's ruling in this case and

AFFIRM.

ORFINGER, J., concurs.

SHARP, J., concurs specially with opinion.

SHARP, Judge, concurring specially.

We should exercise our discretion to assume jurisdiction pursuant to rule 9.030(b)(4) in this case. However, we should restrict the question and its answer to the context and facts of this case, and the rulings made by the county court. ¹ The general question answered by the majority was not answered nor ruled upon by the county court.

This is an appeal from a judgment of the county court pursuant to Florida Rule of Appellate Procedure 9.030(b)(4). The issue in the jury case was whether or not Adele Van Sickle's chiropractic treatments, which she received for her back, neck and wrist, were incurred as a result of injuries she received in an automobile accident, thereby entitling her to receive medical insurance payments from Allstate Insurance Company. The jury found in favor of Allstate and Sickle appealed.

Adele Van Sickle sued Allstate Insurance Company for its failure to pay some $3,497.00 for treatments she had received from a chiropractor, Dr. Stansbury. Allstate had required Sickle to have an independent medical exam ² by Dr. Urbach, an orthopedic surgeon. It ceased further payments under its policy issued to Sickle, based on Dr. Urbach's opinion that the injuries for which she was being treated were not caused by the automobile accident, which had triggered Allstate's liability under the policy.

At the commencement of the trial, the court ruled that Dr. Urbach would be allowed to testify as to the "necessity" for the chiropractic treatments in the context of whether they were necessitated by the automobile accident. It also ruled that Dr. Urbach would not be allowed to testify as to the reasonableness of Sickle's care by the chiropractor, presumably meaning the reasonableness of the frequency, type, and cost of such treatments. The court ruled:

I'll grant the motion in limine that Dr. Urbach's testimony is limited solely to the necessity of medical treatment and not to the reasonableness of it.

The attorneys for both sides accepted the court's ruling. Sickle's attorney did not object to the bulk of Dr. Urbach's testimony. It dealt primarily with whether or not the defects and abnormalities shown by the X-rays of Sickle's spine, neck and hand were caused by the automobile accident, or whether they were caused by long-term degenerative diseases.

Dr. Urbach testified (without objection from Sickle's attorney), that Sickle's neck and back problems were degenerative in origin, and they were not caused by the automobile accident. He also testified Sickle's hand and wrist problem (capral tunnel syndrome), although possibly caused by the accident, could only be remedied by surgery. He said that the chiropractor's therapy for this injury would not be of any value.

The only objection Sickle's attorney made to Dr. Urbach's testimony came when Allstate's attorney asked him whether or not the chiropractor's spinal and neck manipulations might worsen Sickle's condition. The trial judge sustained the objection, but he later allowed Dr. Urbach to answer the question after Allstate's attorney laid a predicate for the witness' knowledge about the techniques of spinal manipulation. ³ Dr. Urbach testified he was fearful of spinal manipulation being done on persons, such as Sickle, who had arthritic or other degenerative problems.

I agree with all of the trial court's rulings regarding Dr. Urbach's testimony. He was accepted as an expert in his field of medical practice, and it is clear that orthopedic medicine encompasses the causes of injuries to the spine, neck and bones in the hand and wrist, as well as what kinds of medical treatment are suitable to cure or remedy such injuries. It is not necessary to bring in as an expert witness another chiropractor, ⁴ where the fields of medical expertise of the two professions overlap. ⁵ Further, Dr. Urbach was shown to have sufficient knowledge about the techniques of spinal manipulation (which perhaps all orthopedic surgeons would not have), in order to permit him to testify about the effects of spinal manipulation on an arthritic or...