Medical Non-Compliance in a Workers’ Compensation Case

When you treat with an authorized doctor following a workplace accident, you must comply with the physician’s recommendations for treatment, if reasonable and medically necessary. If you refuse such treatment, the workers’ compensation carrier may cutoff your benefits for “medical non-compliance.” Contact a West Palm Beach workers’ compensation attorney before you begin missing appointments, or if you have been ordered to attend an appointment because you have skipped appointments in the past.

Medical Non-Compliance is an Excuse the Employer/Carrier May Use to Terminate Your Benefits

By refusing treatment, you may set yourself up for a possible attack by the employer/carrier on your workers’ compensation benefits including your wage replacement pay. The common thought behind your employer’s decision is that by refusing treatment:

• You are not really injured and are just trying to get wage replacement benefits without having to work or with only having to work part time; or
• You want to delay your recovery to maximize the time you get wage replacement benefits.

Failure to See the Employer/Carrier’s Independent Medical Examiner

If the employer/carrier secures an Independent Medical Examiner (IME) and you fail to attend, you may forfeit your workers’ compensation benefits and will have to repay the employer/carrier 50 percent of that physician’s cancellation fees, per Fla. Stat. 440.13.

Common Reasons Injured or Sick Workers Refuse or Miss Treatment Dates

The vast majority of injured workers want to get back to work as soon as possible. Partial wage replacement is just what it sounds like: partial. Injured workers lose substantial amounts of money while they are injured. Typically, an injured worker receives 66.66% of his/her average weekly wage when on a no-work status and 60% when on a light-duty status that the employer cannot accommodate. The most common reasons an injured worker misses doctor appointments are:

• Mistake as to when and/or where the doctor’s appointment was: No problem. Make the doctor’s office aware of your unintentional mistake, apologize, and reschedule. Inform your attorney so that the attorney can inform the carrier.
• The travel to and from the physician’s office is too far: If this is true, you may be entitled to a replacement doctor, without having to use your one-time change in physician, to a doctor closer to your residence. This is especially true if you move to another state or country, or even outside of 50+ miles from your current doctor’s location;
• Personal reasons such as a death in the family: In order to prevent any issues, if you are aware you will be missing an appointment, inform the doctor’s office immediately and reschedule if possible. Contact your attorney as well so the attorney can inform the carrier so as to prevent a medical non-compliance defense; and
• The injured worker doesn’t like the doctor or the treatment isn’t working: If this is true, you may be entitled to a one-time change in physician.

Contact Our West Palm Beach Workers’ Compensation Attorneys

For any questions or help regarding your benefits and care, call the West Palm Beach law offices of the Celeste Law Firm today.

Resource:

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.13.html