Recent case law serves as a reminder: even when the Carrier relies upon a physician’s MCC determination and uses it to deny further treatment under the 120-day rule, that does not preclude a Claimant from seeking a one-time change in physician.
In Babahmetovic v. Scan Design Florida, Inc./Zenith Insurance Company (Case 1D14-2986, 1st DCA, May 1, 2015), the Employer/Carrier provided medical care to a Claimant. After the authorized physician concluded the Claimant’s condition was 60% preexisting, the Employer/Carrier issued a Notice of Denial based upon the 120-day rule and maintained the denial when the Claimant sought a one-time change physician.
However, the First District Court of Appeal confirmed that the Claimant remained entitled to a one-time change of physician, noting that there was a difference between the existence of a compensable accident and the need for treatment. Where a compensable accident exists, the Claimant is entitled to a one-time change. While the Employer/Carrier can issue a denial of medical treatment with a provider based upon major contributing cause, it does not preclude the one-time change. Additionally, in Babahmetovic, the First District noted that a Carrier that wishes to retain its right to issue a denial under the 120-day rule must explicitly say so when beginning to pay benefits.