An appeals court held that an employer could not deauthorize a physician who demanded up-front payment beyond statutory rates to treat an injured employee. However, the court found that a judge of compensation claims also couldn’t compel the company to pay for the treatment.

However, the District Court of Appeals of Florida, 1st District in Tallahassee, held Thursday in a 2-1 decision that a judge of compensation claims also couldn’t compel the company to pay for the treatment demands above the state’s legislative statutory rates.

In MarineMax Inc. v. Blair, Charles Blair, who had been receiving treatment since 2010 after a fall from a ladder while working for Clearwater, Florida-based boat dealer MarineMax Inc., sought to resume treatment in 2017 from his authorized physician, Dr. Jonathan Yunis. However, when the insurance adjuster contacted the doctor for an appointment, he learned that he had begun his own practice and demanded payments beyond legislative statutory rates and that those amounts be paid in advance to treat Mr. Blair. 

MarineMax said it would not accept Dr. Yunis’ statutory rates and authorized treatment with another physician, but Mr. Blair refused to go to an appointment with the other doctor.

Mr. Blair argued that he had an existing patient-physician relationship with Dr. Yunis and that MarineMax could not interfere with that relationship by “deauthorizing” his doctor. MarineMax argued that payments beyond statutory rates are only allowed if the employer agrees to pay the higher amount and the provider “specifically agrees in writing to follow identified procedures aimed at providing quality medical care to injured workers at reasonable costs.” Because MarineMax had no such agreement, the company argued that it was only left with the option of authorizing another physician.

A judge of compensation claim held that MarineMax’s actions were “tantamount to a unilateral deauthorization” and ordered Marine Max to continue to authorize and pay Dr. Yunis. MarineMax appealed.

A majority of the District Court of Appeals of Florida, 1st District, Tallahassee, reversed the decision in part. The court held that the judge of compensation claims had no authority to order MarineMax to pay Dr. Yunis, but found that the judge was correct to order the physician’s continued authorization. Although MarineMax contended that it is “illogical to require continued authorization of a doctor unwilling to treat the claimant on statutory terms,” the court held that the state’s law limits the basis on which an employer may officially deauthorize a previously authorized physician. However, the court also noted that all authorization does is allow Mr. Yunis to demand compensation if he chooses to treat Mr. Blair, but if he is unwilling to come to a payment agreement with MarineMax or proceed under the statutory limits created by the legislature, “no employer can force him to do otherwise,” which may leave Mr. Blair untreated and forced to seek authorization of a replacement physician.

While the court held that it is not overlooking the importance of the physician-claimant relationship, it noted that other cases have not required an employer to prepay above-schedule rates to avoid a potential disruption of that relationship,” and, therefore, in accordance with legislative fee schedules, it must reverse to the extent that it commands MarineMax to pay fees that do exceed the applicable fee schedule.

Judge James Wolf dissented in part from the decision, stating that under the facts of the case, he would hold that MarineMax was required to continue to provide treatment with Dr. Yunis, regardless of Dr. Yunis' willingness to treat Mr. Blair for rates within the statutory limits.

None of the attorneys in the case or MarineMax immediately returned calls for comment.