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Florida appeals court overturns denial of attendant care services

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attendant care

A Florida appellate court overturned the denial of a worker’s request for the attendant care services prescribed by her doctor.

After Kelly Girardin suffered a work-related injury, her authorized treating physician wrote her a prescription for a home health evaluation and attendant care for 12 hours a day, according to Girardin v. AN Fort Myers Imports LLC, filed in the Court of Appeal for the 1st District of Florida in Tallahassee.

Ms. Girardin attached a copy of the prescription to a petition for benefits. Her employer’s insurer responded that attendant care was authorized, then contacted the doctor to ask for more information.

The doctor said he prescribed the home evaluation because he did not know anything about Ms. Girardin’s home situation and could not provide any specifics about how much and what type of attendant care she would need.

Over the next few months, the insurer retained agencies that conducted three home visits and assessments, with the last occurring just a few days before the final hearing. The insurer did not provide the doctor with the evaluations.

At the final hearing, the insurer argued it had not yet received a written prescription that was sufficiently specific.

The judge of compensation claims agreed, finding that the carrier was not responsible for providing attendant care until a physician provided a written prescription that specified the time periods for such care, the level of care and the type of assistance required.

The appeals court reversed and remanded, stating that law requires a written prescription with certain information before a carrier will be responsible for providing attendant care, but the carrier cannot “attempt to hide behind a wall of willful ignorance” by failing to provide the doctor with the results so that he could give written specifics.

“This was little more than using the statute as a shield absolving them of their duty to ‘monitor a claimant's injuries and provide needed benefits,’” the ruling states.

WorkCompCentral is a sister publication of Business Insurance. More stories here.