Proposed Workers'
Compensation Reform Act of 2001
MEDICAL
MANAGED CARE
Current Situation
In 1993, the Florida Legislature mandated the
conversion of health-care delivery under the workers’ compensation
system to a managed-care model. Managed care was supposed to reduce the
cost of medical services rendered to injured workers while upholding the
quality of care. The cost-savings have not appeared; in fact, managed care
seems to be causing an increase in costs, mostly due to increased
administrative expenses. The function of managed-care coordinators does
not operate as intended. The fabric of managed care has also been tattered
by case law also allows claimants to leave the managed-care network if
they don’t get treated quickly enough.
Recommendation
This bill eliminates the managed-care provisions of the
workers’ compensation law.
OBJECTIVE FINDINGS FOR PSYCHIATRIC
DISABILITY
Current Situation
Case law involving claims for psychiatric disability
has been liberalized to the point that claimants’ lawyers shop around
among doctors until they can find one who will diagnose a psychiatric
disability, which often is remote from the original injury. Employees with
small physical impairment ratings are using pre-existing mental,
psychological, and emotional conditions to boost their impairment ratings
until they can qualify for permanent-total disability. This practice
increases medical costs, attorney involvement, and indemnity benefits
beyond reasonable amounts.
Recommendation
This legislation would fix abuse of the system by
clarifying that there will be no impairment ratings after maximum medical
improvement for mental, psychological, and emotional conditions.
INDEPENDENT MEDICAL EXAMS
Current Situation
Currently, an injured worker can receive independent
medical exams in an unlimited number of specialties. A claimant’s lawyer
may request independent medical exams by a psychiatrist, a psychologist, a
neurologist, a neurosurgeon, an orthopedic surgeon, a chiropractor, etc.
All of these different exams drive up the medical costs and attorneys’
fees, and serve as an abuse of the system that drives up benefit costs.
Also, a carrier is not allowed to charge these expenses as medical costs,
but rather as legal and administrative expenses.
Recommendation
This legislation limits independent medical exams to one per injury,
and clarifies that these exams are to be charged as medical benefits.
ELIMINATE INTEREST ON MEDICAL BILLS
Current Situation
The First District has ruled that interest must be
calculated on unpaid medical bills and paid to the claimant. Employees do
not pay for their medical care under the workers’ compensation system,
however, and payment of this interest merely increases the system’s
costs.
Recommendation
This legislation eliminates this judicially created
payment of interest on unpaid medical bills.
REHABILITATION PROVIDERS’ RIGHT TO MEDICAL RECORDS
Current Situation
The law requires access to all medical records without
encumbrance, but some judges of compensation claims are denying those
records to rehabilitation providers.
Recommendation
This legislation clarifies that access to an injured
worker’s medical records must be given to all persons who are
responsible for returning the employee to work.
