Jeffrey P. Gale, P.A. // Key Florida Workers’ Compensation Emergency Medical Care Issues

Emergency medical services and care can play a pivotal role in Florida workers’ compensation cases.

Under section 440.13(1)(e), Florida Statutes, “emergency services and care” is defined by its reference to section 395.002, Florida Statutes (2024), as follows:

(9) “Emergency services and care” means medical screening, examination, and evaluation by a physician, or, to the extent permitted by applicable law, by other appropriate personnel under the supervision of a physician, to determine if an emergency medical condition exists and, if it does, the care, treatment, or surgery by a physician necessary to relieve or eliminate the emergency medical condition, within the service capability of the facility. 

An “emergency medical condition,” as defined in section 395.002(8)(a), Florida Statutes (2024), means:

(8) “Emergency medical condition” means:

(a) A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:

1. Serious jeopardy to patient health, including a pregnant woman or fetus.

2. Serious impairment to bodily functions.

3. Serious dysfunction of any bodily organ or part.

In addition, doctors who furnish “Emergency services and care” are considered authorized treating providers under section 440.13(5)(e), Florida Statutes (2024), allowing them to offer opinion testimony in workers’ compensation proceedings. This was explained in Cespedes v. Yellow Transport, Inc., 130 So. 3d 243, 253 (Fla. 1st DCA 2013):

‘Thus, based on a reasonable and harmonious reading of the statutory provisions, we conclude that where the admissible medical and lay testimony establishes that a physician has provided compensable emergency medical services, that physician’s medical opinion testimony is admissible as an “authorized treating provider” under section 440.13(5)(e).’

To get paid, healthcare providers who render emergency care must notify the carrier by the close of the third business day after the care has been rendered. See Section 440.13(3)(b). The failure of a healthcare provider to meet this deadline does not disqualify the physician from testifying. Interestingly, a provider denied payment for missing the deadline cannot seek payment from the injured worker. Attempting to seek payment might violate one or more sections of Florida Statute 559.72.

Notice timeliness alone is not enough for the provider to get paid. These additional factors are required:

• The medical services and care were “emergency medical services and care.”
• The injury arose out of work performed in the course and the scope of employment.
• The accident is the major contributing cause of the injuries, with “major contributing cause” meaning the cause that is more than 50 percent responsible for the injury as compared to all other causes combined for which treatment or benefits are sought. Section 440.09(1).