Stanton v. Equity Lifestyle Properties, Inc. / Liberty Mutual Insurance

Scott B. Miller

JCC Beck – Sarasota (7-12-19) – Denied authorization of PCP. Claimant, rendered a quadriplegic from a surgical fracture, sought authorization of a PCP, costs, and attorney fees. E/C argued it timely authorized Dr. Cosmo (pulmonologist and internist) as Claimant’s PCP, and no costs/fees were due. Since 440.13(1) does not contain a definition of PCP, the JCC looked to “PCP” as defined in the managed care section 440.134(1)(k), which states that “Primary care provider” means, except in the case of emergency treatment, the initial treating physician and, when appropriate, continuing treating physician, who may be a family practitioner, general practitioner, or internist physician licensed under chapter 458…” The JCC held that, although Dr. Cosmo did not know he was authorized as a PCP, he had been acting as a PCP in that he agreed to and did everything asked of him by Claimant and the nurse case manager. Petition for Benefits denied/dismissed.
View JCC Merits Order