What's Hot in Workers' Comp
Workers’ Compensation Decision Clarifies that Out‑of‑State Family Visits Don’t Meet Medical Necessity Standard
What’s Hot in Workers’ Comp, Vol. 30, No. 6, June 2026
June 8, 2026
Purple Pride, Inc. v. Burgess, 51 Fla. L. Weekly D479 (Fla. 1st DCA Mar. 18, 2026), reh'g denied (Mar. 31, 2026)
The claimant suffered a work-related motor vehicle accident in 2019 that caused him to become tetraplegic (or quadriplegic), requiring around-the-clock attendant care. In 2024, the claimant filed a petition for benefits, requesting certain attendant care benefits he felt were necessary to allow him to take a trip to visit family in New York. The benefits he sought included the extra cost of traveling attendants, including their overtime pay and accommodations, and the extra cost of renting a Hoyer lift, commode chair, and other durable medical equipment (DME) needed for the trip. The employer/carrier denied the request as not being medically necessary.
The claimant obtained an opinion from the treating psychotherapist that a visit to see family in New York would improve claimant's mental health. The psychotherapist opined that the trip was “medically necessary” in the sense that it could improve claimant's symptoms related to depression and anxiety.
The Judge of Compensation Claims (JCC) rejected the claimant’s position that the trip to New York itself was medically necessary under the definition of medical necessity in § 440.13(1)(k), Fla. Stat. (2024). However, the JCC found that the employer/carrier should nonetheless be required to pay for the additional costs the claimant would incur to travel with the attendants and DMEs. In the JCC's view, the employer/carrier should cover those costs anywhere, pursuant to “the maxim that industry is responsible for what industry causes.”
The First District Court of Appeal set aside the JCC’s order and held that because the JCC concluded that the claimant's trip to New York was not medically necessary, it was error to require the employer/carrier to pay for the additional medical benefits he sought for the trip. The court explained that “transportation other than to a doctor” reflects on quality of life rather than medical necessity and is “generally considered gratuitous and not compensable.” Therefore, the JCC’s order was set aside.
