A Florida police officer in training suffered an injury on the job and was denied compensation for medical bills that he received for tests he had after his initial visit to the emergency room. He went to the state’s District Court of Appeals to have his workers’ compensation benefits reinstated for these bills and they decided to reverse an earlier decision and award him benefits because diagnostic tests can be compensable if they are used to find out the cause of the symptoms of the compensable injury.

Juan Alvarez was a police officer in training who passed out, fell to the concrete and hit his head on February 7, 2014. He went to the emergency room and his employer and their insurer paid for that trip. After he was discharged, he went back to the hospital for diagnostic tests because the CT scan taken at the emergency room showed signs of a stroke and they wanted more testing to rule out other medical issues and symptoms. He was denied workers’ compensation benefits for these additional tests.

When Alvarez took his case to the Judge of Compensation Claims, he argued that the new tests were to diagnose the extent of his head injury, which all parties agreed was compensable. The judge ruled that the additional tests were not to treat or diagnose his initial injury, so they should not be included in his benefits.

Alvarez appealed and the court was presented with the results of other cases which ruled in similar instances. In one case it was determined that employers/insurers were required to provide medical treatments if they were necessary to identify or treat the whole injury, as long as it took the patient to recover.

The employer conceded that his initial CT scan was compensable as it was used as a diagnostic test, but after it showed evidence of a stroke, he did not need to go back for further testing and they argued they were not responsible for that. Dr. Moore, who referred him for extra testing after the initial CT scan, said he sent him for a carotid arteriogram to rule out a carotid dissection or any other kind of hemorrhaging caused by the head trauma. Dr. Aldana recommended a CT scan with contrast (a dye they put into your body to highlight certain areas for easy viewing) to determine if he really did have a stroke or if it was edema. Another physician, Dr. Molloy recommended him for an EEG and another CT scan to rule out post-concussive edema.

The District Court reversed the earlier ruling which claimed the tests were not for diagnostic purposes, and they said the diagnostic tests Alvarez went through were permissible because they were used to identify the injury and find out the cause of his symptoms.

Even if the results of the diagnostic tests had not provided a causal link to his symptoms and injuries, they would still be compensable because they were administered with the purpose of finding out the cause of what became a compensable injury, they said.