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In a Defeat For Non-English Speakers, Court Bars Entitlement to Spanish-Speaking Shrinks in Workers-Comp Claims

| June 3, 2014

A court's message to Spanish speakers in Florida. (© FlaglerLive)

A court’s message to Spanish speakers in Florida. (© FlaglerLive)

In what could be a first-of-its-kind decision in Florida, an appeals court ruled Tuesday that a man suffering from head injuries was not entitled to treatment from a Spanish-speaking psychologist as part of a workers-compensation insurance claim.

The issue stems from a 2012 accident in which roofing-company employee Jesus Trejo-Perez was seriously injured, including suffering head injuries, when he fell 30 to 40 feet while on a job in Hillsborough County, according to documents in the case.

Trejo-Perez’s employer, Arry’s Roofing, and insurer Builders Insurance Group, agreed that the man’s injuries would be treated through workers-compensation coverage. But after a neurologist recommended a neuropsychological evaluation be conducted by a Spanish-speaking psychologist, Trejo-Perez was referred to an English-speaking psychiatrist with an interpreter made available.

Trejo-Perez, whose primary language in Spanish, refused to attend the first scheduled visit and sought authorization to see a Spanish-speaking psychologist, according to the court documents. But an ensuing legal dispute centered on whether Trejo-Perez and his neurologist, Angelo Alves, had shown a “medical necessity” for the request, a key test in the workers-compensation insurance system.

The 1st District Court of Appeal, in a 2-1 decision Tuesday, ruled that Trejo-Perez had not met the test.

“(A) fair reading of Dr. Alves’ testimony is that a Spanish-speaking psychologist would be merely preferable under the circumstances,” wrote Judge Simone Marstiller, who was joined in the majority by Judge Scott Makar. “Preferable, perhaps; but (a section of state law) requires that recommended treatment be medically necessary if the employer is to pay for it.”

But that drew a blistering dissent from Judge Brad Thomas, who wrote that the case was one of “first impression,” meaning that it raised a first-of-its-kind question. Thomas pointed to testimony from Trejo-Perez and the neurologist that the “presence of a non-psychiatric interpreter would interfere in the sensitive nature of the psychotherapist-patient relationship.”

“Furthermore, and perhaps even more significant, is the majority opinion’s adverse practical impact, although surely not its intent, which establishes a precedent by which Spanish-speaking employees (in workers-compensation cases) can be required to accept a lesser standard of medical care in Florida than English-speaking employees, who could not be required to accept the presence of a third-party layperson during medically necessary, intimate psychotherapist-patient treatment sessions,” he wrote.

The appeals-court decision upheld a decision by Doris E. Jenkins, a state judge of compensation claims. While Marstiller’s majority opinion said Trejo-Perez sought treatment from a Spanish-speaking psychologist, other documents sometimes refer to seeking treatment from a psychiatrist.

In a concurring opinion Tuesday, Makar offered an overview of challenges in the health-care system related to providing care to people who speak limited English, writing that making services more accessible to those patients is a “Herculean and glacial task.”

But he also wrote that the only question in the Trejo-Perez case is whether treatment from a Spanish-speaking doctor was medically necessary.

“Undoubtedly, patients and physicians desire to speak in a common language to avoid potential miscommunication; this commonality is highly desirable whether the physician is a gastroenterologist, ophthalmologist or a psychiatrist,” Makar wrote. “Linguistic desirability, however, is not medical necessity absent a specific showing that the use of an interpreter is inconsistent with prevailing practice parameters and that a linguistically-compatible psychiatrist is a widely accepted practice among those practicing in this field.”

But Thomas contended that it was necessary for Trejo-Perez to get treatment from a Spanish-speaking doctor.

“(This) case necessarily turns on the issue of whether a Spanish-speaking employee may be required to accept psychiatric evaluation by a non-Spanish speaking psychiatrist, against the medical opinion of a treating neurologist,” Thomas wrote. “The obvious answer in my view is no, because to do so is to deny medically necessary treatment in violation of (state law).”

–Jim Saunders, News Service of Florida

11 Responses for “In a Defeat For Non-English Speakers, Court Bars Entitlement to Spanish-Speaking Shrinks in Workers-Comp Claims”

  1. Steve Wolfe says:

    This case hinges on the absence of two words, “medically necessary.” It isn’t about the comp program’s racism. The bureaucracy just requires those words to be submitted in writing by the doctor of record in order to pay. The irony is in the conflict between the bureaucracy and the court system, two unelected bodies of government. That’s like King Kong vs. Godzilla. Neither likes to yield to anyone. Both are major pains in the arse. And the little guy, who is supposed to be the beneficiary of the government-run health care system, loses again.

  2. Gia says:

    This is America. Speak English, if you don’t like it go back were you came from.

    • Atlanta says:

      Used to hear people saying the same thing during the civil rights protests in the 1960’s.

      Same song different verse. That train is never late.

    • Geezer (El Geezer) says:


      I have to say that I am moved and inspired by this most succinct comment
      which you generously shared with all of us. :)

      In your honor Gia, I’m going to strive to speak more Spanish whenever
      possible, in any locale, be it the post office, the grocer’s, the local bakery, etc..
      And as a nod to your name of Italian derivation, I too shall endeavor to brush up
      on my Italian, with an eye towards Portuguese and Russian
      in the future.

      And as a bonus, I will encourage any and all people who speak Spanish to
      continue to speak this most beautiful of the romance languages as much as possible.
      This way I can have the joy of practicing more often.

      Adios Gia, que Dios la bendiga.
      Buenas noches señora.

      -El Geezer

    • Thoeni says:

      Much of America once belonged to Spain. The people of those areas di not change their race, genealogy or language simply because the country’s borders moved. Maybe you should go back and study more history. The Mexican-American border has been modified multiple times — even within the last 10 years.

      • Steve Wolfe says:

        In fact New Mexico is officially bi-lingual. There is a high concentration of Mexican descendants there from the re-drawing of the border for the sake of the railroads.

  3. confidential says:

    Learning English should be mandatory for “all” immigrants and specially for the “so called refugees” brought up here by religious organizations or for political reason, with all expenses paid and with no health and background screening and some of them turn around and attacks us here at home. Boston Marathon, 5 land owners hunters shoot dead by an Asian Humong tribes man, the Virginia tech shooter was another Asian refugee despondent of our way of life and the Easter European man on his 30’s shooting several customers in a Midwest Mall.
    Speaking or learning English should be a requirement in spite of the choice of speaking privately the language of their native countries.

    • No Stinking Badges! says:

      Yes all terrorists and serial killers should bone up on their English.
      David Berkowitz, Charles Manson, Ted Bundy, and others spoke excellent English.
      How about the Beltway Sniper (trained by the Army) and his young accomplice? English? Check.
      The Columbine shooters? English? Check.
      Less we forget the Boston Strangler! English? You guessed! Check.

      All these folks were American-born and spoke (speak) a mean English
      (John Malvo might have been an immigrant.)

      Maybe we need a charter school for budding terrorists to speak English, darn it.

      First they take our low paying jobs, and now they want to corner the market on murder
      and they fail to learn our lingo. THE GALL!

      I am angry too.

  4. Sherry Epley says:

    Those insisting that every single person living the the USA should speak our native language should actually be boning up on those languages spoken by the FIRST people living here such as Cree, Mohican, Navaho, Oneida and Potawatomi. The people currently living in the USA actively speak over 200 languages.

    I would love to see an only English speaking US citizen working in and injured another country NOT insist on the services of an English speaking physician. . . especially for the intimate, subtle treatment of a psychiatrist/psychologist .

  5. Steve Wolfe says:

    You’ve managed to miss the point of the article in order to throw mud at each other’s righteousness. This is about the demands of a bureaucracy for a carefully crafted response on the forms they demand in order to illicit the desired response. The poor fellow’s doctor just didn’t use the words “medically necessary.” It has nothing to do with anyone’s native language.

    This is but a tiny example of what the government has become. The servant has become the master. Thank yourselves for looking the other way. Good luck unseating the monster.

  6. Sherry Epley says:

    By the way. . .The USA is NOT the only America. The people who live in Canada, Central and South America are also Americans. . . and many think of themselves that way. Please do try, try very hard to learn about the planet we all live on, and to think beyond such myopic views.

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