Expert Medical Advisor in WorkComp Cases | Workers Comp Attorney Stuart 0 Comments

Expert Medical Advisor in WorkComp Cases | Workers Comp Attorney Stuart

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Florida Worker’s Compensation law provides for the appointment of an Expert Medical Advisor. An Expert Medical Advisor (herein referred to as “EMA”) is called to resolve situations in which: (Please see Florida Statutes Section 440.13(9)(c): 1) Doctors disagree on medical evidence supporting the employee’s complaints, 2) Doctors disagree on the need for additional treatment, 3) doctors disagree that the employee is able to return to work. The law affords a legal presumption that the EMA’s opinion is correct. However, this presumption is rebut-table if a party can prove by clear and convincing that the evidence is to the contrary. The Judge of Workers Compensation Claims must order an EMA if the injured worker or the Employer/Carrier requests one, and it is determined that there is substantial conflict between the opinions of two treating physicians or Independent Medical Examiners.

Workers Compensation IME’s

In practice, most EMA situations arise when there is a disagreement between two IME doctors. IME’s are independent medical examiners that evaluate injured workers on a one-time basis. Both the Injured Worker and the Employer/Carrier will generally hire IME’s if two authorized treating doctors render: conflicting medical opinions, there is a disagreement as to an employee’s work status, medical overutilization, etc. When two IME’s or two treating physicians disagree about one of the above mentioned medical opinions, either party may request an EMA. The Judge of Compensation Claims may order an EMA on his/her own volition, if the Judge feels as if there is substantial conflict which mandates such appointment.

The EMA cannot have any contact with either the attorney for the injured worker or the attorney for the Employer Carrier or related to workers compensation throughout the process. The doctor will review every medical record at his/her disposal, and will evaluate the injured worker. The EMA will ultimately make a decision to break the tie between two conflicting IME and treating physician’s opinions as to whatever the conflict is. The Judge will review the EMA’s decision and is most cases will affirm the decision unless there is clear and convincing evidence to the contrary. If an EMA rules on behalf of the injured worker, the injured worker will be awarded a reimbursement for expending costs on the evaluation and deposition. If the JCC appointed the EMA the Employer/Carrier will pay for the doctor.

It is very important to contact an experienced attorney to discuss the ramifications of hiring an EMA. The likelihood of prevailing at a Final Hearing without an attorney is extremely difficult. When there is a substantial conflict between two doctors, an appointment of an EMA must be considered. Hiring an advocate is crucial to discuss these pressing matters.

 

About Masnikoff

The Law firm of Lyle B Masnikoff and Associates handles Workers Compensation, Social Security Disability, PIP claims, and Employment disputes in the entire State of Florida including West Palm Beach, Fort Lauderdale, Miami,and Orlando.

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