The services of an Expert Medical Advisor (EMA) are necessary in cases of Workers Compensation claim disputes. Consulting an EMA can be required by law, especially when one party questions the treatments, or therapies of the physician.
In the state of Florida, for example, the roles and duties of an Expert Medical Advisor are defined in the Florida Statutes Section 440.13. This law necessitates that EMA’s must work with Judges of Compensation Claims (JCC) and the Division of Workers Compensation.
Importance of Experts Medical Advisors in Workers Compensation Claims
To the worker
Expert Medical Advisors provide an unbiased evaluation to ensure that an injured worker receives the proper medical treatment and recovery time to be able to get back to work. They carefully scrutinize the etiology of the worker’s injury, as well as the diagnosis, treatment, and prognosis from the physicians.
EMAs need to establish that the medical diagnosis was accurate, or that the prescribed treatment was medically necessary. They may also help communicate to the employer the restrictions and limitations of an injured, or recovering worker who may not yet be able to work full time, or requires a transitional period.
In cases where the injured worker has more than one physicians who disagree over the course of the treatments, the judge deciding on the case will look into the opinion of the EMA to determine the outcome.
To the employer
On the other hand, EMAs also protect the interest of the employers and their insurance provider/carrier to prevent excessive treatments and unnecessary medical costs. They recommend the best course of action in impairment and disability cases.
EMAs will match the standards of care that should be provided to the patient relevant to the medical findings, which the employer, or the insurance provider/carrier must shoulder. This may include the type, duration, and intensity of treatments, therapies, and medications, including any mental health sessions that the EMA will deem important to the recovery of the worker
Though they cannot decide on the compensation case per se, the EMAs evaluation of the claims will greatly impact the decision makers at the Division of Workers Compensation. However, not all Workers Compensation claims will need to be reviewed by the EMAs. In some cases, only the ones that carry complex medicolegal, clinical, and disability issues have to be referred to the EMAs.
When to Seek Experts Medical Advisors Help
Injured workers filing for claims will normally be assigned a case manager at the Division of Workers Compensation. It is the case manager, not the claimant nor the other parties, who should contact an EMAs from the division’s certified pool or list if the case warrants further evaluation. It is also the case manager who arranges for the EMAs to render their services on the case.
By law, the EMAs have to disclose any conflict of interest before the expert gets to review the claims. He, or she must also submit the evaluation within two weeks after receiving the necessary documents from the injured worker’s case.
Where can I find a Workers Compensation Plastic Surgeon Expert Medical Advisor?
Thomas Zaydon, M.D. has many years of experience serving as a Workers Compensation Plastic Surgeon Expert Medical Advisor. Read more about Dr. Zaydon’s role as a Workers Compensation Plastic Surgeon or Contact Dr. Zaydon’s office for more details.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.