An Expert Medical Advisor (“EMA”) may sometimes be required in a Workers Compensation claim. An EMA is generally required when there is a dispute between the opinions of physicians that are treating an injured worker. An EMA reviews the facts of the case and then offers his or her opinion and testimony regarding the injuries. According to Florida Statutes Section 440.13(9)(a), the role of an Expert Medical Advisor is to “assist the Judge of Compensation claims within the advisor’s area of expertise.”
A situation in which an EMA is usually required is if the opinions of the authorized physicians treating an injured worker differ. For example, one physician may opine that the cause of the employee’s symptoms are from the work accident, while another physician may opine that that causation is from a prior car accident. In this case, there is an obvious dispute between the physicians. An EMA would be required in order to break the tie between the differences of opinion. If the EMA believes the injuries were caused by the prior car accident, then the injured worker would not be entitled to any ongoing Workers Compensation benefits. However, if the EMA agrees with the physician that opined that the work accident is the major contributing cause of the injured worker’s symptoms, the Employer/Carrier would then be Ordered by the Judge to provide ongoing care through the Workers Compensation system.
If either the injured employee or the Employer/Carrier do not agree with the opinion of an authorized physician, either party is permitted to pay for an Independent Medical Examiner (“IME”). An IME is a physician that evaluates an injured worker and gives his or her opinion regarding the employee’s injuries. An IME’s opinion is given the same weight as that of an authorized physician. Thus, if there is a dispute between the opinion of an authorized physician and an IME, then an EMA would once again be required in order to resolve the dispute.
In order for an EMA to be appointed, a Notice of Conflict would need to be filed with the Office of the Judge of Compensation Claims. Once a Notice of Conflict is filed, the Judge is required to appoint an EMA. Pursuant to Florida Statutes Section 440.13(9)(c), the “Judge of Compensation Claims shall, upon on his or her own motion, order the injured employee to be evaluated by an Expert Medical Advisor.”
Therefore, if there is a situation in a claim where there is a dispute between the opinions of the treating physicians or if an injured worker does not agree with the opinion of an authorized physician, options do exist to dispute the opinion which will likely lead to the appointment of an EMA. That is why it is important to hire a Workers Compensation attorney who handles these types of situations. If you were injured on the job or know of someone who was, have them give us a call at (844) 762-8155.