"One Time Change of Physician", "Expert Medical Advisors", and "Major Contributing Cause"
When the claimant's treating physician opines that the claimant's industrial accident is no longer the "major contributing cause" of her ongoing medical problems, is the claimant entitled to a "one-time-change-of-physician" in order to obtain a contrary medical opinion? Yes, said the First DCA in Dawson v. Clerk of the Circuit Court - Hillsborough County, reversing the JCC who had concluded that in such circumstances the claimant's only recourse is to request an "independent medical examination."
In the same case, at the E/C's request the JCC had appointed an "expert medical advisor" to resolve a conflict between two physicians on the issue of whether the claimant's industrial accident was the "major contributing cause" of her shoulder injuries. [Section 440.13(9) authorizes the appointment of an expert medical advisor ("EMA") when there is conflict in the medical testimony]. The EMA had concluded that the claimant's shoulder injuries were not caused by her accident, and accordingly the JCC denied any treatment for those problems. But the First DCA reversed, holding that an EMA should never have been appointed in the first place because in fact there was never any "conflict" in the medical testimony. The court noted that the physician who gave the allegedly conflicting opinion on the issue of causation (1) had not been authorized by the carrier to treat the shoulder, (2) never examined the claimant's shoulder, and (3) did not review any diagnostic studies or or medical records pertaining to the claimant's shoulder. Under these circumstances, there was insufficient evidence of a "conflict" on the issue of causation.
