Disabled Workers Advocates, a Support Claim Services company, has been providing the best-in-class medical experts to our valued clients since 1991.
Our administrative team is trained and educated to manage the entire work process for your cases.
This includes selecting the proper medical expert, case convening, record management, legal coordination and a timely report that addresses the issues.
Qualified Medical Evaluations (QME)
A Qualified Medical Evaluator (QME) is a physician who is certified by the Division of Workers’ Compensation (DWC) Medical Unit to examine and evaluate an “applicant’s” disability and write medical-legal opinions. An applicant is the party that opens a case at the local Workers’ Compensation Appeals Board by filling out an application for adjudication of claim after they suffer a work-related injury.
The purpose of the QME is to provide a neutral evaluation of an applicant’s injury and help resolve any dispute between the applicant and the Workers’ Compensation insurance carrier over whether an applicant should receive benefits.
Agreed Medical Evaluations (AME)
An Agreed Medical Evaluator (AME) is when both parties ‘agree’ on a physician to perform an Independent Medical Evaluation. If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the California state system used to pick a Qualified Medical Evaluator (QME). The doctor your attorney and the claims administrator agree on is called an Agreed Medical Evaluator (AME).
Subsequent Injury Benefit Trust Fund (SIBTF)
Patients may qualify for the additional disability benefits provided by SIBTF regardless of the origination of their labor-disabling condition. This includes congenital disease, prior industrial injury, a slip and fall, and more.
Also known as the Subsequent Injuries Fund, SIBTF is meant to provide disability payments in the event of workplace injuries that cause permanent disability in addition to pre-existing disabilities. This limits liability on the part of the employer and allows the injured employee to access additional compensation."
Fit for Duty
Fitness-for-duty evaluations are important in the assessment of functional capacity and in the determination of an appropriate fit between the examinee’s capacities and the essential functions of the job without compromising their health and safety.
These evaluations can also be used to see what accommodations employees with disabilities, injuries, or illnesses need to continue working.
Personal Injury Independent Medical Exams
DWA offers professional IMEs throughout the United States for the claims community. Doctors are fully accredited, board-certified medical professionals. DWA assists our clients with meeting jurisdictional concerns and all state requirements. DWA prides itself on a quick turn-around time by utilizing its advanced technological system
DWA’s experienced claim litigation staff communicate directly with claimants’ attorneys. Correspondence is done so through certified mail. Physicians on our panel understand that they may have to testify in court. Post-exam reports are reviewed by a team of experienced claim examiners to ensure all questions are addressed and answered.
A Medical Expert-Witness is a physician with extensive experience or knowledge in a specific medical discipline. In many cases, the attorney will want the medical expert to be board certified, active practice and still performing surgeries. The expert witness's duty is to apply their expertise to give a professional opinion to the tribunal or court on particular matters in dispute.
Medical Record Reviews (MRR) are performed by board-certified doctors to provide an expert opinion in their specialty regarding the appropriateness of care, medical requirements, and other issues. The MRR report will address present-day view, retrospective, and associated issues.
Physicians analyze the claimant’s medical records to determine whether accepted standards of care are met, to determine the root cause of the patient’s symptoms and treatment, and to render impartial opinions. All peer reports submitted by our physicians are scrutinized by the company’s qualified peer team for client's protocol, medical necessity, and/or causal relationship. Each peer review is based on the medical records provided as well as the treatment and diagnostic history.
Bill reviews address provider charges, including physician, dentist, therapist, chiropractic, surgical, laboratory, radiology, hospital, In-Patient DRG's, Out-Patient Hospital, pharmaceutical and supplies against state-imposed No-Fault or Workers' Compensation fee schedules or Usual and Customary reimbursement levels. DWAs software maintains a detailed history for each claimant’s bills, which guards against duplicate billing and addresses situations involving the provision of the same or similar treatment modalities from several different providers. Results include a clear, easy-to-read Explanation of the Review.
DWA provides full-service litigation support. The company utilizes proprietary testimonial software and offers proof of delivery and verification of appointment dates with full physician support. DWA has an in-house quality assurance team, experienced claim adjusters as well as an on-site registered nurse.
Functional Capacity Evaluations
DWA utilizes state-of-the-art facilities to schedule functional capacity evaluations in order to determine the ability of the evaluated to function in a variety of circumstances. Reports are received in a timely manner, which are then reviewed and forwarded to clients as soon as completed.
DWA obtains required authorizations and bill of particulars (BOP) and contacts the radiological facility to obtain pricing, pay the fees (certified mail/return receipt) and follow up for receipt. We arrange pick-up of films from the MRI facility or hospitals and delivers them to the reviewing radiologist. The radiologist prepares an original report and forwards it via ECF to the Quality Assurance Unit.
- Workers’ Compensation
- Civil Litigation
- General Liability
- Expert Witness
- No-Fault Auto
- Fit for Duty
- Case Opportunity throughout the US
- CME Unit
- Report Writing
- Deposition & Trial Preparation
- Peer to Peer Mentoring
- Strategic Exam Locations
- Scheduling Evaluation & Depositions
- Report Quality Assurance
- Transcription & Dictation
- Prompt Payment Options
- Record Management
- QME Education
- Marketing & Industry Conferences
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