All about External Medical Panels
External Medical Panels
The External Medical Panel is made up of independent specialists who consider your injury and provide us with
advice and recommendations based on all available information about your injury.
Who is on the panel?
The panel is a group of medical specialists. Each of them has many years of experience treating injuries like
yours. They understand how injuries and il nesses happen, what treatment and tests should be done and what
makes these injuries or illnesses recover best. These specialists work in hospitals and clinics where they see a
wide range of injuries in all age groups. By getting them together to talk about your injury, we get right to the
important questions and benefit from their discussion. A panel is a reliable and helpful way to answer
important questions and gain more understanding about your injury related problems without you having to
attend another assessment or examination.
Why do we use a panel?
The panel is looking at your injury by examining the medical information held on your file. This is because
either there are questions about your injury (diagnosis) or we need this specialised advice to help us work with
you to manage your injury and plan for better rehabilitation. For each type of injury, the specialists on the
panel will have different skills to bring with their knowledge and experience of that type of injury into the
group. This makes the discussion and the report useful.
The panel helps us to consider things like whether:
•
any changes to your treatment or rehabilitation are likely to help you
•
the injury is still preventing you from doing certain activities
•
we could organise more support or assistance for you
•
your current condition is still a result of the covered injury.
What the panel will do
The specialists on the panel will look at all the medical information about your injury. This includes information
that we give them from your claim file, such as hospital summaries, x-rays, physiotherapy reports and lab test
results. The panel wil then meet to talk about the information and what it means.
Have a look at the information that we’ve given to the panel. If you’d like them to look at any other
information, you can give it to your case manager immediately who will pass it on to the panel.
Updated 17 October 2016
All about External Medical Panels
The panel will then give us their expert advice for example: what your condition is (diagnosis), any more tests
or treatment that might be needed and suggestions on the right rehabilitation for your injury.
After the panel meets
The panel will provide a report based on their discussion and your case manager wil then send a copy to you
and one to your doctor.
This report will go on your file with all your other medical information.
Your case manager will contact you after you’ve received the report to answer any questions you might have
and discuss any possible options or decisions that come from having this new information.
You will also be offered the opportunity to discuss the report with your case manager, your general
practitioner and the panel facilitator if you wish.
What happens next
If new information from the panel could affect your injury claim or the support you need, we’ll discuss this
with you first. For example:
• if the report recommended changes to your rehabilitation, we wil discuss these with you and update your
rehabilitation plan together
• if you’ve recovered from your injury, we’ll discuss the need for ongoing support with you
•
if you’re still unable to undertake activities like work because of your injury, we’ll discuss this with you
and update your rehabilitation plan together
•
if the report and other information confirms your current condition is not caused by your injury, we
won’t be able to provide further support for that condition but we’ll help you to apply for other
assistance and ensure your future treatment provider has the Panel report with the recommendations.
What do I need to do?
Just keep in touch. It is important you understand what is going on and have regular talks with your case
manager.
Next, before the panel, check the information your case manager is sending to the panel and let us know
straight away if there is anything else you would like to send.
When you get the report, check your details: If you can see any mistakes in your personal details, please let us
know. It’s important to know we’re only able to make changes to the report if there’s a mistake in your
personal information. Because the panel’s opinion about your injury is a medical opinion, that part is not
something we can change. However, you are welcome to provide comments on the panel’s report and they
wil be attached to the report and read in conjunction. Please send these to your case manager.
Updated 17 October 2016
All about External Medical Panels
Lastly, make a time with your case manager to talk about the report and next time you see your doctor, bring
your copy to discuss. Your doctor is likely to find the report helpful too.
We’re happy to answer your questions
If you have any language or cultural needs, let us know so we can help. If you’d like to know more
about our services, please call your client service staff member directly or phone
0800 101 996. You
may also find the following information helpful.
For information about…
See the guide…
help we can provide
Getting help after an injury (ACC2399 booklet)
how we col ect and use your information
Col ection and disclosure of information (INPIS01 -
information sheet)
your rights to receive a high standard of service, and
Working together to resolve issues (ACC2393 booklet)
how we resolve any concerns you may have
Updated 17 October 2016
External Medical Panels
Key messages and FAQs for case owners
Scheduled panel dates for 2017
1.
What is an External Medical Panel?
External Medical Panels (EMP; panel) are a way for ACC to receive medical opinion in complex
cases where more direction is required for any onward treatment or rehabilitation.
2.
What types of cases are considered by a panel?
Cases which are complex where there might be conflicting diagnoses or different recommended
approaches, or where there are other medical conditions which are impacting or being impacted by
an injury.
3.
How is using an EMP different to seeing a medical assessor?
A medical assessor meets with the client and undertakes a medical assessment. The resulting
report provides findings and makes recommendations about onward treatment or rehabilitation.
An EMP is a group of specialists who are independent from the case. They review assessments and
other medical information available from the client’s file, discuss clinically complex issues related to
cases, answer questions and reach a consensus opinion as to the best onward treatment or
rehabilitation approaches.
The panel does not meet with the client.
4.
Is an External Medical Panel just a way for ACC to decline a claim?
The EMP is not a decision making panel. Its role is to discuss the complex medical issues related to
a case and recommend the best onward treatment and/or rehabilitation.
ACC will use this information along with other information to make a decision about the onward
management of the claim.
5.
Who’s on a panel?
Panels are made up of at least three specialists who have expertise in the medical field relevant to
the cases being put forward. Members have been endorsed by their professional body as being
experts in their field. They are independent with no conflict of interest in the client’s case.
Current panels are multidisciplinary usually involving the disciplines of orthopaedics, neurology, pain
management, occupational medicine, specialist general physician, psychiatry and radiology.
The panel is facilitated by a branch medical adviser who has had additional training in facilitation.
6.
What if some on the panel has been a treatment provider or has assessed the client?
The panel member discloses this fact and where appropriate declares a conflict of interest. Where
there is a conflict of interest, the panel member will not provide an opinion on the case.
7.
What if the panel members don’t agree?
Sometimes cases are so complex that the panel are not able to reach a consensus. When this
occurs, the facilitator asks the panel to find a point of agreement and then try to move forward from
that point. Where the panel can’t reach a consensus opinion, the report records this.
8.
Do I need to obtain client consent for a case to be referred to a panel?
Specific consent is not required but you do need to discuss with your client why a referral is being
made, their ability to review the file being sent to the panel and ask their own questions of the panel,
and how the panel report will be used.
9.
Do clients get a copy of the panel report?
Yes, and they’re able to participate in a case conference that may include their GP and the panel
facilitator if they wish.
10.
Can the client request a review of the External Medical Panel recommendation?
The panel provides external medical opinions and recommendations - they don’t make decisions.
If a client is unhappy with the recommendations in a report, they can discuss this with their ACC
case owner.
A client can review any decision made by ACC. They can also appeal a review decision.
11.
How much time will a client (and/or their doctor) have to prepare information for the panel if
they decide to submit something?
There is usually around a fortnight but it is dependent on when referrals are received for any
upcoming panels.
12. How much does a panel cost?
Panel members are paid the normal specialist rate for their time.
13. How can a panel member who is paid by ACC give an independent opinion?
Medical professionals take an oath when they qualify to practice medicine in accordance with
professional and ethical standards. Their opinion should have nothing to do with who’s paying them.
The group discussion encourages panel members to question assumptions and challenge each
other and this helps to make sure opinions are independent and have a strong reason behind them.
The panel discussion is focused on clinical information only, not legal issues.
14. Does the EMP process mean potential delays getting treatment or rehabilitation for clients
while they wait for panels to meet and report back?
Where a case owner needs to make changes that are urgent, the case should not be referred to an
EMP. The cases referred are complex where decision making is unlikely to be delayed by waiting on
a panel recommendation.
If you have an urgent case there could be a space for an extra case to be discussed at the next
panel. In the first instance call the EMP coordinator to discuss.
In all cases, the current rehabilitation plan should continue to be implemented while waiting for the
panel report.
15. What is the schedule for panel meetings in 2017?
• February 3
• March 3
• March 31
• May 5
• June 2
• June 30
• July 28
• August 25
• September 15
• October 13
• November 10
• December 15
Updated November 2016
Document Outline
