“Impartial” Examinations

People get hurt on the job every day. Under M.G.L. c. 152, an injured employee generally only has one remedy against their employer – to file for workers compensation benefits. There is no “pain and suffering” claim like we see in a car accident or slip and fall accidents. The remedy that the employee has is a percentage of their lost wages and potentially compensation for scarring, amputation, or general disfigurement.

After a workplace accident, in most cases, the employer conducts an investigation and then pays the employee for the time they missed or for disfigurement they suffered. This does not require the employee to file a claim with the Department of Industrial Accidents (the “DIA”).

However, in cases where the employer claims there was no workplace injury or that the injuries are not consistent with the accident that occurred, the employer will deny the claim and the employee only has one option. The employee’s lawyer will have to file a claim at the Department of Industrial Accidents.

Like we discussed on other pages, the stages to a workers compensation claim are (1) filing, (2) conciliation, (3) conference, and (4) hearing. Here, we are focused on the “Impartial Examiner” which occurs sometime between the conference and hearing.

When your lawyer files a claim at the DIA, your lawyers and the insurance company’s lawyers will likely disagree about your medical condition. You’re injured and can’t work, and your doctor agrees. The insurance company thinks you’re fine, and they hire a doctor that agrees with them. When doctors are saying different things, the DIA judge needs help to determine which doctor is right.

The Impartial Examiner is hired by the DIA judge and they are there to give an unbiased or untainted medical opinion of the employee’s injuries. These are usually doctors and specialists who are established in their respective fields. For instance, if the employee has a shoulder injury the Impartial Examiner will usually be an orthopaedic surgeon or if the employee has a foot injury the examiner may be a podiatrist.

If one of the parties appeals the judge’s decision at conference, the employee will be seen by the expert Impartial Doctor before the hearing. When the employee arrives, the examiner will likely have them fill out a sheet regarding their medical history and current condition.

Before the visit, the examiner will have been given everything that the lawyers submitted at the conference. This includes any medical records the employee’s attorney and the insurance company’s attorney have deemed relevant to the workers compensation claim.

The Impartial Examiner will then ask the employee a series of questions and may perform some tests on them. The questions will include how the accident happened, treatment to date, and other pertinent medical history. The tests might include range of motion or a neurological exam, which will depend on what kind of injury you have.

After the examination, the doctor will issue a report. It will make determinations on a number of items, including:

• Whether your injury was caused by the workplace accident,
• How long the employee was totally or partially disabled,
• Extent of disfigurement,
• The employee’s prognosis;
• Recommendations for more treatment.

The report will be submitted to the DIA and to both the employee’s and the insurance company’s attorneys. At hearing, the Impartial Examiner’s is presumed to be correct. However, sometimes the report does not address everything necessary, so there are ways to include more medical records into evidence, or even require the doctor to testify under oath.

That is why it is crucial to have a Lowell Workers Compensation Lawyer with you at the examination. If the Impartial Examiner’s report is not favorable to the employee’s case, you need a seasoned workers compensation attorney to be able to explain away the report or combat it with their own expert witness.

At Marcotte Law Firm, our Lowell Workers Compensation Attorneys have decades of experience representing hundreds of injured workers. Marcotte Law Firm has these seasoned attorneys waiting for your call. Call us today for a free consultation, (978) 458-1229.