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Workers' compensation and impartial medical examiners

Massachusetts workers who are injured on the job or suffer a workplace-related illness will want to pursue workers' compensation benefits. Not all cases are settled quickly and there might be a dispute as to whether the worker's application will be approved or not. It might be necessary to have an impartial medical examiner examine the worker. Knowing the law in relation to this situation is imperative so the worker is prepared.

When there is a dispute regarding the medical issues and an appeal of a conference, there will be an impartial medical examiner. There is a roster from which the medical examiner will be selected by the parties. The name will be submitted to the administrative law judge overseeing the case within 10 calendar days of the appeal. The judge can also appoint an independent medical examiner. The insurer or claimant who is filing the appeal will submit a fee that is equal to the average weekly wage in the commonwealth when the appeal is made so the cost will be defrayed. If there is more than one party filing an appeal, the cost will be shared. If the claimant wins, the fee will be refunded.

The examination will be done and a report will be filed at least one week before the hearing. The report will say: if there is a disability; if it is partial or total; and if there is a reasonable degree of medical certainty that it stems from the employment. The medical report will have the medical examiner's opinion as to whether the issue is permanent and if the final result of the impairment has been reached. If the worker does not report to the impartial medical examiner or all the necessary information is not provided, the benefits can be suspended. The report will be admitted into evidence in the hearing. The medical examiner can be deposed for cross-examination.

Workers who are injured or ill because of their work and are seeking workers' compensation must be aware of the possibility that an impartial medical examiner will be necessary for the decision on whether the application will be approved or not. This entire process can be complex and those who are seeking workers' compensation should have legal help. A lawyer experienced in workers' compensation is essential.

Source: malegislature.gov, "Section 11A," accessed on Dec. 11, 2017

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