The Workers’ Compensation Appeals Board (WCAB) issued a 15-day notice of the proposed amendments to its Rules of Practice and Procedure, including regulations of the Physicians’ Report as Evidence (Regs) on July 9, 2013; you have until July 25, 2013 to submit comments to the WCAB.
What does this mean to your Med-Legal Practice?
Get ready to revise your reports, to ensure that your opinion will be considered in weighing the evidence. For example, a new proposed change under future medial includes “treatment indicated, including past, continuing, and future medical care.”
As well, there are some minor proposed changes including “listing of all information from the parties reviewed in preparation of the report or relied upon for the formulation of the physician’s opinion.” To ensure your compliance, make sure you reference ALL information relied upon to render your opinion.
Also, remember the new DWC AD 10133.36? This mandates AME, QME and PTP to include functional measurements in all Med-Legal reports once permanent disability is determined. A simple statement can ensure your compliance. For example, “I reviewed the functional capacity measurements mandated by DWC AD 10133.36, and incorporated the findings to render my opinion”
As you should be aware and as I alluded to in my example above, the DWC mandated functional measurements and testing for all PTP, QME & AME reports to ensure a safe return to work. If you are not incorporating our DWC Approved services into your Med-Legal reports, contact us immediately.
PROPOSED REGULATION CHANGES TO MEDICAL REPORTS
§ 10606. Physicians’ Reports as Evidence.
(a) The Workers’ Compensation Appeals Board favors the production of medical evidence in the form of written reports. Direct examination of a medical witness will not be received at a trial except upon a showing of good cause. A continuance may be granted for rebuttal medical testimony subject to Labor Code Section 5502.5.
(b) Medical reports should include where applicable:
(a)(1) the date of the examination;
(b)(2) the history of the injury;
(c)(3) the patient’s complaints;
(d)(4) a listing of all information received from the parties reviewed in preparation of the report or relied upon for the formulation of the physician’s opinion;
(e)(5) the patient’s medical history, including injuries and conditions, and residuals thereof, if any;
(f)(6) findings on examination;
(g)(7) a diagnosis;
(h)(8) opinion as to the nature, extent, and duration of disability and work limitations, if any;
(i)(9) cause of the disability;
(j)(10) treatment indicated, including past, continuing, and future medical care;
(k)(11) opinion as to whether or not permanent disability has resulted from the injury and whether or not it is stationary. If stationary, a description of the disability with a complete evaluation;
(l)(12) apportionment of disability, if any;
(m)(13) a determination of the percent of the total causation resulting from actual events of employment, if the injury is alleged to be a psychiatric injury;
(n)(14) the reasons for the opinion; and,
(o)(15) the signature of the physician.
Failure to comply with (a) through (o) will be considered in weighing the evidence.
In death cases, the reports of non-examining physicians may be admitted into evidence in lieu of oral testimony.
(c) All medical-legal reports shall comply with the provisions of Labor Code Section 4628. Except as otherwise provided by the Labor Code, including Labor Code Sections 4628 and 5703, and the rules of practice and procedure of the Appeals Board, failure to comply with the requirements of this section will not make the report inadmissible but will be considered in weighing the evidence.
ABOUT Medical Legal Experts
Medical Legal Experts is a group of Qualified Medical Evaluators (QME), Agreed Medical Evaluators (AME) and Medical-Legal Experts here to give you a fair and ethical examination and functional capacity evaluation (FCE) with a disability rating. To schedule an appointment contact us at your convenience. Medical Legal Experts proudly serves California and is approved as a continuing education provider for the California Division of Workers’ Compensation (DWC) for Qualified Medical Evaluators (QME), the California Board of Chiropractic Examiners, the U.S. Federation of Chiropractic Examiners and Canadian Memorial Chiropractic College.