MEMORANDUM NO. 2010-04

Commissioner’s Examination Procedure – Effective August 1, 2010

 


TO: Commissioners, District Administrators, Advisory Board, Legal Advisory Panel, Medical Advisory Panel, Medical Practitioners, Self-Insureds, Insurance Carriers, Attorneys, and Unions
FROM: John A. Mastropietro, Chairman
DATE: July 27, 2010
RE: Commissioner’s Examination Procedure – Effective August 1, 2010

 

Effective August 1, 2010, the following new procedure regarding Commissioner’s Examinations will be implemented by the Workers’ Compensation Commission.

This new procedure requires that medical information be provided to the Commissioners in a more timely and more orderly fashion, resulting in fewer delays in providing appropriate benefits to injured employees and a more efficient use of the Commission’s hearing time. Please take the time to familiarize yourself with the following new procedures. Please note also that parties not following the new procedure may be subject to sanctions by the Commissioner.

 

COMMISSIONER’S EXAMINATION PROCEDURE

  1. When the Commissioner orders a Commissioner’s Examination, the file will be given to the paralegal or other designated staff member. (The Commissioner should request the claimant’s telephone number to allow the designated staff member an opportunity to contact the claimant should scheduling complications arise.)
     
  2. The Commissioner will identify the individual party responsible for accumulating the medicals, putting them in chronological order, and forwarding them to the district office.
     
  3. The designated individual shall submit a complete medical packet to the paralegal or designated staff member within two weeks of the hearing or by a designated date. The completed medical packet shall include:
  • an index sheet listing each medical record;
     
  • medicals submitted in chronological order (oldest medicals on top of the packet);
     
  • no duplicates;
     
  • the name and address of the insurance company responsible for paying the bill; and
     
  • the adjuster’s name, telephone number and extension.
     
  1. Once the paralegal or designated staff member receives the medical packet, he/she will schedule the Commissioner’s Examination and the parties will be notified of the date and time of the examination.
     
  2. Note: the appointment will not be scheduled until the district office receives the medicals.
     
  3. The claimant is responsible for hand-carrying any x-rays, MRIs, CT scans, etc. to the appointment with the doctor. Please make sure the claimant requests the films in a timely manner as the physician may postpone the examination if the claimant arrives without them.
     
  4. If the claimant requires an interpreter, it is the responsibility of the claimant to bring a friend, relative, etc. to the medical appointment.
     
  5. A copy of the Order scheduling the Commissioner’s Examination will be forwarded to all parties.
     
  6. The district office will handle all communications with the physician regarding the Commissioner’s Examination.
     
  7. IF RECORDS ARE NOT RECEIVED IN THE DISTRICT OFFICE BY THE DATE DUE:
  • a hearing will be scheduled for the Friday in the calendar week following the deadline set for receipt of medical records;
     
  • BOTH PARTIES MUST APPEAR BEFORE THE COMMISSIONER AT THE HEARING; and
     
  • the Commissioner will determine if sanctions are warranted.