A medical-legal (or med/legal) examination is an evaluation of an injured worker wherein the doctor completes a comprehensive report outlining an injured workers’ eligibility for benefits and/or evaluating an injured workers’ disability. Generally, a medical-legal examination is requested when there is an issue that must be resolved, such as compensability of the injury, future medical treatment, permanent disability, permanent and stationary status, permanent work restrictions, etc.
The medical-legal examiner is provided with a copy of the injured workers’ medical records and background facts of the case and is asked to comment upon multiple areas such as whether the injured workers’ condition has reached a permanent and stationary status (meaning the condition has plateaued and has not become worse or is not getting better), any periods of temporary disability, future medical care, apportionment (percentage of disability attributable to other injuries/medical conditions which can be nonindustrial or industrial), and permanent work restrictions.
A medical-legal examination can be completed by an agreed medical examiner, a panel qualified medical examiner, or an independent examiner. An agreed medical examiner is an evaluator who is agreed upon between the parties; the applicant’s attorney and the defense attorney/insurance company. A panel qualified medical examiner is obtained through a request made to the Medical Unit. This type of exam is requested when the parties are unable to reach an agreement on an examiner. The last type, an independent medical examination will generally be ordered by a workers’ compensation judge. This may occur when the parties have already gone through the medical-legal process and some questions have arisen that the judge needs an independent examiner to address and the previous examiner is unable to address or may no longer be available to address the issues.
There are times when a medical-legal examination is not necessary. If the parties are able to agree upon the treating physician’s findings (opinions) then a medical-legal examination will not be necessary.
If you have questions about your workers' compensation case and want to talk to an attorney in Fresno, call 559-408-7436 or fill out the form to the right.
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