Physician Review of Workers' Compensation Case Files: Can It Affect Decision Outcomes?

Abstract

There is preliminary evidence that the opinion letters of Navy physicians influenced case decisions. Because of the selection bias in how the cases came to the study population, a prospective cohort study is warranted to establish whether this conclusion and the other results noted are valid.

Training Occupational and Environmental Medicine (OEM) Residents at the Uniformed Services University

“…Residency faculty provide didactic sessions on how to complete these case reviews and review the residents’ drafts of case reports before submission to human resources specialists. The reviews give residents an opportunity to apply principles of causation to real world cases 10 . Since December 2018, residents have completed 22 reviews that led to $2 million in cost avoidance.…”

“…The reviews give residents an opportunity to apply principles of causation to real world cases. 10 Since December 2018, residents have completed 22 reviews that led to $2 million in cost avoidance.…”

First-time decisions regarding work injury annuity due to occupational disease: a gender perspective

“…The Social Insurance Agency's claims examiners are often not familiar with the meaning of scientific studies and the gender bias in the scientific literature and, thus, are too dependent on the agency's medical advisor's (physician’s) assessment. A study by Hammett et al 20 found that physicians’ medical review of workers’ compensation claims had a strong impact on the final case decisions. A study by Lippel has shown that women’s claims were more likely to be denied if a medical assessor participated in the decision making 4.…”