Code of Massachusetts Regulations
452 CMR - DEPARTMENT OF INDUSTRIAL ACCIDENTS
Title 452 CMR 1.00 - Adjudicatory Rules of the Industrial Accident Board
Section 1.14 - Impartial Physicians

Universal Citation: 452 MA Code of Regs 452.1

Current through Register 1531, September 27, 2024

(1) If within ten calendar days of filing the appeal the parties have not selected, or an administrative judge has not appointed, a physician from the impartial physician roster to examine the employee, the impartial unit shall choose a physician as directed by the Senior Judge.

(2) Once the impartial physician has been selected or appointed, the administrative judge shall submit to the impartial unit all approved medical records, any hypothetical fact patterns and any stipulations of fact for transmission to the impartial physician. No party or representative may initiate direct, ex parte communication with the impartial physician and shall not submit any form of documentation to the impartial physician without the express consent of the administrative judge.

(a) The impartial physician may not communicate with the parties unless authorized to do so by the administrative judge, except that a party who wishes to engage the impartial physician to be deposed for the purposes of cross examination may contact the physician or his office for the purpose of scheduling a deposition.

(b) The impartial physician may contact the impartial scheduling unit to request medical records and reports from providers who have treated the employee prior to the date of the selection or appointment of the impartial physician. Providers of diagnostic services and testing shall send these records directly to the impartial physician upon request of the impartial physician or of the impartial unit. The administrative judge shall give all parties the opportunity to review the additional medical records, and rule on any objection raised by the parties to submission of the additional records to the impartial physician.

(c) Except by leave of the administrative judge, hypothetical questions to the impartial physician must be submitted to the administrative judge within 14 days of the appeal of the conference order.

(3) The filing fee paid pursuant to M.G.L. c. § 11A(2) to defray the cost of an impartial examination is $650.00, with further provision when required for a $150.00 cancellation or missed appointment fee, and a $200.00 supplemental report fee. The fee for deposition of an impartial physician is $750.00 for up to two hours, and $150.00 for each hour thereafter. The fee for a review of the records and report, without examination is $300.00. Any appeal of a conference order will be rejected if a fee in the aforesaid amount is not filed with the Department within ten days of the filing of the party's appeal.

(4) An impartial physician may request increased impartial fees. The request for increased fees shall be allowed if agreed to by the parties, or the administrative judge may order increased fees where extraordinary time and effort is required based on the complexity of medical issues, voluminous medical record submissions or other justification warranting additional compensation.

(5) Filing fees posted on behalf of an indigent claimant by the Department to defray the cost of an impartial examination under M.G.L. c. 152, § 11 A(2) shall be reimbursed to the Department by the insurer if the claimant prevails at the hearing.

(6) The filing fee paid pursuant to M.G.L. c. 152, § 11A(2) shall be reimbursed by the Department to each appellant if the parties have agreed pursuant to 452 CMR 1.1 l(l)(c) that an impartial physician is not required or the matter is resolved by the parties prior to the scheduled impartial examination. Any fee required to be paid to an impartial physician for cancellation of a scheduled impartial examination shall be deducted equally from each appellant's reimbursed filing fee.

(7) A party requesting the appointment of an impartial physician by the senior judge under the provisions of M.G.L. c. 152, §8(4) shall be responsible for payment to the impartial physician for the procurement of a report in an amount consistent with criteria developed by the health care services board pursuant to M.G.L. c. 152, §13.

(8) Any payment made by a party to an impartial physician appointed by the senior judge under the provisions of the second paragraph of M.G.L. c. 152, § 8(4) shall be reimbursed by the insurer if the report determines that the particular course of medical treatment claimed was appropriate.

(9) Parties precluded by 452 CMR 1.00 from procuring the appointment of an impartial medical examiner under M.G.L. c. 152, § 11A(2) may, by agreement, petition the administrative judge having jurisdiction over the case for the appointment of a impartial physician. If the petition is granted, said impartial physician shall be paid an amount consistent with M.G.L. c. 152, § 11 A(3) by, or amongst, any of the requesting parties.

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