Workers’ Compensation Case Review: Medical Experts who do a file review are not “examining physicians” and therefore do not have to simultaneously provide a report to the injured worker.

Aug 21, 2014 | WC & Other Laws

When Doctor Henry Roth performed a record review of Sally Luke’s case, he did not simultaneously send a copy of his report to her as is required of physicians who examine injured workers.  CRS §8-43-404(2).  The claimant sought to bar Dr. Roth’s report at hearing, and to impose penalties against Dr. Roth and/or the insurance carrier.

Administrative Law Judge (ALJ) Friend denied the penalty, holding that Dr. Roth was not an “examining physician.” The Industrial Claims Appeals Panel (ICAO) agreed:


“ §8-43-404(2)(a), C.R.S. is inapplicable here. That section provides that an “employee shall be entitled to receive from the examining physician . . . a copy of any report that the physician . . . makes to the employer, insurer, or division upon the examination, and the copy shall be furnished to the employee at the same time it is furnished to the employer, insurer, or division. The employee shall also be entitled to receive reports from any physician selected by the employer to treat the employee upon the same terms and conditions and at the same time the reports are furnished by the physician to the employer.” As found by the ALJ, Dr. Roth did not examine or treat the claimant but, instead, performed a records review. The claimant has failed to point to any evidence demonstrating that the contrary is true. As such, we will not disturb the ALJ’s denial of penalties as a result.”


As always, how this or any other case we discuss in this blog would apply to your case depends on many more factors.  We urge you to call us to see if you are entitled to workers’ compensation benefits.  Workers’ Compensation is difficult, confusing, and very complex.  Kaplan Morrell has helped thousands of injured workers since 1997 get the benefits they deserve.   Contact us here or call us at 303-780-7329 for your FREE CONSULTATION.


Cite:  Sally Luke v. Hospital Shared Services, WC No. 4-788-773 (January 30, 2014)