Are the Results of a “Commissioner’s Exam” Binding in a Connecticut Workers’ Compensation Case?
When seeking workers’ compensation benefits, the doctors hired by your employer may disagree with your own physician’s diagnosis regarding the cause of your injury or illness. If this disagreement persists into a formal hearing, the Connecticut Workers’ Compensation Commissioner can ask you to submit to a separate exam by an independent third doctor. This “Commissioner’s Exam” can help resolve the deadlock. But is the Commissioner legally required to accept the independent examiner’s views?
Review Board: Commissioner May Believe Testimony of Employee Over Examiner
The short answer is “no.” The Commissioner ultimately weighs all of the available medical evidence and decides which testimony is the most credible. In some cases, this means agreeing with the injured employee and their physician’s assessment.
A recent decision from the Compensation Review Board, which handles workers’ compensation appeals in Connecticut, provides a useful example of this principle. In this case, Smith v. Regalcare at Waterbury, LLC, an employee suffered a knee injury while working for the employer. Specifically, the employee was taking a break in the lobby of the employer’s offices. When she attempted to sit down on a couch in the lobby, she “felt and heard her right knee pop,” according to the Board’s decision.
The employee’s primary-care doctor later determined that she had suffered a torn meniscus in her right knee. Eventually, this injury required surgery. Both the primary-care physician and the surgeon who performed the operation agreed the meniscus tear was a work-related injury.
A physician retained by the employer disagreed. He initially said it was unclear whether the knee injury was work-related or the result of a preexisting condition. Later, the employer’s physician amended his findings to more conclusively state that the employee’s right knee problems “were developmental, preexisting, and unrelated to the work-related incident” in the lobby.
The Commissioner decided that an independent examination was necessary. The commissioner’s examiner ultimately said it was “likely [the employee] had a degenerative tear that was preexisting that became symptomatic for which attention was appropriately rendered.” In other words, the examiner believed the employee’s need for the knee surgery was not work-related.
Despite this finding, the Commissioner awarded workers’ compensation benefits to the employee. The Commissioner found the testimony of the employee and her treating physicians “credible and persuasive.” Conversely, the Commissioner did not find the independent examiner’s opinion persuasive.
On appeal to the Board, the employer argued the Commissioner must accept the views of her own examiner and reject the employee’s claim. But the Board said its own prior decisions allow the commissioner “to accept the opinion of a treating physician over that of a commissioner’s examiner.” It is the commissioner’s job to weigh the credibility of witnesses. And if the Commissioner decides “not to accept the opinion of a commissioner’s examiner they generally should proffer a reason why they found another expert more persuasive,” which she did in this case.
Speak with a Connecticut Workers’ Compensation Lawyer Today
Workers’ compensation disputes usually turn on the expert opinions of doctors. A board-certified Stratford workers’ compensation attorney can help ensure the Commissioner receives the strongest possible medical evidence in support of your claim. If you need representation in any workers’ compensation matter, contact the Morizio Law Firm today to schedule a free consultation.
Source:
wcc.state.ct.us/crb/2020/6316crb.htm
