Court addresses workers’ comp physician conflict of interest — Business Management Daily: Free Reports on Human Resources, Employment Law, Office Management, Office Communication, Office Technology and Small Business Tax Business Management Daily

Court addresses workers’ comp physician conflict of interest

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In a case that could have complicated workers’ compensation cases in Colorado, the Court of Appeals of Colorado has decided to allow physicians to do limited work for insurance carriers while still performing independent medical examinations on employees whose employers are insured by the same carrier.

If the court had ruled the other way, employers and their carriers would have had to arrange independent medical exams with completely unaffiliated doctors.

The case involved a woman who was injured while working at the Cheyenne Mountain Zoo when she fell into a moat. Her doctor rated her disability at 65%, but the employer and its workers’ compensation insurer insisted on an independent medical examination.

That exam revealed less permanent impairment, and the insurer therefore paid less in workers’ comp benefits.

The woman appealed, arguing that the doctor had a conflict of interest because he was also on the insurer’s approved-provider list. The court rejected her claim, concluding that nothing in Colorado’s workers’ compensation law prevents a doctor from having a contractual relationship with an insurer while also conducting an unrelated independent medical examination on a patient who happens to work for a company also insured by the insurance company. The court said the relationship wasn’t close enough to constitute a conflict of interest.

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