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I had a worker’s compensation claim denied for a broken bone, and I’m going to have my condition sent to a California medical evaluator. Does it matter who sees me?


Yes! Under the current workers' comp system, the Department of Industrial Relations (DIR) will tell you that your injury must be evaluated by an orthopedic doctor. You will be sent a list of doctors to choose from, and you must pick one. In most cases, these doctors live all over the state and visit towns in order to participate in panels. Orthopedic injuries such as broken bones account for roughly half of all California workers' comp claims, so most of the evaluations are done by the same group of conservative physicians.

Many of the doctors on orthopedic panels do not care about the cases they evaluate. They are paid per decision, so they logically try to turn over cases as quickly as possible and move on to the next one. Some do not even apply the AMA disability guidelines correctly or will not use the proper instruments to evaluate impairment. Worst of all, once the decision has been submitted, it cannot be appealed.

Since your workers' compensation decision relies heavily on the outcome of your evaluation, you should choose your evaluator very carefully. An attorney can help you vet your doctors to decide which one has the most experience in your type of injury. He can also help you bypass the medical panel altogether and get an Agreed Medical Evaluator to assess your condition, giving you a much better chance of a favorable decision.

Want more helpful hints on dealing with the workers' comp system? The Ledgerwood Law Group has covered the most popular topics and problems from our clients into one book, The Northern California Workers’ Compensation Survival Manual. Click the link on this page for your FREE copy.