Links to industry are grounds for disqualification of "independent" medical examiner in workers' comp case

Law Reporter, Dec 2001

EVIDENCE

Laskey v. S.D. Warren Co., 774 A.2d 358 (Me. 2001).

The Maine Supreme Judicial Court held that a workers' comp hearing officer acted correctly in disqualifying an "independent" medical examiner (IME) who had done consuiting work for employers and the insurance industry.

Here, a state workers' compensation board was considering a case involving an injured employee. A hearing officer of the board disqualified an IME who had examined the employee, stating that the examiner had a conflict of interest due to his work as a consultant for employers, insurance carriers, and industry groups. The employer appealed this decision, contending that the relevant rule promulgated by the board permits disqualification based on an IME's relationship with the specific employer or employee in a case, but not based on connections to the insurance industry as a whole.

Affirming, the state high court pointed out that the rule requires IMEs to disclose relationships with "industry, insurance companies, and labor groups." The next sentence says a conflict of interest may arise when a physician "receives something of value from one of these groups," and another provision states that a conflict may exist if the physician is merely an employee of an organization that has sufficient contact with these groups. Given the IME's failure to disclose his extensive consulting work for both employers and insurance companies, the court said that the hearing officer's disqualification decision could not be deemed clearly erroneous.

The employer also argued that the hearing officer usurped the authority of the workers' compensation board in determining whether the physician should be disqualified, and that the rule permitting this action was not authorized by statute. But the court noted that the board is permitted by law to delegate such decisions to its employees and in fact is granted the power to "adopt any rules considered necessary to effectuate" the workers' comp law. The disqualification rule, which promotes the important objectives of preserving the independence and integrity of IMEs, is within the parameters of this broad grant of authority, the court concluded.

Plaintiff's Counsel

*James J. MacAdam, South Portland, Me.