The letter usually arrives after your case has been sent to a judge. It names a doctor you have never met, gives a date and an address, and says little else. If you are already in pain, already short of money, and already tired of appointments, this feels like one more thing being done to you. It is worth understanding what it is, because this particular examination carries more weight than most.

What is an impartial examination?

When an injured worker and an insurer disagree about a medical question, the Massachusetts workers’ compensation system does not simply let each side bring its own doctor and leave the judge to guess. Under Massachusetts General Laws Chapter 152, Section 11A, the Department of Industrial Accidents appoints an independent physician to examine the worker and report to the judge on the medical issues in dispute.

The disputed question is usually one of these:

  • Is there still a disability, and is it total or partial?
  • Is the disability caused by the work injury?
  • Has the condition reached a medical end point?
  • Is the treatment being requested reasonable and related to the injury?

The impartial physician is not treating you. They are not going to prescribe anything, order physical therapy, or take over your care. Their job is to examine you once, read the records, and write a report answering the medical questions the judge has put in front of them.

Who chose this doctor, and why not mine?

Neither you nor the insurer chose the physician. The DIA maintains a roster of doctors who have been approved to serve as impartial examiners, and the appointment is made from that roster based on specialty and geography. Your own treating doctor cannot serve as the impartial examiner in your case, and neither can any doctor who has examined you for the insurer.

That is the point of the arrangement. Your treating physician knows you best, and their opinion still matters and still goes into the record. But because they are your doctor, the insurer will argue they are on your side. The insurer’s examiner has the mirror-image problem. The impartial examiner is meant to be the one medical voice in the case with no prior relationship to either party.

Dr. Ackland is a certified expert examiner for the Massachusetts Department of Industrial Accidents, which means he performs these examinations when appointed. We explain that role on the DIA impartial examinations page. It is a different thing from an insurer-arranged independent medical examination, and different again from treatment, which we cover under workers’ compensation care.

Do I have to go?

In practical terms, yes. Attendance at the impartial examination is part of the process once it has been ordered, and failing to appear can affect your case. If you genuinely cannot attend, because of a hospital admission, a transport problem, or a scheduling conflict you cannot move, contact your attorney or the DIA well before the date rather than simply not showing up. Rescheduling is a procedural matter and there are rules about it, so do not rely on an informal arrangement.

If you do not have a lawyer, you can still call the DIA to ask about the process. The Department publishes contact information and guidance on mass.gov.

What actually happens at the appointment

Expect it to feel like a medical appointment that stops short of treatment.

Checking in. Bring photo identification. You may be asked to confirm your name, date of birth, the date of your injury, and your employer. There may be a short form.

History. The examiner will ask you to describe how the injury happened, in your own words. Then what your symptoms are now, what makes them worse, what you can and cannot do at home and at work, what treatment you have had, and what medication you take. Answer plainly. Do not exaggerate and do not minimize. If you have a good day and a bad day, say that, and describe both.

Physical examination. This depends on the body part and the questions asked. It commonly involves measuring how far a joint moves, testing strength, checking sensation and reflexes, and specific tests for the structure in question. You may be asked to change into a gown or to expose the injured area. Tell the examiner if something hurts. Stopping a movement because it genuinely hurts is information, not failure.

Records and imaging. The examiner will have been sent a set of medical records by the parties, called the statutory package. They may review your imaging reports or the images themselves.

Most examinations take somewhere between twenty minutes and an hour. It is normal for the history to take longer than the physical part. The examiner will not usually tell you their conclusions in the room, and it is not a sign that things went badly if they do not.

What to bring

  • Photo ID and your claim or board number if you have it.
  • A written list of your current medications and doses.
  • A short written timeline: date of injury, what happened, surgeries and dates, courses of therapy.
  • Any imaging discs or reports you hold yourself.
  • Your brace, cane, sling, or splint if you use one. Use it as you normally would.
  • An interpreter if you need one. Arrange this in advance through your attorney or the DIA rather than bringing a family member and hoping.

What not to bring: an argument. The examiner is not the person deciding your benefits and is not the insurer. Being straightforward with them is more useful than being defensive.

What happens to the report

The examiner writes a report addressed to the judge and files it with the DIA. It goes to both sides. You are entitled to see it, usually through your attorney.

Under Section 11A the impartial report carries particular weight, and it is generally the only medical evidence before the judge unless the judge allows additional medical evidence. That is why the appointment matters more than a routine visit. Either party can ask the judge to allow more medical evidence, and judges do grant that in some circumstances, for example where the report is inadequate or the medical issues are complex. There is also a process for asking the examiner questions in writing or by deposition. These are legal steps, and how they play out varies case by case.

The report is a medical opinion, not a decision. The judge decides your case, weighing the report along with everything else in the record: wage evidence, testimony, vocational factors. A report that is not what you hoped for is not the end of a claim.

What to do next

Put the date in your phone with the address and travel time. Write your timeline out before you go, because it is hard to remember dates while a stranger is asking you questions. Keep going to your own treating appointments in the meantime, because gaps in treatment become an argument later. If you have an attorney, tell them the appointment is scheduled and ask whether anything specific is in dispute. If you do not have one, the DIA can explain the procedure to you.

For a wider view of where this step sits in the process, see how workers’ compensation works in Massachusetts. If you are a patient of this practice and have questions about your own treatment, you can reach us through the contact page.

This article is general information about how the Massachusetts workers’ compensation system works. It is not legal advice and it is not medical advice about your condition or your treatment.

Common questions

Can I bring someone with me to the impartial examination?

Policies vary by examiner and by office. Someone can usually accompany you to the building and the waiting area. Whether they can be in the examination room is up to the examiner and the rules that apply. If you need an interpreter, arrange that in advance through your attorney or the Department of Industrial Accidents rather than relying on a relative to translate.

Will the impartial examiner give me treatment or a prescription?

No. The examiner's role is to examine you and report to the judge on the disputed medical questions. They are not taking over your care and will not prescribe medication, order therapy or schedule surgery. Keep seeing your own treating doctor.

Do I get a copy of the report?

The report is filed with the Department of Industrial Accidents and provided to both parties. If you have an attorney, it will normally come to you through them. If you are unrepresented, ask the DIA how to obtain your copy.

What if I disagree with what the report says?

You cannot change the report, but you are not stuck with it as the last word. Either side can ask the judge for permission to submit additional medical evidence, and there are procedures for questioning the examiner. Whether a judge allows this depends on the case, so discuss it with an attorney.

Is the impartial examiner working for the insurance company?

No. The examiner is appointed from a Department of Industrial Accidents roster, not chosen by the insurer or by you. A doctor who has already examined you for the insurer cannot serve as the impartial examiner in your case.

References