Physician Review of Workers' Compensation Case Files: Can It Affect Decision Outcomes?

Abstract

To identify common attributes of Federal workers' compensation cases referred to Navy physicians for medical opinions and to determine the impact of the review on the final case decision. Retrospective case study and descriptive analysis of 258 opinion letters written by physicians on referred cases from 2006 to 2010. Navy physician opinions were considered in the outcome in some of the cases, and there was a statistically significant difference between the claim acceptance rate in the study population and the total population. Worker age was correlated with certain claim types. There is preliminary evidence that the opinion letters of Navy physicians influenced case decisions. Because of the selection bias in how the cases came to the study population, a prospective cohort study is warranted to establish whether this conclusion and the other results noted are valid.