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Case name: Dutton v. Workforce Safety & Insurance, No. 20090177 (N.D. 06/10/10).

Ruling: The North Dakota Supreme Court held that a doctor who evaluated an employee and later worked for the insurer paying the claims could not have an unbiased opinion of the employee's condition. Therefore, the employee was entitled to a further evaluation.

Summary: An employee suffered two work-related injuries and filed claims for workers' compensation benefits that were accepted by the insurer. The employee continued to suffer problems and underwent evaluations to determine whether she was entitled to permanent partial disability benefits. A doctor evaluated her back and wrist. The employee was awarded benefits for a 53 percent whole body impairment and denied additional benefits. Later, the doctor was hired by the insurer, and the employee requested a further evaluation and impairment rating for her chronic pain. The doctor was asked whether he had conducted an informal pain assessment on the employee because the insurer wanted a further opinion. The doctor opined that the employee was not entitled to a further evaluation and impairment rating for her chronic pain because he had previously considered it. The employee claimed that the doctor's testimony was not credible because he was employed by the insurer. The North Dakota Supreme Court concluded that the evaluation was not conducted by an independent, unbiased doctor so the employee was entitled to a further evaluation.

The employee challenged the reliance on the doctor's opinion and contended that the doctor was not an independent and unbiased evaluator qualified to give an opinion on her right to further impairment based on her chronic pain. The court explained that under North Dakota law, a physician conducting a pain evaluation must provide an "independent unbiased assessment."

Read more at the WorkersComp Forum homepage.

September 7, 2010

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