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The Claimant May Be Required
To Release Medical Records As Part Of IME
The claimant duty to cooperate with an independent medical evaluation (IME), pursuant to §314 of the Act, includes a requirement that claimant provide a release of her/his relevant medical records. Cooperation requires more than mere attendance at the appointed time and place. Prior appellate decisions interpret the term "physical examination" to include all reasonable medical procedures and tests necessary to permit a provider to determine the extent of a claimant’s disability. This includes non-evasive diagnostic testing such as an MRI or bone scan. In this case, the matter was remanded for a determination of whether the claimant’s psychiatric treatment records were relevant to the physical injuries with psychological components. See: Central Dauphin School District v. WCAB (Siler), No. 612 C.D. 2006 (Pa. Cmwlth. 10-17-06).
In the earlier claim petition litigation, the workers’ compensation judge found that claimant suffered work-related musculoskeletal injuries, neurological pathologies, and myalgias. He also found that claimant takes medications for attention deficit, depression, fibromyalgia, and seizures. "Her symptoms are not purely psychological, but have psychological components." In this context, employer scheduled an IME by an neurosurgeon and a second IME by a psychiatrist. The claimant attended the examinations. In the course of psychiatric examination, claimant disclosed she was previously treated for psychiatric problems. The IME physician stated that she would be unable to render an opinion without reviewing these prior records. The employer requested the release of the records, but the claimant refused. Employer filed a petition to compel physical examination requesting release of the medical records. The workers’ compensation judge denied this request, asserting the employer "should have sought" the records while the claim petition was being litigated.
On appeal, the Commonwealth Court agreed that §314 of the Act requires cooperation by the claimant and cooperation requires more than mere attendance. In Coleman, the Supreme Court concluded that a physical examination includes all reasonable and medical procedures, including non-invasive diagnostic testing. Here the Court reasoned if a claimant can be compelled to undergo additional diagnostic testing as part of a "physical examination," then the claimant surely must be required to release medical records and test results that preceded the §314 examination. This is particularly true where a medical opinion by an examining physician, who has not reviewed the claimant’s medical history and records, can be considered a legally incompetent opinion. The Court held that the workers’ compensation judge has the authority to order the claimant to release medical records, which in this case were psychiatric treatment records, in the context of a petition to compel a physical examination. The case was remanded to determine if these particular records were relevant to evaluation of claimant’s work-related injuries, which included altered states of consciousness and fibromyalgia.
Practice Pointer: Secure complete medical records of treatment prior to any independent medical evaluation. If the claimant does not cooperate, file a petition to compel physical examination. For the additional remedy of a suspension of benefits, a separate petition must be filed.