Services provided by Disability Evaluators' Panel (DEP) physicians
Permanent partial disability examinations
The purpose of the exam is to provide an unbiased, objective estimate of the whole-person, percent impairment for a given
allowed condition. This must be based on the most current edition of the American Medical Association's (AMA's) Guides to the
Evaluation of Permanent Impairment, using the available medical documentation, history and physical examination. Examining
physicians should generate reports, which identify the appropriate tables or figures from the guides that they used to reach
their conclusions. There is no decision making process other than interpretation of the medical exam, medical records and
history, and applying this information to the guides. Most physicians who perform these exams must receive additional training
that explains the process, since these examinations are not routinely performed in medical residency. The more examinations a
physician performs, the better the physician becomes at the process. Primary issues are objectivity of the examiner and
appropriately using the guides. In some areas of the state there are shortages of qualified examiners for particular specialties.
File reviews for requests to increase permanent partial disability benefits
This review requires the physician to visit the local BWC customer service office and review medical files with newly submitted
medical documentation from the injured worker to determine whether to grant additional impairment. It does not require clinical
decision making in terms of alternative treatment, diagnosis or examination of the patient. It requires a good knowledge and
application of the Guides to the Evaluation of Permanent Impairment. These physicians may be involved in auditing and dispute
resolution of permanent partial issues in the C-92 Quality Assurance Program.
90-day, 200-week and independent medical examinations
These exams require the physician to review medical records, obtain a history and examine the injured worker to answer questions
raised by a party in the workers’ compensation process. It does not require the use of the American Medical Association guides.
Typically, questions address continuation of treatment, recommendation of future treatment or procedures, determination of
maximum medical improvement or return-to-work issues. Ideally, physicians performing these exams should be experts in their
specialty and up to date on treatment options. An active clinical practice, which includes treatment of injured workers, would be
Medical file review
This review usually requires the physician to review medical records at the local BWC customer service office to answer specific
questions about treatment continuation, specific treatment requests, appropriateness of medication or claim allowance.
Physicians should be knowledgeable of appropriate treatment and up to date on commonly accepted practice guidelines. They do not
need to have a current clinical practice. In fact, many may have retired or quit performing surgical procedures.
Alternative dispute resolution (ADR)
Physicians involved in the ADR process are frequently specialists and sub-specialists, who help resolve difficult dispute
resolution issues such as whether requested medical services are medically necessary and appropriate based on the allowed
conditions in the claim. They should be in active clinical practice and highly regarded in the medical community performing
up-to-date procedures and practices. Spine surgeons, hand surgeons, joint replacement orthopedists, and physical medicine and
rehabilitation physicians are some examples. Many of these physicians will not perform medical file reviews or permanent partial
Click here to learn more about reviewing the BWC online claims documents.