Dear Physician:
The Public Employee Retirement Administration Commission (PERAC) was created by Chapter
306 of the Acts of 1996 and is dedicated to the oversight, guidance, monitoring, and regulation
of the 106 Massachusetts public pension systems. PERAC’s Disability Unit schedules medical
examinations of retirement system members who have applied for disability retirement, as well
as their subsequent periodic evaluation for restoration to service.
PERAC would like to offer you the opportunity to participate in our Medical Panel program.
Physicians are needed to make critically important objective evaluations about whether an
individual is disabled, whether that disability is permanent, and whether it is causally related to
employment. Physicians are also needed to make equally essential determinations about whether
disability retirees could be restored to employment after retirement.
PERAC’s streamlined Medical Panel process lets you focus on your examination and analysis,
while PERAC focuses on completing the paperwork, processing invoices in a timely fashion, and
exercising regulatory oversight. The Comptroller of the Commonwealth has recognized
PERAC’s outstanding record of timely payment. In fact, over the last three-month period,
PERAC paid 100% of its bills within thirty days of their receipt.
Every effort will be made to limit the amount of administrative time your office devotes to the
disability review process. PERAC staff will work with your staff to establish blocks of time for
PERAC examinations that are built around your availability. If a PERAC Case Manager is
unable to fill a reserved time block, you will be given two weeks’ notice, so that the time can be
used for other patients.
PERAC’s established rate of reimbursement is $375 per examination. However, when there is
an urgent need for a particular medical specialty, or a case is unusually complex, or voluminous
medical records must be reviewed, the rate will be negotiated.
PERAC is seeking physicians from most adult medical specialties, but we have a particular need
for orthopedists, neurologists, pulmonologists, oncologists, cardiologists, and psychiatrists. This
need is more acute in central and western Massachusetts.
For your perusal, we have included copies of PERAC’s Restoration to Service Packet and
Regional Medical Panel Packet (for disability retirement). When PERAC makes a case referral,
the Disability Unit forwards the relevant packet to the physician(s). The packets include
guidance on the review process, as well as information about how to complete the certificates
and format the narrative report. The member’s medical records and employment records will
also be transmitted to the assigned physicians.
For both the disability retirement and the restoration to service process, three physicians must
evaluate the member, submit a medical report, and sign certificates confirming the case findings.
For disability retirement medical examinations, PERAC seeks to schedule joint medical panel
examinations, except when logistics prevent it or when a disability retirement applicant requests
three separate single examinations. Finding physicians who will participate in a joint panel has
always been a scheduling challenge, and it is a challenge that PERAC would very much like to
surmount.
We provide physicians with comprehensive and detailed information about each case we refer to
them. PERAC staff members respond readily to questions throughout the process. PERAC’s
Disability Unit staff is committed to working with physicians and their staffs to process these
referrals. Our goal is to achieve outcomes that are fair, objective, and properly documented.
We hope that you will consider playing an important part in the lives of public employees and
retirees and join us in providing services to them in a sensitive and appropriate manner. If you
are interested in conducting medical panel examinations, please submit your curriculum vitae to
PERAC. In response, Disability Unit staff members will contact you. If you have any questions,
please contact Barbara Lagorio, Director of Disability, at 617-591-8952.
Sincerely,
Joseph E. Connarton
Executive Director
REGIONAL MEDICAL PANEL OVERVIEW
SCHEDULING
• PERAC Disability Unit staff members will initiate contact with physicians to schedule
examinations.
• PERAC generally gives applicants for disability retirement and retirees who are being
evaluated for restoration to service at least 14 days advance written notice about
examination appointment dates, times, and locations.
• PERAC will send an appointment notice to the physician, the member, the member’s
retirement board and employer. The member will also receive directions to the
physician’s office and an evaluation sheet to complete after being examined.
MEDICAL PANEL CONFIGURATION & DUTIES
Disability Retirement Regional Medical Panels
Three physicians must evaluate the member. For these medical examinations, PERAC seeks to
schedule joint medical panels (three doctors convening in one place on the same date) except
when logistics prevent it or when a disability retirement applicant requests three separate single
examinations. Regardless of whether the doctors meet jointly or conduct separate examinations,
the three physicians are referred to as a regional medical panel.
When a joint regional medical panel is convened, PERAC will designate one physician to write
the report and complete the certificate (to be signed by all three doctors). When “separate single
examinations” are conducted, each physician writes his/her own report and signs separate
certificates.
When a physician disagrees with the other physicians, he or she must submit a minority report in
support of his/her own conclusions.
Restoration to Service Regional Medical Panels
Three physicians must evaluate the member. These examinations are not conducted on a joint
basis. Each physician will conduct a separate examination, write his/her own report, and
complete a PERAC Certificate.
MEDICAL SPECIALTIES
At least one of the three regional medical panel physicians must be specialist in the medical field
related to the condition for which the member seeks to retire (or in the case of restoration,
retired). The other two physicians will specialize in fields whose relevancy is determined by
PERAC.
For members with multiple conditions, multiple medical panels may be appropriate.
APPOINTMENT TO A REGIONAL MEDICAL PANEL
• No physician who has already examined or treated a member, except as part of a prior
disability medical panel, can be appointed to a regional medical panel (joint or
separate/singles) to examine a member.
• PERAC will not appoint physicians who have a direct and substantial financial in each
other’s practice, unrelated to their service on PERAC appointed regional medical panels,
to serve with each other on a regional medical panel (joint or separate/singles). Statute
provides that physicians who provide services through a disability review organization
are not “associated” unless they have a direct and substantial financial interest in the
profit and loss of the organization.
MEDICAL TESTS
• In no event will PERAC approve any invasive medical tests.
• Physicians may order additional testing if it is necessary to complete the evaluation.
• A physician, who determines that additional testing should be performed at a facility
other than his/her office, should contact PERAC. PERAC will work with the physician
to make the necessary arrangments
• Testing fees that do not exceed $100 total per case do not require PERAC’s prior
approval.
• PERAC must pre-approve all fees for testing that exceed PERAC’s fee schedule.
• Charges for additional testing will be reimbursed in accordance with PERAC’s fee
schedule.
REPRESENTATION
In addition to the member, his/her legal counsel and personal physician may attend. The
member’s employer may also attend, as well as the employer’s legal counsel and physician. At
the discretion of the member and employer, these “outside” physicians may observe and answer
questions raised by the panel physicians. They may not otherwise participate and they have no
vote in the regional medical panel’s final determination.
SUBMISSION OF NARRATIVE REPORT
A physician should submit his/her completed PERAC certificate and narrative report to PERAC
within 60 days of examining the member. PERAC reviews the documents to insure that they are
complete and then sends them to the member’s retirement board.
For disability retirement examinations, the physician should also submit a signed payment
voucher and an itemized invoice for any additional services.
PAYMENT
PERAC guarantees payment within 30 days of receipt of the completed PERAC certificate,
narrative report and voucher/invoice.
CLARIFICATION
The retirement board may seek clarification of a regional medical panel report either by
contacting the physicians directly or with assistance from PERAC. Physicians are reimbursed
for such clarifications by PERAC.
MEDICAL PANEL QUALITY ASSURANCE PROGRAM
PERAC’s Disability Unit has designed a program to systematically monitor and evaluate the
medical panel processes. Disability Unit staff members review each certificate and narrative
report to ensure that each question has been answered and that written conclusions reflect the
proper legal language, and the provider has fully complied with PERAC’s procedures and
requirements.
PERAC Disability Unit staff members communicate with providers on a regular basis to make
them aware of the latest statutory changes and procedural modifications.
PERAC Disability Unit staff members visit provider locations to ensure that the directions to the
provider location are correct and easy to follow, that the office is wheelchair accessible, and that
the staff is helpful and accommodating.
QUESTIONS
Please contact Barbara Lagorio, PERAC’s Director of Disability, by phone at (617) 591 8952 or
via fax at 617-628-4414 or write to Ms. Lagorio at:
The Disability Unit
Public Employee Retirement Administration Commission
Five Middlesex Avenue, Third Floor
Somerville, MA 02145
Extensive information about the disability review process may also be found on PERAC’s Home
Page, www.mass.gov/perac under the Disability Unit.