Regional Medical Panel Examinations
- When will a medical panel be appointed to examine me?
When your retirement board determines that your application for accidental or ordinary disability retirement is complete, the board (which meets at least once each month) may petition PERAC to appoint a three-member, independent regional medical panel, paid for by PERAC, to examine you. No physician who has already examined or treated you, except as part of a prior disability medical panel, can be appointed to a panel to examine you.
- May physicians who are associated with each other serve together on a medical panel?
PERAC will not appoint physicians who have a direct and substantial financial interest in each other's practice, unrelated to their service on PERAC appointed medical panels, to serve with each other on a medical panel. The 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.
Separate Single Physician Examinations
- Do the three physicians who are appointed to my medical panel have to conduct a joint examination?
You have the right to request three separate single physician examinations when you file your disability application. Such separate examinations can be scheduled by PERAC to take place on three separate days, in three separate locations. If you do not request separate single examinations at application filing time, PERAC will generally schedule a joint examination. In instances where a joint examination cannot be convened in a timely manner, PERAC may schedule separate single physician examinations instead.
You may request separate examinations at any time prior to a joint examination date, but PERAC will not ordinarily consider requests for separate examinations less than 48 hours prior to a scheduled joint examination.
- If I undergo three separate examinations, will the examining physicians each write his or her/ own report?
Regional Medical Panel Findings
- What questions must be addressed by the members of a regional medical panel?
The members of the regional medical panel must answer whether or not they find that you are unable to perform the essential duties of your job and whether such incapacity is likely to be permanent. In the case of an accidental disability retirement, the physicians must also state whether or not your disability is such as might be the natural and proximate result of the accident or hazard upon which your retirement application is based. The physicians must submit a written report in support of the conclusions that they reach.
- Do all three physicians on a regional medical panel have to agree about the findings?
No. In a situation where two of the three members agree but the third physician doesn't agree with them, the physician who is not in agreement with the majority finding must submit a minority report in support of his or her own conclusions.
- Who schedules regional medical panel examinations?
PERAC's Disability Unit staff members schedule medical panel examination(s) for disability retirement applicants. You will be given at least 14 days written notice in advance of your appointment date(s), time(s), and location(s).
- Under what circumstances may I request that a regional medical panel examination be rescheduled?
You may request that an examination be rescheduled only for compelling personal reasons including, for example, a death in the family or your own hospitalization. In the event you are unable to attend a scheduled examination, you should notify PERAC immediately.
If your request to reschedule your examination hasn't been approved, and you fail to keep your appointment, your application may be denied and you may have to reimburse PERAC for the cost of the appointment before a new examination will be scheduled.
- May my own doctor and attorney attend the exam(s)?
When an examination(s) has been scheduled, you will be notified in writing of your right to have legal counsel and your physician attend the examination. Please note that it is your responsibility to notify them of the date(s), time(s), and location(s) of the examination(s). In addition, your employer may also have legal counsel and a physician attend your examination(s).
At your discretion, your physician's discretion, and the discretion of your employer and its physician, such physicians may answer questions from the panel, but they will have no vote in the final determination made by the panel.
PERAC will pay your physician a fee at a state-established rate for each examination attended, provided a third party does not reimburse such fees.
Applicant's Attendance at Regional Medical Panel Examination
- Is a disability retirement applicant required to attend the regional medical panel examination?
In general, the applicant must be present for the examination. However, in a limited set of circumstances, exceptions are permitted. In accordance with PERAC guidelines, the requirement for a regional medical panel examination can be satisfied by the submission of records to be reviewed by three physicians appointed by PERAC, provided the following conditions are met:
- The application must be a voluntary disability retirement application filed by the member, not an involuntary disability retirement application filed by the employer.
- The member must reside more than 150 miles from Boston.
- The member must waive his or her right to attend the examination, in writing.
- The member's employer must waive his or her right to attend the examination, in writing.
- The member's physician must provide a statement detailing the medical reason, accompanied by supporting medical documentation, that would prevent the member from traveling to an examination.
- What materials does a member have to submit to his retirement board when requesting the appointment of a regional medical panel for an examination based on a review of the records?
Documentation supportive of each of the conditions listed above must be submitted, as well as a completed Member's Application for Disability Retirement(described under the section of this guide entitled, "Disability Application").
After PERAC has scheduled the regional medical panel examination of records, PERAC's Medical Panel Unit will notify your retirement board and require your board to submit complete medical records and all other required documents to the medical panel physicians in the same manner as if you were being examined.
Posthumous Regional Medical Panel Examination of Record
- Is a disability retirement automatically precluded if a member dies before a regional medical panel can examine him or her?
The member’s retirement board may ask for a posthumous medical panel examination of records if the member’s completed disability retirement application had been on file with the retirement board for at least 15 days prior to the member’s death in the case of an ordinary disability retirement. In the case of an accidental disability retirement, the posthumous medical panel examination may be requested if the applicant submitted a complete application with the retirement board prior to his or her death.
After the Regional Medical Panel Examination
- Does the regional medical panel have a time frame in which to complete its work?
The regional medical panel has 60 days in which to submit its report to your retirement board through PERAC.
- When will my retirement board inform me of the medical panel's findings?
Your retirement board must notify you and your employer of the panel's findings within 30 days of their receipt of the medical panel report or, in the case of separate examinations, within 30 days of receipt of the last of the three separate reports.
- What happens to my application if the medical panel does find me to be disabled?
Your retirement board will consider the report(s) of the regional medical panel and determine whether or not to approve your application. While the regional medical panel report is a very important element in the retirement board's consideration, it is only part of the information that must be reviewed by the board.
- Will there be a hearing?
The board may hold a hearing on any disability retirement application, and must hold a hearing upon your request.
Retirement board hearings are conducted in accordance with PERAC’s Standard Rules for Disability Retirement, 840 CMR 10.12. These regulations cover notice, discovery, and conduct of the hearing, evidence, and subpoenas. These regulations are available on PERAC’s website, but your retirement board or PERAC will furnish you with a copy of the regulations upon request.
- What if I apply for accidental disability retirement, but my board approves an ordinary disability retirement for submission to PERAC?
If PERAC approves an ordinary disability retirement in light of your retirement board's findings, the regional medical panel's report, and other evidence, you may be retired for ordinary disability provided you meet the other eligibility requirements for ordinary disability.
- What happens if both the regional medical panel and my retirement board find me to be disabled?
PERAC's staff will review your disability application. PERAC may return any application to the board for further action, within 30 days of its receipt, if PERAC finds the board's decision to have been made upon unlawful procedure, unsupported by substantial evidence, arbitrary and capricious, or a result of fraud or misrepresentation.
When your application has been approved by PERAC, or if no action is taken by PERAC within 30 days, your retirement board will notify you that your application for disability retirement has been granted.
- What happens to my application if the medical panel does NOT find me to be disabled?
You have a right to request a hearing before your retirement board upon your notification about the findings of the medical panel. Your retirement board may deny your application, or the board may seek additional information or clarification from the panel, or it may petition PERAC to schedule a new examination.
If your board requests a new examination, PERAC will either schedule a new panel examination or decline to do so. In the event PERAC declines to schedule a new panel examination, the board must deny your application.
If your application is denied, you must be notified of your right to appeal the denial of your application to the Contributory Retirement Appeal Board (CRAB). Please see the section of this guide pertaining to appeals.
- Is there a deadline by which my retirement board must complete action on my disability application?
Your retirement board has 180 days from the filing of your application to make a final determination. If circumstances warrant, an extension may be granted by PERAC.
|Date published:||July 1, 2015|