STUDY OF INCOMPLETE PHYSICIAN REPORTS

Incomplete physician reports have been cited as a major factor leading to inconsistency in permanent disability ratings. Many of DWC's disability evaluators have said that their largest problem with the current system is the poor quality of medical reports that have been submitted to them for rating.

The Commission has undertaken a study to:

• Determine the nature and magnitude of the problem
• Ascertain who is producing incomplete reports and why
• Develop quantitative analysis
• Provide recommendations for improving the quality reports
• Calculate the cost-benefit obtained from the system

A random sample of medical reports was drawn from the DWC Disability Evaluation Unit and evaluated by the project team and representatives from the Industrial Medical Council. The costs of the reports were estimated separately using data from bill review companies or carriers.

Preliminary findings indicate that:

• Physician reports are of a poorer quality. However, QME reports exhibit many of the same problems, though less frequently.

• Approximately 60% of the treating physician reports were subject to qualifications by the rater or, in other words, the reports were incomplete in some way. With QMEs, only 40% were subject to qualification. There is still a problem with the QME reports but it is more serious for the treating physicians.

• Approximately 50% of the submitted reports are from treating physicians. One-third of these treating physicians were registered QMEs.

• In approximately 20% of the reports submitted as QME reports, the doctor was not listed by the IMC as Qualified Medical Examiners

This project is in progress. The study report will be available in the fall of 1998.