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Physician review of workers' compensation case files: can it affect decision outcomes?
Mark E Hammett1, Christopher Jankosky, John Muller
1Occupational and Environmental Medicine Department, Navy and Marine Corps Public Health Center, Portsmouth, VA 23708, USA.
Objective:
To identify common attributes of Federal workers' compensation cases referred to Navy physicians for medical opinions and to determine the impact of the review on the final case decision.
Methods:
Retrospective case study and descriptive analysis of 258 opinion letters written by physicians on referred cases from 2006 to 2010.
Results:
Navy physician opinions were considered in the outcome in some of the cases, and there was a statistically significant difference between the claim acceptance rate in the study population and the total population. Worker age was correlated with certain claim types.
Conclusions:
There is preliminary evidence that the opinion letters of Navy physicians influenced case decisions. Because of the selection bias in how the cases came to the study population, a prospective cohort study is warranted to establish whether this conclusion and the other results noted are valid.
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