§ 667. Examination by independent medical examiners

(a) Whenever it appears that a dispute exists regarding the reasonableness and necessity of treatment for an injury, or regarding the claimant's ability to perform suitable work, including light duty work, or regarding any other medical issue, the Commissioner may appoint an independent medical examiner to examine the employee and report to the Commissioner. Whenever a dispute exists regarding the nature and extent of any permanent partial impairment which involves permanent partial disability ratings which differ by more than 10 percent, the Commissioner shall appoint an independent medical examiner to examine the employee and report to the Commissioner the examiner's opinion regarding the nature and extent of any permanent partial impairment. The opinion of the independent medical examiner as to degree of impairment shall be binding on the parties absent a showing of substantial error or omissions fraud or a gross departure from generally accepted medical practices. If a dispute involves permanent partial disability ratings which differ by 10 percent or less, the rating shall be determined by the Commissioner.

(b) A pool of independent medical examiners shall be established to perform independent medical examinations. Representatives of management and labor from the Governor's Advisory Council on Workers' Compensation, if available, otherwise other representatives of management and labor shall each submit a list of health care providers as proposed members of the pool. The Commissioner shall select the common names from both lists. If, in the opinion of the Commissioner, the number of independent medical examiners in the pool is not sufficient for any reason, or does not adequately represent a range of health care providers, the Commissioner shall select additional health care providers or request additional names. All health care providers in the pool shall receive training about the nature and purpose of workers' compensation and shall follow the guidelines developed by rule by the Commissioner. Where a dispute involves a determination of the degree of permanent partial disability, the independent medical examiner shall use the most recent edition of the American Medical Association Guides to the Evaluation of Permanent Impairment or the supplement provided by the Commissioner.

(c) The Commissioner shall determine fees to be paid to independent medical examiners for examinations pursuant to subsection 640(d) of this title. The fee shall be paid by the employer in an amount and proportion determined by the Commissioner.

(d) If a claimant fails or refuses to undergo an independent medical examination without good cause, the Commissioner may assess all or a part of the cost of the examination or any missed appointments against the claimant or may suspend payment of compensation to which the claimant may be entitled, or both.

(e) The independent medical examination report shall be admitted into evidence in any Superior Court appellate proceedings concerning the claim. The use of an independent medical examiner under this section shall not limit the right of a claimant to obtain his or her medical examination and report on any disputed medical issue.

(f) If an independent medical examiner is appointed, all parties to the dispute shall immediately provide the examiner with copies of all relevant medical records in their possession and shall assist the examiner in obtaining any other medical records deemed relevant to the proceedings. (Amended 1963, No. 134, § 4, eff. June 6, 1963; 1993, No. 225 (Adj. Sess.), § 11.)