The Workers’ Compensation Section of the Division of Industrial Relations (DIR) reported in their winter newsletter that an average of 464 ratings are sent in each month. Nevada law requires insurers to send a copy of all PPD evaluation reports to DIR. As of December 1, 2010, there were 141 rating doctors who were on DIR’s rotating list of physicians and chiropractors. The Workers’ Comp Section (WCS) takes three rating doctors from the north of the state, and three rating doctors from the south to meet every six weeks to review about 10% of the ratings that the WCS randomly reviews for possible errors. DIR’s Southern District Manager wrote to me that of the 10% that are reviewed by WCS employees, about 30 PPD reports that have possible errors or discrepancies are sent to the PPD Panel for further review.
The PPD Panel then provides confidential recommendations to those 30 or so rating doctors whose ratings have mistakes. This review is supposed to be for the benefit of the individual rating physician to improve the overall quality of impairment evaluations in Nevada. When I asked the Southern District Manager whether an insurer or injured worker is entitled to see a Panel review, she responded that legally, neither the insurer, nor the claimant, may see or obtain a copy of Review Panel’s comments.
Nor may an injured worker or an insurer request that the WCS or the PPD Review Panel check over a particular rating report. If an injured worker or the insurer thinks that the PPD rating doctor made a mistake, they must pay for a second evaluation or pay for their own review by another doctor. Some insurers send all larger PPD ratings to an outside service to check whether a lower percentage should be offered. The DIR quality assurance process is not something that an injured worker can use to determine whether their rating was done correctly.
Click here for more information on how to obtain a second rating evaluation if you think your rating percentage is incorrect. Please keep in mind that if you are unsure about whether your rating percentage is incorrect, this attorney will review your rating report for you free of charge to advise you whether you should pay for a second rating evaluation or not. Given the high cost of a second rating evaluation, you don’t want to pay for one without first knowing the likelihood of obtaining a higher percentage with a second rating physician.
