MEDICAL PANELS REGULATION 2006_290.pdf

8/11/2019 MEDICAL PANELS REGULATION 2006_290.pdf

1/10

Published by Alberta Queens Printer

E-mail: [email protected] on-line at www.qp.alberta.ca

Alberta Queens Printer

5th

Floor, Park Plaza10611 - 98 Avenue

Edmonton, AB T5K 2P7Phone: 780-427-4952Fax: 780-452-0668

Province of Alberta

Office Consolidation

Alberta Regulation 290/2006

With amendments up to and including Alberta Regulation 319/2009

WORKERS COMPENSATION ACT

MEDICAL PANELS REGULATION


2/10

Copyright and Permission Statement

Alberta Queen's Printer holds copyright on behalf of the Government of Albertain right of Her Majesty the Queen for all Government of Alberta legislation.Alberta Queen's Printer permits any person to reproduce Albertas statutes andregulations without seeking permission and without charge, provided duediligence is exercised to ensure the accuracy of the materials produced, andCrown copyright is acknowledged in the following format:

Alberta Queen's Printer, 20__.*

*The year of first publication of the legal materials is to be completed.

Note

All persons making use of this consolidation are reminded that it has nolegislative sanction, that amendments have been embodied for convenience ofreference only. The official Statutes and Regulations should be consulted for all

purposes of interpreting and applying the law.


3/10

(Consolidated up to 319/2009)

ALBERTA REGULATION 290/2006

Workers Compensation Act

MEDICAL PANELS REGULATION

Table of Contents

1 Definitions

2 Difference of medical opinion

3 Selecting medical panel members

4 MD advocate

5 Review of records and information

6 Duties and powers of medical panel

7 Report of medical panel

8 Rules of procedure

9 Access to information

10 Remuneration

11 Cost of tests and assessments

12 Duties and powers of panels commissioner

12.1 Immunity

13 Expiry

14 Coming into force

Definitions

1 In this Regulation,

(a) Act means the Workers Compensation Act;

(b) claim means a claim for compensation under the Act;

(c) claimant means a worker or, in the case of a workersdeath, a dependant of the deceased worker;

(d) MD advocate means a physician selected by a claimantunder section 4;

(e) medical opinion means a full statement of the facts,medical evidence and reasons supporting a physiciansmedical conclusion;

(f) panels commissioner means the medical panelscommissioner appointed under section 46.3(1) of the Act.


4/10


5/10

Section 3 AR 290/2006MEDICAL PANELS REGULATION

3

(a) one physician chosen by the claimant from the caseeligibility list;

(b) one physician chosen by the employer from the caseeligibility list;

(c) one physician chosen by the Board from the caseeligibility list.

(4) Notwithstanding subsection (3)(b), the panels commissionermust choose a physician on behalf of the employer if

(a) the claimant is

(i) self-employed,

(ii) a member of the employers family, or

(iii) a partner in, or a director of, the employers firm,

or

(b) the employer has ceased to carry on business in theindustry in which the workers injury occurred.

(5) Notwithstanding subsection (3), the panels commissioner mustchoose a physician if

(a) the claimant, employer or Board does not select aphysician within 2 weeks, or such longer period asdetermined by the panels commissioner, from the date of

receiving a copy of the case eligibility list undersubsection (2)(b), or

(b) 2 or more of the parties choose the same physician.

(6) Notwithstanding subsections (3) and (4), a physician is noteligible to be chosen as a member of a medical panel if the

physician

(a) is or was the workers treating physician,

(b) is being or has been consulted with respect to the workersinjury unless, in the opinion of the panels commissioner,special circumstances exist and choosing the physician

would not create a conflict of interest,

(c) is providing or has provided medical services to theworker or the employer, or

(d) is or was a partner or associate of a physician referred toin clause (a), (b) or (c) unless, in the opinion of the panels


6/10


4

commissioner, special circumstances exist and choosingthe physician would not create a conflict of interest.

(7) The panels commissioner must choose one of the panelmembers as the chair of the medical panel.

MD advocate

4(1) A claimant may select a physician to provide input and makerepresentations on behalf of the claimant before a medical panel.

(2) The panels commissioner shall, when sending a copy of thecase eligibility list to the claimant under section 3(2)(b), providethe claimant with notice of the claimants right to select an MDadvocate under this section.

(3) A claimant must select an MD advocate by notifying the panelscommissioner of the selection in writing within 2 weeks from thedate of receiving a notice under subsection (2).

(4) An MD advocate may provide input and make representationson behalf of the claimant before a medical panel in person, bytelephone or in writing.

(5) A claimant is responsible for paying an MD advocates feesand expenses unless the MD advocate is the workers treating

physician in which case the MD advocates fees and expenses shallbe paid pursuant to section 10.

Review of records and information

5(1) After a medical panel has been appointed, the panelscommissioner

(a) must review the records and information received fromthe referring body that relate to the medical issue ormatter,

(b) may request the referring body to provide additionalrecords and information related to the medical issue ormatter, and

(c) must provide copies of the records and informationreceived under clauses (a) and (b)

(i) to each member of the medical panel, and

(ii) to all other interested parties including the MDadvocate, if the claimant has selected one.


7/10


5

(2) A person receiving records and information under this sectionshall not use or disclose the records or information except for a

purpose related to the proceedings of the medical panel.

Duties and powers of medical panel

6 For the purposes of providing a report of its medical findingsunder section 7, the medical panel

(a) must review the records and information received undersection 5,

(b) if the claimant has selected an MD advocate, arrange toreceive the MD advocates input and representations, and

(c) may

(i) interview or examine the worker,

(ii) invite the workers treating physician, or any otherhealth provider whom the medical panel considersappropriate, to provide input,

(iii) seek, or request the panels commissioner to seek,advice or information relevant to the medical issue ormatter from one or more medical specialists or healthcare providers, and

(iv) request the panels commissioner to do one or both ofthe following:

(A) to arrange for any tests on or assessments of theworker;

(B) to compile medical information relevant to themedical issue or matter.

Report of medical panel

7 A medical panel must prepare a report of its medical findings,including reasons supporting the medical findings, and through the

panels commissioner provide copies of its report to

(a) the claimant,

(b) the employer,

(c) the Board, and

(d) if the Appeals Commission has referred the medical issueor matter to the medical panel, the Appeals Commission.


8/10


6

Rules of procedure

8(1) The panels commissioner must establish general rules of

procedure for proceedings before a medical panel.

(2) The chair of a medical panel may make additional rules ofprocedure for a medical panel that are not inconsistent with thegeneral rules of procedure established by the panels commissioner.

(3) Without restricting the generality of subsection (2), the chair ofthe medical panel may determine whether anyone other than anMD advocate may appear on behalf of the claimant before themedical panel.

Access to information

9 A medical panel may, through the panels commissioner, request

the Board, the Appeals Commission or the claimant to provide itwith any records or information that it considers necessary to makea medical finding.

Remuneration

10 The panels commissioner, the members of a medical panel anda workers treating physician who participates in the proceedings

before a medical panel shall be paid remuneration and expensesunder section 46.3(2) of the Act at the rates set by the Minister.

Cost of tests and assessments

11 The Board shall pay the cost of any tests on or assessments of

a worker that are requested by a medical panel under section 6 aspart of the claim.

Duties and powers of panels commissioner

12 In addition to the panels commissioners other powers andduties under this Regulation, the panels commissioner isresponsible for the operation of the medical panel process,including, without limitation,

(a) co-ordinating the referral of medical issues and matters tomedical panels,

(b) developing and implementing processes to ensure the

timely completion of medical panel reviews and reports,and

(c) ensuring the efficient operation and financial managementof the medical panels office.


9/10

Section 12.1 AR 290/2006MEDICAL PANELS REGULATION

7

Immunity

12.1 No action may be maintained or brought against the panels

commissioner or an employee of the panels commissioner inrespect of any act or decision done or made in the honest belief thatit was within the panel commissioners jurisdiction.

AR 319/2009 s2

Expiry

13 For the purpose of ensuring that this Regulation is reviewedfor ongoing relevancy and necessity, with the option that it may berepassed in its present or an amended form following a review, thisRegulation expires on June 30, 2016.

Coming into force

14 This Regulation comes into force on the coming into force ofsections 3 and 4 of the Workers Compensation Amendment Act,2005 (No. 2).


10/10

Printed on Recycled Paper*9780779746057*

Documents

MEDICAL PANELS REGULATION 2006_290.pdf