The new Medical-Legal Fee Schedule went into effect on April 1, 2021. Due to the new requirements to designate the number of pages of records being submitted and to declare this under penalty of perjury, there will likely be problems early on. This will especially be true for those evaluations that are scheduled in April and in which records have already been submitted to the doctors.
It is in everyone's best interests to ensure that the declarations are provided to the doctors. The regulations do indicate that a doctor may not bill for reviewing records without the declaration and attestation. If necessary, evaluations can be moved out to ensure that the appropriate declarations and attestations are completed.
Melton reiterated that the April guidance was for a transition period that likely will be resolved quickly. Nevertheless, he offered some options for parties looking to cooperate: If medical records have been sent to a QME, it would be “best practice” for the parties to get the physician a declaration of the number of pages provided prior to the evaluation itself, Melton said. If a declaration is not provided prior to an evaluation, Melton said the DWC recommends going forward with the evaluation and, depending the case, a supplemental report might be necessary for the record review after the evaluator receives the proper attestation. The parties can come to an agreement on the number of pages sent, Melton said, and they can state the agreement in writing before the evaluation.