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Medical Review Panels

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(POL 02/2023)

1. The Workers’ Compensation Act, 2013 (the “Act”) establishes a Medical Review Panel (MRP) as the forum by which injured workers may resolve disputes on medical issues (Section 59). Medical questions from injured workers or deceased worker’s dependants, and their physician or chiropractor can be reviewed by an independent body of medical practitioners once the Workers’ Compensation Board (WCB) appeals process has been exhausted.
2. The Board Members have the exclusive jurisdiction to make adjudicative decisions (Section 20). As such, only medical questions can proceed to an MRP.
3. A worker or deceased worker’s dependant may request an MRP if they have a valid medical question regarding a greater debilitating effect of an accepted area of a work-related injury than has been acknowledged by the WCB, and they have exhausted their rights to appeal regarding that same area of injury. The Act sets specific requirements for workers or deceased dependants when requesting for an MRP (Section 59).
4. The Act outlines the requirements for the appointment of a chairperson, selection of specialists, and the constitution of the MRP (Sections 60, 61, 62 and 65).
5. The final certificate of the MRP is binding on the WCB and the worker or the deceased worker’s dependant requesting the examination (Sections 63 and 64).
6. The Act recognizes the authority of the Board Members to develop policy directives (Sections 18 and 23).

1. A worker or dependant of the deceased worker may request an MRP in relation to an accepted WCB claim when they have:
   1. Exhausted their rights to reconsideration or review of a decision made by the WCB (i.e., they already have a related decision from both the Appeals Department and the Board Appeal Tribunal).
   2. A valid medical question regarding the greater debilitating effect of the area of a work-related injury than has been accepted by the WCB. The medical question must have arisen from the position taken by the Board Appeal Tribunal in their decision, and
   3. Represented that they:
      1. Suffered a greater functional impairment or limitation in working capacity than that decided by the WCB.
      2. Should be granted compensation for a longer period than allowed by the WCB, or
      3. Received a WCB decision based on an inaccurate or incomplete medical report.
2. Adjudicative issues (i.e., claim acceptance or denial) cannot proceed to an MRP as the Board Members have exclusive jurisdiction to make adjudicative decisions on all claims.

Enabling Certificate

3. All requests for an MRP are to be made in writing, accompanied by an enabling certificate from a physician or chiropractor.
4. The physician or chiropractor must identify the following in the enabling certificate:
   1. The medical position taken by the WCB that they disagree with.
   2. The specifics about the medical question in the Board Appeal Tribunal decision they disagree with, and
   3. The sufficient particulars to define the issue, detailing what medical grounds their disagreement is based on.
5. The Tribunal will review the request and the enabling certificate to determine if the legislated requirements for an MRP are met. The decision will be made in writing and will be provided to the injured worker and their representative (if applicable) or deceased worker’s dependant. If the MRP can proceed, the pre-injury employer will be notified. Board Services will provide the worker or the deceased worker’s dependant an explanation when an MRP request is not accepted.

MRP Chairperson

6. In consultation with the Saskatchewan Medical Association, Board Services will appoint an MRP chairperson or alternate chairperson, who is:
   1. A qualified physician engaged in the practice of general medicine, and
   2. A resident of Regina or Saskatoon.
7. Board Services will review the eligibility (e.g., place of residence) of appointed chairperson(s) and alternate(s) every three years.

MRP Member Selection

8. In addition to the chairperson, the MRP will be comprised of two practitioners, either two specialists or a specialist and a chiropractor, chosen by the worker or dependant of the deceased worker.
9. Board Services will provide the worker or dependant of the deceased worker, depending on their choice, either:
   1. A list of specialists within Regina or Saskatoon, or
   2. One list of specialists and one list of chiropractors within Regina or Saskatoon,

   based on the expertise of the specialists in dealing with the class(es) of injury (e.g., musculoskeletal, psychological, neurological) for which compensation had been claimed. Depending on the class(es) of injury involved, specialists who treat a particular medical condition or different aspects of a class of injury are to be included on the list. The list(s) of specialists and/or chiropractors is provided to Board Services by the WCB Chief Medical Officer.

10. The worker or the deceased worker’s dependant will provide Board Services in writing the names of the two physicians they have chosen from the list(s) provided to them.
11. If there are no specialists or chiropractors willing to sit on the worker’s or deceased worker’s dependant’s Panel, lists of specialists or chiropractors in the alternate city (i.e., Regina or Saskatoon) may be provided to the worker or deceased worker’s dependant.
12. A medical practitioner with a potential conflict of interest is not eligible to be a member of the MRP considering the principles of natural justice (i.e., rule against bias or the perception of bias, and the right to a fair decision). This includes a physician or chiropractor who has:
    1. Provided the enabling certificate.
    2. Provided a recorded opinion regarding the medical question stated in the enabling certificate.
13. If there is a conflict of interest or a perceived conflict of interest, the Board Appeal Tribunal will make a decision regarding a medical practitioner’s eligibility as a panel member and ability to perform the assessment without bias or the perception of bias.

Medical Examination

14. The chairperson will contact the medical practitioners who have agreed to participate in the MRP to set up a date, time and location for the MRP to take place.
15. The WCB will provide the worker with travel allowances to attend the MRP, if appropriate (POL 05/2023, Travel Expenses – General).
16. If the MRP has been requested by the deceased worker’s dependant, the MRP will set up a date and time to discuss the deceased worker’s medical documentation provided to them by the WCB.

MRP Final Certificate

17. The chairperson will provide Board Services with an MRP final certificate as soon as possible after the examination, which states (Section 62(2)):
    1. The condition of the worker.
    2. The fitness of the worker for employment.
    3. Where the worker is found unfit to work, the cause of that inability to work.
    4. The nature and degree of any limitation in the worker’s capacity to work caused by the work-related injury (e.g., part-time or full-time, partial or full duties).
    5. The extent of any permanent functional impairment of the worker caused by the work-related injury based on the American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guides), and
    6. Any further medical matters that any member of the MRP considers to be relevant to the claim.
18. If the MRP’s final certificate of decision fails to address all of the above stated issues, Board Services will return the certificate to the Panel for clarification.
19. A complete final certificate of decision is binding on both the injured worker and the WCB
20. The WCB will not be bound by opinions or recommendations made in the MRP final certificate that are outside the scope of the legislated issues or the disputed medical question.
21. Within 10 days after Board Services receives the certified decision from the MRP, Board Services will provide the worker or deceased worker’s dependant a written decision with respect to the matters set out in the final certificate.