, 

U.S. DEPARTl'YfENT OF LABOR 

EMPLOYMENT STANDARDS AoMINISTRAnoN 

Office of Workmen's Compensat!On Programs 

May 20, 1974 

NOTICE TO INSURANCE CARRIERS, SELF-INSURED 

UNDER THE LONGSHOREMEN'S COMPENSATION ACT, 

INTERESTED PERSONS 

\Xtashirt~ton, D.C 202l 1 

No. 16 

EMPLOYERS 

AND OTHER 

Subject: Policy of OWCP Regarding Utilization of Impartial 

Medical Examinations in Evaluating Disability 

under the Longshore Act, as Extended 

This notice is to advise interested parties of the Office 

of Workmen's Compensation Programs' policy with respect 

to the utilization of section 7(e) of the Longshoremen's 

and Harbor Workers' Compensation Act, in particular with 

respect to resolving questions of permanent partial 

disability. The section states that in the event that 

medical questions are raised in any case, the Secretary 

of Labor has the power to cause the employee to be examined 

by a physician employed or selected by the Secretary (or 

his designee), and to obtain from the physician a report 

"containing his estimate of the employee's physical 

impairment and such other information as may be appropriate." 

The language of the Act is discretionary with respect to 

the use of such examinations, and neither the employee 

or the employer-carrier may compel a Deputy Commissioner 

(the Secretary's designee) to order such an examination. 

The authority granted by section 7(e), utilizing the procedures described therein, will be used liberally in cases 

where medical questions arise regarding the necessity for 

medical treatment, indications for or against medical procedures, the duration of required treatment, and the 

effectiveness of such treatment as may have been provided. 

It may also be used to resolve questions of ability to 

work, and duration or periods of inability to work. 

The procedures in 7(e) may also and are to be used when 

questions arise as to the degree of "the employee's 

physical impairment." In this connection it must be 

noted that questions about the nature and extent of disability 

are not medical questions, but are adjudicatory or 

administrative questions, involving an economic, rather 

than a medical concept. The American Medical Association 

Inciude yaur addrtJJ, ZIP code, and file number on at/ corruprmdtnce 
- 2 -

has pointed out that the ascerta_inment of· "disability" 

***is an administrative, not medical, responsibility and function. Evaluation of*** disability 

is an appraisal of the patient's present and 

probable future ability to engage in gainful 

activity as it is affected by non-medical factors 

such as age, sex, education, economic and social 

environment and the medical factor - permanent 

impairment.,,--,,* 

***It is not and never can be the duty of 

physicians to evaluate the social. and economic 

effects of permanent impairment. These effects 

must be evaluated by administrators in making 

determinations of permanent disability. "A Guide 

to the Evaluation of Permanent Impairment of the 

Extremities and Back," Journal of the A.M.A., 

February 15, 1958 (Special Ed.), Preface (emph&sis 

in original). 

In referring a claiment for a medical examination in connection 

with a permanent partial disability rating the physician 

will be asked to examine the employee and describe his 

physical impairment, and will not be asked to evaluate the 

employee's "disability." 

Consequently, and for purposes of furthering amicable disposition of contested claims, Deputy Commissioners have 

been instructed to utilize the section 7(e) procedures 

extensively to obtain medical information on impairments 

resulting from injuries when questions arise. 

As a general ~ule, all medical examinations authorized 

pursuant to Section 7(e) will be conducted in the office 

of the attending physician or within a recognized medical 

facility. 

1-/4v~o/- ,<1 ~t J, 

HERBERT A. DOYLE, JR. 

Director, Office of Workmen's 

Compensation Programs