Question

Can Principal's independent physician determine what I can and cannot do?

Asked on April 30th 2019 by Another Principal Casualty
Principal relied on a “paper review” from a physician who never examined me. He determined that I’m capable of performing any occupation and then placed certain restrictions around his opinion (shouldn’t work with the public, etc). They did not seek the opinion of a vocational specialist because there isn’t a gainful clause under the any occupation definition (their reason when I inquired). When did physicians become qualified vocational specialists capable of determining what jobs I can do? Given that he put restrictions on his own opinion, should Principal not be required to retain a vocational specialist in order to determine if there are in fact actual positions that I can do since the physician isn’t in a position to opine once my age, education and experience qualifiers are factored in and need to be taken into consideration? Their “independent” physician is so on the ball that he took it upon himself and changed the definition of total disability to “being hospitalized” and was stupid enough to put that in his report. He also failed to answer their written question where he was to explain why his opinion differed from the treating physician. (You know, the one actual question that could technically be considered substantial medical evidence under abuse of discretion review had he chosen to answer it even if his theory wasn’t correct). They must have had to search under a lot of rocks to find this Rhodes Scholar. But, Principal is choosing to rest it all on his opinion and I’d like to know how the courts would likely consider his standing as a vocational specialist proxy.

Answer

Answered on April 30th 2019 by Attorney Cesar Gavidia

APC, it is difficult to know what they courts would do or how they would weigh the opinion of Principal’s consultant under the appropriate standard of review. Notwithstanding, it is not uncommon for a doctor to impose or recommend restrictions and / or limitations on account of your disability. Its presumed that your doctors are doing exactly that as well when they provide you with restrictions and limitations and advise you should not work in your occupation or any occupation. Please contact our office to in order for us to further discuss your case and questions.