In the world of work, a medical evaluation involves seeking the opinion of a medical evaluator (or medical expert) concerning the state of an employee’s health and is usually requested by an insurer, an employer or a public body. The expert’s report provides the employer or file manager with an informed opinion of a worker’s CNESST, absenteeism or disability file.
In Quebec, the drafting of a mandate given to a medical evaluator is overseen by the Collège des médecins du Québec (CMQ) and is defined as follows: a written document that guides the medical evaluator’s work. The mandate sets out the conditions for the evaluation and the questions the physician must answer. It must be written in a clear, concise and comprehensive manner to ensure an objective evaluation. The requestor must include all known and relevant information about the worker’s situation to ensure the assessment and the report are complete.
The Ducore team has prepared this guide to simplify the task of writing a mandate, thus ensuring that workers can be evaluated quickly.
How to write a clear, complete medical evaluation mandate
Drafting an evaluation mandate requires careful preparation; you must take the time to collect as much relevant information as possible for inclusion in the worker’s file so that the medical evaluator can understand the context and issues.
In addition to setting out the context of the evaluation, the mandate must include specific instructions and questions to be answered in the physician’s report.
How can you be sure the mandate contains all the necessary information and will yield the desired answers? Here are nine recommendations to keep in mind so that you can draft a complete mandate:
- Write the mandate in a clear, concise manner
- Include all known facts, avoiding rumours or impressions
- Use neutral, precise vocabulary
- Give precise instructions to the medical evaluator
- State your expectations of the report
- Do not divide your request into multiple mandates
- Limit yourself to the questions needed to resolve the case (diagnosis, recommended treatment, functional capacity examination, etc.)
- Keep in mind that the mandate will be an integral part of the report submitted by the physician and will be consulted by all the parties, including the worker
- Include deadlines for the evaluation and the delivery of the report
A mandate that respects all these criteria will ensure the Ducore Expertise team can process your request properly and efficiently.
What issues can a medical evaluation mandate address?
The questions formulated by the requestor form the core of the evaluation mandate. They will guide the medical evaluator who provides the assessment. The mandate may include several questions concerning the same issue. Here are some examples of questions frequently included in such a mandate:
For a disability file
- What is the diagnosis of the worker’s condition?
- Is the current treatment necessary, suitable and sufficient?
- Is the worker fit to return to work?
- If so, should there be a gradual return as well as limitations in terms of duties or schedules?
- If not, what is the likely duration of the disability?
- What is the prognosis over the short, medium and long terms?
For a CNESST file
- What is the diagnosis?
- What is the forecast injury consolidation date or period?
- What are the nature, necessity, adequacy and duration of the administered or prescribed care and treatment?
- Is there a permanent impairment percentage in terms of the worker’s physical or mental health?
- Does the worker have functional limitations and, if so, what is the assessment of them?
Additional questions
- What is the causal relationship?
- Does a pre-existing personal condition give rise to cost sharing?
A clear, precise medical evaluation mandate will enable you to obtain the answers you need to resolve a disability, absenteeism or CNESST file. Ducore Expertise can assist you with the writing of an effective evaluation mandate by providing compliant examples for consultation purposes.
If you require any assistance with the management of your files, don’t hesitate to contact us at expertises@ducoreexpertise.com.
