Whitt & Del Bueno, Attorneys at Law

Leaders in defending workers' compensation claims.


“I’m Not a Doctor, But I Play One on TV!”

By Mike Del Bueno

Remember those commercial advertisements from years ago? Actors with medical roles marketed medical products to commercial television viewers, while jokingly acknowledging that they did not have a license to practice medicine.

In today’s world, patients frequently are not examined at a medical office by an actual physician – instead, they get to see a nurse practitioner, or some other assistant not actually licensed as a medical doctor. Most of us have likely experienced this on a personal level.

The arena of workers’ compensation is no different. Many times, treatment records for a workers’ compensation patient reveal that a nurse practitioner is not only examining the patient, but recommending a course of treatment, and even assigning disability. Wondering how this is viewed by the Commission and Virginia courts?

The Commission and Virginia courts weigh and consider all medical evidence, and assign to that evidence its due credibility, given, among other things, the credentials of the health professional that is the source of the evidence. The Commission has specifically noted in recent cases that the medical field has changed, and involved more reliance on nurse practitioners and physician assistants. Therein, the Commission has “evolved from not considering opinions from such professionals, to considering and in some cases relying on those opinions for determinations on key issues, including disability and causation.”

Previously, employers and insurance carriers could defend against opinions rendered by medical assistants simply on the ground that those individuals were not medical doctors. Those days are clearly in the past. Recent cases indicate that the Commission may find unchallenged opinions on disability rendered by medical assistants to be persuasive enough to award compensation benefits, and will even include opinions from medical assistants in analyzing causation issues.

Therefore, we must take from these developments the understanding that any medical opinion, even one from a nurse practitioner or a physician’s assistant, will be accepted by the Commission and Virginia courts and analyzed on its merits. Therefore, just as a doctor’s medical opinion can be challenged through a deposition or rebuttal expert opinion, so too, can an opinion rendered by a medical assistant. Depending upon the medical evidence present in a case, it may be necessary to challenge in those ways an opinion rendered by a medical assistant, rather than just leave it alone and argue that it has no credibility simply because it does not come from an actual doctor.

We can certainly help you in cases where there may be medical evidence from a nurse practitioner or medical assistant, rather than from a physician. Feel free to call our offices for assistance and guidance in handling the situation you may be dealing with.