Consultative Examinations, Generally

Consultative examinations (CE) of a social security claimant are used by the Social Security Administration (SSA) when the claimant's medical evidence is insufficient to determine the claimant's disability, or lack thereof. Although the claimant's treating physician is the preferred source of medical evidence, there are instances where a medical examination from an independent source is necessary. These include situations where the treating physician is unwilling to perform the examination, there are inconsistencies in the claimant's file that cannot be resolved by consulting with the treating physician, the claimant himself prefers an examination by a source other than his treating physician with good reason, or prior experience in dealing with the treating physician indicates that he may be unable to effectively provide the necessary service.

Employee Misconduct That Does and Does Not Deviate From Employment

When an employee engages in misconduct, his receipt of workers' compensation benefits can be jeopardized depending on whether such misconduct constituted a deviation from his course of employment. If the employee has deviated from the course of employment, and is then injured, he will generally be denied benefits. Prohibited conduct is a marker for misconduct. It is only that prohibited conduct concerning the employee's fundamental job for which he was employed that will affect compensation eligibility. Even though prohibited, conduct that merely violates the way or means that an employee uses to accomplish his job duties is still within the course of his employment.

Time Requirements Related to Occupational Diseases

With respect to occupational diseases, there are several applicable time restraints including the time between exposure and disability, minimum time periods for exposure, and minimum time periods for an employee's residency. These time requirements vary markedly by state. The limitations period for occupational disease claims also varies widely. Some states bar the receipt of death benefits unless the claim is brought within a specified time after exposure. The majority of states take the view that the limitations period does not begin to run until such time that the claimant had knowledge of his condition and its relationship to his employment. Still another viewpoint on the limitations period is that it begins to run when the employee has become disabled as a result of the disease and with reasonable diligence could discover that the condition is compensable.

Workers' Compensation Medical Benefits as "Property"

The Due Process Clause of the Fourteenth Amendment to the United States Constitution provides that a person shall not be deprived of his property without due process of law. The issue of whether workers' compensation medical benefits are "property" under the Fourteenth Amendment was addressed by the United Supreme Court, which held that such determination hinged on the individual's entitlement to such benefits.

Recreational and Social Activities

Within the Course of Employment)