Third Medical Opinion Sample Clauses

Third Medical Opinion a medical opinion that is provided when there is a conflict between the first medical opinion provided by the employee’s medical provider and the second medical opinion provided by the employer’s medical examiner. The persons providing the first two medical opinions shall select the person to provide the third medical opinion.
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Third Medical Opinion. Medical opinion to resolve disputes between the Employer’s Doctor and the Participant’s Doctor regarding the Participant’s Disability status. If the Participant requests a Third Medical Opinion, the Participant will be examined by a Doctor selected by the Plan Administrator from a list of Doctors that is maintained by the Plan Administrator solely for the purposes of obtaining Third Medical Opinions under the Plan and as required under the Union bargaining agreement. The Doctors on the list shall not be affiliated with the Employer as a senior medical consultant and shall be independent from the medical clinics to which the Employer makes referrals on a regular basis. Further, to the extent practicable, the list shall include up to six Doctors that practice in each of the following categories: orthopedics, neurology, internal medicine, psychology, cardiology, OB/GYN and general practice. When a Third Medical Opinion is requested, the Plan Administrator shall randomly select a Doctor to do the Third Medical Opinion from the category that is most relevant to Participant’s Disability. The Third Medical Opinion is binding upon the Plan Administrator and the Participant.
Sample 1
Third Medical Opinion. Section 1. When there is a difference of opinion between the Company and the Union over the medical condition of an employee which the Union claims will affect the employee’s wages or benefits, the Company and the Union will have the employee examined by a physician. The physician must be acceptable to both the Company and the Union, and the expenses of the examination shall be borne by the Company. The physician’s opinion shall be limited to the “clinical” condition of the employee, which shall be taken into account with respect to the issue in dispute.
Sample 1

Related to Third Medical Opinion

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  • Second Opinions The Member may access a second opinion from a Network Provider regarding a medical diagnosis or treatment plan. The Member may request Preauthorization or may visit a KFHPWA-designated Specialist for a second opinion. When requested or indicated, second opinions are provided by Network Providers and are covered with Preauthorization, or when obtained from a KFHPWA-designated Specialist. Coverage is determined by the Member's EOC; therefore, coverage for the second opinion does not imply that the services or treatments recommended will be covered. Preauthorization for a second opinion does not imply that KFHPWA will authorize the Member to return to the physician providing the second opinion for any additional treatment. Services, drugs and devices prescribed or recommended as a result of the consultation are not covered unless included as covered under the EOC.

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