Doctor Discretion in Medical Evaluations

Marika Cabral and Marcus Dillender

No 33988, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: This paper analyzes the importance of doctor discretion in medical evaluations. Leveraging comprehensive administrative data and random assignment of doctors to evaluations in workers’ compensation insurance, we identify the scope for doctor discretion in medical evaluations of injured workers and the impacts of this discretion on later claimant outcomes. Our analysis indicates there is wide variation across doctors in medical evaluations, these decisions are consequential for later claimant outcomes, and doctor effects vary systematically by observed doctor characteristics. In addition, we analyze the relationship between doctor effects in medical evaluations and market allocation when claimants can select their own doctors. Our findings suggest both claimants and insurers influence the allocation of doctors in line with their respective incentives, indicating market forces shape the distribution of program benefits. Finally, we conclude with supplemental counterfactual analysis and discussion of the policy implications of these findings.

JEL-codes: H0 I11 J0 (search for similar items in EconPapers)
Date: 2025-07
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