When a Massachusetts public employee applies for disability retirement, a PERAC regional medical panel examines the member and answers the retirement board's legal questions on this certificate. The posted 45-page PDF, revised May 2025, holds every version: joint accidental, joint ordinary, joint heart, lung and cancer presumption certificates, and a single-physician violent act injury version. The board relies on the panel's answers and narrative.
Physicians appointed to the regional medical panel, up to three with their specialties listed on the cover page, complete the whole certificate and a narrative, and each signs it. A dissenting physician uses the Minority Opinion pages. The member's treating physician does not complete it.
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Regional Medical Panel Certificate
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No. Physicians on a PERAC regional medical panel complete it after examining the member. The treating doctor's opinion goes on the separate Physician's Statement Pertaining to a Member's Application for Disability Retirement, which is part of the record the retirement board provides to the panel.
Each presumption version includes a guide. The panel answers no to the causation question only if evidence of a uniquely predominant non-service factor obliges the conclusion that the condition is not job-related. The heart guide gives examples such as a congenital problem, endocarditis from intravenous drug use, or cocaine or alcohol cardiomyopathy, and asks panels to quantify risk where possible.
Each version includes Minority Opinion pages repeating the incapacity, permanency and causality questions, so a dissenting physician can record different answers. All examining physicians certify that their findings are a professional opinion reached independently and free of undue influence.