Workers' Compensation Discussion Forums

Full Version: Ame Report Disputes
You're currently viewing a stripped down version of our content. View the full version with proper formatting.
Pages: 1 2
State of California

In the event of an AME disputed report does either party have the right to an additional evaluation . With a different doctor other than the AME.
Lets say another evaluation from either an IME, QME, or even the PTP.

Thanks

Shadow
generally no.
they get prior agreement from the parties before the exam to avoid disputing the report afterward.
1171 Wrote:generally no.
they get prior agreement from the parties before the exam to avoid disputing the report afterward.


Ok ,does one party (that is not happy ) have the right to request the PTP in the MPN to write a rebuttal to the AME report.
yes, but it probably can't be submitted as evidence.
I can't believe your atty would allow it.
Me either

Brief History:
1.Went to an AME he found in my favor.
2.Had a meeting with my AA and we decided to change PTP'S.
3.Received an approval letter from IC for PTP change for treatment.

Two weeks later I receive a packet from the new PTP'S office with forms to fill out just like the AME visit.When I say forms. I mean forms neccessary to perform a complete new medical evaluation.Not just routine forms by any means.

Also received a letter from the new PTP'S office that states the date ,time and specifically states doctor X will perform a medical evaluation.Also that it is imperative that I keep this appointment . Any cancellations will result in fees that I will have to pay.

My Position is: I didn't need anyone to schedule an appointment for me . I am also not requesting this doctor to opine on anything or had I requested an evaluation.All this doctor needs is the existing reports and of course I fill emergency contact info , medication allergies ect..All I need is a prescription filled . No need for my entire life history for that.

It appears that the IC may have used this opportunity( ptp change) to get a new comprehensive medical evaluation.Why? because they do not like the AME report.

If the IC needs clarification should'nt I just return to the AME for any more evaluations?

What are your thoughts on this senario?

Thanks 1171
Shadow, if you car had problems, and you took it to one shop, didn't like their idea, and took it to another repair shop, would you not want them to go over the car again to make sure nothing was missed?

What doctor in their right mind, would not do a evaluation? it seems very normal that they would. All you want is a script filled, I don't know any doctor that would just write a script, without first doing a medical evaluation.

I don't see this an a way to dispute the AME. But I see it as a doctor trying to do best for their patient.
if they want to waste $$ on an expensive PTP exam you can let them.
it cannot be entered into evidence to rebut the AME.
your atty may also file an objection; but again, if the report has no affect on the legal decisions, it may be a moot issue.
their strategy is their own-it's not up to you to agree.

they may be preparing to depose the AME and want the new PTP to surface medical issues that they will use in the deposition.
so even while another comprehensive exam cannot be used to rebut the AME directly it can be used to prepare questions for the AME and get additional clarification in a deposition on certain findings used in the AME report etc.

I'm just guessing but you asked for my thoughts.
Shadow, your only thinking that the IC wants a evaluation. When as far as I can remember, it's any doctor will wish and demand their very own evaluation. As they don't know if another doctor may have missed something.

Maybe, just maybe, your in a Paranoid state is all. remember, when we think the worst, really there is little to worry about.

If you have concerns, surely you can simply just call the doctor's office and ask them why the evaluation. I would bet, they tell you, just like I have, as it is the doctor's request to do it, not the IC in this case.
Bad Boy,
I agree with you .The doctor is free to evaluate the " injury". And he should . He does not need my marital status, education history, how often I have sex, and on and on , or any other information not related to the matter at hand. The questions being asked of me are completely ridiculous and already answered to the AME for an extensive evaluation/opinion. No need for another comprehensive medical evaluation. I am not looking for another opinion.I am not looking for new medical evidence. The medical evidence/records as of current wil be just fine to warrant a written prescription.I do not need this doctor to go over my entire body (like the AME did). just the injury.

Another medical fishing expedition perhaps?

I need a consultation not an evaluation or new opinion.

No, my entire car does not need to be gone over when the problem was repaired to my satisfaction. My car is not in litigation. I am.

I have canceled the appointment . No need for "treatment" at this time.

1171. Your responses are logical and very helpful.......Thank you.

Shadow
Bad Boy. The paperwork says evaluation. Am I paranoid.........Yes. I have good cause not to trust.That's for sure. Already been burned by one doctor. Not happening again

1171, Excellent point, you may have just hit the nail right on the head ?
Thank you both

Shadow
Pages: 1 2
Reference URL's