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#11
My Workers Comp Insurance Agent. Sent me a denial letter. Here in CA. I dont know if this is the QME or are they sending me another letter for QME?
 
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#12
Sounds like just another title used by a claims adjuster.
If so you have to file an appeal with the comp court.
I don't know what it says but doesn't sound like a request for a QME.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#13
Letter say Notice Of Denial for WC Benefits . Dont know if they will send me another form for QME I guess I will need to hire an attorney so I can get some help.
 
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#14
A QME is used to dispute the medical opinion of a doctor. They are denying you have a work injury. They are not the same.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#15
1171 yes they are denaying me due to conditional
 
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#16
(06-26-2017, 01:19 AM)mr.injury Wrote: 1171 yes they are denaying me due to conditional
The next step when you have a denied claim is to request a panel QME doctor.

Does the letter mention panel QME? If so you should talk to an information and assistance officer to help you. There may be a short window for you to pick the specialty of the QME doctor. You do not want the adjuster to pick. Full it out, send it in and you should get a list of 3 names of doctors within that specialty. Once you get that you should reach out to applicant attorney's in the area of the panel and ask them if they can give you advice on who they would pick. If you have an orthopedic injury I recommend picking a chiropractic panel over an orthopedic panel as many are defense oriented now and chiros seem more honest to me. This is my personal opinion. If you have a psych injury then you would pick that specialty.

Since you have a denial I highly suggest consulting with a few workers compensation attorney's and hire one. This system can be difficult to navigate. If you do not want an attorney I recommend going down to the work comp board where you case is located at and ask an information and assistance office to help you.

What type of doctor are you currently being seen by? Who referred you to your current doctor....your claims adjuster or did you pick them from a medical provider list?

If your doctor does states you cannot work due to your injury, I recommend applying for state disability ASAP. If you are still working and your employer is accommodating you then you may not need an attorney as it can make things stressful with work, and can get information about the panel from an I&A officer.(JMHO)
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#17
I dont see the QME here in the letter. Im being treated by WC doctor. But since my claims is deny im sure that Dr. visit will be over to? This thing is getting complicated. I think I need a lawyer now. THANK YOU guys
 
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#18
You should go down to the work comp board and sit down with an I&A officer about that letter or I can send you a link on how to request a panel QME doctor. That is the next step once your claim is denied. This is an important step so I recommend discussing it with an I&A officer or a workers' compensation attorney.

You can use your private insurance now since your claim is denied. Some work comp doctors treat on a lien basis.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#19
I dont see the QME here in the letter. Im being treated by WC doctor. But since my claims is deny im sure that Dr. visit will be over to? This thing is getting complicated. I think I need a lawyer now. THANK YOU guys
 
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#20
(06-26-2017, 05:27 PM)California_Help Wrote: You should go down to the work comp board and sit down with an I&A officer about that letter or I can send you a link on how to request a panel QME doctor. That is the next step once your claim is denied. This is an important step so I recommend discussing it with an I&A officer or a workers' compensation attorney.

You can use your private insurance now since your claim is denied. Some work comp doctors treat on a lien basis.

Thank you
 
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