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AME over rules PTP, yes?? - Printable Version

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AME over rules PTP, yes?? - socal - 06-06-2011

The PTP I had saw me for 6 weeks and put me as P&S and 0% disability, 100% good to return to work...although he did no treatments and he even stated in the P&S I still had no change in my condition - elbow pain in both and numbness in fingers on both hands.

I went to the AME and he diagnosed me with Cubital Tunnel and Carpal Tunnel in both elbows/hands...I went to the surgeon the AME referred me to and the surgeon confirmed - I need surgery on all four areas.

Now, my attorney says I may have to go back to the PTP to get my TTD benefits re-instated and the retro benefits paid.

Why would I have to go to the PTP, I thought the AME was the final say??

Thanks


RE: AME over rules PTP, yes?? - Bummer Knees - 06-06-2011

I would think a hearing needs filed in court to restart the TTD.

May be wrong, 1171 will let us know.


RE: AME over rules PTP, yes?? - 1171 - 06-06-2011

I'm not even sure what you need that ptp for; sounds like they were thru with you.
the only reason i can think of is if you delay or refuse surgery.
you can change to any treating doctor in the network; you should find one that will work with the surgeon.




RE: AME over rules PTP, yes?? - socal - 06-07-2011

(06-06-2011, 07:30 PM)1171 Wrote: I'm not even sure what you need that ptp for; sounds like they were thru with you.
the only reason i can think of is if you delay or refuse surgery.
you can change to any treating doctor in the network; you should find one that will work with the surgeon.

My AA said they needed to reread the P&S report to see if I had to go back to PTP to get him to reinstate TTD benefits and retro paid...seemed odd to me...nothing contradictory in P&S - said I had pain in both, but PTP could not do anything because UR was denying everything, so PTP released me ....put me RTW @ 100%....never returned to work, though.


RE: AME over rules PTP, yes?? - 1171 - 06-07-2011

if your atty says they need to reread the report to clarify an issue I would wait and hear what their final interpretation is.

if your atty is not a workers comp specialist and you are doubting their expertise you can change attys at any time.

you can find specialists here
caaa.org


RE: AME over rules PTP, yes?? - socal - 06-07-2011

(06-07-2011, 02:11 PM)1171 Wrote: if your atty is not a workers comp specialist and you are doubting their expertise you can change attys at any time.

No, they are WC atty's.... the paralegal said they are waiting for a return call from the DA now... I'm just really high strung over the whole thing...quickly running out of $$ to pay bills...a first for me...

Thanks for your patience and the "ear"...


RE: AME over rules PTP, yes?? - 1171 - 06-07-2011

i can tell.

dealing with serious injury and the disruption it can cause is difficult. I know you waited a long while for the AME apt and report.

you need to develop other alternatives that are more reliable; the legal solutions/and $$ are elusive and are not something you should plan on to meet everyday needs. it's difficult to face that you may not be returning to a productive job and earnings anytime soon. it often takes years for many to return to where they were before the injury--if ever.

if you are not receiving TTD then you should apply for State Disability Insurance. If it's likely you'll be disabled for a year file for SDI ( it takes awhile so sooner the better.)
anything could happen to delay or foul up comp benefits even once they are started.

serious injury and litigation takes massively longer then anyone anticipates.


RE: AME over rules PTP, yes?? - socal - 06-07-2011

(06-07-2011, 07:08 PM)1171 Wrote: you need to develop other alternatives that are more reliable; the legal solutions/and $$ are elusive and are not something you should plan on to meet everyday needs.

if you are not receiving TTD then you should apply for State Disability Insurance.

So taking a job that is completely different from the one I was injured - physical labor vs administrative - in order to get medical benefits for my family would not be out of line? Or would that be detrimental to my case apart from obviously not getting TTD $$?

I do not qualify for SDI...there is a window of 49 days I believe after reported injury...I was on TTD at that time.[/font]


RE: AME over rules PTP, yes?? - 1171 - 06-07-2011

as long as the job is within your restrictions it's fine-- discuss it with your doctor.
if you are temporary partially disabled comp will pay disability on some of the wage difference
see page 46 of the guidebook
http://www.dir.ca.gov/CHSWC/Reports/WorkersCompGuidebook-3rdEd.pdf



RE: AME over rules PTP, yes?? - socal - 06-07-2011

(06-07-2011, 10:09 PM)1171 Wrote: as long as the job is within your restrictions it's fine-- discuss it with your doctor.
if you are temporary partially disabled comp will pay disability on some of the wage difference
see page 46 of the guidebook
http://www.dir.ca.gov/CHSWC/Reports/WorkersCompGuidebook-3rdEd.pdf

Will look it up...thank you!! Have a good evening!!