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P&S with a 30% wpi in Calif. - Printable Version

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P&S with a 30% wpi in Calif. - ShatteredSurfer - 03-06-2014

I've been declared p&s with a wpi of 30%. The insurance carrier has denied two surgeries my dr. has requested and I am going to a msc hearing in a couple weeks. The surgeries my neurosurgeon requested are 1.) C3-5 anterior cervical discectomy and fusion.
2.) L5-S1 posterior spinal fusion and decompression.

So I guess my question to anyone who might be able to enlighten me is....... What can I expect to happen when I've been declared p&s and have been rated with a 30% wpi and have not had surgeries?

I also wanted to mention that I went to a qme and the dr. was about 75 yrs old and had a little house on the prairie bag of relic looking exam tools. This dr. said in his report that I was basically faking all my symptoms and doing it for monetary gain. He also said that whatever symptoms I did have were not from a industrial accident. I have 10 Dr's on my side, who are all in agreement on my condition but I'm curious if this one (1) Dr. is going to just destroy my case? I guess we'll find out in a few weeks.

P.S. Anyone know how severe a 30% wpi is? My p&s report says i'm extremely bad but the rating seems low. I don't kmow, that's why I'm asking.

Thanks.


RE: P&S with a 30% wpi in Calif. - 1171 - 03-06-2014

I don't know what the issues are.
if there are none, then they may offer a lump sum buyout (compromise & release) or you may want to opt for periodic disability payments and open medical
if either of you wishes to dispute the rating, then you need to discuss how you want to resolve it.
ratings are not decided by the number of doctors or their age or mannerisms.

if you want to dispute the QME opinion, you can take your evidence to the comp court and they'll decide which is more persuasive.
if you have an atty talk, to them about your options; you may wish to try an use an Agreed Medical Examiner.
in general, AME process may take another 6-9 months

100% is total disability; you've lost about a third.
a WPI/impairment rating is not the same as a permanent disability rating.