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AME/Insurance question
#1
I had an AME per the WC insurance company. The rating given was very much in my favor. Now the defense for the insurance company feels it is too high and want to depo. the one who performed it. Now I have to wait for a future date for the depo. (just when I thought the end was near).
My question: If they are the ones who picked the doctor, why do they get to question him regarding the rating given to me?
My two cents: They picked him, they should be stuck with the results. If this is just a delay to end my claim, what can be done?
 
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#2
I hope this helps you. home.earthlink.net/~ssblaw/wcinfo.htm
 
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#3
doctors can make mistakes, have inaccurate records and history. any number of errors could have occurred.
the court allows either party to question the doctor and make sure the report and opinion is correct.
you would want the same if the rating was low and there were mistakes.
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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#4
If they picked the doctor and the rating was low, yes, I would want to know why. THEY are the one who chose which doctor I was to see. THEY are the ones who scheduled it. THEIR doctor gave me the high rating. I could see it if I picked the doctor and the rating was high. I have not yet read one post in the forum where the doctor from the insurance company gave a low rating and their defense attorney questioned it. I have read of ones that were high, but they were not directly scheduled or chosen by the insurance company.
Why would they want to question a doctor they chose and they paid? Gee, I wonder.
I thought maybe there was something in the system I could do as it was their doctor who gave me the rating and obviously they want a lower number. They win again.
 
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#5
I think you are confused.
it's not a dice roll.
you both picked the doctor. that's why it's called AGREED medical evaluator.
you had to agree or it would not have happened.
it's not their doctor.
more info here
http://www.dir.ca.gov/dwc/FactSheets/FactSheet_E.pdf
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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#6
Yes, they chose the doctor, I agreed to the one they chose, trying to cooperate. This is the point I am asking about. It is not as if I picked him out or was given an option (found out later that I could have not agreed). I got the letter from the insurance company with the appointment scheduled. Once I confirmed the appointment, I found out that that was my 'agreement', per the WC office when I called them. This is why I cannot understand why they can question what they set up and approved.
 
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#7
As they have told you they ask for a depo to make sure what the doctor said is correct. If it is then this depo will only help you out. Yes it does delay things and that could be the only reason they asked for it. Your lawyer will get to be there and ask question.
 
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#8
Update:
Found out this last week that the depo is set for 6 months from now. According to the defense for the insurance, this was the ONLY slot the doctor had available to do a depo. It just amazes me that through all this WC mess that anything that involves what the defense wants to do is put out so far that the injured worker is further distressed. But if they need something (depo the injured worker, getting an exam, needing paperwork), it is needed NOW or you lose your benefits.
Anyway, I called the AME doctor and asked if I wanted to have an AME evaluation, what is the earliest I could get in and how long would the appointment be. They had 6 appointment openings this month, taking from 2-3 hours for the appointment. Calling the WC office, they said that to depo an AME takes from 1-3 hours. So, how is it that he is not available for 6 months (available to do an AME this month, but not a depo that takes the same amount of time)?
Am I missing something here?
(DONE VENTING) Smile
 
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#9
yup, the legal system prioritizes their schedule before yours.
you can still try to settle while you are waiting.
you should be getting treatment and PD advances (unless they are exhausted) so you shouldn't be out much.
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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#10
Hurry up and wait. Learned that from day one with all this.
I could try and settle. I was rated at 80 whole body and their offer was 10k with closed medical.
I am getting PD, by how do you support a family of 6 at $200+ dollars a week?
Amazing system, isn't it.
 
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