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Everyone Should read this. Important info
#1
Exclamation 
Found this post on another site, good info.


Anyone ever use this below before when their AME/QME lags on getting the report out in a timely manner? Supposed to be 30 days that he gets the report out. So, according to this if the AME/QME is running in to like 5 months, 6 months, etc. or anything over 30 days, the applicant can get a new examination with another AME. Huh?


CALIFORNIA LABOR CODE:
If a qualified medical evaluator selected from a panel fails to complete the formal medical evaluation within the timeframes (30 days), established by the administrative director pursuant to paragraph (1) of subdivision (j) of Section 139.2, a new evaluation may be obtained upon the request of either party, as provided in Sections 4062.1 or 4062.2.

139.2 (1) (A) Standards governing the timeframes within which medical evaluations shall be prepared and submitted by agreed and qualified medical evaluators. Except as provided in this subdivision, the timeframe for initial medical evaluations to be prepared and submitted shall be no more than 30 days after the evaluator has seen the employee or otherwise commenced the medical evaluation procedure.

Neither the employee nor the employer shall have any liability for payment for the formal medical evaluation which was not completed within the required timeframes unless the employee or employer, on forms prescribed by the administrative director, each waive the right to a new evaluation and elects to accept the original evaluation even though it was not completed within the required timeframes. 4062.8.
Thanks for all the help.
Confusedd
 
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#2
Well, if you think the report will be favorable to you, it might be worth the wait. But then again, if you want another shot at the AME/QME evaluation, this is your chance. The only good thing is that if you have to go thru it all over again, you know what to expect. The first doctor won't be paid for the exam either. That's his penalty for being late, if you start over again. Too bad, so sad. Tongue

Good luck to you.
Let Go, and Let God......
 
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#3
Wow that is terrific for those who are being screwed by people who are sitting on a report because it is in the patient's favor....I wonder how quick they will show up when this is brought out.

Sithie
The good news is,"You can get used to anything."
The bad news is,"You can get used to anything."
:-)
Sithie
 
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#4
I am scheduled to see a QME. Have you received the doctors report back yet? Was it in your favor? I'm very worried about this appointment since I have met horrible doctors in this system.
 
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#5
**star** Wrote:I am scheduled to see a QME and am in CA. Have you received the doctors report back yet? Was it in your favor? ARe they ever in the patients favor here in CA? I'm very worried about this appointment since I have met horrible doctors in this system.

Hi Star,

I am also in california, I have found my AME Dr. to be very fair as to my injurys for the most part, not really one sided.

However, I do think that the adjust their appts. with the paitents to accomadate the inusrance co. Just like now, I will have appointment with my injurys and it is taking very long to get the report.

For example, Two yrs. limit for TTD benefits, One of my Ame appts. took 7 mo's to see the dr. stretching out the limbo time.

When they wanted me to see the dr. to make me P.S. the Ame appt. only took 2 mo's to see the Dr. and 2 weeks to get the report.

All i can say is dont be in a hurry.

Confusedd.
Thanks for all the help.
Confusedd
 
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#6
Smile
Unfortunately the information from the other message board is NOT correct.
Smile
Under California comp laws the 30 day time limit only applies to reports generated from state approved and certified QMEs
An AME that's reporting thru an agreement between the parties is not subject to the state's QME guidelines and you CANNOT get another AME if the report takes longer.
Please notice the labor code citation only refers to QME and there is no mention of AME.
Smile
Of course this information is only important for those subject to california comp laws and not everyone.
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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#7
1171 Wrote:Smile
Unfortunately the information from the other message board is NOT correct.
Smile
Under California comp laws the 30 day time limit only applies to reports generated from state approved and certified QMEs
An AME that's reporting thru an agreement between the parties is not subject to the state's QME guidelines and you CANNOT get another AME if the report takes longer.
Please notice the labor code citation only refers to QME and there is no mention of AME.
Smile
Of course this information is only important for those subject to california comp laws and not everyone.

You are so informative. How do you know all this? Glad you're here with us Smile
 
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#8
1171 Wrote:Smile
Unfortunately the information from the other message board is NOT correct.
Smile
Under California comp laws the 30 day time limit only applies to reports generated from state approved and certified QMEs
An AME that's reporting thru an agreement between the parties is not subject to the state's QME guidelines and you CANNOT get another AME if the report takes longer.
Please notice the labor code citation only refers to QME and there is no mention of AME.
Smile
Of course this information is only important for those subject to california comp laws and not everyone.


1171, Who are u, Attorney, Adjuster ?
Confusedd
Thanks for all the help.
Confusedd
 
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#9
Smile
I've had various jobs with a state agency that deals with all kinds of work comp matters - many of them regarding california's comp system.
Wink
I notice you and star have not posted anything in your BIO.
would you like to share more about yourselves or your claim?
Shy
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
1171 Wrote:Smile
I've had various jobs with a state agency that deals with all kinds of work comp matters - many of them regarding california's comp system.
Wink
I notice you and star have not posted anything in your BIO.
would you like to share more about yourselves or your claim?
Shy


What is a Gov work comp agency? Are you an investigator or adjuster of some sort or are you on the IW side?
 
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