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pysch.


If you are not being copied you need to contact your doctor(s) offices and make sure you are being copied and on their proof of service page.

Do you have the records on the list?
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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I have gotten all my records together, and copied them with them. The only report I got from the other side is a deposition from the car accident, asking the pqme to apportion some of my injuries out to that. I immediately objected to that being non-medical, and the att. said he would take it out.

I read the rules on the wcab web page, and it say's they have to copy me with the actual records.

I will send it to you, and you tell me what you think.
 
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© At least twenty (20) days before the information is to be provided to the evaluator, the party providing such medical and non-medical reports and information shall serve it on the opposing party. Mental health records that are subject to the protections of Health and Safety Code section 123115(b) shall not be served directly on the injured employee, but may be provided to a designated health care provider as provided in section 123115(b)(2), and the injured employee shall be notified in writing of this option for each such record to be provided to the evaluator. In both unrepresented and represented cases the claims administrator shall attach a log to the front of the records and information being sent to the opposing party that identifies each record or other information to be sent to the evaluator and lists each item in the order it is attached to or appears on the log. In a represented case, the injured worker's attorney shall do the same for any records or other information to be sent to the evaluator directly from the attorney's office, if any. The claims administrator, or if none the employer, shall include a cover letter or other document when providing such information to the employee which shall clearly and conspicuously include the following language: “Please look carefully at the enclosed information. It may be used by the doctor who is evaluating your medical condition as it relates to your workers' compensation claim. If you do not want the doctor to see this information, you must let me know within 10 days.”



(d) If the opposing party objects within 10 days to any non-medical records or information proposed to be sent to an evaluator, those records and that information shall not be provided to the evaluator unless so ordered by a Workers' Compensation Administrative Law Judge.



(e) In no event shall any party forward to the evaluator: (1) any medical/legal report which has been rejected by a party as untimely pursuant to Labor Code section 4062.5; (2) any evaluation or consulting report written by any physician other than a treating physician, the primary treating physician or secondary physician, or an evaluator through the medical-legal process in Labor Code sections 4060 through 4062, that addresses permanent impairment, permanent disability or apportionment under California workers' compensation laws, unless that physician's report has first been ruled admissible by a Workers' Compensation Administrative Law Judge; or (3) any medical report or record or other information or thing which has been stricken, or found inadequate or inadmissible by a Workers' Compensation Administrative Law Judge, or which otherwise has been deemed inadmissible to the evaluator as a matter of law.
 
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Are there records on the list they sent you that you do not have in your possession already?

I recommend calling an I&A officer about this.

Let me know what I&A officer says on this topic as I am curious.
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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I looked into it a bit more and your adjuster is supposed to send the actual records. I will send you a pm about it.
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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That's what I thought too. I was reading the section were it say's that pysch records are not to be sent to injured worker, that would imply that they are talking about actual records, and not a list of said records. I think I will object to all records being provided by da/ca.

I went to the trouble of actually getting all copies of medical records I want the pqme to see, and copied both the ca/da on day 20 before the scheduled appt. so I'm covered.

I heard back from one of the people you mentioned, and he agreed.

Thank you for all your help. Will keep you posted after I object tomorrow, and let you know how the other side reacts.
 
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I would just make sure you keep this QME as he appears fair.

I think a letter that includes the rule you wrote about this topic stating they must provide the actual records and not list of records should do it.

Good luck with everything.
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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I sent them both an email objecting to all records med and non med be barred from presenting to the pqme. I also said since I copied them with all the records I plan on submitting to the pqme, and that is enough for him to render an opinion.

I went through bthe trouble of getting copies of all the records I plan on submitting to the pqme, and I did this on day 20 to make sure I covered my butt. They didn't do that. so I am objecting to all their records.
 
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Went to pqme, he asked me a few questions, and said he couldn't render an opinion by examine me, because he felt I was too limited on the movement of my upper extremities, and said he would make the rating based on the medical records I issued.

I don't know if that is how it works, but I feel he should base it on both the exam, and the records.

What do you guys think?

Also, I have rsd in the back, which is an accepted body part, and both knees, which are also covered under my wc.

I asked the DA/CA if I could let the pqme issue a rating for those body part's, and was told no. They sais that my doctor rated the rsd in the back at 3%.

I contacted my doctor, who said he did not rate my back. I told this to the da/ca before the appointment, and they still refused to allow the pqme to rate the other body parts.

Now I know when the pqme issues his report, they will immediately send the reports to the deu for a final rating, and I want to stop that from happening by filing a DRP and let the judge decide what to do as far as the other body parts are concerned.

Any opinions are greatly appreciated.
 
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It sounds like your QME is trying to do the best he can with what he has to work with. I would think the fact he could not examine you due to the extent of your condition would show how bad your condition is. I would not worry until you get his report, as it may be in your favor. Are the medical records you provided recent and do they show the extent of your injuries or have you gotten worse since those reports were written? Your other doctor was able to examine you and why I ask if your condition is now worse.

It was my understanding you or the defense could ask for a supplemental report if something was not covered by a QME.

Why is the defense deciding what you get rated on? I would call an I&A officer about your rights on this issue. I don't understand why it matters if your PTP has rated you previously, especially if your condition has changed and also if the PTP report is old/stale. I have not read any rule stating a QME cannot opine on a body part that was previously been rated by a PTP. I know people who have been rated by both their PTP and QME or AME and the most well written report is what the judge usually agreed with.

You have a lot of complex medical issues dolphins. I have always told you my opinion, and this is to hire an attorney to help you. If you had an attorney he would know the best strategy to move forward and could depose the QME (if needed).

If you do not hire an attorney, I suggest discussing this with an I&A officer, especially the about the defense stating you cannot be rated on certain body parts. I am not sure they have that right as a QME is supposed to opine on ratings and disputed body parts. Something does not sound right to me, but I am no expert in this so please get another opinion. The medical unit may also be another resource for you to enquire about the QME questions you have and also the question about rating a body part that was previously rated by your PTP.

As you are aware I am not an expert, just an injured worker like yourself. In this situation, you really need an experts advice. Perhaps 1171 will chime in because they know about issues such as this. My strongpoint is getting medical treatment authorized, denials overturned and basic rules in our state. MSA, PD ratings and settlements is not something I am knowledgeable about.

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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