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W/C sent QME papers what next
#1
Shy 
Hi Everyone! I'm an old member LOL 2007. My fiance (construction superintendent) hired May 2014 was injured July 2014 while walking backwards/carry sheetrock with another co-worker.
He developed 3 hernias from this incident. He reported the incident to his employer immediately, the Owner said go to the doctors. he asked for his medical insurance info and the receptionist stated he would get it soon but to go to his local county ER for treatment. SO we went to County, received CChealth plan, and he received treatment. Fast forward, December 2014, doctors schedule him for laparoscopic hernia repair. We ask again for his medical insurance or could we use another facility or doctors, so we wouldn't have to use County Medical since it was work comp. Again the Company receptionist said "well if you get the insurance now it will cost you alot of money since you wont be working much to pay for the insurance." So no company insurance. Even work comp wasn't sending him for a ssecond opinion or telling him to go to any Doctor. He had his surgery 12/12/14 at County Hospital, while in recovery room got up to go to the bathroom as instructed by the doctors, while standing to pee, his incision popped open! Bleed through the bandage and all over his gown. Surgeon was right there and took what looked like masking tape and strapped it across his belly. (it was a sight) 12/13/14 he was discharged with Norco for pain and told he could go back to work 12/15/14. On 12/13/14, for pain control and unbelieveable swelling. 12/22/14 while standing at the bathroom sink brushing his teeth, his incision opened and his belly dripped blood and his abdomen turned red! Went to ER and was told he had an infection. He was treated with IV antibiotics and Keflex for 10 days. Saw surgeon 1/8/15, he said I have never had a patient experience such an infection or complications ever! Right!
Anyway, just received a letter from work comp with a form for a QME. What doctor/specialty should I pick? How will this affect his job? His boss just told him there is no work for him. He told him to start looking for work. He wasn't laid off or fired just told to look elsewhere. He has no medical insurance through the company like he was suppose to after 90 days employment, he still having complications from the surgery, wound has not healed and still opens upon occasion. What to do, what to do?
Hello to 1171 and Cooks Family
Babebahn..."Tongues don't have erasers"
Injured 1999 3 level anterior cervical fusion 2001
Settled Work Comp Case 2006 w/ Lifetime Medical Currently, C7-T1 is being watched will possibly need surgery front/back fusion from C3-T2, lower back needs another facet injection.
 
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#2
general surgeon usually performs hernia repair.
choosing a QME should not affect his job.
workers comp carrier will handle treatment for work injury--I assume they requested the QME.
he should contact the carrier to pay disability while he is recovering.
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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#3
(01-14-2015, 02:09 AM)1171 Wrote: general surgeon usually performs hernia repair.
choosing a QME should not affect his job.
workers comp carrier will handle treatment for work injury--I assume they requested the QME.
he should contact the carrier to pay disability while he is recovering.

Adjuster said today, QME is only if you dislike your doctor or surgeon. She said to go for a follow up with surgeon one more time and then do the QME.
Babebahn..."Tongues don't have erasers"
Injured 1999 3 level anterior cervical fusion 2001
Settled Work Comp Case 2006 w/ Lifetime Medical Currently, C7-T1 is being watched will possibly need surgery front/back fusion from C3-T2, lower back needs another facet injection.
 
Reply
#4
so the QME form was not about attending a specific exam but just informational about the QME process?
there are many forms in the process, it helps to be specific.
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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#5


What state are you in?

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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#6
(01-14-2015, 10:00 PM)1171 Wrote: so the QME form was not about attending a specific exam but just informational about the QME process?
there are many forms in the process, it helps to be specific.

HI 1171, he spoke with the adjuster. She stated he was to fill out the form whether or not he was satisfied with the care he received. This was not at all the process I had when I was going through my w/c issues!
Babebahn..."Tongues don't have erasers"
Injured 1999 3 level anterior cervical fusion 2001
Settled Work Comp Case 2006 w/ Lifetime Medical Currently, C7-T1 is being watched will possibly need surgery front/back fusion from C3-T2, lower back needs another facet injection.
 
Reply
#7
(01-14-2015, 10:16 PM)California_Help Wrote: What state are you in? I'm in California
Babebahn..."Tongues don't have erasers"
Injured 1999 3 level anterior cervical fusion 2001
Settled Work Comp Case 2006 w/ Lifetime Medical Currently, C7-T1 is being watched will possibly need surgery front/back fusion from C3-T2, lower back needs another facet injection.
 
Reply
#8
(01-15-2015, 03:39 PM)Babebahn Wrote: HI 1171, he spoke with the adjuster. She stated he was to fill out the form whether or not he was satisfied with the care he received. This was not at all the process I had when I was going through my w/c issues!

you can always check the rules here
http://www.dir.ca.gov/dwc/medicalUnit/faqIW.html
or
http://www.dir.ca.gov/dwc/MedicalUnit/imchp.html
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.
 
Reply
  


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