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CA Injured Worker - Overturn MMI Report?
#11
(06-14-2016, 02:30 PM)Daimhin Wrote:
(06-14-2016, 01:35 PM)California_Help Wrote: TTD is caped at 104 weeks. 

Also, your date of injury is after 1/1/2013 so the insurance company no longer has to pay PD in advance. It sounds like they paid you some of it.

I have seen PTP's rebut AME reports,. This can be difficult and it is up to the attorney if the PTP's report is written well enough to file for a hearing over the issue.  Has your PTP written a report that rebuts the AME's report that clearly stated why you are still TTD? If your PTP is just writing TTD in his monthly office visit reports without any rational as to why, I do not think this would be enough to file for a hearing (JMO).

1171, could his AA request a supplemental report from the AME on the issue of TTD  due to his doctors reports stating patient is still TTD (I am assuming his PTP is writing reports that give reasoning as to why he is TTD)?

If your doctor has stated you are still TTD, have you applied for state disability? From what I have seen they have been lenient with many injured workers who did not apply timely.

Yes, my doctor has written the correct reports stating why I am still TTD. I actually just got off the phone with my attorney and was asked to call my doctor and have them fax that report so they can petition for a hearing. So, the ball is rolling.

I have applied for SSDI 3 times and was consistently denied. They claimed my injury wasn't severe enough. I would have applied for unemployment, but am still technically employed so that never happened.
Have you applied for state disability (SDI)...this is not social security disability (SSDI)? You are most likely past the deadline but I have read about injured workers being able to still obtain state disability regardless as sometimes they/ADD are lenient about deadlines to apply. I think it is worth a try and state disability can pay up to a year. You and your doctor has to fill out a form. California state disability has different qualifications as SSDI. SSDI is much harder to qualify.

http://www.edd.ca.gov/disability/SDI_Onl...#claimants

Again, I have read it is very difficult to overturn an AME or QME report with a PTP report, but it has happened. Your PTP would have to have written a more well reasoned report than your AME report or show that the AME did not base his report on facts and/or is bias for example. I am surprised your attorney's office stated they wanted your PTP's report faxed to file for a hearing before they even read it.

 I hope everything works out and you get your TTD.

Best of luck to you.
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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#12
(06-14-2016, 09:22 PM)California_Help Wrote:
(06-14-2016, 02:30 PM)Daimhin Wrote:
(06-14-2016, 01:35 PM)California_Help Wrote: TTD is caped at 104 weeks. 

Also, your date of injury is after 1/1/2013 so the insurance company no longer has to pay PD in advance. It sounds like they paid you some of it.

I have seen PTP's rebut AME reports,. This can be difficult and it is up to the attorney if the PTP's report is written well enough to file for a hearing over the issue.  Has your PTP written a report that rebuts the AME's report that clearly stated why you are still TTD? If your PTP is just writing TTD in his monthly office visit reports without any rational as to why, I do not think this would be enough to file for a hearing (JMO).

1171, could his AA request a supplemental report from the AME on the issue of TTD  due to his doctors reports stating patient is still TTD (I am assuming his PTP is writing reports that give reasoning as to why he is TTD)?

If your doctor has stated you are still TTD, have you applied for state disability? From what I have seen they have been lenient with many injured workers who did not apply timely.

Yes, my doctor has written the correct reports stating why I am still TTD. I actually just got off the phone with my attorney and was asked to call my doctor and have them fax that report so they can petition for a hearing. So, the ball is rolling.

I have applied for SSDI 3 times and was consistently denied. They claimed my injury wasn't severe enough. I would have applied for unemployment, but am still technically employed so that never happened.
Have you applied for state disability (SDI)...this is not social security disability (SSDI)? You are most likely past the deadline but I have read about injured workers being able to still obtain state disability regardless as sometimes they/ADD are lenient about deadlines to apply. I think it is worth a try and state disability can pay up to a year. You and your doctor has to fill out a form. California state disability has different qualifications as SSDI. SSDI is much harder to qualify.

http://www.edd.ca.gov/disability/SDI_Onl...#claimants

Again, I have read it is very difficult to overturn an AME or QME report with a PTP report, but it has happened. Your PTP would have to have written a more well reasoned report than your AME report or show that the AME did not base his report on facts and/or is bias for example. I am surprised your attorney's office stated they wanted your PTP's report faxed to file for a hearing before they even read it.

 I hope everything works out and you get your TTD.

Best of luck to you.

Thanks. We'll see how it all plays out...

As for the SDI... I didn't qualify. I was 24 when injured. Not enough job credits. Or whatever.
 
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