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AME for DOI and additional body parts, TTD capped
#1
CT ortho is 2003.  Medicals indicate CT period was 2001 - 2002, ongoing.  Defense has agreed to use AME for DOI but not additional body parts.  I'm P&S by QME for ortho in 2014, still TTD on psyche but 5 year cap, so no benefits other than PD.  If I can ever get an AME, would TTD be paid since it's before the 5 year rule.  
 
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#2
different rules for different states.
in california if there was not a prior award then maybe.
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
(06-22-2016, 04:01 PM)Leah Wrote:
CT ortho is 2003.  Medicals indicate CT period was 2001 - 2002, ongoing.  Defense has agreed to use AME for DOI but not additional body parts.  I'm P&S by QME for ortho in 2014, still TTD on psyche but 5 year cap, so no benefits other than PD.  If I can ever get an AME, would TTD be paid since it's before the 5 year rule.  
 
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#4
(06-22-2016, 04:53 PM)1171 Wrote: different rules for different states.
in california if there was not a prior award then maybe.

Thank you, longest serving member, your service is certainly appreciated.  Is there anything I can do as the I.W. to move this along?  There is no prior award, only P&S by Panel QME in 2014.  Thank you.
 
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#5
attys move quicker when they are facing a hearing date.
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
(06-23-2016, 01:41 AM)1171 Wrote: attys move quicker when they are facing a hearing date.
****
I have a Panel QME for psyche next month, Ordered by the Judge.  If QME determines TTD due, I'll request an expedited hearing.  Defense has agreed to AME for DOI (2002) but not to alll body parts on original App.  My Initial attorney retired shortly after I filed my claim. Progress has slowed over the past 3 years.  I understand W.C. will be phased out in CA eventually.  I'm concerned that I may not get an award before I pass away.  
 
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#7
Work comp is here until the law changes.
Can,t predict what laws will be passed in the future.
I think you,ve misunderstood something or someone.
I wouldn't bet against 100+ years of comp law in California ending anytime soon.
To my knowledge they haven,t found a better system.
And even if they did the legislature would talk it to death before it'd ever happen.
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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#8
(06-23-2016, 07:22 PM)1171 Wrote: Work comp is here until the law changes.
Can,t predict what laws will be passed in the future.
I think you,ve misunderstood something or someone.
I wouldn't bet against 100+ years of comp law in California ending anytime soon.
To my knowledge they haven,t  found a better system.
And even if they did the legislature would talk it to death before it'd ever happen.
 
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#9
(06-23-2016, 07:22 PM)1171 Wrote: Work comp is here until the law changes.
Can,t predict what laws will be passed in the future.
I think you,ve misunderstood something or someone.
I wouldn't bet against 100+ years of comp law in California ending anytime soon.
To my knowledge they haven,t  found a better system.
And even if they did the legislature would talk it to death before it'd ever happen.
 
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#10
QME psyche Panel Ordered by Judge.  1.  If the QME states I'm P&S with TTD due, and TTD has been capped, would SCIF pay TTD?  They stopped TTD since I was P&S by ortho QME, but began TTD again upon psyche report, which they agreed to.  Psyche was not denied nor accepted by SCIF.  Benefits stopped, I assumed it was for TTD cap.   I did not receive ending TTD notices or PD start notices, and PD currently being paid.  If the QME psyche determines I'm P&S with TTD due, or if I'm still TTD, would it be paid?  If I am not P&S by psyche, would it prevent a settlement until I'm P&S?  Coverage also by AIG, picked up since CT extended to the end of my employment, have partially denied claim for psyche, however they have been paying for psyche RX and med mileage.  Multiple ins. companies involved and they have agreed to AME for DOI being prior to 2003, however refuse to body parts, therefore I can't get the AME.
 
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