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Qme report
#1
Hello everyone... I am new to this forum but I wish I would have found this sooner.

My claim is in the state of California

To make a long story short. I went to see the qme a while back. I was there for about 15-20 minutes and he said my injury was 100% work related and that I can return to work with no restriction. He order me to get an mri. So I got one done about a month after seeing him.

I got his report last week from him but it was only two sentence long. It basically said that he didn’t see any new findings from his first report and that I am at mmi on the date of the mri.

Is this common? I know I’m going to need to possible appeal it but could I just have him explain why he didn’t give a rating? Doesn’t this just delay the already long process. Isn’t he required to at least list the injury date?

What steps should I take to resolve this as quickly as possible.

Claim has been denied as well


Thanks
 
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#2
(07-18-2018, 04:37 PM)Lostandconfused Wrote: Hello everyone... I am new to this forum but I wish I would have found this sooner.

My claim is in the state of California

To make a long story short. I went to see the qme a while back. I was there for about 15-20 minutes and he said my injury was 100% work related and that I can return to work with no restriction. He order me to get an mri. So I got one done about a month after seeing him.

I got his report last week from him but it was only two sentence long. It basically said that he didn’t see any new findings from his first report and that I am at mmi on the date of the mri.

Is this common? I know I’m going to need to possible appeal it but could I just have him explain why he didn’t give a rating? Doesn’t this just delay the already long process. Isn’t he required to at least list the injury date?

What steps should I take to resolve this as quickly as possible.

Claim has been denied as well


Thanks
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
The workers comp system doesn’t Publish medical reports or statistics on QME conclusions. It’s happened before but i cannot guess at how frequently. I suspect different situations and different medical conditions dictatate whether an MRI comes back with significant findings or not. It may even depend on the quality of the MRI and/or the expertise of the radiologist.
You should have supporting evidence of an error/alternate conclusion before asking the comp court to throw out the QME opinion. I would recommend getting legal representation before going that route.
Was the QMEasked to give a rating or anything more?
The parties can jointly request a supplemental report for clarification or additional information.
If the parties agree the report is unusable or inadequate, they can request another QME and file a complaint with the DWC. Again legal representation may be helpful in resolving these issues.
If you are not represented, try the I&A unit
https://www.dir.ca.gov/dwc/IandA.html

More on the QME process here:
https://www.dir.ca.gov/samples/search/querydwc.htm
https://www.dir.ca.gov/dwc/MedicalUnit/discipline.html
https://www.dir.ca.gov/dwc/medicalUnit/faqIW.html
https://www.dir.ca.gov/dwc/DWC_FilingAComplaint.htm
Fact sheet E:
https://www.dir.ca.gov/dwc/iwguides.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.
 
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#4
Yes, the original request for summary of rating determined get of qualified or agreed examiners report. He didn’t give a rating then because he wanted mri done first. In that report it was detailed and showed date of injury and work restrictions. He submitted the second one after he reviewed mri and he only had two sentences. My ptp are disputing it but it’s been over a year since doi so. After reading a post about being an advocate. I decided to look into it so I will havep Of mind.

I just don’t know if I need to request new panel or have him add it.

Thanks 1171, I really appreciate the quick response

I’ve been lead in so many circles since the injury
 
Reply
#5
(07-18-2018, 04:37 PM)Lostandconfused Wrote: Hello everyone... I am new to this forum but I wish I would have found this sooner.

My claim is in the state of California

To make a long story short. I went to see the qme a while back. I was there for about 15-20 minutes and he said my injury was 100% work related and that I can return to work with no restriction. He order me to get an mri. So I got one done about a month after seeing him.

I got his report last week from him but it was only two sentence long. It basically said that he didn’t see any new findings from his first report and that I am at mmi on the date of the mri.

Is this common? I know I’m going to need to possible appeal it but could I just have him explain why he didn’t give a rating? Doesn’t this just delay the already long process. Isn’t he required to at least list the injury date?

What steps should I take to resolve this as quickly as possible.

Claim has been denied as well


Thanks

It sounds like he may have written a report you did not get and the second report was after the MRI.
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
I recommend calling an information and assistance officer for help. You can also take those two reports down to the work comp board and ask if I&A officer can sit with you and go over your options. You can also consult with an attorney.


Sorry about above. We must have been typing at the same time.
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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#7
Thanks everyone, I will go down there. I’ve called inquiring about another issue but I get the vibe that calling will not get me an answer.
 
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#8
(07-18-2018, 06:22 PM)Lostandconfused Wrote: Thanks everyone, I will go down there. I’ve called inquiring about another issue but I get the vibe that calling will not get me an answer.

I have found calling them is like a box of chocolates, you never know what you are going to get.

Good luck.
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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