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Qme report
#11
(12-10-2018, 10:41 PM)Lostandconfused Wrote:
(12-10-2018, 08:46 PM)California_Help Wrote:
(12-10-2018, 02:52 AM)Lostandconfused Wrote:
(12-09-2018, 11:45 PM)California_Help Wrote: This is in response to an earlier question you had about records sent to QME.

http://www.workerscompzone.com/2018/10/2...ey-goosey/

I hope I read this correctly. I’m not sure exactly what the IC sent to the qme or how many times they have contacted him. I know that the IC sent a packet that included most of my medical information and several non-medical that I objected to.

Then I received another packet from their attorney the day being dismissed from my case. This packet had a 6-7 page cover letter, in the cover letter, they submitted more non-medical and videos.

The second packet was sent to me with 9 days until the appointment. I emailed the IC and told them I decided not to object to anything that they want to send to the qme. The reason I changed my mind was I couldn’t afford to wait another 3-6 months for a panel. Secondly, it seems like the IC was purposely sent the second packet so I can request a new panel. Their actions showed me that the IC wanted to break the rules and procedures in order to change this doctor.

The difference in the case in the link is that the IW’s attorneys wanted a new panel. I want to keep this report. My ptp had requested for pain management and it was approved the week before my evaluation.

The question I was wanting to know is can the IC replace qme if they were the party that did follow labor code 4062.3(b). I’m not sure what they sent to the qme but it looks like neither packet was sent. I believe they only sent the videos and of course the employers letter that they’ve been sending to everyone else.

Thanks, I’ll take the report to my ptp and see what he says.

No that is not a reason I could see the judge allowing, unless you object, other wise insurance companies would do that on purpose to get out of a QME. Just in the future do not rely on them to send medicals that help your case, you should send them to QME, but follow the rules on the states website.

Objecting to the non medicals being sent is your right. This does not mean they would get another panel, it means they cannot send the QME those records without the judge ruling on it.

You should have been sent a list of records they were planning to send. If you did not get the list may be the reason the doctor did not receive any medicals. Again, you can also send a list of documents and cover letter to the QME, just as long as you follow the rules on the states website and send list to defense first.


The IC sent two lists and they both have all my medical records. The qme noted that he has not received any medical reports so I’m not sure what the IC is trying to accomplish.

I was approved for pain management before my appointment with the qme and they called to set an appointment. Does this effect the qme report? I just gave a copy to ptp so I’m sure it’s not a referral from the me report.

Is there a form or procedure for the employer to show they offered modified duty? The adjuster argues that there was work available had I not been terminated.

I know what I would do if the adjuster listed records but did not send them is I would send her a letter with a copy of the list and a copy of the QME report that states no records were sent and ask when is she going to send the QME the records and cc their attorney.

I don't see why pain management would affect anything. It can if the claims adjuster picked the pain management doctor (and he is defense oriented) and not you or your PTP. You have the right to pick the doctors you see within the insurance companies MPN (however not all doctors in the MPN's will see injured workers).

This is info about the interactive process.https://www.dfeh.ca.gov/reasonable-accommodation/ I do not believe this applies to your situation as you were let go. I would assume your QME returning you to work means you can now search for work that fits your restrictions. I also don't know if your situation would qualify for unemployment or not. You have a very complicated situation and an attorney is best person to answer these questions.
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
(12-10-2018, 11:37 PM)California_Help Wrote:
(12-10-2018, 10:41 PM)Lostandconfused Wrote:
(12-10-2018, 08:46 PM)California_Help Wrote:
(12-10-2018, 02:52 AM)Lostandconfused Wrote:
(12-09-2018, 11:45 PM)California_Help Wrote: This is in response to an earlier question you had about records sent to QME.

http://www.workerscompzone.com/2018/10/2...ey-goosey/

I hope I read this correctly. I’m not sure exactly what the IC sent to the qme or how many times they have contacted him. I know that the IC sent a packet that included most of my medical information and several non-medical that I objected to.

Then I received another packet from their attorney the day being dismissed from my case. This packet had a 6-7 page cover letter, in the cover letter, they submitted more non-medical and videos.

The second packet was sent to me with 9 days until the appointment. I emailed the IC and told them I decided not to object to anything that they want to send to the qme. The reason I changed my mind was I couldn’t afford to wait another 3-6 months for a panel. Secondly, it seems like the IC was purposely sent the second packet so I can request a new panel. Their actions showed me that the IC wanted to break the rules and procedures in order to change this doctor.

The difference in the case in the link is that the IW’s attorneys wanted a new panel. I want to keep this report. My ptp had requested for pain management and it was approved the week before my evaluation.

The question I was wanting to know is can the IC replace qme if they were the party that did follow labor code 4062.3(b). I’m not sure what they sent to the qme but it looks like neither packet was sent. I believe they only sent the videos and of course the employers letter that they’ve been sending to everyone else.

Thanks, I’ll take the report to my ptp and see what he says.

No that is not a reason I could see the judge allowing, unless you object, other wise insurance companies would do that on purpose to get out of a QME. Just in the future do not rely on them to send medicals that help your case, you should send them to QME, but follow the rules on the states website.

Objecting to the non medicals being sent is your right. This does not mean they would get another panel, it means they cannot send the QME those records without the judge ruling on it.

You should have been sent a list of records they were planning to send. If you did not get the list may be the reason the doctor did not receive any medicals. Again, you can also send a list of documents and cover letter to the QME, just as long as you follow the rules on the states website and send list to defense first.


The IC sent two lists and they both have all my medical records. The qme noted that he has not received any medical reports so I’m not sure what the IC is trying to accomplish.

I was approved for pain management before my appointment with the qme and they called to set an appointment. Does this effect the qme report? I just gave a copy to ptp so I’m sure it’s not a referral from the me report.

Is there a form or procedure for the employer to show they offered modified duty? The adjuster argues that there was work available had I not been terminated.

I know what I would do if the adjuster listed records but did not send them is I would send her a letter with a copy of the list and a copy of the QME report that states no records were sent and ask when is she going to send the QME the records and cc their attorney.

I don't see why pain management would affect anything. It can if the claims adjuster picked the pain management doctor (and he is defense oriented) and not you or your PTP. You have the right to pick the doctors you see within the insurance companies MPN (however not all doctors in the MPN's will see injured workers).

This is info about the interactive process.https://www.dfeh.ca.gov/reasonable-accommodation/ I do not believe this applies to your situation as you were let go. I would assume your QME returning you to work means you can now search for work that fits your restrictions. I also don't know if your situation would qualify for unemployment or not. You have a very complicated situation and an attorney is best person to answer these questions.

Do I fill out that form? Is the form for new employment?

I’m not sure if the qme thought I might still be employed there so I’m not exactly sure what he meant by it.

Is there a labor code or a dwc rule that says if the employer doesn’t offer modified duty then the IW would be entitled to ttd? I read that somewhere but I can’t find it anymore. It also mentioned if in 60 days the employer doesn’t offer a job then the IW can get a supplemental job voucher.

I think the employer didn’t see the second note that had restrictions. They saw the note from the day before with no restrictions. The IC didn’t forward my information and the doctor only wrote that note to excuse me for the day.
 
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#13
You received notification of SJDV. I sent you links about it on another thread.

Your insurance company is denying TTD due to your termination. The judge needs to decide the TTD issue.

Keep looking for an attorney.
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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#14
I recommend calling the defense attorney and ask him for the proof of service page for your SJDV (and then follow up in writing requesting it and save a copy of letter or email for yourself). You should have received around 6 pages in that packet. Once you get that you can apply for RTWSP and if you qualify you will receive a check for 5 grand in aprox 4-6 weeks.

https://www.dir.ca.gov/dwc/sjdb/SJDB_FAQ.html
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.
 
Reply
#15
(12-11-2018, 03:03 PM)California_Help Wrote: I recommend calling the defense attorney and ask him for the proof of service page for your SJDV (and then follow up in writing requesting it and save a copy of letter or email for yourself). You should have received around 6 pages in that packet. Once you get that you can apply for RTWSP and if you qualify you will receive a check for 5 grand in aprox 4-6 weeks.

https://www.dir.ca.gov/dwc/sjdb/SJDB_FAQ.html

I spoke to their attorney yesterday and it sounds like they want to try and settle. I gave him all the evidence to prove that the ER provided them with false information.
I think I know why the ER had so many differ dates of misconduct. The doctor from the network whom I picked faxed the employer a note that says to excuse my absence. I’m sure they jumped the gun and thought the doctor release me back to work. He sent me home because the IC did not forward my information. I came back the next business day and the doctor did a full evaluation. He gave me restrictions and told me I can only work if they can provide light duty work.
They sent Edd a letter that they my termination was justified for failure to follow procedure on a date before doi. I believe they realize the restrictions a month later and submitted a new separation letter with the incident date after my injury so they won’t be responsible for loss wages.
I was at the wcab today but I forgot to ask about the voucher. My hearing is next week and so my mind was focused on that.
I think I know why I have not contacted the attorney that was waiting for the qme report before he takes my case. I think I get really nervous and I can’t make the call. I have a evaluation for this next month. I’m a bit worried about it.
 
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#16
(12-11-2018, 03:03 PM)California_Help Wrote: I recommend calling the defense attorney and ask him for the proof of service page for your SJDV (and then follow up in writing requesting it and save a copy of letter or email for yourself). You should have received around 6 pages in that packet. Once you get that you can apply for RTWSP and if you qualify you will receive a check for 5 grand in aprox 4-6 weeks.

https://www.dir.ca.gov/dwc/sjdb/SJDB_FAQ.html

The IC is now saying that I can be entitled to retro ttd. They are offering 60% at roughly 30k or risk going to trial and getting nothing. I rejected the offer because I need the treatment.

I’m not at mmi so I wanted to see if I can get better physically and mentally. One of my report says chronic pain and I have heard that it take 1 month to heal or long term care.
 
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#17
Or you can take the settlement and pay cash for your treatment and/or apply for Obamacare and pay for it and use it for your injury. That reminds me, have you applied for Medicaid, Medical or Obamacare? With no income you may qualify for free insurance (unknown). I don't know if open enrollment is over or not.

I don't know how your treatment has gone but many injured workers have difficulties getting medical treatment while in the work comp system due to utilization review and IMR denials. There is no guarantee even with an accepted injury that you will get medical treatment.

I still recommend asking for that proof of service page so you can apply for that money. I called I&A and was told you need that page to apply. That money does not come from your insurance carrier. It comes from a fund. If you are short on $$ I would do it ASAP.
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.
 
Reply
#18
You can also try to negotiate a higher offer.
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.
 
Reply
#19
(12-12-2018, 08:09 PM)California_Help Wrote: You can also try to negotiate a higher offer.

I’m not sure how to calculate future medical or ratings and i don’t want to just give any number with no support.
 
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#20
Did the QME opine on what your future medical needs are? I am guessing no if he did not receive your records.

You can calculate just the past TTD owed, 2/3 of your pre taxed wages.. There is a max on 104 weeks. It is not taxed. Hopefully they will send you a check for past TTD owed.
https://www.nolo.com/legal-encyclopedia/...ornia.html

PD ratings are more complicated and I am guessing you have not received rating yet?

An attorney would be helpful with this.
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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