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Pro vs con of QME
#1
Hello
I have a WC claim in California since 2018. I was recently examined by an ortho specialist who said that I was a candidate for surgery to repair a bicep tear. I injured my shoulder, back and neck at work.

Questions: Can a QME go either way? In other words, can it make my claim stronger or weaker? Do the benefits of a QME outweigh not having one at all?

I a, asking because I just elected to have a QME since my WC is pressuring me to settle, yet they are not listing my neck or back body part on the final Compromise and Release settlement.

I appreciate any insight on this.

Thanks!
Kriola
 
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#2
A QME gives their opinion when either party disputes the treating doctor. No one can predict what that opinion will be in advance. The opinion has to be supported by facts and medical findings. They can agree with the treating doctor or disagree.
As long as the medical supports the neck and back injuries you can add them.
Or
You can add specific wording that the settlement does not include the neck and back and you will be pursuing benefits on those conditions separately
Not including them is an oversight on their part and opens the door for you.
If they accepted the claim and you are planing on surgery, are you sure you’re getting all he benefits you are entitled—specially if there are complications?
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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