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WC California /QME
#1
I saw the QME yesterday and after the IC has denied so many treatments, now the QME has decided that I need the treatments, so the question is does the IC have to go with what the QME has suggested or his report? Maximus had denied hand treatment and nerve testing thus far. This QME has not in the past been very patient supportive and yet he had asked if I wanted the treatment that my PTP has suggested! ! Of course I said yes !!! On another note my medicare is set to start in less than 2 months thanks to SSDI and I have a MSA sitting out on the defense desk and the IC also ...

Thanks in advance
 
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#2
It is my understanding they have to approve testing the QME needs done, but not treatment. Treatment is either approved by the claims adjuster, UR or IMR.


There is a lot of under treatment going on in work comp and also a lot of over-treatment going on. I am not surprised he asked you if you wanted the specific treatment, especially if it is surgery. He may be aware of the reputation of your doctor. (unknown)
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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#3
California help, thank you for your response, QME said no surgery at this point, but asked about if I wanted the injections for my hand .Maximus did denied the nerve testing, but yet QME wants it done . I've had no treatment for over 2 years, so I'm surprised at this QME request. Oh and yes the QME is very aware of my PTP, my PTP is also a QME! !! I truly believe it's because of my PTP being who he is ... Guess I should be grateful, but at the same time, it's W/C ...

Thanks Again
 
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#4
I may have gotten you mixed up with another injured worker but does your PTP have initials E.H. ?
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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#5
California help, nope , B.G . Is my PTP initials !!!
 
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#6
Ok sorry. I must have missed you up with another IWf
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
mixed you up
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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