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inaqurate QME report &penalties
#1
ShyHere is a 2 for 1:
Just started as unrepresented IW=pro per)learned that here, thank you 1171!
1- Can I consider penalties for an unreasonable delay(almost 1 yr) in authorization of medical treatment?

2- 1st QME exam was done 4/2006; 2nd eval 3/2007 then appearantly those were followed up by a report I don't yet have a copy of, completed 5/2007. I know of this report after reading the QME deposition. What are my rights, if any, disputing his evaluations now that I am pro per? thank you anyone for input, deni
 
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#2
So a unrepresented person is a PRO-PER? I Never heard of such a thing. I do not have a lawyer, as i have never had a need to even have one. So i guess you could call me a PRO-PER also..lol. You learn something new everyday.
carpal tunnel recurrence/ neuropathy / RSD.
1/29/07 injury date. Permanent. PIR settlement 8/4/08 10%
 
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#3
yes, you'd have to have evidence showing the delay or denial was unreasonable e.g. no medical or legal basis.
Generally an AME overrides all prior opinions so ealier medical reports are basically moot.

ps to sparkey:
in california "pro per" refers to a litigated claim without an atty.
most claims are unlitigated and therefore have no need of representation ---- pro per or otherwise. other jurisdictions may refer to it as In pro se.
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
sparkey Wrote:So a unrepresented person is a PRO-PER? I Never heard of such a thing. I do not have a lawyer, as i have never had a need to even have one. So i guess you could call me a PRO-PER also..lol. You learn something new everyday.

good luck on your claim. they can get pretty confusing as time goes on. As far as the pro per status, i learned a bit about that term from this forum. thanks to member 117. He[/u] responded here again in regards to your claim. hoping this all helps. I found the manual California Worker' Comp how to take charge when you're injured on the job by Christopher Ball/Nolo Press lots of easy to understand terms and procedures if you are on your own or not....luck to you, deni
 
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#5
1171 Wrote:yes, you'd have to have evidence showing the delay or denial was unreasonable e.g. no medical or legal basis.
Generally an AME overrides all prior opinions so ealier medical reports are basically moot.

ps to sparkey:
in california "pro per" refers to a litigated claim without an atty.
most claims are unlitigated and therefore have no need of representation ---- pro per or otherwise. other jurisdictions may refer to it as In pro se.
:

APOLOGIESSad to 1171 from deni.)..I quoted your name incorrectly in my reply to "sparkey"...typo...as was my spelling of "inaccurate", no spell check.Big Grin
Comment on DELAY/DENIAL penalty: I believe I do have the evidence to show the delay and subsequent denial was unreasonable. Eventually, they did have a legal basis, but, even at that point, I have evidence to prove they were being unreasonable. thank you. I will work more on this evidence.
AME response: I am still not clear on your response to question. All 3 QME reports were done by same QME. His reports had conflicting statements and incorrect information as well, his deposition was a train wreck. Then there was a separate AME eval done by a Psychiatrist. It was thorough & covered all reports. It was fairly accurate. Question: Would this psych AME report carry weight on my shoulder & cervical injury since he addressed them in his report? deni
 
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#6
Why don't you just get an attorney? Wouldn't that be the wise thing to do???
 
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#7
I didn't realize the AME was only for one condition. In that case it's the controling decision on just the psyche component.
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
Toungue 
1171 Wrote:I didn't realize the AME was only for one condition. In that case it's the controling decision on just the psyche component.
[font=Arial]
to 1171: that seems logical,thank you, again....my case began being straight forward, uncomplicated. over the yrs, grew more complex, thus, don't want to assume logic .
to stiffnecked:
wise thing to do? i'm not sure...i posted this very question the other day before dismissing my attorney. I do know, the decision was not made lightly. I represented myself 1st 4 yrs, had an attorney for 1+ yrs and now here I am. My experience at my MSC last week was not one I care to repeat OR pay for. They can have their fee, but, I refuse to sit quietly by listen to their "guess work" .
I hoped this forum was a resource for questions.
wise? not so much, but, sane today...you bet!
 
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#9
If your going to try to do it yourself you need to post your questions over on the California forum. They are very knowledgable on the working of the CA/WC rules and regulations.

http://www.workcompforums.com/ca/iw/cate...m?catid=12
 
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#10
stiffnecked Wrote:Why don't you just get an attorney? Wouldn't that be the wise thing to do???

to stiffnecked...please see my respose to your post below (1171 section) I am new to using this kind of forum. deni
 
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