Legal Question in Disability Law in California

Re: Qualified Medical Examiner supports disability claim, what now?

I would need more information as to why the insurance company is denying the claim. But generally if you went to a Panel Qualified Medical Examiner (PQME) and if there is no real dispute as to the facts of how the injury occurred, there should not be a problem. However, if they are denying for other reasons (i.e. the injury did not occur on the job, you reported the injury after termination or notice to be terminated, or a host of other defenses) then they will conintue to deny. It is possible the doctor found impairment (disability) but left the "causation" up to the trier of fact (Judge).

I assume you do not have an attorney, but if you do, discuss this with your attorney. If you do not have an attorney, call the insurance company directly and ask them if they are now willing to accept the claim based on the doctor report.

Don't forget, since the claim is denied, I imagine they did not pay you any temporary disability. If the doctor found there were periods of temporary disability and if you missed time from work from which you were not compensated, they owe you the retroactive benefits if you previal in the case.

I would need more information as to why they are denying the case.

If you do not have an attorney and would like consultations (no cost nor obligation) please contact me directly and I will be happy to discuss this further, as I really need more facts.

You may contact me at one of my 2 email addresses below:

[email protected]

[email protected]

Good Luck and I would be happy to assist you with your claim.

Samuel L. Salazar

Attorney at Law

617 W. 7th St. Suite 402

Los Angeles, CA 90017