Legal Question in Workers Comp in California

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There is a "Bible" of Treatment in Workers' Comp Doctors must consider: ACOEM (american College of Occupational and Environmental Medicine) Guidelines.

ACOEM Guidelines state FIRST try epidurals, if those dont work, then surgery.

If your lawyer goes to an Expedited Hearing on the spinal surgery request, most WCAB Judges just follow whatever report quotes the ACOEM Guidelines.

SOLUTION: YOUR SURGEON needs to "appeal" the 'non=certification" (refusal) of his request for a surgery with A SUPPLEMENTAL REPORT.

Tell your surgeon to write a Supplement Report outlining many reasons WHY THE ACOEM GUIDELINES DO NOT APPLY TO THIS PARTICULAR SITUATION (such as, awaiting the recovery from epidural will further deteriorate the remaining disc material, the nerve root impingment will advance to nerve damage in the months it takes to complete epidurals, you're allergic to the compounds in the epidural steroid compounds, etc).

The Labor Code specifically requires the judges to follow the ACOEM Guidelines unless given "good cause" not to do so. If your surgeon / Treating PHysician doesn't write a report for trial explaining to the judge why the ACOEM Guides shouldn't apply here, you'll have to go through the epidural process first.

Get a CERTIFIED SPECIALIST ATTORNEY in Fresno; certified specialists pass an extra bar exam just in workers comp and they complete continuing education, and they cost exactly the same as other non-specialist attorneys.

I've appeared in Fresno and the judges there are very patient and willing to consider a REASONABLE argument as to why they should order a procedure outside the ACOEM Guidelins... all that I spoke with there really wanted to get the injured worker real treatment.

But the judges can't order something just because a doctor suggests it; the doctor must actually explain why -- in your case -- the judge must not follow the ACOEM Guidelines.

Print this out and take it to your surgeon and see if he's able (and willing) to write such a supplemental report... it's twice the work of a regular report and he might not get paid for it, so don't be surprised if he says no thanks (doctors don't like to work for free).