Legal Question in Workers Comp in California

If you have a Primary Treating PHysician who can rip apart the offending QME report, get that done first. Go through the QME report line-by-line and write clearly for your reporting Primary Treater clear, concise criticisms of the QME findings. When the PTP issues a report discounting and disputing all the QME conclusions, you'll be in a better position to ask for more money.

As you 'no longer receive monetary payments' the insurer is of the opinion all Permanent Disability due has been paid out.

That leaves possible future medical bills for which the insurer might be responsible.

So re-phrase your question with the specific 'future medical' procedures suggested by the Primary Treating Physician and those suggested by the QME -- and note you have received all Permanent Disability due already -- and an attorney might be able to help you.

If the QME report upon which the adjuster is making her decisions says you require only Over-The-Counter medications with no more surgery, no more therapy, no more prescriptive medication and no more injections, there is almost no money the adjuster would have to pay in the future so she wouldn't come up with much more than $4,000...