Legal Question in Workers Comp in California

I have a workers comp claim pending. I was declined so they ordered a QME. I have the appointment set up for the 28th. The problem is that I am in pain very bad pain and my own doctors don't even want to touch me because I have wokers comp claim. What are my options?


Asked on 6/19/12, 5:39 pm

3 Answers from Attorneys

ARMAN MOHEBAN LAW OFFICES OF ARMAN MOHEBAN

QME is only for evaluation on denied claims. You need good reports by treating doctors and you need to select an unbiased QME doctor. I recommend that you immediately retain an attorney and postpone your appointment. It is possible to get the agreement of the defense on AME (Agreed Medical Examiner) which is a lot better than a QME. Feel free to call us at 213.388.7070 for a free consultation.

Read more
Answered on 6/19/12, 8:50 pm
ARMAN MOHEBAN LAW OFFICES OF ARMAN MOHEBAN

Part two

You need to be referred to a worker's compensation doctor and not be treated by your own doctor. Feel free to call us at 213.388.7070 and we will refer you to a worker's compansation treating doctor who will happily bill the insurance company.

Read more
Answered on 6/19/12, 8:54 pm
Nancy Wallace Nancy Wallace Atty at Law

YOUR OPTIONS? A handful of good docs will treat on a WORKERS COMPENSATION LIEN ,

And you need to THOROUGHLY RESEARCH THE QUALIFIED MEDICAL EVALUATOR "they ordered."

If you didnt pick the QME from the Panel, the Insurance Adjuster hand-picked the Panel Doctor she knows will write all your problems are pre-existing and you will be nothing.

IF YOU KNOW NOTHING ABOUT THIS QME NEXT THURSDAY (the 28th) ASSUME THIS DOC IS 'IN BED' with the insurer and will write that the comp insurer owes you nothing.

IT IS NOT TOO LATE to change Panel QME doctors.... BUT you have to cancel the 'AntiChrist Doctor' at least 48 hours before the appointment or the Insurer will pass along his $500 "no show' bill....

...and not showing up or showing up late will result in a $500 bill sent to you too.

YOUR VERY BEST OPTION IS TO BE CERTAIN YOU ARE SEEING THE BEST DOC ON THIS QME LIST!!! YOU have the power to pick the insurance company's evidence!! USE THIS to your advantage!!

NEXT: (2) find a physician agreeing to treat you on a Lien. This doctor will treat you FOR FREE and write reports proving your injury was work-related so you have evidence for trial, and then hope to get paid at the close of your claim...again, no charge to you.

Southland Spine & Rehab used to have some good guys near West Covina... I think Dr. Amin -- a solid orthopedic surgeon -- sees patients in or near West Covina on a lien.

The challenge is no 'procedure' any doctor requests will be approved until you get a QME Report stating clearing the injury IS work related and the treatment needs are the result of the work-related injury OR you go to trial and win.

THE GOOD NEWS: The judge in Pomona (the WCAB office near you) do tend to find for the injured worker when there is medical evidence showing how your description of the injury matches the symptoms they find on examination.

Email me at [email protected] with just the names of the three QME Panel docs so I can see you've got the best guy on the list, and throw in the Insurance company so I can see if I can find any of their Medical Provider Network docs who also treat on a lien (so, after the responsibility for the injury is accepted, you can keep treating with the same workers comp doc).

(3) YOU DO NOT HAVE THE OPTION OF GOING TO YOUR PRIVATE DOCTORS. THEY won't get paid and won't write reports. You're asking them to treat you for free because private insurance does not cover work injuries. You're wasting their time and your time and money.

Hope this gets to you in time !!!

Read more
Answered on 6/20/12, 11:06 am


Related Questions & Answers

More Workers' Compensation Law questions and answers in California