Do I get to see what the adjuster sends to the QME? Can I object?
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- Опубликовано: 9 сен 2024
- This video reviews records going to the QME. If you are an injured worker with a California injury, and don’t have an attorney, this video is intended to help provide an overview of workers’ compensation topics so you can better represent yourself.
Jeremy Lusk is a certified specialist in workers’ compensation with about two decades of experience, and previously served as a Judge at the Fresno District Office of the WCAB. He has worked out of Fresno, but appeared at numerous Boards to represent both injured workers and employers/carriers.
No attorney/client relationship is created or implied by this video. This video is not offering legal advice as to what you should, or should not, do in your workers’ compensation case, but rather offers education/information as to the California workers’ compensation system for unrepresented workers so they can better represent themselves and make more informed decisions.
If you have any questions, let us know at questions@mywcguide.com
I also seen situations when worker compensation on purpose did not sent all medical records, some were skipped because they really showed the injured worker not so great condition. Also it's great for the injured worker and their attorney to keep a good track and save all medical information. Insurance companies are biased and they know their game
Awesome knowledge to know.
Thank you
Happy to help inform!
This video could not have come at a better time! I was served the report that was sent to the (QME). After review, I discovered there is copious amounts of information that does not apply to me whatsoever, i.e. pending criminal charges and much more, which in my view is slander and defamation of my character. I also discovered (2) fax cover sheets within the documents consisting of two other individuals, who are under care at the same facility, which was shocking. I am confidant my case was compromised and contaminated considering the content that does not apply to me whatsoever. The insurance adjuster has been very evasive for the past (6) months. In fact, I was contacted by the (QME) assistant yesterday to inform me they have been unsuccessful trying to reach adjuster as well. There has been a pattern of events established regarding wrong dates on (SDI) claim and the QME request form, from the beginning. Something is drastically wrong and not adding up what are your thoughts and I have a good idea why. Your feedback is appreciated, respectfully.
Unfortunately records going to the QME that shouldn't is not a new issue. I'll do a video soon on the remedies for when that occurs.
@@myworkerscompguide so it’s designed this way to protect corporate giants, I get it despicable acts will go unnoticed
@@authenticallyempowered1 It's not designed that way at all. It's just that there are bad apples that get noticed, and then they create statutes and case law to rectify the situation. Keep in mind that there are probably tens of thousands of QME exams taking place every single day in California, and the system works as intended for most exams. It's just that the bad apples make the news.
Great info, thx!
Happy to help inform.
Hi Sr, Thanks for the help.
Can I ask the court for reconsideration instead of objecting the QME report?
Thank you for your help!
The dispute can go to the Board and have a judge decide, but that would generally start with an objection by one party or the other to the QME report. California law says that the Board likes to keep the same QME if possible, so any problems should first go to the same QME to be fixed, if possible. If they can't be fixed with the QME, then it would go to a judge to decide if the judge will throw out that QME and order a new one or not.
What is a QME?
In the California system the injured worker will often be seen by a QME to provide a final ratable report to use for settlement. The QME (Qualified Medical Examiner) is used in both represented and unrepresented cases. If the injured worker has an attorney, then an AME is a possibility (Agreed Medical Examiner). On rare occasion the judge may appoint an IME (Independent Medical Examiner). The QME will be obtained from a panel of three QME's issued by the State of California. The QME is an independent doctor who offers no treatment, and only offers a med/legal exam and report.
How do you get a QME? I have a feeling that I’m coming up on my last workmans comp Dr. appointment and he’s going to put me on disability.
Good question. There is a form on the DWC Forms website that you can download, fill out, and send to the Medical Unit and the adjuster. I'll do a video on that process in the next day or two.
@@myworkerscompguide wonderful thank you so much I really appreciate it. when you say medical unit are you meaning the doctor that we’re currently seen for Workmans comp.?
@@Analysemarie Happy to help inform. The Medical Unit is an office with the State of California, part of the Division of Workers' Compensation. When an injured worker requests a panel of QME's the request goes to the Medical Unit, which is that independent state office that is not affiliated with the employer or insurance company, or the treating physicians. Their primary job is to send out a list of three QME's when someone requests one.