Announcement

Collapse
No announcement yet.

Permanent and stationary California

Collapse
This topic is closed.
X
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Permanent and stationary California

    Hi,

    My QME thinks I need further treatment and wants me to get permanent disability benefits till then while the worker's comp claim person wants to close the case and just give me permanent and stationary status.

    I have two questions:

    1. Is permanent and stationary looked at negatively by future employers. Can they find out about me filing a claim before they hire me. I would rather not have it on my record but both QME and worker's comp want that to be on my record.

    2.The claims worker said she might bring a deposition against the QME because he is not giving a final report that she wants. What is the best course for me?

    I am in the bay area.

    Thank you.

  • #2
    1. Is permanent and stationary looked at negatively by future employers. Can they find out about me filing a claim before they hire me. I would rather not have it on my record but both QME and worker's comp want that to be on my record.
    Don't know what "record" you think this would go on. There are subscription services carriers participate in that contain all insurance claims filed/paid benefits on. Including auto, home, boat, life, and WC. Some ER's may have their WC carriers check a prospective new hire. It's not something a ER could ask prior to hire, or make a decision on whether to hire you or not. Doesn't mean this doesn't occur, probably everyday somewhere.

    It is discrimination however to refuse a job or your ER to refuse to bring you back to work due to a disability. You can find info on those issues though the EEOC/ADA web site...http://www.eeoc.gov/index.cfm
    Even though Congress has expanded the definition of ''disability'', not all industrial injury/illness result in a ''disability''. EEOC/ADA may or may not apply to your situation.

    A determination of P&S or MMI, the terms are interchangable now, simply means you have reached a point in your recovery where the condition/injury is stable...or you have reached MMI/Maximum Medical Improvement. Your condition is not expected to change...better/worse, in the next 12 months or so.
    Being declared MMI does NOT mean there is no need for further medical care.

    A CA does not make a decision on MMI...that is a medical determination, made by a PTP or PQME/AME only.

    TTD ends at MMI, or when you have reached the statutory cap...104 weeks of TTD
    within 5 years of your org DOI/Date Of Injury.
    2.The claims worker said she might bring a deposition against the QME because he is not giving a final report that she wants. What is the best course for me?
    Deposition is not ''against'' anyone. A deposition of IW is an opportunity to develop the record. A depo of PQME is due to a need for clarification of something contained in the report. You can imagine how a ''medical professional", a Dr or PQME fees about a CA or attoney questioning their medical opinions.
    There can potentially be significant delays by a decision to depose a PQME. There are also regulatory timeframes.
    Deposition of PQME: Allowed after defendant filed application where employee was
    ... unrepresented, ARNELL 28 CWCR 76 discussing and distinguishing from
    ...VENERACION 25 CWCR 308 where it was not allowed

    ....▫ Deposition of evaluator within 120 days of notice at agreed upon or same place as
    ......exam, or if unrepresented worker, at a place chosen by deposing party within 20 miles
    ......of place of exam: 2/09 CCR 35.5(f)

    Deposition of PQME was not ratable (material omitted)
    Don't let this CA intimidate you.
    My QME thinks I need further treatment and wants me to get permanent disability benefits till then
    The CA wants the file closed. S/He wants you rated for PD/WPI and move forward with resolution here.
    The PQME controls the medical in a claim, not the CA. When a PQME opines favorable to the IW, the ER/IC must begin to pay benefits... whether it's TTD or medical care as the basis for the evaluation... OR ...MUST file a DOR/Declaration Of Readiness to proceed to MSC/Mandatory Settlement Conference, including an Application for Adjudication of the claim. And... if/when that happens... the ER/IC is liable for the applicant/IW's attorney fees.

    This doesn't happen all that often... likely the reason for the CA threatening the deposition of the PQME...that is NOT the procedure...and whatever benefits the PQME said were due, ARE due now. Not post deposition. Deposition has no leagl bearing on the provision of benefits. You might want to let the CA in on that little tid bit too.

    Either resume benefits per the Dr PQME report, or file the DOR. Those are the only two options here. Even though the CA will try to tell you otherwise.

    By the way.... If you are noticed for deposition...do NOT go alone... get an attorney. The ER/IC is liable for attys fees for depo only. If you can find one to do this. If things go that far with delay/denial...you need an attorney anyway.

    Comment

    Working...
    X