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  1. #1
    Join Date
    Aug 2007
    Posts
    52

    Default Does the Insurance Company Have to Respond to an Attorney Letter

    In April of this year I received the AME report in which he declared me P&S. The date for that was when I saw him in Oct of 2007. I received some PD advances because the IC-Ca said they paid me out a certain amount based on the 31% swag from 2004, before I had my surgeries and any treatment. My Attorney has me rated around 69-71%, based on the AME report from March 2007 in which he gave me major restrictions and basically gave me sedateroy work restrictions. My question is My Attorney sent a letter to my employers Attorneys requesting that they start paying PD avances based on the AME report of 2007. This was in Augest 08. Is there a time limit that they have to respond to the demand letter, and should my attorny ask for a MSC to start it up again. Thanks again.

    P&S, Work is going great, It feels so good to feel like something again. I am trying to follow the restrictions and the only difference in the type of work i was doing is that now i am rolling and pushing a hand cart insted of pulling and pushing a pallet jack. Not much of a difference, I have started the EEOC lawsuit and my attorney said that there is a very, very good chance it will settle without going to trial.

  2. #2
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Is There a Time Frame?

    the law does not required them to answer your attys letters nor your atty to answer their letters.
    yes disputes and issues that cannot be resolved by the parties can be taken to the comp court.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Is There a Time Frame?

    IC-Ca said they paid me out a certain amount based on the 31% swag from 2004, before I had my surgeries and any treatment.
    That is the rating you will receive PDA's on...(probably fully paid by now...)

    My Attorney has me rated around 69-71%, based on the AME report from March 2007 in which he gave me major restrictions and basically gave me sedateroy work restrictions.
    As your AA is not a medical professional, or a professional 'rater', his opinion on your rating has little/no affect on the final rating to base the PDA's on. The CA's estimate of your rating does...because the IC is the one paying the bills/PDA's.

    For now, you have an AME report from 2004 rated at 31%...
    An AME report from March/2007...not rated...(?) but for your AA estimate...
    And an AME report from April/2008, that has not been rated...(?)

    You are still standing on the rating from the 2004 AME report...and will until the final most recent report is rated, and agreed upon by the parties, or a WCAB judge.

    This was in Augest 08. Is there a time limit that they have to respond to the demand letter, and should my attorny ask for a MSC to start it up again.
    No...if you/AA feel that the PDA's are being unreasonably delayed...file a DOR for expediated hearing and take it to the judge.

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