My workers compensation claim was made in the State of: California.
I had my QME (Utilization Review Board (UR) denied discography) yesterday and it went well. The QME said she would recommend the discography and now I'm just waiting for it to be put in writing. My understanding is that if the UR denies a procedure, I get a QME and if the QME agrees with the doctor's recommendation, then I can get the discography. But what are the details of the next process? After I get the report, does my doctor just schedule the discography or is there still another battle? Also, the purpose of the disco is to determine whether I'm a candidate for Artficial Disc Replacement (ADR). I already know that ACOEM Guidelines does not approve ADR (and I don't want fusion), however the doctor said she would also recommend ADR. IF the disco shows I'm an ADR candidate and the doctor requests ADR, does (UR) still get to deny the request and will have I have to get another QME even if the one I had yesterday said she would recommend ADR?