California Worker's Compensation - Help For Injured California Workers

• California Worker's Compensation - Quick facts about worker's compensation law, benefits and lawyer fees.

• California Worker's Compensation Resources - Links and resources for injured workers.

Results 1 to 7 of 7
  1. #1
    Join Date
    Jul 2008
    Posts
    21

    Default What is the Time Frame for Medical Reports?

    I am an unrepresented IW and had my final P&S eval with my PTP on 11/10/08. It has been 56 days and I still don't have his report. I called his assistant 2 weeks ago and she told me he is "running behind". My question is, by law, how long does he have to provide this report. He has not provided a report for the appointment I had on 09/08/08 either. Thanks for you help.

  2. #2
    Join Date
    Jul 2008
    Location
    California
    Posts
    1,900

    Default Re: What is the Time Frame for Medical Reports?

    I have a similar question. It has been over 60 days since my AME exam, and still no report. I thought they had 30 days, or request an extension. What is the longest amount of time an AME has to write his report? Is there a certain amount of time, that my attorney can just request another AME?(wishful thinking)

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: What is the Time Frame for Medical Reports?

    on 11/10/08. It has been 56 days and I still don't have his report.
    I guess I'm hoping this is NOT "356" days...(?)
    At any rate, the Title 8 CCCR's provide for TWENTY DAYS, barring ''good cause''...
    That the PTP is 'behind' in his reporting is not 'good cause', nor 'agreement between the parties.
    If this were a report to continue your TTD benefits, this would give good cause for the CA to stop your benefits...
    (g) When the primary treating physician determines that the employee's condition is permanent and stationary, the physician shall, unless good cause is shown, report within 20 days from the date of examination any findings concerning the existence and extent of permanent impairment and limitations and any need for continuing and/or future medical care resulting from the injury. The information may be submitted on the “Primary Treating Physician's Permanent and Stationary Report” form (DWC Form PR-3 or DWC Form PR-4) contained in section 9785.3 or section 9785.4, or in such other manner which provides all the information required by Title 8, California Code of Regulations, section 10606. For permanent disability evaluation performed pursuant to the permanent disability evaluation schedule adopted on or after January 1, 2005, the primary treating physician's reports concerning the existence and extent of permanent impairment shall describe the impairment in accordance with the AMA Guides to the Evaluation on Permanent Impairment, 5th Edition (DWC Form PR-4). Qualified Medical Evaluators and Agreed Medical Evaluators may not use DWC Form PR-3 or DWC Form PR-4 to report medical-legal evaluations.http://www.dir.ca.gov/t8/9785.html
    If you are treating in the ER/IC's MPN, you could request an IME evaluation...or PQME...this might get the CA's attention, they dislike paying for med/legal evaluation where it's not necessary. IF this doctor is in the MPN, he is not acting in good faith to his contract with the IC...

    You could also contact the DWC Medical Unit...though if they were to get involved here, you could run the risk of an 'unfavorable' report...even though that would carry and ethics issue with this PTP...

    Is there a certain amount of time, that my attorney can just request another AME?(wishful thinking)
    Sure you can request a new AME>.. if the report is past 30/45 days..the report can be disputed and a new "agreement' with the IC...or a list of PQME's to reselect in the process...though here again, you run the risk of an unfavorable report...
    There isn't really any way for you to acertain if there has been a request to extra time...that is done to the Medical Unit...and there must be 'good cause' here too..eg. lack of requested medicals, testing etc.

  4. #4
    Join Date
    Jul 2008
    Posts
    21

    Default Re: What is the Time Frame for Medical Reports?

    BvIA, thank you for your comprehensive answer to my question. This doctor is in my MPN. He has told me verbally what his report will contain and it is extremely favorable to me, so I guess I should just be patient and wait. Thanks again.

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: What is the Time Frame for Medical Reports?

    A lot of the issues in WC end up being litigated either with a AME/PQME and/or a WCAB judge...

    Nothing in a litigated process moves quick...more as the pace of a snail or ''fast'' turtle.

    Unfortunately ''patience is a virtur''... some would say I don't have any virtues. But then that is what 'some' would say....

  6. #6
    Join Date
    Nov 2007
    Posts
    55

    Default Re: What is the Time Frame for Medical Reports?

    BiVA,
    I tried looking this up in NOLO, but the answer wasn't completely clear. When it is a DQME reporting, what does the 30 day reporting period encompass? 30 calendar days or 30 working days? After that, who does the report go to? I know obviously the IC/DA get a copy, but does one go to the AA or does he have to specifically request it?

    There were no tests done to wait for results therefore delaying reports.

    Thanks.
    Last edited by hurtmom; 12-06-2008 at 01:46 PM. Reason: added info

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: What is the Time Frame for Medical Reports?

    A Defense QME being "their" doctors opinion, there is no mandate for the ER/IC to provide YOU with a report...virtually the only time you'd see that is if they intend to use it at trial as evidence/discovery.
    Obviously if the report is favorable to the defense, they'd try another avenue to get the point across...they are paying for the report, it is theirs to do with as they please.

    But...IF the report of a DQME is favorable to the IW...they better be ready to act on the positive issues...a judge isn't going to allow 'doctor shopping' by the defense any more than s/he would with a AA/IW...

    what does the 30 day reporting period encompass? 30 calendar days or 30 working days?
    I've always understood it to be 30 business/working days...plus 5 for mailing.
    But, that could also depend on the rules/CCR's govening the issue you're referring to...

    And then,...is 5 day for mailing Mon/Fri...mail is delivered on Sat...and mail travels on Sun. as well...(?)

    I only know when a check is late, you have to wait 10 business days to report, then 5 additional days before the CA will cancel, and another few days for the check to reissue...which means 2 weeks/14 'days'...which is the regular check issue schedule for that party...

Similar Threads

  1. Time Frame
    By babyhub in forum North Carolina
    Replies: 1
    Last Post: 10-29-2009, 03:24 PM
  2. Medical Treatment Time Frame
    By Rbabybell in forum California
    Replies: 2
    Last Post: 06-01-2009, 12:56 PM
  3. Time Frame
    By aintquiting in forum New Jersey
    Replies: 2
    Last Post: 12-14-2008, 07:58 AM
  4. Replies: 2
    Last Post: 11-06-2008, 03:49 AM
  5. Time Frame
    By candyman03011 in forum Employment
    Replies: 3
    Last Post: 09-03-2008, 03:13 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
 


Find a Lawyer