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 9 of 9
  1. #1
    Join Date
    Jun 2009
    Posts
    4

    Question What to Expect After QME

    Live in WA, wk in CA, DOI 12/2008, been on WC since. No problems with medical attenton. Dr. eventually recommended Voc Rehab - then all of a sudden QME mandated by claims examiner.

    What can I expect?

  2. #2
    Join Date
    May 2008
    Posts
    329

    Default Re: What to Expect After QME

    Do you have an attorney? If not, you will get a list of 3 doctors, in a field YOU have choosen, and you will have to pick 1 from that list.

  3. #3
    Join Date
    Jun 2009
    Posts
    4

    Default Re: What to Expect After QME

    Yes I picked a Dr. out of a list of three and the exam is sheduled for next week. I don't have an attorney but have called a few, all of which say.."wait and see the result." This is kind of scary, can they just cut off my income if they don't like what they see or if they don't agree with my attending physician (whom they appointed)?

    Although I have shown a great amount of progress since DOI, my condition appears to have reached a plateau (not getting worse and most likely won't get better). They have since stopped authorization of physical therapy also.

    My Dr. clearly states that I can't go back to my same profession of 30 years (truck driving) so I am hoping the QME will see the need for voc rehab or settlement being that I am 55.

    Your thoughts?

  4. #4
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: What to Expect After QME

    that's strange. There is no voc rehab in california. hasn't been for years. old time doc that hasn't been keeping up.

  5. #5
    Join Date
    Jun 2009
    Posts
    4

    Default Re: What to Expect After QME

    The Dr. acknowledges that there is no voc rehab in CA but since I live in WA he believes they should authorize it thru the state of WA.

    What do they do when worker is at a plateau of physical rehab and 55?

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: What to Expect After QME

    What do they do when worker is at a plateau of physical rehab and 55?
    Plateau means MMI/Max Med Improvement.
    This is kind of scary, can they just cut off my income if they don't like what they see or if they don't agree with my attending physician (whom they appointed)?
    TTD will stop. Your condition will be rated for impairment and PDAs, Permenant Disability Advances will begin...at a much lower rate than TTD was.

    That is what you can expect after the PQME report issues.

    PT is not being authorized because you have reached the 24 visit cap, or your doctor can't supply adequate goal of functional restoration.

    The Dr. acknowledges that there is no voc rehab in CA but since I live in WA he believes they should authorize it thru the state of WA.
    Whether WA provides VR services is up to them. Calif laws do not have any legal affect on what WA provides.
    VR in Calif is no longer an option. What is in place of VR is the SJDV/Supplemental Job Displacement Voucher. There are no cash benefits associtated with the SJDV program. The value is based on your PD/WPI rating. You could be eligible for anywhere between 4K and 10K...to be used at an accredited facility in Calif.
    I don't have an attorney but have called a few, all of which say.."wait and see the result."
    There is your best answer.

  7. #7
    Join Date
    Jun 2009
    Posts
    4

    Default Re: What to Expect After QME

    BvIA,

    Thank you for the insight and confirming what we pretty much anticipated. Scary but at least we have an idea what lies ahead - this ending real soon.

    That being said, what do you think about me puting in my papers for retirement?

    Will this raise flags? Should I wait to see results?

  8. #8
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: What to Expect After QME

    "Retirement''...? What retirement are you eligible for at age 55 ?

    IF you see yourself as being 100% 'disabled'. Then you should make application for SSA/SSDI benefits.... there is a much higher threashold for qualification vs comp... and the process is longer as a rule... Information on the SSDI process is here http://www.allsup.com/about-ssdi/ssdi-process.aspx

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

    Default Re: What to Expect After QME

    your california work comp insurer will not provide VR and you are not eligible for washington comp benefits so you will have to apply as a resident
    http://www1.dshs.wa.gov/dvr/

Similar Threads

  1. What to Expect
    By just me in forum Disability Benefits
    Replies: 9
    Last Post: 11-25-2008, 10:08 PM
  2. What Should I Expect
    By telicious in forum New Jersey
    Replies: 3
    Last Post: 11-09-2008, 03:07 PM
  3. What Can I Expect?
    By STIRCRAZY in forum Missouri
    Replies: 5
    Last Post: 08-24-2008, 07:47 AM
  4. What Can We Expect Next?
    By IMHurtin' in forum Insurance Company Practices
    Replies: 6
    Last Post: 07-22-2008, 03:11 AM
  5. What to expect
    By hammer in forum Georgia
    Replies: 1
    Last Post: 11-15-2007, 12:27 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