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  1. #11
    Join Date
    Feb 2007
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    Calif
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    Default Re: Penalty of Purgery at a Deposition

    The problem is that the Defense Attorney Blatantly changed the facts that were in question by the Utilization Board.
    I think you may be misinformed at to what this process really is.
    The AME is not concerned with the UR Dr opinion. There is no "UR BOARD"... each ER/IC must have a UR plan. UR is not mandatory if the CA can authorize a requested treatment.
    The AME would only be provided the medical records relative to what your PTP has requested in treatment. The AME will determine medical necessity and reasonableness. AME trumps a UR Dr.
    The UR Dr isn't looking for anything from an AME.
    My work comp Doctor has been asking for tests and treatment, over and over , Denied denied denied.
    There is a specific process for your PTP to request medical care. If the PTP is in the MPN, s/he is very familiar with that UR process. Deny deny deny isn't how it works. Your PTP apparently has dropped the ball along the way somewhere. That's why you are evaluated by AME.
    Finally i am using my medicare ins. (because I am disabled because of my work comp injuries) and because tests have been denied I can use medicare. The Urologist who has currently treated me and found that it is just as suspected, "Nerve damage" related to my work injury. This Urologist refuses to take work comp cases
    You could see Medicare deny any bills for treatment to your accepted work injury. And they do know about it. Any conditional payments made by Medicare will be reimbursed before this claim can resolved.
    when the third party insurance company denied repeated requests from my work comp Doctor, for tests to check for my situation-- I have bigger problems now, then I did a year ago!!
    Third party IC doesn't approve/deny medical care. The level of care in 3rd party is much different than WC. The 3rd party carrier traditionally lets the WC carrier handle the medical because it's easier to control the costs. Your ER/IC will be reimbursed by the 3rd party recovery before you ever see a dime from that case.
    The recorded Deposition itself, will be the proof of the fabrication that the DA commited.
    Again, I think you are misunderstanding the process. The DA has not fabricated or lied about anything... all he is doing in deposition of the AME Dr is asking questions and presenting secnario that may be possibility. There is no criime in that. The AME is under oath, not the DA.
    And At the Deposition , the AME didn't Recall what he had actually said on my report, he said he didn't remember my evaluation and the report had not been put into print or sent to the Defense Attorney or my Attorney at that time.
    I'm sorry but that makes no sense. If the DA nor your AA had a copy of the AME report, WHAT is the DA disputing ?
    If the AME was not prepared or having recall or his actual report, it would be very difficult to answer any question specific to your claim/injury.

    Again, I think you are making too much of this situation. Your benefits are not based on the results of a deposition. Ever.
    it's just all very disheartning how these "what i feel are crimes" can be done at the cost of an injured workers health and over all life!!
    I'm not defending the system as it is. I beleive the PTP should have the preponderence in medical care. However, the ER/IC is using the same laws and process the IW and AA's have at their disposal in accessing medical care.
    WC is not health insurance for the employee/IW, Medical care is but one of the benefits the ER is liable for. They are not going to pay for anything more than the law demands. When the IW and ER/IC cannot agree on what is to be provided, you go through the disspute resolution process.
    Your AA should have filed a DOR for expediated hearing long ago from what you are saying in this thread.

  2. #12
    Join Date
    Oct 2010
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    44

    Default Re: Penalty of Purgery at a Deposition

    [QUOTE=BvIA;150402]I think you may be misinformed at to what this process really is.
    The AME is not concerned with the UR Dr opinion. There is no "UR BOARD"... each ER/IC must have a UR plan. UR is not mandatory if the CA can authorize a requested treatment.
    The AME would only be provided the medical records relative to what your PTP has requested in treatment. The AME will determine medical necessity and reasonableness. AME trumps a UR Dr.
    ************************************

    Hi BiVA, first who is the CA?? Claims???
    Second--- The Defense Attorney jumped the gun, being that the only record that was presented to the AME at the time of this Depo. was my old AME Exam Report to refer to. And in my old exam, there were no MRI's to prove anything , so the old report from the AME were on "strains".
    It Was one in a half years after the last report was made with a long fight that i finally got MRI's to prove what is really going on--- Then I was Reevaluated by the AME and 30 days after this Evaluation the Defense Attorney Deposed The AME (which my Attorney Objected to because of conflict of calander) But the Defense Attorney did the Depo anyway (the AME was Surprised that the DA was doing this) And The DA only had the old AME's Report at this Depo to refer to and presented to the AME. The DA Asked if the AME recalled what the exams findings from 30 days prior (Being the exam was not finished!!!!)
    The AME does alot of Exams and did not recall my exam.
    Soooooo, the only medical records at this depo. was based on my almost 2 years ago AME report that had no MRI's in it and the current Utilization review doctors Quotes from the MTUS and there concerns.!!??!! But, what the utilization Doctor said and what the DA presented to the AME, were TWO different things!
    BiVA, I get what you are saying that the AME trumps a UR Dr.--- and that is Good-- but what has me concerned is the attempt to sway an AME without right fabrication From a Defense Attorney!
    Of course the AME has Over Rulded the UR DR. and I should be getting my very needed treatment and medicine--- But my medication is still being denied. I'm waiting for Expedite Hearing!!! And I'm having to pay for medication and very needed treatment!!!
    This all makes me very sick!!!!!
    This seems to be so unnecessary

    ---------- Post added at 04:45 PM ---------- Previous post was at 03:58 PM ----------

    Your PTP apparently has dropped the ball along the way somewhere. That's why you are evaluated by AME.
    ************************
    My workcomp Dr. is in the mpn. From what i have seen is that the workcomp Dr. request treatment and tests --- if the Utilization Dr. wants more information then he gives it--- then after several attempts he gives up and i have to get my Attorney to pursue further attempts. Expediate hearings.
    It all takes alot of time. Then when I finally get the Tests to prove anything thats when i have been sent to the AME by my Attorney.

    ---------- Post added at 04:52 PM ---------- Previous post was at 04:45 PM ----------

    Quote byBiVA--I'm sorry but that makes no sense. If the DA nor your AA had a copy of the AME report, WHAT is the DA disputing ?
    If the AME was not prepared or having recall or his actual report, it would be very difficult to answer any question specific to your claim/injury.

    ****************************************

    BOY THIS IS THE TRUTH!!!! LOL!!
    The DA was disputing the medication that i was currently on---- and if it was correct for my (NOW REALIZED) condition. Even though the DA didn't know what the new findings were.
    They way this all happened--- the AME was not Prepared for this at all, other than the 2 year old exam that the DA had to give the AME to comment on( so the AME was commenting on old medication treatment for "Strains" --not being able to comment on my current condition for the new medication i was currently on-- being the AME had no recall of the current exam!)The AME had to depend on the Defense Attorney to tell the truth of what the UR DR was asking! The senireo's are one thing-- i get that. But the True Facts that were fabricated----- THATS NOT VERY NICE!!! How can that be OK?????
    Last edited by nannie; 01-16-2011 at 04:47 PM.

  3. #13
    Join Date
    Feb 2007
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    Calif
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    Default Re: Penalty of Purgery at a Deposition

    The AME had to depend on the Defense Attorney to tell the truth of what the UR DR was asking! The senireo's are one thing-- i get that. But the True Facts that were fabricated----- THATS NOT VERY NICE!!! How can that be OK?????
    The reason IW's have attys is to deal with all these issues without the emotional interference you are experiencing now.

    WC isn't about being "nice"....the DA is not in the position to dispute any medical care. The DA represents the IC in hearings, depos etc as the CA/Claims Administrators don't do this.

    There is a very specific time sensitive process for getting a PTP request for treatment through the process, including a UR Dr determination to medical necessity. You are correct, when the UR Dr delays/denies a request, the PTP may provide additional information to get the UR Dr to approve the treatment requested. When UR finally does deny, you go to AME. That is a part of litigating the claim. AME is the first "judge" in adjudicating the claim.

    As I said before, a deposition is simply held to develop the record, and/or as in your case to see if the DA can get the AME to change his mind. As this line of questioning really had nothing to do with the disputed issues in your claim, the depo was an exercise in futility, and costly to the ER/IC. You can't blame an AME for sitting there dawdling during a DA questioning as s/he has scheduled the time away from his/her own business of treating patients. That is very expensive to the carrier. None of which is of concern to the IW.

    If the AME was not provided the necessary diagnostics/MRI etc to form a opinion to the disputed medical issue, he was certainly within his rights to order those MRI's before submitting a final report. And should have, there is no need to request prior authorization. Or, he could have simply refused to evaluate you that day, and billed the carrier accordingly.

    The DA cannot "purger" himself at a deposition.
    It is fully understandable you are frustrated about this, but at the end of the day, it matters little in your claim or benefits.
    Only the actual AME report is what can be used. Not the deposition transcription.

    IMHO...you really need to let up on this, allow your atty to handle the process, that's why hes there for you.

  4. #14
    Join Date
    Oct 2010
    Posts
    44

    Default Re: Penalty of Purgery at a Deposition

    Gotcha BiVA, and I agree with every thing you are saying here and I really appreciate you taking the time to help explain all of this to me. Your a very good person I can tell. To take the time to help with very good knowledge, and sometimes spending the time to say it over and over until an IW gets it ---- is really Amazing and Wonderful. God Bless you BiVA!!! I always look for your answers, as they are very helpful !!!
    Last edited by nannie; 01-17-2011 at 03:16 PM.

  5. #15
    Join Date
    Aug 2010
    Posts
    27

    Default Re: Penalty of Purgery at a Deposition

    This whole thread is a debacle, first off the word is perjury. 2ndly you really dont need a defense atty at a depo. All you had to say was I'm not answering that question because my attorney's not here if you didn't like it. Not like the DA and the cops are going to come running in the door to arrest you or anybody else for that matter. Sorry to be the bearer of bad news.

  6. #16
    Join Date
    Oct 1971
    Posts
    3,429

    Default Re: Penalty of Purgery at a Deposition

    BobD
    first off the word is perjury
    Very good, you used the spell checker.


    2ndly you really dont need a defense atty at a depo.
    That statement is contradictory.
    The defense attorney represents the insurance and the employer (the opposing) without him asking questions, there would be no depo. (oh by the way, that's deposition, my spell checker caught that)

    WHAT IS A DEPOSITION?
    A deposition is your testimony under oath. You will be asked questions by the opposing
    and your answer will be recorded by an official court reporter.


    All you had to say was I'm not answering that question because my attorney's not here
    Her answering questions is irrelevant, she's taking issue with the defense misrepresenting facts.

    So what's the bad news, I'm curious.

    Tony
    Last edited by tony; 01-21-2011 at 05:41 AM.
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  7. #17
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    Feb 2007
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    Calif
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    Default Re: Penalty of Purgery at a Deposition

    You're right Tony, it's the DA deposing the AME. Trying to get the Dr/AME to change his mind on something in the report.

    The problem here is, from what I can tell....the first AME evaluation, the DA/CA did not provide the medical records necessary for the AME to opine on the disputed medical issue at hand.
    At the depo, the DA was providing information the AME never had, the AME couldn't recall the IW or evaluation.

    A DA or AA may subopena a PTP/AME/PQME or IW for deposition. As long as the opposing party is notified, and given the chance to object to the dates, there is really no rule/statute that prohibits the party requesting the depo to proceed whether or not the other party is present.

    IMHO...NO IW should ever enter a deposition with out representation. IW's do not have to actually have an atty representing them...the defense is liable for atty for depo only if requested.

    From what I can see in this thread... the DA is simply building billable hours to charge the ER/IC...there isn't really anything to come of this. Any affect on this IW's benefits would only be as a result of a supplemental report by this AME.
    The DA is not presenting any medical records here... simply posing questions to the Dr/AME...there is no perjury in that.

  8. #18
    Join Date
    Oct 2006
    Posts
    128

    Default Re: Penalty of Purgery at a Deposition

    That's correct. Attorney questions are not testimony and are not offered under oath, and thus cannot constitute perjury. Attorneys can also ask hypothetical questions of expert witnesses. If an attorney asks an improper question at a deposition, a timely objection should be made.

  9. #19
    Join Date
    Oct 2010
    Posts
    44

    Default Re: Penalty of Purgery at a Deposition

    BvIa I would love to send you a copy of the Depo's. This DA Deposed First the AME and Then my Treating Work comp Doctor. It's really ridicules and I believe that you are exactly right that this DA is just building billable hours to charge the ER/IC!! No Joke!! I will mail them to you if you would like a good laugh!! and then i really need to file complaints with the Board!!
    Thank you,
    nannie

  10. #20
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    Feb 2007
    Location
    Calif
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    Default Re: Penalty of Purgery at a Deposition

    Your filing complaints with the WCAB will go nowhere... fast.
    The defense is encouraged to develop the record by deposition. It's preferable to testifying in court...the reason is, expert witness fees... namely AME/PQME PTP is costly to the ER/IC and the legislature has provided for the deposition process in the labor code.
    You need to move on from this... if your atty has a problem, s/he and get it struck.

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