PTP Says PQME Doctor Not Appropriate

[complwyr]

This whole system is about money and nothing else.

[twboggess]

If you realy like to write, Google California insurance commisioner, open it up and look for the fraud division. get a claim form, then google Ca. Insrance code 1871, it goes 1871 to1879, it lists the things that a CA is not to do and they are illeagle. The IC will also list the things applicable in the labor code and CCP. Wrire a complaint ti the Insurance Commisioner, detailing all of the denials, delays and other isues (there is a box to check if you wish to remain anonymous) This will take the IC's attention off of you and maybe change their attitude.

[BvIA]

The Calif Dept of Ins has NO jurisdiction over workers compensation...none at all. Filing a complaint with the DOI goes nowhere.

then google Ca. Insrance code 1871, it goes 1871 to1879, it lists the things that a CA is not to do and they are illeagle. The IC will also list the things applicable in the labor code and CCP.

Be sure you are looking a claims adjusters for workers compensation, vs CA's for auto/home/health etc. They are different.

[1radjojo]

okay, so moving on to another question: What to expect after the PQME appt? How long does it typically take for the doctor to send their report to my atty and the IC and their atty? I understand that either myself or the IC can dispute the PQME and drag this thing out even longer...... I just can't help thinking of how much money this whole process is costing them (my ER, their IC and their atty) and the tax payers of CA!! I think that they will end up paying MORE than if they just gave me my benefits!! Why would they do this? Anyway, a heads up on what's next, please?

[BvIA]

Doesn't cost the taxpayers a dime... WCAB and DWC are fully funded by the ER/IC's.

PQME/AME reports are supposed to issue within 30 days, unless the Dr requests a extension.
You dispute a medical/legal evaluation by going to court. MSC, or trial.

You aren't going to be paid more than the benefits you may be due.

[1radjojo]

You aren't going to be paid more than the benefits you may be due.

What I meant was that the IC/ER will be out more money just fighting me than paying the benes.

Thanks for the info, I am hoping that this will be resolved before summer..... time to move on with my life, ya know?

[BvIA]

What I meant was that the IC/ER will be out more money just fighting me than paying the benes.

Doesn't matter..they are entitled to litigate the claim.

I am hoping that this will be resolved before summer..... time to move on with my life, ya know?

Yes...I do know. But there is nothing stopping you from "moving on with your life". No reason for this injury/claim to control your life. Do as you like, keeping within any restrictions you have due to the injury, and what you claim as reason for not being able to perform your usual and customary daily living activities.

[1radjojo]

true true. Happy Easter