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  1. #1
    Join Date
    Dec 2012
    Posts
    3

    Default How to Speed Up an AME Re-Evaluation Exam

    I saw a AME back in 2011 and was declared permanent and station. My case later settled with a stipulated award. I have recently reopened my case because my condition has gotten worse and I am no longer able to do my job. I have filed for a CALPERS industrial disability retirement and have a hearing schedule in Feb. but the AME appointment the work comp lawyers agreed to is in June past the 6 months retirement hearing expiration date. Is there anything I can do to get the AME to see me sooner, I need his report for my retirement hearing. My lawyer doesn't give a crap when I see the AME just that I do. I called the DR. office and he has no openings until June. Anyone know what I should do to get seen sooner. The process is so stupid. Please help!

  2. #2
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: How to Speed Up an AME Re-Evaluation Exam

    Quote Quoting hatethesystem View Post
    I saw a AME back in 2011 and was declared permanent and station. My case later settled with a stipulated award. I have recently reopened my case because my condition has gotten worse and I am no longer able to do my job. I have filed for a CALPERS industrial disability retirement and have a hearing schedule in Feb. but the AME appointment the work comp lawyers agreed to is in June past the 6 months retirement hearing expiration date. Is there anything I can do to get the AME to see me sooner, I need his report for my retirement hearing. My lawyer doesn't give a crap when I see the AME just that I do. I called the DR. office and he has no openings until June. Anyone know what I should do to get seen sooner. The process is so stupid. Please help!
    switch to an AME that has quicker appointments.
    of course, the carrier has to agree.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: How to Speed Up an AME Re-Evaluation Exam

    Get a postponement on the CalPERS hearing.

    WC AME is used to resolve a disputed medical issued in your work injury claim.
    CalPERS should be able to make a determination on your disability claim...just like SSA would. Based on your overall ability to work, taking all physical/mental conditions into consideration. Dr's who treat you provide medical evidence on your condition, AME's provide opinion on a disputed medical issue. Big difference.

  4. #4
    Join Date
    Jun 2007
    Posts
    339

    Default Re: How to Speed Up an AME Re-Evaluation Exam

    Not really certain why you would have to have the AME report. The only reason you should have a hearing is if your industrial disability retirement has been denied. In that case what you need will depend on reason for the denial. If it is based solely on the nature of the injury and ability to perform you usual job then your PTP reports should be sufficient assuming they support your claim. Are they disputing causation as being industrial? If that is the case is that the reason for the AME? If WC has already determined causation to be industrial then this should not come into play however if causation has not been established then your industrial disability retirement application was premature. In either case it is not likely that you will be able speed up the AME process. Even if you get the appointment for an earlier date it could take some time for the report to issue.

  5. #5
    Join Date
    Dec 2012
    Posts
    3

    Default Re: How to Speed Up an AME Re-Evaluation Exam

    I have a stipulated award for the injuries. So there is no question whether or not they are industrial, my employer and the AME have agreed they are. I am a local safety member of CALPERS so all disability retirement applications in such members are brought before the local governing board for determination to be submitted to CALPERS by resolution. I was hoping to speed up the AME evaluation because if he sides with me (he most likely will) and says my disability has substantially incapacitated me from being able to safely perform my usual and customary job duties, then my employer will concur and not oppose retiring me during the hearing. If they oppose me they I have to see a QME selected by the retirement board. The situation is kind of a crock because after I got the stipulated award, my employer tried to get me retired by asking my PTP and the AME if I could still perform all my jobs duties with my disability. My PTP just ignored them. But at the time of the appointment with AME, I didn't want to retire and he ended up sided with me and left things on paper pretty vague stating that he agrees that I can continue to work etc. if I believe I can continue to do the job. My employer gave up after awhile which is when I got the award. Things are of course different now and a lot worse, so I rather bug out before any 2013 pension reform screws up my current retirement benefits. Thanks for the info. If you have any more info that will help I would greatly appreciate it.

    - - - Updated - - -

    Yea, I suggested this to my WC attorney and his paralegal said... "no no no..." thats not possible. But I don't think she knows I can. ...

    - - - Updated - - -

    I think I am going to postpone the hearing til the AME evaluation. The problem is that if my employer doesnt have a current AME report they will automatically be opposed to my retiring (so they have told me). If they oppose me, then the retirement board may require me to see a QME of there choice. From what I have heard these local governing boards don't just like taking the PTP's word and reports as legit. So I was toying with the idea of finding my own QME and paying out of pocket to get a report from them, then presenting that with my PTP's report... should make my case stronger. But I don't know what to do. I still need my PTP to write up a decent report stating what has been going on and what my work restrictions actually are stead of vague terms like "desk and office work only". It seems like PTP's don't like to provide details in their reports to employers, most likely to protect their patients but this game of having to ask them provide the details and fill out the retirement medicals forms according is starting to wear on me. Its an ugly mess. Thanks for your help.

  6. #6
    Join Date
    Jun 2007
    Posts
    339

    Default Re: How to Speed Up an AME Re-Evaluation Exam

    Do you work for a local agency? Reason I ask is because the process you are describing is not exactly how it works with a state agency.

  7. #7
    Join Date
    Dec 2012
    Posts
    3

    Default Re: How to Speed Up an AME Re-Evaluation Exam

    yes I do, I am a local safety member and I know it is a quite a bit different. Had I worked for a state agency they would probably had offered me a more suitable position. My employer doesn't accommodate light duty employees. But they sure are dragging their feet when it comes to retiring me.

  8. #8
    Join Date
    Dec 2012
    Posts
    7

    Default Re: How to Speed Up an AME Re-Evaluation Exam

    hate: there is a trend trying to keep people from getting their disability pensions, whether from CALPERS or the Federal Government. I saw some paperwork trying to "up the minimum date to 20 years", meaning you must have twenty years of vested credits to qualify for a disability pension. Since you do not qualify for Social Security, bring every stack of medical paperwork to your hearing and get your PTP along with your other doctors the PTP has sent you to, to provide their opinions you are disabled.


    I know a local school worker in the valley who was badly injured and it took two years to get CALPERs to finally give her the disablity pension. Are you beyond the twenty year mark with your local employer, and do all the doctors agree you are disabled? The committees of these agencies can be cool and brutal, bring everything you have to your hearing! Good Luck!

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