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  1. #1
    lt Guest

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    I received a letter today, from a General Peer Review doctor from the insurance company, that has never seen me or knows about my worker's comp. injury/history.

    I was sent to see Worker man Comp. IME physicians, to get an impairment rating, which he evaluated me at 28%, due to that my Primary Doctor had previously given me a 23% IME.

    Now, a month later I received this stupid letter from a SO call Orthopedic surgeon, claiming he disagrees with the impairment rating assigned by the commission IME Physician.

    He stated that he reviews my medical documentation using 4th editions of the AMA guide of Evaluation of Permanent Impairment, to get his rating. Why would it be different from the commission's doctor rating?

    I have been seeing Neurology surgeons, and not an Orthopedic surgeon for my injury and have had surgery, due to my accident.

    Can they do that and is this legal?

    All bum-out
    in TEXAS

  2. #2
    adjuster Guest

    Default

    Can they do this yes. Is it legal. Only the Judge can decide. Generally Judges do not accept the opinions of doctors who have not examined an iw and only reviewed the medical records. It would have made more sense for them to send the records to the same speciality of doctor you were treating with. That will be another strike against them in court.

  3. #3
    Join Date
    Aug 1972
    Location
    West Central Ohio
    Posts
    9

    Default

    LT,
    I have the same thing in my case. Here in Ohio they give it the nickname of "hired gun doctor", it is common in the corrupt Industrial Commission of Ohio that is above the Ohio laws that they do not follow. And even more common at the Columbus, Ohio district office. The Hearing Officer Manual states that in such a case, your physician is supposed to have more creditability, yea right!
    They may as well take their manual and throw it away as they do not follow it.

    Just a bunch of crooks!

    Ohio Workers Compensation neither works or compensates!

  4. #4
    a Guest

    Default

    An injured workers ability or willingness to either accept or to at the very least - remain open to your "request", is soley an individual one.

    The above IW's personal experience with their employers insurance carrier, absent the "go - between" advantages of legal representation. may well have effected their general perceptions of that "group" as a whole.

    Unfortunately, this is NOT an uncommon determination from the literally thousands of IW's who indeed have been "wounded" by an Adjuster during the WC process.

    Sometimes even the very best of intentions are futile ones, and fact of the matter being - thousands OF IW's will never be exposed to even the possibility of yours!

    The above IW Poster. is NOT familiar with THIS venue, nor the opinions of some of its "regulars". How can anyone here even remotely judge or otherwise be pursuasive in their combined attempts/efforts to otherwise change this IW's mind ???

    If any IW feels that they are, or have been "burned" by the IC - there is actually not a whole lot that can or in fact will change their mind. The personal experience(s) CAN be extremely devastating in several ways.

    Realistically - what ARE the "odds" of you being the actual CA who might handle ANY of the WC claims of ANYONE here?

    As I said....sometimes that road to an Injured Workers Hades might just have been... brimfull of "good intentions" - while their final "destination" was anything but.

    I appreciate the opportunity of expressing my opinion!

  5. #5
    lt Guest

    Default

    Adjuster and Alan, thank you so much for the information, This has help me cope with what is happening to me. Some days, I am so tried of fighting for what I know what happen to me (and it hurts mentally and physically)and some days I am just so mad to be this half person that I use to be.

    Sorry, to hear that they did the same thing, to you Alan!

    Again,
    Thank You

    LT in
    Texas

  6. #6
    cp Guest

    Default

    Lt....I can hear your frustration and I hope you do realise that so many of us have felt your desperation. You HAVE go get mad and fight. It takes strength and knowledge and you can find both of those things here amoung the other injured workers on this forum. Hope you come back often and ask your questions and I'm sure you'll find someone that has an answer for you. Cheer Up and GET MAD ! CP

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