AME on Psyche Claim; are there any regulations? (California)

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AME on Psyche Claim; are there any regulations? (California)

Postby doublecrush on Mon Mar 09, 2009 10:23 am

AME med/legal was done on a timely basis and sent to Applicant Attorney.
Applicant Attorney sent report to I/W's Psychologist for face-to-face evaluation.
AME report was 100% Industrial. I/W was P&S and given a RTW date and a GAF rating. I/W was given some limited, but not clear future medical on report.
I/C asked for a supplemental report.

No further communication to I/W or Psychologist regarding supplemental report.

When A/A and Ass't are asked questions, they just say they are waiting for Defense to make their move.

My question is: Does defense have any time frame or can they just sit on the AME report as long as they want. And, why can't A/A initiate hearing?

Sorry, but I'm clueless with these legalities. The AME was done in July.

Thanks in advance for any comments.

DC :)
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Re: AME on Psyche Claim; are there any regulations? (California)

Postby art... on Mon Mar 09, 2009 10:39 am

Hi DC,

Has the supplemental been issued and served on the respective parties? I couldn't tell for sure from your post.
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Re: AME on Psyche Claim; are there any regulations? (California)

Postby doublecrush on Mon Mar 09, 2009 11:13 am

Hi Art,
Neither I nor my psychologist can get an answer about the supplemental report. I'm assuming it's been received.
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Re: AME on Psyche Claim; are there any regulations? (California)

Postby stevepsca on Mon Mar 09, 2009 12:01 pm

DC,
The AME supplemental report goes to your AA, the DA/CA.
Is the psychologist your PTP ?
Your AA or you, can provide the AME report to the PTP....

I/W was given some limited, but not clear future medical on report.
I/C asked for a supplemental report.
The supplemental was only for clarification on the FMT ?

If the supplemental has been received by the parties, and there is no further dispute, either AA or DA can file a DOR for MSC, if that is your question....(?)

The AME was done in July.

I would think that is an 'unreasonable delay'... unfortunately there are no penalties for this one.
Ask your AA/Asst to clarify what ''waiting for them to make a move'' means...
I think it means your AA is waiting for the DOR/MSC, or a offer to Stipulated, or C&R the claim....
If you are not being denied any benefits, you are not in any jeapordy, and there is no real rush here.

What is it you are anticipating, or wanting to see happen...?



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Re: AME on Psyche Claim; are there any regulations? (California)

Postby doublecrush on Mon Mar 09, 2009 12:43 pm

Thanks Steve for answering. What I have been waiting for is that the TTD be paid to my employer, so they can reinstate 2/3's my sick leave and vacation leave. It was all used up while I was off. I am working today with bronchitis because I have no sick leave left.

My attorney just answered my other question. He said defense is waiting for me to be completely P&S, which is expected soon; and then they will probably offer a settlement, and we will go from there. Fun Fun Fun.

I think I have to go back to PQME for final evaluation of Upper Extremity, since I was not repped until later. Currently undergoing nerve blocks for RSD.

DC
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