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Spinal surgery 2nd opinion process (California)

PostPosted: Wed Mar 18, 2009 12:46 pm
by cement
New question about spinal surgery 2nd opinion process. I received notice from the medical unit, they referred the case to a physician to review the medical records, afte they received my request for a 2nd opinion. But the selected doctor's office no longer does these evaluations. I then received a panel of qme's from the medical unit. Do I go back to the process that both I and the applicants' attorney, get to cross a name of the list and the last one left is the 2nd opinion doctor, or do I get to select a doctor and schedule the applicant for the exam? Not sure of the process, when the doctor selected by the unit, no longer does the evaluations.

Re: Spinal surgery 2nd opinion process (California)

PostPosted: Wed Mar 18, 2009 10:58 pm
by gaiassoul1@yahoo.com
yep you go back to the strike process because your old panel was invalidated.....an all new QME so start from scratch as if the other one never existed...but of course send the prior QME's reporting for comment to the new QME.

Re: Spinal surgery 2nd opinion process (California)

PostPosted: Sun Mar 22, 2009 10:21 pm
by jakelast@aol.com
As this is a second surgical opinion process, not a qme, the qme panel should be irrelevant (unless you agree to one of the docs as an ame).

I would suggest that you immediately advise the AD's office that the second surgical opinion physician is unavailable and request a replacement.

Re: Spinal surgery 2nd opinion process (California)

PostPosted: Mon Mar 23, 2009 10:22 am
by cement
follow up, after sending the panel of QME's the next week, the medical unit, sent notice that they were forwarding the spinal surgery 2nd request to another physician, guess the original one did notify them that he wasn't doing the evals anymore. Thanks for your answers.
I guess an additional question I would have, applicant's counsel, objected to my request for a 2nd opinion, citing that we didn't send in the request timely. He used the date on the report, which is not the date the doctor's office signed the proof of service or the date they mailed the report. I responded showing the proof of service from the doctor's office and the fax documentation to the WCAB. I'm assuming the board will set this matter for an exedited hearing?

Re: Spinal surgery 2nd opinion process (California)

PostPosted: Mon Mar 23, 2009 5:12 pm
by jakelast@aol.com
I do not think the wcab will do anything automatically. If the AA filed for an expedited hearing it will set one.

The DWC Medical Unit will not ordinarily send out the 2nd surgical opinion notice if it concludes the request is untimely.

If your client put the second opinion through UR and it was denied, under Brasher the aa is supposed to file the request. If a UR denial was timely and aa has not filed a request for a second opinion, he had better hope your request is timely or he may have waived the issue.