CT ending 1985- How do I get AOE/COE evidence (California) (

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CT ending 1985- How do I get AOE/COE evidence (California) (

Postby mod2009 on Wed May 20, 2009 9:49 am

IW exposed to various agricultural chemicals during 10 yr period of employment and develops neurological disease which was diagnosed in the 1990's . IW disease is in the advanced stages and he can no longer communicate or move without assistance. The family has found medical studies linking the disease to chemical exposure - specifically agricultural chemicals and welding fumes which the IW was exposed to during his employment. There is no notice issue since IW was never informed by MD that disability may have been industrially caused so I am not too concerned with a SOL defense. My questions are as follows:
1) If a 4060/61/62 objection is issued is IW entitled to his own QME to address AOE/COE? (I have several doctors who are interested in the case but they want to make sure that they get paid for their services. They do not want to take the case on a lien basis.) If IW is entitled to his own QME under the old rules, am I correct is assuming that the AOE/COE exam would be considered a med-legal exam which would be covered under workers' comp?
or
2) Is the IW limited to a Panel under LC 4062.1 or 4062.2.

Your input on this issue is greatly appreciated.
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Re: CT ending 1985- How do I get AOE/COE evidence (California) (

Postby steelmanlaw on Fri May 29, 2009 2:08 pm

if i understand you correctly, you have no written medical opinion of industrial injurious exposure. correct?
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Re: CT ending 1985- How do I get AOE/COE evidence (California) (

Postby samcat on Fri May 29, 2009 8:16 pm

There is a 2005 En Banc decsision which held that for injuries occuring before 1/01/05 the old medical legal process was in place, even when the need to obtain the medical legal report was after 1/01/05.
This would mean that one still has to attempt to go to an AME, but if no agreement can be reached, either/both parties may get their own applicant/defense QME.

The case is called;

Simi vs Save Max 70CCC 217
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Re: CT ending 1985- How do I get AOE/COE evidence (California) (

Postby steelmanlaw on Sat May 30, 2009 1:45 pm

let's not get the cart before the horse.

where is the written medical evidence to support injurious exposure on an industrial basis? i don't think we get to the AME/QME scenario until there is a medical dispute. a difference of legal opinion or positioning is not a medical dispute. Applicant needs a medical opinion in his/her favor or something of the sort to get the ball rolling, even if it is only a disability slip or need for treatment ax request, or anything really stating the need for disability or treatment on an industrial basis.

with a little forethought and implementation of a plan of action designed to invoke 4060/4061/4062 et al, an admissible report could actually result.
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Re: CT ending 1985- How do I get AOE/COE evidence (California) (

Postby jakelast@aol.com on Sun May 31, 2009 10:57 am

4060 allows a report to determine the compensability of a claim of injury once the claim form is filed. there is no requirement for a dispute on compensability although it certainly makes good sense to wait for the claim to be denied before obtaining a qme exam. No reason to address compensability if liability is deemed admitted.

However there is no need to object to a report on the issue of injury (unlike 4062 on all Non-PD issues where objection is required). Just the dispute is sufficient to allow a qme report to be obtained. The initial qme/ame report can be the first and only report addressing liability for injury in the case.
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