Unusual QME Event (California)

This category is meant for discussion of technical legal issues in workers' compensation. If you are an injured worker, do not ask questions here. Go to the Injured Workers' forum.

Unusual QME Event (California)

Postby appliedpsych on Wed Sep 13, 2017 7:51 am

I did a psychological QME re-eval on an older case. Unrepresented worker. IC asked no referral questions in original QME or Re-Eval, so I used a generic approach in trying to summarize my findings. This is a teacher placed on limited duty by MD's due to physical aspects of injury. Also injury to the psyche due to attacks in classroom, which resulted in physical injuries. She finally had psyche treatment.On QME Form 111 I marked that she COULD NOT return to her usual job, being a classroom teacher. She has been performing modified administrative duties for some time, per her MD's.

NOW I get a letter from APPLICANT, stating that despite my marking no return to usual job (classroom). She got a letter from IC stating that she was now able to return to work, and they tried to get her to sign a statement to this effect.

Letter from her says that she went to a local DWC office, and that office told her to write ME, with a copy to IC, asking for clarification. Never had this happen. Shouldn't IC be the one contacting me? Worried on issues of ex-parte contact, etc. Being cautious and seeking input here.

Any advice on how to proceed??
User avatar
appliedpsych
 
Posts: 339
Joined: Fri Mar 06, 2009 8:31 am

Re: Unusual QME Event (California)

Postby LawAdvocate on Wed Sep 13, 2017 12:30 pm

Nope, either party can contact you after the initial evaluation and request clarification. That is NOT ex parte. I hope the IW copied the insurance company. If she did not, then you can send a letter to the IC saying, my office has received this correspondence from the IW absent a good faith objection to this letter within 20 days, I will be issuing a supplemental report, which is my duty as the PQME>

In the interim, you can send the IC a supp report that says - It has come to my attention the injured worker has alleged that she was advise she was cleared to return to work as a classroom teacher. In order to assure a clear record, please be advised that on page x, line y, in my reporting dated mm/dd/yyyy, I stated the Applicant could not return to her usual and customary work as a classroom teachers. The restrictions are as follows:....

Then send the IC the supp report with a copy to the injured worker, there is no psychiatric information which the IW may misinterpret in a work status report so she can get a copy.
LawAdvocate
 
Posts: 888
Joined: Wed Jun 11, 2014 10:55 am


Return to Legal

Who is online

Users browsing this forum: No registered users and 4 guests