I suppose it's too much to ask for emergency (California)

[jobmdpsych]

legislation to allow telepsychology QME examinations for the next few months until this blows over....also there's no reason now we can't be doing teleconferenced depos...

we can reduce connectivity but we don't need to shut the whole system down.

[LawAdvocate]

We are following the physician's lead as to whether or not they want teleconferenced depositions.

Some physicians just separate us enough, which doesn't give total piece of mind - walking into a medical office.

I do not think that when body measurements are needed, not psyche of course, that we can teleconference the whole medical-legal examination, but parties certainly can stipulate to teleconference most of it. If the parties stipulate, we would move faster than with the legislation.

Injured workers are going to be impacted on an exponential level, so any effort to move the cases to resolution, as creatively as possible makes total sense.

[jpod]

At the DWC Conference several years ago a panelist from DWC did a presentation on telemedicine. One of the slides discussed a case in which a psyche QME was done via telemedicine. I do not recall the circumstances for why but think it was the QME could not travel. The case was not published but was designated a significant panel decision. The telemedicine QME exam and report was found to be a valid QME by the WCAB Panel.

The case cite is: Cherish Orange vs. Crestwood Behavioral Health 2014 Cal. Wrk. Comp. P.D. LEXIS

As LawAdvocate pointed out a psyche QME is better suited for telehealth/conference b/c it is all visual/verbal and no physical touching or measuring is required.

Have you tried talking to the parties about agreeing to a teleconference approach? Or was your question just a general plea to allow for teleconference for a psyche QME?

if it is the latter you have the case noted above to hand to the parties as proof the WCAB has allowed a psyche QME to be used to help prove or disprove a contested issue.

[jobmdpsych]

I looked up that published case and that's treatment not a QME exam. Is there any case specific to medical-legal?

[jpod]

I apologize, I didn't re-read that case and embarrassingly must have mis-remembered.

I will look again in my telehealth folder for anything involving M/L.

[jobmdpsych]

Orange County and the Bay Area are on total lockdown so if this doesn't get figured out and soon this will the QME backlog of 2013 on steroids.

[jobmdpsych]

Here's a simple idea: fillable DEU-100 forms. If we email people PDFs, we will never get them back. Also if they don't have an iPad or similar with a connection, lend them one for the appointment.

[jobmdpsych]

I guess it is too much. I guess it's simply impossible to get off the rails when a fright train is coming unless we do hire a RAND consultant and appoint three ad hoc committees first. I just read Dr. Vari's article. Come on people, there is no logical reason that mental health evaluations cannot be via telehealth app, unless cognitive testing is involved.

I understand government moves slow but can we adapt to emergency circumstances? It's not impossible, the military does it all the time.

[DrDoc]

I think the question now is whether there is going to be any real business in the entire system during the stay at home order phase. As a doctor, one may be exempt as an essential provider. But there are so many other people and venues that will be impacted. Will the medical unit be able to stay open? Will the attorneys offices, with all the staff involved in day-to-day operations, continue to conduct business? How many offices will essentially be closed due to lack of security, management, parking, etc.? What about the insurance adjusters? What about the court reporters? So, I guess it comes down to whether work comp evaluations, depositions, and sadly, even treatment, will cease to exist for the time being. Also, on a different, but related note, with the insurance company staff staying at home, I can’t see how any payment checks could be provided to any of the parties.

[DrDoc]

I will be playing chess and backgammon online. If any of you think you can handle such competition, just send me a little message. But, please remember these are stressful times. If you can’t handle being repeatedly beat, as a doctor, I would recommend caution.