Application fo Adj Question (California)

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Application fo Adj Question (California)

Postby paduanow@yahoo.com on Fri Aug 28, 2009 7:41 am

My client was asked to do a psych evaluation due to chronic pain and was referred by the PTP. The case has been denied by the IC. We received a deniel letter from the IC and the DA. The defense attorney stated that there is no psych injury on the Application of Adjudication which they were right. I sent reports to the AA and requested they amend the Application, but they failed to do so.

Is there any I can do?

In more cases we only perform an evaluation and no treatment is necessary. So there is no psych injury and/or the patient does not what treatment.
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Re: Application fo Adj Question (California)

Postby stewshe on Sun Aug 30, 2009 11:27 am

paduanow,

You should file a lien in the w/c claim if you have not already done so.

There are many reasons why the AA may choose to not file a psych claim.

Med-legal evals are frequently done to develop or rule out conditions which may or may not be work related. For example, after a fall a person may be complaining of foot/leg pain. An x-ray of the L/S spine could reasonably be ordered by the treater to see if there is a fracture or problem there causing LEX pain.

Only an ill-informed or dense defendant would deny the x-ray because no back problem was alleged!

As far as psyche med-legal evals are concerned, I suspect your CA would deny or simply not pay your bill even if "psyche" had been alleged! Many posters here complain of not being paid when they are appointed PQMEs or AMEs! That I find astounding!
James T. Stewart (stewshe@comcast.net)
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