Psychological QME Supplemental Report Quandry (California) (

[appliedpsych]

Fourteen months ago, I performed a psyche QME related to depression and pain as a compensable consequence of an orthopedic injury. Since the Orthopedic QME stated that the applicant was not P&S/MMI, and needed more treatment, I opined that I would have to withhold my final opinion until the Ortho QME pronounced the applicant P&S/MMI. He has now made her P&S/MMI, with some improvement, with mixed apportionment to several orthopedic factors.

Applicant QME asks me now to issue a supplemental QME giving an opinion as to psyche issues.

The quandry is that since over a year has passed, and she has had further treatment with improvement, I only have the 14 month old psych testing to refer to.

Can I recommend to all parties that I perform a re-evaluation, administer new psych testing since the ortho QME indicates improvement, and use that as a reasonable basis for rating?

In the specialty of psychology, ethical standards would recommend re-testing, in order to get a good overview of CURRENT psych levels, now that she has improved. How can I rate her using old testing that reflected her psychological state when she was in more distress 14 months ago, than she is in now?

I have been having some struggles coming up with the codes and statutes to refer to and quote on this issue, in my letter to the parties.

Any insight, recommendations for me???

[vampireinthenight]

Hi Appliedpsych,

I don't think you need any codes to support your position. Just issue a report/letter stating that from your review of the medicals, it is medically probable that her condition has changed. Sounds like she was never P&S from a psyche perspective. Note the passage of time. Are you hesitant because of the costs of the testing? Applicant should be on board because once you issue your letter, no judge should rely on your first report. Not that it described disabiity anyway...

Does that help at all? Let me know if you need something more specific.