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Have they lost their minds?... The QME chosen consult... (Ca

PostPosted: Mon Mar 16, 2009 6:09 pm
by chirogeek
One of the things I used to enjoy about being a QME / AME was being able to send the patient out for treatment (if need be) by a top-rate physician--like a skilled PM doctor or Psy--who I knew would afford the best possible care (the kind of care I would want if that particular injury happened to me). Now, however, I won't be doing that anymore! After reading section 32 of the new regs--which actually made me laugh out loud-- I have determined it will be far, far easier to just request another P-qme to fulfill that treatment / consult. (I guess I wouldn't have to do this in the first place if chiros would work more with other specialties.)

For any of you who haven't read section 32 yet, here's what the QME must do if he wants an opinion from a medical specialist:

1.) He (the QME) must set up the appointment himself and then notify all the parties in writing of the appointment specifics. (What's wrong with that, you may ask? Well, no doctor in his right mind will set up an WC appointment until the CA authorizes this in writing--which will open the whole MPN can of worms.... delay, delay delay. So, before setting anything up, now the QME is going to have call the adjuster, "attempt" to get authorization in writing, then set up the appointment and send out notices--I would have to hire a new staff member!

2.) Next, while under the same 30 day time deadline, the QME must get that consult report himself, review it, and generate a supplemental report (I'm still not sure if we can get paid for that or not) and serve it on all the parties.

3.) If the consult doc fails to get you the report in time, 32(f) says you have to serve the sup anyway (I don't know what there would be to talk about if your consult hasn't come in yet). Then, after you finally receive the report, you will issue yet another sup report and discuss what the doctor has opined.

4.) Here's the crazies part: The QME is now the collection point for medical records that the parties could want the consult doctor to review. That is, you're the gatekeeper and may pass on records to the consult doc as you see fit (although you had better to be ready to explain yourself if you choose not to forward something to the consult doc). Moreover, if any of the parties want to write the consult doc, forget it. The CA and DA will send their letters to the QME who "may" forward the information on to the consult doc; they may not for good reason.

So I ask this wise old forum, have the powers above lost their minds? Do they have any idea how much extra work that will place on the QME docs and staff? Seriously, I would have to hire another person just to manage this madness. Nope, I'll be requesting QMEs for problems that are out of my scope, which is a shame for the injured worker. This must have been their intention... no? There must be a reason why they does not want non-QMEs involved in this process. I predict that the they will be issuing a lot more QME panels secondary to these rules!

Sorry for the rant... again.

Re: Have they lost their minds?... The QME chosen consult... (Ca

PostPosted: Tue Mar 17, 2009 1:01 pm
by postscript2
I'm afraid to go back into the water after reading this!!!

Now in "my" case, the original PQME DID refer out to two other PQME's and set the appointments. One of the PQME's did not receive any medicals.

Why must "they" keep muddying the waters?

LCS :?

Re: Have they lost their minds?... The QME chosen consult... (Ca

PostPosted: Wed Mar 18, 2009 11:21 am
by rider001
I think the answer is one of two possible. Either someone writing this stuff is high or it is a controled disfunction. My vote is fot high.