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ANY ATTY? Need Interpretation, Please?

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LadyBlu

Guest
HI All, I was just wondering if any of you could interpret this for me. I know that *Presumptive* is probable cause, but in this context "allows for examinations by a TWCC-selected designated doctor whose report is given presumptive weight (effective September 1, 1999)."

Would this mean that a DD's evaluation would hold extensive weight in a hearing?

[Edited by LadyBlu on 02-14-2001 at 08:35 AM]
 


I AM ALWAYS LIABLE

Senior Member
LadyBlu said:
HI All, I was just wondering if any of you could interpret this for me. I know that *Presumptive* is probable cause, but in this context "allows for examinations by a TWCC-selected designated doctor whose report is given presumptive weight (effective September 1, 1999)."

Would this mean that a DD's evaluation would hold extensive weight in a hearing?

My response:

Hey LB, where have you been ? Still fighting this matter, huh ?

Okay, in answer to your question, the acceptance of the report will be given the probability of accuracy, which automatically affords the report a reasonable ground for belief. In other words, where two or more competing reports are submitted, the scales will be tipped in favor of the designated doctor's report as being the more "presumptively" accurate, believable, and reliable.

That doesn't mean, however, that all other reports will be disregarded. It just means that in the face of two differing opinions on the same matter, the triar of fact has a right to rely more heavily upon the opinion of the designated doctor's opinion.

IAAL


[Edited by I AM ALWAYS LIABLE on 02-14-2001 at 11:59 AM]
 
L

LadyBlu

Guest
I AM ALWAYS LIABLE said:
LadyBlu said:
HI All, I was just wondering if any of you could interpret this for me. I know that *Presumptive* is probable cause, but in this context "allows for examinations by a TWCC-selected designated doctor whose report is given presumptive weight (effective September 1, 1999)."

Would this mean that a DD's evaluation would hold extensive weight in a hearing?

My response:

Hey LB, where have you been ? Still fighting this matter, huh ?

Okay, in answer to your question, the acceptance of the report will be given the probability of accuracy, which automatically affords the report a reasonable ground for belief. In other words, where two or more competing reports are submitted, the scales will be tipped in favor of the designated doctor's report as being the more "presumptively" accurate, believable, and reliable.

That doesn't mean, however, that all other reports will be disregarded. It just means that in the face of two differing opinions on the same matter, the triar of fact has a right to rely more heavily upon the opinion of the designated doctor's opinion.

IAAL


[Edited by I AM ALWAYS LIABLE on 02-14-2001 at 11:59 AM]
Yes, still fighting this *Thing*. It is at the final appeal level with the TWCC, next step the court room. Which of course they will win by default because I would have to pay for my legal fees out of pocket and my pocket is too tight to afford this extra expense.

What you said makes sense, how the CCH Officer ruled doesn't. He literally disregarded all of the Dr's reviews and opinions, (which all stated that they felt this was from the original injury) and made his own determination. I am waiting now for the appeal panels decision. The thing that really pissed me off was at the beginning of the hearing (on record) the counsel for Carrier stated they were not contesting the disk changes at L5/S1, because reports showed there was deterioration and they are accepting compensability for that, they were contesting the herniation at L4/L5. The hearing officer ruled that they were not liable for either the L4/L5 or L5/S1 disk deterioratiion.

Kinda screwed up huh?

This is the wording of my appeal at the end where I can ask for relief:
" I am asking the Appeals Panel to Reverse and Render a decision in my favor. I do not want this remanded back to a Benefit Contested Case Hearing, because I feel that Mr. P only paid attention to the info he wanted to and not to everything presented. Mr. P basically made a medical opinion that the doctor's report were wrong, not a decision based on the opinions of the doctors. Dr B made an assessment that Dr. W should have done MRI's, etc., back in 1995. No one better than a doctor would be able to determine if another doctor had performed the appropriate diagnostic testing, this is not a determination for a hearing officer."

What ya think?
 

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