My lawyer wants me to see an AME a year after my claim

[Nicegirl2]

What is the name of your state (only U.S. law)? California

Hi. My attorney does not respond to my questions and when he does I am not always sure I'm getting all the info. I can't find another one this far into my clam.

I filed a workers comp claim about a year ago. It was denied until I got a lawyer. The case was accepted and they paid for some PT. The PT was helping a bit and I wanted to continue, but the insurance company says they see no reason to continue because one of their doctors examined the reports from PT and my doctor and he does not believe further PT will benefit me. My treating doctor disagrees.

My lawyer scheduled an AME evaluation for me without even letting me know or asking me if I wanted to see one. My understanding was that an insurance company can send you to see an AME or QME within the first 90 days. After, they lose that privilege. I do not understand why my attorney wants me to see an AME a year later??? It was my lawyer who brought up the idea during the deposition (about 8 months ago) while talking to the other attorney. I was not consulted. Am I required to see an AME one year after my claim is accepted? My attorney says if I don't go to this AME the insurance company will send me to someone of their own which will be worse. Please advice.

 

[Willlyjo]

What is the name of your state (only U.S. law)? California

Hi. My attorney does not respond to my questions and when he does I am not always sure I'm getting all the info. I can't find another one this far into my clam.

I filed a workers comp claim about a year ago. It was denied until I got a lawyer. The case was accepted and they paid for some PT. The PT was helping a bit and I wanted to continue, but the insurance company says they see no reason to continue because one of their doctors examined the reports from PT and my doctor and he does not believe further PT will benefit me. My treating doctor disagrees.

My lawyer scheduled an AME evaluation for me without even letting me know or asking me if I wanted to see one. My understanding was that an insurance company can send you to see an AME or QME within the first 90 days. After, they lose that privilege. I do not understand why my attorney wants me to see an AME a year later??? It was my lawyer who brought up the idea during the deposition (about 8 months ago) while talking to the other attorney. I was not consulted. Am I required to see an AME one year after my claim is accepted? My attorney says if I don't go to this AME the insurance company will send me to someone of their own which will be worse. Please advice.

You need to do what your attorney says since he knows best concerning your case. An AME is an Agreed Medical Examiner whose report will carry a lot of weight with the WCAB. Go to this evaluation since it can move your case along.

 

[csi7]

Go to the examination. It will either support your treating doctor's diagnosis, or it won't, and it will explain the difference.
Your attorney is trying to move the case along and in order to know exactly what is possible, the exam is needed to break the issue of where you are at with your recovery.

 

[Handcoc]

Speaking to the subject of PT; many studies have found this to be pretty much useless treatment. Most people just go back to the same condition & PT is pretty much just simple exercises that can be done at your own home.