I was on wc for 13mos. Had ctrs surgery on both wrist, dr release me to return to work w/ no restrictions. Went back from 2/21/13- 4/12/13. I'm out again for the same injury that flared up so bad I'm unable to perform the same duties as before I went out. I went to the dr yesturday now he is requesting for me to see a QME. So do I need to get an attorney to help me with this, Am I Still getting pd from wc? What do I tell my employer? Do I go back to work or is the claim administrator taking care of this. I'm not sure as to what's next or what to expect?
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2 Answers from Attorneys
Yes, you absolutely need to get an attorney.
The treating doctor is 'in bed' with the insurance company, and after making a bad diagnosis is refusing to change their mind.
If you pick the Qualified Medical Evaluator badly -- and most are jerks 'in bed' with insurers, so you are very likely to pick badly -- the QME will write you are fully healed and nothing is wrong and you're just lying about your pain and symptoms.
Are you still getting paid by Workers Compensation? Workers Comp insurance only pays when their network doctors state you cannot work or that you have some permanent disability... so no, since the doc you stayed with won't write you are unable to perofrm these duties, you won't get paid.
Do you go back to work? Yes, or face being fired for job abandonment. A possible alternative is to see another MPN PHysician and see if that new MPN Physician writes you need a brief Temporary Disability Period, but because the first MPN PHysician wrote you are fully healed with no disability, the adjuster would likely just dismiss the new MPN Physician report.
You need to be on temporary total disability (TTD) benefits. Even though you went back to work since you had a flare up , you need to be taken off work again and receive additional treatment. Don't allow the adjuster to pick the QME for you you will end up with a very low percentage of disability and you will lose your job any way. You need to retain an experienced worker's compensation attorney that negotiate an Agreed Medical Examination with a fair and reasonable examiner and get you the maximum settlement. Feek free to call me at 213.388.7070 for a free consultation.
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