Legal Question in Workers Comp in California

after a ame report has been submitted and declare p and s does the insurance company have to start paying pd benefits

Asked on 4/06/12, 1:33 pm

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3 Answers from Attorneys

George Shers Law Offices of Georges H. Shers

They are required to pay PD benefits up to a reasonable amount of the anticipiated percentage of disability, but often they do not.

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Answered on 4/06/12, 2:23 pm

Alison Gude, Attorney Law Office of Alison J. Gude

Generally speaking, they must. However, it depends upon whether the AME reported that you have permanent disability. Considering the fact that you have an AME indicates to me that you are likely represented. I strongly encourage you make an appointment with your attorney to get your questions answered. Good luck!

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Answered on 4/06/12, 4:55 pm
Nancy Wallace Nancy Wallace Atty at Law

Permanent Disability Indemnity Advance Payments are ONLY due when the carrier has (1) accepted liability for the claim and (2) finds rateable disability in the AME Report for which it is liable and hasn't already paid.

If the adjuster rates the AME report to be a small sum and the adjuster overpaid Temporary Disability Payments a few weeks and converted those (re-labled the payments) to Permanent Disability payments, the carrier may have already paid out 80% of it's money due on the report,

In such a case, no PD Payments would issue following the AME Report.

MOST IMPORTANT!!! if there is an AME, that means YOU HAVE AN ATTORNEY! if you have an attorney that you cannot understand and you cannot communicate with (because you have to post questions on LawGuru), you need to give your attorney an ultimatum to explain this clearly to you or get a new attorney!!!

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Answered on 4/09/12, 9:11 am

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