Los Angeles, CA asked in Workers' Compensation for California

Q: My case is almost resolved, my Dr. sent the final supplemental report, & waiting for authorization from opposite side

What is the authorization for, and how long is this suppose to take before everything is settled after the authorization has been received by my Doctor and lawyer?

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1 Lawyer Answer
Nancy J. Wallace
Nancy J. Wallace
Answered
  • Workers' Compensation Lawyer
  • Grand Terrace, CA
  • Licensed in California

A: Authorization is ALWAYS about money! How long is it 'supposed to' take? Sad to say, there is no set time. If the Insurance Adjuster thinks the Treating doctor's opinion is too generous and you really don't have as much disability as the Treating Doctor writes, then she can request a Qualified Medical Evaluation --- the QME (first she or her defense attorney haveto suggest the Agree Medical Evaluaton...the AME, sort of a Doctor 'God' because what he writes 'goes'').

if your attorney and the insurance attorney cannot agree on that Doctor God (an AME), then the aduster/defense lawyer write to that Medical Unit in Oklahoma for a list of 3 specialists...we call that a QME Panel. That takes a couple of weeks, maybe 3. then the adjuster strikes the Nice Doctor, your attorney strikes Dr. Antichrist, and you're left with the doctor nobody knows about in the middle....that's your QME.

Then it takes 60 days to get a QME appointment, and then it takes 30 days to get the report from that appointment... there went 3 more months. If that QME writes something wacky, one of the attorneys (yours or the insurer's) can set his testimony under oath to ask questions...that's a deposition; add two more months.

THEN if the defense attorney (insurance adjuster if no atty) has money ('authorization') for just the low value of the QME report and you want the money in the treating physician's reports, you go to Trial...add on 4 more months.

IF YOU"RE SUPER LUCKY, the adjuster will agree the Treating Physician's supplemental report contains an accurate finding of your permanent partial disability, she will suggest a settlement based on his findings, you will find it fair and a settlement document will be sent in two weeks after the treating doc's supplemental report arrives.

I certainly hope you are lucky.

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