Q: Why did the judge refuse to look at my evidence?
I was advise by I&A that I can bring my medical evidence to the expedited hearing and he will decide if I am entitled to ttd. I brought the ptp’s pr-2 report showing ttd but the carriers attorney told the judge it wasn’t the ptp who did the evaluation. The judge took their words for it and refused to review the reports. The ptp is in the mpn and there are two doctors that sings the report. One is the ptp and the other is the doctor that gave me medication. The judge explain that the first qme said I was mmi and that’s why I can no longer receive benefits. I ask for ttd for the months before mmi date but he argued that my claim was denied and he can only award it if I settle. Amazingly, their attorney told the judge my claim wasn’t denied and it was an accepted claim. The judge couldn’t make a ruling even with all the substantial evidence available. He wanted to wait for second qme report. The new report, says return to work if they can accommodate restriction but I don’t have a job.
A: Welcome to California workers compensation. This is why you should have an attorney. At this point you must file a petition for removal. Without knowing exactly what the PTP reports say, it is not possible to make an informed decision regarding why the WCJ did not award TTD, but consider that the PTP reports must meet certain standards to comply with statue and act as evidence. If the PTP simply says TTD, or "remain off work" it does not explain why TTD is due and therefore the WCJ can, and apparently has, disregarded the reports in favor of the Qualified Medical Evaluator. You should also send the reports to the QME and ask if it changes his opinion regarding TTD.
A: Appeal this decision with a Petition for Reconsideration (due 20 days after the hearing), and the judge with either (1) call you back in to review your evidence before deciding OR (2) write why your evidence was defective and inadmissible. The judge told you s/he believed the QME over your primary doctor. The judge IS permitted to choose between the QME report and the treating physician's report. The QME gets all of the medical records and the PTP typically often gets none, basing an opinion soley on what the applicant says or writes. If the QME has photos or film of the injured worker and medical records, the QME based his opinoin on a more complete evidence package.
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