Q: Qme recommended lower back epidural injection if I refuse that type of treatment will it effect my workman's comp case
A: The QME has exceeded the scope of the evaluation as QMEs no longer control medical treatment. If your treating physician asked for an epidural, then the carrier needs to send the request through UR and IMR. I say this because an epidural is not a diagnostic, but treatment. Rest assured the carrier is not going to approve an epidural based upon a request by the QME. So the request will do nothing for or against your case.
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A: If the TREATING PHYSICIAN tells you the next step is the epidural and you refuse, he will likely just declare you are at Maximum Medical Improvement. It's nearly impossible to get any surgery approved when the treater has not first tried an injection. When a Treating PHysician writes the RFA for a surgical repair and has not tried an injection, the reviewing physician nearly always "non-certifies" the request because an injection was not first attempted, and you don't get the surgery. But the QME suggesting the injection is very different from the Treating Physician writing up a Request For Authorization, RFA form. The QME can suggest any number of treatments but no action is taken on the suggestion.
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