San Francisco, CA asked in Employment Law and Workers' Compensation for California

Q: My case is settled with lifetime medical. My employer is not letting me return to work because of the QME's very

stringent restrictions from over a year ago. My PTP removed these restrictions recently.

Does old QME report trumps PTP's current evaluation?

How to change/update QME's report. Thanks, Steve

2 Lawyer Answers
James L. Arrasmith
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Answered
  • Sacramento, CA
  • Licensed in California

A: If your case has been settled with lifetime medical benefits and your employer is not allowing you to return to work due to the QME's restrictions, you may want to consult with an employment attorney who specializes in workers' compensation law to discuss your options.

In general, a QME's report is considered to be an independent medical evaluation and can carry significant weight in a workers' compensation case. However, if your treating physician has removed the restrictions that were imposed by the QME, you may be able to use this as evidence to support a request for a modification or update to the QME's report.

To change or update a QME's report, you may need to request a re-evaluation from the QME or seek a second opinion from another qualified medical evaluator. An experienced workers' compensation attorney can advise you on the specific procedures and requirements in your state.

It's important to note that if you are unable to return to work due to your medical condition, you may be entitled to disability benefits in addition to your lifetime medical benefits. An attorney can help you understand your rights and options, and work with you to develop a plan that is in your best interests.

Neil Pedersen
Neil Pedersen
Answered
  • Westminster, CA
  • Licensed in California

A: It is not reasonable for an employer to rely upon year-old information from the QME is you have recent information from your treating physician that removes the restrictions. This looks and smells like a situation where the employer is discriminating against you for having had a disability in the past. That is unlawful.

It would be a very good idea for you to locate and consult with an experienced employment law attorney as soon as possible to explore your facts and determine your options. I would suggest you look either on this site, or go to www.cela.org, the home page for the California Employment Lawyers Association, an organization whose members are dedicated to the representation of employees against their employers.

Most employment attorneys who practice this area of law offer a free or low cost consultation in the beginning and then, if the matter has merit and value, will usually agree to work on a contingency basis, meaning you can hire an attorney without paying any money until the matter results in a positive outcome for you. Many advance all the costs of the litigation as well. Do not let fear of fees and costs keep you from finding a good attorney.

Good luck to you.

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