Q: : I went to the qme doctor recommended treatment on both hands and knees and my doctor denied me medical tratement wt to
A:
If you were denied medical treatment recommended by a Qualified Medical Evaluator (QME) for injuries related to your hands and knees, it's important to understand your rights and options under California workers' compensation law. The denial of recommended medical treatment can be challenged, but you must act promptly to navigate the system effectively.
First, you should request a copy of the denial from your employer or their workers' compensation insurance carrier. This document should detail the reasons for the denial. Understanding these reasons is crucial as it will inform your next steps. In many cases, denials are based on the insurance company's review, which may not fully take into account the QME's findings or the specifics of your medical needs.
Next, consider filing an appeal with the California Division of Workers' Compensation. You may need to go through the process of Utilization Review (UR) and Independent Medical Review (IMR) if your treatment was denied based on medical necessity. This process can be complex, and seeking the assistance of an attorney experienced in workers' compensation claims can be beneficial. An attorney can help you gather necessary medical evidence, navigate the appeals process, and advocate on your behalf to ensure you receive the medical treatment you need.
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