Can I the injured employee go talk to the DD that put me at MMI back in October?

Asked almost 4 years ago - Plano, TX

I was injured in May and the insurance company denied a few procedures for my injured back and sent me to a pain managment doctor. I had a few different types of procedures but did not help. Insurance sent me for a DDE back in October and I was put at MMI with a 5% impairment rating. I disputed that along with 2 other doctors but they denied the appeals. I went through an IRO and they overturned the denial and I had an ESI on Dec. 20. That did not help. I went through a BRC and the insurance company stood by the DDE. I have now been sent to P.R.I.D.E for a consultation. I have 3 different doctors including a neurosurgeon disagreeing with the DDE. I have another BRC scheduled in April.Can I go see the DD with disputing reports and see if she will change her mind on my MMI.

Attorney answers (3)

  1. Robert Daniel Kelly

    Pro

    Contributor Level 20

    Answered . You can ask. An attorney might be able to help you with that.

  2. Thomas L. Holder

    Contributor Level 11

    Answered . You can always schedule another appointment and try to talk to the doctor. Although they rarely change their mind, I have seen a few cases in which the doctor was persuaded to, at least, increase the disability rating based on the specific complaints of the injured worker. You may need a lawyer to help arranger for the appointment. Good luck.

  3. Michael Daniel McGrath

    Contributor Level 9

    Answered . I would strongly suggest that you consult with a licensed Texas Attorney for assistance with your claim. Generally speaking, insurance carriers will be in constant contact with all Authorized treating physicians regarding your care. Often, a Nurse Case Manager will be utilized to be present at your appointments and/or speak directly with the doctor following your appointment. The goal for the insurance carrier is to have treatment be completed as inexpensively and quickly as possible. Scheduling an appointment with the doctor to "change his mind" will likely have no result. Again, there may be legal options available for you that would be best pursued with the help of a lawyer.

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