If a my claim has been denied by work comp & I saw a QME, he determined it is work related, does WC need to resume payment?
Pravin's answer
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Answered on July 06, 2019
We need to know why your claim was denied. For example, if they are asserting a legal affirmative defense, the PQME report might not be relevant to...
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I received the c&r settlement paperwork but haven't signed it, is it too late to ask for a second QME exam?
Pravin's answer
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Answered on July 06, 2019
I'm not sure what you mean by a second QME. if it's for the same speciality, then you are stuck with the doctor but you can challenge his opinions....
If the QME agrees with my treating physician of me needing spinal fusion surgery, does WC have to now get me that surgery?
Pravin's answer
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Answered on July 06, 2019
We don't have enough information. For example, you say transportation was denied. But that requires a valid Request for Authorization.
Your...
Archived
Do i still get workers comp after MMI?
Pravin's answer
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Answered on July 03, 2019
They do not owe you temporary disability. They do owe you permanent disability advances if you are entitled to them.
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Will I be disqualified for benefits if I don’t claim it?
Pravin's answer
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Answered on July 02, 2019
I wouldn't say disqualified, but if you wait too long, the insurance company will likely say something like "Oh, you claim this pain happened 4...
Archived
Should I wait for the PQME or take a second opinion from a MPN?
Pravin's answer
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Answered on July 02, 2019
We have no clue about any of the details of your case, the doctors involved, etc. The fact that you didn't get a QME yet is also suspicious because...
Archived
I am workers comp for right knee injury and also own a business. my employer is investigating me.
Pravin's answer
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Answered on July 01, 2019
Yes, you can work at your second job, but any increase in income would offset your current disability.
Archived
Is there someone who can help with a disability claim
Pravin's answer
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Answered on July 01, 2019
As Gary Alan Jackson astutely said, yes, you will need to make this legal argument. Make sure to get an attorney that will also ask for penalties...
Archived
What do I do now?
Pravin's answer
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Answered on June 28, 2019
Depending on the type of injury and where you live, getting a doctor to treat on a denied case can be challenging. We don't have enough information...
Archived
I asked for a compromise and release and was told I couldn’t
Pravin's answer
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Answered on June 28, 2019
You can't force the insurance company to give you a lump sum settlement - especially if you still work for the company.
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