Sacramento Workers’ Compensation Attorneys

Qualified medical evaluators (QMEs) or potentially agreed medical evaluators (AMEs)

Injured workers have the right to be examined by Qualified medical evaluators (QMEs) or potentially agreed medical evaluators (AMEs). The examination aims to determine the injured employee’s rights to benefits or possibly to resolve a dispute over recommendations by the treating physician. Qualified medical evaluations are traditionally licensed medical doctors but can also include other healthcare specialties such as chiropractors, dentists, and optometrists. Agreed on Medical Examiners and Qualified Medical Examiners: The difference between a QME and an AME is primarily because AMEs were negotiated by the parties.

Additional resources from our Sacramento workers’ compensation attorneys

• Claims for Serious and Willful Misconduct of an Employer
• What are an injured employee’s rights to medical treatment?
• What are an injured employee’s rights to permanent disability?
• What are an injured employee’s rights to temporary disability payments just after the injury?
• How to Choose from a Panel QME (Qualified Medical Evaluator)
• What is an AME or QME? How do you receive a Panel List?
• Social Security Disability
• Workers’ Compensation for Public Safety Officers

What should I do if I have a job obtaining a free consultation with our Sacramento workers’ compensation attorneys injury besides?

If you have an on-the-job injury, besides obtaining a free consultation with a Sacramento workers’ compensation attorney, you should immediately report the injury to your supervisor! You must report the injury timely to avoid being denied as untimely and may subject yourself to unnecessary scrutiny and delay.

Conversely, reporting the problem immediately helps prevent delays and other issues, such as obtaining necessary medical care and temporary disability payments.

The best way to protect your workers’ compensation rights is to report your injury when you learn or believe that your job may have caused the damage. The law requires your employer to provide you with a claim form within one working day after learning about your injury or illness. If your employer needs to give you the claim form, a Sacramento workers’ compensation attorney can provide one. Suppose your employer does not document the injury or provide a claim form. In that case, that should be an immediate red flag that your employer or insurance company may not cooperate. A further cause is to contact the Sacramento workers’ compensation attorney immediately!

If you need emergency treatment, get it! Your employer may tell you where to go for treatment, but no matter what, if you need medical help, get it. When you seek treatment, you must tell the healthcare provider who treats you that your injury or illness is job-related.

What do the terms AOE/COE mean?

To have a claim covered by workers’ compensation insurance or be administered within the workers’ compensation system, the application must be AOE/COE. AOE/COE is an acronym used by attorneys within the workers’ compensation system. It means “arising out of and occurring during employment.” Simplified, it means your injury may have happened on the job.

What is a C&R?

Abbreviations in the workers’ compensation systems are standard, and a C&R is one of the most regularly used. It is a short-hand way of saying “compromise and release.” A compromise and release are when you receive a single lump-sum payment now and waive any future rights against your employer or the insurance company for claims arising from your injuries, including medical bills. C&Rs can be very beneficial, but accepting a compromise and release should not be done without the advice of a workers’ compensation attorney.

Why are my benefits being delayed?

If an insurance carrier isn’t paying you benefits, they must send you a letter explaining why they have been delayed or denied. The letter must provide the reason for the delay and the information needed to avoid further delay.

What is a denied claim?

If your claim is denied, the insurance company believes you were not injured or your injury was not work-related.

What does it mean to have a workers’ compensation disability?

To have a disability within the workers’ compensation system is often misunderstood. Unlike the Social Security environment, a disability does not mean you cannot work. Most people who have workers’ compensation disabilities continue to be gainfully employed. A disability is simply a condition that makes engaging in physical, social, and work activities complex.

Our Sacramento workers’ compensation attorneys explain what happens in a workers’ compensation hearing.

Workers’ compensation hearings vary depending on the particular issue. Traditionally, many different matters are on the calendar for a specific time. When your case is called, the judge will discuss the general nature of the dispute with the attorneys to refine the issues. Once the problems are narrowly focused, the judge will ask the attorney to submit into evidence various documents, including medical reports that support or refute the claims. Once the materials are introduced, the judge will often allow the parties to call witnesses when appropriate to provide live testimony. Each side typically has an opportunity to question the witnesses. Once the documents are entered and the witnesses examined, the judge may permit the attorneys to summarize evidence on the record or in writing. This summary is referred to as closing arguments, which are generally allowed. Then, the judge takes the matter under submission/consideration. After considering the case, the judge will typically issue a decision, often called a Findings and Award. If not timely appealed, the findings and award will become the court’s final decision.

What does Maximum Medical Improvement (MMI) mean?

MMI means your condition has reached a plateau and stabilized. There may be some minor improvement or deterioration expected in the future. Still, generally speaking, your situation has reached a phase where significant changes are not likely. This is a critical juncture in your case. Once you have reached Maximum Medical Improvement, a doctor can assess how much impairment and disability you have and hopefully have your disability rated and your case resolved. Settling a workers’ compensation case before reaching MMI is futile and, typically, a lousy idea absent extenuating circumstances.

What is a Medical Treatment Utilization Schedule (MTUS)?

Conventional and alternative medicines are only sometimes in agreement. Because of the complexities of the workers’ compensation system, the law only requires insurance companies to provide evidence-based medical treatment. Stated differently, they only have to provide treatment proven by science to cure or relieve injuries. Some alternative medicines are not approved, and some experimental or cutting-edge therapies can be denied. The Medical Treatment Utilization Schedule (MTUS) is a set of written guidelines that details what types of treatments insurance has to pay.

Our Sacramento workers’ compensation attorneys explain what happens at a Workers’ Compensation Mandatory Settlement Conference.

A mandatory settlement conference is an event that traditionally takes place with the workers’ compensation judge. It is a conference in which the injured employee, insurance adjuster, and attorneys are required to attend or, in some cases, be available by telephone. At the meeting, the judge requires attorneys to review the facts and laws with each other and their respective clients. The court encourages the parties to discuss the matter in detail and hopefully come to a resolution. Attendance at the settlement conference is generally mandatory. The decision at the settlement conference is entirely voluntary.

What is considered a permanent disability?

If you have a permanent disability, this does not mean you cannot work. It merely means you have a condition that results in some limitations. That limitation may affect your ability to earn a living.

Is there a formula for rating a disability?

The Department of Workers’ Compensation publishes schedules to calculate and rate permanent disabilities. A workers’ compensation attorney can assist you in the rating, or you can have your case rated directly by the rating unit at the WCAB.

Please contact our law firm today to discuss your case with one of our Sacramento workers’ compensation attorneys.