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Thread Title: AME Report
Created On Wednesday October 12, 2005 3:46 PM

1952jl
Junior Member

Posts: 10
Joined: Oct 2005

Wednesday October 12, 2005 3:46 PM

I had a AME in January the appointment was setup at the MSC in DEC. will it is now 10 mths later and still no AME report. I have an appointment with my lawyer in a week . This was the last AME before my case was to be ended . My date of injury was 3/27/99. Any ideals on what i can do to get this over with. The doctor Bruce Gillis was the one who did the AME all test was done in his offices the tests were 6 hrs long.

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andyourlittledogtoo
Senior Member

Posts: 504
Joined: Jul 2005

Wednesday October 12, 2005 7:53 PM

Ten months is way too long to wait. Most AMEs are taking up to six months (still too long but at least normal for right now). Your attorney and the CA should be asking the doctor's office where the report is and when it can be expected. Usually the CA pointing out that if the report isn't received by date X it will be considered no longer contracturally relevant and won't be paid for is enough to get them to cough it up pretty quickly (when it's more than reasonably late). See, the exam and tests are completely without probative value until they are memorialized in a medical report. No report, no payment for the examination or the six hours of testing and nothing for the probably considerable time doing a record review. Nada. That's powerful incentive. The only downside for the parties is that the AME may take out his newly created bad mood (due to the threat) on the party who made the no-payment threat and write a report that favors the other side more than they would otherwise have done.

AMEs are tricky beasts.

-------------------------
"For a long time it had seemed to me that life was about to begin, real life. But there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life." Alfred D'Souza

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reynacho
Senior Member

Posts: 277
Joined: Mar 2004

Thursday October 13, 2005 7:32 AM

I kind of wish they'd alter the codes similar to the spinal surgery second opinion and set a time limit to submit a report. The downside of that is we would be getting a bunch of half-assed reports and we'd spend all our time getting supplementals or clarification.

Posts: 64
Joined: Mar 2005

Thursday October 13, 2005 4:38 PM

Something is wrong here. Bruce Gillis, MD is usually very good about getting his reports out. My AME/QME's take about 45-60 days and supplemental reports are a matter of a few weeks. Your attorney AND the defense attorney either need to start bombarding the doctor's office with phone calls or perhaps show up in person to find out what's going on.

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gaiassoul1@yahoo.com
Senior Member

Posts: 2155
Joined: Feb 2004

Friday October 14, 2005 8:14 AM

I disagree, Bruce Gillis, is awful about getting reports out. I have clients who refuse to use him for exactly this reason. The second reason is the amount of his bills. He takes one appointment per day, he refuses to write an initial report based on the information he has on hand.

He is thorough, he is complete, he is medically one of the most competent internists available. However if you do not come up with every record he wants, the report sits waiting for a long dang time.

Has your attorney inquired about the status of the report and why it is not available? That is what needs to happen.

-------------------------
Ginger

To know how to say what others only know how to think is what makes men poets or sages; and to dare to say what others only dare to think makes men martyrs or
reformers - or both. Elizabeth Charles

Posts: 115
Joined: Mar 2005

Monday October 17, 2005 2:13 PM

I think I got REALLY lucky--AME report was out 1 month after exam--a few questions asked by the defense, answered immediately by the AME......The trouble is, the AME came out totally in my favor, so now the defense is trying desperately to have another doctor exam--does this thing ever end?????? I'm not trying to be pompous, assured of the outcome--I just have no idea where this whole thing goes! My AA say the defense may try to get another doctor to examine me, after 3 agreeing reports!!!! I am beginning to think that the "defense" is trying to make us all seem "depressive, unable to make our own decisions, "above" the decisions made by all the doctors' reports--what to do????? I'm about reaching my "end"--if all claims' adjusters, WC "trained" administers, etc., could have back, neck, knee, brain, whatever problems, I think we'd find some totally different answers to our questions! If we could only figure out a "system" that could measure our vastly different problems DUE TO WORK-RELATED INJURIES, then we might be able to make a real statement......anyone interested in going forward with such a concept????????

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andyourlittledogtoo
Senior Member

Posts: 504
Joined: Jul 2005

Monday October 17, 2005 7:02 PM

I'm sorry, but I find it very difficult to take your permanent disability claim seriously now that I know you're out climbing mountains while on disability. I can't help but think that what you're doing is what causes claims administrators to doubt other IWs who may have real serious disability and don't deserve that doubt. If you can explain how you think you have some significant disability while still doing things most uninjured people cannot, I for one would be interested in hearing it.

-------------------------
"For a long time it had seemed to me that life was about to begin, real life. But there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life." Alfred D'Souza

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reynacho
Senior Member

Posts: 277
Joined: Mar 2004

Thursday October 20, 2005 11:57 AM

I agree with AYLDT. When I saw that post about climbing some peak I was amazed. I love hiking in Colorado but I'd die before I was able to do what you did and I'm young and healthy, barring a previous knee injury. If you can do what you claim you can, then I agree wholeheartedly with the IC's decision to fight as hard as possible.

The system today is in line with the rest of the United States. That was the goal of the reforms and that's what has happened. There are still some problems but the sytem is so drastically changed that it's to be expected. As a CA I hate some of the changes of the law because it makes some things more difficult and time consuming. IWs hate it because they don't get as much PD. Someone posted that on a national average 60% of the claims don't result in PD so why do so many people think they have PD when they really don't? People are still used to the old system. California Workers' Compensation is no longer a retirement fund.

I need to add my usual disclaimer about the fact that this post does not apply to those seriously injured people out there.

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1952jl
Junior Member

Posts: 10
Joined: Oct 2005

Thursday October 20, 2005 9:38 PM

date of injury is 3/27/99 off work on 10/1/99 not more lite duty if you could call it that . had right and left shoulder surgerys ,neck and lower back fuzion with screws and plates. p/s in 11/8/02 had vr in 5/03 till 1/03. had 2 ins.co go bankrupt now the state is in charge . as far as this being a retirement fund you half to be kidding i get 170.00 a week who in the hell could retire on that? i'm going for full medical as far as the pass 6 years i just lost them for nothing. so now 10 mths waiting for ame report by a doctor who had 6 appointments set for the same day. who make the money here.

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andyourlittledogtoo
Senior Member

Posts: 504
Joined: Jul 2005

Thursday October 20, 2005 10:15 PM

Yeah, I don't think of this in any way as a retirement fund, but I think what is really meant is that the old system gave a lot of money to a lot of people who really weren't all that disabled. Believe me, I watched them bleed the system. Then you'd see other really seriously hurt folks not get near as much, just because they weren't playing a con game on the system. So folks get a little cynical. But for 99.99% of IWs, there's no real 'win' in work comp. You never really make up for the lost wages while you're off, or for the lack of higher wages after you're P&S, if you need voc rehab (old system) or have to medically retire.

I'm sorry you've had so much difficulty.

-------------------------
"For a long time it had seemed to me that life was about to begin, real life. But there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life." Alfred D'Souza

Posts: 115
Joined: Mar 2005

Thursday October 27, 2005 2:28 PM

I just noticed this thread, after not having looked at it for awhile! Statements made by unknowing people just prove how wrong we can all be by what we hear.........I've made the mistake of telling people (actually hoping to somehow inspire them!) that I've TREKKED, not CLIMBED to high altitudes, all the time being on Duragesic 50's and popping Norcos every 2 hours or so-----when people hear the word, "climbing", they automatically think of ropes, crampons, Hilary, etc........."climbing" can mean merely putting one foot in front of the other to gain altitude, possible even with pain/disabilities! So, please, just like in any situation, don't "assume" one term means another--I'm of the belief that determination is the strongest motivation we have, and to have someone misunderstand statements because of misinterpreting "words" really bugs me! Anyone who has a disability is fully aware that he/she may be able to accomplish many things, even if she/he can't manage to make it through a 40 hour work week!

Posts: 115
Joined: Mar 2005

Thursday October 27, 2005 2:52 PM

Just as a PS.......I've always admitted to the doctors--2QME's, 1AME, deposition, SSDI, you name it, what activities I've partaken in, and I've never felt that admitting these things hindered any of the results from anyone..........I feel like I'm being defensive, but, to the contrary, it just plain p....s me off when people come to their own conclusions about the extent of someone else's "disabilities"--lesson for everyone here!

Posts: 115
Joined: Mar 2005

Thursday October 27, 2005 4:48 PM

Just one more thing--now that I think of it, it feels good to feel "mad" for a change--haven't felt that way for a LONG TIME!!!!!!!!!! ALYDT, just out of curiousity, are you on the defense side, have you ever had a WC injury? Not trying to be argumentative, just questioning some of your remarks........kudos to you if you're truly an injured worker, and have been able to rise above all the issues that torment us! We all rise above things in different ways........

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loislane2
Senior Member

Posts: 599
Joined: Jul 2004

Thursday October 27, 2005 5:01 PM

Hi JJ,

I can empathize with your plight. When you are injured, it seems that folks hang on your every word, and action. I recall when i was first injured, and the Docs were unable to come up with a diagnosis. I continued working full time, doing so in excrutiating pain. i still got dressed well every day, put on make-up, and made it to my desk. My left arm would fluctuate in temperature as much as 12 degrees from my right. It would take on a claw appearance, and change color. And, my co-workers couldn't believe that i was really injured, because i did not have an open wound. When my RSD diagnosis was made, they behaved even worse. Well, if u were able to work for 2 months, why are u going out now? (I guess getting Stellate Ganglion Blocks under anesthesia, played some part in that!) It was heart wrenching to me to be treated that way.
As i came to realise my limits, i always strove to go beyond them, many times at my peril, and to the chagrin of my Docs! I, too take huge quantities of Norco, and other mind screwing drugs, daily. Law school was the most difficult challenge of my life, RSD and narcotics made it almost unbearable. But, i still push through every day. Physicaly, and mentally. I try really hard to be functional, and most people can't tell by looking at me that i am in constant pain.

In closing, I dont think Lil Dog understood fully what u were describing. And, in her defense, she is a very compassionate CA, and one who truly does care and endeavors to provide benes to IW's. However, as a CA, she has some right to be jaded, and as she is a conscienscous CA, i can understand her response.

Best wishes,

Lois

-------------------------
"When one door closes another door opens; but we so often look so long and so regretfully upon the closed door, that we do not see the ones which open for us. -Alexander Graham Bell (1847-1922)

Posts: 115
Joined: Mar 2005

Thursday October 27, 2005 5:49 PM

Thanks, Lois. You have to be a very strong woman to go through what you've gone through........and now that I've "vented" (honestly, first time I've felt "mad" in 5 years, which must mean I'm finally coming to grips with my situation!), I can honestly say I hold no grudges against anyone who states his/her opinions, even he/she may not know the whole story. Everyone's case is just different, and nobody can make snap judgments about the real extent of one's disabilities.........again, thanks, and more power to you!!!!

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STEVEPSCA@YAHOO.COM
Senior Member

Posts: 990
Joined: Jun 2002

Thursday October 27, 2005 6:53 PM

I can understand your reaction to the posts responding to you... and I've had and same reactions from others the same as you and Lois...until one of them suffered an injury... boy did the tune change...just because you can't see the open wound...and can't tell what hardware has been installed dosen't mean there isn't something wrong.
Any way...if you go back and read that post again, it does sound a little 'flip'...you're a baby in this system, ART and I and several others are approaching of have attained 10 years or more dealing with this.
Your major complaint was that you had to cut your vacation short...from climbing 'hills' and building schools for the underpriviliged in a foreign country!...all the while you are 'supposedly' disabled.
( I am not discounting your injury or that you take copious amounts of meds to manage on a daily basis... so do I, so I'm not putting you down) But re read that post and look at it from another side. I don't think anyone was 'assuming"...it was taken pretty much as it was written.
BUT, all that said, that's what this general side of the forum is for... a lttle venting and ranting now and then... so I hope you are feeling better and your case is progressing to a satisfactory conculsion...soon.
Believe me on this though... it helps to get a little mad now and then...dont' wait another 5 years...it's not good for you. This system is adversarial at best and we all need all the support we can get...from where ever.

Posts: 115
Joined: Mar 2005

Thursday October 27, 2005 7:48 PM

You're right, Steve--I did indeed sound "flip"--didn't mean to, but I did.........anyway, ranting done--each one of us has a different case, but it doesn't change the fact that everyone here is suffering from an "on-the-job" injury. I think I was just a little irritated that anytime an IW responds to the professional forum by mistake, someone on the professional side always points out the fact, and my statements in this forum were taken from another site in the forum, and it sounds like there are just some people that are wanting to find fraud where there might not be fraud--no insult to you, AMLDT....this part of the forum is listed as "past experience", and I merely stated my "past experience with my AME--had nothing to do with my dealings in 3rd world countries.......again, sorry if I came on too strongly. I'm off this site--no need for it anymore, and I just don't have enough experience to help people with their questions. Just a word of advice.....take everything with a grain of salt! Best wishes to everyone........

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injuredworker101@yahoo.com
Senior Member

Posts: 1527
Joined: Apr 2004

Thursday October 27, 2005 9:40 PM

JJ, stay with this site because it is the only one where you can get accurate help. You do not need to know the answer to the questions to participate. Often I am silent because others know far more than I.

That being stated IW's are in a difficult place. Like me...If I don't find a job, while I wait this out, I am considered a bum. If I find a job, I am considered not that disabled. No matter what you do in this system, you are not ever in the right position. Working will kill me in pain.

Anyway, I am trying to live my life the best I can. When I see a job that I would really like and think I can do, I apply. And...I will have to let the chips fall where they may. Either way, some day I will need to have a job, so why wait? The other side is the IC will save a ton of money if I find a job. The job... geeze who knows may or may not tolerate my taking off time for surgery. This will be a dicey situation. But then again, how do I predict what will be on the market when I am finally done?

What hurts me now is the full out charactor slam of which the IC is pulling on me. Their DQME, who is not honorable, does a charactor slam and they are attempting to make it look like I am just that. We will have to see how it pans out in court.

In the meantime live your life!

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1952jl
Junior Member

Posts: 10
Joined: Oct 2005

Friday November 18, 2005 9:59 PM

i got my ame report in . doctor report went to rater , they said 85%..... it was 11 mths to get in now we go back to court . this time to settle i hope.

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