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Thread Title: New QME regs effective 2/19/09
Created On Saturday February 07, 2009 5:03 PM


7dayweekend@mindspring.com
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Saturday February 07, 2009 5:03 PM

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I read through them and I didn't see anything about limiting multiple practice locations. Was all of that thrown out before the final cut?

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appliedpsych
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Wednesday February 11, 2009 2:24 PM

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That is correct as far as I can tell. It is nowhere mentioned in the new regs.

Also, I went to a recent CSIMS conference, and they handed out a summary which made no mention of this issue, and none of the presenters said a thing about it.

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7dayweekend@mindspring.com
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Thursday February 12, 2009 8:51 AM

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Pretty amazing that in the end they did nothing about it, because it was the major issue at the beginning. From my first reading, I see a lot of micromanaging of wait times and other annoyances and details but no sweeping themes. I do like that they clarified Agreed Panel QME.

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number6
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Saturday February 21, 2009 6:09 PM

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The use of EAMS forms for unrep'ed reports to the DEU and the Agreed Panel issues are the major changes. Sad to see however that Agreed Panel QME is clearly defined not as the "last QME standing", but only when the 2 attorneys Agree on one of the 3 QME's on the panel. I hope that attorneys will write cover letters which clearly indicate the APQME designation.

Edited: Saturday February 21, 2009 at 7:13 PM by number6

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straightshooter
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Tuesday February 24, 2009 9:13 AM

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hi 6
That's how I underswtand it. What I would like to know is what happens in the situation when the aplicant chooses a Dr. from a panel and then, after the process starts, the applicant hires an attorney. This happens very frequently. Is it then an APQME, PQME with an attorney, or what?

-------------------------
 MAXMEDLEGAL
Max Moses MD
Main Office 877-922-0022
Email:max@maxmedlegal.com

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number6
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Wednesday February 25, 2009 9:13 AM

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Again, it appears that the APQME would be designated only if the two attorneys "agree" to the QME on the panel list. If they each strike one off the list, the APQME is not designated. Sad, as I thought the intent of the striking process was to replace the archaic AME process??

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Jpod
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Wednesday February 25, 2009 10:20 AM

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I think the rules are structured so to give incentives for all QMEs to be acceptable as true AMEs, they are trying to get the bias out of the system.

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ymcgavin@socal.rr.com
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Wednesday February 25, 2009 10:24 AM

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Hi Number6,

You stated: "I thought the intent of the striking process was to replace the archaic AME process??"

First, the "archaic AME process" is still alive and well, and in fact required by LC 4062.2(b) prior to either party seeking a list of PQMEs from the Medical Unit.

Second, the true purpose of the striking process set forth in LC 4062.2 was to eliminate the never-ending 'dueling QME' battles --- where the DQME opines one way, the AQME opines another, and each QME is repeatedly asked to issue rebuttal supplemental reports, ad nauseum.

Number6, you have been around the block more than a few times. Accordingly I am sure you remember these 'dueling QME' battles. The med-legal report writers continued to be paid for supplemental report after supplemental report, as well as numerous depositions scheduled by the aggrieved party, IC or IW.

Natch, due to the never-ending requests from the respective parties seeking still another supplemental report from each of the 'dueling QME' report writers, the practical outcome was that this resulted in delaying resolution of the case-in-chief, and all the while, TTD dollars were being paid.

In short, the true intent of the LC 4062.2 striking process was to reduce med-legal costs.

Just imagine if we still had the 'dueling QME' battles going on now, after issuance of the Almaraz/Guzman companion en banc decisions regarding that sweet phrase, "by analogy" for an IW with numerous compensable consequence injuries.

Heavens, each 'dueling QME' would repeatedly be asked to issue a supplemental report by the AA or DA that chose that particular QME on the basis that QME was known to be applicant friendly QME, or a defense wash-out QME.

Nevertheless, the QME community should be glad for those times when they are mutually chosen off of a panel by the AA and DA as the AME, and getting paid $312.50 per hour --- rather than being the last one standing after the AA and DA have concluded the striking process, and the remaining QME is getting paid $250.00 per hour.

York McGavin
ymcgavin@socal.rr.com

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number6
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Friday February 27, 2009 10:03 AM

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Thanks for your clear words York!

I see (and feel) a couple problems with the APQME designation as it is now described. I have felt these problems as I have been both the "last QME standing" and the "agreed to" off of the panel on several cases in the last few months.

1) I feel I perform the same level of service in each case, and feel the implied additional burden of actin in the APQME role (although I, like most QME's, always attempt to render an unbiased opinion as nature allows on ALL cases). In the "last QME standing" and the APQME roles, I make sure I address all areas of contintion and I address each attorneys cover letter queries with equal attention. Yet only in the Agreed Panel QME designation am I entitled to the 25% adjustment. Seems a small point, but in each case we are providing the same level of service in a near identical role.

2) The attorneys and certainly the carriers seldom inform the QME of the selection mode and thus the APQME designation. I ask my staff to question the attorneys as to how the selection was made. It would be nice to have attorneys specify the selection mode in writting in their cover letters.

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7dayweekend@mindspring.com
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Friday February 27, 2009 5:59 PM

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CSIMS has a template of a form letter you can fax in such cases asking them to clarify the designation.

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