u/beyondlandsend

Hello all,

I have been lurking around this subreddit for a little while, and I’ve noticed a lot of posters mention that they’ve been dealing with an injury for 1+ years, and either they or their WC company ultimately requested a QME panel for evaluation for various reasons. I’ve also read that some people only see a QME once, but others have had multiple QME visits. A lot of people had QME requests after a denial, but others even without any denials.

** I also noticed that there weren’t many, if at all, people who have posted about requesting a QME early in their case (e.g., 1-6 months after reporting the injury). What are advantages to requesting a QME early on in your case even without any denials? **

Is it to establish a (hopefully) fair baseline with a third party opinion alongside a PTP opinion that maybe someone injured can work with down the line? Or other things?

How would WC respond to an early QME request by an injured worker? Curious about how all this works because WC is slow enough even without the purposeful delays as WC adjusters often have 100+ cases on their plate, and the healthcare system is the way it is.

(I’ve read about unrepresented vs. represented QME panels, so I am aware of the advantages of being unrepresented; this post is not about that.)

Hi all,

Just wondering if this situation has occurred to you.

WC lawyer advising to file for a QME request so that we will hopefully have more control over the situation is as early as possible.

I also want to see about switching providers since I have a doctor I have worked with in the past for another claim (who is within the MPN) that I like, but am not currently under the care of due to the WC company directing me to be seen by another doctor when I got injured this time around.

Also curious to know: How long as it taken any of you to switch providers within the MPN?

Hi all,

Trying to figure out where our next Friends&Family vacation will be. We had originally been thinking about Yunnan, Zhangjiajie, and Chongqing, BUT:

1. We will have 2-4 seniors tagging along for the ride, with at least one who is low-mobility. (Low mobility meaning can walk at a slower pace on flat/even ground, but has increased difficulty with uphill walking or going up stairs.) Those destinations, if I understand correctly, might be a wee bit difficult then…

2. Additionally, we have already been to: Hong Kong, Macau, Beijing, Xi’an, Chengdu, Guilin/Yangshuo, Shanghai, Suzhou, Guangzhou, Xiamen, Sanya.

3. We are also planning on contracting a private tour company (e.g., China Highlights, China Discovery, Top China Travel, China Culture Tour, etc.) for tour guide and driver service.

Does anyone have any suggestions? I am interested in opinions from the people here, and would like to compare recommended destinations to proposed itineraries of previously-mentioned tour companies.

Thanks for your time!

***Consulting lawyers said they encouraged people to request a QME panel first regardless to help drive future care and get ahead of claims administrator, and that there were significant advantages to requesting a QME panel as an unrepresented worker (which I have read about and certainly see the merit of), and if that doesn’t work out, seek them out and go the represented route with the panel strikeouts.

Some background: WC company has, so far, accepted claim that was opened about a month ago and have been to initial appointment, and follow-up appointments since then.

PT has also not yet started (albeit very delayed as the third-party PT company insisted that there were no initial consultation appointments available within 3 weeks even though PT was approved fairly timely by the adjuster), until later this week. Also, healthcare provider refused to put in a referral request for another noninvasive treatment, citing, “They never get approved anyway.”

Ultimately consulted lawyers because also concerned about WC potentially denying whole WC claim later down the line due to preexisting conditions, and want to get ahead of the curve. (Technically, nothing has been denied at this time, but assuming WC adjuster is currently reviewing past records, current records, etc.)

Just wondering if this is a common move to request a QME so early on despite nothing being “officially” delayed or denied yet. Or if anyone else has received this advice before.

Most of the info have come across on Reddit and the internet involve QMEs after extensive treatment or outright denials/delays, but it could be that people usually post when they’re more desperate for help (valid) or at their wit’s end (also very valid).

Navigating WC is honestly kind of scary, which seems to be a common sentiment here. Hopefully can get some form of solid advice to knock some sense into me.

Thanks for any insight.