What Happens When a QME Gives a Disability Rating?
After a QME, if you don’t have an attorney, the Qualified Medical Examiner (QME) will send a copy of the report to the claims administrator, the Division of Workers’ Compensation Disability Evaluation Unit (DEU), and to you. The DEU typically has 20 days to issue a disability rating. Once a rating is given, you can begin discussing the settlement of your claim. However, to make sure your claim is handled correctly, it is recommended to speak with a reputable attorney about your case.
What if I Disagree with the QME’s Disability Rating?
If you do not agree with the QME evaluation of your disability, you can request a supplemental report or attempt to make a compromise with the claims administrator or defense attorney. Negotiations, however, are typically best left to attorneys as injured victims may not be fully aware of the benefits they’re entitled to or the value of their disability claim. An attorney will be able to handle negotiations on your behalf or file an appeal with the Workers’ Compensation Appeals Board. The appeals process involves presenting additional evidence, such as medical reports and testimony to support a more accurate assessment of your permanent disability.
How Can an Attorney Help Me With My QME Disability Rating?
If you have an attorney for a permanent disability dispute, the QME will be required to send a copy of the report to both your attorney and the defense attorney. The QME will have 30 calendar days from the day the exam took place to issue the report. However, extensions may be granted to physicians for the following reasons:
- The physician requested medical tests and is awaiting results
- The physician requested consultation and is awaiting a report
- The physician has a medical emergency and must delay the final report
An attorney can advocate on your behalf when disputing a QME disability rating. Injured victims often run the risk of getting less than they’re owed after a serious injury, or having their claim dismissed. Insurance companies are known for taking advantage of injured victims, but an attorney will let the insurance company know you are aware of your rights and are prepared to exercise them to receive fair compensation.
How Do I Get Permanent Disability Benefits in California?
Permanent disability benefits cannot be considered until after temporary benefits have been exhausted by the injured victim. Once temporary benefits have been exhausted, the injured victim’s injuries will be evaluated by an approved physician to determine if they’ve reached Maximum Medical Improvement.
Once you’ve reached MMI, your ability will determine if you can return to work on a restrictive basis or if you’re ready to completely return to your regular duties. Also, your employer will consider your physical restrictions before deciding to offer you “modified work.” Modified work means you will only be required to do a portion of your usual duties. If modified work is unavailable for your specific job, then your employer may choose to offer you “alternative work.” This equates to a different type of work with the same rate of pay and employment location.
If you have reached MMI and you still have physical limitations due to your work-related injury, then you must prove the following to recover permanent disability benefits:
- Your injuries came from your job doing a work-related activity
- The nature and severity of your injuries or illness has resulted in permanent disabilities
- Your disability prevents you from returning to work
Types of Permanent Disability Benefits
California’s workers’ compensation system offers two types of permanent disability benefits. These benefits include:
- Permanent partial disability: people deemed partially disabled with a rating of below 100% are entitled to weekly payments at an established amount. The higher your disability rating, the more money you will be able to collect.
- Permanent total disability: if you become 100% disabled from a work-related accident, then you’re entitled to weekly payment for the rest of your life. You may also be able to receive a lifetime pension if your disability rating is between 70% and 90%.
Contact a Disability Lawyer in California
It can be difficult to secure permanent disability benefits, which is why it is essential to have an experienced attorney on your side. Maison Law is committed to giving accident victims effective legal counsel to collect the benefits they are owed. Whether you’ve suffered permanent injuries, have been denied medical treatment, or need more from your permanent disability benefits, our firm is prepared to exercise the full extent of the law to recover the damages you are owed.
Contact Maison Law today for a free consultation and case evaluation. There is no upfront charge for our legal services and you will not be charged a cent until we’ve won your case.
