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Fallguy

Depose qme

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1 hour ago, RetiredinVA said:

Why open a new thread?   I, for one, am not going to search tne whole site to figure out who the "qme" is and what his report has to do with anything.

 

 

Let me try it again,

 

 

I have a workers comp claim in California and i want to know what happens to the qualified medical evaluators report if he was desposed. The carrier wants to settle before I schedule an appointment with a new qualified medical doctor. Does the old report have any impact on the new doctor report?

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1 hour ago, PayrollHRGuy said:

Fallguy, you really need to get your story straight.  Why would they be making a settlement offer on a denied claim? 

 

 

I dont know the exact answer but my opinion is that it was denied without medical or legal evidence. I think another is to cut cost on a second qualified medical evaluation. 

   I asked about his report so that I can estimate if any ttd is owed. If his report has mmi date but it also has work restrictions and further test and treatments. 

   They may also want to settle because I don’t have an attorney and I don’t know all the available benefits.

 

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I don't know why you would get a 2nd QME, and "deposed" clearly isn't the term you are looking for (I don't know what you are trying to say). Be that as it may, yes, carriers do sometimes settle "denied" claims for nuisance value if they lack merit but the claimant insists on moving forward with litigating the claim. It costs time and money to defend even a meritless case and dealing with a pro se litigant who doesn't know what they are doing and wants to forge ahead anyway is even worse. It is sometimes worth a small settlement to not have to deal with it.

 

I don't know the merits of your case. All of your posts have been extremely difficult to follow and you are all over the map with your questions while not giving us any relevant details to work with. The above comments are simply to comment on the general process that can occur even in a denied case and the most typical circumstances under which they occur.

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4 hours ago, ElleMD said:

I don't know why you would get a 2nd QME, and "deposed" clearly isn't the term you are looking for (I don't know what you are trying to say). Be that as it may, yes, carriers do sometimes settle "denied" claims for nuisance value if they lack merit but the claimant insists on moving forward with litigating the claim. It costs time and money to defend even a meritless case and dealing with a pro se litigant who doesn't know what they are doing and wants to forge ahead anyway is even worse. It is sometimes worth a small settlement to not have to deal with it.

 

I don't know the merits of your case. All of your posts have been extremely difficult to follow and you are all over the map with your questions while not giving us any relevant details to work with. The above comments are simply to comment on the general process that can occur even in a denied case and the most typical circumstances under which they occur.

 

I would like to share more details of my claim but I’m not comfortable on open forum. 

 

Im sorry if my writing is hard to understand. English is my second language so it’s a little difficult to translate into sentences.

 

im not sure if  desposed is a good choice of word but he was replaced. He is no longer available to finish his report. 

 

I have many questions to ask but I don’t want to confuse anyone any further.

 

 

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14 minutes ago, PayrollHRGuy said:

OK.  Have you actually be offered a settlement from the WC carrier?

 

Yes but I decline it because too low. I wanted to understand mmi date so I will know the value.

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You have stated multiple times that your claim was denied.  You have stated as recently as 12 minutes ago that you have not had and don't currently have a lawyer.  I can't imagine any situation where a work comp carrier would offer a settlement. You either have been not telling the truth to us this entire time or are simply too clueless to handle any of this on your own.  

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Deposed isn't the right word. I'm not sure what is the right word as it is unclear what you mean that he was replaced and unable to finish his report. Replaced why whom? Why? When? Unless something called him away in the middle of the exam and he was physically unable to complete the report there would be a record of what was done in the appointment.

 

You don't have to share facts in an open forum but we also can't comment on what we don't know.

 

MMI means you are as good as you are going to get and further treatment is unlikely to improve your condition. This is something you would need to ask your treating doctor. If you are still being actively treated with an expectation of improvement, as opposed to treating to just maintain the status quo, you are not yet at MMI. In a "normal" case,  settlement would not happen until after MMI. If they are settling it to make it go away, it doesn't matter when they do it and it very well may be toward the beginning of the case. They are basically paying you to drop it.

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It is currently denied. I’m not represented. I’m not sure why they want to settle. It’s probably because it’s below the value. I don’t  see any benefits for making this up. 

   I could just ask my attorney if I had one.  I’m as confused as everyone else. This is definitely the strangest experience for me. Would you like a little more detail? 

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I have handled thousands of settlements. It isn't super frequent but yes, I have settled claims which have been denied. As I stayed before, the typical reason for doing so is to offer the claimant something to save the cost of litigating a pointless and meritless claim. Say it costs $5K to take it to a hearing and defend the denial. Even if I win, I'm still out $5K. If the claim isn't worth $5K, say there are only $500 in medicals and $1K in lost time, I may be willing to just offer the claimant some amount of money less than it would cost to go to a hearing to settle it and go away. Whether in a given case that is a good strategy or begging for a bunch of their friends to file meritless claims in the hopes of making a few bucks is a discussion for another day, but such settlements do happen, every single day.

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7 minutes ago, PayrollHRGuy said:

ElleMD,

 

There is no reason, in this case, to think the carrier would settle at all.  He doesn't have a lawyer, he certainly isn't capable of pleading his case well on his own to the carrier and he is likely noncompliant with medical care.

That would be a defense strategy decision. Unsophisticated pro se claimants can also be a thorn and *sometimes* it is better to cut the loss. Again, I haven't seen the facts of this case, but it does happen. I've done it. Successfully. As such, it is within the realm of possibilities that is what is happening here. Telling the poster there is no way that is what is happening because it isn't a defense strategy you would use just confuses them and does the readers a disservice.

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1 hour ago, ElleMD said:

That would be a defense strategy decision. Unsophisticated pro se claimants can also be a thorn and *sometimes* it is better to cut the loss. Again, I haven't seen the facts of this case, but it does happen. I've done it. Successfully. As such, it is within the realm of possibilities that is what is happening here. Telling the poster there is no way that is what is happening because it isn't a defense strategy you would use just confuses them and does the readers a disservice.

 

Would either one of you mind if I pm more detail. I think ellemd is closer to what the carrier is thinking 

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