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Law Offices of Bo Katzakian

Workers' compensation disputes and a medical evaluation

California workers who have been injured on the job will often need workers' compensation benefits to provide them with various benefits as they recuperate. However, not all cases are clear and there are frequently disputes between the employer, the insurance company and the worker. For many, the determination as to whether there should be an approval for workers' compensation benefits will need to be made via a comprehensive medical evaluation. Understanding what the law says about this is key when preparing for the case. This law applies when the employee has legal representation.

Either side can ask for the medical evaluation, completed by a three-member panel of qualified medical evaluators. They will evaluate the person's injuries to determine how to settle the dispute. It is up to the party that requests the evaluation to designate the medical evaluator's specialty, the specialty of the medical evaluator the other party has requested if it is known to the submitting party, and the treating physician's specialty.

Once the panel has been assigned, there will be 10 days for either side to strike a name from it. The other evaluator will handle the case. If the right to do this is not taken within those 10 days, the other party can choose a physician who is on the panel and that person will be the medical evaluator. The employee must arrange for the examination to take place. If the employer has not been informed that the appointment has been made, it can arrange it and tell the employee the details. Under the law, the employee must take part in the examination. At any time during the process, the sides can agree to have a medical evaluation except when there are issues that are subject to an independent medical review. Any issue can be part of the evaluation unless there is written consent by both to cancel it.

It is difficult enough when a work accident victim is confronted with the realities of medical issues and concerns about how they are going to make ends meet if they cannot do the job they were doing before. Workers' compensation is meant to account for that. Sometimes, disagreements between the parties can necessitate a medical evaluation to clear up the issues. For workers who need a medical evaluation, it is imperative to have legal assistance from a workers' compensation law firm.

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  • San Jose: 408-624-8420
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