Tag Primary Treating Physician

Tag Primary Treating Physician

Defendants Denial Of Medical Treatment

Tags: , , , , , , , Benefits, Medical Treatment No comments

Defendants Denial Of Medical Treatment Based On Opinion Of QME(Qualified Medical Examiner)

A defendant can deny medical treatment to an injured worker based on the opinion of a QME(Qualified Medical Examiner), even if the primary treating doctor recommends such medical treatment.

QME Opinion on Permanent Disability

Tags: , , , , , , , Benefits, Medical Treatment No comments

Regarding A QME opinion on Permanent Disability

The opinion of a QME (Qualified Medical Examiner) is not controlling on the issue of permanent disability. A WCJ (Workers Compensation Judge) can follow the opinion of a PTD (Primary Treating Doctor) or an AME (Agreed Medical Examiner) in deciding the level of permanent disability or the issue of apportionment based on which opinion constitutes substantial medical evidence.

For a medical opinion on apportionment to constitute substantial evidence, a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on adequate examination and history, and it must set forth reasoning in support of its conclusions.