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DWC Offers Guidance on Remote Exams; Firm Drops Legal Threat but Says Changes Needed

  • State: California
  • Topic: Top
  • - Average time spent on item: 58 minutes
  • - Popular with: Legal
The California Division of Workers' Compensation over the weekend said it may be beneficial for …

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6 Comments (7 Replies)

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Manuel Rios Mar 31, 2020 a 6:03 am PDT

How they’re going to do when the iw needs an interpreter?

Steven Feinberg Mar 31, 2020 a 6:03 am PDT

Interpreters can be included via telehealth.

Cheryl Chicaul-Sanchez Mar 31, 2020 a 8:05 am PDT

Psychiatrists can definitely perform these exams and are the most at-risk because of the length of the evaluation

Steven Feinberg Mar 31, 2020 a 6:03 am PDT

Interpreters can be included via telehealth.

Steven Feinberg Mar 31, 2020 a 7:03 am PDT

While the DWC strongly recommends certain telehealth criteria, I have been assured by DWC Legal that as long as all the concerned parties are in agreement, telehealth may be used to assist the injured worker when needed.

Now is not the time to bicker or posture - now is the time for all parties to work together as a community to assist injured workers in obtaining benefits and to limit the CA workers' compensation system from slowing down excessively. Collegial dialogue is needed. Telehealth is only one possible resource.

Steve Cattolica Mar 31, 2020 a 9:03 am PDT

Dr. Feinberg, Well said. These issues are already confrontational by definition. Notwithstanding anything else, the opening comment by Mr. Rios begs the question of adding an additional layer of technology - one that requires certified interpreters. Does it fall on the evaluating physician to arrange all this? Even with competent administrative services available to the evaluator, aligning all the variables in a manner that will (eventually) hold up in court is a huge challenge only a cooperative effort can hope to overcome.

Franco Muñoz Mar 31, 2020 a 10:03 am PDT

I couldn't agree with you more, Dr. Feinberg. - Steve Franco

Joan Palmeiri Apr 4, 2020 a 7:04 am PDT

Dr. Feinberg your comment is in line with how all of us have to start thinking not just in the WC community but in our lives as a whole. So far I've found the parties open and agreeable to keeping the system moving and are agreeing to telehealth communications for QMEs. Of course more clarification and specific language by the DWC is needed but until that happens we'll have to work together to keep things moving the best we can.

Ron Perelman Mar 31, 2020 a 10:03 pm PDT

To do a medical legal eval thaat will be substantial evidence, in orthopedics, a physical exam is needed. A history and record review can be sufficient to determine causation and apportionment, but not to determine work restrictions or AMA 5th impairment. Take a simple case, a low back injury. Is there guarding or spasm? What is the ROM? Is the patient exerting maximal effort? Is there a positive SLR or loss of a reflex or a dermatomal sensory loss? The findings can decide if the patient is a DRE I, II, or III. The PE is essential. BTW, the interpreter needs to be part of all this. Telemedicine could work in certain followups, but that is probaby all. It might work in psychological cases- maybe. I suggest we leave this issue alone. The job of the AME/QME is to help resolve the case. A no PE exam won't do it, just delay it

Morfin Barraza Apr 4, 2020 a 11:04 am PDT

I have a soution, in your initial report you only determine causation and request Diagnostic sudies or set up a re-evaluation in 1 or 2 months after if you believe applicant is MMI and then do your complete MMI report!!

Gary Kaplan Apr 3, 2020 a 11:04 am PDT

It should be noted that the entity pushing for remote exams runs one of the largest PQME mills in the state. Their self-serving interests are confirmed by their objection to the guidelines for implementation. Shameful!

Morfin Barraza Apr 4, 2020 a 11:04 am PDT

100% in agreement with you Gary!!!

Anthony Macauley Apr 4, 2020 a 5:04 pm PDT

I agree with Gary Kaplan and Dr. Perelman. Gary's objection is broader but still supportable. However, some preliminary reporting could be very helpful in our cases. A history over the phone, even with reevaluations, would be useful with comments from the doctor regarding that history and suggestions as to additional information we might obtain from both the injured worker and outside sources. Xrays, MRIs, records, legal documents, depo transcripts are often noted by doctors as useful but missing. We could still write our joint letters or our advocacy letters. There is plenty of work the QMEs could be doing and getting paid for. Their cash flow would improve. Our knowledge of our cases would increase. Our work on them would be higher quality. We all have plenty to do. We don't We should not just delay as Dr. Perelman suggests. We should work hard and intelligently during the delay. I wish to digress regarding treatment. I think Gary may not agree with me on this one. We should delay all but the most necessary treatment. We know so many of the exams are cursory. The reports horribly abbreviated. Yet we risk the death of both injured workers and all the people who have intimate unprotected contact on the way to, at, and the way from these exams. Over the phone will work for over 90% of the treatment evaluations. The DWC should address that also. The impact on the spread of COVID 19 could be far greater. Tony Macauley

David Gray Apr 4, 2020 a 9:04 am PDT

I wonder how this practice would affect the outcome of the cross-exam depositions of these doctors.

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