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Friday, March 27, 2020

Firm Will Ask Judge to Act if DWC Doesn't Give Guidance on Remote QME Exams

  • By Mark Powell
  • State: California
  • Topic: Top
  • - Popular with: Legal
  • -  3 shares
A Southern California law firm representing qualified medical evaluators and injured workers will as…

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Randal McClendon Mar 27, 2020 a 8:03 am PDT

Anyone not agreeing to telemedicine on an AME needs to think about why they agreed to an AME in the first place... especially with a re-exam. These cases need to move....

Robert McLaughlin Mar 27, 2020 a 9:03 pm PDT

There are multiple ways. One suggestions is the WCAB's are virtually shut down, including the I&A rooms. Designate 1 room as a 'clean room' which is cleaned after ever patient/injured worker exam. Set up video in the room. Have a DIR employee appropriately attired to prevent infection perform the measurements. Give them an inclinometer to the DIR employee and have them measure per the physician's instructions who is watching on video. The numbers are written down and relayed to the physician. Or other creative ideas. It can be done, just think outside the box.
Instead the AD is like Nero, he is sitting playing his fiddle while he watches Rome burn.

Dr Mar 27, 2020 a 4:03 pm PDT

Telemedicine decisions should be subject to Duty of Care obligations -- at present diagnostic and treatment protocols by treating doctors and their consultants are subject to Duty of Care whereas Utilization Review decisions are exempt. This inequity allows for unfair treatment denials to injured workers. How to repair this fault was discussed in the King case decision (see reference).

1) Duty of Care v Utilization Review, workcompcentral column, 10/30/18, by undersigned

Robert L. Weinmann, MD, QME, San Jose (editor, www.politicsofhealthcare.com)

Keith Pusavat Mar 27, 2020 a 4:03 pm PDT

Aside from psychiatric, I can't see how such exams would constitute substantial medical evidence. Our system relies upon objective diagnostic testing and examination, the vast majority of which cannot be done remotely.

We all have to make some adjustments here. It may well be that comprehensive QME exams need to get postponed like everything else in the world.

But a system-side decision should be made, rather than trying to litigate each individual examination.

Scott Ashby Mar 27, 2020 a 5:03 pm PDT

Agreed. How is an AME/QME going to evaluate impairment based on ROM in a post-shoulder surgery case, or ACL laxity (Lachman) in a post-ACL surgery case? And even if the med-legal exam is done remotely, what about the x-rays, MRIs, EMGs, etc. that need to be done in person? I don't profess to have the answer to this issue, but a blanket rule that all med-legal exams can be done remotely isn't it.

Rene Mu Mar 27, 2020 a 4:03 pm PDT

There should be some guidance by the DWC in terms of what can and can't be done via telemedicine -- i.e., an exception to internal/psyche/infectious disease med-legals vs. orthopedic med-legals. At minimum, provide clear guidance to avoid unnecessary copious amounts of litigation on our system.

Steve Franco, Esq. Oakland (partner, www.francomunoz.com)

Dr Mar 27, 2020 a 5:03 pm PDT

Remote QME examinations deserve fair play and protection under Duty of Care regulations -- that is not now the case. Only treating doctors are currently obligated under Duty of Care. Utilization Review is exempt, see "Utilization Review Physicians do Not Owe Injured Workers Duty of Care," workcompcentral column or Industry Insights, workcompcentral.com, 09/18/18.

- Robert L. Weinmann, MD, QME, San Jose (editor, www.politicsofhealthcare.com)

Ron Perelman Mar 28, 2020 a 4:03 am PDT

Maybe a psyche eval can be done remotely but not an ortho eval. The PE becomes important in many ways. Imaging could be abnormal but the PE is normal. That might affect the ultimate conclusion. I can decide causation and apportionment sith thhistory and record review but that’s it

Gennady Musher Mar 28, 2020 a 5:03 am PDT

Does anyone have any idea what percentage of workers and interpreters would have access to the technology that would allow remote exams? How would a psychiatric exam be done with a patient who has access to a cell phone with intermittent failure of reception?

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