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 4064 (d) Your Greatest Medical Ally
Recently, we were asked to review a rating done by a QME, and our Medical Director, Bruce Hector M.D., determined that instead of an 87% impairment rating, the claimant was only entitled to a 12% rating, saving tens of thousands of dollars. Thorough medical reasoning citing the AMA Guides, 5th edition was used to support the opinion.
In the courtroom the employer and claimant each have attorneys to point out the flaws in the other's arguments. However, under code section 4062.2 there is only one physician. So who can you use to point out the flaws in that physician's statements?
The second sentence of code section 4064 (d) states that
no party is prohibited from obtaining any medical evaluation or consultation at the party's own expense.
This wording remains unchanged by any of the recent legislation that has been enacted. Thus, this section allows you to obtain a consult to rebut the findings of any physician, including but not limited to those situations when you are not satisfied with or uncertain about the impairment ratings, whether or not the impairment/injury is work related, or if the course of treatment or disability status being prescribed by the treating physician is consistent with the ACOEM Guidelines. The physicians at PMG are available to assist in these areas, in addition to the medical legal evaluations that they perform.
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