QME and medical records question
 

So I have my first (and only??) QME visit coming up and I noticed that my medical records that my WC people sent me and to the QME are incomplete. Here is the conversation I had with my adjustor about this:
wc : Well that's what we received. Anything more than what we have is up to you to get if you want the QME to see those records.
me : Ok. How about the 13 visits of PT I had? Those aren't included at all in the records...
wc : Yeah, those aren't usually looked at by the QME. Its only doctors records they focus on.
me: Really?
wc : Yes.
me : Ok- I'll get my missing records. Should I get them all to the doctor before my exam?
wc : No that's not necessary. As long as they have them it will be fine.
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ok guys, is this a load of crap or not? I am annoyed that he put this on ME. But the real questions are:
1. Aren't the Physical Therapy records important in a WC case??
2. Isn't it most beneficial for the examining doctor to get them ahead of time? Its 6 regular visits, a EMG test and 13 PT visits that are missing from the history of this WC claim. That's a lot!!

I will be running all over town to get the missing reports and faxing them into the QME office all the same. I just wanted to see if I am being hostile here or if what my adjustor said was wrong.
Many thanks!!

welll...
do you have an w/c atty?
not that he/she would be much help unless he/she are very very good - sorry, I think mine didn't do the best job for me- just wanted his % of the $$.:(

I found out later that my QME/IME didn't have all drs notes or reports - !
I assumed {big mistake there:( } that all pertinent info was sent.
I assumed that atty & dr took care of all that stuff - NOT!
So at the time I didn't really expand or explain anything about new or old sx since I had been to same IME a few yrs earlier for RSI.
Which i didn't know I could get a copy of the first one back then - I only learned all this stuff after the fact :( .

If I had seen the first report I would have been much clearer as to my pain and symptoms- and probably told the dumb doofus a thing or two about his first report:eek: set him straight anyway. LOL

But of course since they {IME/QME} do get paid by the W/C ins. co. they will most likely discount your injury/pain- so do not be surprised when you request & get the report to read for yourself.

Your treating dr should be getting the reports from PT to keep abreast of your care - but I don't know if my dr got them or not.

I ended up getting all my own stuff for my own personal use - it was too late to help my claim- but it didn't take too long- sometimes it will cost for the copying.
best to call and ask first they may do the copies during off time so they may take a few days to do it.

for the PT maybe just the summary page - ie: before /after testing results and any special notations.
drs don't really put much weight on PT notes unless there is a unusual finding of some sort- but then your txing dr should follow up on that.

The adjuster isn't going to do you any favors though - they are not your friend..

look thru our useful stickys for more info too.

It's likely true PT records aren't looked at but a positive EMG is important and should get there before the exam. It's likely the doctor only looks a clerk's summary of the reports which would include diagnosis, objective test results, and any expensive treatment recommendations. A few QME's read reports but they are rare.

I wish I had known then what I know now about fighting wc. I found out at the end of my case that my dr had taken both my attorney's out to dinner to talk about my case.

get those records. I hope the qme dr is not affilitated with your wc dr.

sometimes WCB leaves some records out. It has happened to us. we are in canada but i requested a copy of my husbands file. got them then asked for another set and both sets were different. missing different files now every 6-8 months i order a new set. I also used this to my advantage during the appeal process because i asked them what else they were hiding and what was missing from my file.

I love this site!!! Thanks for your input on the QME. My attorney just sent the list of doctors to defense. Get this....I have TOS(thoracic outlet syndrome) and the QME doctors are orthopedic doctors. I don't get it, souldn't the QME doc be a Thoracic specialist? And, I see the best doctors in L.A. some are known throughout the country and still I have to see some Ortho doc that knows nothing about me and probably not about TOS, this too is a big deciding factor in my case, apparently what this doc says goes.. WC denied me right off the bat and it's been awful ever since. I would like to know what my rights with the attorney are. Can I request different QME docs? And would I be out of line if i was to request copies of the medical records that this QME doc has prior to the visit? I really feel the need to cover my behind as I didn't have the greatest experience with the WC doc. Yikes!!! This is really testing my patience. Thanks.

Hi Mimi4,
There's also some TOS specific W/C info on out TOS forum - many are going thru it and just can't post on both forums.
http://neurotalk.psychcentral.com/forumdisplay.php?f=24

I've learned it's always best to get copies of everything - reports, tests, billing, letters from your side and their side.

I was sent to an ortho too:( for my IME/QME - I didn't have any orthopedic injury- all soft tissue= RSI/TOS.

skim thru the stickys and the threads here then come on over to the TOS forum for more info.