STEVEPSCA@YAHOO.COM
Senior Member
Posts: 990
Joined: Jun 2002
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Monday January 12, 2009 7:27 AM
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'I have waited for eight months to see a cardio doc as specified in my ame report .So I go to see one of there docs(kaiser) to get a referral to the cardio doc .
They say that is how they do things so I go and this occupational doc calls my adjuster and tells him I don't need to see a cardio doc with only running a ekg.'
You have a referral to a cardiologist from your PTP, disputed and approved as 'industrial' by the AME...(?) so far so good...?
Why then didn't you just make an appt with the cardiologist in the MPN...?
Provide the AME report, and the Dr could request authroization to treat, 'per the Dr. AME' report dated ....etc etc"
'They say that is how they do things...'
Who be 'they'...?
Did you provide the AME report to the Occupational Med. doctor...?
BTW... an 'ekg' is only going to provide information on your condition 'that day/time'... not prior activity, or what may/may not be the case in the 'future'. Basically, unless you are having a heart attack at the time, that test is a revenue generator at best.
(That is not my opinion, but that of the founding physican of 'The Heart Institute of the Desert' @ Eisenhower Medical Center/Rancho Mirage Ca.)
'...he is internal med and tried to examine me for what he said would be any future medical I may need.'
That is a function of your PTP...and you only have ONE "PTP". (you can refer this doctor to the appropriate section of the labor code if necessary...http://www.leginfo.ca.gov/cgi-bin/displaycode?section=lab&group=04001-05000&file=4060-4068...4061.5.)
Or, by a AME/PQME if necessary in a final, ratable report. If the occ. doctor is not your PTP, then he has no authority to issue a 'future medical' determination in your case.
'What can or should I do ?? '
Call your AA, have him/her handle the CA....and make an appt w/Caridologist in the MPN.
WHY is this going on EIGHT months... you have the AME report..and if this is disputed by the ER/IC, they should have filed the DOR for expediated hearing...or your AA can do this...but the CA is supposed to 'dispute' or 'authorize' treatment within the prescribed timelines.
4063. If a formal medical evaluation from an agreed medical
evaluator or a qualified medical evaluator selected from a three
member panel resolves any issue so as to require an employer to
provide compensation, the employer shall commence the payment of
compensation or file an application for adjudication of claim.
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