Padilla Law Group, LLP

Qualified medical examiners and the return to work determination

Workers' compensation benefits can be a financial lifesaver for those Californians who are injured on the job and as a result find themselves unable to work for a period of time. Although it may seem relatively simple to obtain and retain these benefits, it can actually be quite challenging. When issues regarding one's ability to qualify for benefits arise, it may be wise to acquire the assistance of an attorney who is adept at handling these types of legal cases.

One situation where an attorney may be helpful is when questions arise as to a workers' compensation recipient's ability to return to work. Whereas an injured worker may feel like he or she is unable to return to work and should therefore continue to receive benefits, medical professionals and/or the workers' compensation board may feel otherwise. There are many factors that may come into play when a determination is made with regard to one's benefits under these circumstances, including the state of one's medical condition, the type of work the worker can perform, and the type of work his or her employer can make available for the worker.

When it comes to an injured worker's medical condition, both a claim's administrator and the worker may rely on a doctor's report with regard to the condition's current status and prognosis. Each parties' interpretation of those reports can differ, though, which can give rise to a legal dispute. If this happens, a qualified medical examiner, a medical professional who is carefully vetted by the Workers' Compensation Medical Unit, may provide a second evaluation. However, even if an individual disagrees with the qualified medical examiner's report and he or she is being threatened with cessation of benefits, he or she may have legal options for challenging the report or receiving a new one.

Workers' compensation matters like this can be highly contested. Those who find themselves in this situation should carefully consider their legal options, as making competent legal arguments can mean the difference between financial stability while one focuses on recovering his or her health and being thrust back into work prematurely.

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Padilla Law Group, LLP
320 Encinitas Blvd
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Encinitas, CA 92024

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