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Hey, Lexxi Built by a certified CA work comp specialist

Analyzing a
med-legal report

What a complete analysis has to capture. For paralegals and newer attorneys.

Start hereThe one that gets missed

The period of temporary disability. Everyone remembers permanent disability. TD gets forgotten, and it is money.

TTD temporary total TPD temporary partial or a combination (common)

In a P&S report it should be clear on the face of the document. When it isn't, the report often refers back to prior reports, so go pull them. Never record the TD period as unknown because this one report didn't spell it out.

Every report whatever its status

  1. Report typeAME or QME · physician's specialty · initial evaluation, re-evaluation or supplemental · date of report
  2. Diagnoses
  3. Industrial causation determination
  4. Work restrictions
  5. Anything still neededDiagnostics, testing, consultations, other treatment
  6. Specialties being deferred toFlag every one. They drive the settlement analysis below, and they hide in a single sentence

If P&S / MMI additional

  1. WPI per body partPer body part, not one global figure
  2. Basis for eachAMA Guides 5th Edition, or Almaraz/Guzman
  3. Industrial apportionment per body part
  4. Kite/Vigil analysisShould PD for certain body parts be added rather than combined, and did the physician explain it
  5. Full rating stringsEach ratable body part, then the final PD per date of injury
  6. The TD periodSee above. The one that gets forgotten.

The attorney's calls the analysis enables these; it doesn't make them

  1. Supplemental letter, deposition, or neitherA depo can be necessary on complicated issues, but it opens the door to the other side. Both routes cause delay, so sometimes the better move is to settle despite imperfect reporting.
  2. Settlement recommendation to the clientPD value + FMC value (usually a conservative estimate, so say so) + any missing TD. When TD is unknown, request authority on PD + FMC and add a line requesting a current benefits printout.
  3. P&S on all issues, for all specialties?The worker needs to be P&S for every specialty. If that isn't happening, settlement is still available. Consider buying out the pending specialty where the issue is valid, or where there's a risk of it being found industrial.
  4. EDDCheck whether they're claiming a lien or money owed on any claim against the defense client. Easy to forget until it's inconvenient.

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Prepared by Hey, Lexxi for California work comp defense firms. General information for training purposes. Not legal advice, and no substitute for the judgment of the handling attorney. heylexxi.com