GQ Corner
Q. The claimant’s treating doctor certified that the claimant reached MMI with a 0%. It is the first certification in the file. Now, more than 7 months later, the treating doctor has rescinded the certification because he now believes the claimant requires more treatment for the compensable injury. Does this rescission prevent the certification from becoming final?
A. No, the rescission does not prevent the certification from becoming final. Section 408.123 (e) & (f) deal with finality, and the rescission of a certification is not an exception to finality. According to subsection (f), the only exceptions to finality are as follows:
(1) compelling medical evidence exists of:
A. a significant error by the certifying doctor in applying the appropriate American Medical Association guidelines or in calculating the impairment
rating;
B. a clearly mistaken diagnosis or a previously undiagnosed medical condition; or
C. improper or inadequate treatment of the injury before the date of the certification or assignment that would render the certification or
assignment invalid; or
(2) other compelling circumstances exist as prescribed by commissioner rule.
Q. I have a potential death beneficiary who is 21 years old, was living with the deceased at the time of death, but was not enrolled in as a full-time student in an accredited school. Because she was not enrolled in school at the time of death, does this prevent her from being entitled to death benefits?
A. Not necessarily. If the potential beneficiary was a dependent of the deceased at the time of death, then she would still be entitled to death benefits. Rule 132.2 defines “dependent status.”
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