This page was last modified on Sunday, August 08, 2010 03:40 PM
Dr. Ira B. Fishman has focused on the medical legal evaluation of all aspects of internal medicine and releated disease states over the past 10 years for the California Workers' Compensation System. He is board certified in internal medicine having practiced internal medicine emphasizing endocrinology for 19 years in the Monterey Bay area until 2002 when he retired from private clinical practice. Currently, Dr. Fishman exclusively performs medical legal evaluations usually for California Workers' Compensation cases.
Dr. Fishman, as a licensed California Qualified Medical Evaluator (QME), specializes in the analysis of complex issues regarding industrial causation of internal medicine disease states and related industrial problems. Such issues include but are not limited to: hernias, infectious diseases (such as AIDS, hepatitis B & C, MRSA infections), cancer causation (emphasis on public safety officers and the "cancer presumption"), inhalation injuries (including occupational asthma), cardiovascular disease (including heart trouble in public safety officers), functional somatic syndromes (e.g. irritable bowel syndrome), the impact of industrial emotional stress on the internal organs, and industrial causation of death due to internal medicine disease states.
Other areas of interest include the detailed analysis of complex derivative industrial injuries. Typical derivative examples are: orthopedic injury affecting diabetes, drug side effects such as NSAID induced gastrointestinal disease, sleep disorders, obesity, narcotic induced hypogonadism, spinal injuries affecting rectal and urinary function, unusual infectious diseases and a variety of post-operative internal medicine complications.
All medical legal reports contain a complete analysis of disability factors including post-SB 899 issues of permanent impairment using the AMA guides, 5th edition and apportionment per the new California Labor Code Sections 4663 and 4664. If indicated, multiple scenarios are offered to analyze differing legal views concerning apportionment. If required, assessment of permanent disability/impairment is also discussed using the old California schedule.
Dr. Fishman is now familiar with the revised Almaraz-Guzman II decision indicating that the criteria for deciding permanent impairment ratings based on AMA Guides, 5th edition can use all "four corners" of the Guides to issue the most "accurate" permanent impairment rating.
As a result of these efforts, the parties and the trier of fact are provided by Dr. Fishman with substantial medical evidence to assist in deciding all medical-legal aspects of an industrial internal medicine case. Specific recommendations are made when necessary concerning further medical record review, need for investigative reports, industrial hygiene evaluation of the workplace, diagnostic testing and/or consultations required to assess industrial causation, permanent impairment/disability and other medical legal issues.
Required consultations are arranged by my Albany office whenever possible at university centers such as UCSF, Stanford, UCD and CMPC. Routine testing such as but not limited to: blood draws for laboratory testing, cardiovascular imaging, spirometry, EKG stress tests, other body imaging, is scheduled by my staff at a hospital convenient to the applicant's home.
When additional requested medical records, test results and/or consultative reports are received by Dr. Fishman, supplemental reports are issued promptly by the mandated 60 day deadline and outstanding medical legal issues are resolved definitively.