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California Request for Qualified Medical Evaluator for Workers' Compensation

State:
California
Control #:
CA-106-WC
Format:
PDF
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Description Qme Report Sample

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FAQ

A panel QME is a randomly generated list of three QME physicians issued to you when there is a question about whether or not your injury is work related, or if there is a medical dispute that hasn't been resolved by the treating physician's report.

A QME (or AME which is a QME that your attorney and the insurance company have agreed upon) is a doctor that has certification from the Division of Workers' Compensation Medical Unit (DWC). They will examine you and all your medical records to determine the extent of your work-related injury.

If the DWC Medical Unit does not send you and the claims administrator a QME panel within fifteen (15) business days of receiving the request, you may select any QME to do the evaluation. If this happens, call your Information and Assistance Officer at 1-800-736-7401 or the Medical Unit at 1-800-794-6900.

How much does the current QME system cost? According to a recent WCIRB report in calendar year 2018 the costs were $280 million and 2019 were $290 million.

A. The QME should issue the supplemental report within 60 days.

Don't exaggerate your symptoms. Don't be rude or negative. Don't lie.

What Happens Once the QME Report is Completed? The QME should send copies of the report to you, your attorney, the claims administrator, and the Division of Workers' Compensation Disability Evaluation Unit (DEU). The DEU should issue a rating of your injury within 20 days.

To prepare, you may want to go over your notes and review the timeline of what happened between your accident and the date of the evaluation. You should be prepared to tell the doctor how your activities of daily living (abilities to dress yourself, cook, clean, go about your day) have been affected by the injury.

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California Request for Qualified Medical Evaluator for Workers' Compensation