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What is a qualified medical examiner? 

You fall from a ladder at work and break your arm. You’re not even a doctor, and you know full well that it’s broken. You assume you can work with any doctor to come to that same conclusion, but you’ve heard that you may need to seek out a qualified medical examiner (QME).

What sets this person apart from any other urgent care doctor or primary physician? 

Are there questions about your injury?

Per the California Department of Industrial Relations, the QME is someone who may give an evaluation “when there are questions about what benefits you should receive.” This is someone who partakes in ongoing education and has passed specific tests to qualify for work in this field. They can help with any medical disputes. 

For instance, maybe your employer is claiming that you actually broke your arm at home. They say that you did fall from the ladder, but you were unhurt. After going home from work, you were injured there, and you merely blamed the ladder fall to get workers’ comp. 

The doctor who initially treated you may well know you had a broken arm, but there are now other questions beyond that. When did the break happen? Is there any evidence of how it occurred? Is there long-term damage from the break that is still causing you pain or other limitations?

What can this tell you about your workers’ comp rights? If there’s a dispute, the QME can dig into things a bit deeper and find these answers. 

When a workers’ comp case gets complex, know your options

You have rights as a worker who was injured on the job. Be sure you know what options you have when your case becomes more complex than you anticipated.