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Leep, Tescher, Helfman And Zanze

How does California assign a QME to injured workers?

On Behalf of | Jul 30, 2021 | QMEs |

If you suffer an injury at work or develop a job-related medical condition, you will likely apply for workers’ compensation benefits. Under California’s system, you need to have an evaluation performed by a qualified medical evaluator (QME) before you receive benefits.

A QME helps determine if the condition is serious and if it requires medical care or a leave of absence from work. In cases where there is a question about whether a worker suffered the injury on the job or outside of work, the state might appoint not just one QME but a panel of three.

The state goes to great lengths to avoid bias

Letting the employer or the worker choose the medical professional could lead to bias. If an employee picks the doctor who reviews their condition, the doctor will want to please them and will likely try to support their claim that the injury is work-related. The inverse could be true if the employer is the one who selects the QME.

To prevent such issues from compromising the integrity of California’s workers’ compensation system, the state maintains a list of doctors who are certified QMEs. It then provides individual workers’ compensation applicants with a list of some of those doctors.

The system relies on random generation to create the list for a worker. Unfortunately, this may mean that the doctors selected in your case are not located close to you. The state will not reassign new doctors but will instead expect you to travel to them.

If you have concerns about the QME process, legal guidance can be valuable. Understanding the various steps involved in a workers’ compensation claim can help you get the benefits you need.