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Leep, Tescher, Helfman And Zanze

Who covers the expense of traveling for a QME or panel QME?

On Behalf of | Jan 26, 2022 | QMEs |

California is a very big state with millions of residents and thousands of medical practitioners. Thankfully, the size of the state and its population means a well-structured and funded workers’ compensation program.

Unfortunately, the large size of the state can create challenges for those handling a complex workers’ compensation claim.

Claimants may need to travel

When someone working in California gets hurt on the job or diagnosed with a work-related illness, they will usually file a claim for workers’ compensation benefits.

In scenarios where there is a disagreement about the treatment a worker requires, they may need to see a qualified medical examiner (QME). If their employer tries to claim that they didn’t get hurt at work, a worker may need to undergo a panel QME to validate their need for benefits.

The assignment of the QME is random, potentially requiring someone to travel a substantial distance for treatment or evaluation. Who pays for those expenses?

Workers compensation fully covers medical care

The California Workers Compensation Program will pay for all approved and necessary medical care and will reimburse people for other expenses. This includes reimbursement for necessary travel. If you track how far you travel, you can request reimbursement for your mileage. As of January 1, 2022, the Division of Workers’ Compensation will reimburse claimants $0.585 for every mile they drive related to medical care. This would include travel for a QME appointment.

Keeping detailed records with exact mileage, the times of travel and the dates will be necessary if you intend to make a mileage claim as part of your workers’ compensation claim. Understanding what workers’ compensation benefits are available and what the state will cover can help you limit your personal financial losses caused by your work-related medical condition.