Redding Workers’ Compensation Law Blog

In this article, you can discover… How A Qualified Medical Evaluator (QME) can impact your workers’ comp case. The timeframe for selecting a QME. Common pitfalls to avoid when choosing a QME. What Is A Qualified Medical Evaluator (QME)? A Qualified Medical Evaluator (QME) is a doctor who sees you after you’ve filed a workers’ comp claim. They provide a comprehensive medical and legal evaluation to determine various factors in your workers' compensation case. Why Is Selecting The Right QME Crucial For Your Workers' Compensation Case? Selecting the right Qualified Medical Evaluator (QME) is a critical decision that can significantly impact the outcome of your workers' compensation case. The QME plays a vital role in ensuring your injury is evaluated...

There are two pressing financial factors that tend to affect those who have recently been hurt on the job in California. The first is the cost of medical care, which can be significant if an individual’s injury or medical condition is particularly severe. The second is the possibility of lost wages because someone cannot do their job as normal due to their medical condition. The California workers’ compensation program helps to reduce that financial stress on employees by providing them with benefits. Workers can typically receive full medical coverage for necessary treatment and disability benefits until they can return to work. However, many injured workers find themselves disagreeing with their employers about whether they are ready to go back to...

Some California workers’ compensation claims are quick and straightforward. The employee has an obvious injury that directly relates to the job that they do, and their employer acknowledges that they need support. The worker will apply for and receive benefits, and they can trust that their employer will accommodate their work restrictions as they transition back to their job. Other times, the employer might try to fight the worker. They may question whether the injury is serious enough to warrant accommodations and benefits and may even claim that the worker didn’t incur their injury on the job. Workers have the right to keep pushing for benefits, but such situations can become complicated very quickly. In a situation where there is...

If you are injured at work and make a claim to obtain workers’ compensation, there is a chance that you will need to see a medical professional for a qualified medical evaluation. This evaluation can be requested when your claim is denied or delayed and you’d like a medical evaluation to determine if the claim should be payable. Additionally, you can ask for the evaluation by a qualified medical evaluator, or QME, if you disagree with your current treating physician’s thoughts on your condition or if you want to find out if you are permanently disabled and may need future medical treatment. In California, you are able to see a  list of QMEs to choose from, so you can select someone...

If you are applying for California workers’ compensation benefits, you could face opposition from the claims administrator about the severity or cause of your workplace injury. They might even question whether the illness or injury was employment-related at all. These, and more, questions could give rise to the need for a qualified medical evaluator (QME) on your case. Below is some important information to understand about the role of a QME in workers’ comp cases. Are QMEs On Your Side? At best, they will be neutral. These medical professionals, certified by the Division of Workers’ Compensation Medical Unit, perform legal and medical evaluations of claimants. They become involved when your doctor’s assessment of your condition gets called into question, and they may include:...

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...

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...

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...

Countless Californians suffer injuries while on the job each year. The state requires almost every employer to have workers’ compensation coverage in case such an event occurs. It’s in situations where there are questions about how much in benefits you may be eligible to receive that state officials may schedule you to see a qualified medical evaluator (QME). Your participation in this examination could shape the outcome in your case. You must know what steps to take should you be unable to attend this critical appointment. State officials randomly assign you to see a QME that has an office in select zip codes closest to your home. Your claim administrator may be willing to switch that assigned doctor out for one closer...

Those living and working in California may want to know more about the QME as it relates to compensation for injured workers and the Division of Workers’ Compensation Medical Unit. It is important to understand the QME when it comes to claims and navigation through the system. According to the State of California Department of Industrial Relations, a claims administrator helps workers with advice about their rights and the steps needed to get medical care. A worker may also learn of other benefits they are entitled to under workers’ compensation laws in California. A QME stands for qualified medical evaluator; this is a physician who does the evaluation and advises what benefits are available. The QME is trained in the workers’...