How to choose the best QME possible for your claim
At some point in your claim, the insurance company is going to request/ require you to get a Qualified Medical Evaluation to move your claim forward. (See Denied claims) In unrepresented claims, the adjuster will send out a Request for panel form. Once you fill out the request for a QME panel form, titled State of California DIVISION OF WORKERS' COMPENSATION - MEDICAL UNIT REQUEST FOR QME PANEL UNDER LABOR CODE § 4062.1UNREPRESENTED, you will receive a list from the Director of the Medical Unit with 3 doctors listed on it. The doctor you or your attorney select will become the med-legal evaluator for your claim.
The key to getting a "good" QME is in filling out the panel request. When filling out the panel request make sure you select the correct specialty. While it may seem obvious to just select the specialty you were injured for, this may not always be the best case. For example, orthopedic specialties are often the most conservative specialty, meaning they favor the insurance company. It may be better to request a chiropractic or pain medicine specialty instead. This will depend on if you are looking for a more natural medicine approach or looking to use a more modern medicine approach. If you have questions about which specialty to choose, please contact a local Workers' Compensation Attorney.
FILLING OUT THE PANEL REQUEST
ONCE YOU RECEIVE THE PANEL
The panel will include 3 doctors. You have 10 days to choose the doctor you wish from the panel. If you do not choose within 3 days, the insurance company will. Insurance companies will choose the one most favorable to them. If you have questions about which doctor to use, feel free to contact our local office, or another local Work Comp lawyer and ask whom they would recommend. Our offices are always happy to help you choose the doctor most favorable.
Should you have questions or concerns about choosing the right doctor, what you should do before or after the QME, or are upset with the reporting of the QME, please contact our nearest office to set up your free consultation.
If you become represented before you have seen a QME, you will have an option to see an Agreed Medical Evaluator. These doctors are agreed upon between your attorney and the insurance carrier. These doctors are generally middle of the road and provide some of the most reliable reports. Should you wish to have an AME, contact our offices for your FREE consultation so we can guide you down the proper path.