What is a Workers Comp QME and AME?

QME and AME in California Workers Compensation Cases

California Workers Comp QME (Qualified Medical Evaluator)

QME stands for “Qualified Medical Evaluator” and refers to a physician who evaluates you when there are questions about what Workers Compensation benefits an injured employee should receive.

To qualify as a Qualified Medical Evaluator (QME) a physician must meet certain educational and licensing requirements set forth by the California Workers Compensation Division. QMEs must also pass an exam, as well as participate in ongoing education regarding the workers’ compensation evaluation process.

The QME will be picked from the Division of Workers Compensation list of state-certified QME. The QME lists are generated randomly.

California Workers Comp AME (Agreed Medical Evaluator)

AME stands for Agreed Medical Evaluator (AME), and refers to a doctor whom the worker, their attorney, and the claims administrator have agreed upon to resolve a medical treatment dispute.  Under California Workers Compensation law, one can only use an AME if they are represented by an attorney.

AMEs can be used no matter what year the employee sustained his/her injury. However, once the worker sees an AME he or she is no longer entitled to see a QME. While an AME may be a QME, he or she is not required to be one.

California Workers Compensation QME Panel

A QME Panel is simply a randomly generated list of three QME physicians, issued when there is a dispute regarding whether or not the worker’s injury is work related – and/or when there is a medical dispute that has not been specifically resolved by the treating physician’s report.

The QME panel of three doctors is randomly selected through a computer program. Physicians who wish to be on these QME panels must meet all the requirements to be a QME, as stated above.

When there is a dispute requiring the use of a QME Panel, whoever fills out the form to request the QME Panel gets to choose the specialty of the doctors on the panel.

The injured worker receives the panel request form from the claims administrator – and the employee is always given the first chance to fill out and submit the form.  However, if the injured worker or his/her attorney does not submit the form within 10 days, the claims administrator will get to choose the specialty of the QME that the worker will see.

The QME then has 30 calendar days from the date of the commencement of the exam to issue their report. Under limited circumstances there are reasons a QME physician may request an extension.

Our Workers Comp Attorneys Can Help With Your QME

Our experienced Long Beach Workers Compensation attorneys are here to help you with all aspects of your California Workers Comp Case – including your QME or AME Review. Our experienced lawyers would be happy to discuss your unique situation with you, to ensure that you receive the maximum workers compensation benefits for which you may qualify. Call us today for a FREE CONSULTATION: 562-622-4800

Our workers compensation attorneys service Los Angeles, Orange County & Southern California, including: Anaheim, Carson, Bellflower, Compton, Downey, Fullerton, Garden Grove, Huntington Beach, La Habra, La Mirada, Lakewood, Long Beach, San Pedro, Santa Ana, Torrance, Wilmington, Whittier, and Yorba Linda.

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