Orange County Workers Comp Attorneys Explain:
What is a QME or Med Legal Evaluation?
When you apply for workers comp, your employer’s workers comp insurance company can dispute what your treating physician recommends for you. Often times the workers comp insurance company will dispute your doctor’s opinions on whether you are permanently or temporarily disabled. The insurance company may also dispute or disagree with your doctor’s prescribed medical treatment(s).
And, in some case, the injured worker may also dispute or disagree with your treating doctor’s opinions, recommendations or treatments.
Either the workers’ comp insurance company – or the injured worker – can request a “Medical/Legal Evaluation” by a “Qualified Medical Examiner” (QME) if they disagree with the treating doctor. A QME is a doctor who has taken special classes and tests to obtain a QME license.
Attending a Med Legal Evaluations is Mandatory
If the insurance carrier requests a “med-legal evaluation” they get to request that you go to a doctor they select for the evaluation – and you must attend. The opinions of the QME doctor may or may not be considered for settlement of your case.
If you do not disagree with your doctor’s opinions, you should not request a “Medical/Legal Evaluation” by a “Qualified Medical Examiner”. But, if you disagree with your treating physician’s opinions, you can request the “Medical/Legal Evaluation” by a “Qualified Medical Examiner”. But this can have serious ramifications. So you should always contact an experienced workers comp attorney before requesting the QME. The reason for this is that once you have selected your QME that doctor’s opinions become binding on you for the remainder of the case.
However, experienced workers comp attorneys have their own Medical/Legal evaluators they prefer to use. Since a workers comp attorney deals with QME Doctors all the time, they can help you select one whom they know will be fair, reasonable and easy to work with.
Agreed Medical Examination vs. Qualified Medical Examination
An “Agreed Medical Examination” is where both the employee and the employer’s insurance company agree upon a doctor, whose opinion will be binding on both parties. Using an agreed medical evaluator can simplify the examination and reporting process, which can speed up the settlement of your case.
But, again, you should only select an Agreed Medical Examination with the assistance of an attorney. An experienced workers comp attorney will know which doctors are regarded as being fair, impartial and helpful in settling cases. Once you select an Agreed Medical Examination, their opinion is binding upon you, so they must be chosen wisely.
In sum, one or both sides can always proceed with an individual examination by their own QME doctor whom they have selected. Or the parties can agree to an Agreed Medical Examination. However, once either party selects the AME or the QME, the Doctor’s opinions will then take the place of the opinions of the treating physician for them.
Orange County Attorneys Can Help With
Workers Comp Med Legal Evaluations
If you are facing a Med Legal Evaluation, call our experienced Orange County Workers Comp Attorneys for a free consultation today. Our Workers’ Comp attorneys have helped hundreds of Orange County residents through the med legal evaluation process and get the workers comp benefits they deserve.
Call our Orange County Workers Comp Attorneys for a
FREE CONSULTATION: 562-622-4800.