Maison Law helps people that have been injured at work in California. Seeing a qualified medical evaluator (QME) is one of the most significant–and potentially uncomfortable–parts of your workers’ compensation claim. Our team at Maison Law can make sure you’re prepared for this evaluation. Contact us today for a free consultation to learn more.
How Important is a QME Visit to Your Workers’ Compensation Claim?
Any workers’ compensation claim is going to involve a visit to a qualified medical evaluator, also known as a QME. This is a licensed doctor that is picked by your employer’s workers’ compensation insurance provider, and their job is to give you a medical exam to review your injuries, evaluate how injured you are, whether you need disability benefits, and to provide an official record of the visit for your claim.
With that, it’s pretty easy to see that this is an important part of the process. But specifically, there’s a number of reasons that this visit is going to have a significant impact on your claim:
- Neutral medical opinion – Even though they’re picked by the workers’ comp insurance company, the QME gives an unbiased evaluation of your injury to set a baseline for your claim.
- Decision – The QME’s report helps decide your workers’ comp benefits, including medical treatment, temporary disability, and permanent disability.
- Dispute resolution – The QME’s findings can settle disagreements over the severity of your injury or whether it’s work-related.
- Legal and financial importance – Courts and insurance companies rely on the QME’s report to make decisions about your claim, which will be factored into your benefits or damages.
The QME’s report usually has a big impact on the outcome of your workers’ compensation claim. That’s why it’s so important to be honest and provide complete details about your injury during the visit, so the QME gets the right information.
How Can You Prepare For a QME Visit?
In the vast majority of workers’ compensation claims, the QME visit is going to be extremely impactful. But, the entire purpose of the QME revolves around your injury–how it happened, was it work-related, and how much you should get in workers’ comp benefits. So, you’re probably wondering how you can prepare for such an important medical visit. Here’s a few things you can do:
- Review your records – Look over your medical history related to the injury, including doctor visits, treatments, and any tests you’ve had. This will give the QME a better idea of the medical side of your injuries.
- Note your symptoms – Write down all the symptoms you’re experiencing, including pain, mobility issues, and how your injury affects your daily life. This will ensure you don’t forget any details during the appointment.
- Be ready to explain your injury and how it happened – Be prepared to describe how your injury happened at work, how it has affected you, and how it limits your ability to do your job.
- Bring your own records – Take any relevant documents, like workers’ compensation forms, prior medical reports, or referrals, to give the QME a full picture of your situation.
- Be consistent – Be truthful and consistent when answering questions about your injury. Exaggerating or downplaying your condition can hurt your claim.
Remember, you’re able to ask questions for clarification. It’s important to have a clear understanding of the evaluation, but being well-prepared will help the QME make a fair and accurate evaluation of your injury.
What Can You Get in a Workers’ Compensation Claim?
If you reach the QME stage, you’ve already filed a workers’ compensation claim because of an injury or illness at your workplace. However, what you’re actually able to recover in the claim is going to be heavily based on your particular accident, as well as the QME’s evaluation. So, it’s helpful to look at what benefits are available in a typical claim:
- Medical expenses – This covers costs related to any doctor visits, treatments, and medications for your injury.
- Lost wages – These benefits cover any income or wages you miss out on because you can’t work during your treatment.
- Temporary disability benefits – These benefits, called TTD, give you partial pay if you can’t work for a while due to your injury.
- Permanent disability – These cover costs if your injury causes long-term damage that takes away your ability to work.
- Job retraining – This covers costs related to retraining if you can’t return to your previous job.
Probably the best thing about workers’ comp is that you don’t need to prove your employer was at fault to access these benefits. However, if the benefits don’t cover all your needs, especially for severe cases, you may have the option to file a lawsuit. This could involve suing your employer or the company responsible for the accident that left you injured.
A lawsuit can provide additional financial support, called damages, that are decided by a judge or jury. for lost income, medical expenses, pain and suffering, emotional distress, and more.
Contact Maison Law For Legal Support During Your Workers’ Compensation Claim
Facing a QME during the workers’ comp process can be stressful, but it’s not something you have to face alone. Our team at Maison Law can make sure you’re prepared for this visit, and that you have ongoing legal support throughout the entire claims process. To get started, contact us today for a free consultation.
