Maison Law helps injury victims through the workers’ compensation process in California, which is going to include a visit to a qualified medical evaluator (QME). This doctor’s visit and report is going to be a huge part of your claim, but our team of lawyers will be there to make sure you’re prepared and protected. To get started on your claim, contact us today for a free consultation.
Do You Need Our Lawyers For a QME Visit?
A QME visit is a requirement for any workers’ compensation claim in California. While you don’t need a lawyer to file a claim or to go through with a QME visit, our team has extensive experience with this entire process. While we can’t give you medical advice, we can make sure you’re prepared as best you can for any questions or other parts of the QME visit by:
- Helping you understand what to expect
- Gathering important documents
- Explaining your rights.
- Challenging findings if the QME report is not in your favor or if there are disputes about your injuries
In cases where your injury or condition is severe, or if your claim is complicated, having the legal support of our team can make a big difference in making sure your claim is evaluated fairly and you get the benefits you need.
What Happens During a QME Visit?
A big part of your workers’ comp claim is going to involve a visit to a QME that’s picked by your employer’s workers’ comp insurance carrier. Even though every injury is different, the actual visit is going to follow a general outline that includes the following steps:
- Reviewing your medical history – The QME will ask about your medical history, focusing on the injury or illness related to your job. They may also review medical records provided by your doctors.
- Questions about your injuries – You’ll be asked to explain how the injury happened, what symptoms you’re experiencing, and how it affects your ability to work and perform daily tasks.
- Examination -The QME will conduct a physical examination to evaluate the extent of your injury or condition. They may check your movement, strength, or any specific areas related to the injury.
- Diagnostic tests – In some cases, the QME might order additional tests, like X-rays or MRIs, to get a better understanding of your condition.
The QME visit is a key step in your workers’ compensation claim, so it’s important to be honest and provide as much detail as possible during the visit. At the same time, though, it’s important to know what you can do to make sure you’re evaluated fairly.
How Should You Prepare For a QME Visit?
As you might expect, the QME visit can greatly impact your workers’ compensation claim one way or the other. The QME’s job is to evaluate your injury and determine how it happened, whether it’s work-related, and what benefits you should receive. Here’s a few things you should do to make sure you’re as prepared as possible:
- Review your medical records – Go over your medical history, including doctor visits, treatments, and tests related to your injury. This helps the QME understand your condition.
- List your symptoms – Write down all the symptoms you’re experiencing, like pain, movement problems, and how the injury affects your daily life. This way, you won’t forget any details during the appointment.
- Explain how the injury happened – Be ready to describe how your injury occurred at work, how it impacts you, and how it limits your ability to do your job.
- Bring important documents – Take any relevant paperwork, such as workers’ comp forms, previous medical reports, or referrals, to give the QME a full view of your situation.
- Be honest and consistent – Answer questions truthfully and stick to the facts about your injury. Don’t exaggerate or downplay your condition, as this will probably impact your evaluation.
You can also ask questions if you don’t understand something during the visit. Being prepared will help the QME make an accurate evaluation of your injury, but remember, it’s not necessarily an adversarial process–despite the fact that the QME is chosen by the workers’ comp insurance company.
What Happens After the QME Visit During a Workers’ Comp Claim?
Facing a visit to a QME is obviously pretty stressful for a number of reasons, but most of all because it’s not your regular doctor, and their findings are going to impact what you can get in terms of benefits. But remember, a QME is still a licensed doctor that is supposed to be neutral. So, it’s important to keep the process in mind after you visit the QME:
- QME report – The QME will write a report based on your exam and the information you shared. This report includes details about your injury, whether it’s work-related, and recommendations for treatment and benefits.
- Sending the report – The QME’s report is sent to the workers’ compensation insurance company, your employer, and our team. This report is important for deciding what happens next in your claim.
- Claim review – The insurance company will review the QME’s findings to decide on your benefits, such as medical treatment, temporary or permanent disability payments, or job training if you need a new job.
- Possible disputes – If the QME’s findings are not in your favor or there’s a disagreement about your benefits, you can contest the report. This might involve asking for another evaluation or taking legal steps to challenge the decision.
- Benefit determination – Depending on the QME’s report, your workers’ comp benefits may be approved, changed, or denied. If the report supports your claim, you should start receiving benefits like medical expenses, disability payments, or help with job retraining.
This stage is important because the QME report strongly influences your claim outcome. If you’re not happy with the result, our team will be there to help you through the dispute process. Our overall goal is to make sure you’re treated fairly and that you get the benefits you need to get better.
Experienced Legal Support For Workers’ Compensation Claims in California
At Maison Law, our team of California workers’ compensation lawyers can help you through the entire claims process, including preparing you for a visit to a QME. This is an incredibly important part of your claim, and we’ll be there to make sure you have the support you need. For more information about how we can help you, contact us today for a free consultation.
