No, injured workers cannot choose their own doctor for workers’ compensation claims in California. Only if the injury was prior to January 1st, 2005, can parties select their own QME and are not required to request a panel from the Medical Unit. The parties may request a panel QME if both parties agree and make a joint request.
When Can I Choose My Own Doctor for Workers’ Compensation in California?
If you choose a doctor provided by the Department of Workers’ Compensation (DWC) website, then you can choose your own doctor. If you choose a doctor without a Workers’ Compensation Attorney, then you will be at the mercy of the insurance adjuster if you fail to request a QME or you do not inform the adjuster of your selection.
When choosing a QME, you should do the following:
- Obtain the list of approved doctors by mailing the appropriate paperwork to the Department of Workers’ Compensation Medical Unit.
- List your adjuster on the forms to ensure your adjuster receives the list as well.
- You have 10 days to notify your adjuster of your QME choice from the day you received the list.
- You must schedule an appointment with the QME within 90 days. If no appointments are available in 90 days, then you may request a new QME panel and start the process over again, or choose a different doctor on the list.
How Do I Prepare For My QME Examination?
It is important you go into a QME prepared and be honest. Being prepared for a QME is similar to a job interview. While the visit will feel like a doctor’s visit, it is not. At a QME, you are being evaluated, not treated. For a successful QME, you should:
- Be punctual and make a good impression.
- Dress appropriately. You want the doctor to focus on your medical condition and not what you are wearing.
- Bring all your medication bottles with you or write down your prescriptions as your doctor will want to know what you’re taking.
- Be truthful. Your QME will be notating your symptoms, pain levels, and the impact your injury has had on your life. This information will largely be used to determine what your case is worth when a settlement is calculated or if your case goes to court
How Does the QME Process Work if I Have a Lawyer?
If you have legal representation, you do not get to select any doctor from the list provided by a QME panel. Instead, your lawyer gets to strike one doctor and the insurance company gets to strike one doctor. Whichever doctor is left will be the QME selected for your case. A lawyer will help you navigate the QME process by helping you select the best option and preparing you for your QME appointment. Also, in the case there is an error in the QME’s report, your attorney can question it and help you appeal it if necessary.
Is a QME Result Final?
While a QME’s rating carries a lot of weight in your claim, the final result is not set in stone. If you’re given a diagnosis after a QME, your attorney, your employer, the insurance company, or the defense attorney can all formally dispute a QME’s finding through the Workers’ Compensation Appeals Board.
The Board will examine all medical evidence and testimony given on the matter to determine if the QME’s opinion warrants being overturned. Having your diagnosis overturned is possible if you believe it is inaccurate. An experienced Workers’ Compensation Attorney can help you with the appeals process, as well as negotiate a fair settlement on your behalf.
Contact a Workers’ Compensation Lawyer in California
If you or a loved one has suffered an injury that has left you disabled or severely injured and you are concerned about getting the most from your workers’ compensation claim, the attorneys at Maison Law can help. Our firm will help you navigate the complexities of legal and we’ll be with you every step of the way until you receive the compensation you are owed. Contact Maison Law today for a free consultation and case evaluation. No upfront money is required for our services and we don’t get paid unless we win your case.
