The timeline for a QME evaluation can vary depending on the injured worker’s legal representation. As with any workers’ compensation claim, an attorney is not required to collect benefits. However, a Workers’ Compensation Attorney can ensure you receive the maximum amount of benefits for your workers’ compensation claim.
Timeline for QME Evaluation
A standard QME appointment typically involves the following steps:
- Medical records will be reviewed by the evaluating QME physician
- The physician will interview the patient in person
- After visiting with the patient, the physician has 30 calendar days to issue a report
- The physician submits a QME report detailing the diagnosis, analysis, and conclusion
It is important to remember that the QME is an independent consultant in your case. Their medical opinion is not legally binding in the same way a court’s judgment would be. Accepting the diagnosis of a QME is voluntary unless a comprehensive hearing overturns their findings.
QME Timeline for an Injured Worker with Legal Representation
An injured worker with legal representation may request a QME through their attorney no earlier than the first working day 10 days after mailing a request for medical evaluation. If you are seeking to strike a QME, it must be done within 10 days of the QME being assigned to the claim. However, it is not recommended to decline a QME in workers’ compensation claim as it can hurt your case.
The injured worker or their attorney has 10 days from the date a QME is selected to schedule an appointment. If the injured worker fails to schedule the appointment or one is not available within ten days, then the QME must schedule an examination within 90 days of the initial request period.
QME Timeline for an Injured Worker without Legal Representation
Injured workers without legal representation must wait for a medical panel to assign them a QME within 20 working days. After 20 business days, the injured worker may select a QME of their choice within a reasonable geographic area. The employer of the injured worker may also select a QME and schedule an appointment after the injured worker has had 10 days to select a QME.
Locations for a QME
QMEs can be scheduled at any of the medical offices listed by the medical panel. The injured worker and the insurance adjuster must both agree to the QME selection and the location once the panel has selected their QME. Previously, in California, initial evaluations were required to take place in the medical office listed by the panel. Now, parties must agree before a visit can take place.
Both parties must agree to the location of the QME within 90 days. The office location should be within reasonable geographic distance from the injured worker’s residence. Remote evaluations are also available to injured workers, seeking a QME. California Code of Regulation 46.3 specifies the legality of remote health evaluations. The rules define remote health as visits or evaluations that can be conducted via video-conferencing or similar technology.
Contact a Workers’ Compensation Lawyer in California
It can be difficult to secure all of your workers’ compensation benefits, which is why it is essential to have an experienced attorney on your side. Maison Law is committed to giving accident victims effective legal counsel to collect the benefits they are owed. Whether you’ve suffered permanent injuries, have been denied medical treatment, or need more from your workers’ compensation claim, our firm is prepared to exercise the full extent of the law to recover the damages you are owed.
Contact Maison Law today for a free consultation and case evaluation. There is no upfront charge for our legal services and you will not be charged a cent until we’ve won your case.
