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Glossary

Workers' comp

Agreed Medical Evaluator (AME)

A doctor the applicant's attorney and defense agree on to evaluate disputed medical issues in a represented California comp case, instead of a panel QME.

What an AME is

An Agreed Medical Evaluator is a physician both sides choose by agreement to write the medical-legal report on disputed issues. Title 8 of the California Code of Regulations defines the AME in section 1, alongside the QME. Only a represented employee can use an AME: an unrepresented worker goes through a panel.

The rule

In a represented case, the parties may agree to an AME at any time, except on issues that belong to independent medical review. Once an issue has been agreed to go to an AME, neither side can request a QME panel on that issue unless both cancel the agreement in writing (Labor Code section 4062.2(f)). With an AME, the parties also agree on what records the evaluator receives, and every written communication to the AME must be served on the other side when it is sent (Labor Code section 4062.3).

Why it matters to an applicant firm

Defense carriers and applicant attorneys both tend to give an AME's opinion more weight, since neither side picked the doctor alone. That cuts both ways: an AME's opinion is hard to overcome, so the choice of physician is a strategic call. AMEs in common specialties are often booked far out, which affects how quickly a case can reach a mandatory settlement conference. Firms should track the agreement itself, the agreed records list, the appointment date and the report due date. The QME and AME process guide compares the two paths.

Sources

  1. Cal. Code Regs., tit. 8, § 1 (Definitions)
  2. Cal. Labor Code § 4062.2
  3. Cal. Labor Code § 4062.3

General information about California and federal rules, not legal advice. Rules change and every case turns on its facts: check the statute and your own analysis before relying on a date or a figure.

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