Qualified Medical Evaluator (QME)

What a QME is

A Qualified Medical Evaluator is a licensed physician the Administrative Director of the Division of Workers' Compensation (DWC) appoints, by specialty, to evaluate medical-legal issues. Appointments run for two-year terms, and a physician must pass the DWC's competency examination before the first appointment (Labor Code section 139.2). When the parties dispute a treating physician's findings on causation, disability, work restrictions or permanent impairment, the QME's report is usually the evidence the judge and the parties work from.

The rule

In a represented case, a QME comes from a three-doctor panel. Either side can request the panel once the waiting period after an objection has run, and each side may strike one name within 10 days of the panel's assignment (Labor Code section 4062.2). The represented employee arranges the appointment. Anything a party wants the QME to see must be served on the other side 20 days before it goes to the evaluator, and the other side has 10 days to object to nonmedical records. Ex parte contact with a panel QME is prohibited (Labor Code section 4062.3).

Why it matters to an applicant firm

The QME report often decides the value of the case: whether the injury is industrial, how much permanent disability there is, and how much is apportioned to other causes. Missing the strike window hands the choice of evaluator to the defense, and a records packet served late cannot go to the doctor. Firms track the panel date, the strike deadline, the appointment and the 20-day service date for every QME on the docket. The QME and AME process guide walks through each step, and the panel QME and AME entries cover the alternatives.