How to Look Up a QME in California

How Do You Look Up a QME in California?

Search the Division of Workers' Compensation's free Qualified Medical Evaluator database by name, or by specialty and ZIP code, to see a doctor's certified specialty, license type, and every office address and phone number the state has on file.

A Qualified Medical Evaluator, or QME, is a physician the state certifies to write medical-legal reports in a workers' compensation claim. When a panel of three QMEs arrives in the mail, it can be hard to tell whether a name or a specialty code on that letter matches what the state actually has on record.

The Division of Workers' Compensation, often shortened to DWC, keeps a public database of every active QME. You do not need an account or a password. You only need a name, a ZIP code, or a specialty to start searching.

This guide explains how to search that database, how to read the specialty codes, how to confirm a doctor is still certified, and what to do if the office is far from home.

How Do You Search the DWC QME Database?

Open DWC's QME database and search either by name, or by specialty plus a ZIP code and a mile radius.

The Qualified Medical Evaluator database gives you two ways to search:

1. Search by name. Enter the doctor's last name. First name, city, and ZIP code are optional. The results show every address DWC has on file for that physician, along with the specialty or specialties the doctor is certified in.
2. Search by specialty and ZIP code. Pick a specialty from the list. Enter a California ZIP code and choose a mile radius. The results show every certified doctor in that specialty near that ZIP code. Use this search for a city or region, such as a Bay Area ZIP code or one near San Bernardino, when you do not have a name yet.

Either search returns the same core details for each match: the doctor's name, listed degree, certified specialty, and every office address and phone number on file. Labor Code section 139.2(h)(2) already requires your panel notice to list each physician's name, address, phone number, specialty, years in practice, and training. The database search mainly confirms those details and shows every office the doctor uses.

What Do the Specialty Codes on a QME Panel Mean?

DWC assigns every QME specialty a three-letter code. MOS means Orthopaedic Surgery and DCH means Chiropractic, for example, and the state publishes the full list for physicians and for non-physician evaluators separately.

If your panel letter or a database result shows a short code next to a specialty, it comes from one of two official reference lists DWC keeps: one for medical doctors and doctors of osteopathy, and one for every other evaluator type, such as chiropractors, acupuncturists, dentists, optometrists, podiatrists, and psychologists.

These are the specialties evaluators most often hold in a workers' comp claim, not the complete list. DWC publishes every code, with a short description of what each specialty covers, in two reference guides: specialty codes for medical doctors and doctors of osteopathy and specialty codes for every other evaluator type. Check those two pages before assuming a code on your letter is a typo.

How Can You Check That a QME Is Still Certified?

Search the doctor's name in DWC's database. If the name and specialty appear, the doctor is currently certified in that specialty.

DWC's database lists only evaluators who are currently active. Appointments run in two-year terms under Labor Code section 139.2(a). A name can drop off the list because a term lapsed, not only because of discipline. If a name does not turn up, or the specialty does not match, raise it right away. Tell the claims administrator if you are unrepresented, or tell your attorney if you have one. DWC's Medical Unit appoints every QME and issues every panel, so it is the right place to resolve a mismatch.

Certification status and discipline history are two different questions. DWC's Medical Unit investigates complaints against QMEs. It can place a doctor on probation, suspend a doctor, or terminate certification. The QME discipline process page explains how a complaint gets filed. It also lists physicians with a disciplinary action on record, so you can check a name there too.

Can You See a QME's Office Locations and Languages?

Yes for office locations: the database lists every address DWC has on file for that doctor. The database does not list which languages a doctor or office speaks, so call the office directly to ask.

A single QME can hold evaluations at more than one address. State law caps how many:

He or she is certified by the administrative director to evaluate in an appropriate specialty and at locations within the general geographic area of the employee's residence. An evaluator shall not conduct qualified medical evaluations at more than 10 locations.

A name search shows every one of those addresses with a phone number for each. It will not tell you which languages the doctor or the front desk speaks. If you need an interpreter at the exam itself, that is a separate right with its own process; see what to expect at a QME appointment for how to request one.

What if the QME on Your Panel Is Too Far Away?

The Medical Unit will not swap a doctor only because of distance, but a new panel is available if you have moved, if the doctor cannot schedule you in time, or if both sides agree to search near your workplace instead.

Panels are already built with distance in mind. Title 8, California Code of Regulations, section 31 weighs how close a QME's office is to your home when the list is built, and it requires at least five active QMEs in a specialty before a panel can issue there. A personal preference for a closer office, on its own, is not grounds for a new one.

A replacement panel is available in specific situations instead, under Title 8, California Code of Regulations, section 31.5:

• You moved to a new address after the panel was issued, and you have not yet been seen by any doctor on that panel.
• No doctor on the panel can schedule your exam within 90 days of your request, or 120 days if that limit was extended.
• The claims administrator and you agree in writing to a new panel near your workplace instead of your home.
• The panel is more than 24 months old and no listed doctor has examined you yet.

If one of these applies, say so when you contact the Medical Unit, the claims administrator, or your attorney. Requesting a replacement panel follows the same form and deadline rules as the original request; see how the QME panel and strike process works and the forms used to request a panel for the specifics.

Confirming a doctor's specialty, certification, or office address is something you can usually do yourself with the tools above. Picking which doctor to strike, or requesting a different specialty, is a bigger decision. So is choosing an Agreed Medical Evaluator instead of the random panel. See how to choose a QME doctor for that question, or QME versus AME in a California claim if you are represented and weighing that option.

Eman Yazdchi reviews each workers' compensation matter individually, including questions about a QME panel, a specialty mismatch, or a doctor's certification status. Call (661) 273-1780 or use the contact form to describe what is on your panel letter and what you have found so far.