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✦ Certified Specialist in Workers’ Compensation Law, certified by the State Bar of California, Board of Legal Specialization ✦
By Eman Yazdchi, Esq. · Certified Specialist in Workers' Compensation Law, State Bar of California Board of Legal Specialization · Cal Bar #285231
(a) Whenever a comprehensive medical evaluation is required to resolve any dispute arising out of an injury or a claimed injury occurring on or after January 1, 2005, and the employee is represented by an attorney, the evaluation shall be obtained only as provided in this section.
Labor Code 4062.2 controls how a represented worker gets a QME when the parties need a medical-legal evaluation.
A QME is not a treating doctor. A QME writes a medical-legal report for disputed issues such as injury, causation, permanent disability, apportionment, work restrictions, or future medical care. Labor Code 4062.2 explains how that evaluator is chosen when the injured worker has an attorney.
The process usually starts after a written objection or a medical-legal dispute. The requesting party asks the Division of Workers' Compensation Medical Unit for a three-member panel in the proper specialty. The specialty choice can shape the whole case.
The strike deadline is short, so the panel should be reviewed as soon as it arrives. Eman Yazdchi is a Certified Specialist in workers' compensation law, certified by the California Board of Legal Specialization, State Bar of California.
A party requests a three-doctor panel from the Medical Unit after the required objection or evaluation trigger.
The request identifies the case, body parts, dispute, treating physician specialty, and requested QME specialty. The Medical Unit then issues a panel of three doctors. The panel is supposed to match the specialty needed for the medical dispute.
If the wrong specialty is requested, the report may miss the real injury. Orthopedic, neurological, psychiatric, internal medicine, pain, and dental issues may call for different choices. A worker should not treat the panel request as clerical.
Each side has 10 days after panel assignment to strike one doctor, leaving the remaining QME to examine the worker.
The strike is a strategic choice. Each side reviews the doctors' specialties, locations, reporting history, availability, and fit for the injury. If both sides timely strike one name, the remaining doctor becomes the evaluator.
If a party misses the strike window, the other side may choose from the remaining doctors. Missing the deadline can decide the medical expert for the entire claim.
The QME examines the worker, reviews records, and writes a report on the disputed medical-legal issues.
The QME report may address whether work caused the injury, whether the worker is permanent and stationary, impairment, apportionment, work limits, need for future care, or whether additional testing is needed. The report can drive settlement value and trial outcome.
The worker should prepare carefully. That means giving an accurate history, listing all injured body parts, explaining job duties, and making sure the records sent to the QME are complete and organized.
A QME is selected through the statutory panel process. An AME is a doctor both sides agree to use.
An Agreed Medical Evaluator can be useful when both sides trust a particular doctor and want a direct evaluation. A QME is used when there is no agreement. Both reports can be powerful evidence, but an AME report often carries special practical weight because both sides chose the evaluator.
The decision to use an AME instead of a panel QME should be made case by case. Speed, specialty, reputation, and the disputed issue all matter.
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