Due to precautions related to COVID-19, we have expanded our options for remote consultations. Please contact our office to discuss whether a full phone consultation or video conference is appropriate for your situation.

Call For A Free Consultation: (530) 287-6674

Call For A Free Consultation: (530) 287-6674
  • By: Benjamin Helfman, Esq.
  • Published: July 26, 2022
A doctor interacting with patience - Leep Tescher Helfman and Zanze

If you are injured at work and make a claim to obtain workers’ compensation, there is a chance that you will need to see a medical professional for a qualified medical evaluation. This evaluation can be requested when your claim is denied or delayed and you’d like a medical evaluation to determine if the claim should be payable. Additionally, you can ask for the evaluation by a qualified medical evaluator, or QME, if you disagree with your current treating physician’s thoughts on your condition or if you want to find out if you are permanently disabled and may need future medical treatment.

In California, you are able to see a  list of QMEs to choose from, so you can select someone to take a look at your health situation.

When Will You Be Forced To Go Through A QME?

Generally speaking, many people don’t need an evaluation by a QME if they get their claims approved. It’s when your claim is delayed or denied that it may be necessary to look into seeing a QME. If the insurance company wants you to see the QME, it will give you a form stating that you need to see one and give you 10 days to turn in the form to the Department of Workers’ Compensation Medical Unit. If you don’t send that form back within the timeframe, the insurance company can determine which doctor you’ll see.

That’s why it’s important to make sure you return the document as soon as you can. By doing so, you can maintain some control over who you see.

Do QMEs Represent The Insurance Company?

No, they are third parties. The DWC Medical Unit sends three QME possibilities to your insurance company at random. You get to choose one of those people. If you don’t, then the insurance company will choose from the list.

If you think that you may want a QME or you have been asked to get one, it’s helpful to know your rights. You need to know where you stand with your case and what to do if you’ve faced an unfair rejection of your claim. You may still be able to get the compensation you need.

Attorney Benjamin Helfman is a dedicated California workers’ compensation attorney serving injured workers and employees in Shasta County and beyond. Attorney Helfman brings a wide breadth of experience and deep knowledge to the field of workers’ compensation, aiming to demystify its complex legal procedures to help the injured and disabled understand their rights and secure the financial compensation they deserve.

Connect with the law firm of Leep, Tescher, Helfman and Zanze to stay up to date on workers’ compensation laws and practices in California.

Call For A Free Consultation: - (530) 287-6674.

Translate »
Accessibility Accessibility
× Accessibility Menu CTRL+U