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This document provides guidelines and procedures for Qualified Medical Evaluations (QME) related to workers' compensation claims, detailing the notice requirements, filing timelines, dispute resolution,

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What is qualified medical evaluations?

Qualified Medical Evaluations (QMEs) are medical evaluations conducted by physicians who have been certified by the Division of Workers' Compensation Medical Unit in California. These evaluations are used to resolve disputes related to workers' compensation claims.

Who is required to file qualified medical evaluations?

Employers, injured workers, and claims administrators may request a QME to obtain an independent medical opinion regarding a workplace injury or illness. The requesting party is responsible for filing the QME.

How to fill out qualified medical evaluations?

QMEs must be completed by a certified physician who specializes in the appropriate medical field for the injured worker's condition. The physician will examine the worker, review medical records, and provide an objective opinion regarding the nature of the injury, treatment options, and any work restrictions.

What is the purpose of qualified medical evaluations?

The purpose of QMEs is to provide an independent medical evaluation in workers' compensation cases. These evaluations help determine the extent of an injury or illness, the need for medical treatment, and any work limitations or disability ratings.

What information must be reported on qualified medical evaluations?

QME reports typically include the injured worker's medical history, physical examination findings, diagnostic test results, treatment recommendations, and any permanent impairment or disability ratings. The reports should also address specific questions posed by the requesting party.

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