California Worker's Compensation - Help For Injured California Workers

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  1. #1
    Join Date
    Feb 2009
    Location
    San Diego, California
    Posts
    10

    Default What Does QME & Eme Stand For?

    I've been looking on-line to find out what eme & qme stand for & I can't find it anywhere. I'm going to be having one of those examintions next month & I wanted to read up on it. Can anyone help me? Does anyone know of any good websites?

  2. #2
    Join Date
    Jul 2008
    Location
    California
    Posts
    1,900

    Default Re: What Does QME & Eme Stand For?

    http://www.dir.ca.gov/DWC/MedicalUnit/faqiw.html


    You can click on the link above for QME information. A QME is a qualified medical evaluator.

    Did you pick the QME from a panel of three doctors?

  3. #3
    Join Date
    Jul 2008
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    California
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    1,900

    Default Re: What Does QME & Eme Stand For?

    This is some of the information from the above link.


    About the qualified medical evaluator (QME) process

    Q. What is a QME?

    A. A qualified medical evaluator (QME) is a physician who evaluates you when there are questions about what benefits you should receive. A physician must meet educational and licensing requirements to qualify as a QME. They must also pass a test and participate in ongoing education on the workers' compensation evaluation process. If you have an attorney, you and your claims administrator might agree on a doctor to resolve medical disputes. This doctor is called an agreed medical evaluator (AME). An AME or a panel QME will be used to resolve medical disputes in your workers' compensation case.

    Q. What is the difference between an AME and a QME?

    A. If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the state system used to pick a QME. The doctor your attorney and the claims administrator agree on is called an agreed medical evaluator (AME). A QME is picked from a list of state-certified doctors issued by the DWC Medical Unit. QME lists are generated randomly. An AME can only be used if you are represented by an attorney. Once you see an AME you are not entitled to see a QME. An AME may be used regardless of the year of injury. An AME physician may be a QME, but does not have to be one.

    Q. What is a panel QME?

    A. In this context, the word panel means a list. A panel QME is a randomly generated list of three QME physicians issued to you when there is a question about whether or not your injury is work related, or if there is a medical dispute that hasn't been resolved by the treating physician's report. Whoever fills out the form to request the panel QME chooses the specialty of the doctors on the panel.

    Q. Who completes the panel request form?

    A. You will receive the panel request form from the claims administrator and are given the first chance to fill out and submit the form. If you do not submit the form within 10 days, the claims administrator will do it for you and will get to choose the specialty of the QME you'll see.
    (Title 8, California Code of Regulations, section 30, Labor Code sections 139.2(h), 4061(d), 4062(b))

    Q. I have two different problems from the same injury (for instance, a psychiatric and an orthopedic problem). May I request two panels, one psychiatric and one orthopedic?

    A. The basic rule is that you get one. The claims administrator is only required to pay for one QME evaluation. The selected QME can get a consultation from another physician if there is a need for input from more than one medical specialty.

  4. #4
    Join Date
    Jul 2008
    Location
    California
    Posts
    1,900

    Default Re: What Does QME & Eme Stand For?

    This information is for California WCAB. I just noticed a post that says you are from Utah, so the process may be different in your state.
    Last edited by kelly38; 02-26-2009 at 08:46 PM.

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