If there’s a dispute in your California workers’ comp case about your injury, treatment, or disability, you may be required to see a Qualified Medical Evaluator (QME).
But not all QMEs are created equal — and your choice can make or break your case.
At Employees First Labor Law, we help injured workers pick the right QME to maximize their benefits and protect their rights.
🔹 What Is a QME?
A Qualified Medical Evaluator (QME) is a doctor certified by the Division of Workers’ Compensation (DWC) to evaluate injured workers when:
- Your treating doctor’s report is disputed
- You need an independent assessment
- You’re unrepresented and need a medical opinion on your condition
If you’re represented by a lawyer, you and the insurance company may instead agree on an Agreed Medical Evaluator (AME).
🔹 Why Your QME Choice Matters
The QME’s report influences:
- Whether your injury is work-related
- What treatment you need
- How disabled you are
- Whether you can return to work
- How much your permanent disability is worth
Insurance companies often rely on QME reports to accept or deny claims. A bad QME can:
- Downplay your symptoms
- Assign an unfairly low disability rating
- Apportion most of your injury to pre-existing conditions
That’s why choosing the right specialty and doctor is critical.
🔹 How to Choose a QME Specialty
When requesting a QME panel, you must pick a medical specialty — which determines what type of doctor you’ll get.
Some common specialties include:
- Orthopedics – bones, joints, spine
- Neurology – brain and nerve conditions
- Psychiatry or Psychology – mental/emotional trauma
- Pain Management – chronic pain syndromes
- Internal Medicine – systemic or internal health issues
🔎 Tip: Choose the specialty most relevant to your primary symptoms — not just your job title.
Example: A warehouse worker with a back injury should choose orthopedics, even if they also have stress-related symptoms.
🔹 How the Panel Process Works
If you’re unrepresented:
- You request a QME panel from the DWC Medical Unit
- You choose one of three randomly assigned doctors
- You must schedule the evaluation within 10 business days
If you’re represented by an attorney:
- You may agree on an AME instead
- Your lawyer may help strike biased doctors
- You get greater control over the process
🔹 Red Flags to Avoid in a QME
Not all QMEs are neutral. Watch out for:
- Doctors who do mostly defense work
- Poor online reviews or high-volume “mill” clinics
- Evaluators who rush the exam or don’t read your records
- Reports that ignore your treating physician’s findings
These doctors often issue low impairment ratings that benefit the insurance company.
🔹 How EFLL Helps You Choose the Right QME
At Employees First Labor Law, we:
- Select the best specialty for your injuries
- Help you strike biased panel members
- Ensure medical records are delivered on time and complete
- Prepare you for the evaluation so you know what to expect
- Challenge unfair QME reports through rebuttals and trial
We’ve handled thousands of QME and AME cases — and we know which doctors are fair and which to avoid.
✅ Don’t Leave Your Case to Chance
Choosing the wrong QME can cost you thousands in lost benefits.
Let our team guide you to the right evaluator and protect your claim from bias and misrepresentation.
