Health Care

What Does it Mean When Compensation Adjuster Requested You a QME?

Qualified Medical Evaluator is often requested by worker’ compensation adjuster for providing a final medical report. QMEs are predicted to be unbiased, but this doesn’t always happen. Some QMEs are more employee friendly, and some are more employer-friendly, and some QMEs works in the middle of the road, and they are called AME or Agreed Medical Evaluators. If you want legal representation, you are going to get an AME.

What if you are in the QME process and do not need representation legally?

For a QME to be valid many procedural and technical aspects, have to be looked into. From a list of three doctors, one doctor will be chosen as a QME in a case. But in reality, things don’t work so much according to the procedure, and the adjusters request a list of another QMEs. The truth is that according to both sides are correct if they request a different list of QMEs for procedural defects, but the QME is usually requested by the side who didn’t like the existing QME. The adjuster will always prefer an employer biased QME, whereas the injured would like to have an employee biased QME. The adjuster has information of the QMEs they like or dislike, whereas the person who is injured has no idea about the QMEs.

QME Panels for Replacement

When a party obtains a list of another QMEs, many procedures are violated. It is required that the evaluation takes place in 60 days after the injury took place, but most of the doctors are not available as doctors are busy. If any procedural violation takes place, the party may request for another panel of QMEs. If the second list also contains some of the names of the QMEs from the first list, so there is another violation that took play. All these things will make the procedure to delay more than 60 days.

Representation

If an attorney isn’t representing you, and the adjuster is setting you in the vicious cycle of replacement of the QME panels, you should find your representation immediately.

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