How are communications between parties and a QME conducted prior to an
examination?
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All communications prior to an examination by the parties with a QME must
be in writing and served on the QME at the same time as the opposing
party.
A QME panel is requested, a QME is selected, the QME evaluation with the injured
worker occurs, and the QME issues a report. It is then discovered that the QME panel
was requested for compensability but the claims administrator had already accepted 1
body part as work-related. Who is liable to pay the QME fees?
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, Neither party is liable for paying the QME fees. A QME panel should not be
requested based on compensability (also known as Labor Code section
4060).
Why was the combined values chart in the AMA Guides created?
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So that multiple impairment calculations do not exceed 100% whole person
impairment.
Who can become a QME?
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Only physicians as defined by the Labor Code can be a QME (M.D., D.O.,
Psychologist, Acupuncturist, Dentist, Podiatrist, Chiropractor, or
Optometrist).
If a party fails to provide a QME with any relevant medical record which the QME
deems necessary to perform a comprehensive medical-legal evaluation, what may
the QME do?
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The evaluator may contact the treating physician or other health care
providers to obtain such record(s).
,A QME is selected from a panel but realizes that they had previously treated the
injured worker. In what situations can the QME proceed with this evaluation?
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Never. A physician can never serve as QME for a case that they previously
treated the injured worker.
What is the standard for medical decision making in a QME evaluation?
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Reasonable medical probability. The QME must have greater than 51%
certainty of their opinion.
If a QME must render emergency treatment, then does it need to follow the Medical
Treatment Utilization Schedule (MTUS) or American College of Occupational and
Environmental Medicine (ACOEM) guidelines?
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No. The QME can administer any necessary emergency treatment.
What is the first evaluation by a QME called?
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, A comprehensive medical-legal evaluation.
How long does the employer have to provide access to a physician within the MPN
from the time the injury was claimed?
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24 hours.
What can an injured worker request to see at the time of a QME evaluation?
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The QME's state medical license, the QME's certificate to perform QMEs at
that location, and the QME's curriculum vitae.
A party supplying information to the QME must serve the same information to the
opposing party how many days before the information is provided to the QME?
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20 days.
What happens if an unrepresented injured worker fails to inform the claims
administrator of the physician selected from the QME panel within 10 days of being
examination?
Give this one a try later!
All communications prior to an examination by the parties with a QME must
be in writing and served on the QME at the same time as the opposing
party.
A QME panel is requested, a QME is selected, the QME evaluation with the injured
worker occurs, and the QME issues a report. It is then discovered that the QME panel
was requested for compensability but the claims administrator had already accepted 1
body part as work-related. Who is liable to pay the QME fees?
Give this one a try later!
, Neither party is liable for paying the QME fees. A QME panel should not be
requested based on compensability (also known as Labor Code section
4060).
Why was the combined values chart in the AMA Guides created?
Give this one a try later!
So that multiple impairment calculations do not exceed 100% whole person
impairment.
Who can become a QME?
Give this one a try later!
Only physicians as defined by the Labor Code can be a QME (M.D., D.O.,
Psychologist, Acupuncturist, Dentist, Podiatrist, Chiropractor, or
Optometrist).
If a party fails to provide a QME with any relevant medical record which the QME
deems necessary to perform a comprehensive medical-legal evaluation, what may
the QME do?
Give this one a try later!
The evaluator may contact the treating physician or other health care
providers to obtain such record(s).
,A QME is selected from a panel but realizes that they had previously treated the
injured worker. In what situations can the QME proceed with this evaluation?
Give this one a try later!
Never. A physician can never serve as QME for a case that they previously
treated the injured worker.
What is the standard for medical decision making in a QME evaluation?
Give this one a try later!
Reasonable medical probability. The QME must have greater than 51%
certainty of their opinion.
If a QME must render emergency treatment, then does it need to follow the Medical
Treatment Utilization Schedule (MTUS) or American College of Occupational and
Environmental Medicine (ACOEM) guidelines?
Give this one a try later!
No. The QME can administer any necessary emergency treatment.
What is the first evaluation by a QME called?
Give this one a try later!
, A comprehensive medical-legal evaluation.
How long does the employer have to provide access to a physician within the MPN
from the time the injury was claimed?
Give this one a try later!
24 hours.
What can an injured worker request to see at the time of a QME evaluation?
Give this one a try later!
The QME's state medical license, the QME's certificate to perform QMEs at
that location, and the QME's curriculum vitae.
A party supplying information to the QME must serve the same information to the
opposing party how many days before the information is provided to the QME?
Give this one a try later!
20 days.
What happens if an unrepresented injured worker fails to inform the claims
administrator of the physician selected from the QME panel within 10 days of being
