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What Makes Qualified Medical Evaluations So Important?

A female doctor with stethoscope

What Makes Independent Medical Exams So Important?

Being involved in an accident or any event that led to injury or sickness at your place of work, is not always a great experience for those seeking workers’ compensation benefits. Some can say that it’s difficult to navigate the workers’ compensation claim process. Indeed, this can be quite difficult even with the help of workers’ compensation attorneys. However, not pursuing claims just isn’t an option as they can help make up for the lost wages and medical benefits that can help you stay afloat. Now, one thing that can make or break your claim is Qualified Medical Review (QME).

But what exactly is an QME, and what makes it so important? Read on if you want to know the answer to these questions!

What Is a Qualified Medical Evaluation?

Let’s say that you put out a claim for a work-related injury or illness. The doctor that initially treats you will assess the gravity of the injury or sickness and determine the extent of the claim—this is mostly standard procedures. However, if your employer’s insurance company has any issues or disputes the initial claim, then you must undergo an entirely new medical evaluation with a new doctor. This doctor, who presumably has a neutral standpoint, will reassess the injury or illness to determine whether the claims are valid—this is what the QME is all about.

What Makes a Qualified Medical Evaluation So Important?

So, what happens during an QME? Well, the records and any relevant documents to the injury or illness must be submitted to the doctor conducting the examination. The doctor will then review them to see whether or not they hold up to scrutiny. While this seems harmless, one important aspect of the QME is that your employer’s insurance company will be providing the doctor with guided questions that will be used to review the documents and records. This can be troublesome as they can use it to frame the doctor’s examination and end up weakening your claim.

However, you are well within your right to ask the QME doctor to review the letter sent by your employer. This gives you a chance to correct any inconsistencies that may be present in your record. Another thing you should remember is that the doctor is not bound by the rules of a normal physician-patient relationship. This means that any information that you share with the QME doctor can be used against you during your workers’ compensation hearing.

Given how tricky this process is, it’s in your best interest to hire a worker’s lawyer for workers’ compensation to help get you through the process. Our team of experienced lawyers can help you navigate this difficult situation and ensure that you are in the best possible position to win your case. Now, the workers’ compensation carrier is supposed to let your attorney know that you are scheduled for an QME, but this isn’t always the case. As such, be sure to keep your lawyer in the loop whenever any developments are regarding your claim!


Hopefully, this article has shed some light on QMEs. Use this information to your advantage if ever you are put in a situation where you have to file a workers’ compensation claim.

If you’re looking for workers’ compensation attorneys in California, Pacific Workers, The Lawyers for Injured Workers, have your back. Our team of experienced lawyers will do all they can to ensure that you maximize your financial compensation for any pain or suffering you have endured.

Get in touch with us today at 800 606 6999 for a free consultation!

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