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Frequently Asked QME Questions

Also see: The Industrial Medical Council's Frequently Asked Questions

  1. Do I Need and Attorney to Handle my Workers' Comp Case?
    A: You do not need an attorney in order to secure a QME examination or to protect your rights under the California Workers Compensation system; however, depending on your case, the severity of the injury, the duration of the case, extenuating circumstances and other factors which may make your case difficult to handle by yourself, you may benefit from having a workers' compensation attorney representing you. As a treating chiropractic physician I have found that if my patients are overly worried about legal issues, loss of income etc., they may neglect the primary concern which is restoration of health, decreased pain and increased function. In such circumstances, I recommend that the patient seek legal representation.
     
  2. Do QME's Work for the Insurance Company?
    A: QME's DO NOT work for or represent the insurance companies. QME's are duty bound to act in a professional and unbiased manner. The California Industrial Medical Counsel (IMC) which oversees the conduct of QME physicians has strict guidelines which help ensure that QME's remain unbiased. If you ever suspect that you have been treated unfairly or in a biased manner, you should report the incident to the IMC. Bear in mind that your QME may render an opinion that differs from what you expected, that does not automatically mean that the QME was biased.
     
  3. I told the QME doctor that I was hurting all the time, and that I was in severe pain, but his report says I do not hurt that badly. Why is the QME lying?
    A: The words used to describe an injured workers pain are very important. Furthermore these words are subject to interpretation. California has mandated that QME's use very specific words to describe pain. There are very few words that are acceptable. Also bear in mind that "constant severe pain" is in actuality so debilitating as to render that person totally disabled; incapable of even the simplest of tasks. (constant severe pain may imply that the patient is on constant narcotic medication etc.) The QME is no doubt not lying. The QME is trying to accurately describe your subjective pain complaints using the accepted terminology. In addition, it is the QME's job to render his or her opinion regarding your subjective complaints. The patient may overstate OR understate their pain levels. The QME uses all of the information available to render an opinion regarding the level of pain.