Comp Claimants With Attorneys Can Choose New Medical Panels
Workers' Compensation claimants who choose a Qualified Medical Evaluator they later decide they don't like now have one opportunity to pick another QME: Hire a lawyer - quickly!
In June, a Workers' Comp Appeals Board ruled that an unrepresented worker who retains counsel can pick another QME if the medical evaluation hasn't already begun. The WCAB ruled that an injured employee who hired legal representation could request a new panel that included chiropractors because she hadn't yet seen the orthopedist assigned to evaluate her.
The flip side of the ruling is that not even an attorney can fix the problem if the claimant "attends and participates in the medical evaluator's examination."
The safest course of action for an injured worker, of course, is to hire a qualified Workers' Compensation specialist from the moment they begin the Workers' Compensation process.
More on Medical Treatment and QME Disputes
- Comp Claimants With Attorneys Can Choose New Medical Panels
- Controlling Your Medical Treatment: Is Pre-designation the Right Option for You?
- Legal Challenges Are Made To The Medical Treatment Dispute Resolution Process
- Complaint Form Issued for Employers, Insurers that Delay Medical Treatment
- Court Clarifies Procedure for Spinal Surgery Disputes in Workers' Compensation Cases
- Examining the Role of a Nurse Case Manager in a Workers' Compensation Case
- Utilization Review: What Public Safety Officers Need to Know
How QME panels work today
When you and the insurance company disagree about your medical condition, such as the extent of your disability, whether you can return to work, or whether an injury is work-related, the dispute is sent to a Qualified Medical Evaluator. The state’s Division of Workers’ Compensation issues a panel of three QMEs in the relevant specialty. If you have an attorney, each side strikes one name and the remaining doctor performs the evaluation. Represented workers may also agree with the insurer on an Agreed Medical Evaluator instead. If you do not have an attorney, you choose from the panel yourself.
The QME’s report often decides the value of a case, which is why the choice matters so much and why the ruling described above came with a warning: once the evaluation has begun, it is generally too late to change course. Read our guide to choosing a quality QME and our other coverage of medical care, UR and IMR.
