Category Archives: QME

WCAB OVERRULES WORK INJURY APPORTIONMENT MADE BY QME

On March 21, 2023, the Workers’ Compensation Board of Appeals (WCAB) overturned a work injury “apportionment” made by a Qualified Medical Evaluator (QME) in the case of Monter v. Randstad North America, Inc.. In doing so, the WCAB awarded additional workers’ compensation benefits to the claimant. The decision is instructive for employers and insurers. Here, […]

CALIFORNIA REGULATORS RELEASE UPDATED COVID-19 EMERGENCY QME RULES FOR 2022

On January 18, 2022, the California Division of Workers’ Compensation (DWC) announced that updated COVID-19 related emergency regulations for Qualified Medical Evaluations (QMEs) are taking effect. The latest round of emergency regulations are set to last until July 19, 2022—with two separate 90-day extensions possible if deemed necessary. In this article, our Fresno workers’ compensation […]

CALIFORNIA WORKERS’ COMPENSATION: ARE PARTIES REQUIRED TO USE THE SAME QME THROUGH THE PROCESS?

In California, a person injured on the job is generally entitled to no-fault benefits through a workers’ compensation claim. Disputes can sometimes arise over the existence, nature or severity of an employee’s injuries. California’s QME (Qualified Medical Evaluator) process exists to allow an independent medical professional to come in and make an assessment. Once a […]

CALIFORNIA DIR EXTENDS EMERGENCY QME COVID-19 REGULATIONS

According to a report from the Los Angeles Times, the COVID-19 surge driven by the Delta variant started to recede in California in September. Nonetheless, transmission of the COVID-19 virus remains a public health issue in Central California, throughout the United States, and around the globe. With this in mind, California regulators have once again […]

BATTLE OF THE QME SPECIALTY

Every seasoned workers’ compensation attorney knows that the specialty of the Panel Qualified Medical Evaluator has a significant impact on a claim. Once an applicant’s claim requires the use of a medical-legal evaluator, certain rules must be followed. In order to initiate the medical evaluation process, we must first look to see if the applicant […]

HOW TO AVOID BEING STUCK IN A CONSTANT LOOP OF REPLACEMENT PANEL QME REQUESTS

Have you ever been stuck in a constant loop of replacement panel requests, one after another, ultimately causing significant delay in the discovery process? Nowadays, the panel QME process is almost inevitable in the handling of every workers’ compensation claims to resolve any and all disputed medical issues, particularly in cases where the applicant is […]

CALIFORNIA WORKERS’ COMPENSATION QUALIFIED MEDICAL EVALUATORS: FREQUENTLY ASKED QUESTIONS (FAQS)

As explained by the California Department of Industrial Relations (DIR), QMEs are licensed doctors who have been trained and certified by the state’s DWC. When there are questions regarding the nature and severity of an employee’s injury, a Qualified Medical Evaluator (QME) may be brought in to bring additional clarity and help resolve the issue. […]

A TIP TO AVOID FURTHER DELAYS DURING PANEL SPECIALTY DISPUTES

With today’s online Panel Qualified Medical Evaluator request system, it is often a race to be the party to designate the panel specialty.  All too often the fate of a case hinges on the click of a submittal button. Despite defendants’ best efforts, there are times where applicant’s counsel is able to secure the specialty […]

COVID-19 AND WORKERS’ COMPENSATION: AN OVERVIEW OF CALIFORNIA’S PROPOSED EMERGENCY TELEMEDICINE REGULATIONS

The COVID-19 (coronavirus) pandemic is affecting communities across the country. In order to slow the transmission of the respiratory disease, the California Department of Public Health recommends social distancing. Public officials instructed everyone in the state to stay home except for essential needs. In an effort to facilitate social distancing, the Division of Workers’ Compensation […]

Panel Dispute Strategy

By Nicole D. Rothford Panel disputes seem to be the new wave of litigation at the WCAB in the workers’ compensation arena, but a significant panel decision that is resulting in new issues for litigation, is not a new decision. In fact, the 2006 case of Nelly Romero v. Costco Wholesale, PSI, 72 CCC 824; 2007 Cal. Wrk. […]