What is a QME?
QME stands for Qualified Medical Evaluator. It is a term which is only relevant in the California Worker’s Compensation system. A QME is someone who is hired by an injured worker or an insurance company to perform an independent examination of an injured worker for the purpose of resolving a dispute between the worker and the insurance carrier/employer. Disputes may be about whether an injury is or is not the result of employment, whether treatment being requested is appropriate for the injury, whether the patient has reached the maximum benefit from available treatment, whether or not it is time for the worker to return to work, and a variety of other issues. The QME reviews all of the medical records provided for the worker, completes an examination of the worker, and writes a report answering the questions to resolve the dispute. Someone who is a QME has learned enough about the California Worker’s Compensation system to understand the legal as well as medical issues relating to tre
