Santa Barbara County Deputy Sheriffs' Association

Representing Law Enforcement Professionals Since 1971

Unrepresented vs. Represented in the Panel QME Process

In a workers’ compensation case, it is very likely that an injured worker will be evaluated by a Panel Qualified Medical Examiner (QME).  What is less clear is how the Panel QME becomes selected or appointed in a workers’ compensation case.  The confusion may lie, in part, in that the California Labor Code has two separate routes to the selection or appointment of a Panel QME.  One route is for injured workers not represented by an attorney and the other route is for injured workers represented by an attorney.

When an injured worker is not represented by an attorney, the workers’ compensation claims adjuster may start the process of requesting a Panel QME by sending a letter to the injured worker objecting to a substantive issue in the case.  The same letter is then submitted to the Division of Workers’ Compensation’s Medical Unit for issuance of a Panel QME List comprised of three doctors.  If the injured worker does not participate in this process, the workers’ compensation claims adjuster will select the Panel QME doctor he/she believes may be more advantageous to the employer. 

When an injured worker is represented by an attorney and if the workers’ compensation claims adjuster objects to a substantive issue in the case, written notice must be sent to the attorney for the injured worker.  Once the Panel QME List comprised of three doctors is issued, the attorney for the injured worker will research the list of three doctors and remove/strike the medical doctor that may be less advantageous to the injured worker.  Second, when an injured worker is represented by an attorney, the parties may agree to forgo the Panel QME process and agree to use an Agreed Medical Evaluator (AME).

What happens when an injured worker goes from unrepresented to represented by an attorney and a Panel QME List issued while the injured worker was unrepresented, is the injured worker entitled to a new Panel QME List now that he/she is represented by an attorney?  There is persuasive authority to argue that an injured worker is entitled to request a new Panel QME List when the injured worker has not attended an examination by a Panel QME scheduled while the injured worker was not represented by an attorney. (Nelly Romero v. Costco Wholesale, 72 Cal Comp. Cases 824).   

If you have questions, please contact attorney Eli Moreno-Sanchez at (916) 318-4633.

Unrepresented vs. Represented in the Panel QME Process

In a workers’ compensation case, it is very likely that an injured worker will be evaluated by a Panel Qualified Medical Examiner (QME).  What is less clear is how the Panel QME becomes selected or appointed in a workers’ compensation case.  The confusion may lie, in part, in that the California Labor Code has two separate routes to the selection or appointment of a Panel QME.  One route is for injured workers not represented by an attorney and the other route is for injured workers represented by an attorney.
When an injured worker is not represented by an attorney, the workers’ compensation claims adjuster may start the process of requesting a Panel QME by sending a letter to the injured worker objecting to a substantive issue in the case.  The same letter is then submitted to the Division of Workers’ Compensation’s Medical Unit for issuance of a Panel QME List comprised of three doctors.  If the injured worker does not participate in this process, the workers’ compensation claims adjuster will select the Panel QME doctor he/she believes may be more advantageous to the employer. 
When an injured worker is represented by an attorney and if the workers’ compensation claims adjuster objects to a substantive issue in the case, written notice must be sent to the attorney for the injured worker.  Once the Panel QME List comprised of three doctors is issued, the attorney for the injured worker will research the list of three doctors and remove/strike the medical doctor that may be less advantageous to the injured worker.  Second, when an injured worker is represented by an attorney, the parties may agree to forgo the Panel QME process and agree to use an Agreed Medical Evaluator (AME).
What happens when an injured worker goes from unrepresented to represented by an attorney and a Panel QME List issued while the injured worker was unrepresented, is the injured worker entitled to a new Panel QME List now that he/she is represented by an attorney?  There is persuasive authority to argue that an injured worker is entitled to request a new Panel QME List when the injured worker has not attended an examination by a Panel QME scheduled while the injured worker was not represented by an attorney. (Nelly Romero v. Costco Wholesale, 72 Cal Comp. Cases 824).   
If you have questions, please contact attorney Eli Moreno-Sanchez at (916) 318-4633.