What Happens During a Qualified Medical Evaluators Evaluation?

Picture this: you go to work one day at the grocery store at which you have been working for several years. You enter the dairy fridge, ready to restock the coolers only to slip on a floor spill. You hit the ground hard and can immediately tell that something in your back isn’t right. Standing back up is difficult and you are in a lot of pain. You have sustained a workplace injury.

Seeking medical treatment should be your first step. If your treating physician concludes that you are permanently disabled from your injury, or if the insurance company chooses to challenge your treating doctor’s findings, a Qualified Medical Evaluator (QME) will likely become involved.

A QME is a practicing physician who is familiar with the worker’s compensation process. The goal is for them to be completely unbiased and for them to assess you injury with no context for the working environment or your relationship with your employer. Following their evaluation you will be given a disability rating. Their evaluation will determine what type of benefits you receive.

A QME evaluation will be mostly similar to a regular physician appointment, with a few notable exceptions. The QME will have a record of your prior medical treatment. They will ask you about your injury, how it occurred, and how the injury is affecting you both day to day and at work. Lastly, the QME will be reporting on your evaluation. There is no privacy here. Everything about your exam will be shared with other parties.

If you are assigned a QME for assessment, it is important to tell the entire truth. There is no place for lies or exaggeration. If you are worried about seeing a QME without legal protection, call us about representation. We can work with the claims administrator to set up an appointment with an agreed medical evaluator (AME). The appointment process will be largely the same, but the treating physician will be someone that we helped to choose for you.

Don’t wait. Call today.