Fremont, CA asked in Workers' Compensation for California

Q: how accurate is qme report if he modified work duty and request for mri but did not give rating?

The first qme says injury is industrial related and modified my work duty. He requested for mri because he did not have ptp reports or x-rays from 2 other doctors. I’m not sure how he reported no impairment with out all the medical reports. One of my restrictions was no lifting of more than 10 lbs. he submitted his supplemental report 10 months later and it just says mmi date is the date of evaluation. He retired so I can’t get him to comment or explain his findings. Is his report admissible? If so, how can I get this removed. I have a different qme now and I’m just waiting for his report.

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2 Lawyer Answers

Ronald Mahurin

  • Workers' Compensation Lawyer
  • Point Arena, CA
  • Licensed in California

A: First it would be pure guess work for someone to comment on the adequacy of a medical report without reading it, so I cannot address the issues of MMI or TTD. If the PQME is retired you can ask for a replacement panel by downloading the form from the DIR workers compensation website/forms. That is your best option if you are dissatisfied with the medical reporting. And I suggest that you seek representation.

Nancy J. Wallace

  • Workers' Compensation Lawyer
  • Grand Terrace, CA
  • Licensed in California

A: A medical-legal report based on an incomplete/inaccurate medical records and medical history does NOT support a judge's finding, so you want to very quickly object to the QME's report as failing as 'substantial evidence' then very very quickly get that QME report to the PTP, tell the PTP there is a dispute over Permanent Disability and insist the PTP produce a comprehensive medical-legal report that includes a review (and criticism) of the QME's findings. A QME does NOT issue a 'rating', a QME makes a finding as to the injured worker's Whole Person Impairment percentage...and if this QME found you have no Whole Person Impairment then there is nothing to rate. This is way, WAY too complicated for a non-attorney to attempt, if you had an attorney, you probably would never have seen that lame QME in the first place. GET A LOCAL, VERY EXPERIENCED WORKERS COMPENSATION ATTORNEY (NOT THE TV PEOPLE WHO SEND KIDS TO THE HOUSE AND HAVE YOU SIGN BLANK FORMS...MEET AND INTERVIEW THE ACTUAL ATTORNEY).

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