Sacramento, CA asked in Workers' Compensation for California

Q: QME FORM

Hi Guys, I called my adjuster to request a QME form after finding out that my evaluation rating from concentra was zero but as usual the adjuster never replied. So I went online and found the form, I was wondering if and individual involved in the claim can fill this form, I already talk to a lawyer but the said at this point it's better I fill the form alone and they will help me choose a dr although they will not legally be representing me. On the "requesting party" there is options for attorneys and administrator alone. Again am really appreciative of any advice as I go though this difficult process.

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2 Lawyer Answers
Haleh Shekarchian
PREMIUM
Haleh Shekarchian
Answered
  • Workers' Compensation Lawyer
  • Beverly Hills, CA
  • Licensed in California

A: You could fill out the form but I suggest you consult an attorney when striking the names of the doctors as that is very crucial. You can contact anyone of us on Justia for a free consultation.

1 user found this answer helpful

Joseph Alan Hernández
PREMIUM
Joseph Alan Hernández
Answered
  • Workers' Compensation Lawyer
  • Eureka, CA
  • Licensed in California

A: To Whom it may concern:

I agree with the advice you received and that it is better at this point to fill out the form alone and then seek help on choosing the doctor once a "panel" ( the panel is the document that contains three doctors to choose from) has been issued. The form should allow you to indicate that the "requesting party" is the applicant in pro per. If you have further questions we are in the North State region of California. Hope this answers your question.

Sincerely Joseph A. Hernandez, Esq.

707-476-0950

100 H. Street Suite 208. Eureka, CA 95501

1 user found this answer helpful

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