Q: I just saw a QME my attorney sent me to. Now my employer's ins co. will be sending me a MPN list to chose a dr. Its OK?
Do I have to also go to their QME.? Or was the QME I saw approved by both my attorney and their ins.co?
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- California
- (916) 704-3009
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- Answered
A:
Under California workers' compensation law, there are a few key points to understand:
1. QME (Qualified Medical Evaluator): A QME is a physician certified by the Division of Workers' Compensation Medical Unit to evaluate an injured worker when there is a dispute over the injury. Either party (the employee or the employer/insurance company) can request a QME evaluation.
2. MPN (Medical Provider Network): An MPN is a group of healthcare providers selected by an employer or insurance company to treat injured workers. If your employer has an MPN, you typically must choose a doctor within the network for treatment, unless you predesignated a personal physician before your injury.
Regarding your specific situation:
- If your attorney sent you to a QME, it's likely that this QME was chosen to evaluate your injury for the purpose of your workers' compensation claim. This QME may or may not have been agreed upon by both your attorney and the insurance company.
- If your employer's insurance company is now sending you an MPN list to choose a doctor, this is likely for the purpose of ongoing treatment, not for another QME evaluation.
- You should consult with your attorney to clarify whether you need to attend another QME examination requested by the insurance company, or if the QME you already saw was sufficient for your claim.
In summary, the QME is for evaluation of your injury when there is a dispute, while the MPN doctor is for ongoing treatment. Your attorney can best advise you on whether you need to attend any additional QME exams.
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