One factor that can delay a workers’ compensation claim is when a QME moves offices or changes med-legal services, and doesn’t tell the parties. This can and has literally added months to a claim.
If one practices workers’ compensation law on either side of the aisle long enough, this is bound to happen to you. This article will help provide some tips and strategies to help move your claim forward when your QME has decided to throw you a change up.
KNOW THIS LINK
Here is the link to the DWC Medical Unit’s QME database – this lists all of the addresses available for each QME, along with a phone number:
https://www.dir.ca.gov/databases/dwc/qmestartnew.asp
It is a helpful link to know, as it can tell you where the QMEs perform evaluations, and even which QMEs practice in specific zip codes or geographic areas.
WHEN THE QME MOVES
The threshold question that will dictate your remedies is “when did the QME move?”
It’s important to know whether the QME moved to a new address prior to the original evaluation, or after the initial evaluation.
IF QME MOVES AFTER PANEL ISSUES, BUT BEFORE INITIAL EVALUATION
In this scenario, the parties have usually issued their strikes and one doctor remains on the QME panel. However, when they call to book the evaluation appointment, they find out the QME has moved to a new address.
If they have moved to a new address that is different than the one on the DWC Medical Unit’s panel, then:
- The parties must get a replacement panel unless …
- Unless there is a written agreement between the parties to use another QME address listed with the DWC Medical Unit. Then they may choose to have the evaluation performed at the different address according to CCR 34(b).
The problem is that when a QME changes med-legal service providers (the scheduling company that also organizes their records), often all of the addresses change. Still, all of the addresses should be listed with the DWC Medical Unit.
IF THE QME MOVES AFTER THE INITIAL EVALUATION
But what happens if your QME moves offices after the initial evaluation? Well, CCR 34(b) says that you can do a re-evaluation at a new address, as long as it’s located “within a reasonable geographic distance from the injured worker’s residence.”
In other words, you can schedule a re-evaluation address as long as it’s not too far away from the applicant.
OTHER PROBLEMS ABOUT WHEN THE QME MOVES OR CHANGES MED-LEGAL COMPANIES
One thing that is more annoying than the most annoying sound in the world (thanks Jim Carrey) is when your QME changes med-legal companies and/or moves, but doesn’t tell any of the parties. This often leads to a situation where the parties have requested a supplemental report from the QME, only to get no response. After 60 days pass, usually someone will object to the report as being untimely and call the QME’s phone number listed on their reports or QME panel – only to have the receptionist say “sorry, that doctor has moved on and we have no idea where they moved to. I cannot provide you with any more information than that.”
Questions about what happened to your supplemental report are given similar answers. In other words, they probably know where the QME moved to, but instead they pretend that they have absolutely no idea what is going on.
Do not fear! Just fire up your trusty computer and go back to that handy link we told you about:
https://www.dir.ca.gov/databases/dwc/qmestartnew.asp
If your QME is still practicing, their new addresses and phone numbers will be listed on that link. Call the new phone numbers listed on the QME database, ask if they ever got your supplemental (they usually will say they didn’t), and then ask where they want you to send it to.
That should get you your supplemental report.
One other noteworthy problem that occurs when QMEs switch med-legal companies is they trash all of the records that the doctor previously reviewed earlier in the case. So if you intend to ask the QME a question about a record they reviewed before the change in med-legal companies – you might have to resend it to them. Sometimes you resend things to the new address and the QME’s office feigns never receiving them – when that happens, you must simply resend and follow up with the office manager.
REMEMBER TO COMPLY WITH LC 4062.3(e)
While doing all of this fun QME stuff, please remember to comply with LC 4062.3(e) and avoid any ex-parte communication with the QME. This important statute says that all communications with a medical evaluator before a medical evaluation shall be in writing and shall be served on the opposing party 20 days in advance of the evaluation. Any subsequent communication with the medical evaluator shall be in writing and shall be served on the opposing party when sent to the medical evaluator.
If you’ve already abided by this statute and the other party didn’t object, then simply resending your correspondence to the QME’s new address shouldn’t be a problem. Just make sure that you haven’t made any notable changes to your letter.
CONCLUSION
When your QME moves or changes scheduling companies, it’s not the end of the world – as long as you know about CCR 34(b) and the DWC’s QME database. So keep these handy tools in mind and you should be able to proceed with discovery as you originally intended!
Got a question about the good faith personnel action defense or other workers’ compensation defense issues? Feel free to contact John P. Kamin. Mr. Kamin is a workers’ compensation defense attorney and equity partner at Bradford & Barthel’s Woodland Hills location, where he monitors the recent legislative affairs as the firm’s Director of the Editorial Board. Mr. Kamin previously worked as a journalist for WorkCompCentral, where he reported on work-related injuries in all 50 states. Please feel free to contact John at jkamin@bradfordbarthel.com or at (818) 654-0411.
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