What to Expect at a QME Exam

Most of the work that determines the quality of an evaluation happens before anyone walks into the exam room. The evaluator receives the records the parties provide, along with the questions the report is expected to answer. A complete, well-organised file and a precise set of questions produce a focused report; a partial file produces a report full of qualifications.

Scheduling is coordinated in advance, including the location. Evaluators on a panel are assigned with reference to a geographic area near the injured worker, so attendance is normally practical, and our network can coordinate travel across California where a case calls for it.

The appointment usually begins with the evaluator taking a history directly from the injured worker: how the injury occurred, what symptoms followed, what treatment has been provided, and how the condition affects daily activity and work. This is not a repeat of the treating physician's notes — the evaluator is forming an independent picture and testing it against the record.

The interview is conducted in the language the parties have arranged for. Where an interpreter is needed, that should be identified during scheduling rather than discovered on the day.

The physical examination is directed at the body parts and issues in dispute, and its content depends on the evaluator's specialty. An orthopedic evaluation, a neurological evaluation, and a pain-management evaluation each involve different measurements and manoeuvres. The evaluator records objective findings that can be cited later in the report.

The evaluator may consider diagnostic studies already in the file, and in some cases may indicate that further studies are needed before a question can be answered properly.

Remote evaluations may be available in some circumstances, where appropriate for the case and permitted under current California DWC rules. Suitability depends on the specialty, the issues in dispute, and whether the physical examination required can meaningfully be conducted at a distance.

Where a remote format is appropriate, it can reduce travel burden considerably — particularly for people with mobility limitations or long distances to cover. It is a case-by-case decision, confirmed during scheduling rather than assumed.

The evaluator is not there to treat. No treatment plan is issued, no prescriptions are written as part of the evaluation, and the appointment does not create a doctor-patient treating relationship. The evaluator's output is a written opinion, not care.

The evaluator also does not decide the claim. The report informs the parties and, where relevant, the court — the decision itself sits elsewhere.

Attendance matters. The medical-legal fee schedule includes a specific code for a missed appointment (ML200), which is billable when a scheduled evaluation does not go ahead. Beyond the direct cost, a missed appointment pushes the whole timeline back — rescheduling a specialist evaluation is rarely quick. Fee figures are listed on the QME fees page.

The evaluator writes the report, drawing together the records, the history, and the examination findings into reasoned answers to the questions posed. On existing claims coordinated through our network, standard reports average around two weeks, with expedited options available on request. See reports and timelines for detail.

QME California coordinates evaluations for law firms, third-party administrators, employers, and corporate clients. We do not work directly with claimants.