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If you have suffered a workplace-related illness or injury, and have submitted a claim under your employer’s workers’ compensation insurance policy, you may decide or be required to see a Qualified Medical Evaluator (“QME”). A QME, is a physician who is specially qualified to provide medical-legal evaluations of a worker’s job-related injuries. In this article, we explain what the purpose of a QME is, some details of the process, along with the pros and cons of requesting a QME and how that may affect your particular circumstances.

The purpose of a QME is to evaluate your workplace-related injury or illness when there is a question about what workers’ compensation benefits you should receive. The basic idea is that a QME can provide a neutral evaluation of your condition, and help resolve any dispute or disagreement between you and the workers’ compensation insurance carrier over whether, or how much, or for what conditions, you should receive benefits. QMEs are trained to evaluate a number of different injury situations. Some of the more difficult injuries to evaluate are injuries to the psyche. When a person is emotionally traumatized by an event such as sexual harassment, workplace violence, a workplace robbery, etc., the necessary compensation can be difficult to determine. A QME is a physician or other health care professional who meets certain qualifications set by the California Division of Workers Compensation (“DWC”) Medical Unit.

Who Decides If You Need to See a QME?

Either you or the workers’ compensation insurance claims administrator can request that you see a QME. But, you get the first crack. Here’s how it works. If there are questions about your workers’ compensation claim that a QME might be able to help sort out, you can fill out a QME request form obtained from the DWC Medical Unit website above. Alternatively, you may receive a QME request form directly from the workers’ compensation carrier, in which case you have ten days from receiving the form to request a QME. It’s up to you if you want to make the request. If you don’t make the request within the ten-day window, however, then your time is up and the workers’ compensation insurer gets the chance to request a QME.

Who Picks the QME?

Whoever fills out the QME request form decides the specialty of the QME you will see. As a practical matter, the specialty you or the claims administrator chooses for the QME ought to have something to do with your injury or illness, or with the reasons why there are questions about your claim. For example, if you suffered a twisting knee injury and there’s a question about how severe the injury was, you could request that the QME be an orthopedist.

It’s important to understand, however, that you don’t get to name your QME directly. Instead, if a QME is requested by either party, the DWC Medical Unit will send you a randomly generated list (or “panel”) of three approved QMEs in the requested specialty to choose from. You have ten days from when the list is generated to select one of the doctors on the QME list, tell the insurance company who you picked, and make an appointment. If you miss that deadline, the workers’ compensation insurance carrier has the right to select the QME you will see and make the appointment for you. If you are entering this process without qualified legal counsel, you may end up choosing a QME who will assess your injury in a way that offers you less compensation than you deserve.

Who Pays for a QME?

In California, the workers’ compensation insurance company pays for the QME exam, regardless of who requested it.

What Happens at a QME Examination?

A QME examination is basically a doctor’s appointment at which the doctor evaluates your workplace-related injury or illness, with an eye to helping resolve the dispute or question that led to the QME being appointed.

What Are the Pros and Cons of Requesting a QME?

A QME can be a convenient way to resolve a dispute or question about your eligibility for workers’ compensation benefits. For example, if you disagree with your regular doctor’s assessment of your injury or illness and how it affects whether you are entitled to benefits, a QME can offer a second, more useful opinion for resolving your claim.

But, beware, requesting a QME (or having one requested by the workers’ compensation insurance carrier) can carry significant risks. You may not be satisfied with the QME options presented to you in your “panel.” The specialty of the QME may affect how your injury or illness is perceived and judged, and may not be appropriate for establishing you are entitled to benefits. A qualified Workers’ Comp Attorney will help you choose an excellent doctor from a QME panel and fight for the payout you deserve.

How Does an Attorney Help With the QME Process?

Consulting with an attorney may help you avoid some common, but serious, risks and mistakes in the workers’ compensation and QME process. If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the state system used to pick a QME. The doctor your attorney and the claims administrator agree on is called an agreed medical evaluator (AME). as an alternative to being forced to select a QME from a randomly generated list.

Contact an experienced workers’ comp attorney from Brand Peters PC for assistance in choosing a QME who will get you the compensation you deserve. ​​​​​ Call the firm today to receive your free initial consultation.

The role experts play will vary from case to case. Expert witnesses are hired for their knowledge and have become an indispensable part of litigation. Therefore, you get paid for your time spent preparing and attending the deposition.

Sometimes an expert will serve solely as a consultant to the lawyer, and remain in the background, without his or her name ever being known to the other side. At other times an expert will be used in the pre-trial stages, perhaps to give an affidavit supporting an element of the case. In other cases, the expert may serve solely as a witness at trial. Sometimes an expert will play a combination of these roles.

A common issue among expert consultants is, “How do I make sure I get paid?” Determining who is responsible for expert witness fees can be a bit of a challenge. However, the code of civil procedure (CCP) offers much guidance on this matter and can assist legal practitioners in understanding the rules in California and apportioning the financial responsibility accordingly.

The party who requests the deposition is responsible for paying the expert’s fees in advance of the deposition, if possible. Otherwise, the fees should be provided at the deposition. The expert witness’s fees should not only involve the time on the witness stand, but the time spent evaluating matters, studying files or reviewing evidence, meeting with lawyers, coming to conclusions, and sitting around waiting to testify.

If an expert witness’s fees are not paid prior to the deposition, the expert and the non-deposing attorney have the option of canceling the deposition under CCP §2034.460(b). If you go forward, without the fee, make sure that the payment arrangement regarding what they’re going to pay you and when they’re going to pay is on the record. Most experts who testify are paid at rates comparable to the normal fees they earn. It is not all that unusual for the expert to be paid slightly more for appearing at trial, than doing ordinary office work.

The most important step in getting paid is planning to get paid. Being compensated for your work is too important to leave to chance, hope or optimistic confidence in the decency of your clients. It’s business. Reviewing an entire case and then sending an attorney a large bill without having come to an agreement on the scope and cost of your work will cause a problematic situation, as you and the attorney most likely have different expectations. The video included in this blog post presents best practices that will help you get the fee you deserve.

The discovery depositions of an expert witness will play an important role in the litigation process because of the huge impact it has both in trial and of course and on the overall outcome of the case. Expert witness testimony is a crucial part of litigation strategy that can mean the difference between a successful case and one that results in disappointment. The most important role of an expert is to endorse and lend credibility to the concerns of the party that called the expert at trial. If you plan to serve as an expert witness retained for trial or testify as a treating physician or would like to simply better prepare yourself for a deposition or trial, you will find this and the remaining videos in the series very useful.

This is the first video blog in a series designed to inform the chiropractic physician about his or her role in the legal system and how to be better prepared for the sometimes-unfamiliar trial process. The series will provide an overview of the dos and don’ts around expert chiropractic testimony, tell you how to prepare for testimony and give you an idea as to what subjects you may testify on in court. The presenter in the videos is Jonathan Brand who has nearly thirty years of trial experience, including the use of chiropractors as expert witnesses. With his background as a highly qualified trial attorney, he can share the nuances of vetting and preparing witnesses

Depositions are opportunities to secure sworn testimony to be used at trial. Since there are specific rules that govern depositions of witnesses and further the deposition of experts, it is important to be familiar with these rules. Preparation is the key to a successful deposition, for both the witness and the attorneys. Expert witnesses who excel at deposition will earn repeat and word-of-mouth business and see gains in their practice.

The single most important piece of advice for the expert witness is to tell the truth, simply and directly. This cannot be overemphasized. As an expert witness, you have a legal, moral, and ethical obligation to tell the truth. You are testifying under oath. Nothing ruins a case faster than exaggerating, misrepresenting, or otherwise telling an untruth. Giving false testimony, is not only a crime but it will destroy your reputation as a reliable expert

Equally as important, is that you understand the question before answering is emphasized and repeated. The witness cannot be afraid to say that he doesn’t understand the question, you are not expected to know the answer to every question. If you are not sure of the answer, you should not guess nor assume the facts. If the matter is beyond your memory or personal knowledge, “I don’t know,” or “I do not remember” are perfectly appropriate responses to any question at a deposition. If a question pertains to an existing document, don’t be afraid to ask to review that document. A witness can review referenced documents before giving an answer during a deposition. The document may help to refresh your memory.

How Documentation Helps Your Case

Documenting your injuries can, in the long run, increase the value of your case. Treatment for even the most minor injury can generate an intimidating amount of paperwork. Insurance questionnaires, medical bills, explanation of benefit letters and various other administrative documents are generated upon any hospital visit. To make things easier, create a file and save a copy of all these documents. Keeping an ongoing record of your treatment serves two purposes. First, it creates a narrative of your injury and subsequent treatment. Second, it tracks any expenditures associated with your medical treatment. Since medical expenses are reimbursable as economic damages, keeping accurate treatment records and billing records will allow you to claim every dime you are owed. There is no substitute for good documentation. Memory alone cannot do it.

Keep A Daily Record

A personal injury claims diary is a great way to record your pain levels, what kind of medicine you took, medical appointments, physical limitations and your ability to perform daily activities are all significant details. Keeping a diary also allows you to document any mental issues you may be having. Treating physicians and injured parties alike often ignore stress, sleepless nights, confusion and other outward manifestations of mental trauma. If you focus on keeping a record of your overall condition, these seemingly innocuous manifestations of mental trauma could lead to an actual medical diagnosis, which will bolster any claim for damages you make, including one for pain and suffering stemming from your injuries

With thorough and accurate medical records, documentation and a personal injury claim diary, a person will have made the foundation for a sound presentation of their pain and suffering. These records assess and document the nature and extent of your injuries; your treatment for those injuries; your progress and recovery; your complaints of pain, discomfort and limitations; any ongoing or permanent health problems; and the effect that the injuries have had on your life. This documentation will help your attorney prove how serious, severe and/or debilitating the injuries have been for you.

Seek Medical Attention Immediately

Although the aftermath of a serious accident can be disorienting, it is extremely important to take steps to document your injuries to help win your case. Another important factor in documentation is to obtain official documentation of your physical condition immediately after you are injured. Your condition immediately post-injury will serve as a baseline for your condition as your case proceeds. Without immediately obtaining medical attention, you will have no concrete way of proving your condition contemporaneously with the accident. Depending on the type of accident and your ability to take photographs at the time of an accident can be one of the best ways to document evidence. Take pictures of your own injuries, the damage to the vehicles (if it is a car accident), including the surroundings where the accident took place.

Documentation Is Essential To Success

It is important to provide your attorney with all relevant documentation throughout your case, and it is essential to update your lawyer each time you visit the doctor or receive any information from your insurance company. Documenting your medical condition is an essential part of any successful personal injury claim. Whether you are negotiating a settlement with an insurance adjuster or presenting a lawsuit to a jury, the more facts you have supporting your position, the higher the likelihood of a satisfactory outcome. Plan to share everything you have with your attorney, who can go through these materials to determine which documents will be the most helpful in winning your case. Following the few simple steps described in this article can help ensure that your injuries are properly documented, and you receive the compensation you deserve.

As the United States finds itself amid an opioid crisis, officially designated a “public health emergency,” more Americans are seeking relief from their chronic pain with methods outside of traditional medicine. Incredible advancements in medical knowledge and technology have occurred in the past century. There is little debate that modern medicine has dramatically improved the overall health and lifespan of people throughout the world, but in some areas, such as chronic pain, traditional methods have sought to treat the problem rather than solve it.

With over 100 million Americans suffering from chronic pain, an entire industry has evolved to treat their conditions. Medical practitioners often have difficulty determining the cause of a patient’s pain and, if they can identify the cause, have limited options to address the issue. The conventional approach to relieving patient suffering is to medicate them which has led the pharmaceutical industry to develop multiple opioid-based pain medications.

Opioids, presented initially as a safe and effective treatment for pain, has been shown to be highly addictive and deadly. Despite of these facts, the pharmaceutical industry has responded by developing increasingly stronger and more addictive drugs. The attention given to the opioid epidemic in the U.S. has led many Americans to seek a non-drug approach to treating their pain.

Many times, chronic pain involves issues with a body’s basic elements such as bones, joints, and tissue, whether from age or injury. As the body ages, muscles, spinal discs, facet joints and ligaments become less hydrated, weaker, and less able to withstand normal stresses. Trauma from an accident or fall can also cause unnatural stress leading to pain. Rather than treating the symptom, pain, chiropractic treatment focuses on the issue that is causing the pain. Opioids and pain medications may mask the pain, but the longer the injury is left untreated, the more adverse effect it will have on the patient.

Chiropractic treatment seeks to treat the issue directly by focusing on the spine and the central nervous system. The nervous system effects and controls the functions of every organ and tissue in the body. A misalignment or kink in the spine can cause a variety of symptoms including pain and even a lowered immune system.

Doctors of chiropractic enhance flexibility, muscle strength, and range of motion through hands-on techniques. Chiropractic solutions work on muscular, skeletal and nerve issues all over the entire body and can also outline a program of exercise designed to rehabilitate and strengthen specific muscle groups. The chiropractic adjustment directly addresses the mechanical components and often provides immediate relief of pain as well as restoring proper range of motion.

Doctors of chiropractic are uniquely positioned to treat individuals suffering from chronic pain without the use of prescription drugs and their possible side effects. Chiropractors are designated as physician-level providers in most states and have the same licenses and privileges to serve as a primary care doctor. The typical training for doctors of chiropractic includes four years of pre-medical undergraduate college education plus four to five years of study at an accredited chiropractic college. In addition to the hands-on nature of chiropractic, and their knowledge of complex adjusting techniques, Chiropractors are qualified to order tests and recommend other types of specialists if needed.

Traditional medicine has provided a pharmaceutical solution to the treatment of pain which not only does not address the cause of the pain, but creates many other issues that are equally, if not more, unacceptable. This concern is changing the public perception of opioids and prescription drugs and has led more Americans to search for medication-free treatment options to treat their pain symptoms.

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Chronic pain can have a range of causes, from an injury or illness to aging, but there may also be no clear cause. This ambiguity in causes can make chronic pain very hard to treat and can have negative impacts on the patient’s lifestyle. A study by the National Institutes of Health found one in ten Americans experienced pain every day for three months. Lower back pain is the most common form of frequent or chronic pain, affecting more than 26 million Americans between the ages of 20-64.

A Growing Epidemic

One can hardly pick up a newspaper these days without reading another story about the alarming rise in addiction to prescription pain killers, particularly opioids. Those stories are backed up by figures from the National Institute on Drug Abuse. According to their recent analysis, more than 30 million people worldwide are addicted to opioids, including some 2 million in the United States alone.

Addiction, however, is not the only problem with the use of these powerful pain killers. Many who take these drugs, although they don’t experience addiction, suffer other problems, ranging from hormonal imbalances to digestive problems, infertility, depressed immune response, liver toxicity, gastrointestinal bleeding and depression.

Increasingly, recognizing not only the dangers of addiction (among others) associated with these medications, an increasing number of Americans are seeking alternative approaches to chronic pain relief. Among the most effective is chiropractic therapy.

The Impact of Chiropractic Treatment on Pain Management

A host of recent studies have established definitively the positive impact of chiropractic care on the alleviation of pain. Those benefits extend to a wide variety of conditions, from shoulder pain to arthritis, carpal tunnel syndrome, neck pain, back pain headaches and fibromyalgia. Essentially, the chiropractor’s manipulation of the spine and extremities promotes the body’s ability to heal itself, without the introduction of potentially dangerous medications, by combatting oxidative stress and promoting the repair of DNA at the cellular level.

Of these several studies, one from the American College of Physicians and the American Pain Society found chiropractic treatment so effective that they recommended physicians routinely recommend spinal manipulation for pain management. That study, and the several others which have reached similar conclusions, has prompted researchers to continue studying the effectiveness of chiropractic treatment for a wide range of conditions in which chronic pain is a principal symptom.

Although the alleviation of pain is a principal reason people increasingly seek out the services of competent chiropractors, it isn’t the only one. In addition to pain relief, chiropractic treatment provides additional benefits, including stress relief, improved posture, overall mood enhancement and better sleep.

Conclusion

The rash of addictions and overdoses related to prescription painkillers has induced an increasing number of people to find and utilize alternative therapies. Chiropractic therapy is chief among those which are relieving pain, improving mood, reducing stress and enhancing physical wellbeing without the use of these medications. If you are one of the millions of Americans suffering from chronic pain, you owe it to yourself to find a skilled chiropractor in your area today.