What is a QME and what happens at the exam?

A QME, or qualified medical evaluator, is a doctor certified by the Division of Workers’ Compensation (DWC) Medical Unit to examine an injured worker and write a medical-legal report when the worker or the claims administrator disputes what the treating doctor said. Its report is due within 30 days, and the employer pays for the evaluation (Labor Code 4064(a)).

The DWC’s guidebook warns that the report “will affect your benefits,” and that in many cases you will not be able to choose another QME or AME.

What is the difference between a QME and an AME?

A QME comes from a state list. An agreed medical evaluator (AME) is a doctor both sides agree on, and the DWC’s Fact Sheet E says that option exists only when the worker has an attorney. Labor Code 4062.2(f) lets represented parties agree to an AME at any time.

QMEs are California-licensed doctors, including chiropractors, psychologists and acupuncturists. A “panel QME” is one doctor from a random list of three in the specialty requested.

When is a QME exam needed?

Fact Sheet E lists the usual disputes that call for a QME: whether work caused the injury, whether you need time off to recover, whether you are permanent and stationary, whether you have new and further disability, and what your permanent disability rating should be.

A dispute over a specific treatment request takes a different path, through utilization review (the claims administrator’s review of the request) and independent medical review (Labor Code 4062(b)). For any evaluation on or after July 1, 2013, the QME gives no opinion on disputed treatment, only on whether you will need future medical care (8 CCR 35.5(g)).

How is a QME panel requested?

With an attorney, for injuries in 2005 or later, the panel request is filed online on the DWC’s website, and the paper QME Form 106 is no longer accepted for these cases (8 CCR 30(b)). It can be filed no earlier than the first working day at least 10 days after the objection was mailed. The side that files names the specialty (Labor Code 4062.2(b)). The requester must serve the request and the panel list on the other side, with a proof of service, within one working day after the panel is generated (8 CCR 30(b)(1)(C)).

Without an attorney, the claims administrator sends QME Form 105. Fact Sheet E says you have 10 days to send it to the DWC Medical Unit, or the claims administrator files it and chooses the specialty. Once the panel arrives, you have 10 days from the date on the list to pick a QME, make the appointment and tell the claims administrator. The Medical Unit answers questions at 1-800-794-6900.

What is the 10-day strike rule?

In a represented case, each side may strike one name from the three-doctor panel within 10 days of the panel’s assignment, and the remaining doctor becomes the QME (Labor Code 4062.2(c)). The DWC’s regulation counts the 10 days from service of the panel (8 CCR 30(b)(1)(C)). If a side does not strike in time, the other side may choose any doctor left on the panel.

If the Medical Director approves a request to replace a doctor on the panel, the strike deadline is on hold until the replacement issues (8 CCR 31.5(b)). Once the QME is selected, the represented worker sets the appointment. If the employer is not told within 10 days, the employer may arrange it (4062.2(d)).

What happens before the exam?

Records move first, on a schedule set by 8 CCR 35. The claims administrator must send the QME the treating and other relevant medical records, plus a letter listing the issues to address, served on the other side at least 20 days before the exam. Anything either side sends the QME must go to the other side at least 20 days before it goes to the QME (8 CCR 35(c); Labor Code 4062.3(b)).

The claims administrator’s cover letter must say: “If you do not want the doctor to see this information, you must let me know within 10 days.” An objection within 10 days keeps non-medical records, such as personnel files or video, away from the QME unless a judge orders otherwise. Every communication with the QME must be in writing and copied to the other side.

What happens at the QME exam?

The QME examines you on the disputed issues and may need test results or a consulting physician’s report before finishing the report (8 CCR 38(c)(1)). A QME may not obtain a consultation for an opinion on permanent disability or apportionment (8 CCR 32(b)). Labor Code 4663(d) requires a worker who claims an injury to disclose, on request, all earlier permanent disabilities or physical impairments.

Labor Code 4620(d) gives a worker who cannot communicate effectively with the examining doctor in English a qualified interpreter during the exam, paid by the employer or insurer on request. A provisionally certified interpreter is paid for only if the employer agreed in advance or the language is not one designated under Government Code 11435.40.

This page does not tell anyone what to say at an exam. Questions about your own evaluation belong with your attorney or, without one, a DWC Information and Assistance (I&A) officer.

What does the QME report cover, and when is it due?

The report must address every contested medical issue within the QME’s scope of practice and try to answer each question in the issue letters (8 CCR 35.5(c)). A report on permanent disability must address causation and include an apportionment finding (Labor Code 4663(b) and (c)). If the QME finds you permanent and stationary with permanent partial disability, the QME also completes form DWC-AD 10133.36 and serves it on the claims administrator with the report (8 CCR 35.5(c)(2)). The job displacement voucher depends on that form (Labor Code 4658.7).

The report is due 30 days after the exam (8 CCR 38(a)). The QME can get up to 30 more days for missing test results or a consultant’s report, or 15 days for good cause such as a medical emergency.

What are the QME deadlines?

Step	Deadline	Source
Object to the treating doctor’s report	20 days with an attorney, 30 without	LC 4062(a)
Request a panel (represented)	First working day at least 10 days after the objection is mailed	LC 4062.2(b)
Strike one name each	10 days	LC 4062.2(c); 8 CCR 30(b)
Tell the employer the appointment	10 days after the QME is selected	LC 4062.2(d)
Serve records before they go to the QME	At least 20 days ahead	8 CCR 35(c)
Object to non-medical records	10 days	8 CCR 35(d)
QME cannot schedule the exam	Replacement if the QME cannot schedule within 90 days of the first appointment request	8 CCR 31.5(a)(2)
Report served	30 days after the exam, plus any approved extension	8 CCR 38(a), (c)
Supplemental report	60 days after the request	8 CCR 38(i)

Source: Labor Code 4062 and 4062.2 (captured from leginfo October 8, 2026) and Title 8 regulations on dir.ca.gov, read October 8, 2026.

Who pays for the QME exam and the mileage?

The employer pays for each reasonable and necessary comprehensive medical-legal evaluation under Labor Code 4060, 4061 and 4062 (4064(a)). The worker’s own medical-legal expenses, the costs incurred to prove or disprove a contested claim, are reimbursed when reasonably, actually and necessarily incurred (Labor Code 4620(a), 4621(a)). For a worker without an attorney, the employer must pay the estimated travel expense once it has notice of the appointment (Labor Code 4062.1(c)).

Mileage is paid at the DWC rate for medical and medical-legal travel: 76 cents a mile for travel from July 1, 2026, and 72.5 cents from January 1, 2026 (DWC Newsline 2026-60; DWC benefits table). When the employer, its insurer, the administrative director, the appeals board or a judge requests the exam, Labor Code 4621(d) and 4600(e) add meals, lodging and one day of temporary disability for each day of wages lost. Mileage and tolls for those exams are paid when you are told the exam’s time and place.

What do people get wrong about QMEs?

“The QME is my new doctor.” A QME evaluates and does not treat. A panel doctor who is or has been your primary treating physician or a secondary physician for the disputed injury is replaced (8 CCR 31.5(a)(7)).

“I can ask for new names if I don’t like the panel.” Replacements are allowed only for reasons listed in 8 CCR 31.5, such as a doctor who cannot schedule the exam within 90 days, two doctors in the same group practice, or a move before the first exam.

“Missing a 10-day deadline is harmless.” It can hand the choice of the specialty, or of the doctor, to the other side (Labor Code 4062.1(b) and (c), 4062.2(c); Fact Sheet E).

Where does the Law Office of Jesse Melendrez fit in?

When we represent an injured worker, the attorney side of this process is our work: the objection, the online panel request, the strike, the records exchange and the review of the report. Jesse Melendrez (State Bar of California #263751, admitted 2009) limits his practice to California workers’ compensation and represents injured workers only.

This page explains the process. It is not legal advice about your exam or your claim.

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What should you read next?

• How the impairment number becomes a rating: What is a permanent disability rating?
• The benefit page: QME and medical evaluations
• When the dispute is a treatment request: Utilization review and independent medical review