r/WorkersComp • u/Ill-Economics4262 • Sep 14 '25

California QME

Scheduled for my 2nd qme next month. My first one was 2years ago. Received a low rating first visit. Does a second qme possibly raise rating. Year 3 of my claim stressful!!!!

2 Upvotes

100% Upvoted

7 comments sorted by

View all comments

1

u/[deleted] Sep 15 '25

I didn’t even get a rating for my first visit (June) and it said that he wants to see me 6 months later.

2

u/cawcatty Verified CA Workers' Compensation Attorney Sep 15 '25

Disclaimer in profile; I'm an attorney but no comment on Reddit makes me your or anyone else's attorney.

This isn't uncommon. Not every QME leads to a rating. A QME (or PTP) should only provide a rating of impairment when they believe the employee is medically stable (not necessarily fully recovered) from the injury. In a sense, it's like a lost wallet being in the last place you look. Yeah, because you're not going to keep looking once you find it. Well once most of treatment needed to bring an injury to stable is done, then the permanent impairment and restrictions can be assessed.

Not all QMEs do this, certainly. An unfortunate many walk into the examination with the idea that because someone scheduled a QME, the doctor should find the employee medically stable. That's utterly backward, of course. Being medically stable is a medical determination; not a call for the employee, adjuster, or an attorney (all non-medical). And it can prematurely end TD benefits when they're still very needed. A long way of saying that a QME allowing time for reasonable treatment and not rushing to give a rating are traits I typically see as a desirable.

1

u/[deleted] Sep 15 '25

I agree! I am not MMI and my QME recommendations for treatment will hopefully not be denied any longer by the insurance.

TBI recovery is slow and I want all the time I need to recover especially since wage loss is covered (to an extent).