How to Prepare for the Most Important Part of Your Workers’ Comp Case: The QME Exam
If you’ve filed a workers’ compensation claim in California, especially in a major hub like Los Angeles, one of the most critical moments in your case is the Qualified Medical Examiner (QME) exam. The outcome of this exam can shape everything—your disability rating, future medical care, wage loss payments, and ultimately, your settlement.
Here’s how to prepare for your QME exam to give yourself the best chance at a fair, accurate, and favorable evaluation.
1. Understand What a QME Exam Is
A QME, or Qualified Medical Examiner, is a physician appointed by the state of California to act as a neutral evaluator in workers’ compensation cases. When there's a disagreement about your injury, your employer’s insurance, or your benefits, a QME steps in to offer a medical opinion.
After each side strikes one doctor from a state-issued panel, you’re left with one remaining QME. That doctor becomes the evaluator—and their report will carry enormous weight in your case.
Important: QMEs are not truly neutral. Some lean toward injured workers; others favor insurance companies. That’s why preparing for your QME exam with a skilled workers’ comp attorney in Los Angeles is vital.
2. Review Your DWC-1 and Application for Adjudication
Before the exam, go back to the very beginning. Review the DWC-1 claim form and your Application for Adjudication—especially if your attorney filed them without you seeing the exact allegations.
Make sure you know what injuries and body parts were originally claimed. Even if something doesn’t hurt as much today, staying consistent with your original filings can help protect your credibility.
3. Review Your Medical Records (If You Can)
If your attorney allows, review your medical reports so far. Pay attention to:
What body parts have been treated
What diagnoses have been made
Whether any injuries have been missed or ignored
Sometimes industrial clinics rush injured workers through without proper documentation. The QME may rely heavily on these flawed reports if you’re not prepared to clarify your full injury history.
4. Write a List of All Medications You’re Taking
Before your QME exam, make a written list of all medications, supplements, and treatments you’re currently using. Include:
Prescription medications
Over-the-counter drugs (like ibuprofen or allergy meds)
Sleep aids or muscle relaxants
Supplements or herbal remedies
This helps the QME understand your pain management, potential side effects (like drowsiness or cognitive fog), and how your condition is being treated. Many injured workers forget this step—and it can be crucial for establishing how your injury affects your daily life.
Bring the list with you to the appointment or give it to the QME’s assistant when asked for your medical history.
5. Be On Time—No Exceptions
This exam was likely scheduled 90 to 120 days ago. If you're late or miss it, you may be forced to wait another 3–6 months to reschedule, delaying your case by a year.
Give yourself plenty of time for traffic and logistics. Arrive early.
6. Be Honest—But Don’t Minimize Anything
The most important advice: tell the truth.
If you’ve had past injuries, surgeries, or even previous workers’ comp claims—say so. Hiding them will hurt you. The QME will have access to prior medical records, and if they catch you omitting or lying, it can:
Reduce the value of your case
Destroy your credibility
Lead to denial of benefits
Your current work injury may have aggravated older injuries, and California law still allows compensation in many of those cases. Let your attorney argue the legal issues. Your job is to be truthful and thorough.
7. Tell the QME Everything That’s Bothering You
Many injured workers make the mistake of staying silent or toughing it out. Don’t. No complaint is too minor or trivial. Something minor now may develop into something serious later.
Be very clear about:
Which body parts are in pain
How the injury affects your daily life
Any symptoms you experience, including sleep, digestion, or mental health
Whether you use assistive devices (like a cane or brace)
For example, if shoulder motion causes pain, tell the doctor during range-of-motion testing. Much of your disability rating is based on what the doctor observes during this portion of the exam.
Warning: Don’t exaggerate. Insurance companies sometimes conduct surveillance. If you say you use a cane 24/7 and then they catch you walking without one, that footage may ruin your case.
8. Be Professional During the Exam
You’ll likely first speak with a medical assistant or nurse who gathers your history. The QME doctor may only spend 30–60 minutes with you, so make it count.
Be polite, respectful, and focused. Avoid confrontational language, and speak clearly about your experience. Doctors are human too—credibility, attitude, and presentation all matter.
9. What Happens After the QME Exam?
Under California law, the QME has 30 days to issue a report. The report usually covers:
Your official diagnosis
Whether you’ve reached Maximum Medical Improvement (MMI)
Whether you qualify for Temporary Disability (TD)
Your Permanent Disability rating
Any job restrictions or limitations
Your need for future medical care
Once your attorney receives the report, they should schedule a call to go over it with you and plan next steps.
10. Conclusion: Don’t Face the QME Alone—We Can Help
At Lee Partners Law, we’ve sat on the other side of these exams. As former defense attorneys, we know exactly how insurance companies use QME reports to minimize or deny claims. Now, we use that knowledge to empower injured workers—just like you.
We take the time to:
Help you prepare thoroughly for your QME
Ensure you understand what to expect
Make sure the QME has all the right documents
Protect your credibility and build your case from day one
If you're facing a QME exam in Los Angeles or anywhere in California, let us help you get it right.
David A. Lee and Michael Lee lead Lee Partners Law: The Injured Employee Attorneys—a dedicated California workers’ compensation firm that puts injured workers first.
Free Consult Call or Text us Today (310)295-0822
To learn more about the QME Process click here.