Qualified Medical Examinations (QME)
In workers compensation and other medical legal situations, an independent medical opinion can be critical. TruVida Health offers Qualified Medical Examinations and related medical legal evaluations to help clarify diagnoses, work relatedness, and functional capacity.
What is a Qualified Medical Examination?
In California workers compensation cases, a Qualified Medical Evaluation is an independent medical exam used when there is a dispute about diagnosis, treatment, or disability. A Qualified Medical Evaluator is a licensed physician authorized to provide an impartial opinion and a detailed report that can influence benefit decisions.
While terminology and specific legal requirements come from the Division of Workers Compensation, the core idea is consistent: the examiner is not your treating doctor, but a neutral evaluator.
When A Qualified Medical Examination May Be Requested
Qualified medical or independent examinations may be requested to help answer questions such as:
Is the condition related to work or another cause?
Has the injury reached maximum medical improvement (MMI)?
What is the degree of permanent impairment or functional limitation?
What ongoing medical care is reasonable and necessary?
Employers, insurers, attorneys, or sometimes patients may be involved in requesting an evaluation, depending on the case.
What To Expect At TruVida Health
Step 1: Record review
Detailed review of prior medical records, imaging, and test results
Step 2: History & Examination
Structured interview about your symptoms, work duties, and medical history. Physical examination focused on the issues in dispute.
Step 3: Additional testing If Indicated
Ordering of labs or imaging when needed to clarify the diagnosis.
Step 4: Medical Legal Report
Comprehensive written report answering the specific questions posed in the referral. Objective findings, diagnoses, and opinions supported by medical evidence.
Important Distinctions
- The examiner’s role is to provide an objective opinion, not to act as your primary treating physician.
- Recommendations are made within the context of relevant laws and guidelines.
- You should continue to follow up with your own treating clinicians for ongoing care.