Do I Need to See a Qualified Medical Examiner?


Many injured workers contact the Law Offices of Marc Francis, serving injured workers in Santa Rosa, Sonoma County, and the greater north bay area, to ask whether they should be examined by a Qualified Medical Examiner before proceeding with settlement of their work injury case. For a number of reasons, the answer is usually “yes” and it is advisable to consult with a specialist in workers compensation law before doing so.

Often the insurance company will send a letter to the injured worker offering a small settlement based on the brief “check-the-box” reports from the industrial clinic that treated the worker for the work injury. These reports are usually inadequate because they often do not fully address all of the parts of the body or body systems that were injured, they often understate or simply leave out many the problems the injured worker is experiencing, and they commonly do not fully describe needed future medical treatment.

If you were treated for your work injury by a clinic controlled by the insurance company the chances are that the parts of your body treated by the clinic were only those parts approved by the insurance adjuster and that other body parts injured in the work injury, or other parts that become problematic after the initial injury by compensating for the injured part (for example you injured your right shoulder and now the left shoulder is a problem from using the one side to compensate for the originally-injured other side) have not been fully addressed in the clinic reports.

Many times, in work injuries the emergency room or industrial clinic treats the “most serious problem” (such as a broken bone or open wound) and defers treatment of other injured parts causing pain (such as a back or knee) that were also hurt in the work injury. A typical example is where someone falls from a ladder or roof, breaking a leg. The medical treatment facility will often repair the broken leg but fail to make note of or provide treatment for other patient complaints. These other injured body parts can become symptomatic once the initial pain medicine wears off, but if the other injured parts were not discussed by the emergency room or industrial clinic the insurance company will not provide benefits for those body parts in a settlement.

An examination with a Qualified Medical Examiner, who is a specialist licensed by the State of California to perform workers compensation disability and medical treatment assessments, can be of great benefit in ensuring that all injured body parts and systems are evaluated before settlement or trial of your case. The preparation of your case before seeing the Qualified Medical Evaluator is very important in obtaining a complete and thorough report from that physician. The Qualified Medical examination process can be complicated and confusing, beginning with the selection of the proper specialist.

At the Law Offices of Marc Francis, serving injured workers in Santa Rosa, Sonoma County and the greater north bay area, we can help with the selection of the examining physician and preparation of your case before it is submitted to the medical examiner. Please call us today for a free consultation.

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