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Shortage of QME's may upset and delay settlement of disputed workers' compensation claims.

March 9, 2018

 The recent decrease in qualified medical evaluators may upset and delay the settlement of disputed workers' compensation claims in California. The California Workers Compensation Institute recently released a study which showed the number of qualified medical evaluators has decreased 20% between January 2012 and September 2017. 

 

An article published by Business Insurance states, "If you look at the average age of the people who do most of the medical legal evaluations, they are a lot of the baby boomers," said William Zachry, San Francisco-based senior fellow at the Sedgwick Institute. "Baby boomers are retiring or leaving the industry for various reasons as they get older. In California, there has always been a problem with getting good medical legal evaluations in the rural area ... that is one of the challenges that has been problematic for as long as there has been comp in California." 

 

Regardless of the reduced number of QME's, it is noted QME's are taking on more evaluations. While some express concerns that the decrease in QME's will have a definite impact on the time-frame to settle claims, others are waiting to see if the injured workers wait time increases before making a determination if these concerns are truly an issue.  

 

High-quality medical legal evaluations has been an ever present concern in the workers' compensation industry, especially pertaining to quality, timeliness and accuracy.  In addition, the strict QME selection process may increase frictional costs as a result of time delays in receiving evaluations and reports. 

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