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QME Process for workers compensation

San Francisco, CA |

Are the P QME paid a based rate even if you have buckets and buckets of medical reports?

Attorney Answers 5


  1. Best answer

    PQMEs charge based on the amount of time it takes for them to review records in addition to their other services.


  2. A PQME can charge for review of the medical records.


  3. In my state the IME drs do not receive a lot of money for the exam and review of records so if they have a chance to charge extra for review of a thick packet of medical records they frequently do so. Mr Borah would know if that occurs in your state, however don't be surprised if that is what happens given your description of the amount of records in your case.

    If this information has been helpful, please indicate by providing feedback that the answer was either "helpful" or "best answer" as appropriate. Legal Disclaimer: Mr. Connell is a Colorado attorney licensed in only that state. The response herein is not legal advice and does not create an attorney/client relationship. The response is in the form of legal education and is intended to provide general information about the matter within the question.


  4. Depending on the amount of time the doctor spends with you and on the records, there are different codes the doctor will bill under. When there an examination is considered complex, they bill strictly by time. If you are curious on the amounts, you can see this code: https://www.dir.ca.gov/t8/9795.html

    Disclaimers: Making a false or fraudulent workers compensation claim is a felony subject to up to 5 years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine. Each case is pursued differently based on its own merits. As such, there is no guarantee as to the outcome of any case. No attorney/client relationship will be established by contact with this AVVO communication or any messages or emails from Silberman and Lam, LLP. An attorney/client relationship will begin only when a retainer has been signed.


  5. The doctor is generally paid based upon the amount of time put into the evaluation. An extensive medical record review costs more, but may be critical to a thorough report that covers all the issues needed to be addressed in your case.

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