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QME vs. AME in California Workers’ Compensation: What’s the Difference?
TL;DR: A QME and AME are both doctors who evaluate medical disputes in California workers’ compensation cases, but they are chosen differently. A QME is selected through the state's QME process, while an AME is a doctor both sides agree to use. Knowing the difference can help you understand what to expect and why the type of evaluation matters for your claim.
Table of Contents
 What Is a QME in Workers’ Compensation? What Is an AME in Workers’ Compensation? QME vs. AME: What’s the Difference? How the QME and AME Process Works How a Workers’ Compensation Attorney Can Help Frequently Asked Questions |
What Is a QME in Workers’ Compensation?
A qualified medical evaluator is a doctor who has been certified by California's Division of Workers' Compensation to evaluate injured workers when there is a medical dispute in a workers’ compensation case.
A QME may be asked to evaluate issues such as:
Whether an injury is related to your job The extent of your work-related injuries Whether you have reached maximum medical improvement Any permanent disability Work restrictions or future medical care
If the parties cannot agree about a medical issue, a QME evaluation may be part of the process used to obtain an independent medical opinion. The QME process has specific rules about how the doctor is selected and how the evaluation is conducted. That's one of the biggest differences between a QME workers’ compensation evaluation and an AME.
What Is an AME in Workers’ Compensation?
An agreed medical evaluator is a doctor that both sides agree to use to resolve a medical dispute. Instead of going through the QME panel process, the injured worker and the insurance company agree on a doctor. The doctor then evaluates the injured worker and provides an opinion about the disputed medical issues.
Because both sides have agreed to use that doctor, an AME can sometimes make the process more straightforward. However, agreeing to an AME also means giving up the QME panel-selection process for that particular evaluation.
That's why it's important to understand what you're agreeing to before scheduling an AME workers’ comp evaluation.
QME vs. AME: What's the Difference?
The biggest difference between QME vs. AME is how the doctor is chosen.
With a QME, the evaluator is selected through California's QME process. With an AME, both sides agree on the doctor.
Here's a simple way to think about it:
| QME | AME | |
| What it means | Qualified Medical Evaluator | Agreed Medical Evaluator |
| How the doctor is selected | Through the QME process | Both sides agree on the doctor |
| When it's used | When there is a disputed medical issue | When both sides agree to use an evaluator |
| Role | Provides an independent medical evaluation | Provides an agreed-upon medical evaluation |
Neither one is simply a routine appointment with your treating doctor. The purpose is to obtain an independent medical opinion about disputed issues in your workers’ compensation case.
How Does a QME Evaluation Work?
If you need a QME California evaluation, the process generally starts with a request for a QME panel. A panel provides a list of qualified doctors from which the evaluator is selected under California's workers’ compensation rules. The doctor reviews relevant medical information and examines you before preparing a report.
The QME report can address certain questions about your injury, including whether your condition is work-related, the extent of your impairment, and whether you have permanent restrictions or disability.
The QME isn't simply another doctor's appointment. What you tell the evaluator and what the medical examination shows can become part of the evidence used to resolve your claim.
QME vs. AME: Which One Will You Have?
Not every injured worker will go through both types of evaluations. If you and the insurance company agree on a doctor, an AME may be used. If you don't agree on a medical evaluator, the QME process may come into play. There can also be important decisions along the way, such as choosing the appropriate medical specialty for a QME panel.
For example, if your dispute involves a specific orthopedic injury, the evaluator's medical specialty can matter. You want the doctor evaluating the issue to have the appropriate background to address the medical questions involved.
This is one reason the difference between QME vs. AME isn't just about the name of the doctor. The process used to select the evaluator can play a key role in your case.
How a Workers’ Compensation Attorney Can Help
A QME or AME evaluation can have a significant impact on a workers’ compensation claim, particularly when the parties disagree about the extent or cause of an injury. At Yepremyan Law a North Hollywood workers’ compensation lawyer can help you understand what type of evaluation is being requested, review the issues being disputed, and prepare you for the process.
Your attorney can also review a QME or AME report and determine whether it raises concerns or needs to be challenged. Understanding the process before you walk into the doctor's office can make a big difference. You should know what the evaluation is for, what medical issues are being disputed, and how the resulting report may affect your claim.
If you have questions or need legal advice, our injury law firm in North Hollywood is just a phone call away. Since 1998, we've helped thousands of clients recover millions of dollars. Call us today to schedule a free case evaluation with a personal injury attorney in Studio City or North Hollywood who can help.
Frequently Asked Questions
Who chooses the QME in a California workers’ compensation case?
The QME is selected through California's QME panel process. The specific steps for requesting and selecting a panel depend on the circumstances of the workers’ compensation dispute. Your attorney can help you understand the process and applicable deadlines.
Can the insurance company choose my QME?
Not necessarily. The QME process has specific rules for requesting and selecting a panel and evaluator. The insurance company does not simply get to choose any doctor it wants to evaluate you.
Can I choose the medical specialty for my QME panel?
The appropriate medical specialty depends on the medical issue being evaluated. California's QME process includes rules regarding the specialty of the evaluator, so it's important to make sure the panel requested is appropriate for the dispute involved in your case.
How can a workers’ compensation attorney help with a QME or AME evaluation?
An attorney can explain whether a QME or AME evaluation is appropriate, help with the selection process, prepare you for the evaluation, and review the resulting medical report. If the report contains significant problems or doesn't accurately address your condition, your attorney can also explain what options may be available.
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