What Is a Panel Qualified Medical Evaluator?

What Is a Panel Qualified Medical Evaluator?

A Panel Qualified Medical Evaluator (PQME) is a doctor who is supposed to be neutral. He’s not the employer’s doctor and he’s not the injured workers doctor, he is neutral and supposed to be fair.

Before there were PQME doctors, opposing parties had their own medical professionals. As you can imagine, this led to numerous expensive and lengthy court appearances. A judge was forced to decide which doctor was the most reliable and accurate in expressing their medical opinion. Judges typically don’t like to make medical decisions.

Under today’s system, the PQME is supposed to remove medical uncertainty. However, it is not guaranteed that a judge is automatically going to follow what the PQME says. The law provides that a treating physician’s report is just as admissible in court as the PQME report. However, in the “real world,” judges usually follow the PQME’s opinion, unless one side or the other can poke holes in it so as to render it “not substantial medical evidence.” When that occurs, the judge may strike the report or send it back to the PQME for revision or choose to follow the primary treating physician’s findings and opinions. Sometimes, the parties agree to forego the PQME process by simply agreeing with the primary treating physician’s findings.

Another possible outcome (besides settling a claim based on the findings of the PQME or primary treating physician) is that the parties decide to go outside the PQME system and agree to a doctor they both have confidence in. This person is called the Agreed Upon Medical Examiner (AME) who essentially serves in the same capacity as a PQME. However, the findings of an AME are much harder to challenge.

To learn more about settling work injury claims work or to enlist the help of a Santa Clarita workers’ compensation attorney, please contact us online or call (661) 771-3004.

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