Perhaps you’ve heard from a friend or colleague about QME work and are interested in getting started. This is potentially life-changing work for the new Orthopaedic Surgeon or the Orthopaedic Surgeon finding that reimbursements are declining from year to year with the need for additional supplemental income. It is also great for Orthopaedic Surgeons who want to transition to a less clinical practice for various reasons—family, retirement, and quality of life.
You have found a great solution to the gap between declining clinical reimbursements and rising costs of running a practice that we’ve seen for over 20 years now. The reason that QME work is so well-suited to Orthopaedic Surgeons is that QME work is Orthopaedic work. Think about that again. Litigated workers compensation cases are largely musculoskeletal injuries. Approximately 60% of QME panels are specific requests for Orthopaedic Surgeons, including General, Spine, and Hand. The next largest cohorts are Chiropractic and Pain Management, and Psychiatry. Most of the other specialties (ENT, GI, Internal Medicine) each comprise only 1-2% of QME work. There is plenty of work for an Orthopaedic Surgeon, and plenty of opportunity for an Orthopaedic Surgeon to use his or her expertise. Litigated Workers Compensation claims require the unbiased testimony of a musculoskeletal specialist to determine factors required for treatment and settlement.
Becoming a QME is a lengthy process and worth starting as early as possible; you will thank yourself later. Starting the process requires a California Medical license, first and foremost. This can take up to six months and starting this process early is essential. Those living and practicing in California fortunately will have this already. The second requirement is taking a mandatory report-writing course. We have negotiated a discount for a report-writing course. The course is 8 hours of didactics with four hours dedicated to completing a sample report afterwards.
When should I apply?
Apply as soon as you can. The application process is not time-consuming for the physician but is a lengthy process for the DWC. The examination to become a QME is only offered twice a year in April and October and registration must be completed one month in advance.
Tell me about the examination.
The examination to be a QME is focused on the laws surrounding QME work—deadlines, case law, and requirements. There are many courses and study guides to get you through the examination. It does take about two weeks of study in the evenings as there’s quite a bit of memorization. The exam is done over a week time frame at a Pearson VUE testing center.
When should I start?
We strongly encourage all orthopaedic surgeons to start as early as possible. Getting the exam behind you and starting to earn ancillary income are two major benefits of starting early. You do not need your board certification to do this work. This is a common misconception. You can begin your first year in practice to help allay the start-up costs of a practice.
Which specialties should I register for?
The State of California only recognizes specialties that have their own Board Certification (though Board Certification is not required to practice as a QME). Orthopaedic Surgeons of any specialty may register for General Orthopaedics and Spine Surgery. Spine cases are already included in General Orthopaedics, and your volume will be higher by signing up for both. Therefore, Orthopaedic Surgeons of any specialty AND Spine Surgeons should sign up for both. Board Certified Hand Surgeons may also sign up for hand. It seems that in the past, just a hand fellowship was necessary for Hand, but the DWC lately has required the Hand Boards to register.
If you are a Plastic Surgery hand surgeon and wish to opt into craniofacial or other Plastics related fields, please discuss this with us further. These have rare needs for QMEs but very few Plastic Surgeons do the work, so you could see an increase in volume.
What is the ideal timeline?
If you complete everything as quickly as possible, here is an ideal timeline for the Spring and Fall exams. You can see why it is so critical to keep up with the paperwork in order to begin the work as soon as possible. It takes about nine months from registration to the first paycheck even completing the paperwork as quickly as possible.
Spring Exam:
March: Registration due
April: Examination
May: Exam scores released
June: Registration of sites
July-August: Listed on DWC website; will begin to receive requests
October-November: First evaluations completed
November-December: First reports due; expect paycheck 2-3 months later.
Fall Exam:
September: Registration due
October: Examination
November: Exam scores released
December: Registration of sites (often delays at the DWC around the holidays; expect this to take longer than the usual 30 days)
January-March: Listed on DWC website; will begin to receive requests
April-July: First evaluations completed
June-August: First reports due; expect paycheck 2-3 months later