Being a Qualified Medical Evaluator (QME) in California requires continuing education and requalification to remain current and proficient for medicolegal work. An active California medical license, continuing education credits, and reappointment are required to maintain a QME qualification in California.
Continuing Medical Education:
QMEs are required to complete 12 hours of continuing medical education (CME) accredited by the Department of Workers’ Compensation (DWC) within the prior 24 months. Successfully completing the QME examination qualifies for 6 hours of CME, applicable to the initial appointment, but 6 additional hours are required for reappointment after two years. Credit can be obtained through professional conferences and seminars either in-person or online, and are of varied value. The annual California Orthopaedic Association meeting which will be held at Coronado Island in May 2024, offers a full day of valuable QME education with guest speakers including Workers’ Compensation officials, judges, attorneys, and QME/AMEs that completes the two-year requirement for continuing education. Additionally, this meeting also fulfills the requirements for education in pain management and fluoroscopy, both required by the State of California. We recommend that all OrthoLegal physicians attend this conference for both the networking and the education.
QME Location Listing Renewal:
QMEs must renew their locations annually and submit the annual fees for relisting. Working with a good management company streamlines this process, ensuring seamless and punctual renewal.
Compliance with QME Regulations:
Adherence to regulations and guidelines set forth by the DWC is paramount for QMEs. Conducting evaluations impartially, maintaining confidentiality, and following ethical standards are non-negotiable. Violations of DWC rules and regulations can lead to disciplinary action, including license suspension.
Record-Keeping:
Maintaining meticulous records of evaluations, reports, and communications within your practice is obligatory for QMEs. These records must align with state regulations and remain subject to audit by the DWC. A QME must retain a copy of all comprehensive medical-legal reports that they have completed for a period of five years from the date of each evaluation report. This five-year regulation is also applicable to applicant medical records and claim files based on the date of injury or from the date on which the last provision of compensation benefits occurred, whichever is later.
Diligent record-keeping facilitated by experienced case managers fosters transparency and accountability within your practice.
Reappointment:
A current California Medical License must be maintained with all of its requisite reporting and CME. In addition, any complaints or actions against the medical license must be disclosed to the DWC during reappointment.
QMEs may apply to be reappointed every two years, requiring payment of the annual fee, 12 hours of continuing education, and application for reappointment. For the first reappointment, the QME qualifying examination may count towards the total if it was completed in the prior two years. Maintaining a QME license in California requires ongoing education, regulatory compliance, meticulous record-keeping, and continuous professional development. By fulfilling these requirements and remaining proactive in your practice, you can ensure the continued validity of your license and uphold the highest standards of quality and integrity in your evaluations.
