Whether or not you live in California, you probably have seen colleagues travel some distance for QME exams and question whether QMEs pay well enough to justify the commute. With nearly one eighth of the US population, the number of injured workers throughout the state far exceeds any other state. There are 18.5 million people in the greater Los Angeles area alone, with the greatest number of Workers’ Compensation claims and highest concentration of industrial jobs throughout California.
Heavy concentrations of manual labor are underserved by Orthopaedic QMEs. Areas with new or established claims include construction, manufacturing, healthcare, transportation, farming, and animal production. With 23,000 different manufacturers and over a million industrial workers, California holds the distinction of being the largest manufacturing state in the US. Some of the largest industrial areas within California include Los Angeles, the Central Valley, and the Bay Area, where the greatest number of injured workers in the state reside. For QMEs who live in San Diego, the Central Coast, or more remote parts of California with a smaller industrial population, conducting QME evaluations in the busier areas will bring significantly greater income.
California’s Workers’ Compensation system prioritizes protecting injured workers, and therefore spends nearly $1B on forensic evaluations annually; it boasts some of the highest reimbursement rates for QMEs in the nation, exceeding other state fee schedules by more than eight times. For reference, the most recent fee schedule change in California in 2021 increased the reimbursement of comprehensive medical-legal evaluations up to $2,015, which includes a record review of up to 200 pages. By comparison, a similar examination in Nevada bills $950, Wyoming $750, Washington $712, and Texas (a state not known for its social services) $300. In Arizona, physicians are only compensated $150 for an hour of testimony related to Workers’ Compensation claims. Traveling quarterly from out of state to perform QMEs in California more than justifies the time and financial expense.
A number of OQME physicians travel from out of state to use our management services, and many more travel within the state, with driving commutes up to 90 minutes or weekend trips to high volume areas. Becoming a QME does require a California Medical License, which can take about six months to apply for. Our CEO and founder lists locations in Northern and Southern California, as do many of the other physicians. “I love my Napa work trips,” she tells me. “I go a few times a year with a Thursday in Fairfield, a Friday in Vallejo, and then I relax in Napa for the weekend.” By doing so, she has been able to increase her QME volume without an additional weekday commute.
By only working in a small radius, a QME is severely limiting their ancillary income. The opportunity in California is enormous for growth of a medicolegal practice and unparalleled in any other state. Considering the income opportunity of a full day of evaluations, an extra half hour on the road or a weekend away will greatly outweigh most other earning opportunities for Orthopaedic Surgeons. One report may exceed the income from a weekend on call without taking on any medical liability. Perhaps a little time behind the wheel is looking a little more appealing.
