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In certain workers’ compensation cases, you will require an examination by either a qualified medical evaluator (QME) or an agreed medical evaluator (AME). As an employee, it’s better to have an AME assigned to you. However, to obtain an AME’s opinion, you first need to acquire legal counsel. If you don’t have a workers’ compensation attorney, a QME will be assigned to your claim.Once you have your legal representative and an AME, you must know how to handle your evaluation. This means keeping valuable tips in mind, such as telling the truth, being prepared, taking notes, and keeping an even demeanor throughout the process. Your attorney can provide more tips to help you plan for your evaluation and help ensure that your AME examination results in the workers’ compensation benefits you deserve.
Tips for Handling an AME
When meeting with an AME, you must be cooperative. That does not mean giving in to things that are not true; it just simply means showing them respect within reason. Evaluators should provide their expert opinion without interference from outside forces, but they are human, and acting positively towards them can benefit you.
Be Prepared
Preparation entails a few different elements. First, be on time. If you are late for your appointment or you do not show up at all, your AME, as well as the judge who will be ruling on your claim, could view that negatively.
Additionally, if you are asked to bring documentation or medical records, make sure you do. You may also be asked to provide medical history from before your injury. This is not a way to lessen your claim; it should strengthen it. By looking at your past medical records, an AME can determine that you were undoubtedly injured at work.
Tell the Truth
You may be tempted to leave out details that could ultimately result in a ruling against you. If so, refrain. If you are asked to provide your medical history, be honest about any previous illnesses, injuries, or concerns that could have affected your current situation.
If you do not tell the truth, you are giving the judge and your employer’s insurance company reason to doubt your story, which could result in a denial of benefits.
Do Not Be Defensive
Remember, everyone is trying to figure out exactly how your injury occurred. With an AME, you will see a medical professional that your legal representative is confident in you visiting. This AME will not have an ulterior motive or try to prevent you from obtaining the benefits you deserve.
Be polite and answer any questions the AME may have for you. Be thorough and explain everything as best you can without being confrontational.
Take Notes
Do not be afraid to take notes. It is your financial situation at risk, and you will undoubtedly have questions for your attorney after your visit with your AME. By taking notes, you can ensure you can adequately explain your concerns to your attorney. This will allow them to better assist you.
What Is an AME?
For an AME to be assigned to your workers’ compensation case, your attorney and your employer’s insurance company must agree upon a physician. This physician could be anyone as long as both parties agree their opinion and determination would prove sufficient in resolving any outstanding matters.
How Does an AME Differ From a QME?
AMEs and QMEs have all the same qualifications, but how they are chosen is different. The California Division of Workers’ Compensation (DWC) assigns a QME to a case. Parties will still have some say in the evaluator assigned to their case, as the DWC will provide three different eligible medical professionals to the case. Each party will then be able to omit one of the three names.
An AME can be any doctor specializing in a field related to your injury. For example, if you suffered damage to your teeth during a work accident, your choice of the QME for your case would be between three dentists or orthodontists the Department of Workers’ Compensation Medical Unit chooses. However, an AME could be any dentist or orthodontist that both parties agree can sufficiently review the injury.
Benefits of an AME
An AME can be a doctor you trust entirely. This does not mean your primary care physician will be named your AME. Your employer’s representative may not agree to have you evaluated by someone you are so close with. However, an AME is often someone who you at least have some form of relationship with.
Because both parties agree upon an AME, a judge takes their decision much more seriously. A QME’s opinion will still be considered when determining benefits, but an AME’s opinion could help close the case faster and ultimately help you get paid.
A Workers’ Compensation Lawyer Can Support You Throughout Your Case
Choosing an AME and preparing for an evaluation are just two of the many ways a workers’ compensation attorney may assist you. They can manage all aspects of your case for you, such as:
- Gathering evidence
- Filing your claim
- Fighting denials and filing appeals
- Meeting deadlines
- Assessing your benefits
- Talking to involved parties
- Representing you during all proceedings
- Negotiating a settlement
They can provide these services for you on a no-win, no-fee basis.
Contact KJT Law Group for Help With Your Workers’ Compensation Claim Today
If you need the assistance of a medical evaluator, contact KJT Law Group so that we can help you obtain an AME rather than a QME. We will be able to help you choose a physician, speak with your employer’s representative to reach an agreement on a physician, and ultimately, help you prepare for your evaluation.
Do not take chances when it is your financial future on the line. Contact or call us today at (818) 507-8525 so we can handle your workers’ compensation case.
