Legal Question in Workers Comp in California

what happens after a supplimentary qme report is issued and the opinion of selected doctor is different than the actual facts of the injured worker. Surgery performed for injury. One qme,s opinion does not constitute reality. 1 in person encounter cannot determine entire outcome? a seperate orthopedic doctor assesed the same infomation and offered an additional solutioon for the pain and performed the well known possible surgery cure to releive problem and with great percesion and it worked. An opinionated stranger expressed only his absolute opinion which was unfortunetly absolutly wrong. Patient is happy and almost completely free of total limp numbness everyday. That in itself shows the opinion of 1 is only that of 1. and not proven facts but opinions.

Asked on 4/11/22, 9:22 am

2 Answers from Attorneys


You can take the QME report to your treating doctor and ask him to review and issue a rebuttal report. If your case goes to trial, you will have a second opinion from your treating doctor and the judge has to decide between the findings of QME report or your treating doctor reports. If you need assistance and representation, please call me at 213-388-7070.

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Answered on 4/11/22, 11:26 am
Nancy Wallace Nancy Wallace Atty at Law

YES just 1 one-person encounter can determine THE ENTIRE OUTCOME of a case.

THE WCAB JUDGE CAN ONLY DECIDE ON TWO REPORTS: (1) The QME report or (2) the Primary Treating PHysician's report, and the PTP must be on the insurer's Medical Provider Network. The Judge cannot and will not decide on the Injured worker's testimony or observations.

So if the plan is to prove the QME Opinion wrong, the Treating Physician must be the one to do it.

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Answered on 4/12/22, 6:17 pm

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