What Happens If Both Parties Can’t Agree on a QME?
In represented California workers’-comp cases, the applicant’s attorney and the defense attorney first try to select an Agreed Medical Evaluator (AME). An AME’s opinion is usually final and carries significant weight. But negotiations sometimes stall—perhaps the parties can’t agree on a specialty, or one side vetoes every proposed name. When impasse occurs, the system defaults to the panel QME process, guaranteeing that the dispute still moves forward on a fixed timetable.
Step-by-Step When Agreement Fails
- Document the Impasse. After at least 10 calendar days of written proposals (CCP-compliant correspondence), either party may declare that agreement is unlikely.
- File QME Form 106. The party declaring impasse completes “Request for QME Panel—Represented Case” (Form 106) and submits it to the Division of Workers’ Compensation (DWC) Medical Unit. The form asks for the injured worker’s basic data, requested specialty, and proof that an attempt to obtain an AME was made.
- DWC Issues a Three-Doctor Panel. Within days, the Medical Unit emails and mails a Panel Assignment Letter listing three randomly selected QMEs in the requested specialty and geographical area.
- Each Side Strikes One Name. • Applicant has 10 days to strike one doctor.
• Defense has the next 10 days to strike one of the remaining two.
The physician left after both strikes becomes the panel QME. - QME Must Offer an Appointment. The chosen doctor has 60 days to offer an examination date; failure to do so can trigger a replacement panel.
Why The Panel System Works
Random selection prevents “doctor shopping” and keeps the process moving even when negotiations break down. Both sides still have some control through the strike mechanism, but neither can unilaterally derail the evaluation.
Practical Tips
• Choose the right specialty at the outset: The Medical Unit rarely grants specialty changes after issuing a panel.
• Watch your deadlines: Missing the 10-day strike window means you accept whatever doctor the other side leaves.
• Communicate professionally: Email chains showing reasonable attempts to agree on an AME help if a replacement panel is later contested.
For official forms, deadlines, and FAQs, visit the DWC’s “Represented Panel QME” page.