What Is the Panel QME Process in California Workers’ Compensation?
The panel QME process is the state-mandated method for selecting a neutral Qualified Medical Evaluator when the parties cannot agree on an Agreed Medical Evaluator (AME). It ensures that injured workers and employers each receive a fair, unbiased opinion on medical causation, permanent impairment, apportionment, and future care.
1. Initiating the Panel Request
- Unrepresented Injured Worker
• Either the worker or claims administrator submits QME Form 105 (“Request for QME Panel – Unrepresented”).
• Filed electronically or by mail with the DWC Medical Unit. - Represented Worker
• The parties first try to agree on an AME.
• If no agreement within 10 days, either side files QME Form 106 (“Represented”) to request a panel.
2. Panel Issuance
The DWC Medical Unit randomly selects three QMEs from its statewide database, matching the requested specialty and geographic proximity (typically within 30 miles of the worker’s ZIP code). The Panel Assignment Letter lists:
- Three physician names, specialties, addresses, phone numbers
- Response instructions and timelines
- Deadline for striking a doctor
3. Striking and Selection
- Unrepresented cases: The worker has 10 calendar days to strike one name; the remaining two are then struck by the claims administrator. The last name standing becomes the QME.
- Represented cases: Each side has 10 calendar days to strike one name. The doctor left after both strikes is the QME.
4. Scheduling the Examination
Once selected, the QME must offer an exam date within 60 days of receiving notice. If the physician cannot meet this window—and no extension is agreed upon—the parties may petition for a replacement panel.
5. Post-Exam Deadlines
- Comprehensive medical-legal report due within 30 days of the examination (CCR §38).
- Late reports are subject to fee reductions or panel replacement.
6. Replacement Panels
Grounds for replacement include specialty mismatch, office more than 30 miles away, conflicts of interest, or the QME’s inability to schedule timely. File Form 31.5 within 16 days of discovering the issue.
Key Takeaways
- Use Form 105 (unrepresented) or Form 106 (represented) to start the process.
- Deadlines are tight—10 days for strikes, 60 days to schedule, 30 days to report.
- Late scheduling or reporting can cost the QME the case—and fee.
Download the official forms and detailed instructions on the DWC’s Panel QME Process page.