Who Pays the QME in California Workers’ Compensation Cases?
The workers’ compensation insurance carrier—or self-insured employer—ultimately pays the Qualified Medical Evaluator (QME) for comprehensive evaluations, supplemental reports, and most deposition testimony. In practice, the entity that issues payment is the claims administrator handling the injured worker’s file. Below is a concise guide to responsibility in both unrepresented and represented claims.
Unrepresented Cases (Panel QME)
When neither party has an attorney and a QME panel is issued, the employer/insurer pays 100 % of the evaluation fee (ML200). The QME invoices the claims administrator directly; payment is due within 60 days of service under Labor Code §4622.
Represented Cases (Panel QME)
Even when both sides have attorneys, the claims administrator still bears primary responsibility for medical-legal costs. The party that requested the panel may advance payment, but Labor Code §4621 requires the employer to reimburse reasonable, necessary expenses if the injured worker’s claim prevails.
Agreed Medical Evaluator (AME)
Because an AME is chosen jointly, the parties often split the cost by agreement—50/50 or proportional to settlement—but the default position under §4620 is that the employer reimburses the employee’s share at the end of the case.
Deposition Fees
For depositions, California Labor Code §5710 places the obligation on the party requesting the testimony. If the defense attorney notices your deposition, the insurer pays the $325/hour ML400 fee; if the applicant’s attorney notices, the applicant’s counsel advances the fee and later seeks reimbursement from the carrier.
Missed-Appointment Fees (ML203)
The claims administrator also pays the $503 ML203 fee when the worker fails to appear or cancels late—regardless of which party requested the QME.
Billing Workflow
- Serve the report and invoice on all parties and the claims administrator.
- The claims administrator remits within 60 days (or 20 days for deposition fees in some cases).
- If payment is late, add the 10 % penalty and interest allowed by Labor Code §4622.
For the official rules governing payment responsibility, see Labor Code §§4620–4622 and the Medical-Legal Fee Schedule in CCR §9795.