FAQ
Frequently Asked Questions by Categories
Attorneys
Is CME a referral service?
CME is not a referral service or an expert database. CME is a practice management company that provides attorneys, insurers, employers and agencies access to our panel of highly qualified medical experts. For our CME panelists, who have busy, active practices, we provide administrative support for all aspects of their med-legal work.
Does CME work with both plaintiff and defense firms?
Yes, CME works with both plaintiff and defense attorneys throughout California.
Does CME have medical experts in all specialties?
Yes, CME works with physicians in all specialties throughout California. If CME does not have a particular specialty in the geographic region needed, CME’s consultants will find one.
What types of services does CME offer attorneys?
CME provides attorneys with access to our network of excellent, board-certified physicians for medical-legal services in a variety of matters. CME’s physicians regularly conduct initial case assessments (to determine the viability of a claim), record reviews, QMEs, AMEs, IMEs, and FFDEs. Our physicians may also be retained as expert witnesses specifically to testify at trial.
Doctors
I am new to medical-legal work. Does CME offer any assistance with report writing and/or training?
Yes. CME offers our doctors a report writing consulting program. Our medical-legal consultants have extensive experience in the workers’ compensation industry and are certified workers compensation professionals. CME has collaborated with QME, AME and IME physicians on thousands of reports regarding all facets of reporting including:
- Preparing for the evaluation including record review
- Report templating
- Report compilation
- Impairment Ratings
- Causation
- Apportionment
- P+S Status
- Temporary and Permanent Disability
- Future Medical Treatment
- Deposition Preparation
Panelists give high ratings to the CME medical assistants, staff and practice managers who support them in their med-legal practices.
When I am at an evaluation, do I have anyone assisting me that day?
Yes. When you conduct an evaluation through CME at one of CME’s offices, we will provide a medical assistant to help you on-site.
What type of insurance coverage do I need to perform medical-legal evaluations?
CME requires that our doctors carry both medical malpractice and errors & omissions coverage. It is important for doctors to determine whether their current medical malpractice policy covers medical-legal evaluations (most do not). Doctors may carry their own coverage or opt to be covered under CME’s policy.
How many cases/evaluations will I get through CME?
There are many variables that determine the volume of cases a doctor will get. Some of those variables include specialty, location, availability, and type of evaluation. When you set up an initial consultation with CME, the volume of cases/evaluations will be assessed and discussed based on statistics involving these variables. It also depends on how much time you wish to devote to med-legal work.
Where are CME’s offices? Are they equipped for psychological and medical evaluations?
CME has over 150 office locations throughout California that are equipped for both psychological and medical evaluations.
Where are the medical-legal evaluations performed?
Workers’ Compensation Evaluations (QMEs) are performed in the designated CME offices where the doctor is listed (per state regulation). When a doctor signs up with CME, there will be an initial consultation in which the doctor and trained CME staff can discuss locations. Independent Medical Evaluations can be performed in either the doctor’s own office or any one of CME’s offices. Pursuant to California law, an IME must take place within 75 miles of a plaintiff’s residence. Accordingly, the location may be dictated by geographic restrictions.
What types of services does CME provide to doctors?
CME is a full service medical-legal practice management company dedicated to providing our doctors with all the administrative support they need to run a successful med-legal practice. Our services include:
- Scheduling & calendaring of evaluations
- On-site medical assistant for evaluations
- Review of your performance, billings and progress with a practice manager
- Document management
- Handling of retention agreements (applicable to medical experts)
- Correspondence with state agencies (applicable to QMEs)
- Large network of medical offices
- Billing & collections
- Dictation services
- Transcriptions
- Report writing consulting and review
- Report quality assurance program
- Marketing of your services where appropriate
- Full insurance coverage (medical malpractice and errors & omissions)
Employers
Are CME’s doctors trained to do employee evaluations?
Yes. CME provides training for physicians performing employee psychological and medical evaluations to ensure that employers receive a thorough and applicable medical opinion and report.
What if I don’t know what type of doctor I need?
CME will provide you with a complimentary phone consultation to help you determine what type of physician you need.
Does CME have doctors in all specialties?
Yes, CME has board-certified physicians in all specialties throughout California.
What services does CME provide to employers?
CME provides complimentary consultations with employers to determine the type of service they need as well as the specialty of doctor that will be required to perform the service. CME’s board-certified physicians perform employee medical evaluations, employee psychological evaluations, fitness for duty evaluations, “direct threat” psychological evaluations, disability evaluations and job applicant screening. CME can also provide employers with customized risk management and applicant screening and personality testing programs.
Fitness for Duty Evaluation
What’s the difference between a restriction and an accommodation and what should be included in my report?
An accommodation is assistance or changes to a position or workplace that will enable an employee to do his or her job despite having a disability. Under the Americans with Disabilities Act, employers are required to provide reasonable accommodations to qualified employees with disabilities, unless doing so would pose an undue hardship. Whether to provide an accommodation (and whether the accommodation is reasonable) are legal determinations that are outside the scope of your opinion as an FFDE doctor.
When drafting your FFDE Report, you should provide information about medical restrictions that you believe are necessary for the employee to perform his/her job given the employee’s medical/psychological condition. For example, if you believe that the employee has a medical condition that allows him/her to work no more than 5 hours per day, your report would include the restriction as follows:
“Due to the employee’s medical condition, employee should not work more than 5 hours per day.”
Based on your opinion, the employer will then determine whether or not to allow the employee to work a shorter day, which would be an accommodation.
What happens after CME submits the FFDE report to the employer?
The employer will make decisions relating to the employee’s employment status, such as whether to provide accommodation or not, whether to move the employee to a different job or location, whether to put the employee on administrative leave, and whether to terminate or keep the employee. Once the physicians’s FFDE report is sent to the employer, the physician is not part of the conversation regarding the employee’s employment status.
What is included in an FFDE report?
The physician will answer all questions posed in the employer’s cover letter, which may include the following questions:
Does the employee currently have a medical/psychological condition?
If yes, does the medical/psychological condition affect the employee’s ability to perform his/her job functions?
Does the employee currently have a medical/psychological condition that renders him/her unfit to perform the employee’s essential job functions?
If the employee is not fit for duty, what period of time is expected before he/she can achieve a fit for duty status?
Identify and document any work accommodations, if any, that we can consider to assist the employee in performing the full scope of his/her job functions.
In your professional opinion, does the employee need to undergo evaluations by any other type of specialist in order to determine his/her fitness for duty?
These questions may vary slightly from case-to-case, but the general issues are the same.
What if the Doctor thinks the employee should be evaluated by another specialist?
There may be times in which the doctor does an evaluation and concludes that there are other medical or psychological issues affecting the employee’s ability to perform his/her job. (e.g. an employee is sent to an orthopedic surgeon to evaluate whether a back injury affects the employee’s ability to lift boxes, but the doctor believes that dementia is affecting the employee’s job functions, not the injured back). In such cases, the doctor may include in the FFDE report a referral to another specialist for an evaluation (identified by specialty NOT name).
How does the physician prepare for the FFDE?
The physician will review the employer’s cover letter (which will summarize the events/issues leading up to the employer’s request for an FFDE), the employee’s job description, the employee personnel file, and possibly the employee’s medical records (if medical records exist and the employee consents to release them to the doctor for review in connection with the FFDE).
Is an FFDE the same thing as an Independent Medical Evaluation (IME)?
No. An Independent Medical Evaluation (IME) is a medical examination of a plaintiff in a civil case. The physician, who must be a non-treating physician, is hired by the defendant to examine the plaintiff to determine such things as causation, severity of injuries, future treatment, etc. The rules governing an Independent Medical Evaluation are found in the California Civil Code.
A non-treating physician also performs an FFDE, but there is not a pending lawsuit as is the case with an IME. The requesting party is the employer, and the FFDE is governed by the ADA and California Fair Employment and Housing Act. The doctor examines the employee to determine only whether he/she has a medical or psychological condition that either (1) affects the employee’s ability to perform essential job functions, or (2) poses a threat to the employee or others.
Is an FFDE the same thing as a disability evaluation?
No. A disability evaluation occurs when an individual is seeking disability benefits and a doctor must determine impairment ratings within very stringent guidelines. An FFDE occurs because an employer has objective evidence that an employee has a medical or psychological condition that is affecting his/her ability to successfully and safely perform the employee’s essential job functions.
Who are the parties involved in an FFDE?
The parties involved in an FFDE are the employer, the employee, and sometimes Human Resources firms. There are generally no attorneys involved, unless the employee has retained an attorney.
What is the doctor’s role in an FFDE?
The doctor’s role in an FFDE is to determine in his/her professional opinion whether the employee is medically able to perform his or her job duties safely without harm to himself/herself or others. Additionally, it is the doctor’s role to determine whether or not an employee has work-related restrictions (due to a medical/psychological condition) that should be considered by the employer.
Why would the employer request an FFDE?
There are many reasons why an employer would require an employee to undergo an FFDE. Some examples include excessive or extended medical leave, disconcerting, dangerous or violent behavior at work, reported medical or psychological incidences at work, or self-reported medical conditions affecting the employee’s ability to perform essential job functions.
What is an employee Fitness for Duty Evaluation (FFDE)?
A Fitness for Duty Evaluation (FFDE) is a medical or psychological evaluation of an employee to determine whether he/she is fit (physically, mentally, emotionally) to perform the essential duties of his or her job. The evaluation is requested by the employer who has concern for the employee’s health and well-being and/or the safety of the employee, co-workers or the public.
IME
Who is being examined in an IME?
In an IME, the plaintiff who has filed a lawsuit claiming damages because of his/her injuries is examined at the request of their attorney, insurer or third parties. IMEs generally are not involved in workers compensation cases.
Where does an IME take place?
An IME will take place in the examining physician’s office, or in one of CME’s office locations. In California, an IME must take place within 75 miles of the plaintiff’s residence.
What medical specialties are most in demand for IMEs?
Given the nature of injuries that are litigated, the most common specialists needed to perform IMEs are orthopedic surgeons, neurosurgeons, physiatrists and neurologists. Mental health experts (psychiatrists, psychologists and neuropsychologists) are also frequently retained.
Does a doctor need to be certified to perform an IME?
A doctor does not need to be certified in California to perform an IME.
What is an IME?
An Independent Medical Examination (IME) is a medical evaluation performed by a physician for the purpose of resolving specific questions related to the individual’s injuries. Most frequently, an IME is conducted in the context of a civil lawsuit, although an insurance company can request an IME pre-litigation. The IME physician must be someone who has not previously been involved in the examinee’s care.
Insurers
What is the turnaround time for an IME report?
Deadlines are discussed with clients prior to CME providing a medical expert. Accordingly, we find a doctor who can meet the necessary deadlines. If no deadlines are set in advance, reports are provided to the requesting party within the timeline set forth by California law.
Does CME have medical experts in all specialties?
Yes, CME works with physicians in all specialties throughout California. If CME does not have a particular specialty in the geographic region needed, CME’s consultants will find one.
How does CME find their medical experts?
CME takes great pride in selecting the best medical experts in their respective fields. We have an intensive screening process where our specialists carefully review each doctor’s qualifications and conduct interviews to ensure that our physicians are top quality. All of CME’s medical experts are board-certified and actively practicing.
What types of services does CME provide to insurers?
CME’s broad network of board-certified physicians are available to insurers for pre-litigation record reviews, evaluations and case assessments.
QME & AME
Does a doctor need to be certified to conduct QMEs and AMEs?
QMEs must be certified by the Division of Workers’ Compensation – Medical Unit to examine injured workers. To become a certified QME, a physician must pass an exam (given twice annually), pass a report writing course and submit an application to the DWC. AMEs do not need to be certified to examine injured workers.
What state entity regulates the workers’ compensation industry in California?
The Division of Workers’ Compensation (DWC) monitors the administration of workers’ compensation claims and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers’ compensation benefits. The DWC is also responsible for regulating QME testing and licensing.
Who determines the fees for QMEs and AMEs?
The fees billed for a workers’ compensation evaluation (both QME and AME) are set by California law and can be found here: http://www.dir.ca.gov/dwc/
What is the difference between a QME and an AME?
In the context of a workers’ compensation claim, an Agreed Medical Evaluator (AME) is used if the applicant attorney and the insurance company can agree on a physician to conduct the medical examination. If the two sides cannot agree or if the claimant does not have an attorney, the exam will be conducted by a Qualified Medical Evaluator (QME). QMEs are selected from a randomly generated list of certified physicians provided by the DWC.
