The California Workers Compensation System
Medical-Legal Reports
Medical-legal reports are conducted to determine the following issues:
- Worker’s eligibility for benefits
- Ability to return to work
- Permanent and stationary status of the employee’s medical condition
- Existence and extent of permanent disability
- Employee’s preclusion or likely preclusion from engaging in his or her usual occupation
- Extent and scope of medical treatment
- Existence of new and further disability
These exams are conducted at the request of the worker, the employer, and on some occasions at the
request of a DWC/WCAB referee/judge.
Under current law, these evaluations are carried out by the injured worker’s treating physician(s) or a
Qualified Medical Evaluator (QME) as approved by the Industrial Medical Council (IMC). QMEs can be
acting as an Agreed Medical Evaluator (AME)/Independent Medical Evaluator (IME) agreed upon by
both parties or appointed by a judge, a QME chosen by either the employer or the worker in a dispute
where the worker is represented by an attorney, or a QME chosen from a panel when the worker is not
represented. Prior to the 1993 reforms, the evaluator chosen by parties in a disputed case was not
required to be a QME if the worker was represented.