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.