Report: Number of Qualified Medical Evaluators in California Workers’ Comp Fell

The series of competent medical evaluators solve disputes over California workers’ remuneration explain issues fell 20 percent between Jan 2012 and Sep 2017, according to a new California Workers’ Compensation Institute study.

However, a CWCI investigate shows that a impact on QME accessibility was partially equivalent by an boost in a median series of bureau locations per QME, that doubled over a same period.

The investigate also records that after climbing usually from 2007 by 2014, a normal remuneration per med-legal use intended off in 2015 and 2016, with information from a initial half of 2017 suggesting a normal might now be declining.

The investigate compares information from a list of physicians approved by a state as QMEs in 2012 to a approved QME list from Sep 2017, identifying a series of providers, their specialties, their addresses and their series of bureau locations.

Findings from a investigate include:

  • The series of QMEs fell by 20 percent from 3,239 physicians in 2012 to 2,578 as of Sep 2017, as 1,244 physicians dropped their certification, while 398 were combined to a QME list.
  • Over that same period, a median series of bureau locations per QME rose from one to two, so notwithstanding a 20 percent dump in a series of approved QMEs a sum series of analysis locations usually declined 14 percent.
  • Most pursuit damage claims engage musculoskeletal injuries, so orthopedists supposing some-more than half of all medical-legal services in both 2012 and 2017 even yet they represented usually one-in-six QMEs in both years. In contrast, one-in-five QMEs was a chiropractor, though they usually accounted for 5.1 percent of med-legal services in 2012 and 6.7 percent in 2017.
  • In 2012 and 2017 orthopedic surgeons, spine specialists or chiropractors, or mental health specialists supposing some-more than 70 percent of all med-legal services. More than 85 percent of harmed workers who requested med-legal services from one of these specialties had entrance to 5 or some-more QMEs in those specialties within a 30-mile radius of their home.
  • 2007 was a initial full year underneath a revised price report that introduced new time-based billing codes for med-legal testimony and supplemental evaluations. Between 2007 and Jun 2017, a normal volume paid for time-based supplemental evaluations some-more than doubled and a normal paid for time-based supplemental reports rose 162 percent.

Despite a increases in a normal amounts paid for time-based services, normal payments for med-legal services altogether intended off in 2015 and 2016 and declined in 2017. The investigate links a new change in a med-legal remuneration trend to a change in a brew of services, as a formula uncover that given 2015, reduction dear simple reports and supplemental reports have represented a incomparable share of all med-legal services, while some-more minute and dear extensive evaluations have accounted for a shrinking share.

The study, including additional background, graphics and analyses, is accessible in a CWCI investigate section.

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