The State Auditor's report exposing the Department of Industrial Relations' failure to adequately administer the qualified medical evaluator process continues to ripple throughout the workers' compensation community.
And while the report rightfully characterizes the decline in QMEs as a longstanding problem causing delays in injured workers' ability to access benefits, there are other key components compounding the crisis: specifically the lack of certain specialty QMEs needed to evaluate some of the most catastrophic injuries in the system.
The Joint Legislative Audit Committee held an oversight hearing on Jan. 7 to review the findings of the auditor's report, and testimony was given on behalf of California Applicants' Attorneys Association that the failure to recruit and retain certain QME specialties is exacerbating the issue.
An example is the Division of Workers' Compensation completely eliminating the specialty of neuropsychology from the QME panels — the specialty most frequently requested in traumatic brain injury cases — in 2015. The DWC subsequently opposed a bill, which passed with bipartisan support, to reinstate the neuropsychology specialty. This opposition resulted in the bill's veto by former Gov. Jerry Brown.
Additionally, there are several specialties such as oncology and infectious diseases for which there are not enough doctors for a panel to issue.
The lack of specialist QMEs has resulted in injured workers having to travel hundreds of miles to be seen, as there are no doctors available on the list in their area. Injured workers are not even able to get an evaluation with an appropriate specialist for some of the most serious and catastrophic injuries.
A pertinent story from one of our members showcases a typical delay in the QME process:
How does any of this make sense?
To view the full hearing and to hear testimony from Diane Worley, CAAA's director of policy implementation, click here (CAAA's testimony begins at 2:14:57).
To read how the system has failed others, check out an article from CalMatters, here.
Michael Castillo is communications director for the California Applicants' Attorneys Association. This opinion is republished, with permission, from the CAAA website.
May 5-8, 2024
Amplify Your Impact There’s no limit to what you can achieve when you join the global risk managem …
May 13-15, 2024
Join us May 13–15, 2024, for NCCI's Annual Insights Symposium (AIS) 2024, the industry’s premier e …
May 13-14, 2024
The Board of Managers is excited to announce that the CSIA 2024 Annual Meeting and Educational Con …
No Comments
Log in to post a comment