Finally got my QME report back after 4 months of waiting

The doctor actually agreed my shoulder condition is work related, which felt like a win after my employer's insurance fought it for so long. My lawyer said this puts me in a way better spot for settlement talks next month. Has anyone else had to wait past the 45 day deadline for their QME report?

3 comments

3 Comments

price.tara11d ago

My QME took SIX months back in 2022 and the insurance company tried to say I missed the deadline too, so I feel your pain. Great that they agreed it's work related though, that makes a HUGE difference for your settlement.

henry_martinez11d ago

Actually, QME timelines are a bit different depending on your state. In California, the QME process has specific deadlines written into the labor code, but the insurance company trying to claim you missed them usually just means they're looking for a reason to delay things. The real key is that once a QME finds it work related, it's a big win for settlement talks. Just make sure to keep an eye on those Section 4060 notices if you're dealing with a new injury claim - that's where employers sometimes try to trip you up. You're dealing with a specific body part or multiple areas for your claim?

jordan_young10d ago

Actually @henry_martinez, I gotta push back a little on the 4060 notice stuff. Those Section 4060 notices are specific to the new injury claim process, yeah, but they actually work the other way - the employer sends them to you to pick a doctor or go through the QME process, so you gotta respond or they can use it against you. It's not really a trap they spring on you, more like a form you can miss and then they'll say you waived your rights. But the part about insurance looking for reasons to delay is spot on. Once a QME puts it in writing that your condition is work related, it really changes the game for settlement negotiations.