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California sees drop in qualified medical evaluators

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The number of qualified medical evaluators who resolve disputes over California workers compensation claims fell 20% between January 2012 and September 2017, according to a California Workers’ Compensation Institute study released Wednesday.

The study compares data from the list of physicians certified in California as QMEs in 2012 to the certified QME list from September 2017 to analyze changes in the QME population.

The average payment per medical-legal service leveled off in 2015 and 2016 after climbing steadily from 2007 through 2014, with data from the first half of 2017 suggesting the average may now be declining, the CWCI said in the study.

The majority of job injury claims involve musculoskeletal injuries, and orthopedists provided more than half of all medical-legal services in both 2012 and 2017, according to the study. They represented only one in six QMEs in both years. One in five QMEs was a chiropractor, but they only accounted for 5.1% of medical-legal services in 2012 and 6.7% in 2017, according to the study.

In 2017, orthopedic surgeons, spine specialists or chiropractors, or mental health specialists accounted for almost 70% of all medical-legal services. More than 85% of injured workers who requested these specialists would have access to five or more QME’s within a 30-mile radius, according to the study.