QME & AME Evaluations
Independent medical evaluations for California workers' compensation cases.
For Injured Workers — What Is a QME Evaluation?
If you've been directed to see me for a Qualified Medical Evaluator (QME) examination, you may have questions about what this means. Here's what you need to know.
A QMEis a physician certified by California's Division of Workers' Compensation (DWC) to provide an independent medical opinion when there's a disagreement in your workers' compensation case — such as the nature of your injury, whether you need further treatment, or whether your condition has stabilized.
I'm not “the insurance company's doctor” or “your attorney's doctor.” My role is to conduct a thorough, impartial evaluation and provide an honest medical opinion based on the evidence.
What to Expect
Your appointment will last approximately 2–3 hours and includes:
- A detailed history— I'll ask about your injury, symptoms, medical history, and how your condition affects your daily life and work.
- A physical examination — A focused exam related to the body parts in dispute.
- A records review— I'll review your medical records, imaging, and any other documentation provided.
What to Bring
- A valid photo ID
- A list of your current medications
- Any medical records or imaging you have (if not already provided)
- A written list of complaints and symptoms if that helps you remember
What Happens After
I'll prepare a comprehensive medical-legal report that gets sent to all parties— your attorney, the insurance company's attorney, and the Workers' Compensation Appeals Board. You're entitled to receive a copy. Reports are typically completed within 30 days.
Your Rights
- Bring an interpreter if English is not your primary language
- Record the examination (audio only) with notice
- Be treated with dignity and respect throughout the process
- Receive a copy of the report
This is not an adversarial process. My job is to provide an honest, thorough medical opinion — nothing more, nothing less. Please be open and candid about your symptoms and limitations.
For Attorneys — My QME Qualifications
I'm a DWC-certified Qualified Medical Evaluator specializing in pain medicine and physical medicine & rehabilitation, available for both Panel QME (ML-201-95) and Agreed Medical Evaluator (ML-201-94) appointments.
Board Certifications & Training
- Pain Medicine — ABPM and CCPM
- Physical Medicine & Rehabilitation — ABPMR
- Subspecialty expertise: Interventional pain management, CRPS, neuromodulation, spinal disorders
Evaluation Standards
- AMA Guides, 5th Edition
- Almaraz-Guzman rebuttal analysis when clinically indicated
- ACOEM/MTUS treatment guideline compliance
- Reports address causation, apportionment, future medical care, and work restrictions
Turnaround & Reliability
Reports are delivered promptly, with clear organization and evidence-based reasoning.
A Unique Clinical Perspective
As both a treating interventional pain physician and a chronic pain patient myself, my evaluations reflect a deep clinical and personal understanding of pain conditions — thorough, empathetic, and clinically grounded.
Frequently Asked Questions
How is a QME different from my treating doctor?
Your treating doctor manages your care. A QME provides an independent medical opinion for your workers' compensation case. I won't take over your treatment — I evaluate and report.
Can I bring someone with me to the appointment?
You may bring an interpreter or attorney representative. Family members may accompany you to the waiting area.
Will the QME prescribe treatment or medications?
No. A QME evaluation is not a treatment visit. I may make recommendations for future medical care in my report, but I won't prescribe treatment directly.
How long until the report is ready?
Reports are typically completed and distributed to all parties within 30 days of the evaluation.
What if I disagree with the findings?
Any party may request a supplemental report to address specific objections. Your attorney can advise you on the process for challenging findings through the Workers' Compensation Appeals Board.
Have Questions?
If you'd like to learn more about your treatment options or have a question for Dr. Patibanda, reach out.
Contact Dr. Patibanda