Ame Agreement

An agreed medical assessor is a medical assessor who is chosen by mutual agreement between your lawyer and the insurance company. Unrepresented injured workers should not agree with an AME insurance company to protect the worker (probably because the state does not think the insurance company will be fair). Agreed medical assessors are generally known and have become familiar with all parties in the workers` compensation system. A panel of qualified legal medical examinations (QME) is a physician selected from a list of three groups. There are different sections of the Labour Code on how to obtain this list depending on whether or not an injured worker is represented by a lawyer. If an injured worker is not represented, they can request a list of three doctors (usually in the specialty of the treating physician) and then choose a doctor from that list. Lawyers representing injured workers can also request a list of three doctors. On the other hand, an agreed legal medical assessor (AME) is a physician on which the insurance and the lawyer of the injured workers have agreed. The panel process is bypassed. Note that unrepresented workers are not allowed to enter into an AME agreement with the insurance company, as aggrieved workers are not familiar with forensic experts in the sector.

Despite efforts to be neutral, the truth is that some medical and legal evaluators are highly biased, either for insurance or for injured workers. Competent lawyers know who serious doctors are. The workers are not injured. California Labor Code 4062.2 (a) stipulates that an AME can only be used if a lawyer represents you. If you have a lawyer, your lawyer and the employee claims administrator can enter into an agreement whereby the doctor sees you without going through the state plan used to select a QME. However, as soon as you are seen by the AME, you are not allowed to see a QME. An AME doctor may be a QME, but it is not necessary to be one. In California, an independent medical assessment (IME) is an examination by a physician with an injury that is not work-related. For example, if one person was injured in a car accident, that person could sue the other person for lost income as a result of the injury. MEIs are not related to DWC and have far fewer regulations than MQ and LES. There is no formal procedure for selecting an independent medical assessor and there is no need for special certifications beyond a medical license. In most other states, the med-legal industry is much less regulated than in California, and Workers`Comp cases are also treated as EMs.

If there is a question about the work allowances you should receive as a result of your injury, you will see either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator (QME) in the resolution of medical disputes. Disclaimer: The content of this article or the content of this website is exclusively intended for general information purposes. This information does not create any relationship between the lawyer and the client and is not intended for it.