How QME Panels Work: Panel Requests, Forms 105 and 106, and the Strike Process
Short answer: a QME panel is a list of three qualified medical evaluators in one specialty and geographic area, issued by the DWC Medical Director when a medical issue in a workers' compensation claim is disputed. In a represented case each side strikes one name and the remaining physician does the evaluation. In an unrepresented case the injured worker picks from the three. The whole process runs on 10-day clocks, and missing one hands control to the other side.
This is how cases reach a QME's office, and it is why QMEs cannot market themselves to attorneys: neither side chose you, they only failed to eliminate you.
What is a QME?
A Qualified Medical Evaluator is a physician certified by California's Division of Workers' Compensation to resolve disputed medical issues in workers' compensation claims. QMEs can be medical doctors, doctors of osteopathy, chiropractors, dentists, optometrists, podiatrists, psychologists, or acupuncturists, though acupuncturist QMEs may not opine on permanent disability or impairment.
The QME is not the treating physician and is not hired by either party. The evaluation exists to resolve a dispute, and the report goes to both sides, the claims administrator, and where necessary a workers' compensation judge.
QME vs AME: what is the difference?
An Agreed Medical Evaluator is a physician both sides agree to use. No panel, no strikes, just agreement between the applicant's attorney and the claims administrator.
In practice, AME appointments go to evaluators with long track records and reputations for even-handedness, and they are rare for anyone new. One long-practicing chiropractic QME with roughly 2,000 evaluations behind him estimates he has been named AME about 20 times in his career. New QMEs should expect essentially all of their work to come through panels.
AMEs are only available in represented cases. Under Labor Code §4062.1, when the worker is unrepresented, the employer is prohibited from even seeking agreement on an AME, because a claims administrator who knows hundreds of physicians would hold an obvious advantage over a worker who knows none.
What triggers a panel request
Three Labor Code sections cover the universe of disputes a QME is called in to resolve.
Labor Code §4060: compensability. The claims administrator has denied the claim. Is the injury work-related at all? These arrive at the beginning of a claim, and the date of injury on the panel is usually recent. This is roughly half of a new QME's caseload. Section §4060 applies only where no part of the injury has been accepted.
Labor Code §4061: permanent disability and future medical care. Either side objects to the treating physician's determination about the existence or extent of permanent impairment, or about the need for future treatment. These arrive at the end of a claim. A typical trigger: the treating physician projects injections, surgery, and a spinal cord stimulator, and the claims administrator wants a second opinion on whether any of it is needed.
Labor Code §4062: everything else. Any other medical determination by the treating physician that a party objects to, including permanent and stationary status and work restrictions. Section §4062 also carries the panel process itself in subdivisions .1 and .2.
Knowing which section generated your panel tells you what the evaluation is for. A §4060 panel means you are deciding compensability and should be building the causation analysis. A §4062 panel on an accepted claim means causation is settled and asking the examinee how the injury happened is wasted time.
The forms: QME 105 and QME 106
QME Form 105 is used when the injured worker is unrepresented. It is a paper form, and the reasons for the panel request are spelled out in plain language rather than by statute, because an unrepresented worker does not know the Labor Code.
QME Form 106 is used when the worker is represented. It is filed online, and it identifies the reason for the request by Labor Code section, because the applicant's attorney filling it out knows exactly what §4060 means.
On either form, the requesting party designates the specialty of the panel. That single choice shapes the outcome more than most people outside the system realize, which is why the right to make it moves back and forth on a clock.
The unrepresented process: Labor Code §4062.1
The injured worker gets the first move. They may submit Form 105 and designate the specialty. If they have not done so within 10 days of the employer furnishing the form and requesting they submit it, the employer may submit it instead, and the employer then picks the specialty.
That is the whole game in one sentence. A worker who sits on the form for two weeks may find themselves evaluated by an orthopedic surgeon when they wanted a chiropractor, or the reverse.
Once the panel issues, the worker has 10 days to select one of the three physicians, schedule the appointment, and tell the employer which physician and when. If they do not, the employer may select the physician and arrange the appointment.
The represented process: Labor Code §4062.2
Here the panel of three gets struck down to one. Within 10 days of the panel being assigned, each party may strike one name. The physician left standing does the evaluation.
If a party fails to strike within its 10 days, the other party may select any physician remaining on the panel. So an applicant's attorney who strikes promptly and then watches the defense miss its deadline gets to choose between the two survivors, which in practice means picking whichever evaluator they consider most favorable.
There is real strategy in this, and both sides maintain informal reputational knowledge of who tends to write what. That is a fact of the system. It is also why the strike process is the structural protection against bias: an evaluator both sides declined to strike is, by construction, acceptable to both.
Why you should always ask for a copy of the panel
When a case comes in, request the panel document itself, not just the appointment details. You want to see the strikes on it.
A panel arriving with no strikes marked means the process has not run properly. Setting up an evaluation on that basis risks doing the entire workup only to have the report objected to later and a replacement panel issued. The panel form shows the panel number, the requesting party, the date of injury, the employer, the claims administrator, the injured worker, the three physicians, and the strike dates. All of it is worth reading before the appointment is scheduled.
Who carries the burden of proof
Under Labor Code §5705, the burden of proof rests on the party holding the affirmative of the issue. On compensability, that is the injured worker. Under §3202.5, the standard is a preponderance of the evidence: evidence with more convincing force than what opposes it, judged on the strength of the evidence rather than the number of witnesses.
An injured worker with a denied claim, no witnesses, and no video has essentially one way to carry that burden, which is a medical-legal report. That is why they are in the QME's office. The report is not advocacy for them. It carries weight precisely because the evaluator was not chosen by either side, and it is evidence whichever way it comes out.
The four kinds of work a panel produces
A single case rarely resolves in one visit. Over a career, a QME's work falls into four categories:
- Initial evaluations, the first face-to-face with the examinee
- Follow-up (re-)evaluations, which involve another face-to-face
- Supplemental reports, which answer new questions without a new examination
- Depositions, where the parties question the evaluator under oath
Depositions arrive on a substantial share of cases, and physicians who are uncomfortable being questioned about their reasoning will find this work difficult. Medical-legal testimony is compensated at $455 per hour with a two-hour minimum under the current fee schedule, so a deposition carries a floor of $910.
What this means for how you set up
Panels are issued geographically, which is why the office address on the panel matters and why the initial evaluation must happen at that address. Panels are also issued by specialty, so the specialty you register determines what volume you see. And because you cannot solicit work, the only lever you control is whether attorneys who could strike you choose not to.
That comes down to reports: complete, on time, and reasoned. Attorneys strike evaluators whose reports are late, thin, or unusable, and they leave standing the ones whose reports resolve the case.
Which brings it back to the records. A panel case arrives as a phone call and, later, a box or a PDF of several hundred to several thousand pages. Lexamed reads the full production and returns a dated, page-cited chronology with the causation and MMI evidence flagged, so the review that determines report quality is done against organized evidence rather than against the clock.
Frequently asked questions
What is a QME? A Qualified Medical Evaluator is a physician certified by California's Division of Workers' Compensation to examine an injured worker and resolve a disputed medical issue in a workers' compensation claim. The QME is not the treating physician and is not retained by either party.
How does a QME panel request work? A party files QME Form 105 (unrepresented worker) or Form 106 (represented worker) with the DWC Medical Unit, designating a specialty. The Medical Director issues a panel of three QMEs in that specialty and area, and the parties then narrow the panel to one evaluator.
Who picks the QME from the panel? In a represented case, each side strikes one of the three names under Labor Code §4062.2 and the remaining physician performs the evaluation. In an unrepresented case, the injured worker selects one of the three under §4062.1, and if they do not do so within 10 days the employer may select.
What is the difference between a QME and an AME? A QME is selected through the panel and strike process. An Agreed Medical Evaluator is a physician both parties agree to use, without a panel. AMEs are only available in represented cases, and new evaluators rarely receive them.
What is QME Form 105 used for? Form 105 is the panel request form for injured workers who are not represented by an attorney. It states the reasons for the request in plain language. Represented parties use Form 106, which identifies the dispute by Labor Code section and is filed online.
What deadlines apply to the QME panel process? Ten-day clocks run throughout. An unrepresented worker has 10 days to submit the panel request form before the employer may do so, and 10 days after the panel issues to select a physician and schedule. In a represented case each party has 10 days to strike a name from the panel.
What does Labor Code 4060 mean on a panel request? It means the evaluation is a compensability evaluation: the claims administrator has denied the claim entirely, and the QME is being asked whether the injury is work-related. Labor Code §4061 covers disputes over permanent disability or future medical care, and §4062 covers all other medical disputes.