A study out of the California Workers’ Compensation Institute (CWCI) reveals that the number of qualified medical evaluators who resolve disputes over California’s workers’ compensation claims declined by 20 percent, from 3,239 to 2,578, between January of 2012 and September of 2017. 1,244 physicians discontinued certifications and 398 added them.
The CWCI study compared data from a list of physicians who were certified in California as QMEs to compare changes. The list identified the number of providers, their specialties, addresses and number of office location per provider. The study authors show that the impact on QME numbers was offset by an increase in the median number of office locations per QME. That number doubled over the same period from one to two median office locations per QME.
Orthopedists provided more than half of medical-legal services even though they represented one in six QMEs, since musculoskeletal injuries are common in work comp. Chiropractors accounted for one in five QMEs but performed just 5.1 percent of services in 2012 and 6.7 percent of services in 2017.
The study also found that the average payment per med-legal service leveled off starting in 2015 and data from the first half of 2017 shows the average may be starting to decline. The authors of the study say that may be due to a shift in the mix of services. Since 2015 basic reports and supplemental reports have taken up a larger portion of all medical-legal services, and more expensive comprehensive evaluations have started to decline.
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