Agreed Medical Evaluation (AME)

Work Comp Medical works with several qualified physicians. Click here to see list of physicians.

 

STEP 1: Download Intake Form: Click Here
STEP 2: Print Intake Form
STEP 3: Fill out and Fax to 619-704-1077

 

Qualified Medical Evaluation (QME)

Note:

  • Injuries before 2005- parties are allowed to choose a QME after an AME attempt.
  • Injuries after 2005- parties request a panel of QME’s

For more info see FAQ relating to: SB 899
STEP 1: Download Intake Form: Click Here
STEP 2: Print Intake Form
STEP 3: Fill out and Fax with the AME Attempt Letter to 619-704-1077

Click here to see list of physicians.

Consultation Only

STEP 1: Download Intake Form: Click Here
STEP 2: Print Intake Form
STEP 3: Fill out and Fax with relating documentation to 619-704-1077

  • If applicable; Please fax authorization letter.
  • If applicable; please fax physician referral for consult and treatment.

Click here to see list of physicians.

Consultation and Treatment

Consultation and Treatment:
STEP 1: Download Intake Form: Click Here
STEP 2: Print Intake Form
STEP 3: Fill out and Fax with relating documentation to 619-704-1077

  • If applicable; Please fax authorization letter.
  • If applicable; Please fax physician referral for consult and treatment

Click here to see list of physicians.

Medical Provider Network:

Currently, there are very few MPN’s that have treating psychiatrists that will take workers’ compensation patients. Our staff will seek authorization outside the MPN.

Additional information:
Title 8, California Code of Regulations, sections 9767.1 – 9767.15 (MPN regulations).
The regulations are posted: http://www.dir.ca.gov/dwc/mpn/DWC_MPN_Main.html

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Questions?

For Scheduling Questions: Please Call 619-222-0651
Contact Us