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What actually happens
A no-show fee. The evaluator may charge for the missed appointment, and that charge can end up disputed between the parties. It is usually not the real problem.
Delay. This is the real problem. Medical-legal reporting is the single largest source of delay in California workers’ compensation, and a missed appointment can push a case out by months in a system where you are the one without income.
And a possible argument against you — that you failed to cooperate, or that the delay was your doing. That argument is much weaker where good cause is documented.
Good cause
Document it now, while it is provable.
Illness on the day (get anything in writing from a provider). Transportation failure. A conflicting medical appointment. Lack of an interpreter where one was requested. A notice that arrived late or never arrived. A location so far away that attendance was not reasonable. A family emergency.
Late or defective notice is a real defense and it happens often. The parties have obligations about how and when an evaluation is noticed. Keep the envelope.
What to do this week
1. Write to the claims administratorClaims administrator / adjuster The person handling your claim for the insurer or self-insured employer. and the evaluator’s office, the same week, explaining what happened and asking to reschedule. Email or letter — something dated.
2. Ask for a new appointment date in writing. Do not rely on a phone call nobody logged.
3. If distance was the issue, say so — distance is a legitimate objection and there are standards about it. When they send you too far.
4. If you needed an interpreter and did not have one, say that too. You are entitled to a certified interpreter for a medical-legal exam, at no cost to you. Your interpreter rights.
5. Keep going to your treatment appointments. A missed medical-legal exam and a gap in actual treatment are different problems, and the second one hurts your case more.
And the thing to avoid
Do not let this sit. The most common version of this problem is not the missed appointment — it is the four months of nothing that follow it while everyone assumes someone else is rescheduling.
Nothing in this system advances on its own. When nothing is happening.
Doctors, exams, and records
Who examines you, who chooses, and what the report has to say.
Sources
8 CCR § 34 (appointment notice and scheduling)8 CCR § 33 (unavailability of a QME)8 CCR § 31.5 (replacement panels, including for good cause)Labor Code § 4062.2 (panel process)§ 4600(f) (certified interpreter at a medical-legal evaluation, at no cost to the employee)§ 4620(a) (certified interpreter fees as a medical-legal expense)8 CCR § 9795.3 (interpreter fees).
General information about California law, not legal advice about your case.
Reviewed by Jamey Teitell, Partner & Trial Attorney · Last reviewed
Law Offices of Solov & Teitell, APC · (213) 380-9310
Printed from https://www.solovteitell.com/answers/i-missed-my-qme-appointment/ · Last reviewed