Three former qualified medical evaluators (QMEs) who were denied re-appointment are suing the Department of Industrial Relations (DIR) and its director Christine Baker for using “underground regulations” to deny them re-appointment.
The former QMEs claim that the DIR has established new criteria for determining who can serve as a QME without undergoing the required process for doing so. According to them, QMEs are consistently being denied reappointment without notice or hearings.
The lawsuit alleges that the DIR has denied reappointment to approximately 400 QMEs so far, which amounts to over 13% of the QMEs that were in the system. The lawsuit also alleges that before the denial of reappointment, none of the QMEs had ever received complaints from the DWC about their billings.
The former QMEs behind the lawsuit claim they were denied reappointment after DIR officials alleged that they had each violated California’s medical-legal fee schedule. Attorneys for the former QMEs claim that they haven’t been able to get a hearing for the doctors to dispute these allegations, and that the DIR will not respond to requests for reinstatement until such hearings take place.