Filing a Stress Claim With Workers’ Comp: Psych QME Evaluations

Work is a big part of life for most of us, and unfortunately, it is common to have problems at work, just as in any area of life.  As a psychologist and Qualified Medical Evaluator (QME; in some cases called an Agreed Medical Evaluator or AME) for the California Division of Workers’ Compensation (DWC), I see many workers with injuries arising from stress at work

Why a QME Psych Eval Is Required for Many Stress Claims

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Stress claims are often denied at first in the DWC, particularly when the cause of stress and any related mental health symptoms is something that occurred over time; these are called “cumulative trauma” claims.  These claims are less clear cut than, for example:

  • A physical injury that can be seen on imaging

  • A physical condition that can be documented with blood tests

  • Stress resulting from a sudden event, like a violent act in the workplace

These types of claims may also be denied and sent for a QME evaluation, but a stress claim will almost always require a psych assessment.  

Cumulative trauma from stress: 

  • Occurs over time

  • Is not always well documented

  • May not be clear based on medical records

  • Might be difficult to measure

For these reasons, the DWC usually wants an expert medical opinion about what is going on.  This is where a psych QME eval or psych AME eval comes in.

What to Expect From a Stress Claim Psych QME Evaluation for Workers’ Comp

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If you have filed a cumulative trauma claim of workplace stress that has caused psychological symptoms, there’s a good chance you will eventually be evaluated by a psych QME or psych AME.  Your psychology work comp evaluation will involve:

  • A thorough interview to find out what happened at work

  • Interview questions about your history

  • Several tests to measure psychiatric symptoms (these can be long!)

  • The psych QME will review medical records related to the case

All of this comes together to support the psych QME doctor’s opinion about any diagnosis you may have, whether it was caused by work, and what treatments and/or work restrictions you may need related to your diagnosis.

After a Psych QME Eval for Stress

After your psychology QME testing, your evaluator will write a report summarizing all of the data they gathered from your interview, records, and test results.  Unlike a self-referred neuropsychological evaluation, QME and AME evals don’t involve a feedback session where you hear the results of your testing.  This is because the “customer” seeking the report is the DWC, so it goes directly to them. The report goes to the attorneys on both sides (when the worker has an attorney), and ultimately, to a DWC judge.  The judge will use the report, along with other information, to make a decision about compensation and medical care related to the claimed workplace injury.  

How to Prepare for a Psych QME for Workers’ Comp

As with any neuropsychological or psychological evaluation, I recommend a few things to prepare:

  • Be ready for an all-day appointment (not always the case, but sometimes)

  • Bring water

  • Bring snacks

  • Eat a hearty breakfast

  • Get a good night’s sleep prior to the appointment

  • Wear glasses, hearing aids, and bring any other adaptive equipment you will need to hear, read, and write

  • Avoid drugs or other substances that might impact your speech, alertness, or thinking

  • Take your usual prescribed medications on the day of testing

  • Be ready to answer honestly

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You can Receive QME Reports in Los Angeles, CA

Do you have psych claims for workers’ compensation and need an evaluation? Dr. Reger provides QME psychological evaluations at several locations in Southern California. You can schedule an appointment by following these steps:

  1. Contact (424) 262-1925 to schedule your appointment

  2. Meet with a Los Angeles Psychologist for your QME psychological evaluation

  3. Get answers that you need to continue with your work comp claim

OTHER MENTAL HEALTH SERVICES IN LOS ANGELES, CA

There are multiple neuropsychological and psychological assessments that you can receive from Dr. Reger. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, she also provides individual therapy, counseling for older adults, and provides mental health consultations and presentations.