Support Suzanne Honor-Vangerov’s Medical Legal Fee Schedule Proposal!

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Problem
QMEs in California are paid pursuant to the Medical Legal Fee Schedule which has not been meaningfully revised since 2007. For the past 12 years, QME physicians have not received any adjustments to their compensation, resulting in a significant shortage of QME physicians.

The California Division of Worker’s Compensation (DWC) has asked for input from various stakeholders on a new fee schedule. Suzanne Honor-Vangerov is a workers’ compensation attorney who worked for DWC for 20 years where she managed the DWC Medical Unit and played a vital role in the drafting of the medical-legal fee schedule.

Solution
Ms. Honor-Vangerov has drafted an updated medical-legal fee schedule which aims to right-size QME reimbursement and reflects today’s complex medical-legal environment in California Worker’s Compensation.

Highlights of this proposed fee schedule include:


- Hybrid Flat Fee-Variable Fee System for Evaluations and Supplemental Reports

  • Minimum Flat Fee of $2,200 for non-psych initial evaluations and re-evaluations (includes review of first 50 pages of records)
  • Minimum Flat Fee of $3,850 for psych initial evaluations and re-evaluations (includes review of first 50 pages of records)
  • Minimum Flat Fee of $1,000 for non-psych supplemental reports (includes review of first 50 pages of records)
  • Minimum Flat Fee of $1,750 for psych supplemental reports (includes review of first 50 pages of records)
  • $5.50/page for every page of records in excess of the first 50 pages
  • $95/100 pages of records which are not received in chronological order or with an index
  • $100/quarter hour for every 15 minutes of face-to-face time in excess of the first two hours
  • $500/impairment rating in excess of the first body system/region or limb
  • $400 for complex apportionment analyses
  • Increase of 10% for evaluations requiring an interpreter
  • Increase of 25% for evaluations by an Agreed Medical Evaluator

- Missed/failed appointment fee of $1,000 for evaluations which are not completed due to the failure of the applicant or an interpreter to attend the examination in part or in whole, or if cancelled or rescheduled by either party fewer than six (6) business days before the scheduled appointment, or if it rescheduled fewer than six (6) business

  • Plus $5.50/page for every page of records in excess of the first 50 pages

- 5% premium for reports served ten or fewer business days after the date of the evaluation

- $600/hr for deposition testimony

- Cost of living adjustment annually of the greater of 4% or annual Consumer Price Index

The time is now to make your voice heard to DWC! This fee schedule is simple, transparent, and will incentivize QMEs to provide their vital services to California’s injured workers.

Click here to read the full draft regulations

Sign today!

 

Supporters:

Suzanne Honor-Vangerov, Honor System Consulting

Gabor Vari, MD, Chief Executive Officer, California Medical Evaluators

Brock Curry, Chief Executive Officer, Premier Physicians Management Company

Scott Thompson, Chief Executive Officer, Arrowhead Evaluation Services