Essential Tips for Your Meeting with a Qualified Medical Examiner

• Oct 30, 2025
• Blog
• Michael Burgis & Associates, P.C

Preparing for a Qualified Medical Evaluation (QME) in internal medicine is one of the most important steps in your workers’ compensation case. I’m Michael Burgis, managing attorney at MB&A, and I want to make sure you go into this appointment confident and informed.

The purpose of this exam is to obtain a clear, comprehensive medical report that supports your industrial injury, outlines your level of disability, and details your future medical needs. In this blog, I’ll explain how to make a strong impression while ensuring you communicate all relevant symptoms, even those outside the doctor’s specialty.

I’ll also discuss how to handle questions about prior medical history, treatment preferences, and secondary health issues like weight gain or high blood pressure.

With proper preparation and awareness, you can help ensure that your QME report accurately reflects the full extent of your condition and supports your case.

Transcript:

Hi, my name is Michael Burgis, and I’m the managing attorney of MB&A. If you’re watching this video, it’s because you’re going to see a neutral, panel qualified medical examiner in internal medicine. And I want to take a few minutes to have some general preparation notes and advice prior to that appointment.

Goal of Your QME Appointment

Most firms wouldn’t do this, but here at MB&A, I want to be proactive versus reactive because I find that the better the information is going in, the better the report is coming out. Let’s take a few minutes.

First, it’s important you realize what the goal is from this appointment. The goal is to get a good comprehensive medical report from the neutral state doctor finding the greatest injuries to industrial causation, the greatest overall permanent disability, and the greatest need for future medical care.

General Advice for Your QME Appointment

Be Prompt & Friendly

First off, fundamental bits of advice: show up on time. Whatever you do, don’t be late. This is the judge, the neutral person who’s going to decide your case. You don’t want to start off by being late and having this person upset with you. Inversely, you’ll probably be sitting in their lobby for quite some time before the doctor sees you. It’s very common. Don’t give that person animosity or attitude. Again, this is the judge. We don’t want to upset them. Even if they’re rude or condescending, kill them with kindness. This is the judge. We want the best medical report.

Be Credible

There are two ends of the spectrum I don’t want you to be on, and this deals with credibility. One end is this stoic, tough, sort of macho: “I’m fine. Life goes on. Everything will be okay.” Don’t do that. The squeaky wheel gets the grease. If you say you have no injuries, or that you’re fine, or it doesn’t affect you in your activities of daily living, you have no impairment, and your case is not going to be worth very much, if anything.

Inversely, I don’t want you to exaggerate. Don’t say you can’t do things you can, or that you don’t do things you do. These doctors are going to say that you’re exaggerating, and it’s going to affect your credibility in your case. Pain—and especially internal medicine-related symptoms—are very subjective. Nobody knows the true level of pain or discomfort you’re in other than you. As long as you’re credible, there won’t be issues. But if your credibility is undermined, then we can’t believe the pain you’re in. So be honest; fairly articulate everything.

Be Accurate About Your Medical History

You might have a historian call you before the appointment, or the doctor might go over your entire treatment history. Especially in internal medicine, they’re going to go over your entire treatment history, and you’ve got to assume they know the questions and the answers, or at least they have medical records that discuss prior treatment and symptoms. They typically subpoena all your medical records through your Social Security. If you’re at Kaiser or wherever, they get all these records, and all those records are sent to the neutral doctor.

For instance, let’s say you’re seeing an internist because you’re having significant upper or lower gastrointestinal issues, and the doctor asks, “Have you ever had that before?” and you say, “No, never.” But five years earlier, there’s a whole treatment record where you were on some medication like Prilosec for acid reflux. Again, assume they know the answers to the questions. Don’t try to outsmart them. Be honest. Let the cards fall where they fall.

It’s okay if you have prior injuries to the same body parts or symptoms. That doesn’t invalidate the workers’ comp case. That just means we have to show an aggravation of a pre-existing condition versus direct causation. But again, credibility is very important.

Leave Future Treatment as an Option

The doctor might ask you questions about your treatment goals. When it deals with internal medicine, it’s less likely to be surgical. But if a doctor says, “Do you want surgery?” and you say “No,” that could potentially negatively affect your case.

Don’t worry. You’re not forced to have medical treatment that you don’t want. Nobody can force you to have surgery you don’t want. But what I don’t want you to do is tell a doctor you don’t want some specific treatment—because they’ll write that in the medical report. I want to argue that you might need that treatment, whatever it may be, and that it may be expensive. I want to argue to the defendant that you might need some sort of treatment that’s expensive.

But if it’s written in the medical report that you don’t want it, it will cut the legs out from that argument. So again, if you don’t want some specific treatment, that’s okay. Just tell the doctor, “I don’t want it at this time, but I’d like provisions under future medical.”

How to Address Weight Gain

Now I’m going to address some of the more fundamental issues in internal medicine. A lot of this comes with weight gain. On a typical orthopedic case, let’s say someone has a bad back injury and can’t work out like they used to. They’re probably depressed. Sometimes they’re now eating more calories. With catastrophic injuries—especially orthopedic—you often see significant weight gain.

That weight gain can cause significant internal complications. You can get diabetes, high cholesterol, high blood pressure, and a whole host of things associated with weight gain. So if you’ve gained significant weight and you believe it’s because of your work-related claim, this is important. Try to roughly estimate how much you weighed prior to the injury versus how much you weigh today. If we can show that weight gain, and get that found to be industrial, then the compensable consequences of that weight gain—like hypertension, diabetes, sleep apnea—can potentially be linked.

Discuss All Medical Issues, Regardless of QME’s Specialty

Also remember, even though you’re seeing an internist, don’t forget to discuss all the orthopedic pain and symptoms, stress, depression, and anxiety. Just because it’s an internist, don’t hyper-focus on internal medicine. Make sure this doctor has a clear picture of all your industrial injuries—whether orthopedic, psychological, neurological, rheumatologic, or anything else outside the scope of that physician’s expertise.

Summary of Advice for Your QME Appointment

Again, the goal is that this doctor generally likes you, feels sympathetic for what you’re going through, wants to link everything to industrial causation, and writes a really good report finding the greatest amount of disability to all of those internal conditions and the greatest need for future medical care. That’s the evidence I need to really argue on your behalf.

So again, when you see this neutral doctor, to summarize everything: be on time, be polite, be honest, don’t minimize, don’t exaggerate. Fairly present all prior injuries and your current pain and symptoms.

Remember that those pain and symptoms are based on what’s called the AMA Guides. They’re based on objectives and subjectives. Objectives are diagnostics. Subjectives are your personal pain and the impact on your activities of daily living. So if you have any impacts on those daily activities, you must let them know.

Ultimately, again, this is just a general video. Avoid taking pain medication if you can—not that I want you in pain unnecessarily, but I do want the doctor to see you at your worst. However, take any medications you need to, especially those for industrial-related conditions like high blood pressure. Make sure the doctor knows exactly what you’re taking and when. For example, if we’re asserting you have high blood pressure, but you just took antihypertensive medication, it may appear you don’t have hypertension, when in fact you do without the medication. So it’s important the doctor knows about all that.

Contact MB&A If You Have Questions About Your QME Appointment

Again, this is a general prep video. I hope this video is helpful. If you have any questions or concerns on an individual basis, our office can go over that with you one-on-one. The better the report coming in to us, the better the evidence. I look forward to representing you and giving you a great settlement and a happily ever after.