QME report workflow, step by step
Short version: a California QME report moves through 8 steps: scheduling, record intake, page count, history and exam, drafting, DWC forms, service and billing. 6 of them run on a DWC clock. Practice software tracks the clocks and fills the forms; record software shortens intake and drafting; the exam, the opinions and the signatures stay with you.
Limits: We read each vendor's own pages and the DWC regulations on 2026-11-12 and did not test any product with real records. Prices change, and nothing here is legal or billing advice.
The QME clock on 1 page
Every deadline below comes from Title 8 of the California Code of Regulations, read on 2026-11-12. Day 0 is the day you see the worker.
Step 1: scheduling and the QME 110 notice
What happens: a party contacts you from a panel, you book the exam at an office listed on the panel form, and you send the appointment notice.
The rule: the QME 110 goes by mail or fax to the worker and the claims administrator, and to each attorney if known, within 5 business days of making the appointment. It must say whether a certified interpreter is needed, and in which language. You can't cancel inside 6 business days except for good cause, and then you explain why in writing (8 CCR 34). Missing the QME 110 deadline is grounds to deny reappointment.
What software does: QME Companion autofills QME 110 from the case record; SimpleExam generates DWC forms, syncs calendars and shows examiner availability; Report Depo lists scheduling. A generic calendar can't count business days for you or print the form.
What stays with you: choosing exam days and offices, and checking the printed form before it goes out.
Step 2: record intake
What happens: each party sends records, usually as PDFs or paper, often from several sources with repeats.
The rule: records must come with a declaration under penalty of perjury that the sender complied with Labor Code 4062.3, plus an attestation of the total page count. Without it, you may not bill for reviewing those documents, and they don't count as received (8 CCR 9793(n)).
What software does: SimpleExam lists "expedited intake via DWC EAMS" and an AI demographics sheet parser. Record tools sort pages by date and provider and build a page-cited chronology. Docura lists duplicate pages once; Medrecords AI (ours) removes exact duplicates before billing; OctopusLM bills every uploaded page, duplicates included.
What stays with you: logging which declaration came with which batch, and setting aside anything that arrived without one.
Step 3: the page count
What happens: you total the pages you reviewed for the bill and the report.
The rule: a page is 1 side of an 8.5 by 11 sheet, paper or electronic, and condensed pages count separately (8 CCR 9793(n)). When billing ML201 or ML202 you include a verification, under penalty of perjury, of the total pages reviewed (8 CCR 9795). How excess pages are paid is a billing question this site leaves to that regulation.
What software does: SimpleExam lists an "excess pages calculator". Record tools report pages processed, which is a file count, not your review count.
What stays with you: the verification. Compare 3 numbers before you sign: the senders' attested counts, the pages in the files, and the pages you reviewed.
Step 4: history and exam
What happens: you take the history, examine the worker and dictate or type findings.
The rule: the report states the date the exam was completed and the street address where it took place; if you sign on another date, that date goes next to the signature (8 CCR 35.5(b)).
What software does: dictation and transcription. ZyDoc sells edited transcription at about $350 a month for about 100 documents. easyIME, Long Health and InjuryMgmt's EMR add-on list dictation. SimpleExam offers transcription and a history-of-injury phone call as paid services.
What stays with you: the history, the exam and reading every transcript. Speech tools mishear drug names, levels and left for right.
Step 5: drafting the report
What happens: the record review section, the history, findings, diagnosis and opinions go into your template.
The rule: serve the report within 30 days of the exam (8 CCR 38(a)). Address every contested issue in your scope and each question in the parties' cover letters (8 CCR 35.5(c)). The WCAB lists 15 items a medical report should include where they apply, from the date of the exam to the signature (8 CCR 10682).
What software does: QME Copilot drafts the Review of Medical Records with a page citation on every fact. Docura has QME, AME, P&S and supplemental templates. IME Coach, easyIME, Long Health and InjuryMgmt draft fuller reports. Medrecords AI (ours) drafts from your exam notes for you to edit and sign.
What stays with you: the opinions and their reasons. 8 CCR 10682 item 14 is "the reasons for the opinion"; no tool supplies those.
Step 6: DWC forms
What happens: the forms around the report get filled: extension requests, the P&S form, service declarations.
The rule: if you will miss day 30, send QME 112 to the Medical Director and the parties no later than 5 days before the deadline. Missing test results or a consultant's report earn up to 30 more days; good cause, defined narrowly, earns 15. Missing records don't earn an extension (8 CCR 38(c) to (h)). When you find the worker P&S with permanent partial disability, DWC-AD Form 10133.36 goes with the report (8 CCR 35.5(c)(2)).
What software does: QME Companion lists autofill for QME 110, 111, 112 and 122. SimpleExam lists DWC form and CMS 1500 autofill and "regulation pop ups". The full form list is on the forms and service page.
What stays with you: deciding to request an extension in time, and signing the forms.
Step 7: service
What happens: the signed report goes to the parties with the right declaration.
The rule: in a represented case, attach QME 122 and serve the worker, the attorney and the claims administrator. In an unrepresented case, complete QME 111. If the report finds permanent impairment, disability or apportionment for an unrepresented worker, the report, QME 111, DWC-AD 100 and DWC-AD 101 go with separator sheets to the local DEU at the same time (8 CCR 36).
What software does: SimpleExam runs "electronic-to-print" mailing and creates a proof of service each time. QME Companion fills QME 111 and 122; its legal mailing is charged separately.
What stays with you: confirming the service list matches the case, and the declaration.
Step 8: billing and collection
What happens: you bill the ML code, track the payer and chase what is short.
The rule: the claims administrator pays within 60 days of receiving the "reports and documents required", or pays the uncontested part and sends an explanation of review. If you dispute the amount, request a second review, then independent bill review (8 CCR 9794). The second review request is due within 90 days of the EOR (8 CCR 9792.5.5). The required documents are an itemized bill, the report, the parties' correspondence and any page verification (8 CCR 9793).
What software does: SimpleExam lists EDI e-bills, status tracking, second review submission, and penalty and interest on late payments. QME Companion shows bill status by case. daisyBill sells workers' comp e-billing with a medical-legal fee calculator.
What stays with you: the ML code and modifiers you bill, and the decision to dispute.
Where each step usually breaks
| Step | Common failure | The software check that catches it |
|---|---|---|
| Scheduling | QME 110 sent on business day 6 | Business-day countdown from the booking date |
| Record intake | Batch arrives with no declaration | Intake field for declaration received, yes or no |
| Page count | Verified count differs from the attested count | Side-by-side attested, file and reviewed counts |
| Drafting | A cover-letter question goes unanswered | Question list pulled from each cover letter |
| Forms | QME 112 sent after day 25 | Day-25 alert per case |
| Service | DEU copy missing in an unrepresented PD case | Service list built from representation status |
| Billing | Second review window passes | 90-day timer from each EOR |
These are the failure points the rules imply, not survey data. Ask each vendor in the demo which of the 7 checks it runs, and see it on 1 of your cases. Then use the buyer checklist.
Questions about the QME workflow
How long does a QME have to serve the report?
A QME has 30 days from the exam to prepare and serve an initial or follow-up report under 8 CCR 38(a). An extension needs QME 112, sent no later than 5 days before the deadline.
Which QME report software tracks the 30-day deadline?
SimpleExam lists compliance reminders and a task dashboard, and QME Companion tracks cases and appointments and fills QME 112. Record review tools don't track DWC deadlines.
Does missing records extend the QME deadline?
No. 8 CCR 38(h) bars extensions for records not received; the QME completes the report on what is available and says the opinion may change.