What is the primary focus of a QME's evaluation?

The primary focus of a Qualified Medical Evaluator (QME) is to determine the compensability of claims and disability status. This evaluation is essential in the context of workers' compensation, where the QME assesses whether an injury is work-related and the extent to which it has affected the individual's ability to work.

In this capacity, the QME performs a thorough examination, reviews medical records, and may consider additional diagnostic tests to provide an objective assessment of the employee's condition. The findings help to resolve disputes regarding claims and ensure that injured workers receive appropriate benefits if their injuries are indeed compensable under the law.

While diagnosing medical conditions is certainly part of the evaluation process, it is not the sole or primary focus. Treatment recommendations are typically not within the scope of a QME's function, as their role is more about evaluation rather than ongoing patient care. Similarly, approving insurance claims is a separate administrative function that falls outside the QME's responsibilities. The emphasis on compensability and disability status aligns most closely with the role and responsibilities of a QME in the workers' compensation system.