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Agreed & Qualified Medical Evaluators (AME & QME)

When there’s a dispute in a workers’ compensation case, a neutral medical evaluation may be required. In California, there are two main types:.

Agreed Medical Evaluator (AME)

An AME is selected by mutual agreement between both parties (typically when the worker has legal representation). The chosen physician provides an impartial opinion. AMEs are not required to be certified QMEs.

Qualified Medical Evaluator (QME)

A QME is certified by the California Division of Workers’ Compensation (DWC) and selected from a state-regulated panel. QMEs are used when:

  • The injured worker is not represented by an attorney.
  • The parties cannot agree on an AME.

 

Both AMEs and QMEs examine the injured worker and provide a medical opinion regarding the nature and extent of the injury. They assess factors such as impairment or disability using the AMA Guides, and their findings are documented in a report. This medical report is then used by attorneys and judges to help resolve disputes and make determinations about benefits.

Medical professional reviewing workers' compensation case files, representing AME and QME evaluations in California.

Who Qualifies for SIBTF?

You may be eligible if:

  • You had a pre-existing permanent partial disability.
  • You sustained a new work-related injury that caused additional permanent disability.
  • The combined disabilities equal 70% or more of total permanent disability.

 

Additional conditions include:

  • The previous and new disabilities affect opposite limbs (e.g., right leg and left leg) and the new injury rates at least 5%, or
  • The new injury alone rates at least 35% permanent disability.

 

SIBTF benefits are paid in addition to workers’ compensation for the subsequent injury alone.

Why Choose Spectrum Eval for SIBTF Evaluations?

At Spectrum Eval, we specialize in disability evaluations that meet
the complex legal and medical requirements of California’s SIBTF program.

Board-Certified Experts

We have Board-Certified Experts across orthopaedic and internal medicine specialties.

Legally defensible reports

Our evaluations meet California’s strict legal and medical documentation standards.

Accurate disability calculations

We apply the Combined Values Chart (CVC) for precise and compliant impairment ratings.

Trusted by Legal Experts

Extensive experience supporting attorneys and insurance carriers with reliable reports.

Timely reports & follow-up

We deliver on schedule and provide ongoing support throughout the claim process.

Who Qualifies for SIBTF Benefits?

SIBTF benefits are paid in addition to your workers’ compensation award, offering crucial financial support for workers with cumulative impairments.

  • You had a pre-existing permanent partial disability.
  • You sustained a new work-related injury resulting in additional permanent impairment.
  • The combined disability rating is 70% or more under California’s rating schedule.
  • You may qualify if the new injury is rated 35% or more, or 5% with impairments on opposite sides of the body.

How the Evaluation Process Works

Case Intake & History Review

We gather detailed medical records of past and recent injuries for a complete case assessment.

In-Person Medical Evaluation

Conducted by an experienced evaluator who specializes in impairment ratings.

Disability Rating Calculation

Using California’s guidelines and the Combined Values Chart to determine eligibility.

Certified Report Delivery

A comprehensive, physician-certified report suitable for SIBTF claim submission.

Support for Legal Proceedings

Continued availability for documentation clarifications and expert testimony, if needed.

Case Intake & History Review

We gather detailed medical records of past and recent injuries for a complete case assessment.

In-Person Medical Evaluation

Conducted by an experienced evaluator who specializes in impairment ratings.

Disability Rating Calculation

Using California’s guidelines and the Combined Values Chart to determine eligibility.

Certified Report Delivery

A comprehensive, physician-certified report suitable for SIBTF claim submission.

Support for Legal Proceedings

Continued availability for documentation clarifications and expert testimony, if needed.

Frequently Asked Questions

What is the SIBTF in California?
The SIBTF provides lifetime supplemental benefits to workers who had a pre-existing disability and then experience a new work-related injury that together result in serious permanent impairment.
No. The prior condition may be from birth, illness, or non-work injury—it doesn’t need to be industrial in nature.
Our medical evaluators will calculate your total impairment using the Combined Values Chart (CVC) and provide a clear report of your eligibility.
We typically deliver evaluations and reports within 2–3 weeks after your appointment and document review.
No. SIBTF payments are in addition to your original workers’ comp benefits. They’re meant to ensure fair compensation for compounded impairments.

Take the Next Step Toward Financial Recovery

If you or your client may qualify for the Subsequent Injuries Benefit Trust Fund,we’re here to help. Get accurate, defensible medical evaluations from California’s trusted experts.
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