What medical records does the QME need, and who on the claims desk sends them?

The claims administrator, or the employer if there is none, shall send the QME all treating-physician records, other medical records relevant to the disputed issue, and a cover letter on the issues to address. The injured worker may send records too. Serve the opposing party 20 days before the packet goes to the QME office.

This is for the claims assistant, case coordinator or medical-only examiner at a regional TPA, self-insured desk or carrier unit who works California files in Guidewire, Origami Risk, mySedgwick, Juris or a spreadsheet of outstanding items.

A QME packet is the medical-legal exhibit set a California Qualified Medical Evaluator reviews before writing the report. It is not the treating-chart request to HIM, not a work status form, and not a Texas designated-doctor packet. Chase treating records into the file first, serve that set on the other side, then send it to the QME office. Rules vary. Check the state’s rule and counsel. This is not legal advice.

What belongs in the packet

8 CCR §35(a) (amended 2024-02-26, read 2026-10-12) is the list the claims administrator shall provide, and the injured worker may provide, to a QME or an AME.

Item	Why it belongs
All records prepared or maintained by the treating physician or physicians	History of this injury: diagnosis, treatment, and work status
Other medical records relevant to the disputed issue, including prior treatment	Apportionment and causation
Imaging, labs, operative notes, and consults matching the body part and date of injury	So the QME does not redo tests already in the file
A cover letter on the treating physician’s determination, or the issues the evaluator must address	§35(a)(3) requires this letter, served on the other side at least 20 days before the evaluation
A records log listing each item in the order it appears	Required of the claims administrator. The applicant attorney attaches one for records sent from that office
On an unrepresented permanent-disability exam, DWC-AD Form 101 and Form 100	8 CCR §10160 (read 2026-10-12): Form 101 and the records go to the QME before the exam; Form 100 goes to the employee

Labor Code §4062.3(a) (SB 863, effective 2013-01-01, read 2026-10-12) is the statute: treating records, plus medical and non-medical records relevant to the medical issue. Chase the treating chart into the file first. That request is how long a provider has to send records. HIPAA on the carrier’s request and when HIM still wants a signed form are clinic-side packets, not the QME serve.

What to leave off

Item	Why it fails
A stack handed to the QME at check-in	Pre-exam communications with a panel QME must be in writing and served 20 days first. On r/WorkersComp in September 2025 a commenter wrote that QME offices often will not take records handed at the appointment
Records sent to the QME without a copy to the other side	§35(g) treats that as ex parte. The other side can dump the evaluator
An untimely medical-legal report, a non-treating impairment report no WCJ has admitted, or anything a WCJ has stricken	§35(e) bars all three
Non-medical records the other side objected to within 10 days	Stay out until a WCJ orders them in. Depositions, surveillance, and personnel files sit here
Mental health records under Health and Safety Code §123115(b), served on the injured employee	§35(c) sends those to a designated provider, with written notice
A lifetime “any and all” dump, or asking the injured worker to carry the chart as the only send	Recut to the body part and date of injury. Do not autodial the injured worker’s cell

Who sends it

The statute says any party may provide records. The regulation puts the duty on the claims side.

Party	What that party does
Claims administrator, or the employer if there is none	Shall provide treating records, other relevant medical records, the cover letter, and the log
Injured worker	May provide records. Must serve the claims administrator 20 days first
Applicant attorney, represented file	May send a packet from that office, with its own log, served on the defense 20 days first
Defense attorney	Often serves the carrier’s set. The duty in §35(a) still sits on the claims administrator
QME office	Receives the packet at the records address on QME Form 110 (rev. 10/2013, read 2026-10-12)

On r/WorkersComp in May 2024 a commenter wrote that the defense has the obligation, that the applicant attorney can send records too, and that neither side can object to medical records. That tracks §4062.3(b): the 10-day objection is for non-medical records only. On an AME, §4062.3(c) and §35(b)(2) tell the parties to agree on what goes.

When to serve it

The 20-day clock is service on the opposing party, not the day the QME opens the envelope.

Clock	What it is
20 days before the information goes to the evaluator	Serve the other side the same records and the cover letter. §4062.3(b) and §35(c)
10 days after that service	Window to object to non-medical records. A timely objection keeps those records out unless a WCJ orders them in
5 business days after the appointment is made	QME serves Form 110 on the employee, the claims administrator, and known attorneys. Use the records address on that form
Unrepresented worker books within 20 days of the panel	§35(h) drops the 20-day wait for medical information. Non-medical information still needs the 20-day serve so the worker can object

On an unrepresented serve, §35(c) requires this cover language: “Please look carefully at the enclosed information. It may be used by the doctor who is evaluating your medical condition as it relates to your workers’ compensation claim. If you do not want the doctor to see this information, you must let me know within 10 days.” Call the QME office only to confirm the file arrived. Do not discuss the case.

When the office says the records never arrived

On r/WorkersComp in December 2025 an unrepresented worker wrote that the doctor had not received medical records at an August 1 QME. Missing records do not pause the report clock.

What happened	What the desk does
Office says the CD is unreadable, or the portal never opened	Resend the same complete set on the channel the office will take. Log the date, address, and who took it
Records still out 10 days after the exam	§35(i): the evaluator writes the report, notes the gap, then a supplemental. Send the late records with a written request, served on the other side
QME wants to cancel because the chart is not in	8 CCR §34(f) (read 2026-10-12): not good cause, except a psychiatrist or psychologist on a disputed psyche injury who needs the records first. Keep the appointment. Resend
QME asks for more time because the carrier sent nothing	8 CCR §38(h) (read 2026-10-12): no extension for missing records. Report still due in 30 days. DWC’s physician FAQ (February 2026, read 2026-10-12) says the same. Send the packet

How to tell the packet is complete

What landed	Why it is not done	What to do
Treating notes, no cover letter and no log	Incomplete under §35(a)(3) and §35(c)	Add the issues letter and the itemized log. Serve again
Packet to the QME, no proof of service on the other side	Ex parte risk under §35(g)	Serve the same set on the opposing party. Log it
Sent to the exam suite, not the Form 110 records address	Office never saw it	Resend to the records address on Form 110
Unrepresented PD exam with no Form 101	§10160(c) wants Form 101 and the records before the exam	Complete Form 101, serve it, send it with the records

Pull the open California files with a QME exam in the next 21 days. Next to each row write whether treating records matching the body part and date of injury are in the claim file, whether the opposing party has been served, and the records address on Form 110. Serve any set still on the coordinator’s desk, recut any lifetime dump, and log the sent date that afternoon.