What claims assistants do when the QME did not receive the medical records

Resend the same complete QME packet to the Form 110 records address, with a page-count declaration and proof the other side already has the set. Keep the appointment. The report is still due in 30 days.

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.

This page is the file where a QME exam is booked, or already happened, and the office says the medical records are not in. How claims assistants serve medical records on a QME is the first send. What records the QME needs is the exhibit list. QME service is a California medical-legal step. Other states use an IME or a designated doctor. Rules vary. Check the state’s rule and counsel. This is not legal advice.

Confirm it is a miss

A “did not receive” diary is one where the office, not the diary, says the file is empty.

What landed	What it usually is	First move
Office says nothing arrived	Wrong address, exam suite, or never sent	Confirm the Form 110 records address. Resend there
CD, USB, or portal file will not open	Unreadable media	Resend the same set on the channel the office will take
Office has a stack with no declaration	Not considered received	Send a signed page-count declaration. Keep the item open
Office says the portal never opened	Upload without a confirmation	Call. Get the name who takes records. Resend with a log
Injured worker handed a stack at check-in	Office refused it	Do not treat that as the send. Serve and resend

On r/WorkersComp in August 2024 a worker wrote that the nurse said the adjuster never sent records, the doctor still did the exam, and the copies in the car were refused. On r/WorkersComp in September 2025 posters wrote offices refused a walk-in stack without a cover letter, proof of service, and a declaration.

What to send on the resend

Resend the same complete set. A new inbox from a rush email loses the first attempt on the log.

Item	Why it is on the resend
Treating records and other medical records relevant to the disputed issue	8 CCR §35(a)(1)–(2) (amended 2024-02-26, read 2026-10-12)
Cover letter on the issues the evaluator must address	§35(a)(3)
Records log listing each item in the order it appears	§35(c)
Declaration under penalty of perjury of Labor Code 4062.3 compliance, with the total page count	8 CCR §9793(n) (operative 2021-04-01, read 2026-10-12). Without it, the records are not considered received
Proof of service on the opposing party	8 CCR §10625(c) (amended 2022-01-01, read 2026-10-12). §35(g) treats a send without copies to all parties as ex parte
Dates of every prior attempt, with fax, portal, or address used	So the office can find the first packet
On an unrepresented PD exam, DWC-AD Form 101	8 CCR §10160(c) (read 2026-10-12)

Send it to the records address on QME Form 110 (rev. 10/2013, read 2026-10-12), or on the portal or fax that office named for records. Form 110 has a separate line from the examination address. Call only to confirm the file arrived. Labor Code §4062.3(f) (SB 863, effective 2013-01-01, read 2026-10-12) allows talk about furnishing records. Do not discuss the case. Do not autodial the injured worker’s cell for this packet.

What still leaves the item open

What came back	Why the outstanding item stays open
Office says they have the cover letter, not the records	Incomplete packet
Tracking shows delivered to the exam suite	Wrong desk. Resend to the records address
Oral “we have it” with no name, date, or channel	Not a log the adjuster can defend
Injured worker’s walk-in stack	One-sided contact the office will not take
Treating chart still at HIM	Chase the clinic first. See how long a provider has to send records

How to chase after the office says no

1. Pull the QME exam row from Guidewire, Origami Risk, mySedgwick, Juris or the spreadsheet. Confirm Form 110 is on the file.
2. Call the records desk on Form 110. Log the date, number, and who picked up. Ask which channel they will take and whether a declaration is on the last set.
3. If treating records matching the body part and date of injury are not in the claim file, chase HIM on that request. The QME resend cannot invent a chart that never landed.
4. Serve the opposing party if the 20-day serve is not on the log. Then send the same complete set to the records address.
5. If the office has not confirmed the file 10 days before the exam, resend the same complete set on the channel they named. Do not open a second address from a rush email.

On r/WorkersComp in December 2023 a commenter wrote that QME groups run their own upload sites, and when the portal fails both sides should mail the set to the doctor. On r/WorkersComp in December 2025 an unrepresented worker wrote that the doctor had not received records at an August 1 QME.

Clocks we read

Only California QME rules we read. Other states differ.

Clock	What it is
5 business days after the appointment is made	QME serves Form 110. Use the records address on that form. 8 CCR §34(a) (read 2026-10-12)
20 days before the information goes to the evaluator	Serve the other side the same records and the cover letter. Labor Code §4062.3(b) and §35(c)
Exam day	Missing records are not good cause to cancel, except a psychiatrist or psychologist on a disputed psyche injury who needs the chart first. 8 CCR §34(f) (read 2026-10-12)
30 days after the exam	Report due. 8 CCR §38(a) (read 2026-10-12). §38(h) and DWC’s physician FAQ (February 2026, read 2026-10-12) say no extension because the carrier failed to provide records
10 days after the exam if records are still out	Evaluator writes the report, notes the gap, then a supplemental. §35(i)
60 days from a written request	Supplemental report. §38(i). Parties may add 30 days by agreement

DWC’s injured-worker FAQ (November 2023, read 2026-10-12) tells the worker they may cancel the appointment or keep it and have records sent after. That FAQ is marked for claims filed on or before January 1, 2013. For the claims desk, §34(f) keeps the exam on the calendar except the psyche exception.

When the exam already happened

Missing records do not pause the report. Keep the outstanding item open.

What happened	What the desk does
Exam done, office still empty	Send the late records with a written request for a supplemental, served on the other side. §35(i)
Report issued noting the gap	Same send. The evaluator need not re-examine if a records review is enough
QME asked for more time because the carrier sent nothing	No. Report still due in 30 days. Send the packet
Psyche QME cancelled for missing records	That is the §34(f) exception. Rebuild the packet. Reschedule inside the office’s window

On r/WorkersComp in August 2025 a commenter was told the doctor would file the exam report in 30 days and write a supplemental once the records landed.

When the office still says no

Keep the outstanding item open. Keep the log.

If the office changed its mailing address, stopped taking paper, or lost the portal login, get the current records channel in writing and resend the same complete set there. On r/WorkersComp in September 2024 a commenter listed those office-side misses: new address not noticed, paper no longer accepted, digital no longer accepted, staff who owned the portal gone.

A third-party records portal or a QME group’s upload site is a channel. The duty in §35(a) still sits on the claims administrator.

Pull the California files with a QME date inside 21 days, or an exam already done with no records confirmation. For each one, write whether Form 110 is on the claim, whether the opposing party has the same set, whether the page-count declaration is signed, and the records address actually used. Resend any packet that went to the exam suite, went out without a declaration, or the office still will not confirm, and put the sent date on the outstanding-items list that afternoon.