Post QME Paralegal (Worker's Compensation)

Overview

This role supports workers’ compensation cases after Qualified Medical Evaluator (QME) examinations. Responsibilities include obtaining and submitting medical records, coordinating diagnostic testing, securing treatment and diagnostic authorizations, communicating with clients and medical providers, and taking appropriate legal action when delays or disputes arise.

This is a full-time, remote role for someone with strong organization and attention to detail, and solid knowledge of California workers’ compensation procedures, including QME regulations and WCAB litigation practices.

Responsibilities

Medical Record Procurement & Submission

• Review QME report information to identify all outstanding records requested by the evaluator
• Contact clients to determine where they have treated and gather provider, facility, and treatment history information
• Request, obtain, organize, and submit medical records to QMEs and AMEs
• Track outstanding record requests and follow up with providers to ensure timely receipt
• Maintain accurate documentation of requests, communications, and submissions in the case management system

Subpoenas & Discovery

• Prepare and process subpoenas for medical, employment, wage, and other relevant records
• Coordinate service of subpoenas and monitor compliance
• Review subpoena responses for completeness and identify missing records requiring follow-up
• Assist in obtaining declarations and supporting documentation for discovery disputes

Diagnostic Testing Coordination

• Review QME recommendations for diagnostic studies, including:
  • MRI scans, X-rays, and CT scans
  • EMG/NCV studies
  • Laboratory testing and other specialty diagnostic evaluations
• Request authorization status and vendor information from defense counsel, claims administrators, and utilization review departments
• Coordinate appointments with approved diagnostic vendors and facilities
• Communicate appointment details to clients and ensure attendance
• Obtain completed diagnostic reports and submit them to the appropriate physicians and parties

Defense Communication & Follow-Up

• Communicate with defense counsel and insurance representatives regarding outstanding authorizations, records, and diagnostic testing
• Monitor deadlines and follow up on unanswered requests
• Escalate unresolved issues when authorizations, records, or diagnostic studies are delayed
• Prepare correspondence demanding compliance with QME recommendations and discovery obligations

WCAB Litigation Support

• Identify situations requiring judicial intervention due to delays, denials, or failure to comply with QME recommendations
• Prepare and file:
  • Declarations of Readiness to Proceed (DORs)
  • Status conference and expedited hearing requests
  • Discovery-related petitions and supporting documentation
• Assist attorneys and hearing representatives with hearing preparation

Client Communication

• Educate clients on the importance of obtaining records and completing diagnostic testing
• Coordinate scheduling and provide appointment reminders
• Document all client communications in the case management system

Requirements

• 1+ years of California workers’ compensation paralegal or case management experience
• Working knowledge of QME/AME procedures and WCAB litigation practices
• Experience preparing subpoenas and filing documents such as DORs through EAMS
• Strong written and verbal communication skills
• Proficiency in Microsoft Office (Word, Outlook, Teams) and case management systems
• Ability to work independently and stay productive in a remote environment
• Reliable high-speed internet and a quiet, private workspace

Preferred Qualifications

• Applicant-side workers’ compensation experience
• Experience coordinating diagnostic testing and working with utilization review
• Familiarity with medical terminology and medical record analysis
• Bilingual in English and Spanish

Compensation & Benefits

• Hourly rate: $25–27, based on experience
• Health insurance
• Retirement plans

Location

• California
• Workplace type: Remote/Hybrid (Remote)