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California QME vs Texas Designated Doctor — State Program Comparison

California QMEs are chosen through a 3-doctor panel with strikes; Texas designated doctors are appointed and trained by the Division — and Texas DD findings carry presumptive weight unless clearly rebutted.

1 section·3 sources·Verified 2026-08-15 ✓

What to compare

  • Selection mechanics: panel strikes (CA) vs state appointment (TX).
  • Rating framework: PDRS+AMA5 vs Texas RME rules.
  • Report standard: substantial medical evidence (CA) vs presumptive-weight DD report (TX).
  • Telehealth: Texas now allows MMI-by-telemedicine for minor injuries; California status unverified yet.
Rating basis by jurisdiction10 states profiled
CaliforniaQMELabor Code § 4660(b)(1)AMA Guides 5thPennsylvaniaIRE34 Pa. Code § 123.105; Act 142AMA Guides 6thTennesseeIR trainingState-approved training listAMA Guides 6thColoradoDIMERule 11Edition set by agencyOhioIME / DMEBWC policyEdition set by agencyTexasDesignated Doctor28 TAC 130.1Edition set by agencyWashingtonIMEL&I Medical Examiners' HandbookEdition set by agencyFloridaIRE / Schedule1996 Florida Impairment Rating ScheduleState schedule, not AMANew YorkIME / SLU2018 SLU guidelinesState schedule, not AMAArizonaDMENo canonical state source verifiedNot confirmed

California and Texas sit at opposite ends of the same problem. California fixes the edition in statute and lets the parties strike from a 3-name panel; Texas appoints the doctor and lets the commissioner set the edition. The other 8 jurisdictions profiled here fall somewhere between.

Key facts

Selection

CA: 3-QME panel + strike process. TX: state-appointed designated doctor

Rating standard

CA: AMA 5th + 2005 PDRS. TX: commissioner-adopted edition

Evidentiary weight

TX DD: presumptive weight. CA QME: substantial medical evidence standard

Forms

CA: QME-100/105. TX: DWC-32, Report of Medical Evaluation

Sources

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Last verified: 2026-08-15