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Agreed Medical Evaluator (AME)

Definition - What does Agreed Medical Evaluator (AME) mean?

Claimants who are injured at work performing their normal job duties may qualify for workers’ compensation. They also must seek immediate medical attention for their work injuries. In some cases, the injured workers’ attorney and the workers’ compensation claims administrator may request that an Agreed Medical Evaluation (AME) be performed. This medical evaluation is completed by an Agreed Medical Evaluator.

What information will the Agreed Medical Evaluator provide?

When the Agreed Medical Evaluation is completed the Agreed Medical Evaluator must provide certain information to all interested parties. Specifically, they will prepare a medical-legal report which will “apportion the claim” and give evidence about what percentage of the work injury may have caused the worker’s disability and what percentage may have been pre-existing or may have been caused by another source.

What can the Agreed Medical Evaluator not provide?

The information provided by the Agreed Medical Evaluator is supposed to be objective, solely determined by the status and injuries of the claimant. The evaluator is not supposed to work in conjunction with any person of interest in the case or guarantee any party a certainty of outcome, a guarantee of a specific prognosis, or an expected case outcome.

Instead, all evaluations should be based on the evaluator’s professional medical analysis in conjunction with an interview of the injured worker, considerations of all health issues, clinical research, and current documentation and medical evidence provided. The evaluator must also consider rules of the state and other workers’ compensation regulations which may apply to the case.

What injuries does the Agreed Medical Evaluator evaluate?

The Agreed Medical Evaluator can review any work-related injuries, but some of the most common injuries reviewed include:

  • Broken bones
  • Machinery accidents
  • Chronic pain injuries
  • Neck and back injuries

An evaluator may also have to evaluate secondary injuries which can result from work injuries such as depression, anxiety, mood instability, sleep problems, memory, attention, concentration, reasoning ability, and other general cognitive issues.

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