Medical-Legal Evaluations for Workers' Compensation

Dr. Silva is certified in California as a psychological Qualified Medical Evaluator (QME). Because neuropsychology is no longer considered a QME specialty, it would be advised to designate Dr. Silva as an Agreed Medical Evaluator (AME) for medical-legal neuropsychological evaluations, or request authorization from the claims adjuster for Dr. Silva to perform an evaluation as a medical-legal one. She is board-certified in clinical neuropsychology by the American Board of Professional Psychology (ABPP). Her conclusions are based on empirically-based interpretations of the test data, and consistency of the medical records with the claimant’s self-report.

To Make a Referral: 

Please fax the written authorization from the claims’ adjuster for the medical-legal service being requested to 858-355-9440, along with patient demographics and all medical records. The following describe the verbiage that should be used in the authorization letter.

  1. “AOE/COE Psychological Consultation” describes an initial evaluation with psychological testing for the purpose of determining whether a psychiatric condition exists, and if so, if it was predominantly attributable to work-related events. Please note that Dr. Silva is not accepting PTP assignments at this time, and would only provide the initial AOE/COE evaluation with medical-legal opinions, and treatment recommendations that would require referral to a treating provider. 
  2. “Medical-Legal Neuropsychological Evaluation” if the referral was not made designating Dr. Silva as an AME. A medical-legal neuropsychological evaluation authorization is appropriate if the purpose of the evaluation is to determine causation and impairment ratings for the claimant’s cognitive and/or psychological symptoms. These referrals are typically made by QMEs in other specialties, usually neurology or psychiatry.  Since neuropsychology is no longer considered a QME subspecialty, requesting specific authorization for a “medical-legal neuropsychological evaluation” is recommended when med-legal opinions are needed.