IME, DME, QME and AME are not four names for one thing. They sit in different systems, under different authorities, with different answers to who must interpret, who pays, and what happens if nobody does. Getting them confused is one of the more expensive filing-cabinet errors available in California practice.
The four, briefly
- IME, independent medical examination. In general usage, an examination by a physician who is not the treating doctor, arranged to evaluate a claim.
- DME, defense medical examination. The same examination described from the plaintiff side, on the view that independent overstates the position of a physician selected by the defence.
- QME, qualified medical evaluator. A California workers compensation role: an evaluator on the state panel who performs medical-legal evaluations.
- AME, agreed medical evaluator. Also workers compensation: an evaluator the parties agree on rather than one drawn from a panel.
The first two are civil litigation vocabulary. The second two are workers compensation vocabulary. That split is the key to everything below, because the interpreter rules follow the system rather than the word.
Civil damages examinations: Evidence Code 755.5
For an IME or DME in a civil action, the governing provision is Evidence Code section 755.5, and it is unusually strong.
- Subdivision (a): during any medical examination requested by an insurer or by the defendant, of a person who is a party to a civil action and who does not proficiently speak or understand English, conducted for the purpose of determining damages, an interpreter shall be present to interpret in a language the person understands.
- Subdivision (b): the interpreter fees are paid by the insurer or defendant requesting the examination.
- Subdivision (c): the record of, or testimony concerning, an examination conducted in violation of subdivision (a) is inadmissible in that civil action and in any other civil action.
- Subdivision (e): where interpreters certified under Government Code section 11435.05 and following cannot be present, upon stipulation of the parties the requesting party has discretionary authority to provisionally qualify and use other interpreters.
Two points that surprise practitioners. The consequence in subdivision (c) is exclusion, not a fee dispute. And the credential cross-reference in subdivision (e) points at the administrative language assistance article, meaning the State Personnel Board and related listing under Government Code section 11435.35, rather than the Judicial Council court interpreter list. Court-certified interpreters are not excluded, but the statute's reference point for a medical examination is the administrative list. The full treatment is in interpreters at defense medical examinations.
Workers compensation evaluations: the regulations
For QME and AME evaluations the framework is the workers compensation regulations rather than the Evidence Code. The Division of Workers Compensation recognises, for medical appointments and medical-legal examinations, interpreters listed on the State Personnel Board or California Courts listings, and also interpreters certified by the Certification Commission for Healthcare Interpreters or the National Board of Certification for Medical Interpreters.
Provisional qualification is available where the claims administrator has given prior written consent, or where the worker needs a language outside the specified set, provided that fact is noted in the record of the medical evaluation. Certification requirements are specified for a defined group of languages, currently Spanish, Tagalog, Arabic, Cantonese, Japanese, Korean, Portuguese and Vietnamese.
Fees follow title 8 section 9795.3: for medical appointments and medical-legal examinations, $11.25 per quarter hour or portion thereof with a minimum payment of two hours, or the market rate, whichever is greater. Labor Code section 5811 provides that interpreter fees reasonably, actually and necessarily incurred are paid by the employer under the administrative director's schedule. The detail is in California workers comp interpreters.
Side by side
Reduced to the four questions that matter operationally:
- IME or DME in a civil damages action. Governing provision: Evidence Code 755.5. Interpreter required: yes, where the examinee is a party who is not English proficient and the exam is requested by an insurer or defendant to determine damages. Who pays: the insurer or defendant requesting it. Consequence of proceeding without one: the record and testimony about it are inadmissible in that and any other civil action.
- QME or AME in workers compensation. Governing provisions: the DWC regulations and fee schedule. Interpreter credentials: State Personnel Board or California Courts listing, or CCHI or National Board certification. Who pays: the employer, under Labor Code 5811 and the administrative director's fee schedule. Consequence of proceeding without a qualified interpreter: the evaluation is exposed to challenge, and in practice is often redone.
- WCAB hearings, depositions and arbitrations. Governing provision: title 8 section 9795.1.5. Categories: certified, or provisionally certified by agreement of the parties or on a finding by the judge or arbitrator.
- Civil deposition. Governing provisions: Government Code 68560.5 and 68561. Tier: certified for designated languages, registered otherwise. Cost recovery: only a certified or registered interpreter's fees are allowable under Code of Civil Procedure 1033.5(a)(3)(B).
The errors this prevents
Three specific mistakes follow from treating the four as one category:
- Applying the workers compensation credential rules to a civil defense medical examination, and missing that Evidence Code 755.5 carries an inadmissibility consequence that the comp regulations do not.
- Assuming a court-certified interpreter is automatically the credential contemplated for a medical examination, without checking which listing the applicable provision points at.
- Treating provisional qualification as a vendor fallback. In both systems it requires something specific: a stipulation of the parties in the civil setting, and either party agreement, a judicial or arbitrator finding, or prior written consent of the claims administrator in the comp setting.
When English proficiency is disputed
Each of these provisions turns on the examinee not proficiently speaking or understanding English, and that is occasionally contested, usually where the person has conversational English but not the vocabulary an examination demands.
It is worth being clear about what these examinations actually require of a person. Someone can work, hold a conversation, and follow a television programme in a second language while being unable to distinguish numbness from weakness, describe referred pain, explain how a limitation varies across a day, or understand a question about pre-existing symptoms. Conversational fluency and clinical vocabulary are different competencies, and the examination tests the second one.
The risk is also asymmetric, which settles the practical question. Providing an interpreter that turns out not to have been strictly required costs an interpreter fee. Omitting one where it was required risks the examination itself, and in the civil setting the consequence is exclusion. Where there is genuine doubt, book the interpreter and record the basis for the language need rather than litigating proficiency ahead of an examination that is already scheduled.
Document the language decision when you make it
Whichever exam type is involved, a short contemporaneous note is worth more than a reconstruction months later. Record who identified the language need and how, the language and variety, the credential of the interpreter engaged, and where provisional qualification was used, the agreement or consent that supported it.
That note takes a minute and does two jobs. It supports the evaluation if it is later challenged, and it is the record that shows a provisional route was taken properly rather than improvised. In both systems provisional qualification is legitimate and conditional, and the conditions are exactly the thing nobody remembers a year later.
Practical scheduling advice that applies to all four
Whatever the exam type, the same four steps prevent most problems. Record the examinee's language and variety when the examination is noticed rather than later. Book the interpreter at the same time as the examination slot, since specialist and interpreter availability are separate constraints. Confirm the credential in writing and confirm it is right for that setting. And where the language is scarce, raise the provisional route early enough to obtain whatever agreement or consent the applicable provision requires.
On subject-matter fit, nothing in any of these provisions requires medical experience, and every one of these examinations turns on symptom description and functional limitation. Our guidance on hiring a medical interpreter covers that, and AMS staffs psychological and neuropsychological evaluations, which raise the same issues over a longer format.
Sources
California Evidence Code section 755.5 and Government Code sections 11435.05 and 11435.35, available through California Legislative Information; California Code of Regulations, title 8, sections 9795.1.5 and 9795.3, the latter at the Department of Industrial Relations; Division of Workers Compensation interpreter FAQs; California Labor Code section 5811; California Code of Civil Procedure section 1033.5. Verified against the primary sources in July 2026.
AMS staffs civil defense medical examinations and workers compensation medical-legal evaluations across California, matched to medical subject-matter experience. See our medical interpreting service or our work with insurance defense counsel and carriers.