December 15, 2017

CA DWC: SB 863 Adjustments Made to Qualified Medical Evaluator Writing Course

San Francisco, CA – The Division of Workers’ Compensation (DWC) is advising physicians who wish to be certified as Qualified Medical Evaluators (QMEs) in the California workers’ compensation system that the required 12-hour report writing course has been revised to conform to Senate Bill (SB) 863.

The report writing course requirements are slated for revision as detailed below as a result of SB 863 provisions that affect QMEs:

  • SB 863 eliminated the need for the QME to address medical treatment disputes. For injuries after 1/1/13 and for all dates of injury where treatment is disputed after 7/1/13, medical treatment disputes will be addressed by the Independent Medical Review (IMR) process.
  • SB 863 limited the number of office locations for the QME to ten (10), effective 1/1/13.
  • Effective 1/1/13, in cases involving a physical injury, injured workers will no longer be able to collect additional permanent disability (PD) benefits for sleep disorders or sexual dysfunction that did not directly result from those injuries. Additional PD for “add-on” psychiatric injuries will be limited to cases in which the physical injury is catastrophic or where the injured worker was the victim of, or a witness to a violent crime. QMEs, like Primary Treating Physicians (PTPs), will not be able to comment on PD arising from sleep disorder, sexual dysfunction and non-accepted psychological add-ons, but can still comment on an injured worker’s need for treatment for any of those conditions.
  • After 1/1/14 QMEs may not also be reviewers under the Independent Medical Review (IMR) process.

QME 12-hour report writing courses may be offered only by providers certified by DWC. A list of these providers may be found here in the document titled “Report writing course providers.”

As previously announced, DWC will hold its next QME exam on Oct. 19.

Source: CA DWC

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