San Francisco, CA – The Office of Administrative Law (OAL) has approved the Division of Workers’ Compensation’s (DWC) final version of the Qualified Medical Evaluator regulations, one of the sections that implements reform provisions of Senate Bill 863. The Qualified Medical Evaluator regulations went into effect on September 16, 2013. The final regulations will not affect any qualified medical evaluator requests currently pending with the DWC-Medical Unit. The DWC-Medical Unit will accept all of the older forms filed with the unit until Tuesday, October 1, 2013.
The Qualified Medical Evaluator emergency regulations went into effect on January 1, 2013. The final version of the Qualified Medical Evaluator regulations differs from the emergency regulations as follows:
- Section 34 (b) now requires the first appointment with a qualified medical evaluator selected from a panel to be performed at the location listed on the panel. Any additional appointments with the same qualified medical evaluator may be performed at another location listed by the Medical Director within a reasonable geographic distance from the injured worker’s residence.
- The old forms QME 105 and QME 106, respectively, have been replaced with new forms that were previously titled the QME 105a and QME 106a, respectively, in the emergency regulations. The new forms have a proof of service attached to the form.
- Section 13(b) now requires a QME who wishes to add or remove specialties to do so in writing and requests to add a specialty requires the filing of supporting documentation showing the physician’s qualifications.
- Section 26 replaces section 31.2 and governs the opening and closing of offices where qualified medical evaluations may be performed.
- Under section 32 only acupuncturists may refer the parties back to medical unit for an additional qualified medical evaluation where disability is in issue.
- The unavailability of qualified medical evaluators will be measured by calendar year instead of by fee period.
- There is a new form for parties to request QME Replacement panel, the form 31.5.
- There is a new form for parties to request an Additional QME Panel in a Different Specialty, the form 31.7.
- There is a new Qualified Medical Evaluator Reappointment application form, the form 104.
- There is a new Qualified Medical Evaluator Notice of Unavailability Form, the form 109.
- There is a new appointment notification form, the form 110.
- There is a new QME/AME Time Frame Extension Request Form, the form 112.
- There is a new Qualified Medical Evaluator Course Evaluation Form, the form 117.
Source: CA DWC