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The Division of Workers’ Compensation (DWC) has modified the proposed Qualified Medical Evaluator (QME) regulations. DWC has electronically distributed the 15-day notice of modification to interested parties and has posted the modified regulation text and forms on the DWC website. Members of the public may comment on the modifications until 5 p.m., June 18. The proposed modifications include:

  • Section 13 is revised to require all QME applicant requests to add or remove a specialty to be in writing and include documentation that establishes the physician is board certified in the specialty
  • Section 26 is revised to clarify that QMEs may continue to request additional office locations up to the 10 office location limit
  • Section 30 is revised to state that an issued panel may be revoked by the medical unit if the panel was issued by mistake, misrepresentation of facts, or the parties have agreed to resolve their dispute by using an AME
  • Section 35 is revised to allow the claims administrator or injured worker to provide a letter to the QME or AME outlining the medical determination of the primary treating physician or the compensability issue that the evaluator is requested to address
  • Section 35.5 is revised to state that if the evaluator declares the injured worker permanent and stationary for the body part evaluated and the evaluator finds injury has caused permanent partial disability, the evaluator shall completer the Physician’s Report of Permanent and Stationary Status and Work Capacity and serve it on the claims administrator and the employee, together with the medical report
  • The application for appointment as QME (QME form 100) requires the applicant to indicate whether he or she is certified by a specialty board recognized by the Medical Board of California or the Osteopathic Medical Board of California or have qualifications deemed to be equivalent to board certification in a specialty by the Medical Board or Osteopathic Medical Board, and requires a copy of the board certificate and certificates completion of residency and fellowship training programs
  • The panel request form instructions are stricken. Instructions that explain how to fill out the form field by field will be posted with the final form.

The notice, text of the regulations, and forms can be found on the DWC website.

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