The Division of Workers’ Compensation announces its emergency regulation for Medical-Legal Evaluations became effective on January 18, 2022 and will expire on July 19, 2022.
There are two possible 90 day extensions (in accordance with Government Code section 11346.1(h)).
The emergency regulations can be found on the DWC website.
The regulation allows a QME or AME to complete a medical-legal evaluation through telehealth when a hands on physical examination is not necessary and all of the following conditions are met:
– – There is a medical issue in dispute which involves whether or not the injury is AOE/COE (Arising Out of Employment / Course of Employment), or the physician is asked to address the termination of an injured worker’s indemnity benefit payments or address a dispute regarding work restrictions; and
– – There is agreement in writing to the telehealth evaluation by the injured worker, the carrier or employer, and the QME. Agreement to the telehealth evaluation cannot be unreasonably denied. If a party to the action believes that agreement to the telehealth evaluation has been unreasonably denied under this section, they may file an objection with the Worker’s Compensation Appeals Board, along with a Declaration of Readiness to Proceed to set the matter for a hearing;
– – The telehealth evaluation conducted by means of a virtual meeting is consistent with appropriate and ethical medical practices, as determined by the QME and the relevant medical licensing board; and
– – The QME attests in writing that the evaluation does not require an in person physical exam.
During the time this regulation is in effect, section 34(b) of title 8 of the California Code of Regulations is suspended, and for purposes of QME telehealth evaluations conducted under this regulation, the medical office listed on the panel selection form for the QME shall be deemed the site of the telehealth evaluation.
For all other telehealth evaluations conducted under this regulation, the medical office of the physician that is within a reasonable geographic distance from the injured worker’s residence shall be deemed the site of the telehealth evaluation.