Source: https://www.dir.ca.gov/t8/ch1a10_5.html
Timestamp: 2014-04-19 06:56:50
Document Index: 542868002

Matched Legal Cases: ['§105', '§106', '§107', '§108', '§109', '§110', '§111', '§112', '§113', '§114', '§115', '§116', '§117', '§118', '§119', '§120', '§121', '§122', '§123', '§ 124', '§ 125', '§149', '§149', '§149', '§149', '§149', '§149']

Industrial Medical Council, Article 10.5 QME Process Forms This information is provided free of charge by the Department of Industrial Relations from its web site at www.dir.ca.gov. These regulations are for the convenience of the user and no representation or warranty is made that the information is current or accurate. See full disclaimer at http://www.dir.ca.gov/od_pub/disclaimer.html. Chapter 1. DIVISION OF WORKERS' COMPENSATION-QUALIFIED MEDICAL EVALUATOR
New query §105. The Request for Qualified Medical Evaluator Panel - Unrepresented Form and Attachment to Form 105 (How to Request a QME If You Do Not Have an Attorney) and Form 105a for Dates of Injury on or After Jan. 1, 2013. §106. The Request for Qualified Medical Evaluator Panel - Represented Form and Attachment to Form 106 (How to Request a QME in a Represented Case) and Form 106a for Dates of Injury on or After Jan. 1, 2013. §107. The Qualified Medical Evaluator Panel Selection Form. §108. The Qualified Medical Evaluator Panel Selection Instruction Form.. §109. The Qualified Medical Evaluator Notice of Unavailability Form. §110. The Appointment Notification Form. §111. The Qualified or Agreed Medical Evaluator Findings Summary Form. §112. The QME/AME Time Frame Extension Request Form. §113. The Time Extension Approval Form. §114. The Denial of Time Extension Form. [Reserved]. §115. The Notice of Late Qualified Medical Evaluator Report Form. [Reserved]. §116. Notice of Late QME/AME Report-No Extension Requested Form. §117. Qualified Medical Evaluator Continuing Education Response Form. §118. Application for Accreditation or Re-Accreditation As Education Provider. §119. Faculty Disclosure of Commercial Interest.
§120. Voluntary Directive for Alternate Service of Medical-Legal Evaluation Report on Disputed Injury to Psyche. §121. Declaration Regarding Protection of Mental Health Record. §122. AME or QME Declaration of Service of Medical-Legal Report. §123. QME/AME Conflict of Interest Disclosure and Objection or Waiver by Represented-Parties Form. § 124. Specified Financial Interest Attachment to QME Forms 100, 103 or 104 ("SFI Form 124").
§ 125. S[Reserved].
§149. Definitions. [Renumbered] §149.2. 149.2. Neuromusculoskeletal Evaluation. [Renumbered]. §149.4. Cardiovascular Evaluation. [Renumbered]. §149.6. Pulmonary Evaluation. [Renumbered]. §149.8. Psychiatric evaluation. [Renumbered].
§149.9. Other evaluation. [Renumbered].
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