California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 1 - Division of Workers' Compensation - Qualified Medical Evaluator Regulations › Article 3 - Assignment of Qualified Medical Evaluators, Evaluation Procedure › Section 31.3 - Scheduling Appointment with Panel QME

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) When the employee is not represented by
				  an attorney, the unrepresented employee shall, within ten (10) days of having
				  been furnished with the form, select a QME from the panel list, contact the QME
				  to schedule an appointment and inform the claims administrator of the QME
				  selection and the appointment.
(b)
				  Neither the employer, nor the claims administrator nor any other representative
				  of the employer shall discuss the selection of the QME with an unrepresented
				  worker who has the legal right to select the QME.
(c) If, within ten (10) days of the issuance
				  of a QME panel, the unrepresented employee fails to select a QME from the QME
				  panel or fails to schedule an appointment with the selected QME, the claims
				  administrator may schedule an appointment with a panel QME only as provided in
				  Labor Code section
				  4062.1(c),
				  and shall notify the employee of the appointment as provided in that
				  section.
(d) Whenever the employee
				  is represented by an attorney and the parties have completed the striking
				  processes described in Labor Code section
				  4062.2(c),
				  the represented employee shall schedule the appointment with the physician
				  selected from the QME panel. If the represented employee fails to do so within
				  ten (10) business days of the date a QME is selected from the panel, the claims
				  administrator or administrator's attorney may arrange the appointment and
				  notify the employee and employee's attorney.
(e) If a party with the legal right to
				  schedule an appointment with a QME is unable to obtain an appointment with a
				  selected QME within ninety (90) days of the date of the appointment request,
				  that party may waive the right to a replacement in order to accept an
				  appointment no more than one-hundred-twenty (120) days after the date of the
				  party's initial request for an appointment. When the selected QME is unable to
				  schedule the evaluation within one-hundred-twenty (120) days of the date of
				  that party's initial request for an appointment, either party may report the
				  unavailability of the QME and the Medical Director shall issue a replacement
				  pursuant to section
				  31.5 of Title 8 of the California
				  Code of Regulations upon request, unless both parties agree in writing to waive
				  the one-hundred-twenty (120) day time limit for scheduling the initial or any
				  subsequent evaluation.
(f) The
				  provisions of subdivision (e) of this regulation apply to both requests for any
				  Comprehensive Medical-Legal Evaluation by a QME and requests for Follow Up
				  Comprehensive Medical-Legal Evaluations by a QME.
1. New
					 section filed 1-13-2009; operative 2-17-2009 (Register 2009, No.
					 3).
2. Amendment of subsection (d) and new subsection (e) filed
					 9-16-2013; operative 9-16-2013 pursuant to Government Code section
					 11343.4(b)(3)
					 (Register 2013, No. 38).
3. Amendment of subsection (e) and new
					 subsection (f) filed 2-2-2023; operative 2-2-2023 (Register 2023, No.
					 5).
Note: Authority cited: Sections
						133,
						139.2 and
						5307.3, Labor
						Code. Reference: Sections
						4060,
						4061,
						4062,
						4062.1,
						4062.2,
						4064 and
						4067, Labor
						Code.