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 6 - QME Discipline › Section 63 - Denial of Appointment or Reappointment

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Whenever the
				  Administrative Director determines that an application for appointment or
				  reappointment as a Qualified Medical Evaluator will be denied or that
				  appointment or reappointment will be to a probationary status, the
				  Administrative Director shall notify the applicant in writing of the decision,
				  including the grounds and reasons for the decision, and of the applicant's
				  right to appeal and to obtain a hearing in accordance with the provisions of
				  section 61(b).
(b) The applicant shall have thirty (30) days
				  to submit a written appeal, setting forth with particularity the basis for
				  disputing the Administrative Director's decision and why the applicant believes
				  that he or she is entitled to appointment or reappointment. If the applicant
				  fails to submit a specific, written response to the Administrative Director's
				  determination regarding appointment or reappointment within thirty (30) days,
				  the Administrative Director's decision shall become final without any further
				  notice.
(c) If the applicant
				  submits a timely appeal in accordance with subsection (b), and the appeal is
				  denied by the Administrative Director, the Administrative Director shall
				  provide the applicant with notice of this denial by means of a statement of
				  issues and notice of right to hearing in accordance with Chapter 4 (commencing
				  with Section
				  11370) and Chapter 5 (commencing
				  with section
				  11500) and Part 1 of Division 3 of
				  the Government Code. The statement of issues and notice of right to hearing
				  shall be issued within 60 days of receipt of the timely appeal. The appeal
				  shall be heard and decided in accordance with the procedures set forth in
				  section 61(b), and a final
				  decision shall be subject to judicial review in accordance with section
				  61(c).
				  Notwithstanding the procedures specified in section
				  61, the Administrative Director may
				  at any time during the pendency of an appeal reconsider the decision made under
				  subsection (a), and for good cause issue a new decision granting appointment or
				  reappointment or granting appointment or reappointment to probationary status
				  in lieu of denial. Good cause is evaluated with reference to the the presence
				  and effect of any of the factors of mitigation as well as the factors to be
				  considered in determining penalties contained in section
				  65.
(d) All notices and responses under this
				  section shall be made by certified mail.
(e) Notwithstanding section
				  51 and the other provisions of this
				  section, any physician who (1) has failed to timely pay the fee required by
				  Labor Code Section
				  139.2(n),
				  (2) who is precluded from practice due to the
				  suspension, revocation, or termination of his or her license to practice by the
				  relevant licensing authority, or (3) who has been suspended from participation
				  in the workers' compensation system pursuant to Labor Code Section
				  139.21 and
				  whose suspension is final under subdivision (b) of Section
				  139.21, shall be ineligible for
				  appointment or reappointment as a QME and shall have no further right to notice
				  or appeal under this section or section
				  61.
Note: Authority cited: Sections 133, 139.2(f) and 5307.3,
						Labor Code; Section 11500 et seq., Government Code. Reference: Section 139.2,
						Labor Code.
Note: Authority cited: Sections
						133,
						139.2(f)
						and
						5307.3, Labor
						Code; Section
						11500 et seq., Government Code.
						Reference: Section
						139.2, Labor
						Code.