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 61 - Hearing Procedure

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  Where the Medical Director determines that there is prima facie evidence of any
				  violation of section
				  60 of Title 8 of the California
				  Code of Regulations, he or she shall make and submit a prima facie case of the
				  violation to the Administrative Director.
(b) If the Administrative Director sustains
				  the Medical Director's prima facie case, the QME shall be notified in writing
				  of the determination and shall also be notified of his or her right to a
				  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.
(1) The Administrative
				  Director may, notwithstanding Government Code section
				  11502,
				  assign the hearing to a hearing officer designated by the Medical Director who
				  shall act as an Administrative Law Judge for the purposes of Government Code
				  sections
				  11370 et.
				  seq. and 11500 et. seq., or may delegate in whole or in part to an
				  Administrative Law Judge the authority to conduct the hearing and decide the
				  case. In the event of a hearing, the hearing officer or Administrative Law
				  Judge shall fix the time and place of the hearing and notify interested parties
				  in writing no fewer than 10 days in advance of the hearing and in accordance
				  with Code of Civil Procedure sections
				  1013(a)
				  and
				  2015.5
				  specifying the time and place of the hearing.
(2) If an Administrative Law Judge conducts a
				  hearing, the Administrative Law Judge selected to preside over the hearing
				  shall hear the case alone, and exercise all powers related to the conduct of
				  the hearing.
(3) At the conclusion
				  of the hearing, the Administrative Law Judge or hearing officer shall file a
				  written statement of findings and proposed decision with the Administrative
				  Director. The decision made pursuant to this action shall include specific
				  findings in accordance with section
				  60(b) of Title 8
				  of the California Code of Regulations, and under section
				  65 of Title 8 of the California
				  Code of Regulations shall recommend, but defer to the Administrative Director
				  the final decision with respect to sanctions.
(4) The Administrative Director's decision on
				  which sanction(s) to impose on a QME, pursuant to Labor Code section
				  139.2(k)
				  or any other statute giving the Administrative Director disciplinary authority,
				  shall be in accordance with the Sanction Guidelines for Qualified Medical
				  Evaluators under section
				  65 of Title 8 of the California
				  Code of Regulations.
(5) In
				  accordance with Government Code section
				  11517(c),
				  if the proposed decision is not adopted by the Administrative Director, the
				  Administrative Director shall determine whether or not to decide the case,
				  based on the record and transcript, and/or whether or not to take additional
				  evidence or to refer the case back to the Administrative Law Judge to take
				  additional evidence on any issue or issues requested by the Administrative
				  Director.
(6) Within thirty (30)
				  days of the date the written decision is served upon the QME, the QME may file
				  a petition for reconsideration with the Administrative Director. The petition
				  shall be governed by Government Code section
				  11521 and
				  shall set forth any legal or factual basis as to why the decision should not be
				  confirmed.