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 34 - Appointment Notification and Cancellation

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Whenever an appointment for a
				  comprehensive medical evaluation is made with a QME, the QME shall complete an
				  appointment notification form by submitting the form in Section
				  110 (QME Appointment Notification
				  Form)(See, 8 Cal. Code Regs. §
										110). The completed form shall be
				  postmarked or sent by facsimile to the employee and the claims administrator,
				  or if none the employer, within 5 business days of the date the appointment was
				  made. In a represented case, a copy of the completed form shall also be sent to
				  the attorney who represents each party, if known. Failure to comply with this
				  requirement shall constitute grounds for denial of reappointment under section
				  51 of Title 8 of the California
				  Code of Regulations.
(b) The QME
				  shall schedule an appointment for the first comprehensive medical-legal
				  examination which shall be conducted at a medical office listed on the panel
				  selection form or any office listed with the Medical Director provided there is
				  written agreement by the parties to use a different office listed with the
				  Medical Director. Any subsequent evaluation appointments may be performed at
				  another medical office of the selected QME if it is listed with the Medical
				  Director and is within a reasonable geographic distance from the injured
				  worker's residence.
(c) The QME
				  shall include within the notification whether a Certified Interpreter, as
				  defined by Labor Code Section
				  5811 and
				  subject to the provisions of section
				  9795.3 of Title 8 of the California
				  Code of Regulations, is required and specify the language. The interpreter
				  shall be arranged by the party who is to pay the cost as provided for in
				  Section
				  5811 of the
				  Labor Code.
(d) An evaluator,
				  whether an AME or QME, shall not cancel a scheduled appointment less than six
				  (6) business days prior to the appointment date, except for good cause.
				  Whenever an evaluator cancels a scheduled appointment, the evaluator shall
				  advise the parties in writing of the reason for the cancellation. The Appeals
				  Board shall retain jurisdiction to resolve disputes among the parties regarding
				  whether an appointment cancellation pursuant to this subdivision was for good
				  cause. The Administrative Director shall retain jurisdiction to take
				  appropriate disciplinary action against any QME for violations of this
				  section.
(e) A QME or AME who
				  cancels a scheduled appointment shall reschedule the appointment within sixty
				  (60) calendar days of the date of the cancellation, unless the parties agree in
				  writing to accept an appointment beyond the sixty (60) day limit.
(f) Failure to receive relevant medical
				  records, as provided in section
				  35 of Title 8 of the California
				  Code of Regulations and section
				  4062.3 of the
				  Labor Code, prior to a scheduled appointment shall not constitute good cause
				  under this section for the evaluator to cancel the appointment, unless the
				  evaluator is a psychiatrist or psychologist performing an evaluation regarding
				  a disputed injury to the psyche who states in the evaluation report that
				  receipt of relevant medical records prior to the evaluation was necessary to
				  conduct a full and fair evaluation.
(h) An appointment scheduled with an
				  evaluator, whether an AME, Agreed Panel QME or QME shall not be cancelled or
				  rescheduled by a party or the party's attorney less than six (6) business days
				  before the appointment date, except for good cause. Whenever the claims
				  administrator, or if none the employer, or the injured worker, or either
				  party's attorney, cancels an appointment scheduled by an evaluator, the
				  cancellation shall be made in writing, state the reason for the cancellation
				  and be served on the opposing party. Oral cancellations shall be followed with
				  a written confirming letter that is faxed or mailed by first class U.S. mail
				  within twenty four hours of the verbal cancellation and that complies with this
				  section. An injured worker shall not be liable for any missed appointment fee
				  whenever an appointment is cancelled for good cause. The Appeals Board shall
				  retain jurisdiction to resolve disputes regarding whether an appointment
				  cancellation by a party pursuant to this subdivision was for good
				  cause.
(i) The date of cancellation
				  shall be determined from the date of postmark, if mailed, or from the facsimile
				  receipt date as shown on the recipient's fax copy.
NOTE: Form referred to above is available at no charge by
					 downloading from the web at
www.dir.ca.gov/dwc/forms.html
or by
					 requesting at 1-800-794-6900.
1. New
					 section filed 8-1-94; operative 8-31-94 (Register 94, No. 31).
2.
					 Amendment of subsections (a) and (c) filed 4-14-2000; operative 5-14-2000
					 (Register 2000, No. 15).
3. Amendment of section heading, section
					 and NOTE filed 1-13-2009; operative 2-17-2009 (Register 2009, No.
					 3).
4. Amendment of subsection (b) filed 9-16-2013; operative
					 9-16-2013 pursuant to Government Code section
					 11343.4(b)(3)
					 (Register 2013, No. 38).
5. Amendment of subsections (b) and (d),
					 repealer of subsection (e) and subsection relettering 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 and
						4067, Labor
						Code.