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 65 - Sanction Guidelines for Qualified Medical Evaluators

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The guidelines for determining appropriate sanctions for
					 physicians licensed as Qualified Medical Evaluators shall be set forth in the
					 Sanction Guidelines for Qualified Medical Evaluators as adopted by the
					 Industrial Medical Council on October 21, 1999, and re-adopted and enforced by
					 the Administrative Director.Sanction Guidelines for Qualified Medical
					 Evaluators
I. PART ONE--OVERVIEW
The purpose of these guidelines is to provide the framework
					 of the Administrative Director's (AD) disciplinary process for those affected
					 by it -- Qualified Medical Evaluators, the Administrative Director,
					 administrative law judges with the Office of Administrative Hearings, licensing
					 boards and other interested parties. These guidelines are not intended to be an
					 exhaustive list of violations or disciplinary actions that the Administrative
					 Director may consider against any QME. Any violation of statutory or
					 administrative duties may constitute grounds for discipline under these
					 guidelines.
The Administrative Director believes that education is the
					 most effective course of action in resolving less serious regulatory
					 violations. These guidelines also set out the parameters for discipline for
					 misconduct considered serious.
The Administrative Director recognizes the need to
					 promulgate uniform guidelines for particular violations in order to establish
					 consistency in imposing disciplinary sanctions for similar offenses. The
					 Administrative Director also recognizes that mitigating or aggravating
					 circumstances in a specific case may necessitate variance from these
					 guidelines.
In the event of a hearing, if an administrative law judge
					 finds that the circumstances of a particular case are not adequately addressed
					 in these guidelines, the Administrative Director may request that the
					 administrative law judge include in the proposed decision an explanation of the
					 recommended sanction and/or terms of probation, so those circumstances are
					 better understood by the Administrative Director during its review of the case
					 for ultimate action.
A. Factors to be
				  Considered in Determining Disciplinary Penalties
In cases of violations of Labor Code sections
					 139.2(k)
					 and
					 139.2(m)
					 and/or section
					 60 of Title 8 of the California
					 Code of Regulations, the Administrative Director may impose discipline, up to
					 and including suspension or termination, upon any physician certified by the
					 Administrative Director as a Qualified Medical Evaluator.
In determining the level of the penalty to be imposed in a
					 given case pursuant to section
					 61 of Title 8 of the California
					 Code of Regulations, the following factors shall be considered:
(1) the seriousness of the violation
				  including actual or potential harm to the public and any mitigating or
				  rehabilitation evidence;
(2)
				  whether or not a violation is an isolated incident or part of a pattern of
				  behavior indicative of a disregard for the QME rules; e.g. (prior warnings of
				  record; number and/or variety of current violations, time passed since the
				  act(s) or offense(s));
(3) whether
				  or not a violation is intentional as opposed to negligent;
(4) whether or not there is a history of
				  previous violations cited under this section or by another court or tribunal
				  (e.g.: prior disciplinary record, including level of compliance with
				  disciplinary orders, compliance with terms of any criminal sentence, overall
				  criminal record); and
(5) whether
				  or not further education or training would be beneficial.