Cal. Code Regs. Tit. 8, § 105 - The Request for Qualified Medical Evaluator Panel - Unrepresented Form

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NOTE: Forms are available at no charge by downloading from the web at http://www.dir.ca.gov/dwc/forms.html or by requesting at 1-800-794-6900.

Notes

Cal. Code Regs. Tit. 8, § 105

1. New article 10.5 (sections 105-117) and new section filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15). For prior history see Register 94, No. 31.
2. Amendment of section heading, repealer and new section and new NOTE filed 1-13-2009; operative 2-17-2009 (Register 2009, No. 3).
3. Amendment of section heading, new QME Form 105a and amendment of informational note filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 1). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.
4. Amendment of section heading, new QME Form 105a and amendment of informational note refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 7-1-2013 order, including amendment of section heading and repealer and new Form 105, transmitted to OAL 8-2-2013 and filed 9-16-2013; amendments operative 9-16-2013 pursuant to Government Code section 11343.4(b)(3) (Register 2013, No. 38).
6. Change without regulatory effect amending form and explanatory Note filed 11-6-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 45).
7. Amendment filed 8-12-2015; operative 9-1-2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 33).

Note: Authority cited: Sections 53, 133, 139.2 and 5307.3, Labor Code. Reference: Sections 139.2, 4060, 4061, 4061.5, 4062, 4062.1, 4062.2, 4064 and 4067, Labor Code.

1. New article 10.5 (sections 105-117) and new section filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15). For prior history see Register 94, No. 31.
2. Amendment of section heading, repealer and new section and new Note filed 1-13-2009; operative 2-17-2009 (Register 2009, No. 3).
3. Amendment of section heading, new QME Form 105a and amendment of informational note filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 1). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.
4. Amendment of section heading, new QME Form 105a and amendment of informational note refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 7-1-2013 order, including amendment of section heading and repealer and new Form 105, transmitted to OAL 8-2-2013 and filed 9-16-2013; amendments operative 9-16-2013 pursuant to Government Code section 11343.4(b)(3) (Register 2013, No. 38).
6. Change without regulatory effect amending form and explanatory Note filed 11-6-2013 pursuant to section 100, title 1, California Code of Regulations (Register 2013, No. 45).
7. Amendment filed 8-12-2015; operative 9/1/2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 33).