Cal. Code Regs. Tit. 8, § 31.3 - Scheduling Appointment with Panel QME
(a) When the employee is not represented by
an attorney, the unrepresented employee shall, within ten (10) days of having
been furnished with the form, select a QME from the panel list, contact the QME
to schedule an appointment and inform the claims administrator of the QME
selection and the appointment.
(b)
Neither the employer, nor the claims administrator nor any other representative
of the employer shall discuss the selection of the QME with an unrepresented
worker who has the legal right to select the QME.
(c) If, within ten (10) days of the issuance
of a QME panel, the unrepresented employee fails to select a QME from the QME
panel or fails to schedule an appointment with the selected QME, the claims
administrator may schedule an appointment with a panel QME only as provided in
Labor Code section
4062.1(c),
and shall notify the employee of the appointment as provided in that
section.
(d) Whenever the employee
is represented by an attorney and the parties have completed the striking
processes described in Labor Code section
4062.2(c),
the represented employee shall schedule the appointment with the physician
selected from the QME panel. If the represented employee fails to do so within
ten (10) business days of the date a QME is selected from the panel, the claims
administrator or administrator's attorney may arrange the appointment and
notify the employee and employee's attorney.
(e) If a party with the legal right to
schedule an appointment with a QME is unable to obtain an appointment with a
selected QME within ninety (90) days of the date of the appointment request,
that party may waive the right to a replacement in order to accept an
appointment no more than one-hundred-twenty (120) days after the date of the
party's initial request for an appointment. When the selected QME is unable to
schedule the evaluation within one-hundred-twenty (120) days of the date of
that party's initial request for an appointment, either party may report the
unavailability of the QME and the Medical Director shall issue a replacement
pursuant to section
31.5 of Title 8 of the California
Code of Regulations upon request, unless both parties agree in writing to waive
the one-hundred-twenty (120) day time limit for scheduling the initial or any
subsequent evaluation.
(f) The
provisions of subdivision (e) of this regulation apply to both requests for any
Comprehensive Medical-Legal Evaluation by a QME and requests for Follow Up
Comprehensive Medical-Legal Evaluations by a QME.
Notes
2. Amendment of subsection (d) and new subsection (e) filed 9-16-2013; operative 9-16-2013 pursuant to Government Code section 11343.4(b)(3) (Register 2013, No. 38).
3. Amendment of subsection (e) and new subsection (f) 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, 4064 and 4067, Labor Code.
2. Amendment of subsection (d) and new subsection (e) filed 9-16-2013; operative 9-16-2013 pursuant to Government Code section 11343.4(b)(3)(Register 2013, No. 38).
3. Amendment of subsection (e) and new subsection (f) filed 2-2-2023; operative
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