(a) A QME who
will be unavailable to schedule or perform comprehensive medical evaluations as
a Panel QME for a period of 14 days, or up to a maximum of 120 days during a
calendar year, for any reason shall notify the Medical Director by submitting
the form in section
109 (Notice of Qualified Medical
Evaluator Unavailability) at least 30 days before the period of unavailability
is to begin. The Medical Director may, in his or her or their discretion, grant
unavailable status within the 30-day notice period for good cause, including
but not limited to medical or family emergency or the QME's inability to
schedule any new medical-legal evaluation appointments within 90 days of the
initial appointment request because of time commitments related to existing
medical-legal evaluation appointments. For purposes of this subsection, a "new
medical-legal evaluation appointment" is one that is not currently scheduled at
the time that the physician requests unavailability status. Both Comprehensive
Medical-Legal Evaluations and Follow-Up Medical-Legal Evaluations are
considered new medical-legal evaluation appointments for purposes of this
section.
(b) At the time of
requesting unavailable status, the QME shall provide the Medical Director with
a list of any and all comprehensive medical/legal evaluation examinations
already scheduled during the time requested for unavailable status. The QME
shall indicate whether each such examination is being rescheduled or the QME
plans to complete the exam and report while in unavailable status.
(c) A QME who is unavailable as provided in
subdivision (a) shall not perform any new evaluation examinations as a QME
until the physician returns to active QME status. Such a QME may complete
medical-legal examinations and reports already scheduled and reported to the
Medical Director, as well as reports for evaluation examinations performed
prior to becoming unavailable under subdivision (a). Such a QME also may
complete supplemental reports.
(d)
It shall not be an acceptable reason for unavailability that a QME does not
intend to perform comprehensive medical-legal evaluations for unrepresented
workers. A QME who has filed notifications for unavailability totaling more
than one hundred and twenty (120) days during the QME calendar year without
good cause may be denied reappointment subject to section
51(a)(3). Good
cause includes, but is not limited to, sabbaticals, or death or serious illness
of an immediate family member.
(e)
If a QME fails to notify the Medical Director, by submitting the form in
section
109 (Notice of Qualified Medical
Evaluator Unavailability), of his or her or their unavailability at a medical
office at least thirty (30) days prior to the period the evaluator becomes
unavailable, the Medical Director may designate the QME to be unavailable at
that location for thirty (30) days from the date the Medical Director learns of
the unavailability.
(f) Whenever
the Medical Director is notified by a party seeking an appointment with a
Qualified Medical Evaluator, or otherwise becomes aware, that the QME is not
available and not responding to calls or mail at a location listed for the QME,
a certified letter will be sent to the QME by the Medical Director regarding
his/her or their unavailability. If the Medical Director does not receive a
response within fifteen (15) days of the date the certified letter is mailed,
then the QME will be made unavailable at that location. The time a QME is
placed on unavailable status pursuant to this subdivision shall count toward
the one hundred and twenty (120) day limit in section 33(a).
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.
Notes
Cal. Code
Regs. Tit. 8, §
33
Note: Authority cited: Sections 133, 139.2 and 5307.3,
Labor Code. Reference: Sections 139.2, 4060, 4061, 4062, 4062.1, 4062.2, 4062.5
and 4067, Labor Code.
Note: Authority cited: Sections
133,
139.2 and
5307.3, Labor
Code. Reference: Sections
139.2,
4060,
4061,
4062,
4062.1,
4062.2,
4062.5 and
4067, Labor
Code.
1. New section filed
8-1-94; operative 8-31-94 (Register 94, No. 31).
2. Amendment filed
4-14-2000; operative 5-14-2000 (Register 2000, No. 15).
3. Amendment
of section and Note filed 1-13-2009; operative 2-17-2009 (Register 2009, No.
3).
4. New subsection (h) 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.
5. New subsection (h) 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.
6. Certificate
of Compliance as to 7-1-2013 order, including amendment of subsections (a) and
(d), repealer of subsections (e) and (h) and subsection relettering,
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).
7. Amendment of subsections (a) and (d)-(f) filed
2-26-2024; operative 2/26/2024 pursuant to Government Code section
11343.4(b)(3) (Register
2024, No. 9).