A QME shall complete within the previous 24 months of his
or her term of appointment 12 hours of continuing education in disability
evaluation or workers' compensation related medical dispute evaluation given by
a provider accredited by the Administrative Director. This section shall apply
to applications for reappointment received before April 1, 2026.
(a) There are two types of continuing
education programs:
(1) On-site programs, in
which the instructor and QME are in the same location; and
(2) Distance learning programs.
(A) Providers of distance learning programs
shall give either a pre- or post-course self-examination based on the program
material. The provider shall grade the QME's test. Credit for the course can be
given only for a passing rate of no lower than 70 percent correct responses.
The Administrative Director may audit physicians' examinations and
scores.
(B) Credit for distance
learning courses shall be granted for the actual time spent viewing, listening
to or participating in the program and for the reasonable and necessary time to
take the examinations for up to six hours per program. Credit for the same
distance learning program may be taken only once.
(C) All distance learning materials shall
bear a date of release and shall be updated every three years. The provider
shall notify the Administrative Director in writing of the revision.
(b) In addition to
granting credit for attending a course or program which it gives, the
Administrative Director may grant credit for:
(1) Participating in a panel on the
development or review of the QME competency examination. A physician may
receive one hour credit for each hour of participation on a panel. The QME
shall obtain documentation of participation from the test administrator for
submission to the Administrative Director.
(2) Instructing in a program given for QME
credit by a provider accredited by the Administrative Director. The instructor
may receive two hours of credit for each hour of instruction in an accredited
provider's program or one hour of credit for each hour of participation on a
panel. Credit for the same presentation may be taken only once during each
calendar year. The QME shall submit documentation of participation from the
program provider to the Administrative Director.
(3) Attending a program which is accepted by
the QME's licensing board for renewal of his or her professional license,
provided the subject matter is directly related to California impairment
evaluation or workers' compensation medical dispute evaluation.
To request credit for this type of course, the QME must
submit:
(A) proof of
attendance;
(B) written material
which describes the program content and program faculty; and
(C) documentation that the program is for
continuing education credit by the physician's licensing board.
(4) Passing the QME competency
examination. A QME may be granted six hours of continuing education credit for
passing this examination for the purpose of receiving an initial appointment as
a QME.
(c) To apply to
the Administrative Director for accreditation, a provider shall submit to the
Administrative Director, at least 60 calendar days before any public
advertisement of the applicant's program or course is made:
(1) a completed form 118, in section
118 of these regulations.
(2) A curriculum vitae for each proposed
instructor or author (for paper-based programs). A proposed instructor or
author shall have education and/or training and recent work experience relevant
to the subject of his/her presentation.
(3) The proposed promotional material for the
program.
(4) An outline of course
content, or actual course content, consistent with the topics in section
of Title
811.5(i) of
Title 8 of the
California Code of Regulations.
(d) The Administrative Director shall
accredit an applicant who meets the definition of an education provider in
Section
1(p); submits a
completed, signed and dated application which demonstrates past experience in
providing continuing education programs; and proposes a program which meets the
requirements of section 55(c) or a course which meets the requirements of
section
11.5(a) and (i).
Proposed content for continuing education program credit must relate directly
to disability evaluation or California workers' compensation-related medical
dispute evaluation. No credit shall be recognized by the Administrative
Director for material solely discussing the business aspects of workers'
compensation medical practice such as billing, coding and marketing.
(e) The Administrative Director shall notify
the applicant within 30 calendar days after receipt of the application
containing all the information listed in section 55(c) whether that provider
has been accredited for a two year period. Incomplete applications will be
returned to the applicant.
(f) A
provider that has been accredited by the Administrative Director will be given
a number which must be displayed on any public advertisements of QME continuing
education programs for that provider with the statement "Accredited by the
Administrative Director of the California Division of Workers' Compensation for
Qualified Medical Evaluator continuing education. Physicians may report up to
_____ hours of credit for QME reappointment."
(g) On or before the date the program is
first presented or distributed, the provider shall submit the program syllabus
(all program handouts) to the Administrative Director. Each distance learning
program shall also submit one copy of the examinations and one copy of the
audio/video tapes, computer program or each issue of the journal or newsletter
for which credit is to be granted.
(h) A provider may offer different QME
continuing education programs during the two-year accreditation period provided
the subject matter is in disability evaluation or workers' compensation related
medical dispute resolution. The provider shall send the Administrative Director
the program outlined and faculty for each new program at least forty-five (45)
days prior to the date of presentation of the new program. The Administrative
Director may require submission of program syllabi. The Administrative Director
may require changes in the program based on its review of the program outline,
program syllabi, promotional material or faculty if the Administrative Director
finds that any aspect of the program is not in compliance with these
regulations.
(i) Promotional
materials for a program must state the educational objectives; the professional
qualifications of program faculty (at least all relevant professional degrees);
the content of program activities; the maximum number of credit hours to be
granted; and the intended audience.
(j) Joint sponsorship of education programs
(as between an accredited and an unaccredited provider) must be approved by the
Administrative Director prior to presentation of the program.
(k) Accredited providers that cease to offer
education programs shall notify the Administrative Director in
writing.
(l) Instructors shall not
recruit members or promote commercial products or services immediately before,
during or after a course. Providers or vendors may display/sell educational
related to workers' compensation or applications for membership in an area
adjoining a course. A course provider or faculty member shall disclose on QME
Form 119 (Faculty Disclosure of Commercial Interest), located in section
119 of
Title 8 of the California
Code of Regulations, any significant financial interest in or affiliation with
any commercial product or service held by faculty and discussed in a course and
that interest or affiliation must be disclosed to all attendees. A provider
shall file every Form 119 in its possession or in its control with the
Administrative Director.
(m) The
provider shall issue a certificate of completion to each QME who successfully
completes a continuing education program. The certificate must list the
provider; provider number; date(s); location and title of the continuing
education program; and the number of hours in attendance for which credit is to
be granted. Credit shall be granted only for the actual time of attendance at
or participation in a program. Each accredited provider may in its sole
discretion limit the amount of credit hours that a course will be granted to
less than the amount of time actually spent in attendance in the
course.
(n) To apply for
re-accreditation, a provider must submit a completed QME Form 118 (Application
for Accreditation or Re-Accreditation as Education Provider) (See, 8 Cal. Code
Regs. §
118). The provider may complete
section
2 of the form using a new program
or course or one which was given by the provider during the recent
accreditation period. The Administrative Director shall give the provider
ninety (90) days' notice of the need to seek re-accreditation.
(o) The provider shall maintain attendance
records for each continuing education program for a period of no less than
three (3) years after the program is given. A physician attending the program
must be identified by signature. The provider must submit a copy of the
signature list to the Administrative Director within sixty (60) days of
completion of the program.
(p) The
provider is required to give the QME's Evaluation Form 117 (Qualified Medical
Evaluator Continuing Education Response Form) (See, 8 Cal. Code Regs. §
117) to program attendees and
request they submit the form to the Administrative Director. This information
shall not be used in lieu of a certification of completion given by the
provider, as specified pursuant to section (m). Destruction by a provider or
its employee of a QME's Evaluation Form or failure by such provider or its
employee to distribute Form 117 as part of its program shall constitute grounds
for revocation of a provider's accredited status. The Administrative Director
shall tabulate the responses and return a summary to the provider within ninety
(90) days of completion of the program.
(q) The Administrative Director may audit a
provider's program(s) at the request of the medical director to determine if
the provider meets the criteria for accreditation. The Administrative Director
may audit programs randomly, when a complaint is received, or on the basis of
responses on QME Form 117 (Qualified Medical Evaluator Continuing Education
Response Form) (See, 8 Cal. Code Regs. §
117). An auditor shall not receive
QME credit for an audited program. The Administrative Director shall make
written results of the audit available to the provider no more than thirty (30)
days after the audit is completed.
(r) The Administrative Director may withdraw
accreditation of a provider or deny such a provider's application for
accreditation on the following grounds (in addition to failure to meet the
relevant requirements of subdivision
of Title
811.5(a) or 55(c) of
Title 8
of the California Code of Regulations):
(1)
Conviction of a felony or any offense substantially related to the activities
of the provider.
(2) Any material
misrepresentation of fact made by the provider.
(3) Failure to comply with Administrative
Director regulations.
(4) False or
misleading advertising.
(5) Failure
to comply with Administrative Director recommendations following an
audit.
(6) Failure to distribute
QME Form 117 (Qualified Medical Evaluator Continuing Education Response Form)
(See, 8 Cal. Code Regs. §
117) cards to program attendees.
Note: Forms referred to above are 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.