11. Labor code sections relevant to QME’s 1 Flashcards
What is the role of the administrative director regarding qualified medical evaluators (QMEs) according to Labor Code Section 139.2?
The administrative director is responsible for appointing qualified medical evaluators in various specialties required for evaluating medical-legal issues. Appointments are made for two-year terms.
What qualifications must a physician meet to be appointed or reappointed as a qualified medical evaluator in California?
A physician must be licensed to practice in California and demonstrate that they meet the following requirements: paragraphs 1 2 6 and 7. If the physician is a medical doctor doctor of osteopathy doctor of chiropractic or psychologist they must also meet applicable requirements in paragraphs 3 4 or 5.
What are the paragraphs that a physician must meet for appointment as a qualified medical evaluator?
The physician must meet the requirements in paragraphs 1 2 6 and 7 and for medical doctors and other specified physicians they must also satisfy the requirements outlined in paragraphs 3 4 or 5.
What is the examination requirement for physicians prior to their appointment as a qualified medical evaluator?
Prior to their appointment the physician must pass an examination that is written and administered by the administrative director which is designed to demonstrate their competence in evaluating medical-legal issues.
How often are the appointments of qualified medical evaluators made according to Labor Code Section 139.2?
The appointments of qualified medical evaluators are made for two-year terms.
Define ‘qualified medical evaluator’ as per California Labor Code.
A qualified medical evaluator is a physician who has been appointed by the administrative director to evaluate medical-legal issues and meet specific qualifications and examination requirements.
What happens if a physician fails to meet the requirements to be a qualified medical evaluator?
If a physician does not meet the requirements outlined for appointment as a qualified medical evaluator they cannot be appointed or reappointed thereby disqualifying them from serving in that capacity.
What is the purpose of the evaluation conducted by a qualified medical evaluator?
The purpose of the evaluation conducted by a qualified medical evaluator is to address medical-legal issues which are often related to issues such as injury assessment and determining the extent of physical impairment.
What sections of the Labor Code relate to the definitions and responsibilities of a qualified medical evaluator?
Labor Code Section 139.2 specifically addresses the appointment and requirements of qualified medical evaluators.
As of January 01 2023 which section of the Labor Code outlines the qualifications for qualified medical evaluators?
As of January 01 2023 Labor Code Section 139.2 outlines the qualifications for qualified medical evaluators.
What is the requirement for physicians seeking appointment as qualified medical evaluators on or after January 1 2001?
Physicians must complete a course on disability evaluation report writing approved by the administrative director before their appointment.
What is the minimum duration of instruction required for the disability evaluation report writing course specified by the administrative director?
The course must include 12 or more hours of instruction.
What is one of the eligibility criteria for a physician to be appointed as a qualified medical evaluator?
A physician must devote at least one-third of their total practice time to providing direct medical treatment or have served as an agreed medical evaluator on eight or more occasions in the 12 months prior to applying.
What type of medical degree must a physician possess to qualify as a qualified medical evaluator?
A physician must be a medical doctor (MD) or a doctor of osteopathy (DO).
Which board certifications are recognized for physicians applying to be qualified medical evaluators?
Physicians must be board certified in a specialty by a board recognized by the administrative director.
Is there an examination required for reappointment of physicians within the workers’ compensation system?
No physicians shall not be required to pass an additional examination as a condition of reappointment.
What is meant by ‘agreed medical evaluator’ in the context of workers’ compensation?
An agreed medical evaluator is a physician who has been mutually selected and agreed upon by the parties involved in a workers’ compensation case to assess the medical condition of an injured worker.
What roles does the administrative director play in the approval of the disability evaluation report writing course?
The administrative director specifies the curriculum to be covered by disability evaluation report writing courses and approves the courses for physician appointment.
What options does a physician have to fulfill the practice time requirement for becoming a qualified medical evaluator?
A physician can either devote at least one-third of their total practice time to providing direct medical treatment or serve as an agreed medical evaluator on eight or more occasions in the 12 months before applying.
Why is it important for physicians to receive training in disability evaluation report writing?
Training in disability evaluation report writing ensures that physicians can effectively communicate their medical findings and evaluations in a manner that meets the legal and procedural standards of the workers’ compensation system.
What are the eligibility criteria for a medical evaluator by the Medical Board of California or the Osteopathic Medical Board of California?
- Successfully completed a residency training program accredited by the Accreditation Council for Graduate Medical Education or its osteopathic equivalent. 2. Was an active qualified medical evaluator on June 30 2000. 3. Holds qualifications deemed equivalent to board certification in a specialty by the administrative director and either the Medical Board or the Osteopathic Medical Board of California.
What is the significance of the date June 30 2000 for qualified medical evaluators?
The date June 30 2000 is significant because it marks the cutoff for being an active qualified medical evaluator in California to qualify under certain eligibility criteria set by medical boards.
What requirements must a doctor of chiropractic meet to be certified in California workers’ compensation evaluation?
A doctor of chiropractic must be certified in California workers’ compensation evaluation by a provider recognized by the administrative director. The certification program must include instruction on disability evaluation report writing that meets specific standards.
What are the qualifications required for psychologists to meet the standards set by the administrative director for medical evaluation?
- Board certification in clinical psychology by a board recognized by the administrative director. 2. Alternatively qualifications that demonstrate a recognized level of expertise in clinical psychology.