11 Labor code sections relevant to QME’s 6 Flashcards
What actions can either party take if they request a medical evaluation under sections 4060 4061 or 4062?
If either party requests a medical evaluation under Sections 4060 4061 or 4062 they may submit a prescribed form to the administrative director requesting the medical director to assign a panel of three qualified medical evaluators.
What are the three sections that pertain to requesting a medical evaluation?
The three sections pertaining to requesting a medical evaluation are Section 4060 Section 4061 and Section 4062.
What is an agreed medical evaluator?
An agreed medical evaluator is a medical professional that both the employer and employee agree upon to conduct a medical evaluation regarding the employee’s injury or treatment typically to resolve disputes in a workers’ compensation case.
What might an employer or related entities provide details on for the employee’s treatment review?
The employer or related entities may provide details on the alternative therapy recommended and the development or manufacture of the principal drug device or therapy proposed by the employee’s treating physician.
What is the significance of a panel of three qualified medical evaluators in the workers’ compensation process?
The significance of a panel of three qualified medical evaluators is to ensure an impartial and thorough evaluation of the employee’s medical condition and treatment options helping to resolve disputes or questions related to treatment in a fair manner.
What happens if the employer violates the restriction on seeking an agreed medical evaluator when the employee is unrepresented?
If the employer violates this restriction it may lead to procedural issues in the workers’ compensation claim potentially resulting in the evaluation being deemed invalid or causing further legal disputes.
What is the time frame in which an employee must submit the form after the employer has provided it?
The employee must submit the form within 10 days after the employer has furnished the form and requested its submission.
What must the party submitting the request form designate?
The party submitting the request form must designate the specialty of the physicians that will be assigned to the panel.
What action must an employee take within 10 days of the issuance of a panel of qualified medical evaluators?
The employee must select a physician from the panel to prepare a medical evaluation schedule the appointment and inform the employer of the selection and appointment.
What happens if the employee does not inform the employer of their physician selection within 10 days?
If the employee does not inform the employer of the selection within 10 days then the employer may select a physician from the panel to prepare a medical evaluation.
What is the consequence if the employee informs the employer of their selection within the 10-day time frame?
If the employee informs the employer of the selection within 10 days the process continues with the selected physician preparing the medical evaluation.
What is Section 139.2 related to?
Section 139.2 pertains to the procedures and requirements for the submission of medical evaluation forms between the employer and employee.
In the context of Section 139.2 who is responsible for scheduling the appointment with the selected physician?
The employee is responsible for scheduling the appointment with the selected physician.
What happens if the employer provides the form to the employee but the employee fails to submit it within the specified time?
If the employee fails to submit the form within 10 days the employer is allowed to submit the form on behalf of the employee.
What must an employer do if they select a physician for evaluation according to the subdivision?
The employer must arrange the appointment with the selected physician.
What should an employer do upon receiving written notice of appointment arrangements from an employee?
The employer shall furnish payment of the estimated travel expense.
What opportunity must the evaluator provide the employee during the appointment?
The evaluator must give the employee a brief opportunity to ask questions concerning the evaluation process and the evaluator’s background.
What must an unrepresented employee do during the evaluation unless they have good cause not to participate?
The unrepresented employee shall participate in the evaluation as requested by the evaluator.
What constitutes ‘good cause’ for an employee to discontinue the evaluation?
Good cause includes evidence of evaluator bias against the employee based on race sex national origin religion or sexual preference or evidence that the evaluator has made inappropriate requests.
What are the implications for an employee if they have concerns about the evaluator’s bias?
If an employee has concerns about the evaluator’s bias they may have good cause to discontinue participation in the evaluation.
Why is it important for the employer to furnish payment of estimated travel expenses?
It is important to ensure that the employee can attend the evaluation without financial burden promoting access and fairness in the evaluation process.
What types of bias should an employee be vigilant about concerning the evaluator?
An employee should be vigilant about bias related to race sex national origin religion or sexual preference.
What should be the first step taken by the employer to prepare for an evaluation?
The first step is to arrange the appointment with the selected physician.
How does the process protect the rights of employees being evaluated?
The process protects employee rights by requiring a fair chance to question the evaluator and allowing withdrawal in cases of bias.
