5. QME Availability and Reports 4 Flashcards
How far in advance must a QME notify the Medical Director about their unavailability?
A QME must notify the Medical Director at least 30 days in advance of their unavailability.
What is the consequence of not responding to the Medical Director’s certified letter about unavailability?
The document does not specify consequences but failing to respond may affect the QME’s professional standing or availability.
When may the Medical Director designate a QME as unavailable?
The Medical Director may designate a QME as unavailable if they are not informed about the unavailability at least 30 days prior to the period of unavailability.
What happens after a letter is mailed regarding a QME status?
Once a letter is mailed the QME will be made unavailable at that location. This status will count towards the one hundred and twenty (120) day limit specified in section 33a.
What is the time limit for a QME’s unavailable status as per the provided text?
The time a QME is placed on unavailable status counts towards the one hundred and twenty (120) day limit in section 33a.
What is required whenever an appointment for a comprehensive medical evaluation is made with a QME?
Whenever an appointment is made with a QME the QME must complete an appointment notification form as outlined in Section 110 QME Appointment Notification Form found in 8 Cal. Code Regs. 110.
What is the timeframe in which the appointment notification form must be submitted?
The completed appointment notification form shall be postmarked or sent by facsimile to relevant parties within 5 business days of the date the appointment was made.
Who must receive the appointment notification form in a represented case?
In a represented case a copy of the completed appointment notification form must also be sent to the attorney who represents each party if known.
What constitutes grounds for denial of reappointment under section 51 of Title 8?
Failure to comply with the requirement of submitting the appointment notification form within the specified timeframe constitutes grounds for denial of reappointment under section 51 of Title 8 of the California Code.
What does QME stand for?
QME stands for Qualified Medical Evaluator.
What is the significance of section 51 of Title 8 of the California Code?
Section 51 of Title 8 of the California Code outlines regulations regarding the reappointment of QMEs and the necessary compliance requirements that must be adhered to.
What is the role of the Qualified Medical Evaluator (QME) in the scheduling of comprehensive medical-legal examinations?
The QME is responsible for scheduling the first comprehensive medical-legal examination which must be conducted at a medical office listed on the panel selection form or any office approved by the Medical Director with written agreement from the parties.
Can subsequent evaluation appointments be held at different medical offices?
Yes subsequent evaluation appointments may be performed at another medical office of the selected QME provided it is listed with the Medical Director and is within a reasonable geographic distance from the injured worker’s residence.
What must the QME include in the notification regarding interpreting services?
The QME must include whether a Certified Interpreter is required as defined by Labor Code Section 5811 and must specify the language needed.
Who arranges for the Certified Interpreter and who pays for it?
The party responsible for paying the cost of the interpreter must arrange for the Certified Interpreter as outlined in Section 5811 of the Labor Code.
What does ‘AME’ stand for in the context of medical evaluations?
‘AME’ stands for Agreed Medical Evaluator which is another type of medical evaluator alongside the QME.
What section of the California Code of Regulations defines the need for a Certified Interpreter?
The need for a Certified Interpreter is defined in section 9795.3 of Title 8 of the California Code of Regulations.
What is a key requirement for the location of the first comprehensive medical-legal examination?
The first comprehensive medical-legal examination must be held at a medical office listed on the panel selection form or an alternate office approved by the Medical Director with written agreement from both parties.
What is the significance of Labor Code Section 5811 in the context of medical evaluations?
Labor Code Section 5811 outlines the requirements and responsibilities regarding the use and costs associated with Certified Interpreters for injured workers during medical-legal evaluations.
How far must a subsequent medical evaluation location be from the injured worker’s residence?
The subsequent medical evaluation must be at a reasonable geographic distance from the injured worker’s residence according to the provisions set by the QME or AME.
What does the acronym QME stand for?
QME stands for Qualified Medical Evaluator.
What is the rule regarding canceling a scheduled appointment less than six business days before the appointment?
An appointment cannot be canceled less than six business days prior to the appointment date except for good cause.
What must an evaluator do if they cancel a scheduled appointment?
The evaluator must advise the parties in writing of the reason for the cancellation.
Who retains jurisdiction to resolve disputes regarding appointment cancellations?
The Appeals Board retains jurisdiction to resolve disputes among the parties regarding whether an appointment cancellation was for good cause.