The Investigations Unit of the DWC Medical Unit investigates complaints about physicians in the workers' compensation system. In some cases, the person who contacts the DWC Medical Unit is interviewed to obtain further information; then a letter is sent to the physicians (QME) asking for a response to the complaint. In other cases, a field investigation is conducted, including witness interviews and collection of other evidence, prior to contacting the QME. Investigations which reveal misconduct are referred to the administrative director and/or a licensing agency, the complaining party is advised by letter of the outcome of the investigation. Complaints can be sent by mail to the Investigations Unit, DWC Medical Unit, PO Box 71010 Oakland, CA 94612 or emailed to QMEInvestigations@dir.ca.gov. The unit also has a toll free number where a message can be left anonymously. It is important to leave sufficient information so that the unit can respond to a complaint properly. The number is 1-800-999-1041.
DWC Medical Unit provides a QME medical evaluation complaint form for your use.
The information below summarizes final disciplinary action taken by the administrative director. Decisions by the administrative director to impose discipline which are under reconsideration or appeal are not considered final decisions and not posted here until final. During the appeal process, a QME may continue to perform evaluations in some cases. Call 1-800-794-6900 for information.
What is a precedent?
"Precedent" is a group of decisions which include significant legal or policy determinations, and are designed to guide an administrative law judge in deciding cases involving the DWC Medical Unit. The authority to establish precedent for administrative matters, by identifying cases and certifying them, was established fairly recently although precedent is used routinely by judges in other civil cases and in criminal cases. Precedent is important to parties in a legal case involving the department, because the precedent establishes what the DWC Medical Unit has done in the past, and why. The procedures that apply to an administrative case are in the Administrative Procedures Act and are more fully described by the Office of Administrative Hearings, which assigns judges to make the decisions in the cases.
How is a decision, which is relied upon as precedent, used?
The administrative law judge is required to apply the principles of the DWC Medical Unit's precedent, to the extent that the facts and issues are the same. The judge's final decision must be consistent with the precedential decisions. An attorney for the DWC Medical Unit may, in an administrative case, bring one or more of the decisions to the administrative law judge's attention when it appears that the facts and other issues are the same or similar. If you are a respondent in a case involving the DWC Medical Unit, and you believe that one or more of the decisions which the department identified as precedent is binding in your case, you should inform the department and administrative law judge at the time of the hearing or before the hearing.
How can I obtain a copy of DWC Medical Unit's precedent?
Decisions designated as precedent, as well as the index, are available here on the DWCMU Web site. Copies of these decisions may also be requested by contacting the DWC Medical Unit. A charge of 10 cents per page will be assessed if your request exceeds 100 pages.
Index of precedential decisons
|2005-25392||Michael A. Fraga, Psy.D.|
|01-9713||Sheridon H. Groves M.D.|
|2000-4672||Kesho Hurria M.D.|