Chapter 1. Industrial Medical Council
Article 2. QME Eligibility

§11.5. Disability Evaluation Report Writing Course

Prior to appointment as a QME, a physician shall complete a course of at least twelve hours of instruction in disability evaluation report writing. The course curriculum shall be specified by the Council.

(a) To apply to the Council for accreditation, a provider shall submit:

(1) a completed IMC Form 118 which contains

(A) the applicant's name; address; director of education with contact information; type of organization; length of time in business; nature of business; and past experience providing continuing education courses (including a list of other accrediting agencies that have approved such courses);

(B) a description of the proposed education program or course which includes the title; type (continuing education program or disability evaluation report writing course); location(s); date(s); length of training in clock hours; educational objectives; a complete description of the program or course content; faculty; and the names of other accrediting agencies that have approved the program.

(2) A curriculum vitae for each proposed instructor. A proposed instructor 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 or course. A course may be advertised to the public prior to accreditation by the Council so long as the promotional material states in at least 12 point type on the first page of the promotional material “this course is pending approval by the Industrial Medical Council and may not be approved for credit.”

(b) The Council shall accredit a applicant that meets the definition of provider in Section 1(r); 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 55(c) or a course which meets the requirements of 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 IMC for material solely discussing the business aspects of workers' compensation medical practice such as billing, coding and marketing.

(c) The Council shall notify the applicant within 5 calendar days following the next scheduled Council meeting after receipt of the application containing all the information listed in Section 11.5(a) whether that provider has been accredited for a two year period and the proposed course has been approved. Incomplete applications will be returned to the provider.

(d) A provider that has been accredited by the Council will be given a number which must be displayed on course promotional material.

(e) On or before the date the course is first presented, the provider shall submit the program syllabus (all program handouts) to the Council.

(f) An approve course may be offered for two (2) years. A provider shall notify the Council in writing of any change to the faculty in an approved course.

(g) To apply for re-accreditation, a provider must submit a completed IMC Form 118, using the application process in 11.5(a). 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 Council shall give the provider 90 days' notice of the need to seek re-accreditation.

(h) Promotional materials for a course must state the provider's educational objectives; the professional qualifications of course faculty (at the least, all relevant professional degrees); the content of course activities; and the intended audience.

(i) The minimum of 12 hours of instruction in disability evaluation report writing shall include:

(1) The Qualified Medical Evaluator's Role in the Disability Evaluation Process (minimum 1 hour) How disability evaluation reports are used The reasons why reports must be clear, complete and timely The QME's role as an expert witness Impact of the QME's report on the injured worker QME ethics and the Confidentiality of Medical Information Act

(2) Elements of the Medical-Legal Report (minimum 1 hour) The Labor Code and regulatory requirements for medical-legal reports.

(3) The Language of Reports (minimum 4 hours) Evaluation of disability in California (impairment and disability) The occupational history

The physician examination and the role of testing

Labor Code requirements to use Packard Thurber's Evaluation of Industrial Disability Factors of disability

Subjective

Objective

Work restrictions

Loss of pre-injury capacity

Causation

Determination of permanent and stationary status

Vocational rehabilitation

Apportionment

Future medical treatment

Review of records

Providing sufficient support for conclusions

(4) The Council's Disability Evaluation Protocols (minimum 1 hour) An overview of the protocols and an in-depth discussion of one or more of the Neuromusculoskeletal, Pulmonary, Cardiac, Immunologic, or Psychiatric protocols.

(5) The Third Party Perspective (minimum 1 hour) The report from the perspective of those who read it: Judge(s), attorney(ies), insurer(s), rater(s), employer(s), qualified rehabilitation representative(s).

(6) Anatomy of a Good Report (small group or other interactive sessions -- minimum 3 hours)

Discussion of examples of good reports and identification of weaknesses in reports Opportunities for the practitioner to critique and/or correct reports. If feasible, physician should have the opportunity to write a sample report. Review of results of IMC annual report review and identification of common problems with reports

(7) Mechanics of Report Writing (minimum 1 hour)

The QME Process

Face to face time

Timelines for submission of report

Completion of required forms

Service of reports

Final questions and answers

(j) No more than four hours of the required twelve hours of instruction may be taken by distance learning. All audio or video tapes, computer programs and printed educational material used in the course must be submitted to the Council on or before the date the course is first given. All distance learning materials shall bear a date of release and shall be updated every three years. The provider shall notify the Council in writing of the revision.

(k) Instructors shall not recruit members or promote commercial products or services during course instruction immediately before, during or after a course. Providers or vendors may display/sell educational materials related to workers' compensation or applications for membership in an area adjoining a course. A course provider or faculty member shall disclose on IMC form 119 any significant financial interest in or affiliation with any commercial product or service which it/he/she discusses in a course and that interest or affiliation must be disclosed to all attendees.

(l) The provider shall maintain attendance records for each disability evaluation report writing course for a period of no less than three years after the course is given. A physician attending the course must be identified by signature. The provider must submit a copy of the signature list to the Council within 60 days of completion of the course.

(m) The provider is required to give the IMC's Evaluation Form 117) to course attendees and request they submit the form to the IMC. This information shall not be used in lieu of a certification of completion given by the provider, as specified pursuant to section (n). 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 course shall constitute grounds for revocation of a provider's accredited status. The Council shall tabulate the responses and return a summary to the provider within 90 days of completion of the course.

(n) The provider shall issue a certificate of completion to the physician which states the name of the provider, the provider's number, the date(s) and location and title of the course. To be eligible for appointment as a QME, a physician must complete no less than 12 hours of the curriculum specified in Section 11.5(i) and must submit a copy of that certificate to the Council.

(o) Joint sponsorship of courses (as between an accredited and an unaccredited provider) must be approved by the Council prior to presentation of the course.

(p) The Council may audit a provider's course(s) at the request of the medical director to determine if the provider meets the criteria for accreditation. The Council may audit courses given by providers randomly, when a complaint is received, or on the basis of responses on IMC Form 117. An auditor shall not receive QME credit for a course which s/he is auditing. The Council shall make written results of the audit available to the provider no more than 30 days after the audit is completed.

(q) Accredited providers that cease to offer disability evaluation report writing courses shall notify the Council in writing.

(r) The Council 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 subsections 11.5(a) or 55(c)):

(1) Conviction of a felony or any offense substantially related to the activities of the provider.

(2) Material misrepresentation of fact by the provider.

(3) Failure to comply with Council regulations

(4) False or misleading advertising

(5) Failure to comply with Council recommendations following an audit

(6) Failure to distribute Council form 117 cards to course attendees.

NOTE

Authority cited: Sections 139, 139.2, 4060, 4061 and 4062, Labor Code. Reference: Sections 139, 139.2, 4060, 4061, 4061.5 and 4062, Labor Code.

HISTORY 1.

New section filed 10-16-2000 as an emergency; operative 1-1-2001 (Register 2000, No. 42). A Certificate of Compliance must be transmitted to OAL by 5-1-2001 or emergency language will be repealed by operation of law on the following day.