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Division 1. Department of Industrial Relations
Chapter 1. Division of Workers' Compensation-Qualified Medical Evaluator Regulations
Article 2. Qme Eligibility

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§14. Doctors of Chiropractic: Certification in Workers' Compensation Evaluation


(a) All doctors of chiropractic shall be certified in workers' compensation evaluation by either a California professional chiropractic association, or an accredited California college recognized by the Administrative Director. The certification program shall include instruction in disability evaluation report writing that meets the standards set forth in section 11.5.

(b) California professional chiropractic associations or accredited California colleges applying to be recognized by the Administrative Director for the purpose of providing these required courses to chiropractors in California workers' compensation evaluation, shall meet the following criteria:

(1) The provider's courses shall be administered and taught by a California professional chiropractic association or a California chiropractic college accredited by the Council on Chiropractic Education. Instructors shall be licensed or certified in their profession or if a member of a non-regulated profession have at least two years experience in their area of instruction regarding workers' compensation issues.

(2) The provider's method of instruction and testing shall include all of the following:

(A) Lecture, didactic sessions and group discussion including an initial 8 hours of overview of the workers' compensation system and 36 additional hours in medical-legal issues for total minimum class time of 44 hours. Up to 4 hours of the instruction covering the regulations affecting QMEs and/or writing ratable reports may be satisfied by distance learning. The initial 8 hours of overview are transferable to any other approved program provider for credit;

(B) Passing a written test at the completion of the program to determine proficiency and application of course material;

(C) Writing a narrative conclusion to medical-legal issues in response to facts presented or a narrative report, in appropriate format, which would meet the standards of a ratable report;

(3) The initial 8 hours of the course material shall cover the following information:

(A) Overview of California Labor Code, DWC (Division of Workers' Compensation of the California Department of Industrial Relations) and the regulations of the Division of Workers' Compensation and of the Workers' Compensation Appeals Board governing QMEs, medical-legal reports and evaluations;

(B) Obligations of the treating and evaluating physicians;

(C) Review of appropriate workers' compensation terminology;

(4) The remaining 36 hours shall include but not be limited to the following:

(A) History and examination procedure requirements, including all relevant treatment, treatment utilization and evaluation guidelines and regulations adopted by the Administrative Director;

(B) The subjects outlined in subdivision 11.5(i) not already addressed in the first 8 hours, including, but not limited to, proper use of the AMA Guides, and the medical treatment utilization schedule (MTUS) adopted pursuant to Labor Code section 5307.27;

(C) Apportionment, including the changes in Labor Code sections 4660, 4663 and 4664 by SB 899 (Stats. 2004, ch. 34);

(D) Future medical care.

(5) The provider's course material and tests shall be submitted to the Administrative Director for annual review and the Administrative Director shall monitor a provider's course as necessary to determine if the provider meets the criteria for recognition.

(6) The provider's course advertising shall clearly state whether or not the course is recognized to satisfy the requirement for chiropractic California workers' compensation evaluation by the Administrative Director.

(c) Course Material shall also cover at a minimum, the material within the text of the “Physicians Guide to Medical Practice in the California Workers' Compensation System (Current Edition).”

(d) No one shall recruit members or promote commercial products or services in the instruction room immediately before, during, or immediately after the presentation of a course. Education 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 QME Form 119 (Faculty Disclosure of Commercial Interest) (see, 8 Cal. Code Regs. ยง 119) any significant financial interest held by faculty in or affiliation with any commercial product or service which is discussed in a course and that interest or affiliation must be disclosed to all attendees. An education provider shall file every Form 119 in its possession with the Administrator Director.

NOTE: The “Physicians' Guide” does not appear as a part of this regulation. Copies are available through the Medical Director Division of Workers' Compensation, Attention: Medical Unit, P. O. Box 71010, Oakland, CA 94612.

Note: Authority cited: Sections 122, 133, 139.2, 139.3 and 5307.3, Labor Code. Reference: Sections 139.2, 4060, 4061, 4062, 4062.1, 4062.2, 4062.3 and 4067, Labor Code.

HISTORY

1. New section filed 4-9-93 as an emergency; operative 4-9-93 (Register 93, No. 15). A Certificate of Compliance must be transmitted to OAL 8-9-93 or emergency language will be repealed by operation of law on the following day.

2. Editorial correction amending subsections (a)(1) and (b) and Note (Register 93, No. 17).

3. New section refiled 9-16-93 with amendment of subsections (a)(1)-(b) as an emergency; operative 9-16-93 (Register 93, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-14-94 or emergency language will be repealed by operation of law on the following day.

4. Certificate of Compliance as to 9-16-93 order including amendment of subsections (b) and (c) transmitted to OAL 10-28-93 and filed 12-14-93 (Register 93, No. 51).

5. Relocation of article 2 filed 8-1-94; operative 8-31-94 (Register 94, No. 31).

6. Amendment of subsections (a)(1) and (a)(2), repealer of subsections (b)-(b)(2) and subsection relettering, and amendment of newly designated subsections (b) and (c) filed 8-23-96; operative 9-22-96 (Register 96, No. 34).

7. Amendment filed 6-7-99 as an emergency; operative 6-7-99 (Register 99, No. 24). A Certificate of Compliance must be transmitted to OAL by 10-5-99 or emergency language will be repealed by operation of law on the following day.

8. Reinstatement of section as it existed prior to 6-7-99 emergency amendment by operation of Government Code section 11346.1(f) (Register 2000, No. 3).

9. Amendment filed 1-19-2000; operative 1-19-2000 pursuant to Government Code section 11343.4(d) (Register 2000, No. 3).

10. Renumbering of former section 14 to section 16 filed 4-14-2000 pursuant to section 100, title 1, California Code of Regulations (Register 2000, No. 15).

11. Renumbering and amendment of former section 13.5 to section 14 filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15).

12. Amendment of subsections (a), (b), (b)(4) and (b)(6) and redesignation and amendment of former subsection (b)(7) as new subsection (c) filed 8-23-2001; operative 8-23-2001 pursuant to Government Code section 11343.4 (Register 2001, No. 34).

13. Amendment of section and Note filed 1-13-2009; operative 2-17-2009 (Register 2009, No. 3).

14. Amendment of subsection (b)(4)(B), repealer of subsection (b)(4)(D), subsection relettering and amendment of newly designated subsection (b)(4)(D) filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 1). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.

15. Amendment of subsection (b)(4)(B), repealer of subsection (b)(4)(D), subsection relettering and amendment of newly designated subsection (b)(4)(D) refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.

16. Certificate of Compliance as to 7-1-2013 order transmitted to OAL 8-2-2013 and filed 9-16-2013 (Register 2013, No. 38).

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