Chapter 1. Industrial Medical Council
Article 3. Assignment of Qualified Medical Evaluators, Evaluation Procedure

§32.5. Rebuttal QME Examinations.

(a) For injuries occurring between January 1, 1991 and December 31, 1993, an unrepresented employee shall have the right to a QME panel for one comprehensive medical-legal evaluation to rebut the findings of a panel QME, provided however, that the rebuttal evaluation is reasonable and necessary to resolve a disputed medical fact as defined in section 9793(e) of this Title. The employee shall notify in writing the claims administrator, or if none, the employer, the justification for the rebuttal evaluation. A copy of this notice shall be submitted to the Medical Director with this request. Reasonable and necessary justification shall include but not be limited to a discrepancy between the treating physician's conclusions and the QME's conclusions as to the level of permanent impairment, the need for medical treatment or the employee's status as a Qualified Injured Worker.

(b) For injuries occurring on or after January 1, 1994, and upon request by the Appeals Board, the Medical Director shall assign a QME to address disputed issues provided, however, that the claims administrator or if none, the employer, agrees to pay for the cost of this rebuttal examination.

NOTE: Authority cited: Sections 139.2, 4061, 4062 and 4064, Labor Code. Reference: Sections 4061 and 4062, Labor Code.

HISTORY

1. New section filed 8-23-96; operative 9-22-96 (Register 96, No. 34).

2. Renumbering of former section 32.5 to section 32 and renumbering and amendment of former section 32.7 to section 32.5 filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15).