TITLE 8. INDUSTRIAL RELATIONS
DIVISION 1. DEPARTMENT OF INDUSTRIAL RELATIONS
CHAPTER 1. DIVISION OF WORKERS' COMPENSATION-QUALIFIED MEDICAL EVALUATOR

Article 6. QME Discipline

§60. Discipline.

(a) The Administrative Director may, in his or her discretion, suspend or terminate any physician from the QME list without hearing:

(1) whose license has been revoked;

(2) whose license has been suspended or terminated by the relevant licensing board so as to preclude practice;

(3) who has been convicted of a misdemeanor or felony related to the conduct of his or her practice or who has been suspended or placed on probation by his or her licensing board;

(4) based on a stipulation or a decision by the physician's licensing board that the physician has been placed on probation;

(5) who has failed to pay timely the appropriate fee as required under section 17 of Title 8 of the California Code of Regulations.

(b) The Administrative Director may, based on a complaint by the Medical Director, and following a hearing pursuant to section 61 of Title 8 of the California Code of Regulations, suspend, terminate or place on probation a QME found in violation of a statutory or administrative duty as described in the Administrative Director Sanction Guidelines for QMEs under section 65 of Title 8 of the California Code of Regulations. Such violations include, but are not limited to:

(1) one violation of Labor Code section 139.3 or 4628;

(2) failure to follow the medical procedures established by the Administrative Director pursuant to Labor Code section 139.2(j)(1)(2)(3)(4)(5) or (6);

(3) failure to comply with the requirements of Labor Code section 139.2(b) or (c) and/or section 10, 10.5, 11 or 12 of Title 8 of the California Code of Regulations;

(4) failure to comply with the unavailability notification requirements pursuant to section 33 of Title 8 of the California Code of Regulations.

(5) failure to comply with the disclosure, ethical or conflict of interest requirements pursuant to sections 40, 41 or 41.5, respectively, of Title 8 of the California Code of Regulations;

(6) failure to complete accurate and complete reports pursuant to Labor Code section 139.2(i) or to comply with section 39.5 of Title 8 of the California Code of Regulations.

(7) one finding by the Appeals Board of ex parte contact by the QME prohibited by Labor Code section 4062.3.

(8) one finding by the Administrative Director that the QME solicited an injured worker to take over that worker's treatment for his or her workers compensation claim.

(9) failure to disclose a disqualifying conflict of interest as required by section 41.5 of Title 8 of the California Code of Regulations;

(10) failure to disclose a significant financial interest, as defined in sections 1(cc) and 29 of Title 8 of the California Code of Regulations.

(c) The Medical Director may file a complaint with the Administrative Director against a QME on any of the grounds listed in subsection (b) based on a complaint from a member of the public and/or the Medical Director's own initiative. The Medical Director may assign legal counsel and investigators to conduct all matters related to this Article.

(d) The powers and discretion of the Administrative Director are hereby delegated to the Medical Director of the Division, or his or her designee Associate Medical Director, with respect to:

(1) Conducting investigations and assigning investigators;

(2) Issuing subpoenas for testimony and/or production of documents;

(3) Propounding interrogatories;

(4) Receiving and filing requests for hearing and notices of defense;

(5) Setting and calendaring cases for hearing;

(6) Issuing notices of hearing;

(7) Assigning counsel; and

(8) Performing all other functions related to QME discipline under this Article, except for issuing statements of issues, issuing accusations and issuing disciplinary orders after hearing.

(e) A report prepared by a QME which has not been completed and served on one or more parties prior to the date of the final decision taken by the licensing board or the date of the conviction, whichever is earlier, shall be inadmissible before the Appeals Board and no party shall have liability for payment for the report.

   Note: Authority cited: Sections 11180-11191, Government Code; Sections 111, 133, 139.2 and 5307.3, Labor Code. Reference: Sections 139.2 and 4062.3, Labor Code.

 HISTORY 

   

1. New article 6 (sections 60-62), renumbering of former section 51 to new section 60, repealer and new subsection (a), amendment of subsection (b), new
subsection (b)(6) and subsection renumbering, and new subsections (b)(8) and  (d) filed 8-23-96; operative 9-22-96 (Register 96, No. 34).

2. Amendment filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15).

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