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Chapter 4.5. Division of Workers' Compensation
Subchapter 1. Administrative Director--Administrative Rules
Article 5.1 . Spinal Second Opinion Procedure

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§9788.7. Contents Of Second Opinion and Agreed Second Opinion Physician Reports.

(a) If the second opinion physician or agreed second opinion physician disagrees with the recommendation of the treating physician, the second opinion physician's or agreed second opinion physician's report may include a recommendation for a different treatment or therapy.

(b) Reports of second opinion physicians and agreed second opinion physicians shall include, where applicable:

(1) The date of the examination;

(2) The patient's complaints;

(3) A listing of all information received from the parties reviewed in preparation of the report or relied upon for the formulation of the physician's opinion;

(4) The patient's medical history relevant to the treatment determination;

(5) Findings on record review or examination;

(6) The relevant diagnosis;

(7) The physician's opinion whether or not the proposed spinal surgery is appropriate or indicated, and any alternate treatment recommendations;

(8) The reasons for the opinion, including a reference to any treatment guidelines referred to or relied upon in assessing the proposed medical care;

(9) The signature of the physician.

(c) Second opinion physicians and agreed second opinion physicians shall serve with each report the following executed declaration made under penalty of perjury:

“In connection with the preparation and submission of the attached report of second opinion on recommended spinal surgery, I declare, on the date next written, under penalty of perjury of the laws of the State of California, that I have no material familial affiliation, material financial affiliation, or material professional affiliation prohibited by Labor Code Section 4062, subdivision (c).


___________________________   ___________________________
date   signature”

NOTE

Authority cited: Sections 133 and 5307.3, Labor Code. Reference: Sections 4062(b) and 4600, Labor Code.

HISTORY

1. New section filed 7-2-2004 as an emergency; operative 7-2-2004 (Register 2004, No. 27). A Certificate of Compliance must be transmitted to OAL by 11-1-2004 or emergency language will be repealed by operation of law on the following day.

2. Certificate of Compliance as to 7-2-2004 order transmitted to OAL 11-1-2004 and filed 12-15-2004 (Register 2004, No. 51).

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