DWC Issues Notice of Second 15-Day Public Comment Period for QME Process Regulations

The Division of Workers’ Compensation (DWC) has issued a second notice of public comment period beginning on November 21, 2023, for modifying the text of proposed amendments to the Qualified Medical Evaluator (QME) Regulations. The affected regulations are Title 8, California Code of Regulations Sections 1, 11, 11.5, 14, 33, 35, 35.5, 50, 51, 52, 54, 55, 55.1, 56, 57, 63, 10133.54 & 10133.55. (QME Process Regulations).

The proposed changes are necessary to bring existing regulations into compliance with amendments to the Labor Code and to clarify the Administrative Director’s authority with respect to the process related to appointment and reappointment of QMEs, which is granted by relevant statutory authority.

The proposed regulations are amended to provide greater clarity to the wording. Based upon issues of clarity and to provide ease of interpretation, DWC proposes to update the text of the proposed amendments of the regulations to:

• Provide a clearer definition of and the reason for encryption of Electronic Transmissions.
• Delete unnecessary phase-in periods for certain regulations as a result of the new anticipated effective date of April 1, 2024 for the proposed regulations.
• Add a new regulation that delineates the new continuing education hour and subject matter requirements that apply to applications for reappointment after April 1, 2026.
• Clarify the definition “new medical legal evaluation” for purposes of satisfying criteria for QME unavailability.
• Provide criteria for the Administrative Director’s use of the exercise of discretion in the QME reappointment process.
• Provide examples of good cause, provide clarity to the regulatory language and delete confusing language where necessary in the regulations involving reappointment and denial of reappointment for QMEs.
• Add and in some cases delete language and hours of accreditation to clarify the proper interpretation of regulations related to the Continuing Education requirements.
• Define and add criteria for good cause in the exercise of discretion by the Administrative Director in granting an appeal of denial of reappointment when a hearing is anticipated.
• Correct typographical errors.

DWC has also published a Supplemental Initial Statement of Reasons to provide additional information about the need for and economic impact of the proposed regulations.

DWC will consider all public comments. The 15-day notice of modification to the text of the proposed regulations and the text of the regulations can be found on DWC’s rulemaking page.

Written comments should be addressed to:
Maureen Gray, regulations coordinator
Department of Industrial Relations
Division of Workers' Compensation
1515 Clay Street, 18th floor
Oakland, CA 94612

The Division’s contact person must receive all written comments concerning the proposed modification to the regulations no later than December 11, 2023. Written comments may be submitted by facsimile transmission (FAX), addressed to the contact person at (510) 286-0687. Written comments may also be sent electronically (via e-mail), using the following e-mail address: dwcrules@dir.ca.gov.

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