Medical Unit

The Medical Unit performs a variety of services related to delivery of medical benefits in the workers' compensation system. It establishes policy and guidelines for the treatment and evaluation of injured workers. The unit examines and appoints physicians to be qualified medical evaluators (QMEs), who in turn examine injured workers to help determine the level of benefits they receive. It also certifies and oversees groups -- medical provider networks (MPNs) and health care organizations (HCOs) -- that provide care to injured workers. The unit reviews utilization review (UR) plans and handles UR complaints and investigations jointly with the Audit Unit. The unit oversees the independent medical review (IMR) and independent bill review (IBR) programs used to resolve disputes about medical treatment and medical-legal billing. It also assists the DWC administrative director with other issues affecting providers in the workers' compensation system, such as setting medical fee schedules, and undertakes medical care studies.

System Maintenance Notice

Due to ongoing improvements to the system, the Online QME Form 106 Panel Request system will be offline from 8:00 p.m. to midnight Pacific Time on Friday, September 22, 2017. When visiting the website, if the system is unavailable, please try again later.

Medical Unit Programs:


Online physician education course now Available

DWC offers a free online education course for physicians and others interested in learning about California's Medical Treatment Utilization Schedule. CME credit available at no cost.

Resources:

Database:

Frequently asked questions:

Forms

Medical Unit Office:
Mailing Address:
DWC - Medical Unit
P.O. Box 71010
Oakland, CA 94612
Street Address:
DWC - Medical Unit
1515 Clay Street, 18th floor
Oakland CA 94612
Telephone Number:
510-286-3700 or 800-794-6900
 
PLEASE NOTE:
ALL PACKAGES, CERTIFIED MAIL AND PRIORITY MAIL MUST BE SENT TO THE STREET ADDRESS ONLY

September 2017