Frequently asked questions about QME Form 106 Online Panel Request
About the basics:
Q. How does the online QME Form 106 Panel Request system work?
A. Parties in a represented case are required to submit initial QME panel requests using the online QME system; by doing so, an online panel will issue immediately. The requesting party is then responsible for serving the panel request form, any required documentation and the QME panel on all parties with a proof of service.
Q. Where can I can I access the online QME Form 106 Panel Request system?
A. You can access the online QME system on the DWC Medical Unit web page.
Q. I have an attorney. Do I have to use the online QME Form 106 Panel Request system?
A. Yes. As of Oct. 1, 2015, all represented initial panel requests must be submitted using the online QME system.
Q. I don't have an attorney. Can I use the online QME Form 106 Panel Request system?
A. No. The online system is currently only for represented panel requests (Form 106). Unrepresented injured workers should continue to use the paper Form 105.
About working in the online QME system:
Q. Do I need to enter the workers’ compensation claim number exactly how it was assigned by the claims administrator?
A. Yes. You must enter the workers’ compensation claim number exactly how it is assigned by the employer’s workers’ compensation insurance carrier including hyphens. The system will not accept special characters or spaces.
Q. What date should I enter for a CT case?
A. Enter the ending date for a cumulative injury.
Q. Why would the online system reject my panel request?
A. There are three reasons an online represented panel request will be rejected:
- A panel has already been issued for the case and injured worker
- The panel request is premature as defined by Labor Code section 4062.2; 8 CCR sections 10507 and 10508
- There are insufficient QMEs in the specialty requested.
Q. Why did I receive an ineligibility notice for my panel request being premature?
A. A panel request is considered premature if it is made before 15 days (10 days plus 5 days for mailing) have elapsed after the objection communication or delay/denial letter is sent to the opposing party. In other words, an eligible request can be made on the 16th day. For out-of-state cases, you must wait 20 days (10 days plus 10 days for mailing) for a request to be eligible. Additionally, if the 15th or 20th day falls on a weekend or a holiday, the following business day is considered the 15th/20th day, and an eligible request can be submitted the next day. Please keep in mind that the 20-day waiting period also applies to cases where the claims administrator is located outside of California.
Q. Why was my 4060 request returned as ineligible?
A. For 4060 disputes, you must enter the date of the request for a compensability exam (refer to denial or delay letter). This is not the online submission date.
Q. I received a rejection notice. Am I required to serve it on all parties?
A. If the initial panel request is rejected, you are not required to serve the notice on all parties. Service must be made when an eligible panel is generated.
Q. How does the striking process work with the online system?
A. The parties are allowed to strike at any time once the panel has been issued, but both parties must strike within 10 days of issuance/service. It is up to the requesting party to serve the panel to the opposing party.
Q. What if the date of injury is prior to Jan. 1, 2005? Can I use the online system?
A. No. For dates of injury prior to Jan. 1, 2005, parties may select their own QMEs and are not required to request a panel from the Medical Unit. The parties may request a panel QME by agreement only and use the paper Form 106 indicating that it is joint request.
Q. Once an online panel request has been completed and panel number issued, will I be able to look up that panel in the future?
A. Currently, the online system does not include a database of previously submitted panels. We suggest you download and save your submission to your computer or server for future reference.
You may also call the Medical Unit at 1-800-794-6900 to receive a faxed copy.
Q. Why am I unable to print the panel package documents?
A. To avoid printing issues, please make sure you have disabled any pop-up blockers on your browser. A red X at the bottom of the page (Internet Explorer) or top of the page (Chrome) denotes that a pop up was blocked, and that a pop-up blocker is turned on.
You may temporarily disable the pop-up blocker by:
- Clicking on the red X;
- An option menu will appear;
- Click on the option that allows pop ups for future online visits.
If you are unable to print the panel package documents after disabling the pop-up blockers, you may call the Medical Unit at 1-800-794-6900 to receive a faxed copy.
Q. How do I submit a represented initial panel request for an uninsured employer (UEF) case?
A. You should mail the paper Form 106 to the Medical Unit with a coversheet attached indicating the request is for an uninsured employer case.
About filing using the online QME system:
Q. What if I don’t have a Uniform Assigned Name (UAN)?
A. All attorneys must have a UAN in order to use the online QME Form 106 Panel Request system. New offices and changes of name, location, mailing address, telephone, e-mail, fax, or preferred method of service must be registered with the CRU. Registration requests are submitted on letterhead with an authorized signature by e-mail to email@example.com or fax to (888) 822-9309. The new assigned name or information will be posted within 10 business days of receipt of the request.
Q. Where can I find the proof of service?
A. The online QME system provides a proof of service as a courtesy to the filer. You may either use the proof of service provided at the completion of the panel request submission or use your own.
Q. When do the online QME regulations become effective?
A. The Office of Administrative Law (OAL) has approved the Division of Workers’ Compensation’s (DWC) final version of the Qualified Medical Evaluator (QME) regulations. The effective date of the new regulations is Sept. 1, 2015. You can find the notices of rulemaking, text of the regulations, and the initial statements of reasons on the DWC Rulemaking page.
About training and resources:
Q. What training is available for external users?
A. The Medical Unit web page on the DWC website contains a wealth of information and links, including training tools.
Q. Who can I contact with questions about the online QME Form 106 Panel Request system?A. Information and training materials are available on the DWC Medical Unit website. You may also contact the DWC Medical Unit by email at MUHelpdesk@dir.ca.gov.