Bulletin No. 26-04
May 24, 2004

DWC Medical Unit clarifies QME process

All requests for Qualified Medical Examiner (QME) panels should be sent to the Division of Workers' Compensation Medical Unit at P.O. Box 8888, San Francisco, CA 94128. Request forms must be completely filled out, including the signature line. Claims administrators submitting requests must sign the form on the signature line intended for injured workers until new forms are adopted. Proof that notification requirements per Labor Codes 4060, 4061 and 4062 have been met must be submitted along with the properly filled out request form. Incomplete request forms, or forms submitted without documentation of notice to the injured worker, will be returned.