Online QME Form 106 Panel Request

System Maintenance Notice

Due to ongoing improvements to the system, the online Form 106 panel request system will be unavailable between 10:00 p.m. and 11:30 p.m. Pacific Time on Saturday, January 13, 2018. When visiting the website, if the system is unavailable, please try again later.

In order to provide a more efficient means of requesting and receiving QME panels, the Division of Workers' Compensation (DWC) implemented a new online panel process for represented initial panel requests on Oct. 1, 2015.

How does it work?

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.

Helpful information for completing an online panel request:

Online QME Form 106 Panel Request system:

To avoid printing issues, please make sure you have disabled any pop-up blockers on your browser before filling out the online form.

May 2017