Chapter 4.5. Division of Workers' Compensation
Subchapter 1.6. Permanent Disability Rating Determination

§10162. Summary Rating Determinations, Apportionment.

(a) In cases where the injured worker is not represented and a Qualified Medical Evaluator's formal medical evaluation indicates apportionment of the permanent disability, a summary rating determination will not be made until a workers' compensation administrative law judge has reviewed the medical evaluation to determine if the apportionment is inconsistent with the law. The determination of the workers' compensation administrative law judge will not be admissible in any judicial proceeding.

(b) Upon receipt of a formal medical evaluation which apportions the disability, the Disability Evaluation Unit will transmit the medical evaluation to the presiding workers' compensation administrative law judge of the office of the appeals board designated by the Disability Evaluation Unit, with a request to review the apportionment to determine whether it is inconsistent with the law. The workers' compensation administrative law judge shall make the determination and respond to the Disability Evaluation Unit within 45 days.

(c) If the workers' compensation administrative law judge refers the medical report back to the Qualified Medical Evaluator for correction or clarification, the Qualified Medical Evaluator shall provide a response to the workers' compensation administrative law judge within 30 days of the referral. If no response is received, the workers' compensation administrative law judge shall make a determination whether the apportionment is inconsistent with the law, and a summary rating determination will be made.

(d) In cases where the injured worker is represented and an Agreed Medical Evaluator or Qualified Medical Evaluator apportions the permanent disability, the Disability Evaluation Unit will issue a summary rating determination "Before Apportionment."

   Note: Authority cited: Sections 133, 5307.3 and 5307.4, Labor Code. Reference: Sections 124 and 4061, Labor Code.

 HISTORY 

   

1. New section filed 4-25-91; operative 4-25-91 (Register 91, No. 26). New section is exempt from review by OAL pursuant to Government Code section11351.

2. Amendment filed 11-17-2008; operative 11-17-2008 pursuant to  GovernmentCode section 11343.4 (Register 2008, No. 47).