Title 8. Industrial Relations
Division 1. Department of Industrial Relations
Chapter 1. Division of Workers' Compensation -- Qualified Medical Evaluator Regulations
Article 6. QME Discipline

§63. Denial of Appointment or Reappointment.

(a) Whenever the Administrative Director determines that an application for appointment or reappointment as a Qualified Medical Evaluator will be denied or that appointment or reappointment will be to a probationary status, the Administrative Director shall notify the applicant in writing of the decision, including the grounds and reasons for the decision, and of the applicant's right to appeal and to obtain a hearing in accordance with the provisions of section 61(b).

(b) The applicant shall have thirty (30) days to submit a written appeal, setting forth with particularity the basis for disputing the Administrative Director's decision and why the applicant believes that he or she is entitled to appointment or reappointment. If the applicant fails to submit a specific, written response to the Administrative Director's determination regarding appointment or reappointment within thirty (30) days, the Administrative Director's decision shall become final without any further notice.

(c) If the applicant submits a timely appeal in accordance with subsection (b), and the appeal is denied by the Administrative Director, the Administrative Director shall provide the applicant with notice of this denial by means of a statement of issues and notice of right to hearing in accordance with Chapter 4 (commencing with Section 11370) and Chapter 5 (commencing with section 11500) and Part 1 of Division 3 of the Government Code. The statement of issues and notice of right to hearing shall be issued within 60 days of receipt of the timely appeal. The appeal shall be heard and decided in accordance with the procedures set forth in section 61(b), and a final decision shall be subject to judicial review in accordance with section 61(c). Notwithstanding the procedures specified in section 61, the Administrative Director may at any time during the pendency of an appeal reconsider the decision made under subsection (a), and for good cause issue a new decision granting appointment or reappointment or granting appointment or reappointment to probationary status in lieu of denial. Good cause is evaluated with reference to the the presence and effect of any of the factors of mitigation as well as the factors to be considered in determining penalties contained in section 65.

(d) All notices and responses under this section shall be made by certified mail.

(e) Notwithstanding section 51 and the other provisions of this section, any physician who (1) has failed to timely pay the fee required by Labor Code Section 139.2(n), (2) who is precluded from practice due to the suspension, revocation, or termination of his or her license to practice by the relevant licensing authority, or (3) who has been suspended from participation in the workers' compensation system pursuant to Labor Code Section 139.21 and whose suspension is final under subdivision (b) of Section 139.21, shall be ineligible for appointment or reappointment as a QME and shall have no further right to notice or appeal under this section or section 61.

Note: Authority cited: Sections 133, 139.2(f) and 5307.3, Labor Code; Section 11500 et seq., Government Code. Reference: Section 139.2, Labor Code.

History

1. New section filed 1-13-2009; operative 2-17-2009 (Register 2009, No. 3).

2. Amendment filed 2-26-2024; operative 2-26-2024 pursuant to Government Code section 11343.4(b)(3) (Register 2024, No. 9).