As many of you may have noticed, the time delay between the initial request for a list of panel Qualified Medical Examiners and the receipt of that panel is growing longer. At the time of this publication, the IMC is approximately 65 days out in filling requests for unrepresented panels and 160 days out for represented cases. The changes presented by SB 899 requiring panel QMEs as opposed to independent QMEs selected by the parties has undoubtedly increased the number of panel requests exponentially and with continued government furloughs this trend is likely to continue. What you can ill afford is to have a panel request returned for inadequacy. When submitting your request for list of panel QME(s) make sure to include the following:
For all cases make sure to:
- Use the proper form: Use QME Form 105 for an unrepresented employee and QME Form 106 on a represented claim.
- Identify the disputed issue that requires the comprehensive evaluation: i.e. compensability under LC 4060, permanent disability indemnity under LC 4061 or an objection to a medical determination under LC 4062 (non-treatment or non-UR medical issues only for employers).
- Designate the speciality for the QME panel requested: use the three letter codes outlined on page three of either QME form 105 or 106.
- State the specialty preferred by the opposing party, if known.
- State the specialty of the treating physician.
For represented cases, additional information must be provided including
- Attach a copy of the correspondence relayed to or from applicant’s representative naming a proposed AME once the dispute arose.
- Identify the disputed issue. For represented cases, the identification of the disputed issue should be compatible with the correspondence relayed to or from applicant’s representative naming the proposed AME. Requests that do not identify the disputed issue will be returned.
- Make an AME offer and wait 10 days: Labor Code §4062.2 requires 10 days between the submission of a proposed AME and the filing of QME Form 106. Attempts to request a panel list of physicians prior to 11 days from the initial proposal of an AME will be returned.
- Act immediately after the 10 day wait. If applicant’s representative has issued a proposal for an AME that identifies a preferred specialty, but you are not in agreement with the physicians proposed, request the panel at the expiration of 10 days from the date of that correspondence requesting the specialty noted.
If you are requesting a new or replacement panel pursuant to Title 8 CCR §§31.5 or 31.7 make sure to include the number of the original panel in your correspondence to the IMC in both the caption and the body of your request. Also include the specialty of the original panel physician requested, the current specialty being requested, the reason for the request and the zip code of applicant.
If the case requires Panel lists in more than one specialty, you may reach an agreement with applicant’s representative to have more than one panel issued. The earlier the agreement to multiple panels the earlier the panels will issue and medial legal process may be completed.