California Division of Workers’ Compensation Issues New Proposed Rules for Medical-Legal Evaluations

The California Department of Industrial Relations (DIR), Division of Workers’ Compensation (DWC) has issued a notice that it will file new emergency regulations to allow Qualified Medical Evaluators (QMEs) and Agreed Medical Evaluators (AMEs) to conduct evaluations and visits via telehealth when an in-person examination is not necessary and additional conditions are met. According to a DWC release, these proposed emergency regulations “will help injured workers and employers continue to move their workers’ compensation claims towards a resolution and avoid additional and undue delay.”

The DWC intends to file the emergency regulations with the Office of Administrative Law (OAL) on December 28th. Once submitted, the OAL will have ten days to review and approve the rules, which would take effect for 180 days, with a possible 90-day renewal.

What this may mean for you:

The likelihood of telethealth med-legal evaluations are likely to increase going forward while the COVID-19 emergency regulations are in effect.  This is particularly true when the evaluation is in the fields of psychiatry and internal medicine.  The parties are to agree to telemed evaluations when a hands on evaluation is not necessary.  If a party unreasonably refuses to agree, then a hearing would be required.  The medical legal evaluator must be consistent with the appropriate as determined by the relevant medical licensing board and the evaluator must attest in writing that the evaluation does not require an in person exam.