New Emergency Workers’ Compensation Rules Allow Remote Med-Legal Evaluations By AMEs or PQMEs During Stay-At-Home Orders Due to COVID19 Pandemic

Emergency rules have been passed due to the COVID-19 pandemic to allow remote med-legal evaluation by AMEs or PQMEs while the stay at home orders are in effect. These rules provide:

– existing evaluations can be rescheduled up to 90 days

– the time to have the evaluation take place has been extended an additional 30 days such that is is now 90 days or 120 days upon written agreement

– the time to issue/serve a report has been extended by an additional 15 days such that it is now 45 days

– med-legal reports can now be served electronically if the parties agree [not applicable in pro per cases]

As it relates to the med-legal evaluation itself, the AME/PQME can perform an initial interview of the injured worker by phone or video, do a record review and schedule the one on one in-person evaluation for after the stay at home order is lifted. Moreover, a telehealth evaluation can be performed when the following requirements are met:

  • the injured worker is not required to leave their home;
  • one of the issues is injury AOE/COE, the evaluator is being requested to determine if indemnity benefits can be terminated or if there is a dispute over work restrictions;
  • the parties agree in writing to the telehealth evaluation [of note is the reference that the agreement to telehealth can not be unreasonably denied];
  • the telehealth evaluation is appropriate and consistent with ethical medical practice; and
  • the QME attests in writing that the evaluation does not require a physical exam

WHAT DOES THIS MEAN FOR YOU:  This emergency regulation may have the effect of speeding up the med-legal process which has been stalled somewhat under the stay at home orders. You will likely see less requests for replacement panels due to untimely appointments or reports. In some circumstances, it would appear that the parties can waive the request for an in-person evaluation. This might be particularly applicable in psychology or psychiatry evaluations. However, there is a potential for increased litigation over the issue of what constitutes an unreasonable denial of an agreement to proceed with a telehealth evaluation. If there is such a denial, a DOR could be filed for a hearing on the issue.

The full text of the rules can be found here. SRTK will continue to monitor this development and provide updates as available. Please contact us with any questions.