1
Q
A
2
Q
What is the main law governing QME selection?
A
Labor Code (LC) §§4062.1 & 4062.2 — 4062.1 for unrepresented, 4062.2 for represented injured workers.
3
Q
Who issues QME panels?
A
The DWC Medical Unit issues panels when requested.
4
Q
How many doctors are listed on a QME panel?
A
3 QMEs per panel.
5
Q
How is a panel requested?
A
File QME Form 105 (Request for QME Panel) with DWC.
6
Q
What triggers panel request for unrepresented worker?
A
Dispute about injury, PD, or treatment and worker has no attorney.
7
Q
Deadline for insurer to request panel (unrepresented)?
A
10 days after receiving objection notice.
8
Q
What if both parties fail to request panel timely (unrep)?
A
Employee gets first right to request.
9
Q
Can employer request panel first for unrepresented worker?
A
Yes — but must do so within 10 days of objection.
10
Q
What is the form for represented worker panel request?
A
QME Form 106.
11
Q
Time to strike names (represented)?
A
Each party gets 10 days to strike one QME from the 3-doctor panel.
12
Q
Who chooses final QME if strikes tie?
A
The remaining doctor after both sides strike.
13
Q
Can parties agree on AME instead of QME panel?
A
Yes — AME trumps panel if both sides agree.
14
Q
Timeframe to select AME before panel expires?
A
30 days after panel issued (often extended by agreement).
15
Q
Can parties request new panel if specialty is wrong?
A
Yes — file specialty challenge within 10 days.
16
Q
What if QME specialty dispute unresolved?
A
DWC Medical Director decides.
17
Q
Minimum face-to-face time for QME eval?
A
45 minutes.
18
Q
Time to schedule QME appointment?
A
QME must offer appointment within 60 days.
19
Q
What if QME can’t see patient within 60 days?
A
Party can request new panel.
20
Q
What is the report deadline for QME after exam?
A
30 days from exam date.
21
Q
Max extension time for report if needed?
A
Additional 30 days (total 60).
22
Q
Penalty if QME fails timely report?
A
Report may be inadmissible and new panel allowed.
23
Q
Who pays for interpreter at QME?
A
Insurer/Claims administrator.
24
Q
May interpreter attend without prior notice?
A
No — must be disclosed to all parties.
25
Can parties send observers/witnesses?
**No**, exam is private (except interpreter/chaperone if needed).
26
Audio/video recording of QME?
Only if **all parties agree and QME consents**.
27
Can attorney attend QME exam?
Generally **no**, unless QME agrees.
28
Timeframe to serve records before exam?
**20 days** before appointment.
29
Late record delivery (<20 days)?
QME can **decline or reschedule**.
30
Who can challenge QME for bias?
**Either party** — file with DWC for replacement.
31
New lawyer hired — new panel?
**No — change of counsel ≠ new panel**.
32
If QME moves offices?
Still valid if **within 30 miles/60 mins**; else replacement.
33
Can QME refuse complex case?
**No** — must accept unless conflict/good cause.
34
Can QME demand prepayment for no-shows?
Yes — if policy disclosed and per OMFS rules.
35
What if AME is biased?
Can be challenged, but **harder** than QME; needs WCAB order.
36
Can parties send new evidence after exam?
Yes — but QME must **share with both sides**.
37
QME testifying — phone allowed?
Yes, at **judge’s discretion**.
38
Telehealth QME allowed?
Only if **DWC approves** and case suitable.
39
Who decides disputes over panel replacement?
**DWC Medical Director**.
40
What is dual representation conflict?
QME can’t be **both treater and evaluator**.
41
Must QME disclose insurer financial ties?
Yes — **conflict disclosure required**.
42
What if QME refuses to see IW for safety?
QME may **withdraw**; DWC replaces.
43
Time to pick replacement QME from new panel?
**10 days** after issuance.
44
Can insurer pick QME if worker misses deadline?
Yes — if **worker fails to strike/select in time**.
45
If no appointment within 16 days after contact?
Request **new panel**.
46
What if one side sends undisclosed records?
QME must **disclose and give to other side**.
47
Chaperone required for sensitive exams?
Offer if needed, document acceptance/refusal.
48
What if parties agree to move exam?
Allowed — must be **documented**.
49
What happens if QME doesn’t show up?
Reschedule or request new panel.
50
Are rushed exams ethical?
**No — 45 min minimum face time**.
51
Must QME “show work” in report?
Yes — **list all records reviewed**.
52
What happens if one side doesn’t strike but other does?
The **striking party’s pick stands**.
53
Maximum strikes per side?
**One each**.
54
If QME fails to disclose conflict?
Can lead to **report exclusion & replacement**.
55
What if interpreter is unqualified?
Stop exam, request certified interpreter, document.
56
Must patient consent for audio/video?
Yes — **get and document** consent.
57
What if panel expires before use?
Request **new panel**.
58
What if parties disagree about specialty change?
DWC Medical Director resolves.
59
How soon must QME give first appointment date?
Within **5 business days** of contact.
60
AME vs QME — which is binding?
**AME is stronger** (mutually chosen, harder to challenge).
61
Minimum exam elements?
**HREFIC** — History, Records, Exam, Findings, Impairment, Causation.
62
Substantial evidence must include?
**HERD** — History, Exam, Reasoning, Diagnostics.
63
Rule about ex parte communication?
**No Solo Talk** — prohibited without other party.
64
Fraud suspicion — QME duty?
**See It, Say It** — document & report.
65
Legal advice to parties?
**Facts not Law** — QME gives medical only.
66
Must QME disclose prior treatment history with IW?
Yes — potential conflict.
67
QME replacement if AME fails report?
Usually **new AME or panel QME**; judge decides.
68
Can QME accept gifts from parties?
**No — unethical**.
69
Can QME bill extra if complex case?
Only if **per OMFS & justified**.
70
Who arranges interpreter if needed?
**Claims admin/insurer**.
71
What happens if patient refuses to attend QME?
Document and notify requesting party.
72
Can attorney pre-coach QME?
No — **STAND FIRM**: maintain independence.
73
Minimum CME hours for QME recert?
**12 CME every 5 years**.
74
When to decline case?
If **scope or time limits** make fair eval impossible.
75
Panel invalid if QME not certified?
Yes — **request replacement**.
76
Ex parte contact after panel?
**Prohibited**; can nullify report.
77
New law updates duty?
Stay current — **Know the New**.
78
Can QME demand rush fee?
No — violates ethics.
79
Patient demands report copy?
QME **provides via parties/insurer**, not direct unless authorized.
80
Report language must be?
**Objective & medically reasoned**.
81
What happens if QME refuses to testify?
Judge may **exclude report** or sanction.
82
Is peer review helpful?
Yes — **quality & defensibility**.
83
How long keep records?
**≥5 years** (per QME regs).
84
What if party tries to alter report?
Decline biased edits; only factual corrections.
85
QME CME must include ethics?
**Yes — mandatory**.
QME part 2
flashcards
Decks in class (96)
# Cards
-
Batch 4 (Cards 106 – 140) from Section II — Permanent Disability Determination (deep dive: apportionment, AMA traps, cancer presumption, reporting/ethics, exam hacks):36
-
Batch 5 (Cards 141 – 150) to complete the 150-card deck for Section II — Permanent Disability Determination ✅11
-
Here is Batch 1 (Cards 151–180): PDD section II31
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Here’s Batch 2 (Cards 181–210) — Advanced PD Determination with deeper case law, AMA quirks, benefit timing exceptions, and fresh mnemonics: Question Answer31
-
Batch 3 (Cards 211 – 240) — more advanced PD / AMA / benefit law traps + strong new mnemonics:31
-
Batch 4 (Cards 241 – 255) — advanced Permanent Disability Determination traps with extra mnemonics:16
-
Batch 4 (Cards 256 – 270) — finishing the advanced set to 270:16
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acronym flashcard deck covering all abbreviations & mnemonics we used in the 270-card PD section (plus earlier core sets).61
-
Batch 1 (Cards 1 – 30) for III. Apportionment Determinations (Causation + Risk Factors & Unlawful Discrimination) — exam-ready with mnemonics:31
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Batch 2 (Cards 31 – 60) for III. Apportionment Determinations — Causation & Risk Factors/Unlawful Discrimination (exam-ready, with mnemonics)31
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Batch 3 (Cards 61 – 90) for III. Apportionment Determinations — Causation & Risk Factors / Unlawful Discrimination (exam-ready with mnemonics)31
-
Batch 4 (Cards 91 – 120) for III. Apportionment Determinations — Causation & Risk Factors / Unlawful Discrimination (same exam-ready Q | A | Mnemonic format)31
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Batch 5 (Cards 121 – 150) for III. Apportionment Determinations — Causation & Risk Factors / Unlawful Discrimination (same Q | A | Mnemonic exam-ready format)31
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Advanced Apportionment — Block 1 (Cards 151 – 200)51
-
Advanced Apportionment — Block 2 (Cards 201 – 250) (deep case law + exam hacks + new mnemonics, same table format)51
-
Advanced Apportionment — Block 3 (Cards 251 – 300)51
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Substantive Medical Disputes Resolved by QMEs — LC §§4060-4062 (Disputes over compensability, permanent disability, and all other med-legal issues.) 1-5051
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IV. Substantive Medical Disputes — Block 2 (Cards 51 – 100)51
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IV. Substantive Medical Disputes — Block 3 (Cards 101 – 150) (finishing the 150-card deck on LC §§4060–4062)51
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Block 1 (~35 flashcards) from V. QME Selection Process — Labor Code §4062.1 (Unrepresented) & §4062.2 (Represented)35
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V. QME Selection Process — Labor Code §4062.1 & §4062.2 (continuing):36
-
V. QME Selection Process – Labor Code 4062.1 & 4062.2)85
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Section VI: Benefit Delivery & Math (this covers temporary disability (TD), permanent disability (PD), AWW calculations, penalties, benefit timing, and related rules).37
-
Benefit Delivery & Math — Batch 2 (Cards 36–70) with deeper exam-style details + mnemonics:35
-
Benefit Delivery & Math — Batch 1 (Cards 1–35) rewritten with every acronym fully spelled out:37
-
Benefit Delivery & Math — Batch 3 (Cards 71–105)36
-
Benefit Delivery & Math — Batch 4 (Cards 106–140)39
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Benefit Delivery & Math — Batch 5 (Cards 141 – 175)37
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Batch 6 (Cards 176 – 210) (rare exam traps, presumption exceptions, psych apportionment nuances, AMA quirks, penalty & rating pitfalls).37
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I’ll start with Section VI.A – Scheduling and Cancellation of Appointments (p. 19). Here is Batch 1 (≈35 cards) in the format you like:36
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Batch 2 (Cards 36 – 70) for Section VI.A – Scheduling & Cancellation36
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Batch 3 (Cards 71 – 105) for Section VI.A – Scheduling & Cancellation:37
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Subsection A1 – Remote Health Medical-Legal Evaluations (Telehealth) — Batch 1 (Cards 1 – 40) (Q | A | Mnemonic style with full acronyms spelled out once)40
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Subsection A1 – Remote Health Medical-Legal Evaluations (Tele-QME) — Batch 2 (Cards 41–80):41
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Subsection A1 – Remote Health Medical-Legal Evaluations (Tele-QME) — Batch 3 (Cards 81–120):41
-
e’s Section VI.B – Information to be Provided to the Qualified Medical Evaluator (QME) — Batch 1 (Cards 1–40):40
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Section VI.B – Information to be Provided to the QME — Batch 2 (Cards 41–80):41
-
Section VI.B – Information to be Provided to the QME — Batch 3 (Cards 81 – 120):41
-
VI.B – Information to be Provided to the QME:41
-
VI.C — Ex-Parte Contact (Cards 1–40)40
-
VI.C — Ex-Parte Contact (Cards 41–80)39
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VI.C — Ex-Parte Contact (Cards 81–120)40
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📚 VI.D — Conflict of Interest Disclosure (Cards 121 – 155)37
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VI.D — Conflict of Interest Disclosure (Cards 156 – 190)39
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Section E — Examination Disclosures (Cal. Code Regs., Title 8, § 40) (first 35–40 flashcards in your Q | A | Mnemonic format with acronyms spelled out).36
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VI.E — Examination Disclosures (Cards 226 – 260)37
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VI.F — Ethical Obligations of the QME (Cards 261 – 295)37
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VI.F — Ethical Obligations of the QME (Cards 296 – 330)36
-
VI.G — Evaluation Protocols (Cards 331 – 365)38
-
VI.G — Evaluation Protocols (Cards 366 – 400)37
-
VI.H — Face-to-Face Time (Cards 401 – 435)37
-
VI.H — Face-to-Face Time (Cards 436 – 470)36
-
VI.I.1 — Report Content (Cards 471 – 505)38
-
VI.I.2 — Report Disclosures (Cards 506 – 540)38
-
VI.I.3 — Anti-Self-Referral (Cards 541 – 570)31
-
VI.I.4 — Substantial Evidence (Cards 571-605)36
-
VI.I.4 — Substantial Evidence (Advanced/Exam Traps) — Cards 606-64037
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VI.J — Types of Reports & Reevaluations (Cards 671-705)38
-
VI.K — QME Unavailability (Cards 776-810)37
-
VI.K — QME Unavailability (Cards 811-845)38
-
VI.L — Additional, Replacement Panels & Consultations (Cards 846-880)38
-
VI.L — Additional, Replacement Panels & Consultations (Cards 881-915)37
-
Here’s Section L — Additional, Replacement Panels & Consultations40
-
Here’s the start of Section M — Timeframe for Service of Reports & Timeframe Extensions (Cal. Code Regs., tit. 8, § 38) Block 1 (Cards 951 – 985)41
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Block 2 (Cards 986 – 1020) — advanced rules, penalties, and deeper testable points40
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Here’s Section M — Timeframe for Service of Reports & Timeframe Extensions (Cal. Code Regs., tit. 8, § 38) Block 3 (Cards 1021 – 1055)42
-
Here’s the start of Section N — Service of Reports (Cal. Code Regs., tit. 8, §§ 36 & 36.7) Block 1 (Cards 1056 – 1090) — delivery rules, proof of service, and common test pitfalls38
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Section N — Service of Reports (Cal. Code Regs., tit. 8, §§ 36 & 36.7) Block 2 (Cards 1091 – 1125) — advanced electronic service rules, WCAB issues, and tricky exam points38
-
Here’s Section N — Service of Reports (Cal. Code Regs., tit. 8, §§ 36 & 36.7) Block 3 (Cards 1126 – 1160) — service disputes, penalties, audit traps, and exam-proven memory hacks40
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start of Section O — Retention of Reports & Return of Records (Cal. Code Regs., tit. 8, § 39.5) Block 1 (Cards 1161 – 1195)39
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Section O — Retention of Reports & Return of Records (Cal. Code Regs., tit. 8, § 39.5) Block 2 (Cards 1196 – 1230) — r40
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Section O — Retention of Reports & Return of Records (Cal. Code Regs., tit. 8, § 39.5) Block 3 (Cards 1231 – 1265) —44
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Section M: Timeframe for Service of Reports & Extensions now. Here’s Block 1 (Cards 1231 – 1265) in the Question | Answer | Mnemonic36
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Block 2 (Cards 1266 – 1300) for Section M – Timeframe for Service of Reports & Extensions, with clear acronyms spelled out and mnemonics:35
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Section M – Timeframe for Service of Reports & Extensions35
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Section N: Service of Reports (Cards 1336 – 1370)37
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here’s Block 2 (Cards 1371 – 1405) for Section N – Service of Reports (advanced scenarios, audit traps, test hacks).36
-
here’s Section O – Retention of Reports & Return of Records (First Block 1 — Cards 1441 – 1475,35
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Block 3 (Cards 1406 – 1440) for Section N – Service of Reports (penalties, audit traps & exam hacks).37
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Section O – Retention of Reports & Return of Records Block 2 — Cards 1476 – 1510 (advanced retention scenarios, audits, retirement tips). All acronyms are fully spelled out.35
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More acronyms15
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Block 1 – Acronyms (Cards 1 – 50)53
-
Block 2 – Acronyms (Cards 51 – 100)60
-
Block 3 – Acronyms (Cards 101 – 150)56
-
here’s Block 4 (Cards 151 – 200) of acronyms from the DWC QME Study Guide Competency Examination Study Guide (fully expanded).18
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Block 1 (Cards 1 – 50) of flashcards from your PDF “Important Timeframes in Workers’ Compensation Cases”.48
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Block 2 (Cards 51 – 100) from your PDF “Important Timeframes in Workers’ Compensation Cases”.48
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Here’s Block 3 (Cards 101 – 150) — continuing the flashcards from “Important Timeframes in Workers’ Compensation Cases.”49
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) from your Overview AOE/COE document, in your preferred format — clear Q | A with full expansions for acronyms and useful mnemonics:26
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Batch 2 (Cards 26 – 50) from the Overview AOE/COE document — continuing the same Question | Answer | Mnemonic style, with all acronyms spelled out:26
-
’s Batch 3 (Cards 51 – 75) from the Overview AOE/COE document, continuing the Question | Answer | Mnemonic format with full acronym expansions:26
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Batch 4 (Cards 76 – 100) from the Overview AOE/COE document, continuing the Question | Answer | Mnemonic format with all acronyms spelled out:26
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Batch 5 (Cards 101 – 125) from the Overview AOE/COE document, continuing the Question | Answer | Mnemonic format with all acronyms spelled out:26
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e Deardorf Suicide Causation document (Batch 1 — first 25 cards).26
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Batch 2 (Cards 26 – 50) from Deardorf Suicide Causation — continuing in the same Question | Answer26
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Batch 3 (Cards 51 – 75) from Deardorf Suicide Causation — keeping the Question | Answer | Mnemonic style and spelling out acronyms where used:26
