VI.L — Additional, Replacement Panels & Consultations (Cards 846-880) Flashcards

(38 cards)

1
Q
A
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2
Q

When can a party request an additional QME panel?

A

If the original QME lacks a required specialty to address a disputed issue.

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3
Q

Deadline to request additional panel after discovering missing specialty?

A

15 calendar days from knowledge of need.

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4
Q

Who approves additional panels?

A

DWC Medical Director.

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5
Q

When is a replacement panel granted?

A

If the assigned QME is unavailable, disqualified, has conflict, or fails to schedule timely.

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6
Q

Time limit for QME to schedule exam before replacement can be sought?

A

60 days from assignment (unless both parties agree to later date).

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7
Q

What must party file to request replacement?

A

Form 31.5 (Replacement Panel Request) with explanation & proof.

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8
Q

If QME dies or retires mid-case?

A

DWC issues replacement panel automatically.

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9
Q

If QME moves >30 miles from original address?

A

May justify replacement if unreasonable travel.

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10
Q

Can parties agree on an AME instead of replacement?

A

Yes — AME overrides panel if both consent.

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11
Q

Does QME self-recusal trigger replacement?

A

Yes — if conflict, bias, or health prevents exam.

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12
Q

How long does DWC take to issue replacement after approval?

A

Usually within 5 business days.

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13
Q

Can a party request specific physician on replacement panel?

A

No — random assignment only.

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14
Q

What if QME declines case for scope reasons?

A

DWC issues replacement panel automatically.

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15
Q

How many replacements allowed per case?

A

Typically one per specialty per dispute, absent extraordinary cause.

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16
Q

What is a consulting QME?

A

A QME who provides specialized input at the request of primary evaluator.

17
Q

Who pays for consulting QME?

A

Requesting party or per agreement; otherwise per med-legal fee schedule.

18
Q

Must consulting QME be from panel?

A

No — can be any qualified specialist, but disclosure is required.

19
Q

Can consulting QME write the final report?

A

No — primary QME integrates consulting input.

20
Q

Mnemonic for replacement triggers

A

“SICK 60”: Schedule fail, Illness, Conflict, Kicked (discipline), 60 days no appt.

21
Q

Time for parties to object to specialty of replacement?

A

10 days after notice.

22
Q

If both parties request same new specialty?

A

DWC usually grants that specialty.

23
Q

Is patient travel hardship valid reason for replacement?

A

Yes — if >75 miles or unreasonable burden.

24
Q

Can QME request their own replacement?

A

Yes — file with DWC citing conflict or illness.

25
Replacement if QME fails to issue report on time?
Parties may petition; DWC can **replace for delay**.
26
Mnemonic for consulting QME rules
**“ASK EXPERT”:** **A**dd-on, **S**pecialty help, **K**eep primary, **E**xpense by caller, **X** not final report.
27
When can an **additional specialty** be added mid-case?
When **new disputed issue arises** beyond current QME scope.
28
Time for DWC to issue additional panel after approval?
Usually **10 business days**.
29
Who determines if specialty request is valid?
**DWC Medical Director.**
30
Can parties stipulate to bypass DWC and pick doctor?
Only if **AME agreement** — otherwise DWC panel required.
31
Are remote consultants allowed?
Yes, but **must comply with telehealth rules** if examining.
32
What if QME retires but doesn’t tell DWC?
Panel invalid; **sanctions possible**.
33
Replacement if QME repeatedly cancels?
Yes — **pattern of cancel = new panel**.
34
If replacement is denied, can party appeal?
Yes — **appeal to DWC Medical Director**.
35
Cost shift if replacement caused by QME?
QME may **forfeit payment** or face discipline.
36
Mnemonic for additional panel request
**“MIS-SPEC”:** **M**issing spec, **I**ssue change, **S**ubmit 15-day, **SPEC**ialty needed.
37
Replacement if QME loses license mid-case?
DWC automatically **issues new panel**.
38
Time for DWC to notify parties of replacement decision?
Usually **within 10 days**.