Existing law establishes a workers' compensation system, administered by the Administrative Director of the Division of Workers' Compensation, to compensate an employee for injuries arising out of and in the course of their employment. Existing law establishes procedures for the resolution of disputes regarding the compensability of an injury, including the use of a qualified medical evaluator (QME) to perform a comprehensive medical-legal evaluation to address all contested medical issues arising from all injuries reported in a claim. Existing law requires all communications with a panel QME before a medical evaluation to be in writing served on the opposing party 20 days in advance of the evaluation, and any subsequent communication with the QME to be in writing and served on the opposing party when the communication is sent to the QME.
This bill would require the administrative director to develop and make available a medical evaluation request form for communicating with a panel qualified medical evaluator in advance of an evaluation obtained pursuant to the above provisions. The bill would require the administrative director to develop and make available a template QME report form, which will include all necessary statutory and regulatory requirements for a complete QME report that constitutes substantial evidence. The bill would require the Division of Workers' Compensation to adopt regulations to implement these provisions by January 1, 2027. The bill would also require the administrative director to promulgate regulations by January 1, 2027, to, among other things, establish a process by which a party to a case may submit a medical-legal report that is alleged to be inaccurate or incomplete to the medical director.

Statutes affected:
AB 1293: 4452 LAB
02/21/25 - Introduced: 4452 LAB
03/24/25 - Amended Assembly: 4062.3 LAB, 4062.3 LAB, 4452 LAB
04/09/25 - Amended Assembly: 4062.3 LAB, 139.2 LAB, 139.2 LAB