Emergency Regulations for QME Remote Evaluations

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With the unprecedented public health crisis presented by COVID-19, DWC needs to act now! Please sign this petition to support remote QME evaluations.

Thousands of QME evaluations are currently being cancelled or rescheduled, due to the coronavirus pandemic, wreaking havoc on the lives of injured workers. Every delayed or cancelled QME evaluation results in significant disruption to the life of an injured worker. That worker may not receive timely access to benefits such as medical treatment or financial compensation as a result of such a delay.

There are several barriers at the DWC level to QMEs who wish to perform evaluations remotely:

  • Currently, DWC regulations do not authorize remote evaluations
  • Several organizations, including CSIMS have reached out to DWC to implore them to adopt emergency regulations allowing QMEs to perform remote evaluations. DWC has, so far, not adopted such regulations or such a policy for unclear reasons.
  • In contrast, DWC adopted a policy, recently, allowing for injured workers to provide testimony at hearings remotely. Again, it is unclear why DWC did not simply expand this policy to allow injured workers to appear for QME appointments remotely.

Workcompcentral featured an article on this issue recently (link here). However DWC refuses to issue the required emergency regulations.

On March 19th, DWC issued a Newsline “providing guidance” on remote evaluations. It can be found here: https://www.dir.ca.gov/DIRNews/2020/2020-21.html

A careful reading of the Newsline shows that the only guidance DWC provides is how insurance carriers can deny reimbursement to QMEs who perform remote evaluations. The key line from the Newsline, which sums it all up is: “DWC is not authorizing any particular course of action.”

Until DWC clearly authorizes QME remote evaluations, QMEs are at the mercy of insurance carriers to have their bills denied.

By signing this petition, you demand that DWC immediately:

Stop the delays and bureaucratic wordsmithing and issue a clear and firm policy which states:

  • All QME evaluations should be clearly and unconditionally allowed to be performed remotely. There should not be qualifying language such as  "may be appropriate" and a remote evaluation should not be subject to approval by both parties. Requiring both parties to consent to a remote evaluation is counterproductive because 1) it unnecessarily increases the administrative burden on the QME to request and obtain such consents and 2) it provides a clear path for either party to delay the evaluation if they wish to do so. Granting the parties a path to delay evaluations is contrary to the intent of a remote evaluation policy.
  • Insurance carriers should have no right to withhold payment or object to an evaluation on the basis that it was conducted remotely.

What can you do to help?

Sign this petition and let leadership at the DWC hear your voice!

Vote yes on DWC should immediately enact emergency regulations to allow all QME evaluations to be performed remotely during the coronavirus epidemic and disallow insurance carriers from denying reimbursement for remote QME evaluations.