The surge in infections related to the Omicron variant led the California Division of Workers’ Compensation (DWC) to adopt emergency regulations for medical-legal evaluations that allow Qualified Medical Evaluators (QME) and Agreed Medical Evaluators (AME) to perform medical-legal evaluations using telehealth.
These regulations will remain in place from January 18, 2022, until July 19, 2022, although they may be extended if the DWC considers it necessary.
For the purposes of the new regulations, telehealth is defined as:
- Video-conferencing
- Video-calling
- Similar technology that allows each party to see and talk with the other via a video and audio connection.
What You Need to Know
According to the original text (which you can read here), a QME or AME can perform a medical-legal evaluation using telehealth when a hands-on examination is not necessary and ALL the following four conditions are met:
- There is a medical issue in dispute which involves whether or not the injury is AOE/COE (Arising Out of Employment/Course of Employment), or the physician is asked to address the termination of an injured worker’s indemnity benefit payments or address a dispute regarding work restrictions.
- There is agreement in writing to the telehealth evaluation by the injured worker, the carrier or employer, and the QME. Agreement to the telehealth evaluation cannot be unreasonably denied. If a party to the action believes that agreement to the telehealth evaluation has been unreasonably denied under this section, they may file an objection with the Worker’s Compensation Appeals Board, along with a Declaration of Readiness to Proceed to set the matter for a hearing.
- The telehealth evaluation conducted by means of a virtual meeting is consistent with appropriate and ethical medical practices, as determined by the QME and the relevant medical licensing board.
- The QME attests in writing that the evaluation does not require an in-person physical exam.
As you can see, the rules of workers’ compensation in California evolve constantly. Stay up to date with all relevant changes by checking our blog regularly, and don’t hesitate to contact us if you have any questions or require assistance.
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