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Online QME Form 106 Panel Request. In order to provide a more efficient means of requesting and receiving QME panels, the Division of Workers' Compensation (DWC) implemented a new online panel process for represented initial panel requests on Oct. 1, 2015. How does it work?
TO REQUEST A QUALIFIED MEDICAL EVALUATOR (QME) PANEL FOR AN UNREPRESENTED EMPLOYEE: Complete this form (print or type the information). Sign and date at bottom.
It establishes policy and guidelines for the treatment and evaluation of injured workers. The unit examines and appoints physicians to be qualified medical evaluators (QMEs), who in turn examine injured workers to help determine the level of benefits they receive.
The division’s contact person must receive all written comments concerning the proposed modification to the regulations no later than March 13, 2023. Written comments may be submitted by facsimile transmission (FAX), addressed to the contact person at (510) 286-0687.
Uninsured Employers Benefits Trust Fund (UEBTF) & Subsequent Injuries Benefits Trust Fund (SIBTF)
Learn the process, eligibility, and requirements for obtaining a panel QME in California workers' compensation cases. A panel QME is a medical-legal examination to resolve disputes over injury, impairment, or treatment.
24 lip 2015 · This training video is on how to fill out the online QME Form 106 Panel Request. The training walks you step by step on how to fill out the form.
