Prior to appointment as a QME, a physician shall complete a course of at least twelve hours of
instruction in disability evaluation report writing. The course curriculum shall be specified by the
Council.
(a) To apply to the Council for accreditation, a provider shall submit:
(1) a completed IMC Form 118 which contains
(A) the applicant's name; address; director of education with contact information; type of
organization; length of time in business; nature of business; and past experience providing
continuing education courses (including a list of other accrediting agencies that have approved
such courses);
(B) a description of the proposed education program or course which includes the title; type
(continuing education program or disability evaluation report writing course); location(s); date(s);
length of training in clock hours; educational objectives; a complete description of the program or
course content; faculty; and the names of other accrediting agencies that have approved the
program.
(2) A curriculum vitae for each proposed instructor. A proposed instructor shall have education
and/or training and recent work experience relevant to the subject of his/her presentation
(3) The proposed promotional material for the program or course. A course may be advertised to
the public prior to accreditation by the Council so long as the promotional material states in at
least 12 point type on the first page of the promotional material this course is pending approval
by the Industrial Medical Council and may not be approved for credit.
(b) The Council shall accredit a applicant that meets the definition of provider in Section 1 (r);
submits a completed, signed and dated application which demonstrates past experience in
providing continuing education programs; and proposes a program which meets the requirements
of 55(c) or a course which meets the requirements of 11.5(a) and (i). Proposed content for
continuing education program credit must relate directly to disability evaluation or California
workers' compensation-related medical dispute evaluation. No credit shall be recognized by the
IMC for material solely discussing the business aspects of workers' compensation medical
practice such as billing, coding and marketing.
(c) The Council shall notify the applicant within 5 calendar days following the next scheduled
Council meeting after receipt of the application containing all the information listed in Section 11.5 (a) whether that provider has been accredited for a two year period and the proposed course has
been approved. Incomplete applications will be returned to the provider.
(d) A provider that has been accredited by the Council will be given a number which must be
displayed on course promotional material.
(e) On or before the date the course is first presented, the provider shall submit the program
syllabus (all program handouts) to the Council.
(f) An approve course may be offered for two (2) years. A provider shall notify the Council in
writing of any change to the faculty in an approved course.
(g) To apply for re-accreditation, a provider must submit a completed IMC Form 118, using the
application process in 11.5(a). The provider may complete section 2 of the form using a new
program or course or one which was given by the provider during the recent accreditation period.
The Council shall give the provider 90 days' notice of the need to seek re-accreditation.
(h) Promotional materials for a course must state the provider's educational objectives; the
professional qualifications of course faculty (at the least, all relevant professional degrees); the
content of course activities; and the intended audience.
(i) The minimum of 12 hours of instruction in disability evaluation report writing shall include:
(1) The Qualified Medical Evaluator's Role in the Disability Evaluation Process (minimum 1 hour)
How disability evaluation reports are used
The reasons why reports must be clear, complete and timely
The QME's role as an expert witness
Impact of the QME's report on the injured worker
QME ethics and the Confidentiality of Medical Information Act
(2) Elements of the Medical-Legal Report (minimum 1 hour)
The Labor Code and regulatory requirements for medical-legal reports.
(3) The Language of Reports (minimum 4 hours)
Evaluation of disability in California (impairment and disability)
The occupational history
The physical examination and the role of testing
Labor Code requirement to use Packard Thurber's Evaluation of Industrial Disability
Factors of disability
Subjective
Objective
Work restrictions
Loss of pre-injury capacity
Causation
Determination of permanent and stationary status
Vocational rehabilitation
Apportionment
Future medical treatment
Review of records
Providing sufficient support for conclusions
(4) The Council's Disability Evaluation Protocols (minimum 1 hour)
An overview of the protocols and an in-depth discussion of one or more of the
Neuromusculoskeletal, Pulmonary, Cardiac, Immunologic, or Psychiatric protocols.
(5) The Third Party Perspective (minimum 1 hour)
The report from the perspective of those who read it:
Judge(s), attorney(ies), insurer(s), rater(s), employer(s), qualified rehabilitation representative(s).
(6) Anatomy of a Good Report (small group or other interactive sessions - minimum 3 hours)
Discussion of examples of good reports and identification of weaknesses in reports
Opportunities for the practitioner to critique and/or correct reports.
If feasible, physician should have the opportunity to write a sample report.
Review of results of IMC annual report review and identification of common problems with reports
(7) Mechanics of Report Writing (minimum 1 hour)
The QME Process
Face to face time
Timelines for submission of report
Completion of required forms
Service of reports
Final questions and answers
(j) No more than four hours of the required twelve hours of instruction may be taken by distance
learning. All audio or video tapes, computer programs and printed educational material used in
the course must be submitted to the Council on or before the date the course is first given. All
distance learning materials shall bear a date of release and shall be updated every three years.
The provider shall notify the Council in writing of the revision.
(k) Instructors shall not recruit members or promote commercial products or services during
course instruction immediately before, during or after a course. Providers or vendors may
display/sell educational materials related to workers' compensation or applications for
membership in an area adjoining a course. A course provider or faculty member shall disclose on
IMC form 119 any significant financial interest in or affiliation with any commercial product or
service which it/he/she discusses in a course and that interest or affiliation must be disclosed to
all attendees.
(l) The provider shall maintain attendance records for each disability evaluation report writing
course for a period of no less than three years after the course is given. A physician attending the
course must be identified by signature. The provider must submit a copy of the signature list to
the Council within 60 days of completion of the course.
(m) The provider is required to give the IMC's Evaluation Form 117) to course attendees and
request they submit the form to the IMC. This information shall not be used in lieu of a
certification of completion given by the provider, as specified pursuant to section (n). Destruction
by a provider or its employee of a QME's Evaluation Form or failure by such provider or its
employee to distribute Form 117 as part of its course shall constitute grounds for revocation of a
provider's accredited status. The Council shall tabulate the responses and return a summary to
the provider within 90 days of completion of the course.
(n) The provider shall issue a certificate of completion to the physician which states the name of
the provider, the provider's number, the date(s) and location and title of the course. To be eligible
for appointment as a QME, a physician must complete no less than 12 hours of the curriculum
specified in Section 11.5 (i) and must submit a copy of that certificate to the Council.
(o) Joint sponsorship of courses (as between an accredited and an unaccredited provider) must
be approved by the Council prior to presentation of the course.
(p) The Council may audit a provider's course(s) at the request of the medical director to
determine if the provider meets the criteria for accreditation. The Council may audit courses given
by providers randomly, when a complaint is received, or on the basis of responses on IMC Form
117. An auditor shall not receive QME credit for a course which s/he is auditing. The Council
shall make written results of the audit available to the provider no more than 30 days after the
audit is completed.
(q) Accredited providers that cease to offer disability evaluation report writing courses shall notify
the Council in writing.
(r) The Council may withdraw accreditation of a provider or deny such a provider's application for
accreditation on the following grounds (in addition to failure to meet the relevant requirements of
subsections 11.5 (a) or 55(c)):
(1) Conviction of a felony or any offense substantially related to the activities of the
provider.
(2) Material misrepresentation of fact by the provider.
(3) Failure to comply with Council regulations
(4) False or misleading advertising
(5) Failure to comply with Council recommendations following an audit
(6) Failure to distribute Council form 117 cards to course attendees.
History: Added 01/01/01
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