California Regulations 41 48

(1) Maintain a clean, professional medical office (as defined in Section 1(m)) at all times includingfunctioning evaluating medical instruments and equipment appropriate to conducting theevaluation within the physician's scope of practice. (2) Schedule all appointments for comprehensive medical-legal evaluations without regard towhether a worker is unrepresented or represented by an attorney. A QME shall not refuse toschedule an appointment with an injured worker solely because the worker is not represented byan attorney or because a promised to reimburse or reimbursement is not made prior to the evaluation. (3) Not request the employee to submit to an unnecessary exam or procedure.

(b) QMs selected by an unrepresented injured worker from a three-member panel provided bythe Council shall not engage in ex parte communication in violation of Labor Code 4062.2.

(c) All QMEs, regardless of whether the injured worker is represented by an attorney, shall withrespect to his or her comprehensive medical-legal evaluation: (1) Refuse any compensation from any source contingent upon writing an opinion that in any waycould be construed as unfavorable to a party to the case. (2) Review all available relevant medical and non-medical records and/or facts necessary for anaccurate and objective assessment of the injured workers' case before generating a writtenreport. (3) Render expert opinions or conclusions without regard to an injured workers' race, sex,national origin, religion or sexual preference. (4) Render expert opinions or conclusions only on issues with regard to which the QME hasadequate qualifications, education, and training. All conclusions shall be based on the facts andon the QME's training and specialty-based knowledge and shall be without bias either for oragainst the injured worker or the employer. (5) Present a report that addresses all relevant issues, is ratable by the DEU, if applicable, andcomplies with all relevant guidelines of the Industrial Medical Council.

(d) All aspects of all physical and/or psychological comprehensive medical-legal evaluations,including history taking, shall be directly related to medical issues as presented by any party oraddressed in the reports of treating physician(s).

(e) No physician certified by the IMC as a QME, or his or her agent, shall contact a QME for the purpose of influencing that QME's opinions or conclusions in any QME evaluation.

(f) No QME shall schedule appointments to the extent that any injured worker will be required towait for more than one hour at a QME's office prior to being seen for the previously agreed uponappointment time for an evaluation. If the injured worker is unrepresented and is not seen by theQME within one hour, he or she may terminate the exam and request a replacement evaluatorfrom the Council. No party shall be liable for the terminated exam. The QME may explain anyreasons for the delay to the injured worker and, provided both parties agree, the evaluation mayproceed or be rescheduled at a later date. If the evaluation is rescheduled, the QME shall providenotice to the claims administrator or, if none, the employer within 5 working days afterrescheduling the appointment.

(g) If the injured worker terminates the examination process based on an alleged violation of eitherSection 40 or Section 41(a) and the Appeals Board later determines that good cause did not existfor the termination, the cost of the evaluation shall be deducted from the injured worker's award. Aviolation of Section 40 or of any part of section 41(a) shall constitute good cause for purposes ofan Appeals Board determination. No party shall be liable for any cost for medical reports or medicalservices delivered as a result of an exam terminated for good cause.

(h) Nothing in this section shall require a QME to undertake or continue a comprehensivemedical-legal evaluation where the injured worker uses abusive language towards the QME or theQME's staff or deliberately attempts to disrupt the operation of the QME's office in any way.(h) Nothing in this section shall require a QME to undertake or continue a comprehensivemedical-legal evaluation where the injured worker or his/her representative uses a abusive language towards the QME or the QME's staff or deliberately attempts to disrupt the operation of the QME's office in any way. The QME shall state under penalty of perjury, the facts supporting the termination of the evaluation process. Upon request, the Medical Director shall investigate the facts and make a final termination of the issue(s).

(i) Nothing in this section shall require a QME to undertake or continue a comprehensive medical-legal evaluation where the injured worker is intoxicated or under the influence of anymedication which impairs the injured worker's ability to participate in the evaluation process. The QME shall state under penalty of perjury, the facts supporting the termination of evaluation process. Upon request, the Medical Director shall investigate the facts and make a final determination of the issue(s).