115....The Notice of Late Qualified Medical Evaluator Report Form. [Reserved]

Note: Authority cited: Sections 139 and 139. 2, Labor Code. Reference: Sections 139. 2, 4060, 4061, 4062 and 4062. 5, Labor Code.   HISTORY   . New section filed ...more

116....Notice of Late QME/AME Report-No Extension Requested Form

NOTE: Form is available at no charge by downloading from the web at www. dir. ca. gov/dwc/forms. html or by requesting at 1-800-794-6900. Note: Authority cited: ...more

117....Qualified Medical Evaluator Course Evaluation Form.

  Note: Authority cited: Sections 53, 133, 139. 2 and 5307. 3, Labor Code. Reference: Sections 139. 2, 4060, 4061, 4062, 4062. 1, 4062. 2, 4064 and 4067, Labor Code. ...more

118....Application for Accreditation or Re-Accreditation As Education Provider

Reference: Sections 139. 2, 4060, 4061, 4062, 4062. 1, 4062. 2, 4064 and 4067, Labor Code. A Certificate of Compliance must be transmitted to OAL by 5-1-2001 or emergency ...more

119....Faculty Disclosure of Commercial Interest

Reference: Sections 139. 2, 4060, 4061, 4062, 4062. 1, 4062. 2, 4064 and 4067, Labor Code. New section filed 10-16-2000 as an emergency; operative 1-1-2001 (Register ...more

12....Recognition of Specialty Boards

The Administrative Director shall recognize only those specialty boards recognized by the respective California licensing boards for physicians as defined in Labor Code ...more

120....Voluntary Directive for Alternate Service of Medical-Legal Evaluation Report on Disputed Injury to Psyche

NOTE: Form is available at no charge by downloading from the web at www. dir. ca. gov/dwc/forms. html or by requesting at 1-800-794-6900. Note: Authority cited: ...more

121....Declaration Regarding Protection of Mental Health Record

NOTE: Form is available at no charge by downloading from the web at www. dir. ca. gov/dwc/forms. html or by requesting at 1-800-794-6900. Note: Authority cited: ...more

122....AME or QME Declaration of Service of Medical-Legal Report

NOTE: Form is available at no charge by downloading from the web at www. dir. ca. gov/dwc/forms. html or by requesting at 1-800-794-6900. Note: Authority cited: ...more

123....QME/AME Conflict of Interest Disclosure and Objection or Waiver by Represented-Parties Form

NOTE: Form is available at no charge by downloading from the web at www. dir. ca. gov/dwc/forms. html or by requesting at 1-800-794-6900. Note: Authority cited: ...more