Young: QME Online Training

Monday, November 20, 2017 | 0

The Division of Worker's Compensation has now unveiled an online qualified medical evaluator training module.

Julius Young

Compressing training into a one-hour online course is not an easy thing, but the course does hit many of the QME basics and high points, with links to various statutes and regulations.

The pool of QMEs is aging, and the goal is obviously to have an easy resource for prospective QMEs to immerse themselves in the basics. The training uses actors, portraying a physician interested in doing QME work as she discusses the system with an experienced QME who is mentoring her.

I was one of a number of comp system veterans who sat in on several focus group sessions to give feedback on drafts of the slides and narrative content.

The main controversy then and now is over the training section regarding QME billing, which starts at page 26 of the slides and runs through page 44. Page 26 outlines the following disclaimer:

“The proper application of the medical-legal fee schedule requires statutory and regulatory interpretation. The presentation that follows represents the interpretation currently utilized by the DWC. Regulations and statutes change over time. The DWC will endeavor to update this presentation to comport with any future changes in the regulations dealing with the medical-legal fee schedule.”

On Sept. 28 I did an in-depth post (“See Ya in Court”) on the festering issue of whether the current DWC interpretation of QME billing rules is an illegal underground regulation. Many QMEs are getting entangled in recertification disputes over what is essentially a new and more strict DWC interpretation of ML 104 billing rules.

An early December hearing is scheduled in Los Angeles County Superior Court on a lawsuit filed by several QMEs over the current DWC interpretation of ML 104 rules and QME recertification practices.

Depending on the outcome, the DWC may need to make amendments to this online training.

Julius Young is a claimants' attorney for the Boxer & Gerson law firm in Oakland. This column was reprinted with his permission from his blog, www.workerscompzone.com.