California Code of Regulations (Last Updated: August 6, 2014) |
Title 8. Industrial Relations |
Division 1. Department of Industrial Relations |
Chapter 1. Division of Workers' Compensation-Qualified Medical Evaluator Regulations |
Article 10.5. Qme Process Forms |
§ 105. The Request for Qualified Medical Evaluator Panel - Unrepresented Form. |
§ 106. The Request for Qualified Medical Evaluator Panel - Represented Form. |
§ 107. The Qualified Medical Evaluator Panel Selection Form. |
§ 108. The Qualified Medical Evaluator Panel Selection Instruction Form. |
§ 109. The Qualified Medical Evaluator Notice of Unavailability Form. |
§ 110. The Appointment Notification Form. |
§ 111. The Qualified Medical Evaluator's Findings Summary Form. |
§ 112. The Qme/Ame Time Frame Extension Request Form. |
§ 113. Notice of Denial of Request for Time Extension Form. |
§ 114. The Denial of Time Extension Form. [Reserved] |
§ 115. The Notice of Late Qualified Medical Evaluator Report Form. [Reserved] |
§ 116. Notice of Late Qme/Ame Report-no Extension Requested Form. |
§ 117. Qualified Medical Evaluator Course Evaluation Form. |
§ 118. Application for Accreditation or re-Accreditation as Education Provider. |
§ 119. Faculty Disclosure of Commercial Interest. |
§ 120. Voluntary Directive for Alternate Service of Medical-Legal Evaluation Report on Disputed Injury to Psyche. |
§ 121. Declaration Regarding Protection of Mental Health Record. |
§ 122. Ame or Qme Declaration of Service of Medical-Legal Report. |
§ 123. Qme/Ame Conflict of Interest Disclosure and Objection or Waiver by Represented-Parties Form. |
§ 124. Specified Financial Interest Attachment to Qme Forms 100, 103 or 104 (‘‘Sfi Form 124”). |
§ 125. [Reserved] |
§ 149. Definitions. [Renumbered] |
§ 149.2. Neuromusculoskeletal Evaluation. [Renumbered] |
§ 149.4. Cardiovascular Evaluation. [Renumbered] |
§ 149.6. Pulmonary Evaluation. [Renumbered] |
§ 149.8. Psychiatric Evaluation. [Renumbered] |
§ 149.9. Other Evaluation. [Renumbered] |