Workers’ compensation: qualified medical evaluators.

Assembly Member Wallis’s proposal would add a new Labor Code provision to standardize the preparation and communication processes for medical-legal evaluations conducted by qualified medical evaluators in California’s workers’ compensation system. The core change requires the Administrative Director to develop and make available a template QME report form that includes all necessary statutory and regulatory requirements for a QME report, and a medical evaluation request form for communications with a panel QME in advance of an evaluation. The bill also directs the Division of Workers’ Compensation to adopt implementing regulations by no later than January 1, 2027, under the Government Code’s Administrative Procedure Act framework.

The new provisions would situate the forms within the existing QME framework, which already governs written communications related to disputes about injury claims. The template QME report form must reflect all statutory and regulatory requirements, but its use would not, by itself, establish that a report is complete or compliant. Similarly, the medical evaluation request form would be available to facilitate advance communications with a panel QME in connection with specified sections, while preserving parties’ rights to submit relevant information under current procedures. The bill emphasizes that providing templates does not limit existing rights to submit information and does not alter the underlying requirements for timely and proper communications.

Implementation would proceed through regulatory action by the Division of Workers’ Compensation, with a targeted effective date in 2027. There is no appropriation accompanying the measure, but the fiscal committee will review the likely costs associated with form development, rulemaking, and ongoing maintenance, including potential guidance materials and updates in response to statutory or regulatory changes. Stakeholders—including QMEs, medical providers, employers, insurers, and claimants and their attorneys—would engage with the new templates as supplemental tools within the current statutory framework, without changing the substantive rights or the basic dispute-resolution workflow.

In the broader policy context, the proposal seeks to provide standardized administrative tools to accompany the existing medical-legal evaluation process, aiming to clarify and streamline communications while preserving existing processes and rights. The forms’ adoption would occur alongside ongoing regulatory design and public input, with the 2027 regulatory timeline marking a transition point for how communications and reporting are structured within the workers’ compensation system.