Workers Comp Zone


The DWC has now unveiled an online QME training module.

Compressing training into a one hour online course is not an easy thing, but the course (see link to it at the bottom of this post) 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 of the slides. 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 September 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 (see link to that post below). 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 of that litigation, the DWC may need to make amendments to this online training.

Here is the link to the online QME course:

Here is the link to my post “Se Ya in Court”:

Stay tuned.

Julius Young