California DWC extends Telehealth Regulations thru January 18, 2023

In a news release today, the Division of Workers’ Compensation (DWC) announced its Emergency Regulation (8 CCR 46.3) for medical-legal evaluations utilizing telehealth and office location flexibility resulting from various state and local public health safety measures related to COVID-19, which became effective on January 18, 2022 and was set to expire in October 18, 2022, has been extended until January 18, 2023. This is DWC’s second and final re-adoption in accordance with Government Code section 11346.1(h). The Division has commenced rulemaking to make this regulation permanent. These documents can be found on the DWC website: https://www.dir.ca.gov/

8 CCR 46.3 permits a QME or AME to complete a MEDICAL-LEGAL evaluation through telehealth when a hands on physical examination is not necessary AND all of the following conditions are met:

(A) AOE/COE, extent of work restrictions, and/or the termination of indemnity payments is in dispute. 

(B) There is agreement in writing to the telehealth evaluation by the injured worker, the carrier or employer, and the QME. Agreement to the telehealth evaluation cannot be unreasonably denied;

(C) The telehealth evaluation conducted by means of a virtual meeting is consistent with appropriate and ethical medical practices, as determined by the QME and the relevant medical licensing board; and

(D) The QME attests in writing that the evaluation does not require an in person physical exam.

The regulation also provides that if a party to the action believes that agreement to the telehealth evaluation has been unreasonably denied under this section, they may file an objection with the Worker's Compensation Appeals Board, along with a Declaration of Readiness to Proceed to set the matter for a hearing. Defendants in California are strongly recommend to consider whether a telehealth evaluation will suffice.  Factors to consider might include the nature/extent of injury, the issues to be decided, and whether an in-person evaluation is necessary for the doctor to gain a clear understanding of the applicant or to assess their credibility.  

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