Although more work still needs to be done, RPNA, which proudly represents over 100 qualified medical evaluators (QMEs) and several QME management companies, was successful this week in its fight to persuade the Division of Workers Compensation (DWC) to take action to protect injured workers and QMEs during the rapidly exploding COVID-19 crisis through the authorization of remote evaluations by QMEs.
While Governor Newsom and many other states have issued stay-at-home orders and endorsed well-established telemedicine technology to preserve healthcare services, the DWC had been slow to react to protect the health of injured workers and QMEs by allowing these evaluations, which are critical to the provision of medical care and benefits for injured workers, to be performed remotely using telemedicine technology.
On March 25, Partner Nicholas P. Roxborough and Senior Attorney Burton E. Falk gave notice on behalf of California Medical Evaluators, Inc., (“CME”) to DWC Administrative Director George Parisotto that RPNA would seek a temporary restraining order or preliminary injunction within days to compel the DWC to “unconditionally authorize the immediate acceptance and implementation of remote QME evaluations” and to prohibit insurers’ objections to payment for such evaluations.
Mr. Roxborough wrote that the DWC recently issued a news release encouraging “all parties to consider creative solutions appropriate to providing care to injured workers” during the pandemic, “including telemedicine,” but they refused to take decisive action to fully authorize remote QME evaluations.
On March 27, Mr. Roxborough and Senior Attorney Ryan R. Salsig reminded DWC that the Government Code gave him the legal authority to issue emergency regulations to bypass time-consuming administrative procedures, to protect the health, safety and welfare of injured workers and QMEs, many of whom are over 65 and especially vulnerable to the virus.
Shortly thereafter, on March 28, the DWC partially implemented the emergency measures RPNA was demanding, stating that it “finds that it may be beneficial for parties to allow telehealth for QME evaluations.”
However, the DWC imposed strict conditions on remote evaluations, which RPNA believes falls short of the full protections that are essential. In that regard, RPNA has been invited to work with newly appointed DIR Director Hagen to hopefully implement “Opt Out” Guidelines for QMEs and injured workers, and will continue the fight to protect its QME clients to protect their health and the health of injured workers.
RPNA would like to give a special thank you to CME for its support in this journey.
RPNA will continue to monitor these developments and provide important updates to our clients as appropriate. If you have any questions please contact the attorneys at RPNA at (818) 992-9999.
Attached is the link to the DWC guideline article
https://www.dir.ca.gov/DIRNews/2020/2020-26.html
