Labor Code 4062.2: Panel QME Requests, Strikes, and Reports

California Labor Code Section 4062.2 sets the rules for how an injured worker who has an attorney gets a neutral medical evaluation when the parties disagree about the medicine in a workers’ compensation claim. The state assigns a panel of three Qualified Medical Evaluators, each side strikes one name within ten days, and the remaining physician performs the exam. The employer pays, and the resulting report usually becomes the most important piece of medical evidence in the case.¹

When Section 4062.2 Applies

The panel process under 4062.2 is for represented workers only. It activates when there is a genuine medical dispute falling under one of three Labor Code sections:

Section 4060 disputes about compensability, meaning whether the injury itself arose out of employment.
Section 4061 disputes about permanent disability, which is the most common trigger. If the treating physician’s permanent disability opinion doesn’t satisfy both sides, either party can start the process.
Section 4062 disputes about other medical issues, including the need for future treatment, the nature or extent of temporary disability, work restrictions, or whether the worker has reached maximum medical improvement.

You cannot jump straight to a panel request. Section 4062.2(b) requires at least ten days to pass after mailing a request for evaluation under Section 4060 or a written objection under Sections 4061 or 4062.¹ That window gives the other side notice before a neutral evaluator is drawn in.

Requesting the Panel

In represented cases, the request is submitted through the Division of Workers’ Compensation’s online QME system. Filed online, the panel issues immediately.² The request needs the claim number, the date of injury, and the medical specialty for the evaluation.³

Specialty selection carries more weight than it looks. The statute requires the requesting party to designate the specialty, disclose the specialty the other party has asked for if known, and identify the specialty of the treating physician.¹ A back case looks different to an orthopedic surgeon than it does to a neurologist, and whichever specialist ends up on the panel will drive the medical story of the claim.

After the panel is generated, the requesting party has to print and serve a paper copy of the request, the panel list, and any supporting documents on the other side with proof of service within one working day.³ Electronic service is permitted as an alternative to mail or personal delivery under California Code of Regulations Section 10625(b). If service is electronic, the proof of service must include the email addresses of both the person serving and the person served.

The Ten-Day Strike

Once the administrative director assigns the three-member panel, each side has ten days to strike one name.¹ The clock runs from the date of panel assignment, not the date the list arrives in the mail. The physician left standing after both strikes becomes the evaluator.

Missing the deadline is costly. If one party fails to strike within ten days, the other side can select any remaining physician on the panel, which effectively lets the opposing party pick the most favorable doctor.¹ Experienced workers’ comp attorneys research each panelist’s history before deciding whom to strike, and ten days passes quickly once mail time is factored in.

The parties can bypass the panel entirely at any point by agreeing to an Agreed Medical Evaluator.¹ In practice this is uncommon because parties who disagree about the medicine rarely agree about the doctor.

Scheduling the Appointment

In represented cases the injured worker is responsible for scheduling with the selected QME.¹ If the worker doesn’t notify the employer of the appointment within ten days after the QME is selected, the employer or its attorney can take over the scheduling.⁴ Letting the other side book your evaluation is not ideal, since control over timing and logistics slips away.

If the chosen QME cannot see the worker within 90 days of the appointment request, the scheduling party can waive the right to a replacement and take an appointment up to 120 days out. Past 120 days, either party can report the evaluator as unavailable and ask the Medical Director for a replacement.⁴ Both parties can also agree in writing to waive the 120-day limit to keep the original evaluator.

Once set, the QME must send an appointment notification form to the worker and the claims administrator within five business days.⁵ Skipping the appointment is a bad move: Section 4062.2(d) says the employee “shall not unreasonably refuse to participate in the evaluation,” and non-attendance can stall benefits or force the case to move forward on whatever medical evidence already exists.

Replacing a Panel Evaluator

The initial panel isn’t always the final panel. California Code of Regulations Section 31.5 lists the grounds for replacing a QME, including a disqualifying conflict of interest, membership in the same medical group as another panelist, prior service as the worker’s treating physician, or inability to schedule within the required timeframe.⁶

When the Medical Director approves a replacement, the strike deadline under Section 4062.2(c) is paused until the new panel or replacement name is issued.⁶ If replacement happens after both sides have already struck and the remaining QME needs to be swapped out, none of the original panel members can appear on the new panel. Replacement requests go on DWC Form 31.5.

Communication Rules and Ex Parte Contact

This is where cases get derailed. Every communication with a panel QME must be in writing, and every document sent to the evaluator must be served on the other side at the same time. Records or information sent to the QME before the evaluation must reach the opposing party at least 20 days before the appointment.⁷

Private contact with the QME is flatly prohibited. Labor Code 4062.3 calls it “ex parte communication,” and both sides are barred.⁷ Certain materials are also off-limits for submission: untimely medical-legal reports, disability or impairment opinions from non-treating physicians that haven’t been ruled admissible, and any report a Workers’ Compensation Administrative Law Judge has stricken.⁸

Penalties are real. If one side makes a prohibited communication, the other side can either end the current evaluation and request a new panel, or continue with the current evaluator. The violating party may face contempt proceedings before the Workers’ Compensation Appeals Board and liability for the other side’s costs, including the evaluation, further discovery, and attorney’s fees.⁷ One narrow exception: the injured worker may speak with the evaluator during the exam itself or when the evaluator asks a question in connection with the exam.

What the Report Must Address

The QME is not just filling in a form. Under California Code of Regulations Section 35.5, the evaluator must address all contested medical issues arising from every injury reported on the claim forms before the appointment date, so long as those issues fall within the evaluator’s clinical competence.⁹ The report should also respond to the specific questions in the parties’ cover letters.

If the QME concludes the worker has reached maximum medical improvement with permanent partial disability, the evaluator has to complete a Permanent and Stationary Status and Work Capacity form (DWC-AD Form 10133.36) and serve it on the claims administrator with the report.⁹ The report also has to include a declaration under penalty of perjury that the evaluator did not discriminate against either party during the evaluation or in the content of the report.

One important boundary: for evaluations performed after July 1, 2013, the QME cannot opine on disputed medical treatment recommendations, because those go through the separate utilization review and independent medical review tracks. The evaluator can still say whether the worker will need future medical care for the effects of the injury.⁹

The QME has 30 days after seeing the worker to prepare and serve the report.¹⁰ Extensions are available from the Medical Unit for complex testing or large record volumes.

Challenging a Report You Don’t Like

A report that seems wrong isn’t necessarily the last word. Either party can send additional records to the evaluator and request a supplemental report. Supplemental communications follow the same rules as the initial ones: in writing, served on the other side at the same time.

If a supplemental report isn’t enough, either party can depose the QME. Unless the Workers’ Compensation Appeals Board orders otherwise or the parties agree to something different, the evaluator must make themselves available for deposition within 120 days of the notice. A deposition lets the attorney probe methodology, conclusions, and inconsistencies. In complex cases involving substantial permanent disability, the deposition can carry as much weight as the report.

Who Pays

The employer is liable for each reasonable and necessary comprehensive medical-legal evaluation obtained under Sections 4060, 4061, and 4062, and also covers the worker’s transportation to the appointment. The employer is not required to pay for more than one QME evaluation per claim, and it is not liable for evaluations obtained outside the procedures in those sections.¹¹ Either party can always pay for an additional consultation out of pocket, but a privately obtained report won’t carry the same weight as the official QME.

Why This Report Matters So Much

The QME’s findings on permanent disability, work restrictions, and future medical needs become central evidence at the mandatory settlement conference and at trial. The disability rating in the report drives the calculation of permanent disability benefits. The work restrictions decide whether the employer can offer modified or alternative duties.

When the employer can’t accommodate the restrictions, the injured worker may qualify for the Supplemental Job Displacement Benefit, a $6,000 voucher for retraining or skill enhancement.¹² Eligibility hinges on permanent partial disability as determined by the evaluator and the employer’s failure to offer suitable work. The QME report is usually what settles that question.

And this is largely a one-shot process. A worker who obtains an evaluation under Section 4062.2 and later stops being represented by an attorney is not entitled to a second evaluation.¹ The one evaluation you get is generally the one you live with, which is why the specialty choice, the strike decision, and the records sent to the evaluator all deserve careful attention from the start.

1
California Legislative Information. California Labor Code LAB 4062.2 – Determination of Medical Issues
2
Division of Workers’ Compensation. Online QME Form 106 Panel Request
3
Cornell Law Institute. Cal. Code Regs. Tit. 8, 30 – QME Panel Requests
4
Department of Industrial Relations. California Code of Regulations, Title 8, Section 31.3 – Scheduling Appointment with Panel QME
5
Department of Industrial Relations. California Code of Regulations Title 8 Section 34 – Appointment Notification and Cancellation
6
Department of Industrial Relations. California Code of Regulations Title 8 Section 31.5 – QME Replacement Requests
7
California Legislative Information. California Code Labor Code 4062.3
8
Department of Industrial Relations. California Code of Regulations Title 8 Section 35 – Exchange of Information and Ex Parte Communications
9
Department of Industrial Relations. California Code of Regulations Title 8 Section 35.5 – Compliance by AMEs and QMEs with Administrative Director Regulations
10
Department of Industrial Relations. California Code of Regulations Title 8 Section 38 – Medical Evaluation Time Frames and Extensions for QMEs and AMEs
11
California Legislative Information. California Code Labor Code 4064
12
Division of Workers’ Compensation. DWC FAQs on SJDB