During the COVID-19 pandemic, emergency regulations were put into place allowing QME and AME evaluations to proceed virtually either by telephone or by videoconferencing. This was seen in Title 8 Section 46.2 of the California Code of Regulations, which has now been repealed, along with many of the other emergency COVID-19 regulations. However, remote medical legal evaluations are still available post COVID-19. Title 8 Section 46.3 of the California Code of Regulations outlines the conditions for a remote medical legal evaluation. This code section states that video conferencing for a medical legal appointment that has both video and audio connection can be utilized if the below conditions are met and a hands-on evaluation is not necessary:

“(A) There is a medical issue in dispute which involves whether or not the injury is AOE/COE (Arising Out of Employment / Course of Employment), or the physician is asked to address the termination of an injured worker’s indemnity benefit payments or address a dispute regarding work restrictions; and

(B) There is agreement in writing to the remote health evaluation by the injured worker, the carrier or employer, and the QME.

(C) The remote health evaluation conducted by means of a virtual meeting is consistent with appropriate and ethical medical practices and the AMA Guides 5^th edition, 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” (Title 8 Section 46.3 of the California Code of Regulations.)

Almost every QME or AME is asked to address either issues of AOE/COE, indemnity benefits, or work restrictions, so this requirement is almost always met. The issue of whether a hands-on appointment is necessary and means in which the appointment is conducted seems to be left to the doctor or for the doctor to attest to, per part C & D. Whether or not the parties can all agree to the remote evaluation seems to be the issue with remote evaluations in my experience. If the parties cannot agree to the remote evaluation for a QME or AME evaluation there becomes a problem with now finding a panel doctor that arranges for in person evaluations depending on the specialty of the QME/AME the parties are seeking.

QME specialties like psychiatry or psychology for example have moved away from in person evaluations since the COVID-19 pandemic, and don’t seem to be moving back to in person evaluations. Many practitioners (myself included) have experienced delay with multiple replacement panel requests trying to find a doctor that will evaluate the applicant in person when there is not an agreement to a virtual appointment. This issue doesn’t seem to be going away anytime soon as more and more of the workers’ compensation practice has moved to virtual settings during COVID-19 (depositions, hearings, etc.). Even though the pandemic has been declared over and most if not all of the COVID-19 emergency restrictions have been lifted with regard to Workers’ Compensation cases virtual medical legal appointments may be here to stay.

The issue may become enduring delay to get an in-person appointment with a QME specialty like psychiatry or psychology if an in-person appointment is the preferred method of evaluation or necessary form of evaluation depending on the circumstances of the case. Even if there is an agreement to a remote medical legal evaluation I recommend a review of the above quoted requirements per Title 8, CCR Section 46.3 in conjunction with any remote evaluation setting to ensure it has been properly set via a virtual setting and is appropriate for the case/issues at hand.