The COVID-19 (coronavirus) pandemic is affecting communities across the country. In order to slow the transmission of the respiratory disease, the California Department of Public Health recommends social distancing. Public officials instructed everyone in the state to stay home except for essential needs.

In an effort to facilitate social distancing, the Division of Workers’ Compensation (DWC) has rolled out proposed emergency telemedicine regulations. The proposed telehealth guidelines have important implications for workers’ compensation defense. Here is an overview of the key items insurers, workers’ compensation administrators, and employers should know about California’s coronavirus-related telemedicine guidance.

Four Things to Know About Workers’ Compensation Medical Evaluations and Telehealth.

  1. The Proposals Apply to QMEs and AMEs

When there is a question regarding the nature and severity of a work-related injury, a claimant may be required to go before a Qualified Medical Evaluator (QME) or an Agreed Medical Evaluator (AME). A QME is a doctor who is selected from a pre-approved list of state-certified medical professionals. An AME is a doctor who has been agreed upon by both the employee and the employer. An AME may or may not be on California’s list of qualified evaluators. In light of the COVID-19 pandemic, California officials want to limit doctor-patient interactions to only what is essential.

  1. Rescheduling of In-Person QMEs and AMEs

California’s proposed emergency QME telemedicine regulations allows for the rescheduling of in-person appointments. Under the regulations, an in-person exam before a QME or AME can be rescheduled up to 90 days after all applicable state and local stay-at-home orders are removed. The purpose of the proposed rule is to give parties more time to deal with matters during this time.

  1. Medical Examinations: Some Tasks May be Handled Remotely

Finally, and perhaps most importantly, the emergency regulations allow certain medical-legal evaluations to be performed remotely. Specifically, a Qualified Medical Evaluator or an Agreed Medical Evaluator, may:

  • Review relevant medical records; and
  • Conduct phone/video conference interviews of the applicant.

The DWC instructs parties to provide their records to the QME/AME at least 10 days before a telehealth examination is scheduled to occur. Once COVID-19 public health restrictions have been lifted, the QME/AME can then be conducted by a face-to-face evaluation. Of course, workers’ compensation evaluations must always be conducted on a case-by-case basis. What type of medical examination will be required depends entirely on the specific circumstances.

  1. DWC Encourages Parties to Get Creative, Find Solutions

In a public letter, the Division of Workers’ Compensation requested all parties to adhere to health guidelines and encouraged parties to get creative in processing workers’ compensation claims. The DWC notes that use of telehealth in a QME/AME may be appropriate when all parties involved, including the doctor, agree that it is well-suited for conducting a fair, comprehensive evaluation.

Call Our California Workers’ Compensation Defense Lawyers for Immediate Assistance

At Yrulegui & Roberts, our California workers’ compensation defense attorneys provide zealous and focused legal representation to employers. We are prepared to go above and beyond to protect your rights and interests. If you have questions about telemedicine and workers’ compensation, our attorneys can help. For a completely confidential initial consultation, please contact us today. From our offices in Fresno, Sacramento, and Bakersfield, we serve communities in Central California and beyond.