California Labor Code § 4062.4

Labor Code
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(a) (1) The administrative director shall develop and make available a template qualified medical evaluator (QME) report form, which shall include all necessary statutory and regulatory requirements for a QME report. (2) Use of a template QME report form developed pursuant to paragraph (1) does not constitute prima facie evidence that a report is complete, accurate, or compliant with applicable statutory or regulatory requirements. (b) (1) The administrative director shall develop and make available a medical evaluation request form for communicating with a panel qualified medical evaluator pursuant to Section 4062.3 in advance of an evaluation obtained pursuant to Section 4062.1 or 4062.2. (2) This subdivision does not limit a party’s right to submit relevant information to a qualified medical evaluator pursuant to Section 4062.3. (c) The Division of Workers’ Compensation, acting in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), shall adopt regulations to implement this chapter with an effective date of no later than January 1, 2027.

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