What Is 8 CCR §31.1: QME Panel Disputes for Represented Workers?

Disputes regarding the validity of panel requests shall be resolved by a Workers' Compensation Administrative Law Judge.

What is 8 CCR §31.1?

It is the rule that sends three specific QME panel disputes in represented claims to a judge.

This rule applies once a represented worker or employer has already asked the Medical Director for a QME panel. It covers what happens when a problem comes up with that request. It does not apply to an unrepresented worker. That process follows separate rules instead.

What if the other side says my panel request itself was not valid?

That dispute goes straight to a judge, not the Medical Director.

Subdivision (a) covers a challenge to the request itself, not just one detail inside it. An example is an argument that the request was too early, filed by the wrong party, or skipped a required step. A judge decides that question instead.

What if we disagree about which specialty the panel should cover?

The Medical Director decides first. Either side can then appeal to a judge.

Subdivision (b) sends a specialty disagreement through 8 CCR 31.5(a)(10) first. That rule lets the Medical Director decide whether the chosen specialty actually fits the disputed medical issue. Once the Medical Director rules, either the worker or the employer may appeal that decision. The judge hears that appeal.

What if the Medical Director never issues the panel?

After 30 calendar days with no panel, either side can ask a judge to step in.

Subdivision (c) starts this clock on the date the Medical Director receives the request. Once 30 days pass with no panel, either party may ask a workers' compensation judge for an order. That order must name the specialty, or name which party gets to choose it.

Where does this rule sit among the other QME panel rules?

It is the dispute backstop; the panel request itself comes from other sections.

A panel is normally chosen at random by specialty under 8 CCR 31. A worker with an attorney requests that panel under Labor Code section 4062.2. Your case may later need a second evaluator in a new field, rather than a dispute about the first request. A related rule, 8 CCR 31.7, covers that instead. Labor Code section 4064 covers who pays once the evaluation happens.

What should you ask your attorney if your panel request is stuck?

Ask which of the three problems you actually have. Each one follows a different path.

A stuck or disputed panel request is not always the same problem. Confirm the date the Medical Director received the request. Get the other side's specific reason for disputing it, in writing. Keep every letter about the specialty chosen. This site's separate guide on QME panel replacement covers a different situation: a panel that already issued but needs to be swapped out.

What should you do about a disputed or delayed QME panel request?

Write down the dates, keep every notice, and raise the specific problem with your attorney early.

Note the date your panel request was filed. Note the date, if any, the Medical Director responded. If your represented claim is stuck on a disputed panel request, call (661) 273-1780 or use the contact form for a free consultation. Yazdchi Law P.C. reviews each workers' compensation matter on its own facts before deciding whether to take it on.