Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) Where the Medical Director determines that there is prima facie evidence of any violation of section of Title 860 of Title 8 of the California Code of Regulations, he or she shall make and submit a prima facie case of the violation to the Administrative Director.
(b) If the Administrative Director sustains the Medical Director's prima facie case, the QME shall be notified in writing of the determination and shall also be notified of his or her right to a hearing in accordance with Chapter 4 (commencing with Section 11370) and Chapter 5 (commencing with section 11500) and Part 1 of Division 3 of the Government Code.
(1) The Administrative Director may, notwithstanding Government Code section 11502, assign the hearing to a hearing officer designated by the Medical Director who shall act as an Administrative Law Judge for the purposes of Government Code sections 11370 et. seq. and 11500 et. seq., or may delegate in whole or in part to an Administrative Law Judge the authority to conduct the hearing and decide the case. In the event of a hearing, the hearing officer or Administrative Law Judge shall fix the time and place of the hearing and notify interested parties in writing no fewer than 10 days in advance of the hearing and in accordance with Code of Civil Procedure sections 1013(a) and 2015.5 specifying the time and place of the hearing.
(2) If an Administrative Law Judge conducts a hearing, the Administrative Law Judge selected to preside over the hearing shall hear the case alone, and exercise all powers related to the conduct of the hearing.
(3) At the conclusion of the hearing, the Administrative Law Judge or hearing officer shall file a written statement of findings and proposed decision with the Administrative Director. The decision made pursuant to this action shall include specific findings in accordance with section of Title 860(b) of Title 8 of the California Code of Regulations, and under section of Title 865 of Title 8 of the California Code of Regulations shall recommend, but defer to the Administrative Director the final decision with respect to sanctions.
(4) The Administrative Director's decision on which sanction(s) to impose on a QME, pursuant to Labor Code section 139.2(k) or any other statute giving the Administrative Director disciplinary authority, shall be in accordance with the Sanction Guidelines for Qualified Medical Evaluators under section of Title 865 of Title 8 of the California Code of Regulations.
(5) In accordance with Government Code section 11517(c), if the proposed decision is not adopted by the Administrative Director, the Administrative Director shall determine whether or not to decide the case, based on the record and transcript, and/or whether or not to take additional evidence or to refer the case back to the Administrative Law Judge to take additional evidence on any issue or issues requested by the Administrative Director.
(6) Within thirty (30) days of the date the written decision is served upon the QME, the QME may file a petition for reconsideration with the Administrative Director. The petition shall be governed by Government Code section 11521 and shall set forth any legal or factual basis as to why the decision should not be confirmed.
(c) Judicial Review of the Administrative Director's decision may be had by the filing of a petition for writ of mandate pursuant to Government Code Section 11523 no later than thirty (30) days after the last day on which the Administrative Director can order reconsideration in accordance with (b)(6) of this section.
1. Renumbering of former section 52 to new section 61, and amendment of subsections (c) and (d) filed 8-23-96; operative 9-22-96 (Register 96, No. 34).
2. Repealer and new section and amendment of NOTE filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15).
3. Amendment of section and NOTE filed 1-13-2009; operative 2-17-2009 (Register 2009, No. 3).
Note: Authority cited: Sections 133, 139.2, 5307.3 and 5307.4, Labor Code; and Sections 11370 et seq. and 11500 et seq., Government Code. Reference: Section 139.2, Labor Code; and Sections 11502 et seq., Government Code.
