California Labor Code 4062: Objection Deadlines and QME Panels

Under California Labor Code section 4062, you challenge a treating physician’s medical finding by mailing a written objection within 20 days of receiving the report if you have an attorney, or 30 days if you don’t. The dispute then moves to a Qualified Medical Evaluator, whose independent opinion resolves the disagreement. The path to that evaluator differs depending on whether the injured worker is represented.¹

Which Medical Disputes 4062 Actually Covers

Section 4062 is the catch-all objection statute for a treating physician’s medical determinations that don’t fall under two neighboring sections. It reaches disputes over whether a specific treatment should be authorized, whether the worker remains temporarily disabled and entitled to indemnity payments, and when the worker can return to work.¹

A common example: the treating physician recommends physical therapy or a procedure and the carrier disagrees. Or the physician clears the worker for full duty but the worker believes the release is premature. Both start here.

Several categories look like they belong under 4062 but don’t. Getting this wrong wastes weeks.

Utilization review denials. If the employer’s insurer used utilization review to modify, delay, or deny a treatment recommendation, the challenge goes through Independent Medical Review under Labor Code 4610.5, not the QME process.¹
Disputes with a physician inside the employer’s Medical Provider Network. Those go through the MPN’s own independent medical review process under sections 4616.3 and 4616.4.¹
Whether the injury is work-related at all (Section 4060) and the existence or extent of permanent impairment or future medical care (Section 4061). Those sections use the same QME panel machinery but have their own triggers.²

Before you object under 4062, confirm the disputed finding involves treatment, temporary disability, or work restrictions rather than compensability or permanent disability.

The Objection Deadline and What It Must Say

The statute draws a hard line based on representation. A represented worker (or the employer objecting to a report in a represented case) has 20 days from receipt of the treating physician’s report. An unrepresented worker has 30 days.¹

The clock starts on receipt, not on the date the report was written. When a report arrives by mail, receipt is typically a few days after the mailing date. Mark the calendar the day the report shows up. Missing the deadline means losing the right to contest the physician’s opinion through the QME process. The time limits can be extended for good cause or by mutual agreement, but planning around an extension is risky.

The written objection needs to identify the treating physician, the date of the report being challenged, and the specific medical determination in dispute. This isn’t housekeeping. When you later request a QME panel, the regulations require you to attach the written objection with these details.³

Getting a QME Panel When the Worker Has an Attorney

Represented cases follow section 4062.2. After the written objection is mailed, there’s a mandatory 10-day waiting period. The panel request cannot be submitted until the first working day at least 10 days after the objection was mailed.⁴ That window exists so the parties can try to agree on an Agreed Medical Evaluator instead.

If no AME agreement is reached, the panel request goes in electronically through the Division of Workers’ Compensation’s online system using DWC Form 106.⁵ The requesting party designates the medical specialty for the evaluation and, if known, the specialty requested by the other side. The panel generates automatically on submission.³

The requesting party then has one working day to print and serve a paper copy of the request, the panel list, and any supporting documentation on the other side. Each side has 10 days from service to strike one name from the three-name panel. The remaining physician becomes the QME.⁴

Miss the striking window and the other party can pick any physician still on the panel. That’s a real consequence that catches people off guard.

Getting a QME Panel When the Worker Has No Attorney

Unrepresented cases follow section 4062.1, and the rules differ in ways that matter. The employer cannot seek an Agreed Medical Evaluator with an unrepresented worker, and no AME may conduct the evaluation.⁶

The panel is requested on DWC Form 105, mailed to the Division of Workers’ Compensation Medical Unit.⁷ There is no online portal for unrepresented cases. The claims administrator must give Form 105 to the employee by personal delivery or first-class or certified mail. If the employee doesn’t submit the form within 10 days after the employer provides it, the employer may submit it.³

Once the panel issues, the unrepresented worker has 10 days to pick one physician from the three-name panel, schedule the appointment, and tell the employer the selection. Miss that 10-day window and the employer can choose the physician and set the appointment.⁶ Unlike the represented process, there’s no alternating strike. The worker simply picks one name.

At the appointment, the evaluator has to give the unrepresented worker a brief opportunity to ask questions about the process and the evaluator’s background. If the worker has good cause to believe the evaluator is biased, the worker can walk out and request a new panel. Good cause includes evidence of bias based on race, sex, national origin, religion, or sexual preference, or evidence that the evaluator requested an unnecessary examination or procedure. If the appeals board later finds the worker lacked good cause, the cost of that evaluation is deducted from any eventual award.⁶

Scheduling the Evaluation

In represented cases, the employee schedules the appointment. If the employee doesn’t notify the employer of the appointment within 10 days of the QME selection, the employer can step in and arrange it.⁴ The same 10-day rule applies for unrepresented workers, with the employer taking over if the worker doesn’t act.⁶

If the party with scheduling rights can’t get an appointment within 90 days, that party may waive the right to a replacement QME and accept an appointment up to 120 days out. If 120 days also fails, either party can report the unavailability and the Medical Director will issue a replacement.⁸ Delays at this stage are common in specialties with few QMEs.

The Agreed Medical Evaluator Alternative

Represented parties have an option that unrepresented workers do not: agreeing on a single physician to resolve the dispute without a panel. Under section 4062.2(f), the parties may agree to an AME at any time, except for issues subject to Independent Medical Review under section 4610.5. If a panel has already been requested, the parties can’t switch to an AME unless both sides cancel the panel agreement in writing.⁴

An AME gives both sides more control over who evaluates the case, which is why experienced attorneys often prefer it. The tradeoff is that both sides need to agree. If discussions stall, the panel process is still available once the 10-day waiting period passes.

Who Pays for the Evaluation

The employer’s insurer pays. Medical-legal expenses must be paid within 60 days after the employer receives the required reports and documentation, unless the claims administrator contests liability for payment within that period.⁹

Fees follow a schedule that multiplies a relative value for each type of evaluation by $16.25. The base fees:

Comprehensive evaluation (ML201): $2,015, covering review of up to 200 pages of records, with additional pages reimbursed at $3.00 per page.
Follow-up evaluation (ML202): $1,316.25.
Supplemental evaluation (ML203): $650.

Regulatory modifiers can increase these amounts, so a comprehensive evaluation on a complex claim with thousands of pages of records often runs well above the $2,015 base.¹⁰

When the Panel Itself Is Disputed

Not every panel request goes smoothly. Disputes over whether the panel request itself was valid go to a Workers’ Compensation Administrative Law Judge. Disputes about whether the designated specialty is appropriate go to the Medical Director, with either party able to appeal that decision to a judge.¹¹

If the Medical Director cannot issue a panel within 30 days of receiving the request, either party may seek an order from a judge directing that a panel be issued. That order specifies the panel’s specialty or designates which party gets to choose it.¹¹ Represented cases usually get an automatic panel online, so this 30-day backstop matters more for unrepresented cases submitted by mail.

1
California Legislative Information. California Code LAB 4062
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California Legislative Information. California Code LAB 4061
3
Department of Industrial Relations. California Code of Regulations Title 8 Section 30 – QME Panel Requests
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California Legislative Information. California Code LAB 4062.2
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Division of Workers’ Compensation. Online QME Form 106 Panel Request
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Justia Law. California Code LAB 4062.1
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Division of Workers’ Compensation. Request for Qualified Medical Evaluator Panel – Unrepresented Employee
8
Department of Industrial Relations. California Code of Regulations Title 8 Section 31.3 – Scheduling Appointment with Panel QME
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Department of Industrial Relations. California Code of Regulations Title 8 Section 9794 – Reimbursement of Medical-Legal Expenses
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Department of Industrial Relations. California Code of Regulations Title 8 Section 9795 – Reasonable Level of Fees for Medical-Legal Expenses
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Department of Industrial Relations. California Code of Regulations Title 8 Section 31.1 – QME Panel Selection Disputes in Represented Cases