When they must send it
• Within ten business days of receipt of the unrepresented employee’s objection to the medical determination of the treating physician.
The deadline this notice puts on you
If you wish to obtain a comprehensive medical evaluation, enclosed is a form that you must submit to the state Division of Workers’ Compensation (DWC) within 10 days to request a panel of three Qualified Medical Evaluators (QMEs). In addition, within 10 days after the DWC sends you a panel, you must choose a QME from the panel, make an appointment to be examined by the QME, and inform me of your choice and appointment time.
Quoted from the model notice below. Your letter should say the same — if it does not, that is worth asking about.
Rule text
8 CCR § 9812 · 10 unspecified
Trigger: after the DWC sends you a panel
In addition, within 10 days after the DWC sends you a panel, you must choose a QME from the panel, make an appointment to be examined by the QME, and inform me of your choice and appointment time
8 CCR § 9812 · 10 unspecified
Trigger: to request a panel of three Qualified Medical Evaluators (QMEs)
The notice shall contain the following statement (with the phrase “ 10 days ” in bold font as shown): “If you wish to obtain a comprehensive medical evaluation, enclosed is a form that you must submit to the state Division of Workers' Compensation (DWC) within 10 days to request a panel of three Qualified Medical Evaluators (QMEs)
Quoted from the statute, marked computed. The deadline table is a draft extraction — read the official code if the two disagree.
The rule behind it
8 CCR §9812(i)
The official model notice
BENEFIT NOTICE INSTRUCTION MANUAL Claims Administrator Name Address City_State_Zip Telephone Number [include if available] Website address Date [Option] SENT VIA E-MAIL TO employee’s e- mail address Employee Employer: Address Date of Injury: City_State_Zip Claim Number: NOTICE REGARDING QME PANEL REQUEST FORM CLAIMS ADMINISTRATOR NAME is handling your workers' compensation claim on behalf of EMPLOYER NAME. This notice is to advise you of the status of disability benefits for your workers' compensation injury on the date shown above. We have received your objection to the medical determination of PHYSICIAN’S NAME regarding (choose one or more of the following:) temporary disability / permanent disability / the need for future medical care / INSERT NATURE OF OTHER OBJECTION(S). If you wish to obtain a comprehensive medical evaluation, enclosed is a form that you must submit to the state Division of Workers’ Compensation (DWC) within 10 days to request a panel of three Qualified Medical Evaluators (QMEs). If you do not submit the form within 10 …
Published by the Division of Workers’ Compensation in the Benefit Notice Instruction Manual. Excerpt — read the full manual at the source. p.87.
Source · dir.ca.gov →When this went wrong
Decisions of the Workers’ Compensation Appeals Board on this subject. Each quotes the passage it turned on and links to the official PDF.
- ADJ21245209 · 2026-08-14 · Fresno District OfficeQME/AME processapplicant prevailed
Determinative passage · p.4The WCJ found that the QME process was not correctly initiated apparently because the QME process is triggered by an objection to a “primary treating physician” and that neither Nurse Uichanco, nor Dr. Roach was a “primary treating physician.” However, Labor Code section 3209.10(a) plainly states:
The WCAB found that Nurse Uichanco was acting under Dr. Roach's supervision, making Dr. Roach the primary treating physician under Labor Code section 3209.10, and that the QME process was properly initiated. The WCAB granted reconsideration and reversed the WCJ's removal of Dr. Bolling as QME, allowing Dr. Bolling to remain as QME.
Official decision · page 4 → - ADJ21809965 · 2026-08-03 · Oakland District OfficeQME/AME processdefendant prevailed
Determinative passage · p.1Applicant seeks removal or in the alternative reconsideration of the Findings and Award (F&A) issued on April 13, 2026. The workers’ compensation administrative law judge (WCJ) found, in relevant part, that the Qualified Medical Evaluator (QME) panel request and panel list number 7893809 dated December 17, 2025 requested by defendant was not defective and was the valid QME panel; that applicant is required to be evaluated by a doctor selected from that list pursuant to Labor Code section 4062.2 1; that the QME panel request and list requested by applicant’s counsel dated December 23, 2025, panel number 7895678, is defective and is not valid; and that applicant is not entitled to be evaluated by doctors selected from that list. Applicant contends that defendant’s panel request was defective as it was requested prematurely pursuant to section 4062.2 because Code of Civil Procedure section 1013 adds 10 days to the time to act where an out of state party is involved. Applicant contends that the WCJ erred by calculating the time based only on service, and only adding 5 days for service based on service on in state parties only, and not taking into account that the sending party was out of state. Defendant did not file a response. The WCJ issued a Report and Recommendation (Report) recommending denial of the petition.
The WCJ and Appeals Board found defendant's QME panel request valid because the denial letter was served on in-state parties, triggering only a 5-day extension under WCAB Rule 10605, not the 10-day extension applicant argued under Code of Civil Procedure section 1013. Applicant's panel request was defective and invalid.
Official decision · page 1 → - ADJ16313390 · 2026-07-30 · Santa Ana District OfficeQME/AME processdefendant prevailed
Determinative passage · p.3It appears that the actual issue in these matters is whether defendant may replace Dr. Krishnareddy due to his alleged unavailability. Rather than try that issue on the merits, the WCJ bifurcated the sub-issue of whether applicant may take the QME’s deposition on the issue of his availability.
The WCJ bifurcated the issue of QME availability and denied applicant's request to depose the QME. The Appeals Board found no substantial prejudice or irreparable harm to applicant to warrant replacement of the QME and dismissed the petition for reconsideration as the order was non-final and removal was not warranted.
Official decision · page 3 → - ADJ19688721 · 2026-07-15 · Fresno District OfficeQME/AME processapplicant prevailed
Determinative passage · p.6Turning now to the merits of the Petition, applicant contends that the WCJ did not adequately weigh the prejudice caused to applicant by restarting the QME process and that substantial justice requires that Dr. Saadat remain as the PQME in this matter. Applicant further contends that the WCJ did not properly analyze the elements set forth in Vazquez. In Vazquez, we held that for represented cases, “the determination of whether a QME should be replaced due to unavailability to set an evaluation is within the discretionary power of the Appeals Board, and a PQME may be replaced where a party demonstrates good cause for the replacement.” (Id. at p. 523.) Under Vazquez, good cause is determined based upon a balancing of multiple factors, which include: a. The length of delay caused by the QME's unavailability.
The Appeals Board found that the defendant did not establish good cause for replacement of Dr. Saadat as PQME, considering the length of delay, prejudice to applicant, efforts to remedy availability, and constitutional mandate for substantial justice.
Official decision · page 6 →