QME-AME Time Frame Extension Request {QME 112} | Pdf Fpdf Doc Docx | California

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QME-AME Time Frame Extension Request {QME 112} | Pdf Fpdf Doc Docx | California

Last updated: 5/30/2015

QME-AME Time Frame Extension Request {QME 112}

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Description

QME Form 112 - QME/AME REPORT TIME FRAME EXTENSION REQUEST. File this form with the Division of Workers’ Compensation-Medical Unit 5 days before your report is due to be served on the parties and send a copy of this form to the employee and claims administrator. The QME may not be entitled to payment for evaluations which are not submitted in a timely manner. (Labor Code § 4062.5.) Review 8 Cal. Code Regs. § 38(i) regarding extension of time for supplemental report. www.FormsWorkflow.com

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