QME Form 37 Request for Factual Correction of an Unrepresented Panel Qme Report - California

QME Form 37 Request for Factual Correction of an Unrepresented Panel Qme Report - California

What Is QME Form 37?

This is a legal form that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 37?
A: Form 37 is a request for factual correction of an unrepresented panel QME report in California.

Q: Who can use Form 37?
A: Form 37 can be used by individuals who are not represented by an attorney and want to correct factual errors in a QME report.

Q: What is a QME report?
A: A QME report is a report prepared by a Qualified Medical Evaluator (QME) in workers' compensation cases.

Q: What kind of errors can be corrected using Form 37?
A: Form 37 can be used to correct factual errors, such as incorrect dates or medical information, in a QME report.

Q: What is the process for submitting Form 37?
A: The completed Form 37 should be submitted to the DWC district office where the original QME report was filed.

Q: Is there a deadline for submitting Form 37?
A: Yes, Form 37 must be submitted within 30 days of receiving the QME report.

Q: What happens after submitting Form 37?
A: After submitting Form 37, the QME will review the request and either grant or deny the request for factual correction.

Q: What if my request for factual correction is denied?
A: If your request for factual correction is denied, you may seek legal representation and explore other options for addressing the issue with the QME report.

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Form Details:

  • Released on October 1, 2013;
  • The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of QME Form 37 by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.

Download QME Form 37 Request for Factual Correction of an Unrepresented Panel Qme Report - California

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