QME Form 120 Voluntary Directive for Alternate Service of Medical-Legal Evaluation Report on Disputed Injury to Psyche - California

QME Form 120 Voluntary Directive for Alternate Service of Medical-Legal Evaluation Report on Disputed Injury to Psyche - California

What Is QME Form 120?

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 the QME Form 120?
A: QME Form 120 is the Voluntary Directive for Alternate Service of Medical-Legal Evaluation Report on Disputed Injury to Psyche in California.

Q: What does the QME Form 120 for?
A: The QME Form 120 is used to request an alternate service for the medical-legal evaluation report on a disputed injury to the psyche.

Q: Who uses the QME Form 120?
A: The QME Form 120 is used by individuals involved in a disputed injury to the psyche in California.

Q: What is the purpose of an alternate service?
A: The purpose of alternate service is to request a different Qualified Medical Evaluator (QME) to conduct the evaluation for a disputed injury to the psyche.

Q: Is completion of the QME Form 120 mandatory?
A: No, completion of the QME Form 120 is voluntary.

Q: Are there any fees associated with submitting the QME Form 120?
A: No, there are no fees associated with submitting the QME Form 120.

Q: What should I do if I have more questions about the QME Form 120?
A: If you have more questions about the QME Form 120, you can contact the California Division of Workers' Compensation or seek legal advice.

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Form Details:

  • Released on February 1, 2009;
  • 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;
  • Fill out the form in our online filing application.

Download a fillable version of QME Form 120 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 120 Voluntary Directive for Alternate Service of Medical-Legal Evaluation Report on Disputed Injury to Psyche - California

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