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.
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.
Form Details:
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.