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This version of the form is not currently in use and is provided for reference only. Download this version of
QME Form 31.5
for the current year.
QME Form 31.5 Replacement Panel Request - California
What Is QME Form 31.5?
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 31.5?
A: Form 31.5 is a Replacement Panel Request form in California.
Q: What is the purpose of Form 31.5?
A: The purpose of Form 31.5 is to request a replacement panel of qualified medical evaluators (QMEs) in California.
Q: Who can use Form 31.5?
A: Form 31.5 can be used by injured workers, employers, insurance carriers, and attorneys in California.
Q: What information is required on Form 31.5?
A: The form requires information such as the injured worker's name, contact information, the date of injury, the case number, and specific reasons for requesting a replacement panel of QMEs.
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;
- Fill out the form in our online filing application.
Download a fillable version of QME Form 31.5 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 31.5 Replacement Panel Request - California
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