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 102?
A: The QME Form 102 is a registration form for the QME Competency Examination in California.
Q: What is the purpose of the QME Competency Examination?
A: The QME Competency Examination is designed to assess the knowledge and qualifications of individuals seeking to become Qualified Medical Evaluators (QMEs) in California.
Q: Who needs to fill out the QME Form 102?
A: Individuals who want to become QMEs in California must fill out the QME Form 102.
Q: Are there any eligibility requirements for taking the QME Competency Examination?
A: Yes, there are eligibility requirements that must be met in order to take the QME Competency Examination. These requirements include having a valid and active license as a physician or psychologist in California, being in good standing with the relevant licensing board, and completing the required training courses.
Q: How much is the fee for the QME Form 102?
A: The fee for the QME Form 102 is $75.
Q: What documents are required to be submitted along with the QME Form 102?
A: The QME Form 102 must be submitted with a copy of the applicant's valid and active license as a physician or psychologist, proof of completion of the required training courses, and the examination fee.
Q: Can the QME Competency Examination be taken multiple times if the applicant fails?
A: Yes, the QME Competency Examination can be taken multiple times if the applicant fails. However, there are limitations on the number of attempts and a waiting period between attempts.
Q: What happens after successfully passing the QME Competency Examination?
A: After successfully passing the QME Competency Examination, the individual becomes eligible to apply for a QME panel certification in California and can perform medical evaluations for workers' compensation cases.
Q: How long is the QME Competency Examination valid for?
A: The QME Competency Examination is valid for a period of five years from the date of passing.
Form Details:
Download a fillable version of QME Form 102 by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.