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California Labor Code Section 4628

Legal Research Home > California Laws > Labor Code > California Labor Code Section 4628

4628.  (a) Except as provided in subdivision (c), no person, other
than the physician who signs the medical-legal report, except a nurse
performing those functions routinely performed by a nurse, such as
taking blood pressure, shall examine the injured employee or
participate in the nonclerical preparation of the report, including
all of the following:
   (1) Taking a complete history.
   (2) Reviewing and summarizing prior medical records.
   (3) Composing and drafting the conclusions of the report.
   (b) The report shall disclose the date when and location where the
evaluation was performed; that the physician or physicians signing
the report actually performed the evaluation; whether the evaluation
performed and the time spent performing the evaluation was in
compliance with the guidelines established by the administrative
director pursuant to paragraph (5) of subdivision (j) of Section
139.2 or Section 5307.6 and shall disclose the name and
qualifications of each person who performed any services in
connection with the report, including diagnostic studies, other than
its clerical preparation. If the report discloses that the evaluation
performed or the time spent performing the evaluation was not in
compliance with the guidelines established by the administrative
director, the report shall explain, in detail, any variance and the
reason or reasons therefor.
   (c) If the initial outline of a patient's history or excerpting of
prior medical records is not done by the physician, the physician
shall review the excerpts and the entire outline and shall make
additional inquiries and examinations as are necessary and
appropriate to identify and determine the relevant medical issues.
   (d) No amount may be charged in excess of the direct charges for
the physician's professional services and the reasonable costs of
laboratory examinations, diagnostic studies, and other medical tests,
and reasonable costs of clerical expense necessary to producing the
report. Direct charges for the physician's professional services
shall include reasonable overhead expense.
   (e) Failure to comply with the requirements of this section shall
make the report inadmissible as evidence and shall eliminate any
liability for payment of any medical-legal expense incurred in
connection with the report.
   (f) Knowing failure to comply with the requirements of this
section shall subject the physician to a civil penalty of up to one
thousand dollars ($1,000) for each violation to be assessed by a
workers' compensation judge or the appeals board. All civil penalties
collected under this section shall be deposited in the Workers'
Compensation Administration Revolving Fund.
   (g) A physician who is assessed a civil penalty under this section
may be terminated, suspended, or placed on probation as a qualified
medical evaluator pursuant to subdivisions (k) and (l) of Section
139.2.
   (h) Knowing failure to comply with the requirements of this
section shall subject the physician to contempt pursuant to the
judicial powers vested in the appeals board.
   (i) Any person billing for medical-legal evaluations, diagnostic
procedures, or diagnostic services performed by persons other than
those employed by the reporting physician or physicians, or a medical
corporation owned by the reporting physician or physicians shall
specify the amount paid or to be paid to those persons for the
evaluations, procedures, or services. This subdivision shall not
apply to any procedure or service defined or valued pursuant to
Section 5307.1.
   (j) The report shall contain a declaration by the physician
signing the report, under penalty of perjury, stating:
   "I declare under penalty of perjury that the information contained
in this report and its attachments, if any, is true and correct to
the best of my knowledge and belief, except as to information that I
have indicated I received from others. As to that information, I
declare under penalty of perjury that the information accurately
describes the information provided to me and, except as noted herein,
that I believe it to be true."
   The foregoing declaration shall be dated and signed by the
reporting physician and shall indicate the county wherein it was
signed.
   (k) The physician shall provide a curriculum vitae upon request by
a party and include a statement concerning the percent of the
physician's total practice time that is annually devoted to medical
treatment.



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Last modified: March 17, 2014