Cal. Code Regs. Tit. 8, § 10164 - Summary Rating Determinations, Reconsideration if Employee is Unrepresented

(a) Requests for reconsideration of the summary rating determination shall be filed with the administrative director in writing within 30 days of receipt of the summary rating determination. The request shall clearly specify the reasons the summary rating determination should be reconsidered and shall include a proof of service on the other party and any other information necessary to support the request. Reconsideration of a summary rating may be granted by the administrative director for one or more of the following reasons:

(1) the summary rating was incorrectly calculated;

(2) the comprehensive medical evaluation failed to address one or more issues;

(3) the comprehensive medical evaluation failed to completely address one or more issues;

(4) the comprehensive medical evaluation was not prepared in accordance with required procedures, including the procedures of the administrative director promulgated under paragraph (2) or (3) of subdivision (j) of Section 139.2.

Requests for reconsideration which are not based on one of the above reasons will be denied.

(b) The administrative director shall not accept or consider, as a basis for a request for reconsideration, a supplemental or follow-up evaluation which was requested by a party after a summary rating determination has already been issued to the parties.

(c) If the administrative director determines that an additional evaluation from another Qualified Medical Evaluator is necessary, the matter shall be referred to the Medical Director of the Medical Unit for the provision of another Qualified Medical Evaluator.

Notes

Cal. Code Regs. Tit. 8, § 10164

1. New section filed 4-25-91; operative 4-25-91 (Register 91, No. 26). New section is exempt from review by OAL pursuant to Government Code section 11351.
2. Amendment of section filed 1-28-94; operative 1-28-94. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 94, No. 4).
3. Amendment of section heading, repealer of subsection (a), subsection relettering, amendment of redesignated subsection (a), new subsections (a)(1)-(4) and (b) and amendment of subsection (c) filed 2-21-95; operative 2-21-95. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 95, No. 8).
4. Amendment filed 11-17-2008; operative 11-17-2008 pursuant to Government Code section 11343.4 (Register 2008, No. 47).

Note: Authority cited: Sections 133, 5307.3 and 5307.4, Labor Code. Reference: Sections 124 and 4061, Labor Code.

1. New section filed 4-25-91; operative 4-25-91 (Register 91, No. 26). New section is exempt from review by OAL pursuant to Government Code section 11351.
2. Amendment of section filed 1-28-94; operative 1-28-94. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 94, No. 4).
3. Amendment of section heading, repealer of subsection (a), subsection relettering, amendment of redesignated subsection (a), new subsections (a)(1)-(4) and (b) and amendment of subsection (c) filed 2-21-95; operative 2-21-95. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 95, No. 8).
4. Amendment filed 11-17-2008; operative 11-17-2008 pursuant to Government Code section 11343.4 (Register 2008, No. 47).