AME Or QME Declaration OF Service Of Medical-Legal Report {QME 122}

QME Form 122, AME or QME Declaration of Service of Medical - Legal Report (Lab. Code § 4062.3(i)). In the context of California workers' compensation law, an AME or QME Declaration of Service of Medical-Legal Report refers to a document that must be filed by an Agreed Medical Evaluator (AME) or Qualified Medical Evaluator (QME) after completing a medical-legal evaluation. Under California Labor Code section 4062.3, when a dispute arises regarding the extent or nature of an employee's work-related injury, an employer can request a medical evaluation by an AME or QME. The evaluator then prepares a written report of the medical-legal evaluation and serves it on the parties involved in the dispute. The AME or QME Declaration of Service of Medical-Legal Report is a document that the evaluator files with the Workers' Compensation Appeals Board (WCAB) to confirm that they have served the medical-legal report on all parties involved in the dispute. The document includes information such as the date and manner in which the report was served, the parties on whom it was served, and their addresses. This declaration is important because it serves as proof that the medical-legal report was properly served, which is necessary for the report to be considered admissible as evidence in a workers' compensation hearing. www.FormsWorkflow.com