ChironAI™ OM · med-legal reference
Laws and regulations Chiron works with.
The sections of California law behind the tasks Chiron performs, with what each one covers and where Chiron applies it. Each citation links to the official text.
This is information about how Chiron applies these rules, not legal advice.
42 citations
What each covers, and where Chiron uses it.
Chiron computes deadlines and checks requirements from these rules. It does not give legal advice, and the physician and your team decide what to do with each result.
| Citation | What it covers | Where Chiron uses it |
|---|---|---|
| Labor Code §3212 and following, including §3212.15 (official text, opens in a new tab) | Presumptions that certain injuries to public safety members are industrial, including post-traumatic stress disorder for certain firefighters and peace officers. | On an apportionment, Chiron raises whether a presumption may apply to the occupation on file, without deciding the question. |
| Labor Code §3600 (official text, opens in a new tab) | When an employer is liable for an injury: one arising out of and in the course of employment (AOE/COE). | The industrial-injury eligibility determination, with predesignation, MPN lookup and pathway guidance. |
| Labor Code §4060 (official text, opens in a new tab) | Disputes over whether an injury is compensable, resolved by a medical evaluation obtained through the QME panel process. | When a carrier denies compensability, Chiron marks the case med-legal and opens the QME panel request. |
| Labor Code §4061 (official text, opens in a new tab) | Permanent disability disputes; a 30-day window to request factual correction of an unrepresented QME report (subdivision (d)); the DEU's 20 days to rate and the 30-day reconsideration window (subdivision (g)). | Form 37 factual-correction requests, rejecting late ones; the DEU rating and reconsideration clocks on unrepresented evaluations. |
| Labor Code §4062 (official text, opens in a new tab) | Objections to a treating physician's medical determination, resolved by a QME or AME evaluation. | Blocks a QME or AME evaluation on a patient whose only cases are personal injury. |
| Labor Code §4062.3 (official text, opens in a new tab) | What information may go to a QME or AME: service on the other side 20 days before it reaches the evaluator and a 10-day objection window for nonmedical records (subdivision (b)); the bar on ex parte communication and the aggrieved party's election (subdivision (g)). | Marking records admissible or inadmissible, the evaluator-scope chronology, study suggestions from admissible records only, and the ex parte communication log. |
| Labor Code §4600 (official text, opens in a new tab) | The employer's duty to provide treatment; a worker's right to predesignate a personal physician (subdivision (d)). | Filing a predesignation and keeping only one valid predesignation at a time. |
| Labor Code §4603.2 (official text, opens in a new tab) | Payment of treatment bills: 45 days, or 60 for a governmental payer, with a 15% penalty and interest when late (subdivision (b)); a 90-day window to request second review (subdivision (e)). | Payment deadlines, the late-payment penalty and interest on treatment bills, the governmental-payer flag in the payer registry, and the SBR-1 request. |
| Labor Code §4603.6 (official text, opens in a new tab) | Independent bill review, which must be requested within 30 days of service of the second-review decision (subdivision (a)). | The IBR filing window and the IBR-1 request. |
| Labor Code §4604.5 (official text, opens in a new tab)The rule behind a task, not cited by section elsewhere | No more than 24 chiropractic, 24 occupational therapy and 24 physical therapy visits per industrial injury unless the employer authorizes more in writing. | Counting therapy visits against the cap and the authorized number, with a warning before the limit. |
| Labor Code §4610 (official text, opens in a new tab) | Utilization review: what a request must contain, the review timeframes, 72 hours for an expedited review (subdivision (i)(3)), and a denial staying effective for 12 months (subdivision (k)). | The RFA composer's list of what is missing, the UR clocks on each RFA, and stopping a re-request of a treatment whose denial still binds. |
| Labor Code §4610.5 (official text, opens in a new tab) | Independent Medical Review: 10 days to request it for a formulary dispute and 30 days for other treatment, after service of the UR decision (subdivision (h)(1)). | The IMR appeals board, the filing-window alerts, the plain-words explanation of each deadline, and the IMR support packet. |
| Labor Code §4610.6 (official text, opens in a new tab) | The IMR organization's determination is binding on all parties (subdivision (g)). | Stopping a re-request of a treatment after IMR upheld the denial. |
| Labor Code §4622 (official text, opens in a new tab) | Payment of medical-legal bills: 60 days, a 10% penalty and 7% annual interest when late, and a 90-day window to request second review. | The late-payment penalty and interest on med-legal bills, and the list of second-review windows still open. |
| Labor Code §4628 (official text, opens in a new tab) | Who may examine the worker and prepare a medical-legal report (subdivision (a)), the disclosures the report must make, and the penalty-of-perjury declaration (subdivision (j)). | Working drafts of report sections for the physician to review and decide, the required-element checklist, the authorship and service disclosure, and the declaration you sign. |
| Labor Code §4658 (official text, opens in a new tab) | How permanent disability is paid, including the adjustment tied to an offer of work for injuries from 2005 (subdivision (d)). | The return-to-work adjustment among the impairment elections. |
| Labor Code §4662 (official text, opens in a new tab) | Disabilities conclusively presumed total, such as loss of both eyes or both hands (subdivision (a)). | The conclusive-presumption election on an impairment rating. |
| Labor Code §4663 (official text, opens in a new tab) | Apportionment of permanent disability is based on causation, and a report on permanent disability must address it. | Asking for your reasoning when you record a finding that only the industrial injury contributes. |
| Labor Code §4664 (official text, opens in a new tab) | Apportionment to a prior permanent disability award, presumed to exist at the time of a later injury. | Finding prior awards in the records and the prior-claim registry, each confirmed by you before any credit is taken. |
| Labor Code §5410 (official text, opens in a new tab) | A worker may claim new and further disability within five years of the date of injury. | Tracking the five-year window on a closed case and the reopen petition. |
| Labor Code §5412 (official text, opens in a new tab) | The date of injury for an occupational disease or cumulative injury. | Cumulative-trauma timing checks, without concluding anything. |
| Labor Code §6409 (official text, opens in a new tab) | The physician's report of an occupational injury or illness within five days of the initial examination, and a 24-hour report to the local health officer for pesticide poisoning (subdivision (a)). | Opening the Doctor's First Report and pesticide-illness obligations at sign-off; the pesticide clock counts in hours. |
| 8 CCR §33 (official text, opens in a new tab)The rule behind a task, not cited by section elsewhere | A QME's notice of unavailability on Form 109, at least 30 days ahead and up to 120 days in a calendar year. | Preparing Form 109 and refusing a notice that is too late or too long. |
| 8 CCR §34 (official text, opens in a new tab) | QME appointment notification on Form 110, and cancellation. | Reappointment-risk counters. |
| 8 CCR §35 (official text, opens in a new tab) | Exchange of information and ex parte communications with the evaluator: service and objection to records (subdivision (c)), reports that may never be forwarded (subdivision (e)), and records that arrive 10 or more days after the examination (subdivision (i)). | Recording who sent each record and when, objections and prohibited reports, and opening a supplemental report when late records arrive. |
| 8 CCR §35.5 (official text, opens in a new tab) | AME and QME compliance with the evaluation and reporting guidelines, including availability for deposition within 120 days of the notice (subdivision (f)). | Computing the deposition availability date from the notice. |
| 8 CCR §36 (official text, opens in a new tab) | Service of med-legal reports, on Form 122 and, for an unrepresented worker, with Form 111. | The service list for each report and the Form 122 declaration of service. |
| 8 CCR §37 (official text, opens in a new tab) | Request for factual correction of a panel QME's report. | Counting the Form 37 window from receipt of the report, and refusing a request only when it is certainly late. |
| 8 CCR §38 (official text, opens in a new tab) | QME and AME report timeframes: 30 days (subdivision (a)); extensions of up to 30 days or 15 days on Form 112 (subdivision (c)); notice at least 5 days before the deadline (subdivision (d)); supplemental reports within 60 days of the request (subdivision (i)). | The deadline chip, extension chain and late-report banner; §38 extension requests; supplemental reports. |
| 8 CCR §41 (official text, opens in a new tab) | QME ethical requirements. | Reappointment-risk counters. |
| 8 CCR §49 (official text, opens in a new tab) | Definitions for the QME minimum-time guidelines, including face-to-face time. | Itemizing face-to-face and other time, and asking for an explanation before finalize when face-to-face time is under the minimum for your specialty. |
| 8 CCR §51 (official text, opens in a new tab) | Grounds for denying QME reappointment, including missing the §34 or §38 timeframes on three or more occasions in a calendar year. | Surfacing late reports as candidate violations for your compliance counters. |
| 8 CCR §55 (official text, opens in a new tab) | QME continuing education for reappointment applications received before April 1, 2026. | Continuing-education hours. |
| 8 CCR §55.1 (official text, opens in a new tab) | QME continuing education for later applications: 16 hours in 24 months, including at least 2 hours of anti-bias training. | Continuing-education hours and the anti-bias minimum. |
| 8 CCR §9785 (official text, opens in a new tab) | The primary treating physician's reporting duties: the first report within 5 working days (subdivision (e)(1)); the PR-2 within 20 days of a triggering event (subdivision (f)) and at least every 45 days (subdivision (f)(8)); the permanent and stationary report within 20 days of the examination (subdivision (i)). | Opening and tracking each reporting obligation, with warnings before it is due. |
| 8 CCR §9792.6.1 (official text, opens in a new tab) | Utilization review definitions, including what makes an RFA "completed" (subdivision (u)(2)). | Checking PM&R DME orders before Chiron drafts the RFA. |
| 8 CCR §9792.20 (official text, opens in a new tab) | MTUS definitions, including functional improvement (subdivision (e)). | Checking PM&R DME orders before Chiron drafts the RFA. |
| 8 CCR §9795 (official text, opens in a new tab)The rule behind a task, not cited by section elsewhere | The Medical-Legal Fee Schedule: ML200 to ML205, modifiers, and the one-hour minimum for a deposition cancelled fewer than eight calendar days ahead. | The ML code shown while you draft, the drafted ML charge with excess-page pricing, ML203, ML204 and ML205 charges, and the late-cancellation minimum. |
| 8 CCR §9795.3 (official text, opens in a new tab)The rule behind a task, not cited by section elsewhere | Interpreter fees, including the minimum fee when a booking is cancelled less than 24 hours ahead. | The interpreter late-cancellation charge. |
| 8 CCR §10605 (official text, opens in a new tab) | Extra time when a document is served by mail: 5 days in California, 10 elsewhere in the United States, 20 outside it (subdivision (a)). | Adding the extension to the IMR filing deadline according to how the UR decision was served. |
| Health and Safety Code §11165.4 (official text, opens in a new tab)The rule behind a task, not cited by section elsewhere | A prescriber's duty to review the patient's CURES history before first prescribing a Schedule II, III or IV controlled substance, and periodically after. | Recording your CURES review when you sign a Schedule II–IV prescription, and the opioid-safety reminder. OM does not connect to CURES. |
| Penal Code §632 (official text, opens in a new tab)The rule behind a task, not cited by section elsewhere | Recording a confidential conversation requires the consent of all parties. | Whole-visit recording starts only with the patient's verbal consent recorded in the visit. |
California AB 489 and AB 3030 are cited by bill, not by code section. Labor Code, Health and Safety Code and Penal Code links open the California Legislature’s official site; Title 8 links open the Department of Industrial Relations’ publication of the regulation.
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