1. A. Qualifications. To be eligible for appointment by the Court to the list of qualified independent medical examiners and for retention on the list, the physician must:

   1. 1. be a licensed physician in good standing in Oklahoma or the state in which the physician practices as provided in 85 O.S., Sections 14(E) and 17(A)(1);
   2. 2. be highly experienced and competent in the physician's specific field of expertise and in the treatment of work-related injuries;
   3. 3. be knowledgeable of workers' compensation principles and the workers' compensation system in Oklahoma, as demonstrated by prior experience and/or education;
   4. 4. have in force and effect health care provider professional liability insurance from a domestic, foreign or alien insurer authorized to transact insurance in Oklahoma or in the state where the physician practices, if different from Oklahoma. The per claim and aggregate limits of the insurance must be at least One Million Dollars ($1,000,000.00). This insurance requirement shall not apply to physicians requesting their services under the independent medical examiner system to be restricted to providing opinions regarding the nature and extent of permanent impairment, if any, and/or opinions in claims against the last employer for combined disabilities or against the Multiple Injury Trust Fund;
   5. 5. have no felony conviction under federal or state law within seven (7) years before the date of the physician's application to serve as a qualified independent medical examiner;
   6. 6. have a valid Oklahoma State Bureau of Narcotics and Dangerous Drugs Control (BNDD) registration (or comparable registration from the state where the physician is licensed and practices if other than Oklahoma) and federal Drug Enforcement Agency (DEA) registration, as authorized by law for the physician's professional license; and
   7. 7. have a valid, unrestricted professional license as a physician which is not probationary.
2. B. Appointment. Appointment of physicians to the list of qualified independent medical examiners, and maintenance and periodic validation of such list shall be by a majority vote of the judges of the Court. Physician appointments shall be for a two-year period.

3. C. Application for Appointment. To request appointment to the list of qualified independent medical examiners, a physician shall:

   1. 1. Submit a signed and completed application Form 463 and a signed and completed physician disclosure Form 17 to the following address: Oklahoma Workers' Compensation Court, Medical Services Division, 1915 N. Stiles Avenue, Oklahoma City, Oklahoma 73105-4918. Illegible, incomplete or unsigned applications and disclosures will not be considered by the Division and shall be returned. A copy of the application Form 463 and physician disclosure Form 17 may be obtained from the Division at the address set forth in this paragraph;
   2. 2. Submit a current curriculum vitae, together with the application Form 463 and physician disclosure Form 17, to the Division; and

   3. 3. Verify that the physician, if appointed, will:

      1. a. provide independent, impartial and objective medical findings in all cases that come before the physician;
      2. b. decline a request to serve as an independent medical examiner only for good cause shown;
      3. c. conduct an examination, if necessary, within thirty (30) calendar days from the date of the order appointing the examiner, unless otherwise approved by the Court, when necessary to render findings on the questions and issues submitted;
      4. d. prepare a written report in accordance with Rule 20 which addresses the issues set out in the order of appointment;
      5. e. submit the report to the parties and the Court within fourteen (14) calendar days of a required examination of the claimant and/or completion of necessary tests, or within fourteen (14) calendar days after receipt of necessary records and information if no examination and/or tests are required;
      6. f. accept as payment in full for services rendered as an independent medical examiner the fees established pursuant to Rule 44;
      7. g. submit to a review pursuant to Rule 42 and 85 O.S., Section 17(D)(9);
      8. h. submit annually to the Workers' Compensation Court written verification of valid health care provider professional liability insurance as and if required in subsection A of this rule;
      9. i. notify the Workers' Compensation Court in writing upon any change affecting the physician's qualifications as provided in subsection A of this rule; and
      10. j. comply with all applicable statutes and Court Rules.
4. D. Disclosure. As part of the application, the physician shall identify, on the physician disclosure Form 17, any employer, insurer, employee group, certified workplace medical plan, or representatives of any of the above with whom the physician is under contract or serves as a company doctor, or who regularly uses the services of the physician.

Adopted by order of the Supreme Court, 1997 OK 130, eff. November 1, 1997; Amended by order of the Supreme Court, 2000 OK 13, eff. April 15, 2000; Amended by order of the Supreme Court, 2001 OK 46, eff. July 1, 2001; Amended by order of the Supreme Court, 2006 OK 6, eff. January 30, 2006 (superseded document available).