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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ15539216, ADJ15538700
Regular
Oct 03, 2025

THOMAS GALLEGOS vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, CALIFORNIA HEALTH CARE FACILITY STATE OF CALIFORNIA

Applicant sought reconsideration of an order requiring an additional Qualified Medical Evaluator (QME) panel for alleged back and neck injuries, arguing it would cause undue delay as another QME had already addressed these parts. The Workers' Compensation Appeals Board dismissed the petition for reconsideration, treating it as a petition for removal, which was subsequently granted. The Board rescinded the underlying decision and returned the case to the trial level, instructing for further proceedings to properly develop the medical record. It also emphasized the importance of correct QME panel procedures and noted the defendant's waiver regarding a second QME.

Workers Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalQualified Medical EvaluatorAdditional PanelSpecialty PanelSpineNeckUpper ExtremityWrist
References
Case No. ADJ13111007
Regular
Oct 13, 2025

CHARLES MISERENDINO vs. CLUB DEMONSTRATION SERVICES, INC.; QBE SPECIALTY INSURANCE

Applicant filed a petition for removal from an order taking the matter off calendar, issued on September 10, 2024, by the WCJ. Applicant contended that the issue of additional panels was ripe for adjudication. The Appeals Board granted removal, finding that the WCJ's order violated due process by being issued without creating a record or explaining the need for further development, thus constituting irreparable harm. Consequently, the Board rescinded the September 10, 2024 order and returned the matter to the trial level to create a record, refraining from making a judgment on the warrant for additional panels without a formal record.

Petition for RemovalOrder Taking Matter Off CalendarAdjudicationDue Process ViolationIrreparable HarmSubstantial PrejudiceWCJ ReportRescind OrderReturn to Trial LevelCreate Record
References
Case No. ADJ16334598
Regular
Oct 13, 2025

ANTHONY REYES vs. XPO LOGISTICS SUPPLY CHAIN, INC.; EVEREST NATIONAL INSURANCE

Applicant Anthony Reyes filed a petition for removal challenging an order by the workers' compensation administrative law judge (WCJ) that took the matter off calendar. The WCAB granted removal, determining that the WCJ's order violated the parties' right to due process by failing to create a record or explain the deferral of the additional panels issue, thus constituting irreparable harm. As a Decision After Removal, the Appeals Board rescinded the April 24, 2025, order taking the matter off calendar and returned the case to the trial level to establish a proper record. The Board explicitly stated it made no judgment on the merits of additional panels at this stage due to the lack of a formal record.

Petition for RemovalOrder Taking Matter Off CalendarAdditional PanelsDue Process ViolationIrreparable HarmSubstantial PrejudiceRecord CreationTrial LevelWorkers' Compensation Appeals BoardRescind Order
References
Case No. ADJ11861160
Regular
Oct 25, 2019

ADRIANA MARTINEZ vs. AVITUS, AMERICAN ZURICH INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

This case involves a dispute over the selection of Qualified Medical Evaluator (QME) panels for an applicant with claimed injuries to multiple body parts. The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for removal, rescinded the prior decision, and found that the applicant's chiropractic QME panel request was proper while the defendant's orthopedic surgery panel request was improper. The WCAB determined that chiropractic medicine is the appropriate specialty and struck the orthopedic surgery panel, ordering the parties to proceed with the chiropractic QME. The WCAB clarified that while chiropractors cannot perform surgery or prescribe medication, they are qualified to evaluate injuries within their scope of practice.

QME panel disputeremoval petitionchiropractic specialtyorthopedic surgery specialtyLabor Code 4062.2Medical Directoradministrative law judgeWorkers' Compensation Appeals Boardproper panel selectioninvalid panel request
References
Case No. ADJ7199986 ADJ7399845
Regular
Oct 03, 2011

ELMIRA SMITH vs. PACIFIC AUTISM CENTER FOR EDUCATION, TRI- STAR RISK MANAGEMENT

The applicant sought removal to challenge a finding that defendant's requested Qualified Medical Evaluator (QME) panel was properly assigned. The Appeals Board granted removal, rescinded the finding, and determined that *neither* panel was properly assigned. Both panel requests were found to be premature as they were made before the statutory 10-day period for agreeing on an Agreed Medical Evaluator had expired, plus an additional five days for mail service. This decision clarifies the timing requirements for QME panel requests following an unsuccessful attempt to select an AME.

Petition for RemovalQualified Medical Evaluator (QME)Agreed Medical Evaluator (AME)Labor Code section 4062.2(b)WCAB Rule 10507Messele v. Pitco FoodsInc.Premature RequestPanel AssignmentMedical Unit
References
Case No. ADJ7532290
Regular
Aug 28, 2012

MAXINE BROWN VIRGIL vs. LUNCH STOP, INC., EMPLOYERS COMPENSATION INSURANCE

This case involves a dispute over obtaining a Qualified Medical Evaluator (QME) panel. The applicant requested a new panel because a QME on the initial panel could not provide an appointment within 60 days. However, the applicant failed to properly strike a physician from the original panel after the defendant did. As a result, the defendant was authorized to schedule an appointment with a remaining physician, and the applicant was not entitled to a new QME panel. The Appeals Board granted removal to amend the prior order to reflect a rescheduled appointment with the original QME.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical EvaluatorpanelstrikeLabor Code section 4062Administrative Director Rule 31.5section 4062.2(c)medical evaluatorappointment
References
Case No. ADJ9501859
Regular
May 13, 2015

, Jose Chavez, vs. , Miracle Farms, d/b/a Golden Valley Farms; Star Insurance Company, Administered By Meadowbrook Insurance Group,

The applicant suffered a low back injury and claims additional injuries, with a Physical Medicine and Rehabilitation physician as his primary treating doctor. The WCJ incorrectly ordered a Spine-MNB QME panel, overriding the parties' requests and the primary physician's specialty. The Appeals Board dismissed the applicant's reconsideration petition as untimely for a non-final order. They granted removal, rescinded the WCJ's order, and substituted their own, directing the Medical Unit to issue a QME panel in Physical Medicine and Rehabilitation.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings and OrderQualified Medical EvaluatorQME PanelPhysical Medicine and RehabilitationSpine-MNBOrthopedic PanelPrimary Treating Physician
References
Case No. ADJ19417386
Regular
Mar 17, 2025

LOURDES AVILA vs. PRIORITY WORKFORCE, MVP PAYROLL FINANCING, LLC, SUNZ INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal regarding a WCJ's order to replace a Qualified Medical Evaluator (QME) panel. The defendant argued that their due process rights were violated and that they were entitled to an additional strike due to an initial double strike of a QME. The Board found that removal is an extraordinary remedy, and the petitioner failed to demonstrate substantial prejudice or irreparable harm. They upheld the WCJ's decision, emphasizing that the subsequent strikes by both parties were untimely and the order to obtain a replacement panel did not determine substantive rights.

Removal PetitionPanel StrikesQualified Medical EvaluatorIrreparable AmbiguityDue ProcessMailbox RuleTimelinessLabor Code Section 4062.2(c)Agreed Medical EvaluatorAlvarado v. WCAB
References
Case No. ADJ8074524
Regular
Jan 17, 2013

Geoconda Acevedo vs. Reliable Caregivers, PEGASUS RISK MANAGEMENT

The Appeals Board dismissed the defendant's petition for reconsideration because the selection of a Qualified Medical Evaluator (QME) is not a final order. However, the Board granted removal to address issues with defective QME panels. The Board rescinded the prior award and ordered the WCJ to appoint a regular physician if the parties cannot agree on an Agreed Medical Examiner. This action aims to resolve the ongoing delays and procedural defects in selecting a QME for the applicant's evaluation.

QME panelremovalagreed medical examinerpanel qualified medical evaluatorWCJ authoritylabor code section 5701substantive right or liabilityprimary treating physicianindustrial injuryreconsideration
References
Case No. ADJ9328371
Regular
Oct 31, 2016

LEYLA FATHI vs. MISSION HOSPITAL REGIONAL MEDICAL CENTER, HARTFORD ACCIDENT & INDEMNITY COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for reconsideration because the WCJ's order for additional Qualified Medical Evaluator (QME) panels was an interlocutory procedural order, not a final determination of substantive rights or liabilities. The defendant's petition for removal was also denied, as they failed to demonstrate substantial prejudice or irreparable harm. While good cause for additional evaluations may have existed, the record was insufficient to make a definitive ruling on the merits of the removal. Therefore, the WCAB affirmed the WCJ's order for further medical development of the record.

Petition for ReconsiderationPetition for RemovalAdditional Panel QMEQualified Medical EvaluatorInternal MedicinePsychiatryNeurologyMedical Record DevelopmentFinal OrderInterlocutory Order
References
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