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

Case No. ADJ9180559
Regular
Sep 18, 2015

JACKIE SUEHIRO (Dec'd), ALVIN SUEHIRO (Husband) vs. RALPHS GROCERY COMPANY, permissibly self-insured, adjusted by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Appeals Board granted the defendant's petition for removal, rescinding a prior Minute Order. The WCJ had found ex-parte communication by the defendant and ordered a new QME panel without a trial or sworn testimony. The Board found this violated the defendant's due process rights, as no evidence was presented to support the ex-parte communication finding. The case is returned to the trial level for a hearing on all issues, including alleged ex-parte communication, with parties afforded the chance to present evidence and witnesses.

Petition for RemovalMinute OrderQualified Medical EvaluatorEx-parte CommunicationDue ProcessWCJReplacement QME PanelLabor Code Section 5313Admitted EvidenceProof of Service
References
Case No. ADJ11584415
Regular
Sep 30, 2019

GUY SYLVA vs. CITY AND COUNTY OF SAN FRANCISCO

This case involves an applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that denied temporary disability benefits and a motion to strike a Qualified Medical Evaluator's (QME) reports. The applicant alleged ex parte communication between the defendant and the QME, violating Labor Code section 4062.3. The WCAB granted reconsideration, finding that the issue of ex parte communication was not adequately addressed due to conflicting dates and unadmitted evidence. The matter is remanded to the trial level for further proceedings to determine if ex parte communication occurred and to address the temporary disability issue.

WCABAOE/COEQMEex parte communicationLabor Code section 4062.3Petition for ReconsiderationFindings and Orderremovaltemporary disabilityprimary treating physician
References
Case No. ADJ8015424, ADJ8102669
Regular
Aug 01, 2018

ESPERANZA SANCHEZ vs. MCDONALD'S/MJD'S, INC., UNITED STATES FIDELITY & GUARANTY, BROADSPIRE

The Workers' Compensation Appeals Board granted applicant's petition for removal, rescinding the WCJ's order that deferred a discovery dispute regarding ex parte communication. The Board found that allegations of impermissible communication between the defendant and the court-appointed physician must be addressed before further discovery. The case is returned to the trial level for proceedings to determine if ex parte communication occurred and if a new physician is warranted.

Petition for RemovalRegular PhysicianEx Parte CommunicationWCJDepositionsAdmitted EvidenceSubstantial JusticeLabor Code § 5701WCAB Rules § 10324(d)Qualified Medical Evaluator (QME)
References
Case No. ADJ7452503
Regular
Sep 26, 2011

PATRICIA MAYORGA vs. MOUNT DIABLO UNIFIED SCHOOL DISTRICT, TRISTAR

The Appeals Board denied the defendant's Petition for Removal, which sought to overturn an order quashing the deposition of a treating physician. The defendant argued the communication wasn't an ex parte communication and was necessary for their defense and fraud investigation. However, the Board found the defendant failed to show substantial prejudice or irreparable harm. While ex parte communications with QMEs/AMEs are prohibited, they are not with treating physicians, and the communication was not barred by statute or case law.

Petition for RemovalPetition to Quash DepositionTreating PhysicianEx Parte CommunicationAgreed Medical EvaluatorQualified Medical EvaluatorSubstantial PrejudiceIrreparable HarmWorkers' Compensation Appeals BoardWCJ
References
Case No. ADJ2902954; ADJ2715753
Regular
Jan 14, 2014

DONALD GREEN vs. COMPTON UNIFIED SCHOOL DISTRICT

The Appeals Board dismissed the lien claimant's Petition for Reconsideration and granted removal on its own motion. It affirmed the Administrative Law Judge's order setting aside a prior lien allowance due to potential service and ex parte communication issues. The matter was returned to the trial level for reassignment to a new judge to address outstanding issues, including proper service, ex parte communication, the propriety of setting aside the lien order, and potential sanctions.

Workers' Compensation Appeals BoardLien claimantReconsiderationRemovalOrder Setting AsideEx parte communicationProper serviceNotice of Intent to Allow LienAmended Order Allowing LienSubstituted counsel
References
Case No. ADJ10305556
Regular
Sep 26, 2016

JOSE MACIEL vs. RP AUTOMOTIVE, INC. d/b/a PENSKE CHEVROLET, SAFETY NATIONAL CASUALTY CORPORATION

The Appeals Board granted reconsideration of an order that had mandated a new Qualified Medical Examiner (QME) panel due to a perceived ex parte communication. The Board found the communication was not ex parte as the applicant was unrepresented and acknowledged receipt, thus rescinding the original order. The case is returned to the trial level for further proceedings, allowing the WCJ to issue a new decision considering all arguments. This decision clarifies that petitions challenging QME determinations are subject to reconsideration, not removal.

WCABQMEex parte communicationpetition for reconsiderationpetition for removaladministrative law judgeLabor Codequalified medical examiner panelSB 899comprehensive evaluation
References
Case No. ADJ7184508
Regular
Nov 15, 2011

LEWIS DALE CUNNINGHAM vs. COUNTY OF SAN BERNARDINO

This case involves a defendant's petitions to disqualify the judge or remove him from the case due to alleged ex parte communications with the Qualified Medical Evaluator (QME). The Workers' Compensation Appeals Board (WCAB) denied both petitions. The WCAB found the defendant failed to provide grounds for judicial disqualification and that the alleged ex parte communications with the QME were insignificant and did not cause substantial prejudice. Furthermore, the defendant failed to timely petition for removal of an earlier order allowing the QME's deposition.

WORKERS' COMPENSATION APPEALS BOARDPetition for DisqualificationPetition for RemovalJudge Robert PuseyPermissibly Self-InsuredQualified Medical EvaluatorQMEDr. Stanley J. MajcherEx Parte CommunicationsWCJ
References
Case No. ADJ7271474
Regular
Aug 22, 2011

BRIAN DEGEN vs. BONITA UNIFIED SCHOOL DISTRICT, YORK UPLAND

The defendant school district sought reconsideration of an order striking the Qualified Medical Evaluator's (QME) reports and ordering a new panel, arguing a voicemail did not constitute ex parte communication and that the WCJ erred on other grounds. The Appeals Board dismissed the defendant's petition as it was not from a final order. However, the Board granted removal on its own motion, rescinded the WCJ's order, and ruled the QME's voicemail was insignificant and not an ex parte communication. Consequently, the QME will remain, his reports are not stricken, and the case is returned for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalRemovalQualified Medical Evaluator (PQME)Ex Parte CommunicationLabor Code Section 5310Alvarez v. Workers' Comp. Appeals Bd.VoicemailDeposition Fee
References
Case No. ADJ4333259 (SAC 0320510) ADJ2035410 (SAC 0320511) ADJ190774 (SAC 0320512) ADJ4455812 (SAC 0344037) ADJ1944370 (SAC 0351922)
Regular
Feb 07, 2011

Christina Aguillon vs. REGIONAL TRANSIT, GREGORY BRAGG & ASSOCIATES; YORK INSURANCE SERVICES SACRAMENTO

The defendant, Regional Transit, petitioned for removal after the WCJ rescinded an order compelling a medical examination, alleging an ex parte discussion with the applicant's attorney violated procedural rules. While the Board agreed the ex parte communication and procedural missteps occurred, they denied removal because the underlying medical examination date had passed, and the issue would be heard on the merits at a conference. The Board found no substantial prejudice to the defendant. However, the applicant's prior attorney's conduct was deemed unprofessional and subject to potential future sanctions.

Petition for RemovalRescinded OrderEx Parte CommunicationWCAB Rule 10324(c)Court Administrator Rule 10281Petition to Compel AttendanceAgreed Medical EvaluationObjectionMinutes of HearingWCJ
References
Case No. ADJ2796539 (LAO 0840098) ADJ4363495 (LAO 0840099) ADJ7155229
Regular
Jun 15, 2010

Felix Aguilar vs. WAREHOUSE DISCOUNT CENTER; SCIF INSURED OXNARD

The Workers' Compensation Appeals Board dismissed the defendant's petition for removal as moot because the AME examination date had passed. The defendant sought to prevent the applicant's attorney from having ex parte communications with the AME. While dismissing the petition, the Board clarified that ex parte communications with an AME are prohibited under Labor Code section 4062.3(f) and can result in significant penalties. These penalties include the aggrieved party's ability to terminate the evaluation and seek a new one, as well as sanctions for costs and attorney's fees.

Workers' Compensation Appeals BoardPetition for RemovalProtective OrderAgreed Medical Evaluator (AME)Ex Parte CommunicationLabor Code Section 4062.3Moot PetitionIrreparable HarmContemptAggrieved Party
References
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