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

Case No. ADJ8750063, ADJ8610968
Regular
Sep 04, 2018

SAYDIEL OCANA vs. SELAH GOURMET FOOD, dba COUNTRY HOUSE, OAK RIVER INSURANCE COMPANY

The Workers' Compensation Appeals Board granted defendant's Petition for Removal, overturning a prior WCJ decision. The Board ruled that defendant is allowed to forward vocational rehabilitation expert reports to the Qualified Medical Evaluators (QMEs). This decision acknowledges the nexus between medical and vocational evidence and allows QMEs to consider this information when determining permanent disability ratings. The case was returned to the trial level for further proceedings.

Petition for RemovalVocational Rehabilitation ReportsQualified Medical Evaluator (QME)Labor Code Section 4062.3Title 8 California Code of Regulations Section 35Joint Findings and OrderIndustrial InjuryPermanent Disability RatingDiscovery OrderNexus
References
8
Case No. ADJ7937506, ADJ7937507, ADJ7937509
Regular
Oct 25, 2018

CHARLOTTE BEY HAWA vs. BURBANK UNIFIED SCHOOL DISTRICT

This case involves a dispute over the selection and validity of Qualified Medical Evaluators (QMEs) for an applicant's industrial injuries. The defendant sought removal after the Workers' Compensation Judge (WCJ) struck the reports of Dr. Martinson, a replacement QME. The Appeals Board granted removal, rescinded the order striking Dr. Martinson's reports, and ordered the parties to select an Agreed Medical Examiner or have the WCJ appoint a physician, as both prior QMEs were unavailable. The Board found the applicant's two-year delay in objecting to Dr. Martinson precluded her objection.

Workers' Compensation Appeals BoardPetition for RemovalPetition for ReconsiderationQualified Medical Evaluator (QME)Replacement QME panelStipulated Medical EvaluatorAgreed Medical ExaminerLabor Code Section 5710DWC Rules 31.5DWC Rules 35.5
References
6
Case No. ADJ3357317 (OAK 0311479)
Regular
May 04, 2016

MERY CORDOBA vs. CALIFORNIA DEPARTMENT OF SOCIAL SERVICES IN-HOME SUPPORTIVE SERVICES, YORK RISK SERVICES

The Workers' Compensation Appeals Board denied Mery Cordoba's petition for reconsideration. Applicant sought reconsideration of the denial of her psychiatric injury claim, arguing that her trial testimony revealed new information not considered by the Qualified Medical Evaluators (QMEs). The Board found that the applicant's testimony regarding childhood molestation and a past stable marriage was unrelated to work events and did not meet the burden of proof for a predominantly work-related psychiatric injury. Furthermore, the Board held that discovery was properly closed, and the applicant had ample opportunity to present this information to the QMEs.

WORKERS' COMPENSATION APPEALS BOARDIN-HOME SUPPORTIVE SERVICESYORK RISK SERVICESPetition for ReconsiderationDENIEDwcjtimely filedDate of Injurycare providerneck
References
0
Case No. ADJ9391561 ADJ8266496
Regular
Apr 12, 2019

HENDRIKUS ANTONIUS BENNINK vs. CITY OF FRESNO

This case involves a police officer claiming industrial injuries to multiple body parts, including orthopedic and digestive systems, in addition to previously resolved cardiovascular and hearing claims. The Workers' Compensation Appeals Board (WCAB) affirmed the trial judge's decision, finding that the applicant did not sustain industrial injuries to his neck, upper extremities, back, legs, or digestive system. This decision was based on substantial evidence from Qualified Medical Examiners (QMEs) who concluded these conditions were degenerative and non-industrial. The WCAB found no error in the QMEs' reasoning or the applicant's failure to prove industrial causation for these specific injuries.

ADJ9391561ADJ8266496Industrial injuryCardiovascular systemHearing lossOrthopedic injuryDigestive systemQMESubstantial evidenceCausation
References
0
Case No. SRO 0130521 SRO 0130522
Regular
Mar 28, 2008

MICHAEL JANSSEN vs. CREAM'S DISMANTLING, INC., ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to further develop the record regarding permanent disability and apportionment due to deficiencies in the medical evidence from both the applicant's and defendant's QMEs. The Board deferred these issues, as well as the determination of attorney's fees, to allow for further proceedings. The decision affirms the finding of industrial injury and the need for future medical treatment.

WCABReconsiderationPermanent DisabilityApportionmentQualified Medical ExaminerSubstantial EvidenceMedical OpinionDeposition FeeAttorney's FeeBenson
References
10
Case No. ADJ6550105 ADJ6777358 ADJ6777361 ADJ6976802
Regular
Oct 03, 2014

ESTHER GARCIA vs. ANTELOPE VALLEY UNION HIGH SCHOOL DISTRICT, CORVEL CORPORATION

The Workers' Compensation Appeals Board granted reconsideration and rescinded an earlier order allowing attorney fees. The Board found that Labor Code section 5710(b) only authorizes fees for depositions of the injured employee or their dependents, not for depositions of Qualified Medical Evaluators (QMEs). Therefore, applicant's counsel was not entitled to fees for attending the QME's deposition. The Board denied the petition for attorney's fees.

Labor Code $\S 5710$Petition for ReconsiderationWorkers' Compensation Appeals BoardQualified Medical Evaluator (QME)Attorney's FeesDepositionInjured EmployeeDependent BenefitsWCJContingency Fee
References
0
Case No. LAO 0862653
Regular
Sep 21, 2007

MICHAEL J. MESTAS vs. HMK ENGINEERING, INC., STATE FARM INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the applicant's Petition for Reconsideration, finding that the WCJ's orders for further medical development were interlocutory and not final orders subject to reconsideration. The Board also denied the applicant's request for removal, finding no substantial prejudice or irreparable harm to justify this extraordinary remedy. The WCJ's orders for panel QMEs were deemed appropriate to expedite the resolution of disputed medical issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationDenying RemovalFindings and OrderOrder To Further Develop RecordQualified Medical EvaluatorInternal MedicineGastroenterologyPsychiatryLabor Code section 5502
References
7
Case No. POM 289340
Regular
Feb 01, 2008

LAURA SCHOONOVER vs. FIRST FINANCIAL FEDERAL, GALLAGHER BASSETT SERVICES

The defendant sought a panel of psychiatric Qualified Medical Evaluators (QMEs) after disagreeing with the treating psychiatrist and alleging the Workers' Compensation Judge refused to order a panel. However, the petition was dismissed as premature because the defendant had not first requested a panel from the administrative director, a prerequisite under Labor Code section 4062.2(b). The Appeals Board clarified that judicial intervention is only appropriate after the administrative director has refused such a request.

Petition to RemoveQualified Medical Evaluator (QME)PsychiatryLabor Code section 4062.2Administrative DirectorStatus ConferenceIndustrial InjuryAgreed Medical EvaluatorJudicial InterventionWorkers' Compensation Appeals Board (WCAB)
References
0
Case No. VNO 0380163
Regular
Dec 14, 2007

LAWRENCE REICHELT vs. CITY OF LOS ANGELES (LAPD), Permissibly Self-Insured

The City of Los Angeles sought removal to obtain a psychiatric QME evaluation for an applicant who claimed psychiatric injury related to a past industrial injury. The Board granted removal, holding that Labor Code section 4062.1 applies prospectively to all injuries, regardless of date. The Court amended the previous order to allow the defendant to request a panel of three psychiatric QMEs under section 4062.1(b).

RemovalPetition for RemovalQualified Medical EvaluatorPsychiatric EvaluationLabor Code Section 4062.1SB 899Date of InjuryProspective ApplicationSection 4067.5Competing Statutory Provisions
References
1
Case No. ADJ7242422
Regular
Sep 24, 2013

TRACIE WHITE vs. COUNTY OF SACRAMENTO, DEPARTMENT OF FINANCE

The Workers' Compensation Appeals Board denied the County of Sacramento's Petition for Removal. The County sought to replace a Qualified Medical Evaluator (QME) due to an allegedly untimely supplemental report. The Board affirmed the administrative law judge's denial, interpreting Administrative Director Rule 38(h) to grant QMEs sixty days for supplemental reports. The Board also noted the County objected to the report before receiving it.

Petition for RemovalQualified Medical EvaluatorQME panelsupplemental reportuntimely reportAdministrative Director Rule 38Report and RecommendationFajardo v. Workers' Comp. Appeals Bd.WCJoff calendar
References
1
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