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

Case No. ADJ9860385 ADJ9860124
Regular
Mar 27, 2017

JANICE HASLEY vs. FRITO-LAY, INC., ACE AMERICAN INSURANCE COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case concerns applicant Janice Hasley's request for a second Qualified Medical Evaluator (QME) panel for a cumulative trauma injury claim. The Board granted reconsideration, treating Hasley's petition as one for removal. The original findings denied the request for a second QME panel, which the Board rescinded due to an unclear record regarding claim forms and injury specifics. The case is returned to the trial level for further development of facts to determine if a second QME panel is warranted under *Navarro v. City of Montebello*.

QME panelNavarro v. City of MontebelloLabor Code sections 4062.3(j)4064cumulative trauma injuryspecific injury claimDeclaration of Readiness to ProceedPetition for Reconsiderationremovalrescinded Findings of Fact
References
1
Case No. SFO 503274
Regular
Apr 02, 2008

RONALD KIHARA vs. UNIVERSITY OF CALIFORNIA, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board granted the defendant's Petition for Removal, rescinding the prior order for a second QME panel. This action was taken because the Administrative Law Judge mistakenly believed both parties agreed to the second panel. The case is now returned to the trial level for further proceedings to determine if a second QME panel is indeed necessary.

Petition for RemovalSecond QME PanelUnrepresented CaseMedical DirectorQualified Medical EvaluatorsSubstantial EvidenceWCJFinding and OrderRescindedTrial Level
References
0
Case No. ADJ7712746
Regular
Dec 08, 2015

Glen Rizuto vs. United Parcel Service, Gallagher Bassett

The Appeals Board granted UPS's Petition for Removal, rescinding the WCJ's order to negotiate a QME selection. The Board found the WCJ erred by not addressing UPS's contentions regarding the validity of the second QME panel issued over 24 months after the first. UPS successfully argued they would be prejudiced if forced to negotiate when the second panel was allegedly the only valid one. The Board ordered parties to select a QME from the July 2, 2014 panel, allowing each to strike one name.

Petition for RemovalQualified Medical Evaluator (QME)Panel SelectionCumulative Trauma InjuryLabor Code Section 4062.1Labor Code Section 4062.2Romero v. Costco WholesaleIrreparable HarmPrejudiceMedical Unit
References
3
Case No. ADJ11139513
Regular
Jul 23, 2018

TEMPE EVERSON vs. STATE OF CALIFORNIA, CTF SOLEDAD, STATE COMPENSATION INSURANCE FUND

This case concerns the proper Qualified Medical Evaluator (QME) panel selection after an applicant became represented by an attorney. Initially unrepresented, applicant received QME panel #2194142, but no evaluation occurred before she retained counsel. A new panel, #2200955, was issued for represented cases, from which applicant timely struck a physician. However, the defendant's strike from this second panel was found to be untimely. The Appeals Board granted removal, amended the prior order, and directed the parties to proceed with an evaluation by Dr. Scheinbaum from the second panel, deeming it the appropriate one.

Petition for RemovalQualified Medical Evaluator (QME) panelrepresented vs. unrepresentedtimely strikeRomero v. CostcoLabor Code section 4062.1Labor Code section 4062.2Code of Civil Procedure section 1013Razo v. Las Posas Country Clubcomprehensive medical-legal evaluation
References
3
Case No. ADJ8045455; ADJ8045600
Regular
Sep 14, 2012

ELSIE PENA CLARK ROSAS vs. SUTTER GENERAL HOSPITAL, SUTTER HEALTH

Here's a summary for a lawyer: The Workers' Compensation Appeals Board denied the defendant's Petition for Removal, which sought to compel applicant's examination by the same Qualified Medical Examiner (QME) for two distinct injuries. The Board affirmed the WCJ's decision, holding that separate QME panels are permissible for distinct injuries to different body parts. This ruling establishes that a second injury does not constitute a "new medical issue" or a "follow-up/supplemental evaluation" requiring the original QME. Therefore, the applicant is entitled to a new QME panel for the second injury.

Petition for RemovalPQMEMedical Unitdistinct injuriesbody partsnew medical issuefollow-up evaluationsupplemental evaluationsecond panel of QMEsLabor Code section 4062.3(j)
References
0
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
18
Case No. ADJ7027233
Regular
Jan 28, 2010

DAVID SHAW vs. THE HOME DEPOT

The Workers' Compensation Appeals Board denied Home Depot's petition for removal, upholding the Administrative Law Judge's order for a second Qualified Medical Evaluator (QME) panel. The first panel included the applicant's treating physician, Dr. King, despite rules prohibiting this. The Board found that the circumstances regarding whether the applicant was properly informed of his right to a replacement QME were unclear. Consequently, ordering a new panel was deemed the most expeditious way to achieve a just resolution without causing substantial prejudice to the defendant.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical Evaluator (QME)Treating PhysicianUnrepresented EmployeeQME PanelCompromise and Release (C&R)DisqualificationAdministrative Director RuleMedical Unit
References
0
Case No. ADJ6632043 ADJ6580510
Regular
Jul 01, 2010

DARRYL PILLORS vs. PENSKE TRUCK LEASING CO., OLD REPUBLIC INSURANCE COMPANY

The Appeals Board granted removal, rescinded the WCJ's order, and returned the case to the trial level. This was because the WCJ improperly ordered a second QME panel before adjudicating the admissibility of the first panel's report. Defendant argued prejudice from incurring costs for two evaluations, and the Appeals Board agreed this raised irreparable harm. The WCJ must now determine the admissibility of the initial QME report and any subsequent orthopedic evaluations.

RemovalQualified Medical EvaluatorQME panelAdmissibility of reportTimeliness of objectionPetition for RemovalWCJ decisionMedical UnitIndustrial injuryBack injury
References
1
Case No. ADJ9368263, ADJ9380293
Regular
Sep 15, 2015

JOSE MELCHOR vs. BRUTOCAO VINEYARDS, STAR INSURANCE COMPANY

This case involves a defendant's petition for removal regarding an order for a second Qualified Medical Examiner (QME) panel concerning the applicant's head injury. The Workers' Compensation Appeals Board (WCAB) granted removal to correct a clerical error in the original order. The WCAB affirmed the necessity of a second QME to further develop the medical record on the head injury claim, specifically in the specialty of Psychology-Clinical Neuro Psychology.

Petition for RemovalSecond QME PanelHead InjuryMedical Record DevelopmentWCJ Duty to Develop RecordPQME SpecialtyPSNPsychology-Clinical Neuro PsychologyMandatory Settlement ConferenceLack of Diligence
References
0
Case No. LBO 380630
Regular
Jul 11, 2008

DAVID CHEN vs. DELUXE CORPORATION, SPECIALTY RISK SERVICES

The Workers' Compensation Appeals Board dismissed the defendant's Petition for Reconsideration because the denial of a motion to compel a second Panel QME is an interlocutory, procedural order, not a final decision. The Board also denied the defendant's Petition for Removal, finding no substantial prejudice or irreparable harm to justify this extraordinary remedy. Furthermore, the Board rejected the argument that a new Panel QME could be sought simply if the initial report was not advantageous to the defendant.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalPanel QMELabor Code Section 4062.2Medical EvaluationFinal OrderInterlocutory OrderProcedural OrderSubstantive Rights
References
5
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