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

Case No. ADJ7692621; ADJ7687042
Regular
May 17, 2012

FREDDY TORRES vs. SCOTT BROS DAIRY INC.; ILLINOIS MIDWEST SPRINGFIELD

This case involves a dispute over the selection of a Qualified Medical Evaluator (QME). The defendant attempted to strike a QME from the panel prematurely, violating Labor Code section 4062.2(c). The applicant's subsequent strike was timely, leaving only Dr. Katz on the panel. The Appeals Board denied the defendant's Petition for Removal, upholding the WCJ's order for an evaluation by Dr. Katz. The Board warned the defendant that denying benefits based on Dr. Katz's report would be at their peril.

Petition for RemovalQualified Medical EvaluationLabor Code Section 4062.2(c)QME PanelAgreed Medical EvaluatorStrike a NameTimely StrikePremature StrikeMedical DirectorDivision of Workers' Compensation
References
Case No. ADJ8835727
Regular
Oct 05, 2015

ELVIRA MAYA vs. WENTE VINEYARDS, ZENITH INSURANCE COMPANY

This case concerns the timeliness of a defendant's strike of a Qualified Medical Evaluator (QME) panel. The Appeals Board determined that the ten-day period to strike a QME from a panel, as per Labor Code section 4062.2(c), is extended by five days when service is by U.S. mail, consistent with Code of Civil Procedure section 1013(a). Consequently, the defendant's strike of Dr. Boyd was deemed timely, and the applicant must now be examined by the remaining panel member, Dr. Gardner. The prior WCJ decision finding the strike untimely was rescinded.

WCABReconsiderationRemovalPetition for RemovalPetition for ReconsiderationPQMEPanel QMELabor Code section 4062.2(c)Code of Civil Procedure section 1013(a)WCAB Rule 10507(a)(1)
References
Case No. ADJ7651955
Regular
Nov 08, 2012

ARTHUR LUCERO vs. CITY OF FRESNO, Permissibly Self-Insured, Administered by AMERICAN ALL RISK LOSS ADMINISTRATORS

This case concerns a dispute over the selection of a Qualified Medical Evaluator (QME) panelist in a workers' compensation claim. The applicant sought to remove Dr. Arora, arguing the defendant's notice to strike Dr. Cayton was insufficient. The applicant, a firefighter, alleged a heart and hernia injury. The Appeals Board denied the petition, agreeing with the WCJ that the defendant's notice of intent to strike was sufficient and timely under Labor Code section 4062.2(c).

Petition for RemovalPanel Qualified Medical EvaluatorNotice of Intent to StrikeLabor Code Section 4062.2Agreed Medical EvaluatorIndustrial InjuryHeart InjuryCardiovascular System InjuryHernia InjuryFirefighter
References
Case No. ADJ8026817
Regular
Apr 22, 2013

MARIA OCHOA vs. RANGERS DIE CASTING COMPANY, COMPWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a decision finding the applicant sustained injury to her respiratory system and psyche AOE/COE. The WCAB rescinded the decision and returned the case to the trial level, finding the medical opinions of Dr. Lipper and Dr. Curtis lacked substantiality. Specifically, the physicians failed to provide clear diagnoses, quantify exposures, or adequately explain causation. The Board noted contradictory testimony from the applicant's supervisor and insufficient evidence to support the initial findings.

Workers' Compensation Appeals BoardMaria OchoaRangers Die Casting CompanyCOMPWEST INSURANCE COMPANYADJ8026817Los Angeles District OfficeOpinion and Order Granting ReconsiderationDecision After ReconsiderationFindings of FactWorkers' Compensation Administrative Law Judge (WCJ)
References
Case No. ADJ9287010
Regular
Oct 22, 2015

Esther Rodriguez vs. MANUEL VILLA ENTERPRISE, NORGUARD INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the applicant's petition for removal, reversing a previous order that deemed her strike from a Qualified Medical Evaluator (QME) panel untimely. The Board found that the applicant's strike was timely under Labor Code section 4062.2(c) and Code of Civil Procedure section 1013(a), which extends the 10-day striking period by five days when the panel assignment is mailed. Consequently, Dr. James Shaw was designated as the proper QME, and the WCJ's prior order was rescinded.

Petition for RemovalQME paneluntimely strikesubstantial prejudiceirreparable harmLabor Code section 4062.2(c)Senate Bill 863Messele v. Pitco FoodsInc.Agreed Medical Evaluator
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. ADJ19432813; ADJ19432814
Regular
Mar 24, 2025

Yeni Saenz vs. Kellermeyer Bergensons Services, LLC; Zurich American Dallas

Applicant Yeni Saenz sought reconsideration of a Workers' Compensation Administrative Law Judge's (WCJ) finding that her strike from a Qualified Medical Evaluator (QME) panel was untimely, granting the defendant the right to select the QME. The Workers' Compensation Appeals Board granted the petition for reconsideration, concluding that although the applicant's strike was indeed untimely, the defendant had subsequently waived its right to exclusively select a QME by failing to act within a reasonable time. Consequently, the Board rescinded the WCJ's decision and ordered the parties to proceed with Dr. Patrick S. Hill as the designated Qualified Medical Evaluator. Commissioner José H. Razo issued a dissenting opinion, arguing that the applicant had obfuscated the untimeliness of her strike and scheduled an appointment during the period when the defendant held the exclusive right to selection.

QME PanelUntimely StrikeLabor Code Section 4062.2WaiverTimely SelectionReconsiderationJoint Findings and OrderWCJAppeals BoardPetition for Reconsideration
References
Case No. ADJ6896705
Regular
Jul 05, 2012

YESENIA GUILLEN vs. ADIR INTERNATIONAL, LLC dba LA CURACAO, TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration as it was based on a non-final procedural order regarding QME selection. However, the WCAB granted removal to address the issue, rescinding the prior order. The WCAB determined that the applicant's early strike from the QME panel was not a nullity, but the parties must proceed with the remaining QME, Dr. F. Daniel Kharrazi.

RemovalReconsiderationPetitionQualified Medical Evaluator (QME)Labor Code Section 4062.2StrikePanel SelectionAgreed Medical EvaluatorFindings and OrderNon-Final Order
References
Case No. ADJ3714921
Regular
Mar 24, 2011

SANDRA GONZALEZ vs. VONS, Permissibly Self-Insured

The Workers' Compensation Appeals Board denied Sandra Gonzalez's petition for reconsideration. The Board adopted and incorporated the findings of the workers' compensation administrative law judge. The judge found that Gonzalez's transfer to a different store after a strike was a good faith personnel action based on legitimate business needs. The judge also gave great weight to his credibility findings, which influenced the decision to deny reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationGood Faith Personnel ActionPsychiatric InjuryTransferCollective Bargaining AgreementUnion GrievanceHearsay ObjectionCredibilityStrike
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
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