CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. SAL SJO 252436 (MF); SJO 246192
Regular
Jul 02, 2007

NIHAL HORDAGODA vs. State Compensation Insurance Fund

This case involves an employer's petition for reconsideration of an order authorizing medical treatment and admitting the Qualified Medical Examiner's (QME) reports. The employer argued the QME reports were inadmissible due to an alleged ex parte communication between the applicant and the QME, and that the awarded treatments were improper. The report recommends denying the petition, finding the communication was permissible under LC § 4062.3(h) and that the QME's opinions and awarded treatments for chronic pain were reasonable and not governed by ACOEM guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorLabor Code Section 4062.3Ophthalmological evaluationFunctional capacity evaluationUtilization ReviewACOEM GuidelinesChronic spinal conditionTreating physician
References
0
Case No. ADJ1732179 (LBO 0394128)
Regular
Feb 15, 2011

LISA WLADKOWSKI vs. BALL METAL CONTAINER CORP.; DISCOVERY MANAGERS, administered by SPECIALITY RISK SERVICES

In this workers' compensation case, the Board dismissed the defendant's petition for reconsideration of an order that struck a Qualified Medical Evaluator's (QME) report due to an allegedly excessive deposition fee. However, the Board granted the defendant's alternative petition for removal. The Board found no legal basis to strike a QME's report solely because their deposition fee exceeds the presumptive statutory rate. Consequently, the original order striking the report was rescinded, and the matter was returned for further proceedings.

Workers' Compensation Appeals BoardPanel Qualified Medical EvaluatorPQMEdeposition testimonyexcessive feemedical legal fee schedulestriking medical reportpetition for reconsiderationpetition for removalevidentiary order
References
5
Case No. ADJ1934243 (FRE 0221043)
Regular
Apr 25, 2011

MARIA RAYOS vs. WALGREENS, ZURICH INSURANCE COMPANY

This case concerns a dispute over a second Qualified Medical Examiner (QME) for an applicant with a work-related knee, back, and hip injury. The defendant sought removal, arguing that allowing a second QME without striking the first QME's reports violated due process and would taint the new evaluation. The Appeals Board granted removal, amended the prior order, and clarified that a new QME is allowed. However, the admissibility of the first QME's reports is deferred to the trial judge, and those reports, unlike diagnostic study results, are not to be provided to the new evaluator.

Petition for RemovalQualified Medical Evaluator (QME)Admissibility of ReportsDue ProcessWorkers' Compensation Appeals Board (WCAB)Administrative Law Judge (WCJ)Industrial InjuryMedical EvaluationsDiscoveryMandatory Settlement Conference (MSC)
References
0
Case No. ADJ8529720
Regular
Feb 06, 2017

ALEJANDRA GONZALEZ vs. 3M COMPANY, OLD REPUBLIC INSURANCE

This case concerns whether an untimely supplemental Qualified Medical Evaluator (QME) report warrants a replacement panel. The applicant requested a new panel because the original QME's supplemental report was late. The WCJ denied the defendant's request to keep the original QME, finding the defendant waived objection by striking a name from the new panel. The Appeals Board granted removal, rescinded the WCJ's order, and remanded the case. The Board clarified that striking a name from a new panel does not automatically waive the right to object to its validity.

PQMESupplemental ReportReplacement PanelLabor Code 4062.5DWC Medical UnitDeclaration of ReadinessMSCWaiverAdministrative Director Rule 38Rule 31.5
References
0
Case No. ADJ8975338
Regular
Jun 21, 2017

Kevin Livingstone vs. ATI, American Insurance Company, ESIS

This case involves a defendant's attempt to strike a Qualified Medical Evaluator's (QME) report and obtain a replacement due to a 7-day delay in a supplemental report. The Appeals Board vacated its prior order granting reconsideration because the initial WCJ's order denying the strike was not a final order subject to reconsideration. The Board further denied the defendant's petition for removal, finding no irreparable harm. The ruling clarifies that only an untimely initial QME evaluation mandates replacement, whereas a late supplemental report is within the WCJ's discretion to address based on good cause.

WCABPetition for ReconsiderationPetition for RemovalQualified Medical EvaluatorQMESupplemental ReportTimelinessFinal OrderInterlocutory OrderAdministrative Director
References
14
Case No. ADJ8410680
Regular
Jun 06, 2014

DAWNN RUDLUFF vs. COVENANT RETIREMENT COMMUNITIES, TRAVELERS PROPERTY AND CASUALTY COMPANY OF AMERICA

The Appeals Board dismissed the applicant's petition for reconsideration, treating it as a petition for removal. Removal was granted because the applicant's emails to the psychiatric QME, sent shortly after the examination, were deemed not to be prohibited ex parte communications under Labor Code section 4062.3(i). Consequently, the WCJ's order striking the QME's report was rescinded, and the report was admitted into evidence. The Board also affirmed the denial of the defendant's motion to strike other applicant exhibits.

QMEex parte communicationremovalPetition for Reconsiderationpsychiatric injurycumulative traumaadministrative law judgePanel Qualified Medical ExaminerLabor Code section 4062.3medical evidence
References
4
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
1
Case No. ADJ8092835
Regular
Mar 04, 2016

Dane Hayes vs. California Dairies, Hartford Fire Insurance Company

The Workers' Compensation Appeals Board denied a petition for removal, affirming the WCJ's decision to deny the defendant's motion to strike a QME's supplemental report. The Board found the supplemental report was timely served, as the 60-day period for completion concluded on the next business day after the Saturday deadline. Furthermore, the defendant failed to object to the report's alleged untimeliness *prior* to its service, which is a prerequisite for obtaining a new QME panel under the regulations. Therefore, the defendant failed to demonstrate the substantial prejudice and irreparable harm required for removal.

Petition for RemovalFindings and AwardQualified Medical Evaluator (QME)Supplemental ReportTimelinessObjection to ReportNew QME PanelLabor Code Section 4062.3Labor Code Section 4062.5California Code of Regulations Title 8 Section 38(i)
References
0
Case No. ADJ6470549
Regular
Feb 27, 2012

KATHRYN BENSON vs. CITY OF SAN DIEGO

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior decision, allowing a Qualified Medical Examiner's (QME) report into evidence. The original decision excluded the QME report, finding no ratable permanent disability based on the treating physician's opinion. The Appeals Board found the QME report should have been admitted, as there are no explicit time limits for objecting to a treating physician's report or obtaining a QME evaluation for permanent disability. The case is remanded for further proceedings on permanent disability and attorney's fees with the QME report now part of the record.

Workers Compensation Appeals BoardFindings and AwardPetition for ReconsiderationQualified Medical Examiner (QME)Permanent DisabilityFuture Medical TreatmentTreating PhysicianAgreed Medical Examiner (AME)Labor Code Section 4061Strawn v. Golden Eagle Insurance Co.
References
1
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
0
Showing 1-10 of 5,893 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational