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

Case No. ADJ4013684 (OAK 0307613) ADJ620772 (OAK 0294537)
Regular
Jul 28, 2014

DANIEL GRANZELLA vs. RICHMOND SANITARY

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration and denied their petition for removal. The defendant sought to be relieved from an agreed medical examiner (AME) agreement with Dr. Warbritton, alleging bias and ex parte communication. The Board found that the WCJ's order denying the motion to be relieved from the AME agreement was interlocutory and thus not subject to reconsideration. Furthermore, the Board found no basis for removal, as the defendant failed to establish bias or irreparable harm, and their ex parte communication claim was waived by their delay in raising the issue after receiving further medical reports.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalAgreed Medical Examiner (AME)BiasEx Parte CommunicationLabor Code § 5900Interlocutory OrderFinal OrderSubstantive Right
References
11
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
1
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
15
Case No. MISSING
Regular Panel Decision
May 07, 1998

People v. Tullo

In this case, the court addresses an application for an ex parte order of protection against a defendant charged with aggravated harassment in the second degree, stemming from a single threatening telephone call. The Assistant District Attorney sought the order based on new facts not included in the original accusatory instrument. Judge Joel B. Gewanter denied the application, interpreting CPL 530.13 (2) to limit ex parte orders of protection solely to factual allegations present within the filed accusatory instrument. The court emphasized the necessity of proper notice and an opportunity for the defendant to be heard. It suggested that for new charges, a new complaint and arrest would be the appropriate procedure for issuing such an order.

Aggravated HarassmentSecond DegreeEx Parte Order of ProtectionCriminal Procedure LawCPL 530.13MisdemeanorFirst ImpressionTelephone CallThreatening StatementDue Process
References
0
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
4
Case No. ADJ971006 (SJO 0265027) ADJ383356 (SJO 0265034)
Regular
Jan 06, 2010

JAMES ALLIVATO vs. CENTRAL VALLEY MECHANICAL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the defendant's petition for removal, finding that Dr. Fujimoto, the agreed medical evaluator (AME), engaged in prohibited ex parte communications with the applicant and his civil attorney. These communications violated Labor Code section 4062.3(f) by occurring without the defendant's presence and not in writing. Consequently, the prior order denying the defendant's petition to strike Dr. Fujimoto was rescinded, and a new AME must be selected.

Workers' Compensation Appeals BoardPetition for RemovalAgreed Medical EvaluatorEx Parte CommunicationLabor Code Section 4062.3(f)Administrative Director Rule 41.5Petition to Strike AMECivil SuitSheet Metal MechanicTemporary Total Disability
References
0
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
6
Case No. ADJ8363948
Regular
Oct 19, 2012

NICOLE NELSON vs. COUNTY OF SOLANO, INTERCARE HOLDINGS INSURANCE SERVICES

The defendant County of Solano sought removal to obtain a new panel of Qualified Medical Evaluators (QMEs) due to alleged ex parte communications between the applicant and the current QME. The Appeals Board denied this petition, finding that the communications were either insignificant and inconsequential or related to the QME examination itself. Specifically, emails concerning necessary forms and an insignificant mention of a claims adjuster's number did not violate the ex parte communication prohibition. Therefore, the WCJ's denial of the defendant's request for a new QME panel was upheld.

Petition for RemovalQualified Medical Evaluator (QME)ex parte communicationLabor Code section 4062.3termination of evaluationreplacement panelinsignificant communicationinconsequential communicationindustrial injurypsyche
References
1
Case No. ADJ10452831
Regular
Nov 09, 2018

CAROLINE DOLLEMORE vs. WAYNE PERRY, INC.; STARR SURPLUS LINES, administered by YORK RISK SERVICES GROUP

The Appeals Board granted the applicant's petition for removal, rescinding the WCJ's findings. The WCJ had improperly stricken the QME's reports due to an ex parte communication from the applicant inquiring about her pain impairment rating. While ex parte communications with a QME are prohibited, the Board found that the applicant's communication was not insignificant and could not be categorized as such. However, the Board remanded the case to the trial level to determine if the defendant elected to terminate the evaluation within a reasonable time or engaged in conduct inconsistent with that election, as required by recent en banc precedent.

ex parte communicationqualified medical evaluatorremovalfindings and orderstricken reportsagreed medical evaluatorpetition for removaldefendant's answertrial levelsupplemental report
References
5
Case No. ADJ1232228 (STK 0213740)
Regular
Jul 20, 2015

LON VALLEM vs. STATE OF CALIFORNIA, CDCR, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the defendant sought removal of the judge's findings, dismissal of the Agreed Medical Evaluator (AME), and a new panel, alleging an ex parte communication by the applicant with the AME. The Workers' Compensation Appeals Board (WCAB) denied the petition for removal, upholding the judge's decision. The WCAB found no effort to improperly influence the AME, and that the communication occurred after the record was submitted on a non-disputed issue. The WCAB agreed that excluding the specific report from the alleged ex parte communication was sufficient to protect due process.

Petition for RemovalAgreed Medical Evaluator (AME)Ex Parte CommunicationLabor Code Section 4062.3(g)Alvarez v. Workers' Comp. Appeals Bd.Findings & OrdersWorkers' Compensation Administrative Law Judge (WCJ)Qualified Medical Evaluator (QME) PanelDiscovery ClosurePretrial Conference Statement
References
1
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