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

Case No. ADJ8606940
Regular
Apr 18, 2013

ANGELICA PEREZ vs. PERMANENTE MEDICAL GROUP, INC.

The Workers' Compensation Appeals Board denied defendant's petition for removal or reconsideration regarding the applicant's entitlement to multiple Panel Qualified Medical Examiners (PQMEs). The defendant contested the procedural validity of the applicant's PQME requests, while the applicant asserted proper procedure was followed due to the defendant's lack of response to an Agreed Medical Examiner offer. The Board found that the February 4, 2013 notation was not a final order, as PQME requests remained pending with the Medical Unit. Therefore, the petition was denied without prejudice to the Medical Unit's future determination on the propriety of the PQME requests.

Panel Qualified Medical ExaminersPQMEPetition for RemovalPetition for ReconsiderationIndustrial InjuryCumulative InjuryAgreed Medical ExaminerAMEMedical UnitAdministrative Law Judge
References
0
Case No. MISSING
Regular Panel Decision

Equal Employment Opportunity Commission v. Grief Bros.

This employment discrimination case, filed July 1, 2002, involves Michael Sabo (Plaintiff) who alleges constructive discharge based on sexual harassment and claims severe emotional pain and suffering. The Defendant moved for a mental examination of Sabo under Fed.R.Civ.P. 35 and to compel the production of his medical records. Sabo alleged severe humiliation, anxiety, depression, loss of self-esteem, sleeplessness, and weight gain, and admitted to a history of depression, past suicide attempts, and current psychiatric treatment with prescribed medications. The court granted the Defendant's motions, finding that Sabo had placed his mental condition in controversy due to the nature and severity of his claims and his medical history, justifying both the examination and the production of relevant medical records. The court also granted Defendant's request for costs associated with compelling the medical records, but denied the request for costs related to the Rule 35 motion itself, and denied Plaintiff's request for counsel or recording during the examination.

Employment DiscriminationSexual HarassmentConstructive DischargeEmotional DistressMental ExaminationRule 35Medical RecordsDepressionSuicide AttemptsCompensatory Damages
References
11
Case No. ADJ8106886
Regular
Sep 12, 2013

HECTOR VAZQUEZ vs. DEUEL VOCATIONAL INSTITUTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of an administrative law judge's decision that applicant Hector Vazquez's heart disease was not industrially caused. The majority adopted the judge's report, noting a clerical error in identifying the medical examiner as an Agreed Medical Examiner (AME) instead of a Panel Qualified Medical Examiner, but found this did not affect the judge's analysis. Commissioner Brass dissented, arguing the record was undeveloped regarding job stress's contribution to the heart disease, and that the medical examiner's opinion was not substantial evidence to rebut the statutory presumption of industrial causation for correctional officers.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical ExaminerAgreed Medical Examinerheart diseasejob stresscorrectional officerpresumptionrebuttalsubstantial evidence
References
3
Case No. ADJ3778927 (SFO 0460851) ADJ334222 (OAK 0285716) ADJ2101319 (SFO 0437718) ADJ4065670 (OAK 0285715)
Regular
Jun 06, 2011

KIMBERLY ROBERTS vs. CITY & COUNTY OF SAN FRANCISCO, INTERCARE

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration because the appealed Minute Order was not a final order, as it only set for trial the issue of proper notice regarding a medical examiner panel. The WCAB also denied the applicant's Petition for Removal, finding no substantial prejudice or irreparable harm that would justify this extraordinary remedy. The applicant sought a third panel of qualified medical examiners, claiming insufficient notice of a second panel. The matter was returned to the trial level for further proceedings.

Petition for ReconsiderationPetition for RemovalQualified Medical ExaminersProper NoticeMinute OrderFinal OrderStatutory TimeDue ProcessShipleyState Farm
References
7
Case No. MISSING
Regular Panel Decision
Feb 08, 1994

People v. France

This is a combined decision addressing motions to vacate homicide convictions in six separate cases. The defendants argued that the prosecutor failed to disclose dictation audiotapes made by the New York City Medical Examiner, which they claimed constituted 'Rosario' material. The court denied the motions, ruling that the Medical Examiner's Office is an independent agency, and therefore, the audiotapes were not under the control of the District Attorney and not 'Rosario' material. The decision further clarifies that CPL article 240 provides for pretrial discovery of written reports but not dictation tapes, unless they contain exculpatory material. The court emphasized the Medical Examiner's role as an independent expert, distinct from 'event' or law enforcement witnesses, and concluded that their dictation tapes are not 'statements' within the 'Rosario' jurisprudence.

Rosario materialDiscovery rulesCPL 440.10 motionHomicide convictionMedical Examiner audiotapeAutopsy reportProsecutorial dutyDuplicative equivalentIndependent agencyCPL Article 240
References
31
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. ADJ7436407, ADJ1895040 (FRE 0238028)
Regular
Feb 04, 2015

Colleen Newby vs. Fresno Community Medical Center, St. Agnes Medical Center, State Compensation Insurance Fund

The Workers' Compensation Appeals Board denied Colleen Newby's Petition for Removal, upholding the denial of her petition to quash a Qualified Medical Evaluator (QME) request. The Board found that the prior employer, Fresno Community Medical Center, was authorized to file an application for adjudication of claim for Newby's subsequent employment with St. Agnes Medical Center. Crucially, the Board determined that a claim form is not a prerequisite for St. Agnes to request a QME panel in this specific scenario, where a second injury is claimed by a prior employer. Newby's due process claim was rejected as she had an opportunity to present her arguments on removal.

Petition for RemovalPetition to QuashQME RequestQualified Medical EvaluatorClaim FormDue ProcessAgreed Medical EvaluatorApplication for AdjudicationTemporary DisabilityPermanent Disability
References
1
Case No. ADJ10335205
Regular
Feb 16, 2017

BARNARD VILLAR vs. STATE OF CALIFORNIA, CDCR, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration. The Board found the medical opinion of the panel Qualified Medical Examiner (PQME) to be substantial medical evidence, based on an adequate examination and supported by reasoning. This opinion was relied upon by the workers' compensation administrative law judge. Consequently, the applicant's petition was denied.

Petition for ReconsiderationDeniedWorkers' Compensation Appeals BoardWCJ ReportAdopted and IncorporatedSubstantial Medical EvidenceReasonable Medical ProbabilityPanel Qualified Medical ExaminerPQMEBarry Gwartz M.D.
References
2
Case No. VNO 391634
Regular
Sep 07, 2007

JEFFREY AUGUSTINE vs. PHILIPS ELECTRONICS OF NORTH AMERICA, TRAVELERS PROPERTY CASUALTY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding that the judge erred in relying on a medical examiner's report for apportionment. The Board determined that the medical evidence was insufficient to support apportionment due to its age and lack of detailed causation analysis as required by current law. The case was returned to the trial level for further development of the record, specifically requiring a panel Qualified Medical Examiner evaluation.

Workers' Compensation Appeals BoardReconsiderationApportionmentQualified Medical ExaminerPermanent DisabilityCausationSB 899Substantial EvidenceMedical HistoryProphylactic Work Restrictions
References
12
Case No. ADJ7294109
Regular
Jun 07, 2013

MANSOUREH AZIMZADEH vs. BURG & BROCK, EMPLOYERS COMPENSATION CO.

This case involves an applicant challenging a Workers' Compensation Judge's decision to disregard the Qualified Medical Examiner's (QME) reports due to flawed apportionment analysis and ordering a new QME panel. The Appeals Board granted removal, rescinded the order for a new QME panel, and returned the matter for further development of the record. The Board agreed that the QME's reports lacked substantial medical evidence due to a misunderstanding of apportionment law and that further development with the same QME would be unhelpful. The Board emphasized that new medical-legal reporting would be necessary to properly weigh evidence.

RemovalReconsiderationPetitionPanel Qualified Medical ExaminerPQMESubstantial Medical EvidenceApportionmentFindings and OrderMedical UnitDiscovery
References
9
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