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

Case No. ADJ11258859
Regular
Jan 23, 2020

Allen, Melanie vs. Stockton Unified School District

The Board rescinded the Finding of Fact, Order and Award due to the Qualified Medical Examiner's (QME) report's non-compliance with Labor Code section 4628. The QME falsely claimed to have personally reviewed all medical records when deposition testimony revealed a third party performed this task. This violation renders the QME's report inadmissible evidence. Consequently, the matter is returned to the WCJ for further proceedings, including potential re-trial and a new decision after a replacement QME evaluation or an agreed medical examiner. The WCJ must also address previously unresolved evidentiary issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationFinding of Fact Order and AwardQualified Medical ExaminerLabor Code section 4628medical-legal reportsubstantial evidenceinadmissible evidenceAgreed Medical Examinerappointed physician
References
0
Case No. ADJ8519763, ADJ8527545
Regular
Oct 28, 2014

SYLVIA KRESS vs. DALLCO, INC. and PROSIGHT GLOBAL, INC.

Defendant Prosight Global, Inc. petitioned for removal, challenging an order continuing a mandatory settlement conference (MSC) to address Qualified Medical Examiner (QME) replacement and medical record issues. Subsequent to the petition, the parties successfully resolved the QME dispute by agreeing to use an Agreed Medical Examiner (AME) and withdrew the QME replacement request at a later MSC. This resolution rendered the defendant's petition moot. Consequently, the Workers' Compensation Appeals Board dismissed the Petition for Removal as the underlying issues were resolved by the parties.

Petition for RemovalMandatory Settlement ConferenceWCJPanel Qualified Medical ExaminerAgreed Medical ExaminerMootDismissedProsight GlobalDallcoLWP Claims Solutions
References
0
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. 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. ADJ7787692, ADJ7787693
Regular
Jan 14, 2016

Elizabeth Sauseda vs. The Permanente Medical Group, Inc.

This case involves the defendant's petition for removal, seeking to replace a Qualified Medical Evaluator (QME) in psychology due to alleged reporting delays. The Workers' Compensation Appeals Board (WCAB) denied the petition, upholding the administrative law judge's (WCJ) decision. The WCAB adopted the WCJ's recommendation, finding that a new QME examination would not proceed and the existing QME would remain. The issue of the defendant's personnel actions as a good faith defense remains for the trial judge's determination.

Petition for RemovalQualified Medical EvaluatorPanel QMEAdministrative Law JudgeSupplemental ReportReplacement QME PanelMandatory Settlement ConferenceGood Faith Personnel DefenseWCJ ReportMedical Unit
References
0
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
Case No. ADJ14547470
Regular
Apr 17, 2025

RICHARD LYNN vs. CONTRA COSTA ELECTRIC, AMERICAN CASUALTY COMPANY OF READING, PA

The Workers' Compensation Appeals Board granted reconsideration to applicant Richard Lynn, who challenged a Workers' Compensation Arbitrator's (WCA) denial of his right to a Qualified Medical Evaluator (QME) examination. The WCA had found that Lynn forfeited this right by not attending a scheduled QME exam, citing an Alternate Dispute Resolution (ADR) agreement. The Board determined that the ADR section did not mandate forfeiture and that the WCA, like a WCJ, possessed discretion to appoint a medical examiner to ensure due process and fully adjudicate issues, especially given the lack of medical-legal reporting on industrial causation. Consequently, the Board rescinded the WCA's Findings and Order and returned the matter for further proceedings consistent with its decision.

ADR ProgramQMELabor Code Section 3600(a)(10)NECA/IBEWsubstantial justicedue processmedical-legal evaluationrescindedreturnedarbitraton
References
14
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. 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
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