What the panel ordered
Petition for Removal denied; Findings and Order issued by WCJ on June 14, 2021 affirmed
Petition for Removal filed by defendant to challenge order for additional QME panels; treated as hybrid Petition for Reconsideration and Petition for Removal; WCJ Findings and Order affirmed after reconsideration
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The court found good cause for additional QME panels in Internal Medicine, Psychology, and ENT specialties because the existing orthopedic QME report did not cover non-orthopedic issues, and the additional panels were necessary to resolve disputed medical issues expeditiously and justly.
From the decision · page 3Petitioner, USA Waste of California, Inc., insured by ACE American Insurance, administered by Gallagher Bassett Services, has filed a timely & verified Petition for Removal, contending this Court should not have Ordered additional QME panels in the fields of Internal Medicine, Psychology, and ENT.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
QME Dr. Frank Guellich testified that non-orthopedic medical issues are outside his specialty and require evaluation by other specialists.
Favours Applicant prevailed
This testimony established good cause for additional QME panels in Internal Medicine, Psychology, and ENT specialties to resolve disputed medical issues.
From the decision · page 6The following month, on November 1, 2019, QME Dr. Guellich was deposed by Applicant's Attorney. During this deposition, Dr. Guellich testified he was an orthopedic surgeon, and asserted that any area that is non-orthopedic is outside of his specialty, and would not be covered in his report. (Joint Exhibit Z - Deposition Transcript of Dr. Guellich Dated 11-01-19), pgs 17, lines 2- 17). Dr. Guellich further indicated that medical evaluations related to constipation and GI would be issues that should be addressed by an internal medicine specialist, not an orthopedic doctor. (Joint Exhibit Z - Deposition Transcript of Dr. Guellich Dated 11-01-19), pgs 15-16, lines 25-11).
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Dr. Guellich issued several medical-legal reports and testified that non-orthopedic issues such as GI, sleep disorder, and dizziness are outside his specialty and should be evaluated by specialists in Internal Medicine, Psychology, and ENT.
Dr. Guellich's testimony and reports supported the need for additional QME panels in different specialties to address disputed medical issues outside orthopedics.
From the decision · page 5In the instant case, QME Dr. Frank Guellich issued several medical-legal reports that were subsequently admitted into evidence. In his May 21, 2019 report (Joint Exhibit W - Dr. Guellich, Orthopedic PQME Re-Eval Dated 05-21- 19), Dr. Guellich summarized various medical records he had reviewed prior to finalizing his report. According to Dr. Guellich, Applicant's medical history consists of issues related to sinus rhythm, premature ventricular complexes, possible left atrial enlargement, borderline ECG, constipation, abdominal distention, decreased hearing in both ears, tinnitus, numbness/weakness in right side of face, mild atherosclerotic changes, keratitis in right eye, sigmoid diverticulosis, dyspepsia, dizziness, hypertension, high blood pressure, and others. ((Joint Exhibit W - Dr. Guellich, Orthopedic PQME Re-Eval Dated 05-21-19), pgs 3-23).
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
California Labor Code
Labor Code Section 5310
Governs Petition for Removal procedure and standards for granting removal.
From the decision · page 4It is from these Findings & Order that Defendant petitions for Removal pursuant to Labor Code Section 5310.
California Code of Regulations
California Code of Regulations 8 CCR 31.7
Allows issuance of additional QME panels in different specialties upon showing good cause.
From the decision · page 5According to 8 CCR 31.7, Obtaining Additional QME Panel in a Different Specialty, in relevant part:
What proof carried it
The evidence the panel weighed, by kind.
Testimony of QME Dr. Frank Guellich that non-orthopedic issues are outside his specialty and require other specialists
From the decision · page 6The following month, on November 1, 2019, QME Dr. Guellich was deposed by Applicant's Attorney. During this deposition, Dr. Guellich testified he was an orthopedic surgeon, and asserted that any area that is non-orthopedic is outside of his specialty, and would not be covered in his report. (Joint Exhibit Z - Deposition Transcript of Dr. Guellich Dated 11-01-19), pgs 17, lines 2- 17). Dr. Guellich further indicated that medical evaluations related to constipation and GI would be issues that should be addressed by an internal medicine specialist, not an orthopedic doctor. (Joint Exhibit Z - Deposition Transcript of Dr. Guellich Dated 11-01-19), pgs 15-16, lines 25-11).
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About this page
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